Glandular fever
glandular; fever; infectious; mononucleosis; kissing; mono;
Contents
Glandular fever is common in children and teenagers. It is sometimes called 'The Kissing Disease', because the virus that causes it is found in saliva, and is passed on by close contact such as kissing (and teenagers are prone to kissing). The medical name for glandular fever is Infectious Mononucleosis.
What is glandular fever?
- Glandular fever is an illness caused by a virus called the Epstein-Barr virus.
- In developing countries most children get the infection before they are 3 years old, and they usually have a very mild illness.
- In developed countries, between 20% and 40% of teenagers may not have had it, and if they catch it they can become quite ill.
How is it spread?
- The virus that causes glandular fever is found in saliva, especially when the person is unwell, but also sometimes when they have recovered.
- Glandular fever is spread through close contact, such as kissing, but also through sharing items such as cups, toothbrushes, cigarettes (another good reason for not smoking!).
- There is no need to keep someone with glandular fever away from others. They can return to school or work as soon as they feel well enough.
- Good hygiene (including hand-washing) is important, and that includes not sharing cups, glasses and cigarettes.
- It takes about 4 to 7 weeks between first ‘catching’ the virus and becoming unwell (the ‘incubation period’).
- There is no immunisation against glandular fever.
Signs and symptoms
- Usually, the first symptoms develop slowly. They may include feeling unwell, tiredness, headache, nausea, loss of appetite, abdominal ("tummy") pain and general aches and pains.
- After 1 to 2 weeks the throat becomes very sore, and usually there is a fever (up to 39°C). The throat can look very red, and the tonsils are usually large and red and they may have white spots (looking like a very bad case of tonsillitis).
- Many glands swell up, especially those in the neck, but often in other parts of the body as well (for example in the armpit and groin).
- Usually the spleen swells. It may cause pain at the bottom of the ribs on the left side of the body. While the spleen is swollen there is a small chance of it being ruptured (split open) if it is bumped, for example during sport.
- The liver is usually affected (hepatitis), but usually the person does not become jaundiced (yellow skin and eyes). The hepatitis is probably why people with glandular fever feel sick, lose their appetite, and cannot drink as much alcohol as usual.
- Some people with glandular fever have a red itchy rash, especially if their tonsillitis is treated with some antibiotics.
- Most people recover fully within 7 to 10 days, but they may feel tired for several weeks and occasionally for several months.
- The virus stays in the person’s body for the rest of their life, and the illness sometimes comes back for a week or so during the first year after getting glandular fever. It’s rare for people to become unwell again some years after the original infection.
Treatment
- There is no specific treatment for glandular fever. Antibiotics do not work for virus infections.
- It is very important to 'listen to your body', and rest when needed.
- Bed rest is not usually needed except if the person feels really unwell.
- Normal activities may need to be cut back for several weeks, especially sport, exercise and late nights. That might mean taking it very easy at the gym, or not going for a few weeks.
- It’s important to drink lots of fluids.
- People with glandular fever may not feel much like eating, but their appetite will return.
- Paracetamol or ibuprofen can be taken for fever or sore throat. A person under the age of 16 years with glandular fever should not take aspirin. It is possible that aspirin could trigger a very rare, but serious illness called Reye’s Syndrome if it is taken by someone with glandular fever.
- Drinking alcohol when you are unwell with glandular fever can make you feel much worse than usual because of the effect of glandular fever on the liver (the liver breaks down alcohol in your body).
- Because of the possibility of a ruptured spleen, sport should be avoided while the spleen is swollen (usually about 2-3 weeks). Check with your doctor.
Glandular fever and school
- If you are at school or university, and may miss assignments or exams, it is important to get a medical certificate early so you can ask for special consideration. Go to your doctor soon after you become ill. Your doctor cannot give you a certificate if he or she did not see you when you were sick.
- Also contact your class teacher or advisor as soon as possible.
Josh says:
"Getting enough sleep, healthy eating and going to see the doctor when you feel crook are things that your parents have been in charge of up to now. As you get older you need to learn to take care of yourself”.
Resources in South Australia
- Your family doctor
- Your local hospital
- Your local community health centre
- The Second Story Youth Health Service (TSS):
Central: 57 Hyde Street, Adelaide
South: 50a Beach Road, Christies Beach
North: 6 Gillingham Road, Elizabeth
West: 51 Bower St, Woodville
- Youth Healthline: 1300 13 17 19
References
‘Infectious mononucleosis’, MedlinePlus (National Library of Medicine, USA): http://www.nlm.nih.gov/medlineplus/infectiousmononucleosis.html
‘Mononucleosis’. Mayo Clinic:
http://www.mayoclinic.com/health/mononucleosis/DS00352
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Youth Healthline on 1300 13 17 19 (local call cost from anywhere in South Australia).