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Infectious Mononucleosis

(This is the first of a series of articles of student health written with the technical assistance of the Department of Hygiene.)

By Seahen B. Shot

Ever since the Cornell game he had felt rotten. This morning he finally climbed the three flights in the Hygiene Building. By noon, he lay quietly, shivering a bit, wondering what had brought him to a bad in Stillman. . .

Infectious mononucleosis is the most common of the prolonged illnesses that attack the Harvard student. Since 1936, over 800 cases have been treated at the infirmary. What causes the disease? How can it be recognized? Cured?

No one knows what causes "mono" although most authorizes favor a virus. However, no transmissible agent has ever been isolated. Doctors, although they do not know the specific cause, claim that young unmarried people who are often fatigued are particularly vulnerable. Perhaps this explains why the colleges and school infirmaries have from five to seven-hundred percent more cases than do public hospitals in the same area. The student who suffers form football weekends and hour exams is more liable to suffer than the office worker who enjoys neither of these benefits.

Recently, new light has been shed on the genesis of the disease. Although "mono" is officially designated as "infectious mononucleosis" in text books, it is relatively non-contagious. Roommates do not give each other the disease and infected students do not transfer it in open wards. The "infectious" part of the title applies only to very close contact between the carrier and the uninfected. A report from the U.S. Military Academy suggests that "an intimate mixture of saliva . . . may transmit the disease." Thus, one might trace the disease to beer bottles or cider jugs. The West Point paper, however, gives as evidence the fact that Plebes who had been socially insolated at the Academy from July through December suddenly had a greatly increased incidence of the disease upon returning from their Christmas vacations.

The symptoms of mononucleosis are deceptively common: A sore throat, a little fever, perhaps some perspiring, slightly swollen glands, and a listless, fatigued feeling. These usual Monday morning sensations are often ignored by students, allowing the disease to entrench and become disproportionately difficult to cure.

If these simple symptoms are the only abnormal indications, how does the doctor know if one really has "mono" or if it is a just another cold? Moreover, why can't the student diagnose it himself? The doctor can be sure only after he has examined a blood smear. If he finds many cells of an abnormal type he has good evidence of the disease. A confirmatory tests consists of adding a small sample of the serum to a much larger amount of sheep's red blood cells. If the sheep's cells agglomerate the physician can be virtually positive that the patient has mononucleosis. Only these two tests can differentiate between "mono" and a common cold, and only a competent doctor can perform them.

Mono is a curable disease. The cure is, however, most exasperating. All the doctor can do is prescribe bed rest averaging two weeks and an adequate diet. Occasionally he may use antibiotics to combat secondary complications which invade the weakened body, but these drugs do not attack the disease itself.

Here the insidious nature of the disease is made apparent. When a patient has been in bed a week, he feels much better; his symptoms are less apparent, he remembers the date he had for the Yale game, and he is bored stiff. However, he is still sick. If he stays bed another week he can probably return to his studies while curtailing himself to limited activity for a short period. If he leaves prematurely he will quite possibly return to Stillman for a lengthy stay.

Infectious mononucleosis is a relatively unellucidated disease. The symptoms are both physically weakening and demoralizing. No one knows the cause and only the body can cure it. All the doctor and patient can do, is to give the body as much help as possible.

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