COVID-19 and mono are two highly contagious diseases caused by different classes of viruses. While mono has been known to humanity since at least the 1880s, COVID is a relatively recent arrival in our lives. Since the beginning of the COVID-19 pandemic in 2019, several research studies have linked these two viruses.

What is the relationship between COVID-19 and mono? Are they similar? Do they share the same symptoms? Which disease is more dangerous to us and why? You can find answers to these questions and more in this guide, where we compare and contrast COVID-19 and mono.

Common Factors Between COVID-19 and Mono

While they are two separate diseases with numerous differences, there are some common factors between COVID-19 and mono. These include the following:

Viral Infection

Both diseases are caused by viruses. Mono is mainly caused by the Epstein Barr Virus or EBV, while COVID-19 is caused by the SARS-Cov-2 Virus.

Common Symptoms

Both diseases share some common symptoms, including fever, cough, tiredness, sore throat, sore muscles, and body aches.

Transmission

Mono is mainly transmitted via the saliva of infected persons. Close contact, kissing, sexual activity, sharing of food, and touching shared items can all spread mono.

COVID can spread through saliva or other bodily fluids, as well as close contact with the infected person. Touching a contaminated surface can also spread the disease.

Cure

No effective cure is available for either mono or COVID. While some anti-virals are prescribed for some COVID patients to curb the length of the illness, both diseases are mainly treated through supportive care. Antibiotics don’t work against either disease since they are not caused by bacteria.

Mortality Rate

Diseases like Rabies and Mad Cow Disease have a 100% death rate. For bird flu, it is 60%, while Ebola has a 50% chance of death. In comparison, both COVID and mono have very low mortality rates. Mono’s mortality rate is less than 1%, while for COVID-19 it is a bit higher at 3.4%.

Diagnostic Testing

Epstein Barr Virus can be detected using various antigen tests like VCA and EBNA. Similarly, the presence of the SARS-Cov-2 virus can be confirmed using RTPC, NAAT, and antigen tests. You can get yourself tested at UrgentMED clinics for both COVID-19 and mono.

Differences between COVID-19 and Mono

Despite these similarities, both COVID-19 and mono are very different in several key aspects. We can divide them into the following:

Virus Family

The SARS-Cov-2 virus belongs to the coronavirus family. These RNA viruses cause diseases that mainly affect the lungs and respiratory systems of humans, birds, and other mammals.

The EBV virus is a type of herpesvirus. These DNA viruses cause various skin-related diseases like herpes, chicken pox, shingles, and certain types of cancers.

Virus Strains

Two main strains of EBV have been identified – Type 1 (type A) and Type 2 (type B). At least four main strains – Alpha, Beta, Delta, and Omicron – have been identified for SARS-Cov-2, with numerous sub-variants also being reported.

Infection Duration

Once you are infected with the mono virus, it will stay in your body for a lifetime. COVID-19 viruses usually clear from your system within 10 days, although in some people the virus has been found 3 months after infection, otherwise known as “long COVID” symptoms.

Severity

While some cases of mono can have severe complications that require hospitalization, the majority can be treated at home. In COVID-19, as much as 20% of all cases have an acute infection that requires intensive treatment for pneumonia, organ failure, sepsis, and other life-threatening conditions.

Infectivity

Mono is not infectious enough to cause epidemics or pandemics, even though it can spread from person to person through intimate contact.

Like influenza and the common cold, coronavirus disease is highly contagious and can spread from one infected person to dozens in the right conditions. It does not require close contact to spread.

Long-Term Complications

Mono does not cause long-term symptoms in the majority of cases. Most infections clear out within a few weeks.

Anywhere from 10% to 40% of all COVID-19 patients have reported long-term impacts on their health from COVID infections. This is a condition called “long COVID” which can last for 6 months or even several years.

Connections Between COVID-19 and EBV Reactivation

An estimated 95% of humans carry the Epstein-Barr virus in a dormant form. While the virus is harmless in this form, EBV reactivation can happen at any time. The risk of an EBV reactivation is higher when the body has high levels of inflammation/low immunity.

COVID-19 is a highly infectious disease that puts enormous stress on the body through inflammation. In many cases, patients suffer from side effects for months or even years after the infection has passed.

There is some speculation that in at least 60% of such cases, EBV reactivation is the culprit. Researchers found that blood tests of many patients with long-haul COVID symptoms tested positive for Epstein Barr Virus activity (high EBV viral loads).

According to current medical research, there is a chance that SARS-Cov-2 is triggering a reinfection of mono in people with long COVID symptoms. However, more research is needed into these reactivation cases to prove this beyond any reasonable doubt.

Everything You Need to Know About Mono

Mono is short for “infectious mononucleosis,” a viral infection quite common in humans. It is caused by several types of viruses. The most common cause of mono is an infection by the Epstein Barr Virus, or EBV.

Infectious mononucleosis is most common among teenagers and college students. It is often called the “kissing disease,” as it spreads mainly through your saliva. Mono is so incredibly common among humans that at least 95% of us get an EBV infection at some point in our lives.

It is also a life-long infection. Once the virus enters your body, it doesn’t leave even when you recover from the disease. Epstein Barr Virus will stay in your body in a harmless, dormant state for the rest of your life without causing further harm.

In some people, the virus can wake up after a long time and reactivate. This may or may not lead to a second bout of mono, depending on how strong your immune system is at that time. In a small percentage of people, Epstein Barr Virus can cause lifelong complications and severe disease.

Why is Mono Called Mononucleosis?

Although the disease was originally mentioned as a separate illness by a Russian doctor in the 1880s, it was officially called infectious mononucleosis in 1920 in an article published in the Johns Hopkins Hospital bulletin.

The term mononucleosis was chosen because of the effect the disease had on white blood cells (WBC) or leukocytes. There are seven different types of leukocytes that help our body fight infections. Of these, monocytes are white cells that fight bacteria. Lymphocytes are used by the body to kill viruses. Both types of cells have a single large nucleus, which is why they are called mononuclear cells.

When you get mono through an infection by the Epstein Barr Virus, the body responds by creating an unusually large number of lymphocytes. Some of these lymphocytes have an abnormally large size and irregular shape (atypical lymphocytes).

Since the EBV infection causes an abnormal spike in these mononuclear cells, the doctors called the illness “infectious mononucleosis.”

Why is Mono Called the Kissing Disease?

The Epstein-Barr Virus is a type of herpes virus. While other herpesviruses can be transmitted during sex via contact with bodily fluids, EBV infection usually spreads through contact with an infected person’s saliva.

The virus usually exists in high concentrations in your mouth during the mono infection. This is why there is a very high chance of the disease spreading when two people kiss. And since the disease is very common among teenagers, it became known as the “kissing disease.”

How Does Mono Spread Among Humans?

The Epstein Barr Virus cannot spread through water or soil. Its main route to infecting people is via saliva of the infected person. Apart from kissing, you can also catch mono through these other channels:

• Sneezing/Coughing: When an infected person coughs, particles of saliva and mucus will spread into the nearby air. Anyone nearby may get infected by inhaling these particles.
• Sharing food, glasses, plates, toys, etc: The virus can stay alive for a few hours in saliva on the surface of objects like glasses and toys. If you touch these infected surfaces and then accidentally touch your mouth or food, you can get infected.
• Sexual contact: Though the virus is more common in saliva, it can also be found in semen and other bodily fluids. People can spread the disease to others through sexual intercourse. Condoms will likely not prevent this infection, since it can be spread by kissing as well.
• Organ transplants: Patients who receive an organ transplant are at a high risk of catching bacterial and viral infections. EBV is one of the possible germs that can infect someone who has received a kidney transplant.

What are the Common Symptoms of Mono?

Mono is a disease that can cause a wide range of symptoms, though these are not shared by every person who catches the virus. Some folks will experience a milder form of mono, while others get all the following symptoms:

• Fever above 100.4F
• Fatigue and loss of appetite
• Sore throat
• Swelling in lymph nodes near the neck and armpits
• Sore muscles and body aches

Most symptoms pass within a few weeks in healthy people. Others may experience side effects like fatigue for a few months after their mono infection. In a small minority, mono can last for more than six months and lead to worse clinical outcomes.

Complications That Can Arise From a Mono Infection

Mono is, for the most part, a relatively harmless disease, especially in people with healthy immune systems (immunocompetent patients). You may get a severe sore throat and fever, much like the seasonal flu. Once the symptoms subside, you likely won’t have any lasting negative effects. But in some individuals, mono can develop into more serious complications. They include:

• Swollen tonsils: The fleshy pads on the back of your throat are called tonsils. A common complication in mono patients is swollen and inflamed tonsils. When this happens, it partially blocks or narrows your airway. Breathing and swallowing food/drink becomes harder and more painful. You should visit an urgent care clinic right away for treatment.
• Enlarged spleen: The spleen is an important organ on the left side of your stomach. It produces the vital cells that fight infections. EBV infections can often cause the spleen to become enlarged. In severe cases, it can burst, causing sharp pain in your belly. This is a medical emergency that needs urgent surgery at a hospital.
• Liver disease: Mono in severe cases can cause inflammation in your liver, a condition that is called hepatitis. In the later stages of hepatitis, your body suffers from jaundice – where your skin and eyes turn yellow and you suffer from fever, chills, weight loss, and fatigue. Liver disease in any form is a major cause of worry and you should consult an urgent care clinic for diagnosis and treatment.
• Heart complications: Myocarditis is a serious situation where your heart muscles become inflamed. It reduces the heart’s ability to pump blood to different parts of your body effectively. This can lead to chest pains, shortness of breath, irregular heartbeats, and possible death from heart attacks.
• Blood disorders: In its attempt to fight the mono virus infection, the body might end up causing excessive harm to your own red blood cells. When too many cells are destroyed as a result of the infection, it causes conditions like hemolytic anemia and thrombocytopenia. Tiredness, weakness, dizziness, and excessive bleeding from cuts are common symptoms of these blood disorders.
• Nervous system complications: In certain severe cases of mono infections, the disease can spread to the brain and cause inflammation. Conditions like encephalitis and meningitis are extremely dangerous and can lead to seizures, stroke, coma, headaches, psychological issues, fever, confusion, sleeplessness, and even death.

How is Mono Diagnosed?

Mono is often suspected or diagnosed on the basis of your age, health, and other factors like living conditions. Your doctor may also order further blood tests to confirm the presence of EBV in your body. They include the following:

• EBV Viral Capsid Antigen (VCA), which can detect mono virus 2-4 weeks after infection
• Early Antigen (EA), which can detect mono virus up to 6 months after infection
• EBV Nuclear Antigen (EBNA), which can detect mono virus any time after infection
• Monospot Test, which is not recommended by the CDC due to lack of accuracy in detecting mono

These tests are only recommended if your mono has unusual symptoms, or if you have some other complications like heart disease or liver disease, and the doctor wants to find out whether mono is the cause.

When you get a viral infection like mono, your body produces several unique antibodies to fight the disease at different stages of your infection. The three mono tests – VCA, EA, and ENBA – look for the presence of different antigens in your body at the various stages of your infection.

The monospot test is popular despite its inaccuracy because it is very inexpensive. It is not useful in children under the age of 5, and in others, it can lead to false positives. Doctors usually recommend another test like VCA, EA, or EBNA as a follow-up after the monospot test.

Mono Treatment and Prevention

Like many other viral diseases, mono does not have any specific medication. The Epstein-Barr Virus cannot be killed off with antibiotics or antivirals. Instead, doctors usually try to provide supportive care, with treatment to reduce the severity of symptoms and prevent complications to major organ systems. To fight a bout of mono, doctors usually recommend the following for healthy adults:

• Plenty of rest
• Drinking lots of water and fluids to stay hydrated
• Using over-the-counter pain medication for fever and headaches (acetaminophen and other non-steroidal anti-inflammatory drugs such as ibuprofen and diclofenac)
• Steroid treatment to reduce inflammation, usually in the throat area

Mono Prevention

At present, there is no vaccine to prevent infective mononucleosis. It is estimated that nearly 95% of all humans get mono at some point by the time they are adults. And since the disease rarely causes death (less than 1% of cases), it is not a high priority for vaccine development.

You can, however, reduce the risk of mono by ensuring cleanliness, and social distancing measures:

• Washing hands often, especially before eating
• Not sharing food, drinks, or other items with others
• Avoiding crowded locations

Everything you Need to Know About COVID-19

COVID-19 is short for “coronavirus disease of 2019,” a deadly new virus that appeared for the first time in humans only recently in 2019. It is caused by the SARS-COV-2 virus, a member of a very large family of viruses called coronaviruses.

The COVID-19 pandemic has killed 6.5 million people in just 3 years. While it only causes mild to moderate symptoms in about 80% of people, at least 20% will have severe symptoms that require hospitalization, with nearly 14% of those suffering from pneumonia.

More severe conditions like septic shock and organ failure can be expected in the remaining 5% of cases, and 2% of infected people will die from COVID. While that may seem like a small number, what makes COVID so dangerous is its high infectivity.

Since this is a brand-new virus, human immune systems are not familiar with it. The virus can quickly infect millions of people. And even 2% of one million is a large number of patients requiring intensive care – this can overwhelm hospitals as we have already seen in 2020 and 2021.

And as the COVID virus is also in a new setting – the human body – it is constantly evolving and changing. New variants of the virus are emerging as it spreads across the world, with new symptoms, higher infectivity, and increased resistance toward vaccines.

Why is COVID called COVID-19?

The earliest cases of the new coronavirus infection were detected in Wuhan, China, in December 2019. COVID-19 is short for “Coronavirus Disease of 2019.”

The official name of the virus is Severe Acute Respiratory Syndrome Coronavirus 2, or SARS-COV-2. This name was chosen by the World Health Organization (WHO) because the new coronavirus is related to the virus that caused the first SARS outbreak in 2003, named SARS-COV-1.

Viruses and diseases usually have different names. For instance, the Spanish Flu was caused by the H1N1 influenza virus. The AIDS pandemic is caused by the human immunodeficiency virus or HIV. The common cold is caused by Rhinoviruses.

How Does COVID Spread Among Humans?

SARS-COV-2 is a highly infectious virus that can quickly spread from one person to another in several different ways:

• Short-Range Aerosol: When you speak, breathe, cough or sing, the virus particles are released from your nose and mouth in the form of aerosols – fine mist-like particles. If someone else is nearby, they can catch the disease either by breathing in the particles, or when the particles touch their eyes or mouth.
• Long-Range Aerosol: In enclosed spaces with poor ventilation, the aerosols can stay afloat for several hours. People staying put for several hours in places like an office or theater can catch the disease even if they were far away from the infected person.
• Surface Contamination: The virus can stay alive for several hours on surfaces in the form of droplets of saliva, mucus, and other bodily fluids. If people touch these surfaces with their bare hands and then eat food or touch their noses/mouths, they can get infected.

What are the Common Symptoms of COVID-19?

Patients across the globe have reported a wide range of clinical symptoms during infection of the SARS-Cov-2 virus. Four of these are widely regarded as the most common:

• Fever
• Cough
• Severe fatigue
• Loss of smell and taste

The vast majority of COVID patients also report a few other symptoms apart from these four. The less common symptoms of COVID-19 include the following:

• Headaches
• Sore throat
• Body pain
• Skin rashes
• Eye infections
• Upset stomach

Complications From COVID-19

At least one in five COVID-19 patients will experience severe symptoms related to the respiratory system. These critically ill patients often end up in an intensive care unit. You should seek immediate medical assistance if you experience:

• Shortness of breath
• Extreme difficulty in breathing
• Confusion or loss of speech skills
• Chest pain
• Bluish tinge on lips and fingertips

Patients who experience severe symptoms are at higher risk of developing COVID-19 complications that require intensive care. They include the following:

• Acute Respiratory Failure: Due to extreme damage to lung tissue from inflammation and pneumonia, the lungs are no longer able to pump enough oxygen into the blood. This is a leading cause of death among COVID-19 patients.
• Pneumonia: The air sacs inside the lungs of infected people become filled with fluid, pus, and damaged tissue. This severely affects the ability to breathe and leads to oxygen shortage in the body and organ damage/brain damage.
• Acute Organ Injury: In severe cases, COVID-19 can affect major organs like the lungs, heart, and kidneys. Those with underlying health conditions like diabetes, heart disease, and kidney issues are more at risk of organ failure and death after COVID-19.
• Septic Shock: The chemicals released by the body to attack a virus can sometimes end up attacking the body’s healthy organs. This leads to a condition called septic shock if it is not treated in time, and can be fatal.
• Blood Clots: Random blood clots can form in the legs or lungs of COVID patients with serious symptoms. These clots are dangerous as they can lead to further complications like internal bleeding, organ failure, brain damage, and death.
• Long COVID: Various symptoms like fatigue, pain, dizziness, brain fog, confusion, and other psychological issues can persist in some patients for months after their COVID-19 infection. Up to 30% of COVID patients become long COVID patients.

How is COVID-19 Diagnosed?

COVID-19 shares common symptoms with many other diseases, most notably the seasonal flu. Doctors need to conduct special tests to confirm the presence of COVID-19 in the body. These include:

• Antigen Tests: These rapid tests give a result within 15-30 minutes. But that speed comes at the cost of reliability. In the early phases of a COVID infection, these tests are not very accurate. But they are inexpensive and don’t require advanced lab equipment or technicians.
• PCR Tests: These tests require time and laboratory equipment, but they are more accurate than antigen tests and can detect COVID-19 in people who don’t have any symptoms. PCR tests are comparatively slow and expensive.

The FDA has also approved several antigen self-test kits that patients can use at home without going to a hospital or urgent care clinic. However, these results are less reliable. For the best results, visit your nearest UrgentMED urgent care center for Antigen/PCR tests.

COVID-19 Treatment and Prevention

For mild cases of COVID-19, at-home treatment is recommended with the following precautions:

• Isolate the patient in a room to avoid the spread of disease
• Caregivers and patients should use N95 masks when in the room together
• Take rest and drink plenty of liquids
• Avoid sharing items with other members of the household
• Monitor temperature and oxygen levels daily using a pulse oximeter

The CDC recommends at least 5-10-day home isolation for people with mild symptoms when they test positive for COVID-19. The virus is most infectious in the first 5 days. If symptoms worsen at any point, please call 911 and seek medical assistance.

COVID-19 Prevention

Several vaccines have been developed for COVID-19. While they cannot prevent the infection, the vaccines can reduce the severity of the disease and help avoid hospitalization and further complications. Numerous guidelines have been released by health authorities regarding COVID management and prevention. They all stress the following key points:

• Getting vaccinated as recommended by the CDC health guidelines
• Cleaning hands frequently with hand sanitizer or antiseptic soap
• Wearing an N95 mask when in public
• Maintaining a safe distance of at least 3 feet from others

UrgentMED Offers COVID-19 Testing and Other Urgent Care Patient Services

The COVID-19 testing options from UrgentMED urgent care clinics include Rapid PCR tests, Nasal Swab Testing, and Antibody Testing. When you suddenly feel ill, it is best to visit your nearest UrgentMED urgent care center. We have a dedicated team of board-certified physicians, nurse practitioners, and other medical professionals to take care of all your urgent care needs.

We are open for extended hours Monday to Friday, and are also open on weekends. At an UrgentMED clinic you can expect high-quality, compassionate and personalized care at a fraction of the cost of an average emergency room visit. We have convenient locations across Southern California. Contact us today to learn more about our services.

---