Still sick after 7 months, Please help with answers

[Jerseygirl38]

My 15 yr old daughter came down with mono back in Dec/Jan. In Feb. she tested positive and was very sick with all the classic symptoms. The sore throat, fever, cough, eventually went away but she has remained very tired. Well in May all the symptoms came back, the doc ran the EBV blood test again and sure enough her numbers are still all high. Except the Early antigen is actually low. Her results are:
IGM VCA is 1.6 <1.0 is negative
Early antigen IGG is 0.5 < 1.0 is negative
Ebv vca Igg is 6.0 8.0  <1.0 is negative
So according to the doc the mono is still active. Almost every article I read states mono rarely lasts more then 6 months. What could be causing this virus to still be active all these months later? Are there any other blood tests I could talk to the doc about? Thanks so much for any info you could help me with!

[9DodgeFan]

Hi, your daughter's story sounds very similar to mine.  I had the initial onset of mono in May 2008 with high fever, sore throat, and so on (but not much fatigue), and then after a few weeks I got back to "normal".  Then, almost a month later I had a major relapse with sore throat and extreme fatigue (no fever).  I did see an infectious disease specialist, and he basically told me it could take quite a while to get over.  I've also talked to a few people who had mono a long time ago; one told me it took him a couple years to get over (not fun)!!  The good news is, a little over a year after I first got sick, I feel like I'm getting my life back.  I'm out of shape now and still haven't started exercising, but I no longer have unexplained fatigue and weakness.  So I don't know of any other tests she could take, but she may just need to give it more time.  I took a LOT of time off work; is she making sure to get plenty of rest?  I've also been trying to eat a lot healthier, not sure how much that helps, but I figure it can't hurt.  I'm sure I'm forgetting something here (it's a long story!), but anyway I just wanted to let you know that relapses DO happen, despite what the cds says.  Let me know if you have any other questions; hopefully I can help!
9

[PlateletGal]

Primary Infection
Primary EBV infection is indicated if IgM antibody to the viral capsid antigen is present and antibody to EBV nuclear antigen, or EBNA, is absent. A rising or high IgG antibody to the viral capsid antigen and negative antibody to EBNA after at least 4 weeks of illness is also strongly suggestive of primary infection. In addition, 80% of patients with active EBV infection produce antibody to early antigen.

Past Infection
If antibodies to both the viral capsid antigen and EBNA are present, then past infection (from 4 to 6 months to years earlier) is indicated. Since 95% of adults have been infected with EBV, most adults will show antibodies to EBV from infection years earlier. High or elevated antibody levels may be present for years and are not diagnostic of recent infection.

Reactivation
In the presence of antibodies to EBNA, an elevation of antibodies to early antigen suggests reactivation. However, when EBV antibody to the early antigen test is present, this result does not automatically indicate that a patient's current medical condition is caused by EBV. A number of healthy people with no symptoms have antibodies to the EBV early antigen for years after their initial EBV infection. Many times reactivation occurs subclinically.

Chronic EBV Infection
Reliable laboratory evidence for continued active EBV infection is very seldom found in patients who have been ill for more than 4 months. When the illness lasts more than 6 months, it should be investigated to see if other causes of chronic illness or CFS are present.

http://www.cdc.gov/ncidod/diseases/ebv.htm




Hi jerseygirl38,


The above information is from the CDC's website. It says that "reliable laboratory evidence for continued active EBV infection is very seldom found in patients who have been ill for more than 4 months."  

I would consider asking your daughter's physicians to run more tests to rule out other possible conditions. I would also consider asking your daughter's physician if he/she knows how to diagnose and treat Chronic Fatigue Syndrome.

Keep me posted and good luck !