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Mononucleosis, also known as infectious mononucleosis (IM), mono, or glandular fever is a contagious disease most common in teenagers and young adults. It is most commonly spread through bodily fluids, especially saliva.[1]

Causative agents[edit | edit source]

Epstein-Barr virus (EBV) is the most common cause of infectious mononucleosis (IM), making up approximately 90% of those diagnosed,[2] but other infectious agents, such as cytomegalovirus, toxoplasmosis gondii parasite, HIV (human immunodeficiency virus), rubella virus, hepatitis A, B, or C viruses, and adenovirus can cause this disease.[1]

Although Epstein-Barr virus is the most common cause of infectious mononucleosis, the majority of people infected with EBV never develop mononucleosis. It is estimated that 80% - 90% of the worldwide population is infected with EBV.[3]

Symptomology[edit | edit source]

Illness duration can vary from several weeks to several months and may include the following symptoms:[4][3]

Treatment[edit | edit source]

Treatment is mainly supportive: rest, plenty of fluids, analgesics, and antipyretics.[4] A vaccine for the prevention of Epstein-Barr virus is being explored.[5]

Trigger for chronic fatigue syndrome[edit | edit source]

A minority of infectious mononucleosis patients develop postviral fatigue syndrome and meet the criteria for chronic fatigue syndrome (CFS). Research studies cite figures from 7% to 13% of healthy people who contract infectious mononucleosis will have the illness progress into chronic fatigue syndrome (CFS).[2][6][7][8] In a 2013 study by Jason and Katz, thirteen percent of adolescents (mainly female) met the criteria for CFS 6 months following infectious mononucleosis; the figure was 7% at 12 months and 4% at 24 months. A year later, Jason and Katz looked at numerous medical, demographic, and psychological factors in an effort to find predictors of which infectious mononucleosis patients would develop chronic fatigue syndrome. They found the best predictor was the illness severity of the case of infectious mononucleosis.[9]

In 2019, Katz et al. found that severity of mononucleosis predicted risk of CFS six months post-infection.[7]

Studies relating to infectious mononucleosis and ME/CFS[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 "Epstein-barr | Mononucleosis | About Mono | CDC". Centers for Disease Control and Prevention. January 23, 2019. Retrieved April 7, 2019.
  2. 2.0 2.1 2.2 Jason, Leonard A; Katz, Ben; Gleason, Kristen; McManimen, Stephanie; Sunnquist, Madison; Thorpe, Taylor (2017), "A Prospective Study of Infectious Mononucleosis in College Students" (PDF), International Journal of Psychiatry, 2 (1)
  3. 3.0 3.1 "Epidemiology of Epstein-Barr Virus Infections, Epidemiology of EBV infection". Retrieved April 8, 2019.
  4. 4.0 4.1 "Epstein-barr | Mononucleosis | About Mono | CDC". Centers for Disease Control and Prevention. January 23, 2019. Retrieved April 8, 2019.
  5. "NIH researchers make progress toward Epstein-Barr virus vaccine". National Institutes of Health (NIH). April 9, 2019. Retrieved April 10, 2019.
  6. 6.0 6.1 Buchwald, Dedra S; Rea, Thomas; Katon, Wayne J; Russo, Joan E; Morrow, Rhoda Ashley (2000), "Acute infectious mononucleosis: Characteristics of patients who report failure to recover", The American Journal of Medicine, 109 (7): 531-7, doi:10.1016/S0002-9343(00)00560-X
  7. 7.0 7.1 7.2 Katz, Ben Z.; Reuter, Caroline; Lupovitch, Yair; Gleason, Kristen; McClellan, Damani; Cotler, Joseph; Jason, Leonard A. (March 7, 2019). "A Validated Scale for Assessing the Severity of Acute Infectious Mononucleosis". The Journal of Pediatrics. 209: 130–133. doi:10.1016/j.jpeds.2019.01.035. ISSN 1097-6833. PMID 30853204.
  8. Lennon, P.; Crotty, M.; Fenton, J.E. (April 21, 2015). "Infectious mononucleosis" (PDF). BMJ. 350 (h1825): 6. doi:10.1136/bmj.h1825. ISSN 1756-1833.
  9. 9.0 9.1 Jason, Leonard A; Katz, Ben Z.; Shiraishi, Yukiko; Mears, Cynthia J.; Im, Young; Taylor, Renee R. (2014), "Predictors of post-infectious chronic fatigue syndrome in adolescents", Health Psychology and Behavioral Medicine, 2 (1): 41-51, doi:10.1080/21642850.2013.869176
  10. Hickie, Ian; Davenport, Tracey; Wakefield, Denis; Vollmer-Conna, Ute; Cameron, Barbara; Vernon, Suzanne D; Reeves, William C; Lloyd, Andrew (September 16, 2006). "Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study". BMJ. 333 (7568): 575–. doi:10.1136/ PMC 1569956. PMID 16950834.
  11. Cameron, Barbara; Galbraith, Sally; Zhang, Yun; Davenport, Tracey; Vollmer‐Conna, Ute; Wakefield, Denis; Hickie, Ian; Dunsmuir, William; Whistler, Toni (July 2007). "Gene Expression Correlates of Postinfective Fatigue Syndrome after Infectious Mononucleosis". The Journal of Infectious Diseases. 196 (1): 56–66. doi:10.1086/518614.
  12. Katz, Ben Z.; Shiraishi, Yukiko; Mears, Cynthia J.; Binns, Helen J.; Taylor, Renee (July 2009). "Chronic fatigue syndrome after infectious mononucleosis in adolescents". Pediatrics. 124 (1): 189–193. doi:10.1542/peds.2008-1879. ISSN 1098-4275. PMID 19564299.
  13. Harvey, Jeanna M.; Broderick, Gordon; Bowie, Alanna; Barnes, Zachary M.; Katz, Ben Z.; O'Gorman, Maurice R.G.; Vernon, Suzanne D.; Fletcher, Mary Ann; Klimas, Nancy G. (April 26, 2016). "Tracking post-infectious fatigue in clinic using routine Lab tests". BMC Pediatrics. 15: 54. doi:10.1186/s12887-016-0596-8. ISSN 1471-2431. PMC 4847210. PMID 27118537.