Infectious Mononucleosis and its Relationship to EB Virus Antibody: A JOINT INVESTIGATION BY UNIVERSITY HEALTH PHYSICIANS AND P.H.L.S. LABORATORIESBr Med J 1971; 4 doi: http://dx.doi.org/10.1136/bmj.4.5788.643 (Published 11 December 1971) Cite this as: Br Med J 1971;4:643
In October 1969 tests made on 1,457 students entering English universities and colleges showed that 57% already possessed antibody to EB virus. The students without antibody in these initial tests were retested seven months later and by then 12% had acquired antibody. In about one-third of them the acquisition of antibody was not associated with any illness. In about 20% respiratory and other illness had occurred, but these symptoms were almost equally frequent in students who had not acquired antibody. Nearly half had developed infectious mononucleosis. In students in whom the acquisition of EB virus antibody was associated with the clinical and haematological manifestations of infectious mononucleosis the Paul-Bunnell test was almost invariably positive. In contrast, when these manifestations were not associated with the acquisition of EB virus antibody the Paul-Bunnell test was always negative.
Tests for cytomegalovirus antibody were also made on the students at entry. The proportion of students with this antibody was much less (30%) and only a small proportion (1·4%) of those without antibody had acquired cytomegalovirus antibody seven months later. In the only patient in whom the acquisition of cytomegalovirus antibody alone was associated with the clinical and haematological features of infectious mononucleosis the Paul-Bunnell test was negative.
↵* The investigation was organized in each area by the following:
Bedford: Dr. J. G. M. Mortimer, Medical Officer of Health, with the assistance of Dr. M. Colebrook, Dr. J. M. Druce, and Sister M. Duckworth, of the Bedford College of Education; and with the assistance of Dr. J. R. Tree, Dr. G. Yerberry, and Sister S. C. Doe, of the Bedford College of Physical Education; haematological examinations by Dr. R. C. Hallam, of the Bedford General Hospital.
Birmingham: Dr. J. C. Bowie, University Health Service.
Gloucester: Dr. A. E. Wright, Gloucester Public Health Laboratory, and Dr. G. C. Mathers.
Keele: Dr. J. Scott, University Health Service; haematological examinations by Dr. C. Giles, City General Hospital, Stoke-on-Trent.
Leicester: Dr. H. L. Binnie, University Health Service and Dr. Hélène J. Mair, Leicester Public Health Laboratory, with Dr. J. L. Crighton and Dr. W. D. Henry, of the University Health Service; haematological examinations by Dr. A. G. Ackerley, Leicester General Hospital.
Nottingham: Dr. S. E. Finlay, with Dr. K. J. Bolden and Dr. I. Flowers, University Health Service; Dr. M. J. Lewis, Nottingham Public Health Laboratory, and Dr. Mary James; haematological examinations by Dr. T. E. Blecher, Nottingham General Hospital.
The virological examinations for Birmingham, Keele, and Nottingham were made at the Virus Reference Laboratory, Colindale, by Mrs. Jean M. Blake and Dr. Marguerite S. Pereira (EB virus); Mr. F. Lach-Szyrma and Dr. Sylvia D. Gardner (cytomegalovirus); Dr. Elise Vandervelde (rubella); for Bedford by Dr. W. F. Lane, Mr. J. Marshall, and Mrs. Caroline J. Reavell, Bedford Public Health Laboratory; for Leicester by Dr. Hélène J. Mair, Mr. G. Grimsley, and Mr. G. Anozie, Leicester Public Health Laboratory; for Gloucester by Dr. A. E. Wright, Gloucester Public Health Laboratory.
The reagents were prepared and standardized by Dr. C. M. Patricia Bradstreet, Dr. Joan M. Edwards, and Miss E. Margaret Bailey, of the Standards Laboratory, Colindale. The fluorescein conjugated antihuman globulins were provided by Hyland Laboratories and the Wellcome Research Laboratories.
Dr. R. L. Carter, of the Chester Beatty Research Institute, reported on the blood films, Dr. D. A. McSwiggan, of the Department of Microbiology and P.H.L.S. Laboratory, Central Middlesex Hospital (Neasden), standardized the Paul-Bunnell tests.
The investigation was co-ordinated and the findings were analysed by Mr. W. B. Fletcher, Dr. T. M. Pollock, and Mrs. Gwendoline V. Smith, Epidemiological Research Laboratory, Colindale.
Requests for reprints should be sent to: The Epidemiological Research Laboratory, Central Public Health Laboratory, Colindale Avenue, London NW9 5HT.