What Are The Stages Of Mono?

By Zina Semenovskaya, MD
Medically reviewed checkmarkMedically reviewed
April 20, 2022

Infectious mononucleosis, or mono, is a contagious disease that many people contract at some point in their life.

Mono usually comes in three phases, and each one can impact individuals differently.

If you have recently been diagnosed with mono or suspect that you might have caught it from someone, then determining which stage of mono you’re in will help you determine whether you might be contagious to others.

It will also guide your recovery.

In this article, we’ll look at the main causes and symptoms of infectious mononucleosis to help you determine whether you have contracted it.

We’ll also discuss the three different stages of mono and characterize them to help guide your recovery and prevent you from infecting others. 

Causes of Mononucleosis

Infectious mononucleosis is most often caused by a virus of the herpes family called Epstein-Barr, but a small percentage of mono cases can be caused by other viruses.

Mono is also called ‘the kissing disease’ because it is transmitted from person to person through saliva, such as when kissing.

While anyone can get it, it is most common in children, young adults, and college students.

A first-time infection is less common in adults over the age of 40, though many older people acquired it when they were younger, and the virus may now be present, inactive, in their body. 

Since the virus is transmitted through saliva, contact with items containing saliva such as toothbrushes, utensils, and cigarettes would put others at risk of contracting it.

If someone with mono shares these items with others, it is possible that the disease would be passed on to them.

It can also be passed on through other bodily fluids such as blood, semen, and breast milk, though this is a less common transmission mode.

Other situations where mono can be transmitted, though far more rarely, include blood transfusions and organ transplants. 

Symptoms

Most people who contract mono, especially at a young age, often don’t even realize that they have it and will carry the virus in their bodies for the rest of their lives, where it remains dormant and doesn’t cause any symptoms.

If the virus reactivates at some point in your life, you may notice some common symptoms of infectious mononucleosis symptoms, including:

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Stages of Mono 

Infectious mononucleosis generally has three noticeable stages.

In each stage, the infection can cause different symptoms and health concerns for each affected person. 

Stage 1: Prodrome

The first stage of mono is when symptoms first begin to appear.

This is also called the prodrome stage.

It may take four to six weeks after the initial contact for symptoms to show up, making it very difficult to know when the mono-infection began.

The prodrome stage can last from a few days to one or two weeks.

Often, a person may go through the prodrome phase without showing any symptoms at all. 

The most telling sign of this period is a feeling of fatigue.

If you have low energy or are feeling a bit ‘off’, then it is best to stay home and rest and keep away from others regardless of whether you think you have mono or any other disease.

This will ensure that you give your body time to recover and prevent passing on anything to others. 

Stage 2: Acute Phase

The second stage of mono, which is called the acute phase, is when symptoms may start to show up or worsen.

Again, not everyone will suffer from the same symptoms, but you may feel that your sore throat is getting worse and your fever getting higher.

Swollen glands and aches in the body are also more common at this stage, as is worsening fatigue.

The acute phase of mono can last two to six weeks. 

Stage 3: Convalescent Phase

The convalescent, or final phase of mono, occurs when a person starts to recover.

This stage can last between three to six months, and you will start feeling better with little or no symptoms fairly quickly.

Some people do feel weak or tired during this period and for long after this, but most symptoms would be resolved by this time. 

During this recovery period, there is still a risk that your spleen could rupture, so it is important to get plenty of rest and to stay away from strenuous activity. 

Prevention

The best way to prevent contracting infectious viruses like EBV, which causes infectious mononucleosis, is to limit contact with others, especially with their saliva, particularly if they are sick or have been recently around others who are sick.

Ways to prevent and curb the spread of mono:

  • Wash hands and items that touch your mouth and face regularly
  • If you notice that you or anyone around you show symptoms of mono or any ailment, stay isolated from others
  • Do not share personal items such as utensils, toothbrushes, and cigarettes
  • Maintain a healthy lifestyle with a nutritious diet and plenty of exercises
  • Take extra safety and hygiene precautions when meeting with vulnerable people like the elderly and small children

Risk Factors

Almost anyone can be at ‘risk’ of contracting infectious mononucleosis, but it is usually not a cause for concern for people with healthy immune systems.

Those living with autoimmune diseases are more at risk for complications due to any virus.

Your doctor will advise you whether you’re at high risk of mono or not.

If you are suffering from other more serious medical conditions, then reach out to your healthcare provider for advice immediately. 

Long-Term Effects

Since mono and EBV leave your immune system compromised, you may find that your body is prone to catching other illnesses more easily.

However, if you maintain a healthy lifestyle and take good care of yourself, this risk can be decreased. 

Some studies show that mono may lead to chronic fatigue syndrome, leaving you feeling tired for long periods.

Other studies show that mono and EBV could lead to multiple sclerosis and other autoimmune diseases and lymphomas, though this association is still being studied. 

If you are concerned about the potential long-term implications of mono, talk to your doctor or reach out to one of our healthcare experts, who can help put this in perspective.

Treatment 

Since infectious mononucleosis is caused by EBV, which is a virus, it has no cure.

Although there is no vaccine to prevent mono and no medication to cure it, most of the symptoms can be treated and kept under control using at-home remedies and over-the-counter medications.

Make sure that you get at least six to eight hours of uninterrupted sleep so that your body has plenty of time to recover.

Drink plenty of liquids to keep your body hydrated and eat nutritious and well-balanced meals. 

The CDC also recommends that you do not take part in any contact sports until you fully recover.

This is because mono often causes your spleen to enlarge, putting it at a significantly higher than normal risk for rupturing. Your doctor may prescribe painkillers and vitamins to aid in your recovery from mono.

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When to See a Medical Provider

If your mono symptoms last for longer than 10 days or you have a severe sore throat for more than two days and think it is getting worse, make an appointment with a healthcare practitioner.

Your doctor may conduct some tests to rule out other illnesses, such as strep throat or influenza

If you have trouble breathing or your fever is not subsiding after several days, then reach out to your doctor.

Call 911 or go to the emergency room immediately if you feel sharp and sudden pain in your side or abdomen. 

How K Health Can Help

Most cases of mono are not serious. However, symptoms like extreme fatigue, sore throat, and body aches can affect your daily life.

Did you know you can access online urgent care with K Health?

Check your symptoms, explore conditions and treatments, and if needed, text with a healthcare provider in minutes. 

K Health’s AI-powered app is HIPAA compliant and is based on 20 years of clinical data.

Frequently Asked Questions

Are there stages of mono?
Yes, there are three main stages for mono. The first one is the prodrome stage, followed by the acute stage, and the convalescent or recovery stage is the third and last stage of mono.
What is the timeline for mono?
Mono usually comes in three stages for most people. The timeline can vary between individuals. The first stage (prodrome) can last up to two weeks. The second stage of mono (acute phase) can last up to six weeks. The final and third stage of mono (convalescent stage), can last several months. Hence, the timeline for mono can be 8-12 months long.
How do you know if your mono is getting better?
You will know if your mono diagnosis is getting better when your symptoms start to subside. If your fever stops, your chest clears up, and you feel more energetic, then you are likely on your way to recovery.
What is the last stage of mono?
The convalescent or recovery period of mono is the third and last stage of mono. Your body will still feel tired, and you may face bouts of weakness, but you will slowly be easing yourself from other symptoms. This stage of mono can last three to six months, if not more.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Zina Semenovskaya, MD

Dr. Semenovskaya specializes in emergency medicine, and received her medical degree from Weill Cornell Medical College. She is currently the medical director at Remote Emergency Medicine Consulting, LLC and splits her time working clinically as an emergency medicine attending in California and Alaska. She is the first of our doctors to be fluent in Russian.

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