PERSISTING MONONUCLEOSIS
Forty-four people (adults and children) who have remained unwell for as long as one year were recently described in the Annals of Internal Medicine (102:1&7). Their symptoms have included sore throat, fever, swollen and tender lymph nodes in the neck and elsewhere, aching joints, slow thinking, tiredness, physical fatigue, and a feeling of gloom. They were generally unwell without first having gone through any recognizable acute illness.
Investigation of these people with blood tests revealed the presence in their tissues of the Epstein-Barr (EB) virus, which, among other things, is responsible for mononucleosis. The illness from which they were suffering is known as the chronic mononucleosis syndrome (CMS).
Mononucleosis of such gradual onset and persistence is not usual. Why, in such cases, the body cannot rid itself of the EB virus is not understood. To date, there is no treatment for CMS, but extra rest seems to help us cope better with its symptoms. After several months to a year, most of the patients begin to feel better, but in a few cases, the illness lasts even longer.
The behavior of children with vague fatigue, and who seem to have lost all interest in school, has often been attributed to some emotional difficulty. Now, Pediatric Notes (9:24) suggests, one of the first things to think about is testing them for CMS.
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