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Can You Get Mono More Than Once?

Infectious Mononucleosis Basics

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Updated June 14, 2014

Can you get mono more than once?

Although technically you should get infectious mononucleosis, or mono, once in your life, there are actually some scenarios in which someone can have mono symptoms more than once and even be diagnosed with mono more than once.

Why?

Well, although the Epstein-Barr virus (EBV) is usually thought of as the official cause of mono, and you should only get EBV infections once, many other viruses can cause similar mono-like illness, including CMV, adenovirus, Toxoplasma gondii, HIV, rubella, hepatitis A, human herpesvirus-6, and human herpesvirus-8. So even after having mono, your child could later get a mono-like illness with the same symptoms as mono, including fever, sore throat, and swollen glands, that is caused by another virus.

Another reason that your child might be diagnosed with mono a second time is that your child was previously misdiagnosed. The monospot test for mono can give false positive results (the test is positive even when your child really doesn't have mono) up to 10 percent of the time. So your child could have had mono symptoms and a positive monospot, but his infection could have been caused by another virus, unless the results were confirmed by positive EBV titers (which isn't always done or necessary).

Also, some children are given a simple clinical diagnosis of mono, without any testing, so you can't be sure that they had mono in the first place. Or they may have been diagnosed with mono after having a suspicious complete blood count, which is not specific for EBV and mono.

So while the 'right' answer may be, 'No, you can't get mono caused by EBV more than once,' your child can have mono symptoms and may even be diagnosed with mono more than once in his life.

Sources:

Behrman: Nelson Textbook of Pediatrics, 17th ed.

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