Glandular fever

We have selected the following expert medical opinion based on its clarity, reliability and accuracy. Credits: Sourced from the Cleveland Clinic, Ohio. Please refer to your own medical practitioner for a final perspective, assessment or evaluation.

Overview

What is glandular fever?

Glandular fever, also known as “infectious mononucleosis", is an infectious disease that is usually caused by the Epstein-Barr virus (a herpes virus). Other viruses can also cause mononucleosis.

Glandular fever is not considered a serious illness, but its symptoms may be severe enough to prevent a person from engaging in normal activities for several weeks. The classic symptoms of this illness tend to occur more frequently among teenagers, especially those 15 to 17 years old, and in adults in their 20s.

How common is glandular fever?

The Epstein-Barr virus is a very common virus. About 85% to 90% of American adults have developed antibodies to the Epstein-Barr virus by the time they are 40 years old, which means that they have been infected with the virus at some point in their lives. Most individuals are infected with this virus early in life (before the adolescent years), and most of these children have no or very mild symptoms from it. Adolescents, especially teens 15 to 17 years of age, and young adults who become infected with this virus are most likely to develop the classic symptoms of mononucleosis.

How is glandular fever spread?

Glandular fever is usually acquired by contact with the saliva or mucus of a person who is infected with or is carrying the virus. (Glandular fever is also known as the "kissing disease," because it can be acquired through kissing.) Occasionally, it can be spread by coughing or sneezing, or when an infected person shares food or tableware with another person.

Symptoms

What are the symptoms of glandular fever?

The most common symptoms of glandular fever are:

• Fever
• Sore throat
• Swollen lymph glands in the neck, under the arms, and in the groin area.

Other symptoms include the following:

• Fatigue
• Muscle aches
• Weakness & malaise
• White patches in the throat
• Skin rash
• Headache
• Loss of appetite

In addition to these symptoms, the spleen (an abdominal organ that stores and filters blood) may become enlarged. About half of those who have glandular fever have enlargement of the spleen sometime during the course of their illness.

The incubation period—the time it takes symptoms to appear after a person becomes infected with the virus—can be 4 to 6 weeks. Symptoms of glandular fever usually last for 1 to 4 weeks, but it might take as long as 2 months before you feel well enough to resume all of your normal activities.

Diagnosis

How is glandular fever diagnosed?

Glandular fever is usually diagnosed based on the patient's symptoms of fever, sore throat, and swollen lymph glands. The doctor may order blood tests to detect antibodies to the Epstein-Barr virus, but sometimes it is inaccurate (yields a false negative) during the first week of infection. Other blood tests, such as a full blood count, might be done to see if the number of lymphocytes is higher than normal, which may support the diagnosis. Occasionally, titres of antibodies against the viruses that cause glandular fever may need to be done to confirm the diagnosis.

Treatment

How is glandular fever treated?

There are no medications that can treat glandular fever, because antibiotics and antiviral drugs are not effective against the virus.

If you are diagnosed with glandular fever, here are some suggestions for how to deal with it:

• Get lots of rest, preferably bed rest, especially the first week or two.
• Drink plenty of water and other fluids.
• Take non-prescription pain relievers, such as ibuprofen or paracetamol, to help relieve the fever and muscle aches that are common symptoms.
• To help soothe a painful sore throat, use throat lozenges, drink cold beverages, or eat frozen desserts, such as popsicles.
• Gargle with salt water several times a day if your throat feels sore. Prepare the salt water solution by dissolving about one-half teaspoon of salt in 8 ounces of warm water.
• Avoid any strenuous physical activity, such as exercise, heavy lifting, or contact sports, for at least 4 to 6 weeks after being diagnosed with glandular fever. This is to prevent rupture of the spleen, which is fragile during glandular fever.

How can Epstein-Barr infections, the primary cause of glandular fever, be prevented?

It is nearly impossible to prevent Epstein-Barr infections, because most healthy people carry the virus and can pass it on to others. After the virus enters the body, the immune system begins to produce antibodies against it. The Epstein-Barr virus remains inactive in the body throughout life, but it may become active from time to time. However, reactivation of the virus does not result in clinical symptoms in individuals who have normal immune systems.

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