U researchers find drug that might counteract symptoms, spread of mono

Former University student Brett McMillan was hospitalized in 2003 after she began feeling weak and disoriented.

Following a series of tests and a misdiagnosed lymphoma scare, doctors told McMillan she had mononucleosis.

Mononucleosis is caused by the Epstein-Barr virus, a member of the herpes virus family. It is transmitted through saliva and typically starts as a prolonged fever and sore throat.

After a yearlong study, University researchers found an antiviral drug effective in treating mono. This drug could potentially reduce symptoms for patients like McMillan, said Dr. Hank Balfour, the study's lead investigator.

Twenty early-stage mono patients were randomly assigned to receive the drug Valacyclovir. Of the participants, 10 received the drug and 10 did not, he said.

The research showed those patients who took the drug had decreased symptoms, Balfour said, who is also a professor of laboratory medicine and pathology and pediatrics.

"It was very effective in reducing the amount of virus in the throat washings... but the pleasant surprise was that they felt better, sooner," he said.

The patients went to regular exams where researchers evaluated symptoms and collected specimens for viral analysis.

In the patients who received the drug, viral analysis showed a decrease in the quantity of Epstein-Barr virus in their saliva and throat cells, Balfour said.

"There was practically no virus found at all during the treatment period in the subjects who were getting the drug," he said. "So it could very well be that this is a method that could be used to prevent transmission of mono."

When a person gets mono, the symptoms usually last about a month, but the virus can still be contagious months after, Balfour said. This is because the virus leaves the bloodstream rather quickly, but continues to stay in the mouth for a long time.

McMillan fought symptoms in the hospital for 10 days and continued to battle mono for about a month.

"I was feeling run down and just really groggy... I wasn't hungry at all," she said. "(I had) the worst migraines I've ever had in my life."

Besides receiving morphine for her migraines, McMillan was not given any further treatment.

"(Mono) pretty much just has to run its course," she said.

The University's new research gives some hope for faster recovery from mono, said Dr. Susan Kline, assistant professor in the division of infectious diseases in the Medical School.

"I think it'll help people recover and hopefully shorten the symptomatic period," she said. "It's encouraging that it looks like we have something effective to offer people."

Balfour said Epstein-Barr is a seasonal virus. It typically peaks in late fall, and again around March and April.

It is most noticeable in teenagers and young adults.

When little children get mono, it's often a milder illness, said John O'Brien, a pediatrician at Park Nicollet in Minnetonka.

"They don't tend to get the kind of dramatic weeks of fatigue that maybe a teenager might get," he said. "So we don't really check little kids as frequently."