Wellness Tips from Josef Schenker, MD
Welcome to our Wellness Tips blog series, brought to you by Dr. Josef Schenker, the Medical Director at Centers Urgent Care. In this series, Dr. Schenker shares his extensive knowledge and experience in internal medicine and emergency medical services, including mononucleosis treatment and recovery, to help you lead a healthier life.
Dr. Schenker will cover a range of crucial health topics, offering expert advice on how to avoid common ailments. With a focus on prevention and practical tips, each blog post is designed to empower you with the information you need to make informed decisions about your health and well-being.
Mononucleosis Treatment and Recovery
A sore throat that lingers, fever, and heavy tiredness can point to mononucleosis, most often caused by the Epstein–Barr virus and seen most in teens and young adults. About 1 in 4 EBV-infected adolescents develop mono.
Treatment is supportive: rest, fluids, and over-the-counter pain or fever medicine. Routine antivirals are not needed because most cases improve on their own. As Medical Director at Centers Urgent Care, Dr. Josef Schenker highlights watching for complications like an enlarged spleen. Let’s go to the next sections for the full care plan.
Dr. Josef Schenker Explains the Symptoms of Mononucleosis
Mononucleosis usually shows up in teens and young adults as the same group of problems: sore throat, fever, and swollen lymph nodes in the neck. According to Dr. Josef Schenker, providers watch these symptoms closely because mono can also enlarge the spleen or, less often, the liver, so rest becomes part of treatment:
- Sore Throat (Pharyngitis): Sore throat in mono is often severe and can look like strep, with red, swollen tonsils and sometimes a white coating. The pain can make swallowing hard, which is why hydration is stressed in mono care.
- Fever: Fever tends to be low to moderate and may last for several days to two weeks. Fever shows the immune system is responding to EBV in the blood and lymph tissues.
- Swollen Neck Lymph Nodes: Lymph nodes, especially at the sides and back of the neck, become enlarged because EBV targets lymphoid tissue. These nodes may feel tender but usually improve as the infection settles.
- Marked Fatigue: Fatigue is often the symptom patients notice most. EBV triggers a strong immune response that can leave you drained even after the fever or sore throat eases.
- Headache and Body Aches: General achiness, including headache, can appear early in the illness. This reflects systemic viral infection, similar to flu-like illnesses.
- Swollen Spleen (Splenomegaly): Mono can enlarge the spleen because the organ filters blood and reacts to the EBV infection.
- Swollen Liver or Mild Jaundice (Less Common): Some patients, especially young adults, develop mild liver involvement. This can show up as discomfort in the upper right abdomen or a yellow tinge to the skin or eyes.
- Rash (Occasional): A pink, measles-like rash can appear in mono, sometimes after taking certain antibiotics that were started before mono was diagnosed.
Younger children, older adults, and people with other health conditions can have milder or atypical signs, so a provider may order blood tests to confirm EBV.
What Is Mononucleosis?
Mononucleosis, or “mono,” is a viral illness caused most often by the Epstein–Barr virus (EBV). EBV is very common worldwide and spreads mainly through saliva, which is why mono is sometimes called the “kissing disease.”
Josef Schenker, MD explains that teens and young adults get the classic form more than children, and most will recover with rest and supportive care. EBV enters the body through close contact. Kissing, sharing drinks, utensils, or toothbrushes, or being exposed to droplets that have saliva on them can pass the virus.
EBV lives in the throat and in white blood cells, so it is easy to shed it in saliva even when symptoms are mild. Because of that, someone can spread EBV at home, in school, or in a dorm setting. Mono is usually self-limited. That means the immune system clears the active infection without antiviral medicine.
Can You Stop Mononucleosis Once It Starts?
Mono cannot be switched off once symptoms begin. EBV is a virus that stays in the body for life in a quiet form, so there is no medicine that clears it right away. Treatment is supportive because most cases improve on their own. Take a look at the parts of mono you can manage while the immune system does the rest:
- Control throat pain: Sore throats in mono can be strong and can look like strep. Using acetaminophen or ibuprofen (if safe for you) plus salt-water gargles helps reduce pain and makes swallowing easier.
- Reduce fever: Fever is part of the body’s response to EBV, but it can make you feel worse and dehydrate you. Over-the-counter fever medicines are recommended for symptom relief, not to fight the virus itself.
- Maintain hydration and rest: Drinking water or oral rehydration drinks prevents dehydration from fever and makes recovery smoother. Rest gives the immune system time to work, which is why most sources list it first in mono care.
- Protect the spleen: Mono can enlarge the spleen, and a direct blow can cause rupture, which is a medical emergency. That is why it’s important to avoid contact sports, heavy lifting, or intense exercise for at least 3 weeks from symptom onset, sometimes 4 weeks, until a provider says it is safe.
- Use steroids only when clearly needed: Corticosteroids are not routine for mono because the illness is self-limited. They are reserved for problems like airway obstruction from very swollen tonsils, severe trouble swallowing, or other serious complications, and their usage is decided by the provider after examining the patient.
So while you cannot clear EBV right away, you can lower discomfort, prevent dehydration, and remove activities that raise spleen injury risk. That is the practical way to “control” mono.
How Long Does Mononucleosis Last?
Most people feel the worst for about 2–4 weeks, then energy slowly returns. Dr. Josef Schenker points out that the early symptoms go first, but the tired feeling can stay for a while, so planning rest is part of treatment. Take a look at how mono usually runs its course:
- Acute phase (about 2–4 weeks): This is when sore throat, fever, swollen neck nodes, and body aches are strongest. Many patients start to improve after the second week, but some stay in this phase a bit longer.
- Lingering fatigue (several weeks to 2–3 months): After the throat and fever settle, tiredness can stay. EBV activates the immune system for a long time, so even basic school or work days can feel heavy.
- Activity restriction to protect the spleen (at least 3–4 weeks): Mono can enlarge the spleen, and the risk of splenic rupture is highest in the first 21–28 days. Because of that, it’s best to avoid contact sports, heavy lifting, or anything that can hit the upper abdomen until a provider says it is safe.
Recovery does not look the same for everyone. Some teens go back to light routines in 2–3 weeks. Others need 6–8 weeks before they feel close to normal. Getting sick again, not drinking enough, or trying to return to sports too early can slow things down.
Josef Schenker, MD, Explains Mononucleosis Treatment and Recovery
Treatment for mono is supportive. The goal is to help the body clear the infection, prevent spleen injury, and catch rare complications early. Here are the main parts of mono care:
- Rest and energy pacing: Fatigue can be strong even after the sore throat improves. Full rest during the first 1–2 weeks helps shorten the worst phase. Going back to school or work in small steps prevents setbacks.
- Fluids and nutrition: Fever, sore throat, and trouble swallowing can lead to mild dehydration. Drinking water, broths, or oral rehydration solutions keeps circulation stable and supports the immune response.
- Fever and pain medicine: Acetaminophen or ibuprofen, when safe for the patient, are the medicines major guidelines recommend for throat pain, headache, and fever. They do not treat EBV but make recovery more comfortable. Avoid aspirin in children and teens.
- Throat care at home: Warm salt-water gargles, lozenges, and humidified air help relieve pharyngitis. This is useful because mono sore throat can look like strep and can be very inflamed. Better throat comfort makes it easier to drink enough.
Some situations mean you should be seen in person. Go to or call Centers Urgent Care if there is sharp pain in the left upper belly (possible spleen issue), trouble breathing, trouble swallowing saliva, yellowing of the eyes, or fever that stays high after several days. Our team can examine the abdomen, check the throat, and advise when sports or gym can safely resume.
How to Lower Your Risk of Mononucleosis
EBV is everywhere and most adults have been exposed by age 35–40, so the goal is to lower exposure. Josef Schenker, MD notes that simple hygiene and avoiding saliva-sharing behaviors during active illness are the practical steps families can follow. Here are realistic ways to reduce your chances of getting mono:
- Do not share cups, bottles, utensils, or toothbrushes: EBV lives in saliva and can pass through shared objects even when the person looks well. Remind teens and college students about this during peak illness seasons.
- Avoid kissing or close mouth-to-mouth contact with someone who has mono: During the first weeks of infection, saliva has more virus and spreads it more easily. Waiting until the person’s symptoms and fever are gone lowers the chance of transmission.
- Practice steady hand hygiene: Hands can pick up saliva from surfaces, shared toys, or tissues. Washing with soap and water or using alcohol-based sanitizer reduces what gets to the mouth or nose.
- Limit sharing of personal items during and after illness: EBV can shed in saliva for months after mono, sometimes up to 6–18 months. Because of this long shedding window, it makes sense to keep toothbrushes, lip balms, and eating tools separate while someone is recovering.
- Be extra careful in group living or team settings: Dormitories, camps, and sports teams involve close contact and shared water bottles. Set rules about labeled bottles and no sharing during outbreaks.
EBV can reactivate and shed again even when a person feels fine. That is why prevention for mono is framed as “lower exposure” instead of “avoid completely.” Consistent habits around drinks, utensils, and kissing make spread less likely in families, classrooms, and dorms.
What to Do if Someone Has Mononucleosis
Most mono cases get better without special medicine, but the illness can stress the throat and enlarge the spleen, so families should know when to call a provider. According to Josef Schenker, early checks help prevent rare problems like splenic rupture or airway trouble. Here are the steps to take:
- Let the person rest at home: Mono drains energy because EBV activates the immune system for weeks. Keep school, work, and social activities light during the first 1–2 weeks so the fever and sore throat can settle.
- Keep up with fluids and easy-to-swallow foods: Fever, throat pain, and mouth breathing can lead to mild dehydration. Offer water, broths, and cold drinks; use soft foods if swallowing hurts.
- Use over-the-counter fever or pain medicine (when safe): Acetaminophen or ibuprofen can bring fever down and make throat pain manageable. This does not treat EBV but makes it easier to eat and sleep. Avoid aspirin in children and teens.
- Watch the throat every day: Mono tonsils can get very swollen and look like strep. If swallowing saliva becomes hard, if the voice sounds muffled, or if breathing seems noisy, the person needs an in-person evaluation.
- Avoid contact sports and heavy lifting: The spleen can enlarge in mono, and injury to an enlarged spleen is the complication we try hardest to prevent. No basketball, football, wrestling, gymnastics, or heavy gym workouts until a provider says it is safe, usually after 3–4 weeks.
- Separate personal items for a while: EBV can shed in saliva for months after symptoms, so avoid sharing cups, utensils, or toothbrushes at home. This does not remove risk but reduces spread to siblings or roommates.
Some symptoms mean you should stop home care and go to urgent care or the ER:
- Sharp or worsening pain in the left upper abdomen (possible spleen problem).
- Trouble breathing or swallowing, or drooling because the throat is too swollen.
- Yellowing of the eyes/skin or dark urine, which can signal liver involvement.
- Fever above 101.5°F (38.6°C) that stays high or returns after improving.
- Confusion, new weakness, or symptoms that are not following the usual 2–4 week course.
Josef Schenker, MD, Answers Frequently Asked Questions:
Recovery from mono usually begins in 2–4 weeks as fever and sore throat improve. Fatigue can last 6–8 weeks while the body clears Epstein–Barr virus. Some people need more time to resume normal tasks, especially after weight loss or poor sleep. Rest, hydration, and avoiding sports help protect the spleen.
The best medicine for mono is acetaminophen or ibuprofen to reduce fever and relieve pain, used only if safe and properly dosed. No antiviral cures Epstein–Barr virus, and antibiotics do not help unless another infection is present. Rest and hydration remain essential alongside symptom control.
Yes. Mono can cause dizziness due to fever, dehydration, or prolonged bed rest, which lower blood pressure and reduce blood flow to the brain. Standing quickly can make it worse. Drinking fluids, eating regularly, and managing fever usually help. Severe dizziness with other symptoms needs immediate medical evaluation.
Do not play contact sports, do heavy lifting, or attend PE for 3–4 weeks after mono due to spleen injury risk. Avoid alcohol until your liver is cleared by a provider. Do not share drinks or utensils while contagious. Rest if fatigue is strong to avoid delaying recovery.
Go to urgent care for mono if throat swelling causes breathing trouble, if there’s drooling, or if sharp pain appears in the upper left belly, which may signal spleen rupture. Yellow skin, high persistent fever, or no improvement after two weeks also require urgent evaluation for complications.
Prioritize Recovery: Mononucleosis Care Made Simple
Mononucleosis care focuses on clear steps: recognize the classic symptoms, rest, stay hydrated, protect the spleen, and avoid contact sports until cleared. The article outlined what to expect in the first weeks, how to manage fever and throat pain, and when to seek in-person evaluation for red-flag signs.
For timely testing, throat evaluation, and return-to-activity guidance, visit our urgent care facility in New York. Dr. Josef Schenker and our clinical team provide careful exams, supportive treatment, and practical recovery plans tailored to your schedule. At Centers Urgent Care, same-day visits make it easy to confirm the diagnosis, monitor complications, and get clear advice on school, work, and sports.
We serve patients across 12 NYC locations, seven days a week. If mono symptoms are holding you back or you need clearance to resume activity, our team is ready to help you feel better sooner. Locate a Centers Urgent Care near you.
About Josef Schenker, MD:
Dr. Josef Schenker, a board-certified expert in internal medicine and emergency medical services, brings extensive experience and compassion to his role as Medical Director and Partner at Centers Urgent Care. With leadership in SeniorCare Emergency Medical Services and as an Attending Physician at New York-Presbyterian Brooklyn Methodist Hospital, Dr. Schenker oversees critical care and treatment protocols across varied medical needs. His dedication extends to chairing NYC REMAC, ensuring adherence to state standards in emergency medical procedures. At Centers Urgent Care, Dr. Schenker's expertise ensures prompt, high-quality emergency care for patients of all ages, supported by state-of-the-art facilities including a dedicated pediatric suite.
