GLANDULAR FEVER
Infectious mononucleosis (glandular fever) is caused by the
Epstein-Barr virus. Unfortunately the words GLANDULAR FEVER often cause
dread and panic as nearly everyone has heard of someone who was terribly
ill for ages with it. This is far from the norm. Most people of whatever
age have a mild illness that is self limiting as the body's own immune
system deals with it and are fully recovered in about 4 to 6 weeks
The virus is spread by contact with infected saliva often through coughs and kissing. Once infected the virus can take between 2 to 6 weeks to produce the sore throat, fever and swollen lymph nodes (or glands). During this 2 to 6 weeks patients often feel tired and run down. Sometimes there can be a rash often caused by antibiotics prescribed for a sore throat
A diagnosis of glandular fever can normally be made by having a blood test performed. However the blood lest can sometimes remain negative even though the patient actually has glandular fever, this is more likely if the test is done too early in the illness
What are the symptoms of glandular fever?
One or more of the following symptoms commonly occur for about a week
or so (symptoms then gradually settle):
- Sore throat - This may be mild, but commonly the throat is very
sore, red, and swollen. It looks like a bad tonsillitis. Glandular
fever is typically suspected when a 'tonsillitis' is severe and lasts
longer than usual. Swallowing is often painful and saliva may pool
in your mouth
- Swollen glands - As the body's immune system fights off the virus
it causes the lymph glands to swell. Any lymph gland in the body
can be affected but the glands in the neck are usually the most prominent.
They can become quite large and tender
- Flu-like symptoms - Like other virus infections, glandular fever
often causes fever (high temperatures), aches, headaches, and can
make you feel quite unwell
- Malaise - A feeling of intense tiredness often develops with glandular
fever. This is often the last symptom to go once the sore throat,
swollen glands, and flu-like symptoms have gone
- Swelling around eyes - About 1 in 5 people with glandular fever
become quite puffy and swollen around the eyes. This goes in a short
time
- Spleen - This is an organ under the ribs on the left side of the
abdomen. It is part of the immune system. Like the lymph glands,
it swells and can sometimes be felt below the ribs if you have glandular
fever. Occasionally, it causes mild pain in the upper left abdomen
- No symptoms - Many people become infected with this virus but do
not develop symptoms. This is called a sub-clinical infection
What is the treatment for glandular fever?
As the illness is caused by a virus there is no specific treatment,
but there are ways to help yourself recover:
- Rest is recommended, not total bed rest but decreased activity
- Plenty of fresh fruit and vegetables
- Regular fluids little and often in the early stages. It is tempting not to drink very much if swallowing is painful. This may lead to mild dehydration, particularly if you also have a fever (mild dehydration can make headaches and tiredness much worse)
- Throat lozenges and gargles to ease the sore throat. You can try gargling with soluble aspirin to ease your throat, if you are allergic to aspirin or have asthma or previous stomach problems or ulcers you should use paracetamol instead
- Exercise should be avoided in the initial stages, but as your condition improves, a gradual return to gentle exercise is recommended (e.g. walking or swimming). Don't overdo it. Slowly increase exercise duration and intensity as your symptoms improve
- Because the liver and spleen are part of the body's immune system they can be affected by the virus as well. For this reason we advise people who have glandular fever to: AVOID alcohol and contact sports for eight weeks
- To prevent spread, avoid kissing and close body contact with other people whilst you are ill. Don't share cups, towels, etc, whilst you are ill
Complications and unusual symptoms
Most people with glandular fever do not have complications or rare
symptoms. For completeness they are mentioned here:
- Damaged spleen - This is serious, but rare. A swollen spleen is
more delicate than normal. A damaged spleen may occur if the left
side of the chest or abdomen is injured, for example, after a fall.
The spleen normally settles down to its normal size after about 6-8
weeks. Therefore, do not play rough or contact sports such as rugby
for eight weeks after having glandular fever
- Rash - A widespread, non-itchy, red rash occurs in some people
with glandular fever. This usually fades quickly
- Jaundice - Mild inflammation of the liver sometimes occurs causing
mild jaundice (yellowing of the skin). This is not serious and quickly
goes
- Malaise and depression - It is common to feel tired and low for the duration of the illness, and for a week or so afterwards. However, it is commonly believed that the depression and tiredness will last much longer. This is not true in most cases, but some people develop 'post viral fatigue' for variable periods. This usually clears in time. But about 3 in 20 people still have fatigue (tiredness) 6 months after the initial illness
See a doctor if any unusual, severe, or unexplained symptoms develop
Source: Adapted with permission from a © document supplied by EMIS and PIP
NHS
Direct 0845 46 47 www.nhsdirect.nhs.uk
