Infectious Mononucleosis

Seronegative glandular fever

“…Antibodies against antigens other than those employed in the complement fixation tests, however, would have escaped detection. Seronegative glandular fever has often been noted to show some degree of infectivity oreven to occur in epidemics (Shubert et al, 1954;Hobson et al, 1958). The present seven cases were sporadic, but investigations of epidemic cases of seronegative glandular fever may well yield results different from those recorded here.…”

“…Shubert et al (1954) used a 0 2% cell suspension in investigating three seronegative cases; they thereby achieved higher unabsorbed titres, but the agglutinins were com-6 pletely absorbed by guinea-pig kidney. Heat inactivation is generally assumed to have no destructive effect on the agglutinins.…”

“…Shubert, Collee, and Smith (1954) regarded such cases as being ofa different disease from seropositive glandular fever, but nevertheless closely allied to it. Hobson, Lawson, and Wigfield (1958) also regarded the two conditions as being different diseases, but quoted Niederman (1956) who regarded them as being the same, as did Evans (1960).…”

Glandular Fever: A Field Study

“…Niederman (1956), reviewing cases admitted to the Yale-New Haven Medical Centre, 1946-55, found 166 " clinically acceptable " as cases of infectious mononucleosis, and considered these 72 seropositive and 94 seronegative cases as examples of the same disease. Shubert et al (1954), reporting upon 27 patients Paul-Bunnell negative but otherwise satisfying the clinical and haematological qualifications for a "diagnosis-of infectious mononucleosis, considered these cases " to be examples of a difierent disease, although closely allied to infectious mononucleosis." Disinclined to employ the term " seronegative infectious mononucleosis " because seronegativity was not the only feature differentiating this from the seropositive disease, the term " epidemic variant of infectious mononucleosis " was adopted.…”

“…By 1944 the number of deaths had fallen to 1,881, and since then the steady decline in mortality has been maintained, the comparable total for 1954 being 969 (Registrar-General, 1935-8, 1944, 1954. The major factor in bringing about this fall in mortality has been the advance in the treatment of peritonitis.…”