Glandular fever

What is glandular fever?

Glandular fever, also called infectious mononucleosis, is a viral infection caused by the Epstein-Barr virus, the name comes from the British researchers who first discovered it. The Epstein-Barr virus is part of the herpes group of viruses and is very common, however, like the other herpes viruses you may be infected but never show any symptoms.

The vast majority of people with glandular fever will make a full recovery and it is extremely rare to develop it again.

Glandular fever can affect anyone but it is most common in young adults and teenagers.

How can I catch glandular fever?

The infection is transferred from one person to another in saliva. This is why kissing is one of the most common ways of catching the disease and why glandular fever is often referred to as the ‘kissing disease’. Coughing, sneezing and sharing cups or cutlery can also pass on glandular fever.

What are the symptoms of glandular fever?

Glandular fever symptoms can take 1-2 months to develop after infection and can produce one or more of the following symptoms:

• Sore throat and swollen tonsils – glandular fever often has similar symptoms as tonsillitis.
• A rash – as doctors can occasionally mistake glandular fever for tonsillitis, they prescribe antibiotics, which may bring you out in a rash.
• Enlarged and sore lymph glands – this is very common, particularly in the neck but there can also be swelling in the armpits and groin.
• Flu symptoms – glandular fever is a virus and like other viruses it can cause high temperatures, aches and pains, loss of appetite and headaches.
• Fatigue – an intense feeling of tiredness often accompanies glandular fever.
• Swollen Eyes – a small number of people experience puffy and swollen eyes. This symptom usually disappears quite quickly.

Symptoms will usually resolve after 2-3 weeks, fatigue is usually the symptom which is last to go and some people can feel tired for months.

If you have any unusual or severe symptoms, you should contact your doctor for advice.

How is glandular fever diagnosed?

Your doctor will probably be able to diagnose glandular fever from your symptoms alone, he will feel for swollen glands, tonsils and spleen. Your doctor might then recommend a blood test to confirm the diagnosis and rule out other conditions. If the blood test is positive it will show abnormal cells called monocytes, this is why in America the infection is commonly known as ‘mono’. Your doctor may also take a throat swab to rule out any throat infections.

What treatment is available for glandular fever?

Most people with glandular fever will require no specific treatment. Antibiotics do not help this type of infection as it is a virus. Your doctor will only prescribe antibiotics if you have another infection present e.g. tonsillitis. Most people will make a complete recovery in 2-3 weeks. However, because of the extreme fatigue it may be several months before you feel perfectly fit. Complete rest is the best treatment for glandular fever, though some symptoms can be relieved with the following:

• Paracetamol – taking paracetamol to the maximum dose (as directed by a doctor/pharmacist) can help relieve the sore throat and bring the temperature down.
• Fluids – it is vital to drink plenty of fluids such as water and fruit juices. You should avoid drinking alcohol as your liver might be weakened due to the infection.
• Gargle with salt water or suck throat lozenges to relieve the throat.
• Rest – it is very important to get rest while you recover.
• Steroids – it is unlikely that steroids will be prescribed, but if they are, it is usually to help reduce severe inflammation of the throat so avoiding any difficulties in breathing or swallowing.

What are the complications of glandular fever?

Complications are very rare, though you may feel extremely tired and run down for some time after the infection has cleared up. Rare complications you may have with glandular fever include:

• Enlarged Spleen – the spleen is an organ situated under the ribs on the left side of the abdomen. Like the lymph glands the spleen may swell up and it can sometimes be felt below the ribs, causing mild pain. The spleen will return to normal after the infection has gone. There is a small risk of the spleen rupturing, the main symptom of this is a sharp pain and you may feel lightheaded or confused. If you develop a sharp pain like this you should go to your A&E dept as left untreated can cause internal bleeding.
• Jaundice – this is a result of mild liver disease. This is not serious and is quickly resolved.
• Anaemia.
• Enlarged tonsils – if the tonsils become very enlarged, breathing may become difficult.
• Pneumonia.

General advice

To prevent the spread of the virus, avoid kissing and close bodily contact with others, don’t share towels, cups and clothing whilst ill.

Try to avoid any rough or contact sport for about 6 – 8 weeks, especially if you have suffered an enlarged spleen.