GSK team up with US researchers to advance search for HIV cure

With more than 35 million people worldwide living with HIV/AIDS, the need for a cure is more vital than ever. Now, global pharmaceutical giant GlaxoSmithKline and the University of North Carolina at Chapel Hill announce they have teamed up to create an HIV Cure center dedicated to finding a way to eradicate the disease once and for all.

One major focus of the new collaboration will be the "shock and kill" approach for curing HIV, which involves unmasking dormant HIV present in patients' immune cells, before boosting the immune system to destroy all traces of the virus.

Due to be located at the University of North Carolina at Chapel Hill (UNC-Chapel Hill) campus, the new center will consist of a small team of researchers from GlaxoSmithKline (GSK), who will work with UNC-Chapel Hill researchers to discover a cure for HIV/AIDS.

The new collaboration aims to advance recent scientific approaches to curing HIV, including a "shock and kill" approach. This involves unmasking dormant HIV present in patients' immune cells, before boosting the patients' immune system to destroy all traces of the virus.

Such an approach has become a major focus in the treatment of HIV. Only last week, Medical News Todayreported on a study in which researchers identified a molecule that they believe could be used as part of a "shock and kill" treatment strategy for the virus.

The researchers, from the Centre Hospitalier de l'Université de Montréal (CHUM) Research Centre in Canada, revealed how a molecule called JP-III-48 acts as a "can opener," forcing the HIV virus to open up and expose its weaknesses, allowing it to be attacked by the immune system.

A team of researchers from UNC-Chapel Hill were one of the first to identify the "shock and kill" approach, and it is hoped the collaboration with GSK can move it forward.

"The 'shock and kill' approach has shown significant promise in early translational research on humans and has been the focus of research for the last several years," says Dr. David Margolis, professor of medicine at UNC-Chapel Hill and leader of the Collaboratory of AIDS Researchers for Eradication (CARE).

"After 30 years of developing treatments that successfully manage HIV/AIDS without finding a cure," he adds, "we need both new research approaches to this difficult medical problem and durable alliances of many partners to sustain the effort that will be needed to reach this goal."

'We must dedicate the next 30 years to finding a cure for HIV'

Since the HIV epidemic first hit in the early 1980s, almost 78 million people worldwide have been infected with the virus and around 39 million people have died from it.

The primary treatment for people with HIV is antiretroviral therapy (ART), which involves taking a combination of at least three antiretroviral medications. While these medications do not destroy the HIV virus, they can stop it from progressing.

Though such medications are life-saving, the virus is still widespread, particularly in sub-Saharan Africa where the population accounts for 71% of all HIV cases worldwide.

"Although today's treatments for HIV mean that millions of lives have been saved, people still have to take a lifetime of treatments, which takes an emotional toll and places an economic burden on society that is particularly challenging in countries with limited resources," says Zhi Hong, senior vice president and head of the Infectious Diseases Therapy Area Unit at GSK.

"This is why we must dedicate the next 30 years to finding a cure and scaling it up so that one day we will end the HIV/AIDS epidemic."

GSK will invest $20 million into the new research center - $4 million per year for 5 years - funding they say is separate from their investment into new antiretroviral therapies through their HIV Discovery Performance Unit based in North Carolina.

GSK CEO Sir Andrew Witty says the pharmaceutical company has a "long legacy of HIV research success" that he believes will be valuable to the new collaboration with UNC-Chapel Hill. He adds:

"This partnership is a testament to our past and present leadership, innovation and commitment to this field. We are inspired by the confidence that with the right resources and research teams, we will be able to make a meaningful impact toward a cure for HIV."

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Pets: are you aware of the risks to human health?

There is no doubt America is a nation of animal lovers. In 2012, more than 62% of American households included at least one pet. But while most of us are aware of the numerous benefits of pet ownership, are you aware of its risks to human health?

Those of you who have a cat, dog, bird or any other animal in your household will likely consider that pet to be member of your family, and rightly so.

Though pets can offer a wide range of health benefits to humans, they can also pose a number of health risks.

Pets offer comfort and companionship, and we can't help but love them. In fact, when it comes to dogs, a recent study found the famous "puppy dog eyes" glare triggers a whopping 300% increase in owners' oxytocin levels - the "love hormone" involved in maternal bonding.

What is more, pets offer a number of benefits to human health. In December 2014, Medical News Today reported on a study that associated household pets with stronger social skills in children with autism. And in May 2013, a study published in the journal Circulation linked pet ownership to reduced risk of heart disease.

But while pets can benefit our health in a number of ways, they also have the potential to spread infection and cause human illness. In this Spotlight, we take a look at the some of the health risks associated with ownership of many of the nation's most-loved animals.

Campylobacteriosis

Most of us have heard of Campylobacter. The bacterium is one of the most common causes of diarrhea in the US, estimated to affect more than 1.3 million people annually.

As well as diarrhea, infection with Campylobacter - called campylobacteriosis - can cause cramping, abdominal pain and fever within 2-5 days of exposure to the bacteria.

While most cases are caused by exposure to contaminated food - particularly meat and eggs - and water, it can also be contracted through exposure to stool of an infected animal - including dogs and cats.

According to PetMD, around 49% of dogs and 45% of stray cats carry Campylobacter and shed it in their feces. It is most common in puppies and kittens younger than 6 months.

It should be noted that infection with Campylobacter is rarely life-threatening, though individuals with weak immune systems, young children and the elderly are most at risk.

Tapeworm, hookworm and roundworm

Dipylidium caninum is the most common tapeworm in both dogs and cats in the US. It is caused by ingestion of fleas that carry the tapeworm larvae. This can happen when the animal grooms itself.

D. caninum can be passed to humans, though the risk of infection is very low. It most commonly occurs in young children who accidentally swallow an infected flea.

According to the Centers for Disease Control and Prevention (CDC), flea control is the best way to reduce the risk of D. caninum infection in both pets and humans.

Hookworm infection in humans most commonly causes a skin condition called cutaneous larva migrans, in which the hookworm larvae penetrate the skin.

Ancylostoma brazilense, A. caninum, A. ceylanicum andUncinaria stenocephala are just some of the species of hookworm that can infect cats and dogs.

The hookworm parasite can be shed in the feces of animals, and humans can contract it by coming into contact with infected feces or contaminated soil and sand where such feces have been.

Hookworm infection in humans most commonly causes a skin condition called cutaneous larva migrans (CLM), in which the hookworm larvae penetrate the skin. This causes a red, itchy and sometimes painful rash.

In rare cases, specific strains of hookworm can infect the intestines of humans, causing abdominal pain and diarrhea.

Toxocariasis is an infection caused by the transmission of Toxocara - parasitic roundworms - from dogs and cats to humans. According to the CDC, almost 14% of Americans have Toxocara antibodies, indicating that millions of us have been exposed to the parasite.

In dogs and cats infected with Toxocara, eggs of the parasite are shed in their feces. Humans can contract the parasite by accidentally swallowing dirt that has been contaminated with these feces.

Though it appears human exposure to Toxocara is high, most people infected with it do not develop symptoms or become sick. In the rare cases people do become ill from toxocariasis, the condition may cause inflammation and vision loss in one eye (ocular toxocariasis), or abdominal pain, fever, fatigue and coughing due to damage to various organs (visceral toxocariasis).

Salmonellosis

Though not as cute and fluffy as kittens and puppies, reptiles - such as turtles, snakes and lizards - are owned by around 3% of households in the US.

There is no doubt reptiles are interesting creatures and can make brilliant pets, but they are also a carrier ofSalmonella - a bacteria responsible for salmonellosis. Humans can contract the bacteria simply through touching a reptile and ingesting the germs.

According to the CDC, more than 1 million people in the US become ill from Salmonella infection each year. Of these illnesses, more than 70,000 are caused by contact with reptiles.

Within 12-72 hours of being infected with Salmonella, people may experience diarrhea, fever and abdominal cramps that last around 4-7 days. While most people fully recover without treatment, others may need to be hospitalized.

Turtles are a main culprit of Salmonella infection in the US. The sale of turtles less than 4 inches was even banned by the US Food and Drug Administration (FDA) in 1975 because of their high disease risk - particularly among young children, the elderly and people with weak immune systems.

Rabies

Rabies is one of the most severe diseases that humans can contract from dogs and cats, as well as smaller animals such as ferrets. A recent study reported by MNT found the disease kills around 59,000 people worldwide every year.

Rabies is a disease that infects the central nervous system (CNS). Caused by a bite from an animal infected with rabies virus, the disease causes fever, headache and weakness, before progressing to more severe symptoms - including hallucinations, full or partial paralysis, insomnia, anxiety and difficulty swallowing. Death normally occurs within days of more serious symptoms appearing.

According to the CDC, domestic animals accounted for 8% of all rabid animals reported in 2010.

In the US, the most common way domestic animals can contract rabies is through a bite from infected wild animals, particularly foxes, raccoons, skunks and bats. Symptoms normally occur 1-3 days after infection and include excess salivation, paralysis and unusual shyness or aggression.

If an owner suspects their pet may have been bitten by a rabid animal, they must take them to a veterinarian for care immediately, even if they have been vaccinated against the virus. Any person who believes they may have been bitten by a rabid animal must seek immediate medical care.

Parrot fever

Despite its name, parrot fever does not only occur in parrots - all birds can be affected. However, human transmission of the disease most commonly involves parrots, parakeets, macaws, cockatiels and poultry - particularly turkeys and ducks.

Also known as psittacosis, parrot fever is a bacterial disease caused by a bacterium called Chlamydia psittacithat humans can contract through inhalation of birds' secretions, including urine and feces.

If a person becomes infected with C. psittaci, symptoms usually appear around 10 days after exposure. These may include fever, nausea and vomiting, diarrhea, fatigue, chest pain and shortness of breath.

In more severe cases, infection with C. psittaci can cause inflammation of the brain, liver and other internal organs. It can also reduce lung function and cause pneumonia.

It is important to note, however, that parrot fever in humans is very rare in the US. According to the CDC, fewer than 50 people a year are infected, and this has been the case since 1996.

Toxoplasmosis

Toxoplasmosis is a disease caused by a single-celled parasite - Toxoplasma gondii. It is most commonly contracted in humans through ingestion of undercooked or contaminated meat.

Cats shed T. gondii in their feces.

However, humans can also contract T. gondii by coming into contact with cat feces or any area or object contaminated with cat feces, as felines are carriers of it. T. gondii cannot be absorbed through skin, but infection can occur if the parasite is accidentally ingested.

It is estimated that more than 60 million people in the US are infected with T. gondii. However, very few people become ill from the infection as the human immune system is normally able to fight it.

If the infection does present symptoms, these may include swollen glands and muscle aches and pains. In very severe cases, T. gondii infection may cause damage to the brain and other organs, or eye damage.

Pregnant women, elderly individuals, young children and people with weakened immune systems are at highest risk of developing symptoms from T. gondii infection.

Cat-scratch disease

Although our cute little kitties very rarely mean to scratch us, it does happen. And while many of us think nothing of a small graze from a cat's claw, it has the potential to cause more damage than you may think.

Cat-scratch disease (CSD) is caused by a bacterium called Bartonella henselae, which around 40% of cats carry at some point in their lifetime, though most show no signs of illness.

B. henselae is most common in kittens under the age of 1 year, and since kittens are more likely to scratch during playtime, they are most likely to spread the bacterium to humans.

An early sign of CSD can be an infection at the site of the scratch around 3-14 days after it occurred, characterized by swelling, pain and tenderness. Headache, fever, loss of appetite and fatigue may also present, and in very rare cases, CSD can affect the brain, heart and other organs.

Children under the age of 5 years and individuals with weakened immune systems are most likely to experience severe symptoms from CSD.

What can be done to prevent pet-related infections?

It is clear pets can harbor an abundance of germs that can be passed to humans, but there are a number of ways pet-related infections can be prevented:

• Wash your hands - hygiene is key for preventing the majority of pet-related infections. After coming into contact with pets, their saliva or feces, hands should be washed thoroughly with warm, soapy water. A scratch or bite from a pet should also be cleaned immediately
• Pick up and dispose of feces - quickly disposing of your pet's feces, particularly in areas where children may play - can prevent the spread of disease to humans and other animals
• Avoid scratches and bites - the best way to avoid infections from pet bites and scratches is to avert them in the first place. If you are scratched by a cat, dog or other animal, clean the wound immediately with warm, soapy water. A cat or dog bite may require medical attention due to the risk of rabies or other serious infection
• Get your pet vaccinated and routinely evaluated - visit a veterinarian regularly to ensure your pet is healthy and to prevent infectious diseases. Also, ensure your pet is up-to-date with the required vaccinations.

It is important to note that the likelihood of a person catching a disease from their pet is low, particularly if the correct precautions are taken. With this in mind, there is no reason why the millions of pet owners in the US can't enjoy the companionship and joy their animals provide.

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New rapid test could distinguish viral infections

A new blood test shows promise as a rapid way to help doctors determine whether a respiratory infection is viral or bacterial and thus reduce inappropriate use of antibiotics, which only work against bacteria.
The study is published in the journal Science Translational Medicine.
Study co-author Geoffrey Ginsburg, a professor at Duke University School of Medicine, says:
"Current tests require knowledge of the pathogen to confirm infection, because they are strain-specific. But our test could be used right away when a new, unknown pathogen emerges."
He explains the new test would be especially useful for spotting new viruses before they spread into outbreaks.
For example, in the case of pandemic flu or MERS, the new coronavirus that has erupted in the Middle East, it would be very important to diagnose new cases quickly, much faster than current diagnostic tests.
The new test uses a different approach to traditional diagnostics: instead of testing the pathogen, it tests the immune response in the infected person.

The new rapid test was able to detect viral infections with 90% accuracy by determining how strongly genes in immune cells and other blood cells were switched on.

Using an approach called "reverse transcription polymerase chain reaction (RT-PCR)," the test evaluates how strongly certain genes in immune cells and other cells in the blood are switched on.
Previous studies have shown these genes are more active in people with respiratory infections caused by viruses. They are not switched on in healthy people or those whose infection is caused by bacteria.
In their study, the team describes how they evaluated the test in a group of over 100 people and found it was able to identify, with nearly 90% accuracy, the ones with viral infections.
The group comprised patients (some with viral infection, the rest with bacterial infection) and healthy controls. The patients had attended a hospital emergency department complaining of fever.
The test positively identified viral infection in 89% of cases, and it correctly ruled out viral infection in 94% of cases.
The team concludes:

"These results show that RT-PCR-based detection of a host gene expression signature can classify individuals with respiratory viral infection and sets the stage for prospective evaluation of this diagnostic approach in a clinical setting."

Christopher W. Woods, co-author and an associate professor of medicine, pathology and global health at Duke and the Durham VA Medical Center, says bacterial resistance, which is largely driven by overuse of antibiotics, is a big global public health problem, causing infections that are increasingly difficult to manage:
"A tool that enables us to accurately identify viral infections could curb the indiscriminate use of antibiotics and reduce the development of resistant pathogens."
The US Centers for Disease Control and Prevention (CDC) says taking antibiotics for viral infections can do more harm than good, citing for instance, that where children are concerned, antibiotics are the most common cause of emergency department visits for adverse drug events in the US.
The team is now working to reduce the time it takes for the test to report results.
It currently takes 12 hours to analyze 30 genes, so Prof. Ginsburg says there is scope to reduce both the time and the number of genes.

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Your Feet Are Home To Nearly 200 Types Of Fungi

Researchers have discovered that there are close to 200 different types of fungi species living on our feet - more than any other part of the body.

Although fungi also inhabit other areas of the body - such as behind our ears - the researchers found that most of them are living between our toes.

The study, carried out and published in the journal Nature, is the most extensive analysis of the body's fungal diversity to date.

Although only about half of all types of fungi are harmful, they commonly live on the skin and can be a major cause of infection. This finding is key to discovering new ways to treat skin conditions caused by fungal infection.

If you have a weakened immune system or take antibiotics you are more likely to develop a fungal infection.

Although there are treatment options available for fungal infections, research published in the journal Nature has shown that fungi have a lot of potential for "horizontal" gene transfer, similar to the mechanisms that allow bacteria to evolve so quickly, which may lead to antibiotic resistance.

Common fungal infections include:

• Yeast infections - a fungus that lives almost everywhere, including in your body. Yeast infections of the skin cause itching and rashes.
• Athlete's foot - A very common infection caused by fungi. It affects the space between the toes. Symptoms include itching, burning, and cracked, scaly skin between your toes.
• Ringworm - a red skin rash that forms a ring around normal-looking skin - the condition is not caused be a worm.

The study was led by researchers at the National Human Genome Research Institute in Bethesda, Maryland.

10 healthy adults participated in the study, the scientists sequenced the DNA of fungi living on their skin and other parts of the body.

They took samples from behind their ears, between their toes, their backs, toenails, groin, chest, forearm, nostrils, heel, and palm.

The part of the body with the most fungi was the heel with 80 different types of fungi, followed by toenail clippings (60 types) and the toes (40 types). The head contained the fewest types of fungi (only 10).

Lead researcher of the study, Dr Julia Segre, said:

"The data from our study gives us a baseline about normal individuals that we never had before. The bottom line is your feet are teeming with fungal diversity, so wear your flip flops in locker rooms if you don't want to mix your foot fungi with someone else's fungi."

The researchers believe that an imbalance of microbes may be the reason why harmful ones spread. In conclusion the diversity of fungi living on the human body was much higher than expected.

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How Cat Litter Parasite Toxoplasma Gondii Influences The Brain

New research led by a team at the Karolinska Institutet in Sweden reveals for the first time what the common "cat litter parasite" Toxoplasma gondii does once it gets into the brain. The study is important in the light of recent observations linking the parasite to risk-taking and other human behaviours, and associations with mental illness.

The researchers write about their findings in a paper published online on 6 December in the journal PLoS Pathogens.

Toxoplasma Infection

Infection by Toxoplasma gondii or Toxoplasma is called Toxoplasmosis. Estimates suggest between 30 and 50% of the global human population is infected. In Sweden the figure is nearer 20%. In the US, the Centers for Disease Control and Prevention (CDC), puts the number of infected men, women and children at 60 million. Animals can also become infected, especially domestic cats.

People usually contract the parasite by eating poorly cooked meat: according to the CDC, toxoplasmosis is the leading cause of death from foodborne illness in the US. Another way people become infected is by touching cat feces, hence the expression "cat litter parasite" because one way of touching cat feces is handling the cat litter tray.

The vast majority of people infected have few symptoms because their immune system usually stops the parasite from causing illness. In newly infected adults the parasite can cause mild flu-like symptoms, and then it usually enters a chronic dormant phase which was thought to be symptom free.

However, when the parasite enters the brain of fetuses, and people with weak immune systems, it can be fatal. Because of this risk, uninfected pregnant women should not touch cat litter trays.

Links to Mental Illness, Risk-Taking Behavior

There is an emerging view that the toxoplasmosis parasite is active to some extent during what was previously regarded as a purely "dormant phase".

For example, rats infected with the parasite lose their fear of cats, and are even attracted by their scent, making them easy prey. Scientists have suggested this is how the parasite assures its own survival and propagation: the cats eat the infected rats, shed more parasite through their feces, and that in turn helps to infect more rats.

Other studies have found schizophrenia, depression, anxiety, and other mental diseases are more common in people with toxoplasmosis, and there is also evidence to suggest infection by the parasite is linked to more extroverted, aggressive and risk-taking behavior.

In a study published in the July 2012 issue of the Archives of Psychiatry, researchers from Denmark's Statens Serum Institut and the University of Maryland in the US, found that women carrying IgG antibodies to Toxoplasma gondii when giving birth have a higher risk of self-harm or suicide later on.

While such a description sounds alarming, study senior author Antonio Barragan, researcher at the Center for Infectious Medicine at Karolinska Institutet and the Swedish Institute for Communicable Disease Control, says:

"At the same time, it's important to emphasize that humans have lived with this parasite for many millennia, so today's carriers of Toxoplasma need not be particularly worried."

Once in the Brain, Toxoplasma Spurs GABA Secretion

The researchers didn't examine how the toxoplasmosis parasite changes host behavior, they were more interested in what it does in the brain.

They found that it takes over one of the brain's neurotransmitters: the chemical messengers that carry signals between various parts of the brain.

In one test tube experiment, they infected human dendritic cells with the parasite. Dendritic cells form the frontline of the immune system, and play a key role in triggering and adapting immune responses. Once infected, the dendritic cells started secreting GABA, a chemical messenger.

In another experiment with live mice, the researchers tracked infected dendritic cells from their initial point of infection to other parts of the brain where they continued to affect the GABA system.

In their author summary, the researchers note:

"Dendritic cells are considered the gatekeepers of the immune system but can, paradoxically, also mediate dissemination of the parasite."

"This study establishes that GABAergic signaling modulates the migratory properties of dendritic cells and that the intracellular pathogen Toxoplasma gondii sequesters the GABAergic signaling of dendritic cells to assure propagation," they add.

GABA does a number of things, but one of them is to inhibit the sensations of fear and anxiety. People with mental illnesses such as schizophrenia, bipolar diseases, anxiety syndrome and depression show disturbances in GABA systems.

Barragan describes the parasite's ability to make the immune cells secrete GABA as "very clever" and says the finding was "as surprising as it was unexpected".

The researchers call for further studies.

"It would now be worth studying the links that exist between toxoplasmosis, the GABA systems and major public health threats," Barragan suggests.

A grant from the Swedish Research Council helped fund the study.

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What Is Glandular Fever? What Causes Glandular Fever? What Is Infectious Mononucleosis?

Glandular fever is a type of viral infection. It is also known as infectious mononucleosis. It can cause fever, sore throat, fatigue, swollen lymph nodes and glands.

It is caused by the Epstein-Barr virus (EBV). It is one of the most common viruses that can affect humans. Most EBV infections occur during early childhood. They usually produce few or no symptoms. Afterwards, the virus will remain in the body for life, lying dormant in a number of throat and blood cells.

According to Medilexicon's medical dictionary:

Infectious mononucleosis is an acute febrile illness of young adults caused by the Epstein-Barr virus, a member of the Herpesviridae family; frequently spread by saliva transfer; characterized by fever, sore throat, enlargement of lymph nodes and spleen..."

When an EBV infection occurs during the teenage years, or early adulthood, it will lead to the development of glandular fever. This is why the majority of glandular fever cases occur in teenagers and young people aged between 15 and 25. Nonetheless, the condition can affect people of any age group.

During the infection, the immune system fabricates antibodies to fight the virus. This then provides lifelong immunity. Therefore, it is rare to have more than one bout of glandular fever.

The virus is contagious. It can be passed on by coming into contact with the saliva of someone who is currently infected with the condition. As may occur when kissing, hence its other name - the kissing disease, via coughs and sneezes and when sharing cutlery and crockery, such as cups, plates and spoons.

A person remains contagious for at least two months after initial infection with EBV. Some people can have EBV in their saliva for up to 18 months after infection.

There is no cure for glandular fever. In most cases, the majority of the symptoms should pass within four to six weeks without treatment. Fatigue can sometimes persist for longer. In most people, fatigue will end after three months. Full recovery is usual.

Complications of glandular fever are uncommon, but can be serious. They include a ruptured spleen, which would require emergency surgery, or a secondary infection of the lungs such as pneumonia.

What are the signs and symptoms of glandular fever?

A symptom is something the patient feels or reports, while a sign is something other people, including a doctor, may detect. For example, a headache may be a symptom, while a rash may be a sign.

Glandular fever has an incubation period of about one to two months, perhaps earlier in children. Incubation period is the time elapsed between initial infection and the appearance of signs and symptoms.

• Flu-like symptoms. As is the case with many virus infections, glandular fever often causes fever and temperature, aches, headaches, and feeling sick.


• A skin rash can appear in some individuals. Widespread, red, non-itchy.


• Loss of appetite.


• Nausea.


• Malaise. A feeling of intense tiredness and weakness often develops.


• Sore throat. The tenderness may be mild, but commonly the throat is very sore, red, and swollen. It resembles a bad bout of tonsillitis. Glandular fever is typically suspected when 'tonsillitis' is severe and lasts longer than usual. Swallowing is often painful.


• Spleen. This organ is under the ribs on the left side of the abdomen and part of the immune system. Like the lymph glands, it swells and can sometimes be felt below the ribs. Occasionally, it causes mild pain in the upper left section of the abdomen.


• Swelling around eyes. About 1 in 5 people with glandular fever become quite puffy and swollen around the eyes. This disappears rapidly.


• Swollen glands. As the body's immune system fights off the virus the lymph glands swell. Any lymph nodes in the body can be affected, but the glands in the neck and the armpits are usually the most prominent. They can become swollen and tender.


• No symptoms. This is called a sub-clinical infection. Many people become infected with this virus but do not develop symptoms.


• The liver can be affected. In some cases, the infection can affect the liver. This can cause jaundice (yellowing of the skin and the eyes). It is more common in people who are over 30 years of age.
  
  Many people with glandular fever will also experience mild inflammation of the liver or hepatitis with symptoms such as:
  
  
  • Intolerance to alcohol
  • Loss of appetite
  • Nausea

The symptoms of jaundice and hepatitis should clear up as the patient recovers from glandular fever.

The symptoms of a sore throat and fever improve usually after two weeks. Fatigue and swollen lymph nodes may persist for longer, occasionally for several months.

What are the causes of glandular fever?

Glandular fever is caused by the Epstein-Barr virus (EBV) mostly. If a person does not have immunity to glandular fever and comes into close contact with infected saliva, the lining of the inside of the throat will become infected first, and then the B lymphocytes (type of white blood cells) nearby, which then spread the infection to other parts of the body, including the liver and spleen

Glandular fever may also be caused by Cytomegalovirurs (CMV) and Rubella (German measles). Glandular fever-like symptoms may also appear in cases of toxoplasmosis, a parasitic infection. Non-EBV causes of glandular fever may harm the fetus/embryo. Pregnant women who become infected may need special treatment with antibiotics and antibodies.

Diagnosis of glandular fever

Physical examination. Medical evaluation will include a description of the symptoms and a physical examination in order to detect swollen lymph nodes, tonsils, liver and spleen.

Blood tests. Blood tests may be recommended in order to confirm the diagnosis. There are two blood tests that can usually help to diagnose glandular fever:

• Antibody test. To detect specific antibodies to the Epstein-Barr virus (EBV).


• White blood cell test. If white blood cell numbers are higher than normal, it usually means the patient has an infection.
Pregnancy - tests to determine whether there is rubella or toxoplasmosis (EBV does not harm the unborn baby).

What are the treatment options for glandular fever?

Currently, there is no cure for glandular fever. However the symptoms can be controlled with:

• Plenty of rest. Patients recover much faster if they are able to get complete rest during the initial month after symptoms. In fact, rest is sometimes the only option, because the patient is too tired and feels too sick to go about his/her daily business.
  
  The National Health Service (NHS), UK, advises patients to do some light exercises after symptoms have gone, in order to regain muscle strength.


• Drink. Drinking plenty of fluids helps prevent dehydration, especially if there is fever. If sore throat symptoms are severe, the infected person may not want to drink - he/she should be monitored carefully to make sure fluid intake is adequate.


• Pain. Painkillers, such as ibuprofen or Tylenol (paracetamol) which can be bought over-the-counter (OTC) may help bring down a fever and reduce pain. Patients under 16 years of age must not be given aspirin.
  
  
• Gargling. Pharmacists may be able to help choose a suitable gargling solution. Some patients find that gargling with salt water helps sore throat symptoms.
  
  


• Antibiotics . Glandular fever is caused by a virus, not a bacterium. Antibiotics are used for killing bacteria. However, the doctor may prescribe antibiotics to prevent secondary infections.
  
  
• Steroids . If the tonsils are very inflamed, a short course of steroids may be prescribed.

What are the complications of glandular fever?

• Ruptured spleen
• Secondary infections, such as pneumonia, meningitis or heart inflammation. Secondary infections are rare, but are a risk for patients with weakened immune systems.
• Prolonged fatigue

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