NYHD: www.health.state.ny.us/diseases/index.htm  
see also www.cdc.gov/ncidod/diseases/ebv.htm

Glandular fever  

What is glandular fever?

Glandular fever (properly known as infectious mononucleosis) is a viral infection that causes an illness similar to influenza. It is sometimes called 'the kissing disease' because it was thought to be passed from one person to another through the mouth. The virus spreads through the bloodstream and the lymphatic system, causing the spleen, liver and lymph glands to swell as well as causing a fever (hence the term 'glandular fever').

What are the symptoms?

The symptoms are similar to those of the flu: fever, headache, blocked nose, nausea, mouth breathing, sore throat (you may have tonsillitis) and a general sense of feeling 'out of sorts'. The patient may be aware of having swollen, tender glands (lymph nodes) in the neck, armpits and groin. Less common symptoms include a rash and jaundice.

How is it diagnosed?

The best way to diagnose the illness is for a blood test to be done. The blood shows abnormal cells (called monocytes) under the microscope, hence the name mononucleosis.

How long does it last?

The major symptoms usually disappear within 2 or 3 weeks, but for a further period of at least 2 weeks you may feel weak, lacking in energy and depressed. Occasionally the lethargy can last for months.

How common is the problem?

It is probably more common than realised, because many cases are mild and pass unnoticed or are simply mistaken for a mild attack of influenza. This applies particularly to children. Children and young adults are those most likely to catch the virus, but the disease is usually seen in the 15 to 25-year-old age group.

What are the risks?

It is not a dangerous disease, but can make you feel extremely sick if it causes hepatitis. You may have a relapse during the course of the first year after contracting it. However, it eventually settles completely and the body returns to normal.

What is the treatment?

Because glandular fever is a viral infection, antibiotics will not help. The illness must simply run its course.

Advice

Do:

• Take aspirin or paracetamol (in modest doses) to relieve discomfort or pain.
• Rest (the best treatment), preferably at home and indoors.
• Drink plenty of fluids such as water and fruit juices.
• Gargle soluble aspirin or 30 per cent glucose to soothe the throat.
  

Do not:

• Drink alcohol or eat fatty foods.
• Push yourself to perform tasks.
• Attempt to return to your normal daily routine until advised to do so by your doctor (about 4 weeks after the illness starts).

Finally, it is common to feel depressed during the illness and in the recovery phase because you may feel tired and lethargic. Report any such problems to your doctor.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia