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Published on: March 30, 2018
Acute and chronic symptoms of mononucleosis
S Lambore1, J McSherry, A S Kraus
1Student Health Service, Queen's University, Kingston, Canada.
Insights
Infectious mononucleosis (IM) causes prolonged illness and significant morbidity in students compared to other upper respiratory infections. Symptoms like fatigue and neck swelling are more severe and last longer, impacting student health.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Clinical presentation and illness duration of infectious mononucleosis (IM) are not well-documented.
- Variability in IM symptoms and recovery times necessitates further investigation.
Purpose of the Study:
- To compare the clinical symptoms and durations of illness in students diagnosed with IM versus those with other upper respiratory tract infections (URIs).
- To quantify the morbidity associated with IM in a student population.
Main Methods:
- A survey of university students diagnosed with IM between 1985 and 1988.
- Comparison of health experiences during acute and convalescent phases of IM with a matched control group suffering from non-Epstein-Barr virus (EBV)-induced URIs.
Main Results:
- Students with IM experienced significantly longer and more severe illness compared to those with non-EBV URIs.
- Acute IM symptoms included higher rates of fatigue, night sweats, and neck swelling.
- Post-acute symptoms such as easy fatigability, diurnal somnolence, and depression were more common in IM patients, with some experiencing prolonged symptoms beyond 100 days or a year.
Conclusions:
- Infectious mononucleosis leads to substantial morbidity in students, affecting both acute and post-acute phases of infection.
- IM imposes a greater health burden on students than other common URIs.
Background:
The clinical symptoms and durations of illness of patients with infectious mononucleosis (IM) are variable and are poorly documented in the scientific literature.
Methods:
Patients who presented for care at the Student Health Service of a Canadian university between September 1985 and May 1988 and had been diagnosed as having IM were surveyed. Health experience during the acute and convalescent phases of IM was compared with that of a group of patients matched for age, sex, date of diagnosis, and year of study, who had suffered acute upper respiratory tract infections (URI), other than Epstein-Barr virus (EBV)-induced, during the same period.
Results:
Students were sicker for longer after IM than after non-EBV-induced URI. During the acute phase of illness, the symptoms of fatigue (P = less than .000001), night sweats (P = .000001), and painful neck swelling (P = .00003) were seen significantly more often in the IM group. The severity and duration of these symptoms were also significantly worse in IM patients. Getting tired easily (P = .002), diurnal somnolence (P = .002), and depression (P = .002) were significantly more common postacute symptoms. Eleven percent of IM patients reported persistence of symptoms longer than 100 days, and in 6% of patients the symptoms had persisted after 1 year. Convalescent cases showed a trend toward reduced alcohol intake and, perhaps, reduced alcohol tolerance.
Conclusions:
IM involves excessive morbidity in a student community compared with URI that was other than EBV-induced, during both the acute and the postacute phases of infection.
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