What's the difference between strep throat and mono?

If you've ever woken up with a scratchy or sore throat, you can usually rest assured that more symptoms are coming. In many cases, a sore throat is indicative of an illness like the common cold, mono, or even strep throat.

The best way to determine what is causing your sore throat is to take note of your other symptoms. While some symptoms of mono and strep throat may overlap, there are key things to look out for that can help you know if you need to seek medical care and what the best treatment may be.

Here's a look at the difference between mono and strep throat and more info on what to do if you suspect you have either one.

What causes strep throat?

Most common in children and teenagers, strep throat is typically caused by an infection of streptococcus bacteria. You're most likely to spread strep throat at the time your symptoms are most severe; however, you are still contagious for up to three weeks after developing strep throat.

Streptococcus bacteria exists in the nose and throat, meaning it's easily spread when someone comes in contact with infected droplets that occur during sneezing, talking, coughing, kissing, etc.

It's also possible to “catch” strep throat by breathing in droplets, sharing personal items with someone who's been infected, and touching something that's been exposed to droplets and then touching your nose or mouth.

What causes mono?

There are several different viruses responsible for mono, with the most common being the Epstein-Barr virus (EBV). Most people have had this virus by middle age; however, not everyone who contracts the virus will develop mono.

Teens and young adults are most susceptible to mono — one in four teenagers and young adults who contract EBV will get mono. It is possible for children and older adults to develop mono as well.

Cytomegalovirus (CMV) is a virus similar to EBV that causes a less severe form of mono. When mono is caused by this virus, symptoms are typically milder.

Commonly known as “the kissing disease,” mono can easily be spread through bodily fluids (i.e., via saliva when kissing). It's also possible to spread the virus through sexual contact. In very rare cases, EBV can be contracted during organ transplants and blood transfusions.

Is strep throat or mono worse?

Both illnesses can be painful and leave you feeling bad. Ultimately, determining which is worse depends on the severity of your symptoms. It's also possible to only experience certain symptoms for each illness, so you may not even know you're sick if you only have mild symptoms.

Many people believe it is worse to get mono than strep throat because mono can last up to four weeks, with some fatigue lingering for several more weeks, while strep throat usually begins to go away within a few days.

It's also possible for mono to spread for several months after symptoms are gone, so it's important to see a medical provider who can begin treating your virus as soon as possible.

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How to tell if you have strep throat or mono

The best way to determine if you have strep throat or mono is to take a look at symptoms. Fever, sore throat, and swollen lymph nodes are common symptoms of both mono and strep throat, but you may notice differing symptoms as well.

Symptoms of mono

• Fever
• Sore throat
• Swollen lymph nodes
• Head and body aches
• Extreme fatigue
• Loss of appetite
• Rash
• Swollen spleen and/or liver
• Red and swollen tonsils
• Red or purple spots on roof of mouth

Symptoms of strep throat

• Fever
• Sore throat
• Swollen lymph nodes
• Red and swollen tonsils
• Nausea or stomach pain
• Loss of appetite
• Strawberry-looking tongue
• Sandpaper body wash
• Red or purple spots on roof of mouth

Other causes of a sore throat

Just because you experience a sore throat doesn't mean you have mono or strep throat. There are a number of other viruses, such as those that cause the flu or the common cold, that can result in a sore throat.

Tonsillitis as well as some sexually-transmitted infections are an example of bacterial infections that may cause soreness in the throat.

It's also possible for the throat to become sore as a result of irritation from things like cigarette smoke, dry air, and allergies.

If you've injured your throat by yelling or using it too much, you may develop a sore throat as well.

Do I have strep throat or mono?

To diagnose mono and strep throat, it's best to see a medical provider who can evaluate your symptoms and offer proper testing.

If you have symptoms similar to that of strep throat, a provider will want to perform a rapid strep test or throat culture. These tests involve swabbing the back of your throat with a long q-tip and then testing the swab.

A blood test is required to correctly diagnose mono. Your blood will be tested for antibodies that your body creates to help fight EBV. It's also possible your provider will test your white blood cell count to see if it's high, which can be indicative of infection.

How to treat mono and strep throat

Since it's caused by a viral infection, antibiotics won't work to cure mono. The best course of action if you're diagnosed with mono is to get plenty of rest, stay hydrated, and take over-the-counter medications for pain.

You can also try gargling with salt water to help alleviate your throat. It's also recommended you avoid sports and other strenuous activities until cleared by your provider.

Strep throat can usually be treated with antibiotics. For additional relief, you can try many of the same at-home remedies as mono: over-the-counter medicines, rest, and gargling with salt water. Drinking water and/or cold liquids and eating soft foods may also help.

If you believe you have either strep throat or mono, it's a good idea to be evaluated by a medical provider regardless of how you feel. Because both illnesses are so contagious, you should begin treatment as soon as possible to minimize the amount of time you can infect others.

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