libertad - 10/04/10 18:43
Whoa, that was way over my head, (e:tiny)! Haha! Really, I get what you were saying, chances are it is mono and that she probably wouldn't have anything else with it. I'm glad to hear that the mono test is pretty accurate. That is a problem with Lyme tests, as I know that you already know.

Get better soon (e:lilho)! You need a cute little plush Mono, I think that would make you feel better.

tinypliny - 10/04/10 00:29
(e:libertad), it's interesting you are asking about the screening validity of the mono-test. I was looking it up recently because of a cross-interest in CMV (Cytomegalovirus) - a relative of the EBV (Epstein Barr Virus), that causes mononucleosis.

Found this study that compared specificity and sensitivity of a variety of EBV tests in the market: :::link:::

The study found that:
"The sensitivities and specificities of the individual tests ranged from 81 to 95% and 98 to 100%, respectively"

To clarify some jargon:
A sensitivity of 100% means that test recognizes all the
actual positives - everyone affected with EBV. The EBV test recognizes that a person is infected 81 to 95% of the time. That's decent. But there is a maximum 19% possibility that it might MISS the fact that you are EBV positive.

A specificity of 100% means that the test recognizes all actual negatives - the healthy people. The specificities of EBV tests are 98 to 100% - that's VERY impressive. It means that if the test turns up positive, it's 98 to 100% likely that you are NOT healthy.

The second question about the EBV test is, can it be positive if there are other underlying diseases, for eg. Lyme disease or what is cross-reactivity of the EBV test?

To answer this question, I found 2 relevant studies:
1. :::link:::
This study found that an EBV test might be positive if there is an underlying CMV infection. This is because the antibodies that are induced by the EBV virus are of a similar class as the antibodies that are induced by the CMV virus. This is not a very surprising finding as the viruses come from the same family. What this means is that anyone who is diagnosed as EBV positive might well be CMV positive. From (e:lilho)'s point of view, this doesn't change things too much. Both these viruses have similar symptoms as well as similar clinical/conservative management and (unfortunately) no specific vaccines or treatment.

2. The other study looks at whether EBV and CMV could be confused for Lyme Disease. :::link:::
EBV and CMV could be confused and interpreted as Lyme Disease. But not the other way round. So if you are positive for EBV/CMV, and have been told that you have mono, you probably have mono. But if you have been told that you have Lyme Disease, you should go in for a second more specific test to check the Lyme diagnosis. In this case, (e:lilho) has been told that she has mono and it is a correct diagnosis with 98 to 100% probability.

I guess there is another possibility that she has BOTH EBV/CMV and Lyme. But that is a very unlikely event... It might be wise to wait and watch to see if the symptoms improve. I tried to search for prevalence of coinfection with Lyme and EBV, but this data seems to be pretty scarce. There was a study looking at evidence of co-infection in the Cerebrospinal fluids of patients who tested positive for the Herpes Simplex Virus (HSV). :::link::: (PDF link) Though they found other herpes-virus family coinfections, they didn't find any evidence of Lyme co-infection in this study.

There are plenty of forums around the web with random people claiming they have everything under the sun but I would be rather hesitant about accepting these claims on face-value.

libertad - 10/03/10 18:01
That's right, (e:lilho), kill it with the constant whining. I would be complaining up a storm so I'm sure it would be gone in just a few days if I got it.

Is a mono test definitive? It just seems like the symptoms could go with a lot of different things, like Lyme. I wouldn't want you to go untreated for something like that. I suppose it would be hard to get in AZ? Maybe not after looking on google.

tinypliny - 10/02/10 16:52
You know chronic fatigue syndrome is now attributed to viral infections. The virus is probably tapping all the resources that your immune system needs to maintain an energetic homeostatic metabolic state.

Eat more fresh fruits and vegetables. Drink a ton of fluids. Go back to sleep. The virus will get tired of all this constant whining in a few days.

Sending you good wishes for a speedy speedy recovery!

tinypliny - 09/30/10 18:12
I think it never really goes away. EBV, CMV and some other members of the herpes virus family just linger on waiting to strike when you are at your most vulnerable.

mike - 09/30/10 17:34
my friend Yosepha said she had it for like 10 years she would claim it as an excuse whenver she was tired

jbeatty - 09/30/10 14:56
I've had it twice. The first time it was basically a bad sore throat and fever that went away after a week. The second time I couldn't eat for nearly 10 days and slept for the entire summer of 1997. Go for it if you feel ok.

carolinian - 09/30/10 11:18
As long as you don't have sex, drink, or stay up too late I wouldn't see any medical reason why still couldn't have mono and still go to vegas.

lilho - 09/30/10 11:11
bed rest?! I have been sleeping about 12 hrs a night, and stayed home for a week from work. i think i'm out of the bed rest stage. i'll take it easy for a few more weeks. i'm done telling people i have it, they think they will get sick too, but most people my age have already been exposed to it.

libertad - 09/30/10 06:50
I gave (e:mike) mono but it is a cute plush toy not the real thing. Sorry, hope you get better fast so you can go to Vegas.

paul - 09/30/10 00:59
Get well soon.

tinypliny - 09/29/10 23:50
It's self containing and there is no particular cure because it's a virus (the Epstein Barr Virus). I would say complete bed rest, plenty of hydration, excellent nutrition with lots of vitamin C, iron and plant-based proteins should quell it in 2-3 weeks. But recovery completely depends on what your immune status has been in the recent past. Considering, you have been posting a ton of sick reports lately, I suspect your immune system is not up to snuff. Could be wise to reconsider that vegas trip and any undue exertion if you want to get rid of it completely.

matthew - 09/27/10 11:11
Cute. Did you know that almost 95% of people have had mono before. Apparently most of us get it when we are under the age of two, so the symptoms come across as just a cold.