Infectious mononucleosis (Glandular fever), or mono, as it is commonly called, is a disease most commonly caused by Epstein-Barr virus, and more rarely by cytomegalovirus. Epstein-Barr virus (EBV) is part of 8 known human herpesviruses that infects up to 90% of the population. Both viruses are very contagious and spread from person to person through close contact. In rare cases the virus has been transmitted through blood transfusion. The virus can affect almost every organ of the body.
The incubation period or the time when one can infect others is about 10 days in children and 30 to 50 days in adults.
Symptoms are similar to those of influenza—fever, sore throat and fatigue. The most characteristic symptom of mono is a persistent, severe sore throat. But mono is notorious for its great variability. A skin rash, headache, weakness, loss of appetite and generalized aching may be present. In a day or two, glands in the neck, armpits and/or groin swell and become painful. The severity of symptoms can vary. In extreme cases, breathing difficulties because of swelling in the throat and other complications can require hospitalization.
The symptoms of infectious mononucleosis usually subside in two to three weeks, although weakness and fatigue can last longer. In people with a compromised immune system, complications of varying degree of severity can develop. These can include inflammation and severe swelling of the throat that can result in life-threatnening obstruction of airways; fatal bacterial superinfection and liver involvement with jaundice
Diagnosis is made when a specific white blood cell is seen in a blood specimen under a microscope. There is little that can be done with this disease except wait it out.
Treatment - Since there is no cure for mono, conventional treatment is largely supportive and consists of rest—often for a month or more—plenty of fluids and aspirin or Tylenol. Antiviral or antibacterial drugs are not effective. Corticosteroids have shown to reduce fever and shorten the duration of symptoms. However, adverse drug complications can result even from short courses of corticosteroid use. There is insufficient evidence to recommend steroid treatment for symptom control in infectious mononucleosis. There is also a lack of research on the side effects, potential adverse effects or complications, particularly in the long term [3].
Prevention - Avoid drinking beverages from a common container to decrease contact with saliva of an infected person.
Health Risks Associated with Epstein-Barr virus infection -Increased risk of multiple sclerosis has been reported among individuals with a history of infectious mononucleosis, a marker of late infection with the Epstein-Barr virus (EBV), or exposure to the canine distemper virus.
Recent studies have also implicated EBV in the development of periodontal disease. Epstein-Barr virus DNA is detected in 15-20% of gum pockets affected by gingivitis and in normal gum tissues. It is believed to promote elevated levels of bacteria in periodontal tissues. Periodontal therapy can significantly suppress the EBV load in gum pockets as well as in saliva, which has the potential to reduce the risk of viral transmission between close individuals [4].
Although several risk factors for breast cancer have been identified, researchers continue to investigate potential causes. The researchers found evidence that EBV infection was detected most frequently in advanced breast tumors with poor prognosis.
The Epstein-Barr virus also has been linked to the development of several malignant tumors, including Burkitt's lymphoma and Hodgkin's disease (cancers of the immune system), some nose, mouth and gastric cancers [5].