The Prevalence and nature of Mononucleosis

Infectious mononucleosis, frequently enough called the kissing disease, is primarily transmitted through saliva. While approximately 25,000 cases are reported annually in Spain, the actual number may be higher due to underdiagnosis or misdiagnosis as other viral illnesses. This acute infection typically presents with fever, swollen cervical lymph nodes, and pharyngitis, causing throat pain.

Pharmacists on the Front Lines: Education, treatment, and research

Coinciding with International Kiss Day on april 13th, the General Council of Pharmaceutical Colleges has highlighted mononucleosis, emphasizing the pharmacist’s multifaceted role. Pharmacists are vital in health education, treatment optimization, and even the growth of new therapies and vaccine candidates. Their expertise ensures rational medicine use and helps prevent complications.

Pharmacists contribute significantly to a better approach to the disease in the frame Pharmacotherapy.

Viral Origins and Symptom Manifestation

The vast majority of mononucleosis cases are viral. The Epstein-Barr virus (EBV) accounts for over 90% of cases, while cytomegalovirus (CMV) is responsible for 5-7%. EBV-related mononucleosis commonly affects individuals aged 15-24,causing symptoms like fever,sore throat,and swollen lymph nodes,particularly in the neck. These symptoms usually subside within a few weeks, though fatigue can linger for up to three months.

CMV-induced mononucleosis in immunocompetent individuals is frequently enough asymptomatic or presents as a mild, nonspecific viral illness.However, monitoring for complications is crucial, especially in immunosuppressed populations.

Symptomatic Treatment and the Role of Corticosteroids

Treatment for mononucleosis in immunocompetent individuals, whether caused by EBV or CMV, primarily focuses on managing symptoms.Analgesics and antipyretics like paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are commonly used. Specific treatments are reserved for complications. Currently, there is no strong evidence supporting the use of corticosteroids for uncomplicated cases.

The Quest for a Vaccine

While research into vaccines for mononucleosis is ongoing,with several candidates in preclinical and clinical trials,no authorized vaccine is currently available. For CMV infections in healthy individuals, antiviral therapy is generally not indicated, except in cases of primary CMV infection during pregnancy. Antiviral agents against CMV include Ganciclovir, Valganciclovir, Cidofovir, Foscarnet, Maribavir (approved in 2024), and Letermovir (approved in 2021).

Community Pharmacists: Guardians of Safe medication Use

Given that most mononucleosis cases require only symptomatic treatment, community pharmacists play a vital role in ensuring safe and effective medication use.They are responsible for guaranteeing the rational use of medicines, detecting potential adverse reactions, contraindications, and interactions. For instance, paracetamol is contraindicated in patients with active liver disease, while ibuprofen should be used cautiously with anticoagulant drugs, certain antihypertensives, or acetylsalicylic acid.

Health Education and Prevention Strategies

Pharmacists are well-equipped to promote both primary and secondary prevention of infectious mononucleosis.While preventing contagion entirely is challenging, general prophylactic measures such as frequent handwashing and covering coughs and sneezes are recommended. Secondary prevention involves symptomatic treatment and a period of relative rest (15-20 days) following the acute phase.

Addressing Misconceptions and Providing Clarity

Pharmacists are also crucial in dispelling myths and addressing concerns about mononucleosis. For example, it’s important to clarify that EBV infection is not a direct cause of multiple sclerosis, and antibiotics are ineffective against this viral illness.