Mononucleosis in Israel – Prevention & Management

We have noticed a significant uptick in the number of gap year students diagnosed with mononucleosis (“mono”) in the last few weeks. This affects many gap year programs – both yeshivas and seminaries – and lots of misunderstandings about mono are going around from parents and program administrators. We want to educate the public about this condition.

Mononucleosis is a contagious illness caused by the Epstein-Barr Virus (EBV).

It is spread through saliva, and in Israel, it is actually called the “kissing disease.” Spreading by saliva can include sharing utensils, drinking glasses, toothbrushes, or eating implements (think about a family dinner where people share food from the platters). Most people who develop mono are teens and young adults, and most adults are immune to it. You cannot get mono more than once unless you are very immunosuppressed, such as a cancer patient.

Mononucleosis symptoms include fever (usually low-grade), fatigue, sore throat (that is strep negative), and swollen lymph nodes. Some people also get a mild rash with mono. The diagnosis must be made through blood tests. Most people recuperate within a few weeks if they rest. Some people continue feeling significantly fatigued for a few months. Many people who have had mono have very mild symptoms and only find out years later when they test immunity.

The incubation period for mononucleosis is 4-8 weeks, which means that for up to 2 months, a person can spread the illness before the development of any symptoms. Many cases of sick students in Israel this year – probably came to Israel as carriers of the illness. The only way to prevent mono is to teach your children to practice good hygiene, including not sharing personal items such as toothbrushes and not sharing eating implements or cutlery.

Treatment includes keeping hydrated, getting plenty of rest, and taking over-the-counter medications for pain and fever symptoms. More information about keeping hydrated is available here. If the liver is involved, we strongly recommend avoiding medications that may affect the liver – such as Acetaminophen or Paracetamol (Tylenol or Acamol).

Complications for mono include inflammation of the liver and enlargement of the spleen – therefore, students should avoid contact sports until full recuperation (to avoid a ruptured spleen). Recuperation typically takes 2-4 weeks but can last 6 months or more.

CAN A STUDENT WITH MONO STAY IN SCHOOL?

In most cases – yes. Remember that students have usually already spread the illness through no fault of their own before they got sick. Once sick and given the correct instructions, students are less likely to spread the illness to others. The school must be aware of the situation to assure that the student uses disposable dishes as much as possible to prevent the spread of mono to others. Most students with the active disease will be unable to participate in trips until recuperated due to severe weakness.

So – speak to your gap year kids and help spreads awareness and facts about this condition to others!

 

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