How to take precautions when a family member has mono

DEAR DR. ROACH >>

My daughter was exposed to infectious mononucleosis (“mono”) at college, and she is coming to spend a week at home. What precautions do we need to take to make sure that the rest of the family remains safe? How long does the virus stay active on surfaces?

Also, can she get her flu and COVID shots?

— D.G.

DEAR READER >> Mono is classically caused by the Epstein-Barr virus (EBV), but very similar symptoms can be caused by other agents, viruses and even a parasite as well. The virus is transmitted through saliva.

The latency period (the time from exposure until the time of symptoms) is longer than you might expect; four to six weeks is typical. Not everybody develops symptoms. Younger children seldom develop symptoms at all when infected, yet still receive immunity. Unfortunately, they may shed infectious virus particles for months, years or even decades.

It is likely that the adults in your family are immune, since 90% of adults have had an EBV infection before. EBV is not a particularly infectious disease, so transmission to family members is uncommon. Still, you should avoid sharing anything that saliva touches, like food, cups or toothbrushes. You don't need to take special precautions about surfaces.

She can get the flu and COVID vaccines as long as she feels well and doesn't have a fever.

DEAR DR. ROACH >> I am an aging athlete (60 years old) with a history of minor injuries and wear and tear on my body that has resulted in minor arthritis. Also, I have recurring bouts of tendonitis, IBS and depression, so I avoid foods that cause inflammation.

Recently, I read that tart cherry juice is very good for reducing inflammation. However, in my efforts to avoid inflammatory foods, I also avoid sugar. A serving of tart cherry juice has a lot of fruit sugar. This is confusing to me. Does tart cherry juice reduce or increase inflammation? What is the difference between sucrose and fructose health-wise?

— P.G.

DEAR READER >> There is some evidence that tart cherry juice does have anti-inflammatory properties,

BROOM HILDA: By Russell Myers

LOOSE PARTS: By Dave Blazek and studies on athletes have shown through blood tests that benefits include faster recovery, improved performance, enhanced muscle oxygenation and decreased inflammation. A glass of tart cherry juice (without added sugar) has 25 grams of sugar, about the same as a glass of orange juice.

The studies that showed improvement included the effect of sugar, but I understand that you want to reduce sugar, which means you will need to be careful elsewhere in your diet if you do start drinking cherry juice.

As far as fructose (most fruit sugar) versus sucrose (table sugar), there is almost no difference in its effect on your health. Sucrose is rapidly broken down into fructose and glucose, and both fructose and glucose are used for energy. Too much of either sucrose or fructose isn't healthy, and there isn't a special benefit to “natural” sugar.

Keeping your simple sugar intake to less than 10% of your total calorie intake (roughly 36 grams for most men) is the healthiest option, so a glass of tart cherry juice would be a significant part of your sugar intake for the day.

Contact Dr. Roach at ToYourGoodHealth@med. cornell.edu.

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