If a patient has current and prior symptoms of fatigue and throat,” I’m going to say that’s probably throat pain, throat pain? … and tested positive for active CMV and possible past EBV in the past three months, should the patient’s spouse also test the same Immunosciences viral panel who has had fatigue for the past few months?

Dr. Amy Nett:  Okay so there’s a couple questions here so I’m going to stop and answer this one first. Positive for active CMV and prior Epstein-Barr. Okay. So should the patient’s spouse also test for these. Okay, well, if the patient’s spouse is really tired and you want to test them independently, then yes. The thing with most of these viruses, like almost all of us have been exposed at some point to EBV, HHV-6, HSV, CMV, a lot of us have been exposed and have the antibodies. The question is, is our immune system handling it appropriately? So if the patient’s fatigued and you think that there is reason to test them, then that’s absolutely reasonable. I don’t necessarily strongly suggest that spouses be tested unless there’s clinical reason because I often have one spouse is just fatigued and they have positive antibodies that indicate ongoing viral infection. But it doesn’t necessarily affect the the other family members. So I would say the testing should be done based on clinical symptoms. You could run the same Immunosciences viral panel. If it’s only CMV or Epstein-Barr virus that you want to check for, it’s going to be less expensive to just run it through LabCorp or Quest. I’ve been running some viral antibody titers just through Quest recently. So that’ll be a little bit less expensive if you want to do a more targeted. And if I’m working up fatigue and I’m trying to, you know, if the patient has good insurance and I want to just do Quest or LabCorp, I’ve been running Quest and I generally run an EBV comprehensive panel, CMV, IgG, IgM; HHV-6, IgG, IgM; and I sometimes do mycoplasma pneumoniae IgG and IgM.