Infectious mononucleosis

Infectious mononucleosis (IM, mono), also known as glandular fever, is an infection usually caused by the Epstein–Barr virus (EBV).[3][2] Most people are infected by the virus as children, when the disease produces few or no symptoms.[2] In young adults, the disease often results in fever, sore throat, enlarged lymph nodes in the neck, and tiredness.[2] Most people get better in two to four weeks; however, feeling tired may last for months.[2] The liver or spleen may also become swollen,[3] and in less than one percent of cases splenic rupture may occur.[6]

While usually caused by Epstein–Barr virus (EBV), also known as human herpesvirus 4, which is a member of the herpes virus family,[3] a few other viruses may also cause the disease.[3] It is primarily spread through saliva but can rarely be spread through semen or blood.[2] Spread may occur by objects such as drinking glasses or toothbrushes.[2] Those who are infected can spread the disease weeks before symptoms develop.[2] Mono is primarily diagnosed based on the symptoms and can be confirmed with blood tests for specific antibodies.[3] Another typical finding is increased blood lymphocytes of which more than 10% are atypical.[3][7] The monospot test is not recommended for general use due to poor accuracy.[8]

There is no vaccine for EBV.[2] Prevention is by not sharing personal items with or kissing those infected.[2] Mono generally gets better on its own.[2] Recommendations include drinking enough fluids, getting sufficient rest, and taking pain medications such as paracetamol (acetaminophen) and ibuprofen.[2][4]

Mono most commonly affects those between the ages of 15 to 24 years in the developed world.[7] In the developing world, people are more often infected in early childhood when the symptoms are less.[9] In those between 16 and 20 it is the cause of about 8% of sore throats.[7] About 45 out of 100,000 people develop infectious mono each year in the United States.[5] Nearly 95% of people have had an EBV infection by the time they are adults.[5] The disease occurs equally at all times of the year.[7] Mononucleosis was first described in the 1920s and is colloquially known as "the kissing disease".[10]

The signs and symptoms of infectious mononucleosis vary with age.

Before puberty, the disease typically only produces flu-like symptoms, if any at all. When found, symptoms tend to be similar to those of common throat infections (mild pharyngitis, with or without tonsillitis).[12]

In adolescence and young adulthood, the disease presents with a characteristic triad:[13]

Another major symptom is feeling tired.[2] Headaches are common, and abdominal pains with nausea or vomiting sometimes also occur.[13] Symptoms most often disappear after about 2–4 weeks.[2][17] However, fatigue and a general feeling of being unwell (malaise) may sometimes last for months.[12] Fatigue lasts more than one month in an estimated 28% of cases.[18] Mild fever, swollen neck glands and body aches may also persist beyond 4 weeks.[12][19][20] Most people are able to resume their usual activities within 2–3 months.[19]

This page was last edited on 9 July 2018, at 09:16 (UTC).
Reference: under CC BY-SA license.

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