Epidemiology: Mononucleosis
Tina Taber
Grand Canyon University:
8 October 2014

Epidemiology is a science that uses quantitative, scientific, and research methods to study the causes of disease, how it is transmitted and preventive measures that can be taken to stop the transmission. Healthcare officials then use the information to help guide the public to optimal health. This paper will take a look at the disease Infectious Mononucleosis and how the community nurse can help fight against it and other infectious diseases. Mononucleosis, also known as the “kissing disease”, is an infectious disease that is mainly found in young adult college students or teen-agers from ages 15-17. Older adults can also get it but it is usually not found in them unless they are immunocompromised. According to the CDC, Epstein-Barr virus (EBV) is the most common cause of infectious mononucleosis, but other viruses can also cause this disease. (CDC, 2014) It is transmitted through the infected person’s salvia, mucous from the nose and throat and sometimes tears, close contact, and sharing drinks and utensils can spread the disease. Mononucleosis can have an incubation period anywhere from 33-49 days, and then symptoms appear around 4-6 weeks. It usually begins slowly with fatigue, a general ill feeling and sore throat. Other symptoms include swollen lymph nodes, fever, muscle aches, and loss of appetite, and possibly a swollen spleen. The treatment for Mononucleosis is usually plenty of rest and plenty of fluids, although in severe cases the doctor may use steroids to reduce swelling. The patient is usually warned not to participate in any contact sports because the patient can experience splenic rupture. This is a medical emergency and should be treated right away. Complications from the disease can include swelling of the Spleen, Liver, Anemia, Inflammation of the heart and blockage of the airway due to the tonsils swelling. It can also cause Meningitis, Encephalitis, Thrombocytopenia, and Guillain-Barre syndrome. (Mayo clinic staff, 2014) This disease is mainly seen in the US but is also found in other countries. In developing countries or lower socioeconomic classes, 80% to 100% of children become seropositive for EBV by 6 years of age, and therefore largely do not express symptomatic IM illness. In higher socioeconomic groups or developed countries, only 50% of children become seropositive for EBV between the ages of 1 and 5 years; therefore, a greater number of people will become infected later in life (ages 10–30 years) with symptomatic IM when compared to other populations. (Hellwig, PharmD, BCPS, 2013) Mortality and morbidity rates due to uncomplicated primary EBV infectious mononucleosis are low. The rare cases of attributed mortality are usually related to spontaneous splenic rupture. Splenic rupture may be the initial presentation of EBV mononucleosis. (Cunha, 2014) It is so important to educate the patient about not participating in sports, heavy lifting, or any activity that may put pressure on the abdomen for a month or while they are symptomatic. The main causative agent for Infectious Mononucleosis is the Epstein-Barr virus, although it can be caused by other viruses as well. Epstein-Barr virus (EBV), also known as human herpes virus 4, is a member of the herpes virus family. It is one of the most common human viruses. EBV is found all over the world. Most people get infected with EBV at some point in their lives. EBV spreads most commonly through bodily fluids, primarily saliva. (CDC, 2014) Mononucleosis is usually seen in adolescence and young adults. Children can get it but it usually goes unnoticed because of the mild symptoms and adults usually develop immunity to the virus. The environment can usually play a role in transmission; people that live in close quarters and people of low socioeconomic status are more susceptible to the disease, because college students live in dorms this puts them at a high risk for developing Mononucleosis. Social determinants of health contribute to the development of illness in a number of ways. According to the World Health Organization, The social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries. (WHO, 2013) Since this is mainly a young person’s disease, education is going to play a key role in the spread of the disease. College students need to be educated about not sharing drinks, eating after one another or kissing while someone is feeling ill. Proper hand-washing techniques are always a must. There is also the fact that most young people have the attitude that they are invincible and it won’t happen to them. Educating needs to start at an early age and we need to express the importance of the steps everyone must take to help break the chain and stop disease in its tracks. In conclusion, the role of the community health nurse is not only to make sure that all patients are educated on the cause, transmission and risk factors for this contagious disease, but to also collect the data in the community to help make changes to get people to their optimal health. The nurse should especially reach out to the parents and college students. Community health nurses are valued for their adaptability and willingness to provide care in many settings, including community health clinics, churches, homeless shelters, and schools. These nurses provide comprehensive care to patients within their homes, at organized events such as health fairs, and at agencies and institutions serving people who have particular health needs. (Meaows PhD, RN, 2009) There are several organizations that are here to help reduce the incidence of many infectious diseases. NIAID conducts and supports basic and applied research to better understand, treat, and ultimately prevent infectious, immunologic, and allergic diseases. For more than 60 years, NIAID research has led to new therapies, vaccines, diagnostic tests, and other technologies that have improved the health of millions of people in the United States and around the world. The Nemours Center for Children's Health Media is a part of The Nemours Foundation, a nonprofit organization created by philanthropist Alfred I. DuPont in 1936 and devoted to improving the health of children. Together with organizations like these and educating the public we could help reduce the cases of Mononucleosis and possibly save some lives.

References
Mononucleosis. (2014, January 1). Complications. Retrieved October 10, 2014, from http://www.mayoclinic.org/diseases-conditions/mononucleosis/basics/complications/CON-20021164
About Infectious Mononucleosis. (2014, January 7). Retrieved October 10, 2014, from http://www.cdc.gov/epstein-barr/about-mono.html
Cunha, B. (2014, January 1). Infectious Mononucleosis . Retrieved October 10, 2014, from http://emedicine.medscape.com/article/222040-overview#a0199
Hellwig, PharmD, BCPS, T., Jude, PharmD Candidate, K., & Meyer, PhamD, B. (2013, January 1). Management Options for Infectious Mononucleosis. Retrieved October 10, 2014, from http://www.medscape.com/viewarticle/805511_2
Meaows PhD, RN, P. (2009, January 1). Community Health Nursing : AJN The American Journal of Nursing. Retrieved October 10, 2014, from http://journals.lww.com/ajnonline/Fulltext/2009/01001/Community_Health_Nursing
What are social determinants of health? (2013, May 7). Retrieved October 11, 2014, from http://www.who.int/social_determinants/sdh_definition/en/
National Institute of Allergy and Infectious Diseases (NIAID). (n.d.). Retrieved October 11, 2014, from http://www.niaid.nih.gov/Pages/default.aspx
About KidsHealth. (n.d.). Retrieved October 11, 2014, from http://kidshealth.org/parent/kh_misc/about.html