Mononucleosis is a disease caused by the Epstein-Barr virus (EBV), which is a member of the herpes family. The herpes family also includes viruses that cause cold sores, chicken pox, genital herpes, and birth defects (7). Mono, short for mononucleosis (3) ‘gets its name from the fact that it causes a person’s white blood cells to become distorted, so that they have only one nucleus (becoming mononuclear) instead of the usual divided nucleus.’; (3)
The first accounts of mono are credited to Filatov and Pfeiffer who around the end of the nineteenth century described and illness known as Drusenfieber or glandular fever which occurred in family outbreaks. However, the establishment of mono is given to Sprunt and Evans. In 1921 they pointed out the mononuclear lymphocytosis that was present in each patient they treated. Two years later, Downey and McKinaly provided more details of the lymphocytes as a marker that led to the disease. (6)
The idea of EBV being connected to mono came about in 1958 by Burkitt. There were some cases in Africa of young children having tumors in their jaw and dying even when the tumor was removed. He later found out that the patients were coming from areas highly infested with mosquitoes, so they figured that the mosquitoes were related. The mosquitoes were carrying a virus in the herpes family, which was later called Epstein-Barr virus. This virus was later revealed to be linked with mono. (6)
Anyone can get mono but it is most common in teens and young adults, mostly high school and college students. Children who are infected with EBV when they are really young are able to manufacture antibodies against the virus. If a person’s body does not have EBV already they will most likely contract the virus later in their life and be able to build these antibodies. Only a small amount of teens and young adults actually get mono because they have already been exposed to EBV at a younger age. (7)
Mono usually occurs in females between the ages of 15 to 16 years, and males between the ages of 18 to 23 years (4). People call it the ‘kissing disease’; due to the fact that it is spread through close contact and saliva (2). Drinking after someone, or eating after him or her can also contract mono (2). In the United States more than 100,000 cases of mono are diagnosed each year (7). At colleges 300 to 1500 out of 100,000 people get mono (7).
Mono affects mainly the lymphatic system (7). ‘The lymph system carries foreign invaders like EBV to special tissues where disease-fighting white blood cells called lymphocytes spring into action.’; (7) However EBV only infects the B cells that produce antibodies. During mono one out of every ten B cells becomes ‘atypical.’; The T cells in the body then go find the B cells infected and that is what makes the body feel fatigued and sick is when it is fighting its own cells. The lymph nodes where the body is attacking itself, such as the tonsils become inflamed, causing symptoms such as a sore throat. Eventually the T cells have done their job and the body is back under control, but there are still infected cells causing mono to relapse and take a long time to recover from. However, it is very unusually for mono to occur more than once in a person’s lifetime. (7)
The symptoms for mono include sore throat, fever, headache, loss of appetite, extreme fatigue, sometimes a measles-like rash, jaundice, or the spleen may enlarge and there is the possibility of a rupture. These symptoms are very common for other disease such as the common cold or strep throat. Blood tests are the only way to find out if someone is infected with mono due to the abnormal white blood cells. (2)
Although there is no specific treatment or medicine for mono the best thing is to just rest (3). Drinking plenty of fluids helps also (3). You can take pain relievers such as acetaminophen, which is Tylenol and others like it, but never take aspirin (3). Taking aspirin while having a viral infection can lead to another serious condition called Reye’s syndrome (3). While having mono, a person should limit their activities such as sports and exercises (7). The Illness can last from two weeks and in the severe cases, months (1).
There is no sure way to prevent mono because it is so highly contagious and there are no vaccines for it. Obviously a person should avoid contact with anyone who is infected with mono. A person with AIDS, and transplant recipients need to be extra careful because contracting EBV can lead to cancer. (7)
EBV can lead to other Illnesses other than mono. Burkitt’s lymphoma patients usually have high antibodies of EBV (6). This disease involves tumors in the throat and jaw area due to EBV (6). There are also traces of EBV genome in specimens from nasopharyngeal carcinoma (6). Nasopharynegeal carcinoma is cancer of the nose and throat and EBV is found in almost all of the tumors (7). Hodgkin’s disease is possibly linked with EBV because of the swelling of lymph nodes in the neck, armpits, or groin, and similar symptoms of mono (7). EBV could be linked with Sjogren’s syndrome, which is a chronic autoimmune disease where the body attacks its own tissues (7). EBV could be involved because an EBV infection of the salivary glands activates the T cells to the infected cells and to other glandular cells (7). Although EBV is linked to many other diseases and could cause cancer, there is no evidence that everyone with EBV antibodies is going to get cancer or another deadly disease (7).
Right now there is no vaccine for EBV or mono, but scientists are working on it (7). A vaccine for EBV would ‘remove a link in a chain’; that leads to cancer and other suck diseases, but would not prevent these diseases from ever occurring because there are other factors involved in these diseases (7). Luckily mono is not one of these deadly diseases, and even though there is not a definite prescription to get rid of mono there are ways to treat it without leading to death.
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Of Diagnosis and Therapy, 17th ed. Whitehouse Station, New Jersey: Merck Research Laboratories, 1999.
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3. Dinamoor, Robert S. ‘When Mono Attacks Take It Lying Down.’; Current
Health 20: 9 (1993): 30-31.
4. Dreher, Nancy. ‘What You Need To Know about Mono.’; Current Health
23: 3 (1997): 28-29.
5. Kaye, Kenneth M., and Elliot Kieff. ‘Epstein-Barr Virus Infection and
Infectious Mononucleosis.’; Infectious Diseases, 2nd ed. Ed. John G.
Barlett, MD, Neil R. Blacklow, MD, and Sherwood L. Gorback, MD.
Philadelphia: W.B. Saunders Company, 1998. 1646-1650.
6. Schooley, Robert T. ‘Epstein-Barr Virus (Infectious Mononucleosis).’; Ed.
John E. Bennett, MD, Raphael Dolin, MD, and Gerald L. Mandell, MD.
Principles and Practice of Infectious Diseases, 4th ed. New York:
Churchill Livingstone, 1995. 1364-1373.
7. Silverstein, Alvin, Virginia Silverstein, and Robert Silverstein.
Mononucleosis. Hillside, New Jersey: Enslow Publishers, Inc., 1994.