A 2019 report from the U.S. National Highway Traffic Safety Administration found that leading contributing factors for fatal crashes included driving too fast for conditions or in excess of the speed limit, operating under the influence, failure to yield right of way, failure to keep within the proper lane, operating a vehicle in a careless manner, and distracted driving.Drivers distracted by mobile devices had nearly four times greater risk of crashing their cars than those who were not. Research from the Virginia Tech Transportation Institute has found that drivers who are texting while driving are 23 times more likely to be involved in a crash as non-texting drivers. Dialing a phone is the most dangerous distraction, increasing a drivers chance of crashing by 12 times, followed by reading or writing, which increased the risk by ten times.An RAC survey of British drivers found 78% of drivers thought they were highly skilled at driving, and most thought they were better than other drivers, a result suggesting overconfidence in their abilities. Nearly all drivers who had been in a crash did not believe themselves to be at fault.
An estimated 1 to 10% of the cases are caused by Epstein-Barr virus.Tonsillitis can also stem from infection with bacteria, predominantly Group A β-hemolytic streptococci (GABHS), which causes strep throat. Bacterial infection of the tonsils usually follows the initial viral infection. When tonsillitis recurs after antibiotic treatment for streptococcus bacteria, it is usually due to the same bacteria as the first time, which suggests that the antibiotic treatment was not fully effective. Less common bacterial causes include:  Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydia pneumoniae, Bordetella pertussis, Fusobacterium sp., Corynebacterium diphtheriae, Treponema pallidum, and Neisseria gonorrhoeae.Anaerobic bacteria have been implicated in tonsillitis, and a possible role in the acute inflammatory process is supported by several clinical and scientific observations.Sometimes tonsillitis is caused by an infection of spirochaeta and treponema, which is called Vincents angina or Plaut-Vincent angina.Within the tonsils, white blood cells of the immune system destroy the viruses or bacteria by producing inflammatory cytokines like phospholipase A2, which also lead to fever. The infection may also be present in the throat and surrounding areas, causing inflammation of the pharynx. Diagnosis
There is no firm distinction between a sore throat that is specifically tonsillitis and a sore throat caused by inflammation in both the tonsils and also nearby tissues. An acute sore throat may be diagnosed as tonsillitis, pharyngitis, or tonsillopharyngitis (also called pharyngotonsillitis), depending upon the clinical findings.