chemo and exposure to mono

[bkjjec]

My sister-in-law  recently had a malignant tumor removed from her colon and 2 out of 13 lymph nodes removed were malignant. She is currently going through chemo and radiation through the summer. My three boys and I are scheduled to go visit them for the summer and stay in their home. My 9 year old came down with mononucleosis 10 days ago. Today he has no fever and is doing well but my concern is that he is supposed to be contagious for months. What are the risks to my sister? Should we be staying with someone else? Should we be canceling the trip since the boys will be spending lots of time with her daughters? I just have no idea what to do. Thanks

[Fernando Roque, MD]

Hi.  Infectious mononucleosis is not as contagious as the flu, since the flu is an airborne pathogen and can travel greater distances and spread more rapidly to a wider area.  Mononucleosis, by contrast, is transmitted only through direct contact with the person's saliva.  However, you have to remember that your sister-in-law's immune system is depressed because of the chemotherapy, and she is more susceptible to catching pathogens which normal people would be more resistant to.  

[bkjjec]

Thank you for answering my question. Could you tell me how serious it would be for her to catch it in comparison to, say, the flu?

[Fernando Roque, MD]

Hi.  The virus causing infectious mononucleosis can be found in the infected person's saliva, so transmission is made through kissing or sharing of drinking glasses.  Your sister-in-law is probably safe, as long as she doesn't come in close contact with your son.  If you wish to be absolutely safe, however, it may be advisable to either stay with someone else or postpone the trip for another time (preferably after she's completed her chemotherapy).  There is a risk that even if your sister-in-law doesn't get infected, someone in her household might come down with it because of exposure to your son (e.g. one of your nieces), and this will in turn, place your sister-in-law at greater risk for developing mononucleosis.