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Communicable Disease: Mononucleosis
Tara Waedekin
Grand Canyon University
March 22, 2015

Communicable Disease: Mononucleosis Mononucleosis has many names you might have heard it also called the “kissing disease,” also called Epstein - Barr virus or just mono. It’s most seen among teenagers and young adults, especially college students. The CDC (2014) states “at least 25% of teenagers and young adults who get infected with Epstein - Barr virus will develop infectious mononucleosis. Infectious mononucleosis is caused by the Epstein - Barr virus which is a member of the herpesvirus family and is one of the most common viruses to infect humans around the world. Although infectious mononucleosis can be caused by other viruses, the most common way of transmission is through bodily fluids especially saliva, but can also be spread through semen and blood during sexual contact, organ transplants and blood transfusions. According to our textbook Community/Public Health Nursing Practice (2013), symptoms are “fever, fatigue, enlarged lymph nodes, sore throat, malaise, at times enlarged liver and spleen.” The incubation period before you would start to show these symptoms would be 4-6 weeks. Infectious Mononucleosis does not have any major complications that come with the virus. You may get some secondary infections such as a sinus infection and strep throat. The only major complication that can happen but is rare is splenic rupture, which can occur 4 days to 3 weeks after you began to have symptoms. Any person that is diagnosed with infectious mononucleosis should avoid any vigorous activity or contact sport for a minimum of one month to prevent splenic rupture, since it could be swollen from the infection. Due to infectious mononucleosis being a virus there is no medication or antiviral drug you can take to make it go away. Sometimes people may be prescribed a steroid to help with tonsil swelling but usually symptoms will resolve on their own within one or two months. The best treatment a patient could do for themselves is take antipyretics for fevers, get lots of rest, drink lots of water, take an analgesic if you’re having any pain, avoid contact sports, and vigorous activities.
The definition of determinants of health include factors that influence the health of a population or individual. How these determinants can contribute to a development of a disease is by the individual’s health behaviors, social and physical environments and access to health care. Health behaviors such as kissing someone with mono or with unknown mono can possibly infect you and also by having unprotected sex with that infected person as well. By having interventions that can modify health determinants it can lead to improved health status and reduction or elimination of health disparities among populations and communities.
Analyzing the communicable disease requires the use of an epidemiological triangle. Some of the factors you may see in this triangle are host factors, agent factors and environmental factors. Any change in any of these factors has a chance of changing the balance of health. How the host factors work with infectious mononucleosis it that needing a host cell from a human that is usually is a teenager or young adult. Infectious mononucleosis does not discriminate against sex, background, race, marital status, religion, education and economic status. There are no genetic risk factors with mononucleosis it is an infectious disease. The anatomical site with infectious mononucleosis is usually swollen and red tonsils, but you might also be able to feel enlarged lymph nodes in your neck, and if it is going on for a while you might even be able to feel an enlarged spleen. If you have infectious mononucleosis you will always carry the virus that caused it, but as soon as you get over mono you are highly unlikely to ever get mono again. By carrying the virus it may become active from time to time, which is considered active immunity, but it will not be accompanied by any symptoms, but when it’s active it is contagious to others. With infectious mononucleosis you can get tonsillitis, the lymphoid tissues in the back of the mouth usually help to filter out bacteria but when the tonsils are infected the lymphatic system is unable to filter the bacteria like it normally should. For infectious mononucleosis there is no passive immunity, you can be a susceptible host to get infectious mononucleosis. If you have infectious mononucleosis it is important to maintain a good diet, and drink lots of water to stay hydrated. But it is important to note that you don’t want to be doing any vigorous activity or contact sport to do a possibly enlarged spleen. It is also recommended to not have any sexual contact or kissing your partner who has infectious mononucleosis since it can be spread through this manner. It is ok for you as the patient to handle their own food, but I would not prepare anyone else’s food since it can be spread through saliva, and you could accidently sneeze while cooking and infect someone. Some of the agent factors that you will see with infectious mononucleosis is that it is a virus and its common mode of transmission is through saliva. The virulent factor of infectious mononucleosis is the “latent infection of the B lymphocytes, it infects the B lymphocytes in lymphatic tissue and blood, because of the infection to the B cells can cause latent infection, stimulate their growth, or immobilize cells,” as stated by (Breland, 2014). As in regards to infectious mononucleosis diagnosis there are really no environmental factors that cause this.
There are many roles a community health nurse face when dealing with a communicable disease. The nurse can help the community by trying to make them understand the communicable disease by providing them with education and intervening as needed. As the community nurse it would be their job to surveillance the communicable disease which includes systematic collection and analysis of data regarding the communicable disease. The primary prevention would be to prevent the occurrence of the communicable disease, educate the patients and public who are at high risk of catching the communicable disease and how to prevent getting the communicable disease and ways to eliminate risk factors for exposure. Secondary prevention would be increasing early detection by screening patients who may have come in contact with the communicable disease, refer suspected cases of a communicable disease for diagnostic confirmation. Tertiary prevention would be to decrease complications due to the communicable disease through proper treatment, monitor treatment compliance, and prevent reinfection. State laws mandate which communicable diseases must be reported to the CDC, infectious mononucleosis is not one of the communicable diseases that needs to be reported to the state of Wisconsin. Because of this you are not going to find much systematic collection and analysis of infectious mononucleosis. There usually is no follow up needed from the community nurse for infectious mononucleosis.
One organization that addresses infectious mononucleosis is the World Health Organization (WHO). The World Health Organization works towards reducing communicable diseases in populations that have been affected by humanitarian emergencies. They provide epidemiological services to help with the surveillance, prevention, monitoring and control of a communicable diseases in humanitarian emergencies.

References
Breland, Sarah. (2014). Infectious Mononucleosis. Retrieved from https://prezi.com/vu2ht2_9_jx2/infectious-mononucleosis/a
Centers for Disease Control and Prevention. (2014). About Infectious Mononucleosis. Retrieved from http://www.cdc.gov/epstein-barr/about-mono.html
Maurer, Frances, and Claudia Smith. Community/Public Health Nursing Practice, 5th Edition. Saunders, 2013. VitalBook file.

References: Breland, Sarah. (2014). Infectious Mononucleosis. Retrieved from https://prezi.com/vu2ht2_9_jx2/infectious-mononucleosis/a Centers for Disease Control and Prevention. (2014). About Infectious Mononucleosis. Retrieved from http://www.cdc.gov/epstein-barr/about-mono.html Maurer, Frances, and Claudia Smith. Community/Public Health Nursing Practice, 5th Edition. Saunders, 2013. VitalBook file.

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