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Short Paper 1: A Look at Mononucleosis
Elizabeth Jeitner
May 5, 2014
Abstract: An overview of mononucleosis is covered such as the definition, cause, common
symptoms, and treatment. Relevant statistics are also provided to give insight into the prevalence
of this illness as well as its burden on society. Mononucleosis most commonly affects
adolescents and young adults. Because of this fact, an example case study which focuses on a 20
year old college male is also available in this document. The purpose of this assignment was to
build one’s ability to review professional medical research as well as accurately inform
individuals about the health issue. I was fulfilling Short Paper 1. The purpose of the writing is to
fulfill course requirements for BBH 411W and to stand as a personal writing sample, but the
findings should not be treated as generalizable research.
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Elizabeth Jeitner
Dr. Joe Gyekis
BBH 411W: Research Applications in Biobehavioral Health
23 February 2015
Short Paper #1
Mononucleosis, more commonly referred to as mono, is caused by the Epstein-Barr virus
(PubMed Health, 2014). It is also called the “kissing disease” because the virus is primarily
transmitted through saliva. Modes of transmission include kissing, coughing or sneezing, and
sharing a glass or utensils with an infected individual (Mayo Clinic, 2012). Transmission of
mononucleosis is not as rapid or aggressive as most infections, such as strep throat yet it is very
contagious (Mayo Clinic, 2012). The symptoms of this disease include sore throat, fever, fatigue,
loss of appetite, and swollen glands in the neck (Stoppler, 2014). Another common and
dangerous symptom of this infection is a swollen spleen, sensed by pain in the upper left part of
the abdomen. This is an important symptom which requires medical attention as to not lead to
further complication such as a rupture. Although the symptoms are straight-forward, an infected
individual may not know they have mononucleosis for weeks due to the long incubation period
of four to eight weeks (Stoppler, 2014). In order to diagnose mononucleosis, blood tests are
required, specifically the monospot and heterophile antibody test (Stoppler, 2014). Most times,
physicians are able to identify the disease by the symptoms alone.
Although 95% of adults in the United States have contracted the Epstein-Barr virus by
ages 35 to 40, only about 35-50% of individuals will develop symptoms after infection (Sayre,
2009). In those 35-50% of infected individuals who contract mononucleosis, there are
contributing factors which make them more susceptible. Age is a primary influence. Most cases
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of infectious mononucleosis occur in the 15-24 age group, which the peak of infection at 15-17
years of age (Stoppler, 2014). Their symptoms during young adulthood are also more severe in
regards to fatigue and other symptoms (Sayre, 2009). This age group is at risk for contraction of
mononucleosis because individuals in this cohort are more likely to be sexually active, with more
than one partner. This increases the exchange of saliva between an infected patient and virus-free
individual. Also, during this time of life, students focus more on academic success than personal
health and hygiene. The majority of college students live in close quarters, such as fraternity
houses, dormitories, and apartments where the viral infection is able to spread with ease. The
same reasons apply to those with lower socioeconomic status. Low-income housing increases
crowding as well as decreases sanitation in many cities and regions. With crowding and tight
living situations, hygiene is less accessible which places individuals at risk. It was also seen that
the youngest child in a family is least susceptible to contraction of mononucleosis, possibly due
to exposure at a younger age (Rostgaard, et. al., 2014).
A 20 year old male has just transferred into Penn State University Park his junior year.
Until now, he has lived spaciously with his parents in a three bedroom home. This individual
commuted to a branch campus and had little to no social life. He is the oldest sibling. During the
week of midterms during fall semester, he began to experience cold-like symptoms. The patient
was having a severe sore throat along with swollen glands. He reported a loss of appetite as well
as extreme exhaustion. This was stated as “no energy to wake up in the morning or attend
classes.” The patient also feels pain and tenderness in the upper left abdomen during rigorous
exercise at the gym. In conjunction, he stated that now he lives in a fraternity house, sharing a
room with three other males. The patient reports lack of sanitation in reference to cups and
utensils in the household as well as tight living quarters. A recent romantic partner was
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diagnosed with mononucleosis three months prior to the emergence of his symptoms. He has
also reported several other recent romantic experiences, which involved exchange of saliva. With
his new freedom of living on his own, he has found little time for self-care. The individual has a
heavy course load and is actively involved in his fraternity as well as the community of Penn
State. A monospot test as well as physician diagnosis confirmed presence of infectious
mononucleosis.
In regards to prognosis, 99.9% of patients will get better over time (Sayre, 2009). The
disease is typically nonfatal, except in cases which involved splenic ruptures. Once you contract
mononucleosis, the virus stays with you forever, yet you will not show the symptoms again. This
is because the body builds up antibodies after initial infection with the Epstein-Barr virus.
Swollen glands heal in about 4 weeks, while tiredness may linger as long as 4 months (PubMed
Health, 2015). Over time, the disease will go away on its own. Treatment focuses on supportive
care such as bed rest and plenty of fluids (Mayo Clinic, 2012). Ibuprofen or acetaminophen
would be used in this patient’s case in order to alleviate some of the minor symptoms which
cause discomfort (Stoppler, 2014). This individual may dislike their current quality of life
because those with mononucleosis are unproductive in their daily lives. Classes may need to be
missed as well as an increase in the inability to fulfill academic and social responsibilities.
Changes in lifestyle, in the past, may have allowed this patient to avoid contraction of infectious
mononucleosis; yet future changes will not have an impact on future encounters with this disease
since it can only be experienced once in the majority of cases. In order to recuperate, changes in
behavior may include avoidance of physical activity. If this change is not made, splenic rupture
may occur which, if not surgically treated in a timely manner, could lead to death (Stoppler,
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2014). Self-care as well as hygiene are also important so other infections are not contracted while
the immune system is weakened.
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References
Mikirova N, Hunninghake R. Effect of high dose vitamin C on Epstein-Barr viral infection. Med
Sci Monit. 2014;20:725–732.
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"Mononucleosis." Mayo Clinic. Mayo Foundation for Medical Education and Research, 19 Dec.
2012. Web. 01 October 2014. <http://www.mayoclinic.org/diseasesconditions/mononucleosis/basics/definition/con-20021164>
"Mononucleosis." PubMed Health. Ed. Jatin M. Vyas. U.S. National Library of Medicine, 2014.
Web. 20 Feb. 2015. <http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001617>
Rostgaard, K., and T.R. Nielson. "Sibship Structure and Risk of Infectious Mononucleosis: A
Population-based Cohort Study." National Center for Biotechnology Information. U.S.
National Library of Medicine, Oct. 2014. Web. 20 Feb. 2015.
Sayre, Carolyn. "Students Still Getting Mono After All These Years." The New York Times. The
New Yorks Time Company, 21 Jan. 2009. Web. 30 September 2014.
<http://www.nytimes.com/ref/health/healthguide/esn-mono-ess.html>
Stoppler, Melissa C. "Mono (Infectious Mononucleosis)." MedicineNet. N.p., n.d. Web. 28
September 2014. <http://www.medicinenet.com/infectious_mononucleosis/page2.htm>