#4.) What is the rationale for suggesting a lack of strenuous physical activity to a patient with an EBV infection?
When an individual has an EBV infection, they will (most likely) also have an enlarged spleen and inflamed liver. Avoiding physical activity for about four to five weeks after diagnosis is insisted on to prevent a spleen rupture. The spleen will already be more sensitive within this state of the infection, and rupturing it can be fatal.
#5.) What innate and acquired protective mechanisms should have been elicited in response to Blake’s viral infection?
For the case of the EBV, a person’s innate immunity in a way preps for acquired (adaptive) immunity.
Innate: Once the virus’ DNAs and proteins are made familiar to the body, this stimulates not only an interferon (elevated levels of INF-y specifically) response, but also NK cell activation. The interferon INF-y is made by activated T and NK cells; in studies this INF has shown to be responsible for causing a number of the symptoms for infectious mononucleosis. Simultaneously functioning at this time is an immunosuppressive cytokine IL-10 (interleukin 10). IL-10 is produced by lymphocytes and monocytes – it serves to help suppress the production of cytokines and inhibit the spread of T-cells. This in turn inhibits the ability of the T-cells to make more INF-y. The dance of this interferon and cytokine is a crucial immunological factor within the duration of EBV/infectious mononucleosis.
Acquired (adaptive): Both cell (t-cells) and humoral (antibody) mediated immune responses are facilitated in this case. The humoral response is important for actually diagnosing infectious mononucleosis while the cell response is responsible for the virus’ replication and also some of the diseases symptoms. The antibodies IgA and IgM are found in higher populations of most individuals diagnosed with EBV, these antibodies form anti-VCA bodies. Viral Capsid Antigen (VCA) is a protein that with proper conditions, develops into the EBV. As for the T-cells, CD8 and CD4 are seen to be as the most dominant during the time of infection. The infection of mononucleosis in turn causes a substantial lymphocytosis (previously mentioned T-cells). The CD8 T-cells are required to help with the turnover of EBV/infectious mononucleosis.
#6.) Infectious mononucleosis is more common in developed countries than developing countries. How do you explain this?
According to research, about 95% of all adults have been infected with the Epstein-Barr virus, and very few of those will actually show the symptoms for it. The difference as to why the virus is more prevalent in developed countries than developing seems to be that in developing countries young children are exposed to the virus and are asymptomatic (due to age). Our hygiene practices render us less susceptible to certain infections and diseases so when exposed to the virus as a young adult in a developing country the symptoms are much more commonly seen in that age frame.