Abstract:
BACKGROUND:Present understanding of increased risk of Epstein-Barr virus (EBV)-related infectious mononucleosis among children of low birth order or small sibships is mainly based on old and indirect evidence. Societal changes and methodological limitations of previous studies call for new data. METHODS:We used data from the Danish Civil Registration System and the Danish National Hospital Discharge Register to study incidence rates of inpatient hospitalizations for infectious mononucleosis before the age of 20 years in a cohort of 2,543,225 Danes born between 1971 and 2008, taking individual sibship structure into account. RESULTS:A total of 12,872 cases of infectious mononucleosis were observed during 35.3 million person-years of follow-up. Statistical modelling showed that increasing sibship size was associated with a reduced risk of infectious mononucleosis and that younger siblings conferred more protection from infectious mononucleosis than older siblings. In addition to this general association with younger and older siblings, children aged less than 4 years transiently increased their siblings’ infectious mononucleosis risk. Our results were confirmed in an independent sample of blood donors followed up retrospectively for self-reported infectious mononucleosis. CONCLUSIONS:Younger siblings, and to a lesser degree older siblings, seem to be important in the transmission of EBV within families. Apparently the dogma of low birth order in a sibship as being at the highest risk of infectious mononucleosis is no longer valid.
journal_name
Int J Epidemioljournal_title
International journal of epidemiologyauthors
Rostgaard K,Nielsen TR,Wohlfahrt J,Ullum H,Pedersen O,Erikstrup C,Nielsen LP,Hjalgrim Hdoi
10.1093/ije/dyu118subject
Has Abstractpub_date
2014-10-01 00:00:00pages
1607-14issue
5eissn
0300-5771issn
1464-3685journal_volume
43pub_type
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