Infectious mononucleosis is often referred to as kissing disease, since the virus Epstein-Barr virus (EBV), is transmitted basically through saliva during kissing. (Aetna InteliHealth, 2005) Concurrently it can also spread through sneezes & coughs. Young children mostly have negligible symptoms however advance infection is commonly seen in adolescents. It can be deduced that most people have had EBV at some stage in their lives consequently, “in the U. S. , up to 95% of adults aged 35-40 have antibodies directed against EBV. “(Stoppler, pg1, 2007)
SYMPTOMS The initial symptoms of mononucleosis can last for 1 – 3 days; they include (Stoppler, pg2, 2007) • loss of appetite, • chills, • fever, • lack of energy, • headaches etc These symptoms usually precede the much intense symptoms like sore throat, joint aches, nausea, anaemia & enlarged spleen. The patient may face breathing problems, complications involving the nervous system or severe coughing. Jaundice or a ruptured spleen (which may cause internal bleeding) is also among rare symptoms of EBV. (Aetna InteliHealth, 2005) DIAGNOSIS
Lab tests are conducted to reveal the contagion these include a high white blood cell count, increased lymphocyte count & the presence of atypical lymphocytes, by indicating a positive reaction to a rapid slide test (Mono-spot test) for the specific antibodies in Mononucleosis. The Mono-spot test is positive in 90% adults/adolescents with IM, but recurrently negative in young children. (DeMoranville, 2007) The total white blood count may increase to 10,000-20,000 per cubic millimeter. Two blood tests that are used in identifying this infection are: Differential white blood cell count:
The test identifies the number of each different type of WBCs present in blood. The quantity of lymphocytes or atypical lymphocytes reaches a high number in the initial stage of mononucleosis. The normal count of monocytes & lymphocytes in WBC is 35% however in infectious mononucleosis they may raise up to 50 – 70%. Heterophile tests: An antibody called heterophil is caused by the mononucleosis, which is very rare in any other conditions. This antibody can be calculated by the heterophile tests. Modern tests produce much swift results as compared to the traditional ones that take 1-2 days.
In helping to make the diagnosis, the change in detected antibody amounts between the two tests can be chiefly helpful. TREATMENT Usually the infection passes without particular treatment; however the symptoms require some medication & adequate rest. The virus can persist in patient for almost 18 months after the initial infection. Penicillin or erythromycin is used for Strep throat that occurs in concurrence with IM. “Ampicillin and amoxicillin should be avoided if there is a possibility of mono since up to 90% of patients with mono develop a rash when taking these medications.
” (Stoppler, pg3, 2007) Infrequently a sinus or tonsils infection occurs easily treated by antibiotics. “The Epstein-Barr virus can cause much more serious illness in people who have impaired immune systems, such as people with HIV/AIDS or people taking drugs to suppress immunity after an organ transplant. “(Mononucleosis- section5, 2007) PROGNOSIS: After recovering, 20-80% mononucleosis patients persist to secrete EBV through saliva as reactivations of the infection, depending on the viral-detection method used. The individual may feel fatigue for some months after the critical phase.
The disease is most contagious at the critical stage hence the sharing of edibles & infected mucus in air after sneezing can also cause the infection.
REFERENCES
“Infectious Mononucleosis”, [20 June 2005] Aetna InteliHealth Inc. [accessed 12 December 2007] <http://www. intelihealth. com/IH/ihtIH/WSIHW000/9339/10351. html> Stoppler, Melissa Conrad- “Infectious Mononucleosis (Mono)” [22 June 2007] Medicine Net, Inc pg: 1-3 [accessed 12 December 2007] <http://www. medicinenet. com/infectious_mononucleosis/article. htm> <http://www. medicinenet. com/infectious_mononucleosis/page2.htm> <http://www. medicinenet. com/infectious_mononucleosis/page3. htm> “Mononucleosis” [23 June 2006] mayo foundation for medical education & research section: 1, 5, 6 [accessed 12 December 2007] <http://www. mayoclinic. com/health/mononucleosis/DS00352> <http://www. mayoclinic. com/health/mononucleosis/DS00352/DSECTION=5> <http://www. mayoclinic. com/health/mononucleosis/DS00352/DSECTION=6> DeMoranville, Victoria E. “Infectious Mononucleosis Test” [2007] eNotes. com [accessed 12 December 2007] <http://www. enotes. com/nursing-encyclopedia/infectious-mononucleosis-test>