Epidemiology Paper: Mononucleosis Naomi R. Walsh
Grand Canyon University: NRS-427V
January 25, 2014

Epidemiology Paper: Mononucleosis Mononucleosis (mono) is most commonly known as the kissing disease. Mono usually occurs in adolescents and young adults. The virus that causes mono is carried in saliva and passed though such activities as kissing, coughing, sneezing, and sharing of cups and eating utensils. Mono is not a fatal disease, but it can cause weeks of uncomfortable symptoms. Although there is no cure for mono, there are many type of therapies that can help to alleviate some of the symptoms. (Mayo Clinic Staff, 2012)
Description and Demographic Mononucleosis is a disease caused by one of the most common human viruses in the world, the Epstein-Barr virus (EBV). According to the University of Maryland Medical Center, “mono effects about 45 of 100,000 people, mostly teens and young adults” (University of Maryland Medical Center, 2013). A person with mono is contagious for several days before symptoms begin to appear and for some time after. The virus is spread through saliva by kissing, sharing drinks and food, sharing cups and utensils, sharing toothbrushes, and sharing toys that have drool on them. Many people are infected with the virus and have no symptoms; those that do suffer symptoms are usually teens and young adults. Once the virus is picked up it has an incubation period of four to six weeks (Mayo Clinic Staff, 2012) . The most common symptoms of mono are fever, fatigue, inflamed throat, strep throat, headache, swollen tonsils, swollen lymph nodes in the neck, enlarged spleen, swollen liver, and rash. Mono is a viral infection so antibiotics are not effective; treatment consists of bed rest, drinking fluids, antibiotics for throat and skin infections, corticosteroids, acetaminophen, ibuprofen, and gargle with salt water. Some other methods to alleviate symptoms are the use of complementary and alternative therapies such as nutrition supplements, herbs, homeopathy, and acupuncture. The symptoms usually last a couple of weeks, but they can take up to months to fully resolve. It is estimated that 90% of adults have built up antibodies to EBV from exposure and are now immune to the virus. Once one has the virus it will always remain dormant in their body and can reactivate at a later time. (University of Maryland Medical Center, 2013)
Determinants of Health
Mono is a viral disease that is transmitted through saliva, therefore most of the factors that can increase the risk of contracting the disease are hygiene based. Hand washing is a very important way to clean the saliva off of hands and prevent the spread of the virus to other people and objects. Income and social status effects the sharing of food and utensils and hygiene tools such as toothbrushes; persons of lower statuses are more likely to not be able to afford new clean items and are more likely to share them. A clean physical environment will help to prevent the spread of the virus. A person with mono needs to make sure they get plenty of rest in order for the body to recover and fight the virus, insufficient rest can result in a prolonged recovery period. Plenty of fluids need to be drank as well to ensure the body can fight off the disease and to prevent dehydration. (World Health Organization, 2014)
Epidemiologic Triangle The epidemiologic triangle is a model used in understanding how a disease is spread. There are three corners that make up the triangle; the agent, the host, and the environment. In mono, the agent is EBV, the host is the human body, and the environment is the saliva and any object the saliva is on. EBV, the cause of mono, is a common virus that is carried by many people and transmitted through saliva. In order to have mono, EBV needs to find an adequate host to live in, once this takes place the person starts to show signs and symptoms of mono. The host is usually in the teens or young adulthood. If the host has a poor immune system or is immune compromised then they are more susceptible to mono since the body is not able to fight the EBV. If the host has poor hygiene they are also more susceptible to the disease since they are more likely to carry the virus into their mouth by not washing hands and being less careful with items that may carry saliva. The environment needs to be just right in order for the virus to grow and turn into mono once it finds a host. A clean physical environment will limit the presence of EVB. Culture and health practices can affect the presence of EBV in ways such as cleaning of hands and surfaces, use hands to eat, sharing of food utensils and cups during eating. (Maurer & Smith, 2013)
Role of the Community Health Nurse Cases of mono do not need to be reported. Since mono is found mostly in the teen and college aged population, nurses who work with the younger population, such as school nurses are going to have a lot of exposure to people with mono. Nurses need to be diligent in teaching good infection control practices to students as well as parents and other family members and friends. Nurses can teach methods such as hand washing, respiratory hygiene, cough etiquette, and cleaning and disinfecting of objects that can spread disease. The proper way to wash hands is to rub hands vigorously for at least 20 seconds and to rinse and dry thoroughly, using a towel to turn off the faucet. The mouth should always be covered during a cough or sneeze, if no tissue is available then the elbow crease is ok to use, if a tissue is used then the tissue needs to be thrown away immediately and hands washed afterwards. People who have mono do not have to be quarantined since most people carry the inactive virus already in their body, they just need to be careful not to spread it to others and ensure that they are feeling ok (Marugg, 2014). Persons with mono also need to avoid heavy lifting and strenuous activities such as sports for up to two months to prevent injury to the spleen. (University of Maryland Medical Center, 2013)
Community Resource Mono is caused by the Epstein-Barr virus (EBV). There is a group called the EBV Association. “The EBV Association promotes and stimulates the exchange of ideas, knowledge and research materials among research workers throughout the world who study the Epstein-Barr virus (EBV) and related diseases” (University of Sussex , 2014). This association conducts an international symposium on research every two years as well as frequent workshops. They work with other institutions, organizations, and societies to gather and apply research on EBV and other associated diseases. (University of Sussex , 2014)

References
Centers for Disease Control and Prevention. (2014, January 6). Epstein-Barr Virus and Infectious Mononucleosis . Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/epstein-barr/about-ebv.html
Marugg, M. (2014). -Clinical Commentary-Infectious Mononucleosis. Retrieved from Association of Camp Nurses : http://www.acn.org/edcenter/selected_articles/infectiousmono.html
Maurer, F. A., & Smith, C. M. (2013). Community/Public Health Nursing Practice: Health for Families and Populations, 5th Edition. St.Louis: Saunders.
Mayo Clinic Staff. (2012, December 19). Mononucleosis. Retrieved from Mayo Clinic : http://www.mayoclinic.org/diseases-conditions/mononucleosis/basics/definition/con-20021164
University of Maryland Medical Center. (2013, May 7). Mononucleosis. Retrieved from University of Maryland Medical Center: University of Maryland Medical Center
University of Sussex . (2014). EBV Association. Retrieved from University of Sussex: http://www.sussex.ac.uk/ebvassociation/index
World Health Organization. (2014). The determinants of health. Retrieved from World Health Organization: http://www.who.int/hia/evidence/doh/en/