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VIII.71 - Infectious Mononucleosis

from Part VIII - Major Human Diseases Past and Present

Published online by Cambridge University Press:  28 March 2008

Kenneth F. Kiple
Affiliation:
Bowling Green State University, Ohio
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Summary

Infectious mononucleosis is an acute infectious disease of children, adolescents, and young adults. It is caused by the Epstein–Barr virus (EB virus) and is followed by lifelong immunity.

Distribution and Incidence

On the basis of the populations investigated, it would seem that infectious mononucleosis occurs worldwide but attacks only those persons who have had no EBV antibodies. The virus replicates in the salivary glands, is present in the oropharyngeal secretions of patients ill with the disease, and continues to be shed for months following convalescence. As a lifelong inhabitant of the lymphoid tissues, it is excreted intermittently into the oropharynx.

In the underdeveloped countries it is a disease of childhood, and, since it spreads by contact with oral secretions, crowding and unhygienic surroundings favor its ready transmission. In more developed countries, it strikes especially those of the 15- to 25-year age group and is recognized clinically as infectious mononucleosis. In the United States, on college campuses, the disease is commonly known as the “kissing disease.”

Children of low socioeconomic state almost universally show antibodies to the virus. (In Ghana, 84 percent of infants have acquired antibodies by age 21 months.) In a worldwide prospective study of 5,000 children and young adults without EB virus antibodies, 29 percent developed antibodies within a period of 4 to 8 years. Among susceptible college students the annual incidence of the disease is about 15 percent.

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Publisher: Cambridge University Press
Print publication year: 1993

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References

Davidsohn, I., and Walker, P. H.. 1935. Nature of heterophile antibodies in infectious mononucleosis. American Journal of Clinical Pathology 5.CrossRefGoogle Scholar
Downey, H., and McKinly, C. A.. 1923. Acute lymphadenosis compared with acute lymphatic leukemia. Archives of Internal Medicine 2.Google Scholar
Epstein, M.A., and Achong, B. G.. 1977. Pathogenesis of infectious mononucleosis. Lancet 2.Google ScholarPubMed
Henle, W., and Henle, G.. 1979. The virus as the etiologic agent of infectious mononucleosis. In Epstein–Barr virus ed. Epstein, B. G. and Achong, B. G., New York.Google ScholarPubMed
Henle, W., and Henle, G.. 1981. Clinical spectrum of Epstein-Barr\ virus infection. In The human herpesviruses: An interdisciplinary perspective ed. Nahmias, Andre J., Dowdle, Walter R., and Schinazi, Raymond F.. New York.Google Scholar
Niederman, James C. 1982. Infectious mononucleosis. In Cecil’s textbook of medicine ed. Wyngaarden, James B. and Smith, Lloys H. Jr. Philadelphia.Google Scholar
Paul, John R., and Bunnell, Walls W.. 1932. Presence of heterophile antibodies in infectious mononucleosis. American Journal of Medical Science 183.CrossRefGoogle Scholar
Pfeifer, Emil. 1889. Drüsenfieber. Jahrbuch Kinderheilkunde 29:257–64.Google Scholar
Sprunt, Thomas, and Evans, Frank A.. 1920. Mononucleosis leucocytosis in reaction to acute infections (“infectious mononucleosis”). Bulletin of Johns Hopkins Hospital 31: 410–17.Google Scholar
Strauss, Stephen E. 1987. Editorial–EB or not EB – that is the question. Journal of American Medical Association 257.Google Scholar

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