Mononucleosis risk factors: Difference between revisions
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==High-risk population== | ==High-risk population== | ||
===By Epidemiology=== | |||
*In underdeveloped countries, almost everyone is exposed to [[EBV|ebstein barr virus]] at a very young age; hence, mononucleosis exists mostly in developed countries. | |||
===By Age=== | |||
*'''''Infants''''' become susceptible to [[EBV]] as soon as [[antibody|maternal antibody protection]] which is present at birth starts to disappears. | *'''''Infants''''' become susceptible to [[EBV]] as soon as [[antibody|maternal antibody protection]] which is present at birth starts to disappears. | ||
*'''''Children''''' if infected with [[EBV]] usually remain asymptomatic and hence are indistinguishable from the other mild, brief illnesses of childhood. However, when the infection occurs during adolescence or young adulthood, it causes acute infectious mononucleosis 35% to 50% of the time. | *'''''Children''''' if infected with [[EBV]] usually remain asymptomatic and hence are indistinguishable from the other mild, brief illnesses of childhood. However, when the infection occurs during adolescence or young adulthood, it causes acute infectious mononucleosis 35% to 50% of the time. | ||
*Among '''''adults''''', increased risk of acquiring mononucleosis is observed among: | *Among '''''adults''''', increased risk of acquiring mononucleosis is observed among: | ||
:*adolescents and young adults | :*adolescents and young adults | ||
:*patients who have intimate contact with the saliva of an infected person | :*patients who have intimate contact with the saliva of an infected person | ||
===By Immune system status=== | |||
*Any condition that '''''weakens the immune system''''' is a predisposing factor for the development of mononucleosis secondary to [[EBV|EBV infection]] | |||
*For example: | |||
:*[[Diabetes]] | |||
:*Following solid organ transplant | |||
:*[[Chemotherapy]] | |||
:*[[HIV]] | |||
==References== | ==References== | ||
Revision as of 20:35, 29 February 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]
Overview
Majority of the population become infected with EBV at sometime during their lives with an estimated 90%-95% of adults demonstrating seropositivity by 21 years of age. Therefore, even individuals exposed to infected contacts have shown to be previously infected with EBV and hence are not at risk for the manifestation of mononucleosis.
However, once infected, the patient carries the virus for the rest of their life with the virus typically residing dormantly in the B lymphocytes. Independent infections of mononucleosis may be contracted multiple times, regardless of whether the patient is already carrying the virus dormantly.
Periodic reactivation of the virus may occur, during which time the patient is again infectious, but usually without any symptoms of illness. Therefore, in susceptible hosts under the appropriate environmental stressors, reactivation of the virus occurs to cause vague subclinical symptoms or remain mostly asymptomatic and diagnosed only by a positive serologic response. However, its imperative to note that during this phase the virus can spread to others.
High-risk population
By Epidemiology
- In underdeveloped countries, almost everyone is exposed to ebstein barr virus at a very young age; hence, mononucleosis exists mostly in developed countries.
By Age
- Infants become susceptible to EBV as soon as maternal antibody protection which is present at birth starts to disappears.
- Children if infected with EBV usually remain asymptomatic and hence are indistinguishable from the other mild, brief illnesses of childhood. However, when the infection occurs during adolescence or young adulthood, it causes acute infectious mononucleosis 35% to 50% of the time.
- Among adults, increased risk of acquiring mononucleosis is observed among:
- adolescents and young adults
- patients who have intimate contact with the saliva of an infected person
By Immune system status
- Any condition that weakens the immune system is a predisposing factor for the development of mononucleosis secondary to EBV infection
- For example:
- Diabetes
- Following solid organ transplant
- Chemotherapy
- HIV