Family doctor

Overview:

• Glandular fever is caused by the Epstein-Barr virus
• It is spread by coughing, sneezing, kissing, and sharing drinks and utensils
• It is more common among adolescents and young adults
• Symptoms include fever, headache, swollen glands and a sore throat
• There is no cure, and recovery takes a variable amount of time
• Most people recover in three weeks but fatigue can last for several months
• Complications include enlarged spleen and inflammation of the liver

What is it?

Glandular fever is often called the kissing disease. The disease peaks around the mid to late teenage years.

The disease is usually found in adolescents and young adults who did not develop immunity to the Epstein-Barr virus as younger children.

Most people have been in contact with the virus and developed immunity by the time they reach adulthood. The illness is often mild in young children, and it can be mistaken for the flu.

The disease is spread from coughing, sneezing, sharing drinks and cutlery, and kissing, which is a common way to catch the virus as a teenager.

The virus has an incubation period of up to eight weeks before a person becomes ill.

What are the symptoms?

The illness begins with a loss of appetite, the chills, and a lack of energy. This lasts for up to three days before more severe symptoms of fever, a sore throat and swollen glands in the neck, groin and armpits develop.

Other conditions like flu and sore throats such as strep throat may be very similar to the symptoms of glandular fever.

Glandular fever can cause enlargement of the spleen in 50 percent of cases, inflammation of the liver, and a blotchy red rash in a small percentage of infected people.

Blood tests are used to diagnose the virus. These are often not accurate during the early part of the illness, so doctors sometimes delay testing initially. They can also show if there is an associated mild hepatitis (liver inflammation) which is fairly common, as the virus involves the whole body to some extent.

The illness is at its worst about one week after the symptoms start and recovery begins during the following 10 days.

Most people have recovered after three weeks but some people continue to experience a prolonged illness of tiredness, fatigue, and depression that can last for several months.

Glandular fever has been linked to chronic fatigue syndrome, although there is no single proven cause for chronic fatigue.

A relapse of glandular fever is possible in the first year after contracting the virus.

In rare cases, the illness can cause inflammation of the heart (myocarditis), and brain (meningitis/encephalitis), but these complications are more likely in people with weak immune systems.

What can be done?

Bed rest is the best treatment because there is no cure for the disease. Keeping up oral fluids by drinking plenty is important.

Drug treatment is available to treat patients with badly swollen tonsils.

Take paracetamol to relieve aches and pains.

Take time off work or school until there has been a full recovery.

Avoid contact sport for up to eight weeks after the first signs of illness to avoid the risk of rupture of the spleen.

Remain in contact with your doctor - particularly if recovery has been slow.

How can it be prevented?

Avoid sharing drinks, food and cutlery. Do not kiss somebody who has recently had the illness or is currently infected.

Getting help

Your doctor will be able to help.