Talk:Infectious mononucleosis/Archive 1

Stupid Article

I still don't know what mono is. It seems like it is written for a doctor to read. —Preceding unsigned comment added by Ikram.The.Muslim.Iraqi.Kurdish.Guy (talk • contribs) 16:02, 11 June 2008 (UTC)

The article is pretty good actually. Mono is a virus. You'll be sick for quite a while. It will go dormant. You may or may not relapse. If you live in a developed country you won't die. The end. Though the part about transmission is kinda shaky. —Preceding unsigned comment added by 24.155.209.17 (talk) 20:32, 16 July 2008 (UTC)

Video on Glandular Fever

• Glandular Fever Video

202.59.91.145 13:51, 31 July 2007 (UTC) i just want to clarify that is there any way to cure or treat the mononucleosis in a short time. my doctors are giving me medicine and are keeping me in the shadow,,means that they are not telling me about the severity of this desease,and i want to know that can it spread with cough or living constantly in an AC room202.59.91.145 13:51, 31 July 2007 (UTC)

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?

--user:Zashaw

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)

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)

Re: Relapse rate: I have mono right now.. My doctor said: "Once you get mono you can never get it again". So I Was a little confused when I read this..

Re: Relapse rate: I had a severe bout of Mono 7 years ago and I have relapsed twice. These reoccuring episodes for me are a milder form of the original.

RE: relapse rate: I too have had several relapses of mono over the years. When I had it as a child, I was 10 years old. I then had Epstein-Barr when I was 23 and mono when I was 36. I think I have it again now at the age of 38. Susie 209.250.12.15 16:25, 8 July 2007 (UTC)

Re: I had mono in 1999, this past April 2007, and now I have it again in September 2007. I believe that stress is a huge factor in relapse rate. Before the April episode my husband and I were having a lot of problems and now I am in med school so stress levels have been through the roof! —Preceding unsigned comment added by 68.94.7.185 (talk) 23:26, 25 September 2007 (UTC)

RE: Relapse rate. I had mono in 1997, not too bad, I missed a week of work, had felt run down a bit for a few months prior. Got it again in July 2007 and it kicked my butt. I was basically out of comission for about 3 weeks. Sore, couldn't eat, fevers. Also, I contest the statement of if not being airborne. Someone in the building had it before me and I never even see tHat person even in passing, let alone sharing any kisses, drinks, or anything else with them. Then after I had it, someone else in my Dept got it too. —Preceding unsigned comment added by 208.44.39.130 (talk) 21:33, 13 November 2007 (UTC)

RE: Hey, thought this might be of help to people. in Nov. 2007, I went to my Dr. because I had been diagnosed with Mono in June '07, but was still tired. My Dr. said that I had not relapsed, but STILL have it! i had strep throat 3 times in 2006, and the 3rd time i had it, the treating dr. said that if we didn't get rid of it, it could cause Mono, which obviously happened, because i have had no contact with any infected people in the last 2 years. so, if ayyone is afraid of it being airborn, be advised that it can be caused by bacterial infections, AND it can last longer than 2 months! looking back, i wish i had chosen to have my tonsils removed to avoid infection! —Preceding unsigned comment added by Redskittle (talk • contribs) 07:59, 7 January 2008 (UTC)

I am on my 4th round with Mono once in college once after my second born once during my divorce in o4 and now again. I think doctors are missing something the reoccuring mono is different but they dont know how or why. The tiredness takes a year to get over but the achy areas are growning first time just my neck and throat second time lost a lot of weight and got a heart arithymia third time extreemly exausted, this time every joint and muscle hurts. I can't help but think their has to be something out their to help us from getting sick again. If you know email me <details removed> —Preceding unsigned comment added by 68.3.228.133 (talk) 22:50, 2 November 2008 (UTC)

We cannot offer medical advice. Please speak to your doctor. —Cyclonenim (talk · contribs · email) 23:05, 2 November 2008 (UTC)

RE: Hey, I had Mono when I was in grade 4 and missed a lot of school and was quite sick. I was showing the same symptoms in grade 7 but was told by a doctor that once you have it, you never get it again. My mom insisted that I was tested and guess what! I had it again! I'm now 29 and still have problems with tiredness..... —Preceding unsigned comment added by 58.170.117.245 (talk) 07:50, 22 April 2008 (UTC)

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 help needed

Good morning!(02:45 GMT-5) :) I'm sorry for putting this here, but I didn't know where else to put it. This article seems to have a lot of contradiction about the link between CFS and mononucleosis, but I don't feel qualified to clean it up. I just thought somebody should know. 97.96.81.245 06:47, 11 August 2007 (UTC)

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)

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

How many "subtypes" of the virus are identified ?

213.6.141.37 21:13, 17 December 2005 (UTC)

i know about at least two strains, american and african, having bit different course of infection and symptoms. this virus have no code allowing it to protect and verify it's own code (thus have oncogenic properties aswell) so perhaps new strains are created everyday . Curious666 09:46, 20 April 2007 (UTC)

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)

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)

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)

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?

simular question; How long after a person is done with the symtons will that person be able to transmit it onto others?? —Preceding unsigned comment added by 87.51.144.248 (talk) 19:35, 27 May 2008 (UTC)

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)

Briget said thanks for the mono

i dont have mono

oh then the message was i gave you mono

..ok my girl friend has mono..and i was wondering...can u get mono from oral sex? Trav69 06:14, 10 April 2007 (UTC)Trav69

Yeah, I was wondering the same thing. The fact that it can be transmitted through the saliva and blood would lead one to think that it would also be transmitted through bodily fluids, but that might not be the case. I'd just go through with it and pray beforehand, hahah. -- Guitarmankev1^(TALK) 04:08, 6 May 2007 (UTC)

Given that apparently the virus can be transmitted through, essentially, mucus membrane contact, and that both the important genital areas and the interior cheek are mucus membranes... Yes. EBV would be transmitted through oral sex. Nevah 00:03, 26 July 2007 (UTC)

Oncogenic properties

why oncogenic properties of EBV are not listed? the virus is known to cause i.e. Burkitt lymphoma and Hodgin's lymphoma, among many others (new ones added recently to polish wiki page about infecteous mononucleosis)

Curious666 09:40, 20 April 2007 (UTC)

Because this is not a page about the EBV; it's a page about a disease caused by EBV.

90.211.184.167 (talk) 21:25, 4 April 2008 (UTC)

Treatment and alcohol

When I had mononucleosis, I was told by the doctor to prevent any intake of alcohol, since even small portions could damage the liver. Any sources about that? Apus 09:23, 24 May 2007 (UTC)

I'm having one right now, but nobody said me not to drink... —Preceding unsigned comment added by 80.186.238.164 (talk) 15:13, 6 December 2007 (UTC)

I had mono some time ago. About 5 weeks after being diagnosed I finally felt better and went to a party. There I only had 3 beers (maybe 600 ml) in a couple of hours, and already my body couldn't take it: I got very sick, had to barf, and my skin and eyes got yellow again. Because of this I also got very tired again for more than a month. My doctor never said anything about alcohol, I wish she did. I'm not a MD (yet) so don't take my word for it. But please ask it to your doctor, and be careful! —Preceding unsigned comment added by 81.71.131.28 (talk) 21:29, 26 October 2008 (UTC)

How easily does it spread

I just moved here and this is my last year of high school. Kids were talking about last year about 20 or 30 people in the school got mono and it started because the cafateria staff wasn't cleaning the trays (we use plastic food trays, very eco-freindly school and all that)and it was being spread through saliva. Is it even possible to spread mono by sharing food trays and plates. FinalWish 15:38, 16 September 2007 (UTC)

If saliva manages to get on the trays/plates, then yes, it can spread. Rostu23 (talk) 04:35, 24 July 2008 (UTC)

Mono

At what period is the person who has a severe case of mono is contagious to others? Also, at what point should they be allowed to return to school or work? —Preceding unsigned comment added by 24.141.30.79 (talk) 00:32, 14 October 2007 (UTC)

Wikipedia is most definitely the last place you should look for medical help. Consult your Physician or Nurse Practitioner

McMundy (talk) 00:35, 29 May 2008 (UTC)

Contradiction in the summary

The summary says "Around 90% of people will acquire the virus even if they exhibit no symptoms. Most of the time subjects show symptoms." Bit of a contradiction there, so which is it? —Preceding unsigned comment added by Zaylea (talk • contribs) 02:50, 24 January 2008 (UTC)

Anecdotes

I moved this piece from the article:

Some patients anecdotally report that chronic fatigue lasting for years after mono is part of a CFS, which, however doesn't prove anything This confusion seems to lie in the nature of the link (note any association does not prove or disprove causality) and possible misapprehension as to the syndromic nature of CFS.

I don't think it's a good idea to fill the article with anecdotes, since there are scientific studies available. Mikael Häggström (talk) 19:37, 10 February 2008 (UTC)

spreading

Can the virus spread while the person shows no symptoms or while they are not effected, or can it only spread while they are suffering from the the disease it self.

The other day in class I used my friends water to take a tylenol, I didn't touch the actual bottle to my lips but I lifted it up and drank, I doubt that makes a difference, but thought I'd give all info.

anyway I took the tylenol then about 3 or 4 days later he found out he had it, think it spread to me?

Thank you.

Mono IS indeed contagious at that stage, but overall is much less contagious than commonly thought. Don't worry about this MINIMAL exposure. Sfahey (talk) 04:13, 1 March 2008 (UTC)

Home Bias?

From the article: "...commonly known as glandular fever in other English-speaking countries.". What does that mean "other English-speaking countries"? Other opposed to what? Whoever wrote this seems to be under the impression that wikipedia.org is the domain of his or her country. It isn't. So please change it to "..in countries other than the US" or "...in countries other than the UK" or whatever is right. —Preceding unsigned comment added by Asdirk (talk • contribs) 08:46, 27 April 2008 (UTC)

Paul Bunnell test

Paul Bunnell test redirects here, but is not mentioned. --Ged3000 (talk) 18:53, 20 May 2008 (UTC)

ref --Ged3000 (talk) 18:56, 20 May 2008 (UTC)

disputed?

Somebody just changed "Individuals in close living arrangements nearly always pass the infection on to each other, although symptoms may not present for months or even years" to "Individuals in close living arrangements rarely pass the infection on to each other, although symptoms may not present for months or even years. Generally Mono is not spread within households because the only way to spread mono is through direct saliva contact." Which of these is correct? Either way, please provide a citation to a reliable source. 69.140.152.55 (talk) 01:33, 30 May 2008 (UTC)

I changed it, and I just had it so I had plenty of talks with my doctor about spreading it to everyone else in my house. I forgot to include verification, Kaiser Website Regarding mononucleosis

It says there, "You can live in the same house with a person who has mono and never become infected with the virus." also, "Epstein-Barr virus (EBV)...is not spread by casual contact."

Sorry for any inconvenience this may have caused that it didn't have verification. —Preceding unsigned comment added by 76.192.51.116 (talk) 03:45, 30 May 2008 (UTC)

I suspect that you have misinterpreted Kaiser's meaning. I think it's clear that they mean "it is possible to live in the same household and not be infected", but the very same article you quote goes on to say "You can get EBV if you share a drinking glass or eating utensils with an infected person (through sharing saliva)." Further, according to the Mayo Clinic Website: "The virus that causes this disease is transmitted through saliva, so kissing can spread the virus, but so can coughing, sneezing, or sharing a glass or food utensil. Mononucleosis isn't as contagious as some other infections, such as the common cold." Based on the fact that highly credible published sources show that casual transmission does occur, I am inclined to strike or reword the sentences in question in the main article. Mroesler (talk) 02:45, 2 June 2008 (UTC)

If the incubation period for IM is between one and two months, then it doesn't make sense to have a sentence like: "...although symptoms may not present for months or even years." Years? —Preceding unsigned comment added by 75.181.131.36 (talk) 22:26, 26 June 2008 (UTC)

Watch the 13th episode of the 7th series of "Malcolm in the middle" Lois (The mother) gets the disease and gives it to Malcolm and the two have to share a bedroom till they get better! Not helpful to the article I know but very funny!! —Preceding unsigned comment added by 90.207.137.35 (talk) 10:16, 12 July 2008 (UTC)

When I had IM recently, my doctor said it rarely goes from sibling to sibling. It's definitely not "nearly always". Rostu23 (talk) 04:39, 24 July 2008 (UTC)