mononucleosis is caused by a pathogen abbreviated as

Unpublished observations). Gu SY, Huang TM, Ruan L, Miao YH, Lu H, Chu CM, Motz M, Wolf H. First EBV vaccine trial in humans using recombinant vaccinia virus expressing the major membrane antigen. Complications during acute primary EBV infection. Leskowitz R, Fogg MH, Zhou XY, Kaur A, Silveira EL, Villinger F, Lieberman PM, Wang F, Ertl HC. Epstein-Barr is the virus that causes mononucleosis. Once infected, your body retains the virus for life. 2007; Merlo et al. Mice are bred onto a transgenic HLA background. You might know this disease better by its nickname, "mono." It's also called the " kissing disease" because of one way you can spread it to. 2013). 2009). The first is the abrupt onset of sore throat, which many patients say is the worst sore throat they have ever had. Though not a model of infection with a great deal of similarity to infectious mononucleosis, rabbits may still provide interesting insight with regard to the kinetics and magnitude of antibody responses to EBV, which has implications for the development and testing of humoral component vaccines such as the gp350 subunit vaccine. 1984). 2001). A CD8+ T cell peptide epitope vaccine was effective in generating EBV specific CD8+ T cell responses, and there was no incidence of infectious mononucleosis in the vaccinated group, although the study was small (Burrows et al. Mononucleosis (Mono/Kissing Disease): Symptoms, Causes, and 2013). Kristin A. Hogquist, Center for Immunology, University of Minnesota, Minneapolis, MN 55455. How preadolescents acquire the virus is not known. Specific deletion of subsets of NK cells could then be performed to examine which were most important during the response to primary EBV infection. Clinical features of primary EBV infections in 72 undergraduate students studied prospectively (48 women, 24 men; age range, 1822 years). Epstein-Barr Virus and Infectious Mononucleosis. government site. Primary infection with the Epstein-Barr virus and risk of multiple sclerosis. 2014). Crawford DH, Macsween KF, Higgins CD, Thomas R, McAulay K, Williams H, Harrison N, Reid S, Conacher M, Douglas J, Swerdlow AJ. Strautins K, Tschochner M, James I, Choo L, Dunn DS, Pedrini M, Kermode A, Carroll W, Nolan D. Combining HLA-DR risk alleles and anti-Epstein-Barr virus antibody profiles to stratify multiple sclerosis risk. Infectious mononucleosis is medically important because of the severity and duration of the acute illness and also because of its long-term consequences especially the development of certain cancers and autoimmune disorders. 2014). Furthermore, MS in EBV negative individuals occurs very infrequently (Levin et al. The germs that cause tuberculosis are a type of bacteria. 2014). However, NKG2C+ NK cells do no expand upon EBV infection (Hendricks et al. What Are the Stages of Mono? How Long Do They Last? Soluble rhesus lymphocryptovirus gp350 protects against infection and reduces viral loads in animals that become infected with virus after challenge. 1998), maternal education (Figueira-Silva and Pereira 2004), day care attendance (Hesse et al. Elegheert J, Bracke N, Pouliot P, Gutsche I, Shkumatov AV, Tarbouriech N, Verstraete K, Bekaert A, Burmeister WP, Svergun DI, Lambrecht BN, Vergauwen B, Savvides SN. Although this virus was discovered more than 50 years ago and infects more than 90% of the worldwide population, there are large gaps in our knowledge of its epidemiology and pathogenesis. Parenthetically, anterior and posterior cervical nodes are usually equally enlarged. Mononucleosis is an infectious illness that's usually caused by the Epstein-Barr virus ( EBV ). Mono is sometimes called the "kissing disease" because it is spread through saliva. During the convalescent period of infectious mononucleosis (3 to 6 months postinfection), the number of CD8+ T cells declines to normal levels (Balfour et al. This theory is supported by the incidence of infectious mononucleosis in family groups. Interestingly, the difference in antibody prevalence between whites and non-whites diminished during the teenage years. 2003). On the dynamics of acute EBV infection and the pathogenesis of infectious mononucleosis. We now know that the characteristic atypical lymphocytes, carefully described morphologically by Downey and McKinlay, 2 . Because of this, the presence of EBNA-1 antibodies during an acute illness rules out primary EBV infection. Prevalence of Epstein-Barr virus antibodies in healthy children and adolescents in Vitoria, State of Espirito Santo, Brazil. Strowig T, Chijioke O, Carrega P, Arrey F, Meixlsperger S, Ramer PC, Ferlazzo G, Munz C. Human NK cells of mice with reconstituted human immune system components require preactivation to acquire functional competence. False positive heterophile tests have been reported in a myriad of conditions including other acute infections, autoimmune disease, and cancer (Sadoff and Goldsmith 1971; Phillips 1972; Horwitz et al. Infectious mononucleosis. More recently, Leskowitz and colleagues showed that an adenovirus based vaccine encoding LCV EBNA-1 induced expansion of CD4+ and CD8+ T cells specific for EBNA-1 in rhesus macaques with natural persistent LCV infection (Leskowitz et al. Other findings, seen in fewer than 20% of cases in our experience, include abdominal pain, hepatomegaly, splenomegaly, nausea, vomiting, palatal petechiae, periorbital and eyelid edema, and rash. 2010). 2008; Okuno et al. Most animals had only transient levels of virus detectable in the blood, but two had consistent viral titers. Class II MHC is also required for viral entry into the cell, although whether or not there are alterations in viral entry efficiency between HLAs prevalent in different racial groups has not been explored. Report of five cases with four--six-year follow-up data. You can get it through kissing, but you can also be exposed by sharing a glass or food utensils with someone who has mono. For example, antibodies against EBNA-1 display an unusually long delay between virus acquisition and the presence of anti-EBNA-1 IgG, as it generally appears only after a patient with infectious mononucleosis has convalesced (Henle et al. 2010). Table 3.1 shows the frequency of signs and their median duration in 72 undergraduate students studied prospectively. Hodgkins disease and the Epstein-Barr virus. Another study found that Greenland Eskimo children acquired primary EBV infection at an earlier age and had higher titers of IgG antibody against VCA than age-matched Danish children (Melbye et al. With the advent of common gamma chain (a receptor component for IL-2, 4, 7, 9, 15, and 21) knockouts, engraftment improved dramatically. 2003). Epidemiology of Epstein-Barr virus infection in pre-adolescent children: application of a new salivary method in Edinburgh, Scotland. Holman CJ, Karger AB, Mullan BD, Brundage RC, Balfour HH., Jr Quantitative Epstein-Barr virus shedding and its correlation with the risk of post-transplant lymphoproliferative disorder. Adhikary D, Behrends U, Boerschmann H, Pfunder A, Burdach S, Moosmann A, Witter K, Bornkamm GW, Mautner J. Immunodominance of lytic cycle antigens in Epstein-Barr virus-specific CD4+ T cell preparations for therapy. Bethesda, MD 20894, Web Policies Infectious mononucleosis is a clinical entity characterized by sore throat, cervical lymph node enlargement, fatigue and fever. 1969), solid organ transplantation (Hanto et al. The virus is spread by intimate oral contact among teenagers and young adults. Previous work in mouse suggested that infection with hepesviruses may cause long term changes to the readiness of host immune cells, thus priming them for subsequent bacterial infections (Barton et al. Heterophile tests are relatively inexpensive and easy to perform. Factors clearly related to early acquisition of primary EBV infection include geographic region (reviewed in (Hjalgrim et al. 2006; Levin et al. 2007; Odumade et al. Subclinical hepatitis documented by elevated levels of alanine aminotransferase occurs in approximately 75% of prospectively followed patients and, in some cases (510%), overt hepatitis develops with tender hepatomegaly and jaundice (Balfour et al. Therefore it is possible that the HLA locus influences the response to infection rather than the infection rate per se. EBV has been shown to be the causative agent of about one percent of the worldwide human cancer burden. Splenic rupture is the most feared complication, which has kept many athletes out of competition for weeks. It is important to note that while early antigen IgG titers were maintained, VCA IgG antibodies were transient even when very high quantities of virus were used (Okuno et al. Mononucleosis (mono) is a contagious infection caused by a herpes virus called Epstein-Barr. Careers, Unable to load your collection due to an error. Several instances of B cell tropic CAEBV have also been reported, but these fall into the minority of documented incidences (Schooley et al. 1997). Unpublished observations). 2013) and in the peripheral blood during acute infection (Hendricks et al. EBV-specific antibody profiles are the best choice for staging EBV infection. Strowig T, Gurer C, Ploss A, Liu YF, Arrey F, Sashihara J, Koo G, Rice CM, Young JW, Chadburn A, Cohen JI, Munz C. Priming of protective T cell responses against virus-induced tumors in mice with human immune system components. An extreme example of this is the very early acquisition of EBV among three distinct Melanesian populations whose infants have multiple caregivers that premasticate the babys food (Lang et al. Hille A, Klein K, Baumler S, Grasser FA, Mueller-Lantzsch N. Expression of Epstein-Barr virus nuclear antigen 1,2A and 2B in the baculovirus expression system: serological evaluation of human antibodies to these proteins. 2013). Dunmire SK, Odumade OA, Porter JL, Reyes-Genere J, Schmeling DO, Bilgic H, Fan D, Baechler EC, Balfour HH, Jr, Hogquist KA. 2007), and race/ethnicity (Balfour et al. Hanto DW, Frizzera G, Purtilo DT, Sakamoto K, Sullivan JL, Saemundsen AK, Klein G, Simmons RL, Najarian JS. HHS Vulnerability Disclosure, Help Morris MC, Edmunds WJ. However, a problem with IgM class antibody tests in general is cross-reactivity with related pathogens. Fever Swollen lymph glands in the neck, armpits, and groin Extreme fatigue Sore throat Enlarged spleen Head and body aches Liver involvement, such as mild liver damage that can cause temporary jaundice, a yellow discoloration of the skin and whites of the eyes due to abnormally high levels of bilirubin (bile pigmentation) in the bloodstream Anaphylaxis In order to determine the spread of Hodgkin disease, the physician would order a (n): lymphangiogram What findings in the laboratory blood study indicate that an acute infection may be present? 2013). Of these two mouse strains, the NSG mouse has more complete reconstitution of the T and NK compartments and could be maintained for 22 weeks with latent virus detectable and without developing tumors or other EBV related pathology (Strowig et al. The seroepidemiology of infection due to Epstein-Barr virus in southern India. Depicted are viral loads in whole blood, saliva, and oral cell pellets (black lines) as well as the relative kinetics of antibodies generated against the EBV antigens p18, p23, BZLF1, p138, and p54 (colored lines). Balfour HH, Jr, Sifakis F, Sliman JA, Knight JA, Schmeling DO, Thomas W. Age-specific prevalence of Epstein-Barr virus infection among individuals aged 619 years in the United States and factors affecting its acquisition. The National Cancer Institute recommended that more clinical trials be conducted to test the safety and efficacy of a vaccine to prevent infectious mononucleosis and cancers caused by EBV (Cohen et al. Impact of gamma-chain cytokines on EBV-specific T cell cultures. 2007). Some peculiar trends exist in the antibody response to EBV. The greatest disparity in antibody prevalence was among the younger children, especially the 6- to 8-year-olds. The virus infects tonsillar epithelial cells as well as B cells in the parenchyma of the tonsil (Wang et al. Although heterophile tests are most commonly used to diagnose infectious mononucleosis, the U.S. Centers for Disease Control and Prevention has recently advised against them for general use because of their non-specificity and the possibility of false negative results especially in young children (Centers for Disease Control and Prevention 2014). Long HM, Chagoury OL, Leese AM, Ryan GB, James E, Morton LT, Abbott RJ, Sabbah S, Kwok W, Rickinson AB. The prevalence of EBV antibodies in preadolescent children is lower, varying from 20% to 80% depending on age and geographic location. Using the NSG mouse and virus obtained from the B95-8 cell line, investigators can now effectively emulate events that occur early during infection in the peripheral blood. 2010; Zhao et al. 2011). In our experience, however, if the clinical picture is typical of infectious mononucleosis and the heterophile antibody test is positive, no additional diagnostic procedures are necessary. Sumaya CV, Henle W, Henle G, Smith MH, LeBlanc D. Seroepidemiologic study of Epstein-Barr virus infections in a rural community. 2011). In total, three prophylactic vaccines have been tested in humans, and although all proved at least moderately immunogenic, none provided sterilizing immunity (Balfour 2014). Gerber P, Walsh JH, Rosenblum EN, Purcell RH. Zhao F, Cannons JL, Dutta M, Griffiths GM, Schwartzberg PL. There may be a cyclic nature to the pattern of infection in the oral cavity as it has been shown in vitro that virus derived from epithelial cells has a much higher entry efficiency for infecting B cells and vice versa, resulting a switched viral tropism depending on the cell type in which the virus replicates (Borza and Hutt-Fletcher 2002). The symptoms of mono are extreme fatigue, fever, sore throat, and swollen lymph nodes. Mononucleosis - StatPearls - NCBI Bookshelf 2013). Raab-Traub N. Epstein-Barr virus in the pathogenesis of NPC. Although the first phase 1 trial for a prophylactic EBV vaccine occurred almost twenty years ago (Gu et al. Takeuchi K, Tanaka-Taya K, Kazuyama Y, Ito YM, Hashimoto S, Fukayama M, Mori S. Prevalence of Epstein-Barr virus in Japan: trends and future prediction. Furthermore, the roles of adaptive immune cells may be examined as well. Less frequently, patients may also present with lymphoma or hemophagocytic disease, a complication of EBV that is discussed in greater detail below (Kimura et al. Studies from Japan have suggested that EBV infection may be modeled in rabbits (Takashima et al. Other factors implicated are socioeconomic status (Henle et al. The gene name of each antigen and the stage of expression (IE: immediate early, E: early, or L: late) are indicated in parentheses. Center for Immunology, University of Minnesota, Minneapolis, MN 55455; Center for Immunology, University of Minnesota, Minneapolis, MN 55455. Wang F. Nonhuman primate models for Epstein-Barr virus infection. While associations between infectious mononucleosis and epithelial carcinomas have not been explored, the presence of EBV in tumors from nasopharyngeal and gastric carcinoma patients is well documented. The median first day of detection was 2 days after onset of illness (Figure 1). The long incubation period of EBV continues to be poorly understood due to a lack of samples obtained between the time of infection and presentation with EBV related symptoms. Takashima K, Ohashi M, Kitamura Y, Ando K, Nagashima K, Sugihara H, Okuno K, Sairenji T, Hayashi K. A new animal model for primary and persistent Epstein-Barr virus infection: human EBV-infected rabbit characteristics determined using sequential imaging and pathological analysis. Although the authors interpreted this genetic influence on susceptibility to EBV infection, not all individuals who are infected with EBV make a strong antibody response to EBNA-1. Cohen JI, Jaffe ES, Dale JK, Pittaluga S, Heslop HE, Rooney CM, Gottschalk S, Bollard CM, Rao VK, Marques A, Burbelo PD, Turk SP, Fulton R, Wayne AS, Little RF, Cairo MS, El-Mallawany NK, Fowler D, Sportes C, Bishop MR, Wilson W, Straus SE. Besides deep kissing, primary EBV infection can also be transmitted by blood transfusion (Gerber et al. A recent example is that 1037 (90%) of 1148 subjects 18 and 19 years old participating in the U.S. National Health and Nutrition Examination Surveys (NHANES) between 2003 and 2010 had IgG antibodies against EBV viral capsid (VCA) antigen, indicative of prior infection (Balfour et al. Antibody responses to Epstein-Barr virus-determined nuclear antigen (EBNA)-1 and EBNA-2 in acute and chronic Epstein-Barr virus infection. Warner HB, Carp RI. Neurologic complications of infectious mononucleosis. Humanized mice exhibit classical features of infectious mononucleosis such as elevated CD8 counts and high levels of IFN (Chijioke et al. Like eBL and HL seen in underdeveloped nations, nasopharyngeal carcinomas from endemic regions are virtually all positive for EBV DNA (Raab-Traub 2002), with these tumors thought to be derived from a single EBV infected epithelial cell (Raab-Traub and Flynn 1986; Pathmanathan et al.
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