Glandular fever

Glandular fever (Infectious mononucleosis)

What is glandular fever?

Glandular fever is a viral infection caused by a member of the herpes virus family, the Epstein-Barr virus.

The virus multiplies in the cells at the back of the throat and spreads to the lymph glands, which produce white blood cells to fight infection. It can cause a sore throat, swollen lymph nodes (which become enlarged due to their increased workload) and extreme tiredness.

Most people, however, especially young children, experience no symptoms at all if infected with the Epstein-Barr virus – or only get a few symptoms. This means that many people are exposed to the virus in childhood and do not even know they have had it. One attack confers permanent immunity – so if you have already had a mild form of the illness as a young child, you will not get the virus again in your lifetime.

Young people aged between 10 and 25 years are most vulnerable to developing glandular fever. It is usually not too serious but recuperation may take some time.

How do you contract glandular fever?

The infection is transmitted from one person to another via the saliva. Kissing is one obvious way of transmitting the disease, hence the reason that it is sometimes known as the ‘kissing disease’. However, it is also spread via airborne droplets in coughs and sneezes. A person with glandular fever is most infectious when they have a fever.

What are the symptoms of glandular fever?

Symptoms of glandular fever appear after an incubation period of four to seven weeks and may include:

  • Malaise
  • Flu-like symptoms for several days or weeks, including muscle pain and headache
  • A sore throat
  • Enlarged lymph nodes in the neck, groin, elbows, throat and armpits
  • A high temperature
  • Extreme tiredness
  • A tendency to perspire
  • Yellow jaundice due to enlargement of the liver
  • Stomach pains and signs of an enlarged spleen
  • 10% of cases develop a rash of small, slightly raised spots, which may appear spontaneously or after administration of an antibiotic called ampicillin.

How is glandular fever detected and treated?

Your doctor will take a blood test to confirm whether your symptoms are due to glandular fever. The illness can often be misdiagnosed as tonsillitis.

As glandular fever is a viral infection, antibiotics are ineffective against the disease. Because there is no cure as such, treatment is aimed at relieving the symptoms of the disease until the virus runs its course – which normally takes a week or two, although it can take up to a month.

What can I do to aid my recovery?

Usually there is complete recovery in less than a month. Good tips to aid recovery include:

  • Take plenty of rest, especially during the acute part of the illness
  • Avoid strenuous exercise as long as the spleen is enlarged
  • Ensure that you replace the fluids lost from your body through perspiration by drinking plenty of (non-alcoholic) fluids.
  • Take painkillers such as paracetamol or ibuprofen to reduce pain and fever
  • Take throat lozenges, gargle with salt water or have hot drinks to relieve a sore throat
  • It is important not to over-exert yourself too soon
  • Wait four weeks before resuming heavy physical activities as you may otherwise risk damaging your spleen.

Are there any dangerous side effects from glandular fever?

In some people the disease may develop into a chronic (long term) condition, i.e. – chronic fatigue syndrome. There are also a very small number of people who are unfortunate enough to develop complications. They include:

  • Blockage of the airways due to severe swelling
  • Pneumonia
  • Rupture of the spleen
  • Meningitis
  • Anaemia
  • Reduction in the number of platelets (blood cells that aid clotting) in the blood (thrombocytopaenia).

Complications are extremely rare however, and most people fully recover within a few weeks.

Reviewed: November 17, 2009