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Mononucleosis
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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.<ref name=":3">{{Cite web|url=https://www.cdc.gov/epstein-barr/about-mono.html | title = Epstein-barr {{!}} Mononucleosis {{!}} About Mono {{!}} CDC | date = 2019-01-23 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2019-04-07}}</ref> ==Causative agents== [[Epstein-Barr virus]] (EBV) is the most common cause of infectious mononucleosis (IM), making up approximately 90% of those diagnosed,<ref name="Jason, Katz, 2017" /> but other infectious agents, such as [[cytomegalovirus]], [[toxoplasmosis]] gondii parasite, [[HIV]] (human immunodeficiency virus), [[rubella virus]], [[hepatitis A]], [[Hepatitis B|B]], or[[Hepatitis C| C]] viruses, and [[adenovirus]] can cause this disease.<ref name=":3" /> 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.<ref name=":2">{{Cite web|url=http://virology-online.com/viruses/EBV2.htm | title = Epidemiology of Epstein-Barr Virus Infections, Epidemiology of EBV infection|website=virology-online.com|access-date=2019-04-08}}</ref> ==Symptomology== Illness duration can vary from several weeks to several months and may include the following symptoms:<ref name=":1">{{Cite web|url=https://www.cdc.gov/epstein-barr/about-mono.html | title = Epstein-barr {{!}} Mononucleosis {{!}} About Mono {{!}} CDC | date = 2019-01-23 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2019-04-08}}</ref><ref name=":2" /> *extreme [[fatigue]] and [[malaise]] *[[fever]], sweating and chills *[[sore throat]] *head and body [[Myalgia|aches]] *[[swollen lymph nodes]] in the neck and armpits *swollen [[liver]] or spleen or both *rash, usually resolving in several days ==Treatment== Treatment is mainly supportive: rest, plenty of fluids, [[analgesics]], and [[antipyretics]].<ref name=":1" /> A [[vaccine]] for the prevention of [[Epstein-Barr virus]] is being explored.<ref>{{Cite web|url=https://www.nih.gov/news-events/news-releases/nih-researchers-make-progress-toward-epstein-barr-virus-vaccine | title = NIH researchers make progress toward Epstein-Barr virus vaccine | date = 2019-04-09 | website = National Institutes of Health (NIH)|language=EN|access-date=2019-04-10}}</ref> ==Trigger for chronic fatigue syndrome== 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).<ref name="Jason, Katz, 2017">{{Citation | last1 = Jason | first1 = Leonard A | authorlink1 = Leonard Jason | last2 = Katz | first2 = Ben | authorlink2 = Ben Katz | last3 = Gleason | first3 = Kristen | authorlink3 = Kirsten Gleason | last4 = McManimen | first4 = Stephanie | authorlink4 = Stephanie McManimen | last5 = Sunnquist | first5 = Madison | authorlink5 = Madison Sunnquist | last6 = Thorpe | first6 = Taylor | authorlink6 = Taylor Thorpe | title = A Prospective Study of Infectious Mononucleosis in College Students | journal = International Journal of Psychiatry | volume = 2 | issue = 1 | page = | date = 2017 | doi = | url = https://www.researchgate.net/profile/Leonard_Jason/publication/312936696_A_prospective_study_of_Infectious_Mononucleosis_in_college_students/links/588a23cc92851c2779b2568c/A-prospective-study-of-Infectious-Mononucleosis-in-college-students.pdf }}</ref><ref name="Buchwald, 2000">{{Citation | last1 = Buchwald | first1 = Dedra S | authorlink1 = Dedra Buchwald | last2 = Rea | first2 = Thomas | authorlink2 = Thomas Rea | last3 = Katon | first3 = Wayne J | authorlink3 = Wayne Katon | last4 = Russo | first4 = Joan E | authorlink4 = Joan Russo | last5 = Morrow | first5 = Rhoda Ashley | authorlink5 = Rhoda Ashley Morrow | title = Acute infectious mononucleosis: Characteristics of patients who report failure to recover | journal = The American Journal of Medicine | volume = 109 | issue = 7 | page = 531-7 | date = 2000 | pmid = | doi = 10.1016/S0002-9343(00)00560-X }}</ref><ref name=":0" /><ref>{{Cite journal | last = Lennon | first = P. | authorlink = | last2 = Crotty | first2 = M. | authorlink2 = | last3 = Fenton | first3 = J.E. | authorlink3 = | date = 2015-04-21 | title = Infectious mononucleosis|url=https://www.researchgate.net/profile/Paul_Lennon/publication/275522485_Infectious_mononucleosis/links/5551166808ae739bdb92056b.pdf | journal=BMJ|language=en|volume=350|issue=h1825 | pages = 6|doi=10.1136/bmj.h1825|issn=1756-1833|pmc=|pmid=|access-date=|quote=|via=}}</ref> In a 2013 study by [[Leonard Jason|Jason]] and [[Ben Katz|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.<ref name="Jason, Katz, 2014">{{Citation | last1 = Jason | first1 = Leonard A | authorlink1 = Leonard Jason | last2 = Katz | first2 = Ben Z. | authorlink2 = Ben Katz | last3 = Shiraishi | first3 = Yukiko| authorlink3 = Yukiko Shiraishi | last4 = Mears | first4 = Cynthia J. | authorlink4 = Cynthia Mears | last5 = Im | first5 = Young | authorlink5 = Young Im | last6 = Taylor | first6 = Renee R. | authorlink6 = Renee Taylor | title = Predictors of post-infectious chronic fatigue syndrome in adolescents | journal = Health Psychology and Behavioral Medicine | volume = 2 | issue = 1 | page = 41-51 | date = 2014 | doi = 10.1080/21642850.2013.869176 }}</ref> In 2019, Katz et al. found that severity of mononucleosis predicted risk of CFS six months post-infection.<ref name=":0" /> ==Studies relating to infectious mononucleosis and ME/CFS== *2000, [https://www.researchgate.net/publication/12262921_Acute_infectious_mononucleosis_Characteristics_of_patients_who_report_failure_to_recover Acute infectious mononucleosis: Characteristics of patients who report failure to recover]<ref name="Buchwald, 2000" /> *2006, [https://www.researchgate.net/publication/6838807_Post-infective_and_chronic_fatigue_syndromes_precipitated_by_viral_and_non-viral_pathogens_Prospective_cohort_study Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: Prospective cohort study]<ref>{{Cite journal | last = Hickie | first = Ian | authorlink = Ian Hickie | last2 = Davenport | first2 = Tracey | authorlink2 = Tracey Davenport | last3 = Wakefield | first3 = Denis | authorlink3 = Denis Wakefield | last4 = Vollmer-Conna | first4 = Ute | author-link4 = Uté Vollmer-Conna | last5 = Cameron | first5 = Barbara | authorlink5 = Barbara Cameron | last6 = Vernon | first6 = Suzanne D | authorlink6 = Suzanne Vernon | last7 = Reeves | first7 = William C | authorlink7 = William Reeves | last8 = Lloyd | first8 = Andrew | authorlink8 = Andrew Lloyd | date = 2006-09-16 | title = Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study|url=http://www.bmj.com/lookup/doi/10.1136/bmj.38933.585764.AE|journal=BMJ|volume=333|issue=7568 | pages = 575–|doi=10.1136/bmj.38933.585764.ae|pmc=1569956|pmid=16950834|quote=|via=}}</ref> *2007, Gene expression correlates of postinfective fatigue syndrome after infectious mononucleosis<ref>{{Cite journal | last = Cameron | first = Barbara | authorlink = Barbara Cameron | last2 = Galbraith | first2 = Sally | authorlink2 = Sally Galbraith | last3 = Zhang | first3 = Yun | authorlink3 = Yun Zhang | last4 = Davenport | first4 = Tracey | author-link4 = Tracey Davenport | last5 = Vollmer‐Conna | first5 = Ute | authorlink5 = Uté Vollmer-Conna | last6 = Wakefield | first6 = Denis | authorlink6 = Denis Wakefield | last7 = Hickie | first7 = Ian | authorlink7 = Ian Hickie | last8 = Dunsmuir | first8 = William | last9 = Whistler | first9 = Toni | date = Jul 2007 | title = Gene Expression Correlates of Postinfective Fatigue Syndrome after Infectious Mononucleosis|url=https://academic.oup.com/jid/article-lookup/doi/10.1086/518614|journal=The Journal of Infectious Diseases|volume=196|issue=1 | pages = 56–66|doi=10.1086/518614|quote=|via= | authorlink8 = William Dunsmuir | authorlink9 = Toni Whistler}}</ref> *2009, [[Chronic fatigue syndrome]] after infectious mononucleosis in adolescents.<ref>{{Cite journal | last = Katz | first = Ben Z. | authorlink = Ben Katz | last2 = Shiraishi | first2 = Yukiko | last3 = Mears | first3 = Cynthia J. | last4 = Binns | first4 = Helen J. | last5 = Taylor | first5 = Renee | authorlink5 = Renee Taylor | date = Jul 2009 | title = Chronic fatigue syndrome after infectious mononucleosis in adolescents|url=https://www.ncbi.nlm.nih.gov/pubmed/19564299|journal=Pediatrics|volume=124|issue=1|pages=189–193|doi=10.1542/peds.2008-1879|issn=1098-4275|pmc=|pmid=19564299|via=|quote= | authorlink2 = Yukiko Shiraishi | authorlink3 = Cynthia Mears | author-link4 = Helen Binns}}</ref> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2756827/ (Full Text)] *2014, [http://www.tandfonline.com/doi/full/10.1080/21642850.2013.869176 Predictors of post-infectious] [[chronic fatigue syndrome]] in adolescents<ref name="Jason, Katz, 2014" /> *2016, Tracking post-infectious fatigue in clinic using routine Lab tests<ref name="Harvey2016">{{Cite journal | last = Harvey | first = Jeanna M. | authorlink = Jeanna Harvey | last2 = Broderick | first2 = Gordon | authorlink2 = Gordon Broderick | last3 = Bowie | first3 = Alanna | authorlink3 = Alanna Bowie | last4 = Barnes | first4 = Zachary M. | authorlink4=Zachary Barnes | last5 = Katz | first5 = Ben Z. | authorlink5 = Ben Katz | last6 = O'Gorman | first6 = Maurice R.G. | author-link6 = Maurice O'Gorman | last7 = Vernon | first7 = Suzanne D. | authorlink7 = Suzanne Vernon | last8 = Fletcher | first8 = Mary Ann | authorlink8 = Mary Ann Fletcher | last9 = Klimas | first9 = Nancy G. | authorlink9 = Nancy Klimas | date = 2016-04-26 | title = Tracking post-infectious fatigue in clinic using routine Lab tests|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847210/|journal=BMC Pediatrics|doi=10.1186/s12887-016-0596-8|issn=1471-2431|pmc=4847210|pmid=27118537|volume=15|issue= | pages = 54|quote=|via=}}</ref> *2017, [https://www.researchgate.net/profile/Leonard_Jason/publication/312936696_A_prospective_study_of_Infectious_Mononucleosis_in_college_students/links/588a23cc92851c2779b2568c/A-prospective-study-of-Infectious-Mononucleosis-in-college-students.pdf A Prospective Study of Infectious Mononucleosis in College Students]<ref name="Jason, Katz, 2017" /> *2019, A Validated Scale for Assessing the Severity of Acute Infectious Mononucleosis<ref name=":0">{{Cite journal | last = Katz | first = Ben Z. | authorlink = Ben Katz | last2 = Reuter | first2 = Caroline | authorlink2 = Caroline Reuter | last3 = Lupovitch | first3 = Yair | authorlink3 = Yair Lupovitch | last4 = Gleason | first4 = Kristen | author-link4 = Kristen Gleason | last5 = McClellan | first5 = Damani | authorlink5 = Damani McClellan | last6 = Cotler | first6 = Joseph | authorlink6 = Joseph Cotler | last7 = Jason | first7 = Leonard A. | date = 2019-03-07 | title = A Validated Scale for Assessing the Severity of Acute Infectious Mononucleosis|url=https://www.ncbi.nlm.nih.gov/pubmed/30853204|journal=The Journal of Pediatrics|doi=10.1016/j.jpeds.2019.01.035|issn=1097-6833|pmid=30853204|volume=209|issue=|pages=130-133|quote=|via=}}</ref> ([https://www.jpeds.com/article/S0022-3476(19)30123-4/abstract Abstract]) ==References== {{reflist}} [[Category:Disease]] [[Category:Triggers and risk factors]] [[Category:Infectious diseases]] [[Category:Diagnoses]] [[Category:Virology]] [[Category:Viruses]]
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