How you should treat symptoms of glandular fever
Glandular fever, or infectious mononucleosis as it is known in the medical world, is a common infection.
In fact, the virus is so common that most of us will be exposed to it at some point in our lives, but never know about it.
A much smaller group of unlucky people will develop symptoms, ranging in severity and duration. So what do we know about it, and how should you treat it if you get infected?
❚ Glandular fever (GF) is caused by infection with the Epstein Barr virus. In many people, exposure to this virus will simply stimulate their immune system to produce antibodies, protecting them from future infection. Others however will go on to develop the illness, sometimes up to six weeks after first exposure (this is known as the incubation period). Contrary to popular belief, as the body produces protective antibodies to the virus, it is actually really uncommon to get a second infection of GF in your life.
❚ Children, teenagers and young adults are most likely to get GF. Older people who weren’t exposed to the virus during childhood can also be infected, but this is less common.
❚ Despite being colloquially known as the ‘‘kissing disease’’ when I grew up, it is actually possible to contract GF many different ways. The virus is spread predominantly in saliva, so kissing can be contagious, but so can sharing cups or water bottles, sneezing or coughing near someone.
❚ The main symptoms of GF can mimic tonsillitis or flu. A sore throat is usually present, but not always, along with fevers, fatigue, enlarged lymph glands (typically in the neck area, armpits or groin), and an enlarged spleen (the organ that sits in the abdomen, under the left side of your ribs). More rarely, people may develop a rash or jaundice (inflammation of the liver) due to GF. Typically, the most severe stage of GF is the first week and then people spend another week getting their energy back, before returning to normal. ❚ As GF is caused by a virus, antibiotics are not effective. Treatment is ‘‘supportive’’, aimed at alleviating symptoms not shortening the course of the disease. Pain relief such as paracetamol and ibuprofen can help ease the pain of the sore throat and achy joints, and bring down fevers. Keeping well hydrated and rested is also important, much as you would if you had the flu. People with GF should also avoid contact sport – this is a precaution, as a swollen spleen can be inadvertently ruptured during forceful impact with the abdomen, leading to serious consequences. In case there is also inflammation of the liver, it is important to avoid alcohol while you recover.
❚ Small numbers of people who get GF will develop post-viral fatigue. This is an extreme type of tiredness and malaise that persists for weeks or months, long after the actual infection has been cleared from the body. Although this can be hugely debilitating and requires quite specialised advice and support, it is important to note that this is definitely the exception not the rule – the vast majority of people with GF will be back at work or school again within two weeks.
❚ Testing for GF is done via blood tests. These can tell you whether or not you have acute (ie current or very recent) glandular fever. They can also tell whether or not you have developed long-lasting antibodies to GF – a good thing to know if you become unwell with similar symptoms in the future.
❚ Dr Cathy Stephenson is a GP and forensic medical examiner.