Glandular fever (infectious mononucleosis)

Reviewed by Dr John Pillinger, GP

What is glandular fever?

Infectious mononucleosis, commonly known as glandular fever, is a viral infection, which is caused by the Epstein-Barr virus.

The disease is, among other things, characterised by a sore throat, swollen lymph nodes and extreme fatigue.

Young people aged between 10 and 25 years are most vulnerable to this infection. The treatment is to ease the symptoms, and the illness usually passes without serious problems.

How is glandular fever contracted?

The infection is caused by the Epstein-Barr virus, which is transferred from one person to another in saliva. Kissing is one obvious way by which the disease can be transmitted. However, the infection is also spread via airborne droplets.

The incubation period from infection to when the symptoms first appear is between 30 and 50 days.

What are the symptoms of glandular fever?

Before the disease breaks out, one to two weeks may pass with symptoms that are similar to those of flu.

A sore throat with swollen tonsils that are heavily covered by a white coating.

Fever.

Severe fatigue.

Muscle pains.

Headache.

Tendency to sweat.

Stomach pains and there may be signs of an enlargement of the spleen.

Swollen and sore lymph nodes in the throat, armpits and the groin.

The liver may become enlarged and yellow jaundice may develop.

There may be a rash.

How does the doctor make the diagnosis?

The diagnosis is made on the grounds of the symptoms, blood samples and a throat swab.

Good advice

Hot drinks can relieve the sore throat.

Drink plenty of fluids when you run a fever.

Rest when you are tired or are running a fever.

Resume physical activities slowly.

Wait at least four weeks before resuming activities involving heavy physical strain.

It is sensible to avoid drinking alcohol for six weeks while recovering from glandular fever.

Can I exercise while I am ill?

Theoretically, there is a risk of damage to the spleen while participating in heavy physical activities such as those involving body contact. Therefore, it is recommended not to exercise until four weeks after the disease has ended.

Because of the severe fatigue, it may take several months before the patient is perfectly fit again after glandular fever, but the majority of people recover much more quickly.

Future prospects

Glandular fever usually takes two to four weeks and resolves itself without complications. In about 3 per cent of all cases, it goes on longer. After having the disease, a person will have lifelong immunity to it, so will not catch it again.

In rare cases, there are complications. Possible, but rare, complications are:

the respiratory passages may become partially blocked.

pneumonia.

the spleen may rupture - this happens in 0.1 to 0.2 per cent of all cases.

the central nervous system may be infected by the virus and can cause complications like meningitis or encephalitis.

anaemia.

the number of blood platelets may decrease (thrombocytopenia).

in rare cases, the disease may become serious and chronic.

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