How mononucleosi spreads

DEAR DR. DONOHUE: My son, a college junior, tells us he has mononucleosis. He’s attending classes, and he’s not on any medicines. Shouldn’t he be resting, and shouldn’t he be isolated from other students to stop the spread of this illness? What medicine do you suggest for him? — R.T.

ANSWER: Mononucleosis — mono, for short — is a viral illness that crops up in quite young children, and again between the ages of 15 and 24. The mono virus is found in oral secretions. It’s passed via infected saliva. Kissing, sharing eating utensils and drinking cups, and other ways in which infected saliva finds its way into other people’s mouths are the route of transmission. However, it’s not the current mononucleosis patient who is most responsible for the virus’ spread. The virus remains in saliva for months after symptoms have disappeared. And former mononucleosis patients can intermittently shed the virus for decades after their infection. Trying to discover how a person became infected is an exercise in futility. Only 6 percent of mono patients have had an encounter with an active case. Roommates of a mono patient are no more likely to come down with the illness than are any other students. The triad of sore throat, fever and enlarged nodes, particularly neck nodes, are mono’s distinguishing features. Headache, muscle pain, tiny spots on the palate, an enlarged liver and spleen, and a wiped-out feeling are other symptoms. Mono patients can engage in daily activities if they feel up to it. They have to avoid contact sports until the spleen has returned to normal size. Many infected people have no symptoms. Others are prostrated by it and are confined to their beds. No medicine cures mono. Medicines that ease the pain — especially the pain of a sore throat — make a person feel better. Tylenol is such a medicine. A usual case of mono runs its course in two to three weeks. You’ll be surprised to learn how many people have been infected with the virus and how few remember having had the infection. More than 90 percent of adults have evidence of past infection.

DEAR DR. DONOHUE: I have a friend who has AIDS. You wouldn’t know it. He looks quite healthy, and he holds down a full-time job. He says he is on heart treatment. What is this? I’ve never heard of it. — P.L.

ANSWER: That’s HAART, not “heart,” treatment. HAART is “highly active antiretroviral treatment.” The AIDS virus is a retrovirus. HAART therapy entails the combination of three medicines active against the virus. Sometimes the treatment involves taking only one pill a day; that pill has three ingredients. Gone are the onerous and complicated pill-taking schedules of earlier days. Current treatment allows most patients to lead an active and fulfilling life.

DEAR DR. DONOHUE: My husband and I are expecting our first baby in eight months. I am not and never have been a heavy alcohol drinker, but I do enjoy an occasional glass of wine. My husband insists I should abstain completely from all alcohol. Is this going too far? — M.M.

ANSWER: I have to side with your husband. Fetal alcohol syndrome is such devastation to an infant that all risks for developing it should be reduced to zero. That means total abstinence during pregnancy. No one can state with certainty what the safe amount of alcohol is during pregnancy. Until that information has been confirmed, stay away from it. Fetal alcohol syndrome retards growth both in uterus and throughout life. It causes abnormal brain development and often severe learning disabilities. There are a number of facial abnormalities that are an additional consequence. Giving up your wine is a small price to pay for reducing any chances of fetal alcohol syndrome.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.