Talk:Infectious mononucleosis
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[edit] EBV v. CMV? Aspirin & Reyes?
There's a few facts I wanted to clarify (meaning I wasn't clear). By way of preamble, I'm not anywhere near an MD - I wanted to make sure the article's clear on any ambiguities in knowledge, but defer to those who know.
- The CDC page linked in the article seems to say that cytomegalovirus does not cause mono. Is this a fuzzy definition, i.e. some people define mono to include cytomegalovirus, while others don't? (Or did I just misinterpret)
- Similarly, the CDC page seemed to say that the mono spot test is specific to EBV, and can distinguish from other causes. Here's a quote: "When 'mono spot' or heterophile test results are negative, additional laboratory testing may be needed to differentiate EBV infections from a mononucleosis-like illness induced by cytomegalovirus, adenovirus, or Toxoplasma gondii." This implies that mono spots are normally negative for e.g. cytomegalovirus infections. My interpretation is that the mono spot is specific to EBV, but may have false positives/negatives for largely unknown reasons (yes, this is maybe a matter of perspective)
- The aspirin thing. It's maybe safer to just discourage people, but it seems like many places I looked (including webmd.com, which gives a medical dictionary entry) recommended aspirin, without mentioning the possibility of Reye's disease, and in lists of viral infection thought to be implicated in Reye's disease, only some web pages or academic paper abstracts mentioned EBV in the list. Is anyone more knowledgeable about the medical community's current understanding of EBV and Reye's?
The relationship between Infectious mononucleosis and the diseases that cause it seems to be vague at best. A quick search showed a lot of contradictory information. I will attempt to look into it more throughly at a later date.
--user:Elfan
- This is quite a good question, and one which I frequently educate medical students and residents on. The thing which makes mono "mono" is the clinical syndrome (sore throat, swollen "glands", and fatigue) plus the increase in lymphocytes and "atypical lymphocytes". This syndrome can be caused by both EBV and Cytomegalovirus. The specific virus in each case is usually not identified, but is by far more likely to be EBV. CMV Mono has slightly different characteristics (specifically re the severity of the sore throat) but is still "mono". Both EBV and CMV trigger a positive monospot test. The monospot is indirect evidence for one of these viruses; it relies on the fact that these (and unfortunately some other) viruses lead to the production of so-called "heterophile" antibodies, which cause red blood cells of other species to agglutinate. The confusion is added to by the fact that these viruses can cause other illnesses besides mono, and the presence of one of these viruses in situations where "mono" per se is not present is one of the possible causes of a false-positive monospot test. When the monospot test is negative in a patient whose picture looks like "mono", specific tests for the presence of antibodies to EBV and CMV should be performed. The aspirin warning kind of spooked me, since I routinely advise against acetaminophen in mono patients, since both mono and APAP can lead to liver toxicity. I found a few references including mono among the illnesses associated with aspirin use and Reyes, and I now suggest Ibuprofen or mild narcotics.Sfahey 20:32, 9 Nov 2004 (UTC)
- Little to add 'cept the difficulty with nomenclature is because "mono" was named long before individual viruses were identified, or even known to exist. I agree with sfahey's explanation above, as do most physicians trained in the 20th century, but if the purists at the CDC are trying to make "mono" only the ebv version, this may eventually take hold. personally i think that, as with "pneumonia", "tonsillitis", and a myriad of other illnesses, there should be no problem with a disease or syndrome having both a clinical (signs, symptoms, lab/xray findings, and course) and a microbiological name. srf,md (usa)
[edit] Relapse rate?
I'm interested in the statement, "About 6% of people who have had mono will relapse," and wish it had been supported by a reference. Anyone know of any studies of the prevelance and course of mono relapse?Meg365@aol.com 15:26, 8 Jan 2005 (UTC)
[edit] Acetaminophen toxicity?
I can't find any information to corroborate the statement that "Acetaminophen must also be used with caution, as it may worsen the hepatitis which often accompanies mononucleosis." --User:cbarrett
- It has been suggested that since mono causes hepatitis and APAP is both metabolized by the liver and causes liver toxicity in (very) large doses, that caution is advised. I found only one report, from the (US) Southern Medical Journal, of APAP toxicity with Mono occurring. I originally put this item in the article, and as it is a VERY unlikely possibility given the mildness of the hepatitis usually seen with Mono, have no problem with it being removed. Sfahey 02:53, 27 Feb 2005 (UTC)
[edit] edit help needed
in the drug interactions section, someone "block" highlighted the subsections, but the * (which codes for the "block" symbol) remains as a * for amoxicillin. either none or all four little subsections should be so-highlighted. Sfahey 01:45, 26 May 2005 (UTC)
- It'd just lost the line break some few edits ago. A * only codes for the bullet point followin a line-break I guess. I thought that para seemed non-sensical at the time, but hadn't clicked that the * meant it was supposed to be a different point.
- NB: Thanks for your intelligent contributions on this talk page. It has provided some more subtle shades of information not on the front page. Limegreen 05:01, 28 May 2005 (UTC)
[edit] duration worth mentioning?
i thought this might be worth mentioning. I got mono from my girlfriend 15 months after she got over it. nothing about our kissing really changed over that time, and we had been together 14 of those 15 months. my doctor did some reading and found out it could lay dormant for up to 18 months after it had gotten to someone. he thought i had strep until that test came back neg - threw him for a loop. i'm not an MD so i don't want to contribute inaccurate / poorly stated info, but i thought this might be useful for people to know --Duozmo
[edit] How many "subtypes" of the virus are identified ?
213.6.141.37 21:13, 17 December 2005 (UTC)
[edit] Contagion
Just out of curiosity, why does it say "contrary to popular belief, it is non-contagious", then immediately following this line says, "...it is also easily spread..."? Sounds rather contradictory in my opinion. Also, is there any documented proof that explains how contagious this virus really is? --user:AWDRacer
- Perhaps whoever wrote that forgot that skin- or mucosa-related transmission is also contagion. Feel free to change this, WP:BB. JFW | T@lk 08:13, 30 January 2006 (UTC)
[edit] Non-functional reference
The link to the UoM research about using antiviral therapy on mono is no longer functional and I haven't been able to find a replacement so far. Since I have mono right now (hey, what do you know!) I cannot think clearly, so if anyone feels like it, either help me find a better reference or perhaps quarantine this part of the article. Emp² 20:48, 21 June 2006 (UTC)
- I found an article on the UMinn Health Center website that describes this research study; the principle investigator seems to be Henry Balfour. Try the link below.
http://www.ahc.umn.edu/news/releases/mono121905/home.html --Bikeracer 18:44, 5 July 2006 (UTC)
[edit] Transfer
Is that the only way to transfer the disease? A friend of mine has this disease and came to school today. Is it possible to transfer it through breath? Or other bodily fluids? --66.218.13.119
- coughing, touching, shared utensils, saliva. Sfahey 03:34, 27 October 2006 (UTC)
Is there any possibly to have the disease and transfer it to someone else and then lose the disease altogether and not have the disease anymore? yup Sfahey 03:34, 27 October 2006 (UTC)
The intro says that "The virus is typically transmitted from asymptomatic individuals through blood or saliva," while the CDC site says "Transmission of this virus through the air or blood does not normally occur." Are these statements contradictory enough to require an edit?--Hjal 08:15, 24 January 2007 (UTC)
[edit] Dormancy and contagion
After someone has shown symptoms and recovered/ become asymptomatic, does the virus remain in the blood stream/saliva, for how long? Have studies been carried out or educated estimates been proposed how long someone remains a carrier?
[edit] type
Is this virus RNA or DNA??? This is the simplest classification for virus' and I didn't see it anywhere. . .
- Infectious mononucleosis isn't a virus, it's a disease which is caused by the Epstein-Barr virus, which is a member of the herpesviridae family, and this family of viruses are DNA.
Blah0401 06:26, 9 March 2007 (UTC)
