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Open Access Research article

The epidemiology of infectious mononucleosis in Northern Scotland: a decreasing incidence and winter peak

Elizabeth Visser1*, Denis Milne2, Ian Collacott3, David McLernon1, Carl Counsell4 and Mark Vickers5

Author Affiliations

1 Division of Applied Health Sciences, College of Life Sciences and Medicine, University of Aberdeen, Room 1:015, Polwarth Building, Foresterhill, Aberdeen AB252ZD, UK

2 Department of Haematology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN, UK

3 Department of Virology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN, UK

4 Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK

5 College of Life Sciences and Medicine, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK

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BMC Infectious Diseases 2014, 14:151  doi:10.1186/1471-2334-14-151

Published: 20 March 2014

Abstract

Background

Infection with Epstein-Barr virus (EBV) is almost ubiquitous in humans and generally occurs at two ages: infantile, which is usually asymptomatic and associated with poorer socioeconomic conditions, and adolescent, which causes infectious mononucleosis (IM) in ~25% cases. The determinants of whether the infection causes IM remain uncertain. We aimed to evaluate seasonality and temporal trends in IM.

Methods

Data from all Monospot tests, used as a marker for IM, were collected from the Grampian population over 16 years.

Results

Positive Monospot test results peaked at 17 years in females and 19 in males. Females had 16% more diagnoses, although 55% more tests. IM was ~38% more common in winter than summer. The annual rate of positive tests decreased progressively over the study period, from 174/100 000 (95% CI 171–178) in 1997 to 67/100 000 (95% CI 65–69) in 2012.

Conclusions

IM appears to be decreasing in incidence, which may be caused by changing environmental influences on immune systems. One such factor may be exposure to sunlight.

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Funding The Medical Research Council and NHS Grampian-MS endowments.

Keywords:
Seasonality; Epstein-Barr virus (EBV); Infectious Mononucleosis (IM); Epidemiology