BEYOND MONOSPOT

Who Is Affected?

Mononucleosis presents with symptoms which tend to mimic many other diseases.  Often, it is not until the disease is well established that testing proves its presence.  Mono is the fruit of the Epstein-Barr virus and it appears most commonly in teens and young adults.  While little children and older adults are often affected as well, testing has proven most successful with the middle group.  Young children between the ages of 4 and 15 are most often affected by a mild illness which resembles a common respiratory infection.  In older adults, mono displays more serious symptoms and they last longer.

How Are They Affected?

The diagnosis of infectious mononucleosis is established generally on the basis of symptoms present in the individual - such as fever, sore throat, swollen lymph glands and the age of the person.  Lab tests are usually performed to confirm the diagnosis and an elevated white blood count (indicating infection) as well as a positive reaction to the monospot test is most often all that is needed.  When the monospot test results are negative but there is a presence of symptoms indicating mono, then additional testing is done using EBV-specific laboratory tests.  Additional tests are also run if the disease has been present for more than six months.

Why Is A Different Test Necessary?

There can be many different reasons for false-positive and false-negative results from tests.  However, the EBV tests seem to be for the most part, quite accurate.  Antibody testing is done by drawing blood from a vein and then tested to see how much it can be diluted before the antibodies against the Epstein-Barr virus can no longer be found.  This test shows how many antibodies are actually present in the blood.  The EBV test can also identify which antibodies are present in the blood and whether the infection is recent or not.  Unlike the quick results obtainable from a monospot test (one or two hours); the results of the EBV test can take up to three days.

What About The Results?

There are times when having the test is not possible or when the results of the testing may be negative.  Having an EBV test within the first few weeks of the mono infection can produce a false-negative result.  There are other diseases which have similar symptoms to mono, but since they are not mono the test will come back negative.  Your health care provider will work with you to establish whether the cause of the symptoms is mono or some other disease and will prescribe the proper treatment.