Another Mono Blog!

http://epstein-barr.blogspot.com/

I was trying to find other pieces of media that discussed mononucleosis, and came across a blog that sparked my interest. I felt that it was a very important blog in the world of mono because as it states in its mission statement above, it is a blog dedicated to the discussion and mutual support of those who have mononucleosis and/or Epstein- Barr virus. On this blog, I found a myriad of articles that all pertain to questions, concerns, new research, and so many other things al having to do with mono and EBV. For example, there was research posted about sexual activity and how that affects someone with the virus, or how there is prevalent research about mononucleosis affecting the duration of pregnancy. There are suggestions of natural remedies for some of the symptoms of mono as well. My first reaction to this blot was that it was a little to casual for my taste, as some of the criticisms on it of a certain doctor were crude, although truthful. However, I did see that the posts all generated some healthy discussion of people with mono trading stories, advice, and other helpful information. Although it is known that there is no real treatment to the disease, it is helpful to know that others are out there who are facing the same problems as you, and to get advice from them in an easy, relatable manner is just awesome. There are so many great links on display at the top of the blog as well for support groups. I also think that it is especially good that it was created and administered by someone who is living with EBV, because it is so relatable, and they know the daily trials that those living with the virus have. I do wish that it had more posts about mono on a worldwide level, and how the readers and writer thinks science can improve their well beings. Future directions of a cure or at least medication to aid symptoms of the virus should be discussed. There is little sense of proactivity on the site, which I wish there was! But in all, I think it a great method for those with the virus to know they are not alone, and to make their own lives a little easier by engaging in healthy discussion about their condition.

Here is another couple of pieces of media I found, not quite long enough to discuss, but these "minute clinics" AOL provides are beneficial for the community in spreading the word about diseases like mononucleosis. They're just short enough to not be boring, and just long enough to get the pertinent information to the audience. Check them out!
Minute Clinic  Mononucleosis

Mono in Mexico: An Epidemiological Study

An interesting primary article I found that is pertinent to my discussion of mononucleosis is "Clinical and laboratory characteristics of infectious mononucleosis by Epstein-Barr virus in Mexican children" by N. Saldana, V. Colin, G. Ruiz, and H. Olguin. You can check out the article in its entirety at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3413594/. It is a descriptive cohort epidemiological study that analyzes the prevalence of mono in Mexican children because little research has been done on the clinical symptoms of mono in developing countries such as Mexico. A cohort study was performed on 163 cases of mononucleosis in Mexican children ranging from ages 0 to 18 years old at the National Institute of Pediatrics in Mexico. The study began in 1970 and ended in 2011, with the accumulation of cases happening during this time period. Their ages, most prevalent symptoms, sex, and any complications were recorded.

Figure 1. Age of 163 patients included in the study grouped by age-ranges: A:0-2.5years (y), B:2.5-5 y, C:5-7.5 y, D:7.5-10 y, E:10-12.5 y, F:12.5-15 y, G:15-17.5 y.

As you can see from the above figure from the study, the age group with the highest prevalence of mononucleosis cases is younger than that of those in the United States. In the US, it is usually those who are teenagers that have the highest amount of mono cases at any given point. However, in this study, it shows that children in Mexico that are 0-7 years of age have the highest amount of cases of mono. So it seems that incidence is higher in developing countries such as Mexico at a younger age than in developed countries for mononucleosis. 

Figure 2 above shows how many cases has each of the respective symptoms. Generally, mononucleosis is characterized by fever, pharyngitis, and swollen lymph nodes, which are all most prevalent as seen in the graph. However, these symptoms occurred at different proportions than that of those in the United States. There were many statistics found on each, but I will summarize their most important findings that were contrary to findings in the United States. In the discussion, it explains how fever was more prevalent in Mexico than in the US, with about 70% of the cases getting it compared to 35% in the US. However, pharyngitis was seen in only about 55% of patients in Mexico, while in the US study it was seen in 100%. Irregular lymph nodes as well as swollen spleens were seen in similar numbers in both US and Mexican populations, and the rest of the symptoms were too few to properly compare. For the most part, they conclude that Mononucleosis was prevalent at earlier ages in Mexico than in industrialized countries, as well as the proportionality that different symptoms of the illness show up in the population.

Their research could definitely be followed up with some etiological studies, as well as clinical studies to see exactly why Mexican children are affected at a much younger age than that of those in developed countries. A study could be done to see how the disease is transmitted most commonly, and if this method of transmission is different than that of industrialized countries. It could be possible that another source is responsible for the spread of the disease other than personal contact. Are there other factors that lead to Mexican children getting this disease at a younger age? Maybe they are exposed to other things that older children are not. Just thinking out loud here, but maybe mononucleosis can be passed through another medium such as breast milk, so younger children are susceptible to it from their mother? Other studies asking why the proportions of different symptoms are so different between countries can be done to test for confounding factors. There may be other explanations for why kids in Mexico get more fever and less pharyngitis than their US counterparts. There could possibly be associations between the prevalence of certain symptoms and the age of the child, another important future direction of study. For the future, I think all of these directions would be beneficial in exploring mononucleosis in Mexico so that we may see differences between the disease in different countries.

How do I get Mono, and How is it Treated?

Here is a great informational video on the cause, symptoms, and other information on mono.

https://www.youtube.com/watch?v=boQpx7L5zxg

If you read my first post, you know that mononucleosis is a disease most commonly spread through saliva, but can also be spread through other bodily fluids such as vaginal fluid, mucus, tears, or even blood. The transmission of any of these fluids from someone with mono can cause contraction of mono. Really anyone can contract mono, but the population most at risk is teenagers and young adults, with over 50% of this population being affected each year. This is because teens still have developing immune systems and are often stressed, tired, and in situations such as parties where mono can easily be transmitted. In some cases, younger children will also contract mono. Below, you can see the geographic distribution of those in the US affected with mono. As you can see, there is little correlation between geographic area and mono contraction, so it is not concentrated in a single area. 

Geographic distribution of mono in the US from 1865- 2009
 http://textmed.com/disease/infectious-mononucleosis.htm

Mononucleosis can only be truly treated with plenty of rest and fluids, and eventually the symptoms will become less severe and go away. However, the virus will always be in your system, and sometimes, even though you do not have the symptoms, EBV can be active in your system and you can transmit it to others. So if you have had mono in the recent past, be cautious in swapping saliva, even if you no longer have the symptoms. Fever reducer can also be taken to relieve the fever, but no other medication is used for the treatment of mononucleosis. In very serious cases, corticosteroids can be used to decrease swelling in the spleen or throat if they become a problem. It is also important to refrain form any strenuous activity or contact sports because the spleen is enlarged and very sensitive during mono.If these measures are met, then the symptoms of mono should decrease and go away after a month or two. If not, a doctor's consultation is advised. So basically, there is no official treatment other then to take care of your body and wait it out.

In order to prevent the further spread of mono, it is recommended not to share utensils, water, or any other methods of saliva transmission with others. Always keep your hands clean and wash them before and after each meal. In general, however, there is no official prevention programs for mononucleosis in the community because the mortality rates are virtually non existent and the symptoms eventually go away. However, I feel that it would be much more beneficial to our young community if a program was set in place to aid in the prevention of mono.

I feel that mononucleosis should be further investigated in order to develop a more concise and efficient means of treatment. It would help if there was a steroid or medication that could help in ridding the body of the virus so that future spread of the disease was decreased. I also think that the issue should be more public. Those with the disease should be more open about the fact that they have it and warn those who they come in contact with. Those who have had mono should also definitely not donate blood. I really think it is in the responsibility of those who have the disease to prevent their part in further spread of mono. Those who do not have it should be very cautious against sharing water bottles, food, tissues, or any other things that contain foreign saliva or bodily fluids. In conclusion, I believe that mononucleosis should be further explored and made more public in order to have a more efficient means in preventing the further transmission of the disease that affects so many young people today.

Mono...What's the Big Deal?

Most people know the illness Infectious Mononucleosis, or its nickname Mono, as the kissing disease that leaves you feverish and tired for weeks. It is very common in teenagers and young adults, affecting millions in the US alone. Everyone in their teens and twenties either was personally affected or knew of someone who was affected by Mono. It affects about 50% of the US teenage population alone. Its symptoms was first recognized in the late 1800s by Russian pediatrician Nil Filatov and later by a German pediatrician, Emil Pfeiffer. Pfeiffer discovered discovered familial clusters with common symptoms of fever, fatigue, and swollen glands. Mononucleosis as a classified disease was not published until 1920 by Thomas Sprunt and Frank Evans at Johns Hopkins. It's link with the Epstein- Barr Virus was not discovered until 1967 at the Children's Hospital of Pennsylvania by the Henles.

But what exactly causes Mononucleosis? That was discovered in 1967 with the association of the Epstein- Barr Virus to the disease. EBV is one of the most commonly spread viruses in humans, and usually is spread through saliva. In more rare cases, EBV can be spread through other bodily fluids, such as mucus, tears, vaginal secretion, or even blood. EBV especially affects the B lymphocytes in your glands, resulting in swelling. The B cells can spread the disease to all parts of the body, mostly including the spleen, liver, and bodily lymph nodes.

Mononucleosis is the most common disease that is a result of the Epstein-Barr virus. Its most common symptoms include sore throat, fever, swollen lymph nodes or glands on the neck, and fatigue. In more severe cases, body aches, especially in he upper left quadrant of the abdomen, which is a result of an enlarged spleen. There could be an increased risk in rupturing the spleen during mono due to its larger size, and so rigorous activity is advised against. If you take antibiotics for mono, sometimes rashes can occur. In general, these symptoms may last four to eight weeks.

Obviously, if you feel that you have a lot of these symptoms, it would be advised to call a doctor to get diagnosed. There are mononucleosis tests, including a monospot test and EBV test, that screen for antibodies present when mono or  EBV is in the body. Blood clumping in a monospot test indicates the antibody heterophil is present, and so mononucleosis is in the body. A complete blood count may also be done to rule out more serious illnesses such as sickle cell when diagnosing mono. Less common diagnosing tests include liver tests to test if mono has spread to the liver. It is most important to know that if you have any or multiple of these symptoms, talking to a doctor sooner rather than later is highly beneficial to you as well as those you could affect.

http://www.digherbs.com/mononucleosis.html