What is glandular fever?

Glandular fever is a viral infection usually caused by the Epstein-Barr virus (EBV). It is also called infectious mononucleosis or ‘mono’. It is sometimes known as the ‘kissing disease’ because it is spread through saliva.

Glandular fever can affect people of all ages but is more common in young adults and teenagers.

What are the symptoms of glandular fever?

Symptoms of glandular fever include:

• sore throat
• fever
• swollen glands, usually in the neck
• fatigue (tiredness)
• nausea

Other signs and symptoms can include:

• rash
• abdominal (tummy) pain
• swelling of your spleen (a large organ in the upper left side of your abdomen)
• jaundice (yellowing of the skin and eyes)

It takes 4 to 6 weeks from the time of infection for glandular fever symptoms to develop.

Symptoms most often occur in older children and young adults. Young children may have mild symptoms or no symptoms. Nearly half of people infected have no symptoms.

Glandular fever symptoms can last weeks to months, especially fatigue and lack of energy.

What causes glandular fever?

Glandular fever is usually caused by infection with the Epstein-Barr virus (EBV).

Most people have been infected with EBV at some time in their lives, even if they have not had symptoms. Once you catch EBV, it is believed that the virus remains in your body for life.

The virus can be passed from person to person through the saliva by:

• kissing
• coughing and sneezing, which spreads the virus in airborne droplets
• sharing utensils and drinking containers

A person with glandular fever is contagious (can pass on the infection) when they are sick with the illness. Sometimes people are contagious for months after the infection.

When should I see my doctor?

A sore throat usually lasts just a few days. But if you have glandular fever, you may still have a sore throat and other symptoms for 2 to 3 weeks.

See your doctor if your symptoms continue and you (or your child) feel unwell. Also see your doctor if you find it difficult to swallow or have abdominal pain.

See your doctor right away if you have glandular fever and:

• have difficulty breathing
• notice a sharp pain under the left chest
• feel lightheaded or confused
• have blurred vision
• faint

How is glandular fever diagnosed?

Your doctor will ask about your symptoms and examine you. A diagnosis of glandular fever can be made with a blood test.

How is glandular fever treated?

There is no specific treatment for glandular fever. The symptoms will normally go away on their own after a few weeks.

Glandular fever is a viral illness, so antibiotics will not work (they work only against bacterial infections).

Self-care treatments

Things you can do to help you feel better:

• drink fluids to stay hydrated (but avoid alcohol)
• get plenty of rest
• eat a balanced diet

Medicines such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) may help to relieve pain and fever.

Children under the age of 16 years should not take aspirin, because it may cause a serious condition called Reye’s syndrome.

Can glandular fever be prevented?

The virus that causes glandular fever is spread from person-to-person through contact with saliva.

Spread of the virus can be prevented through:

• carefully washing your hands
• avoiding contact with saliva
• avoiding sharing cups, glasses and utensils

Rest at home while you are sick to prevent the spread of infection.

Complications of glandular fever

The main complication of glandular fever is an enlarged spleen (an organ in the upper left side of your abdomen). Avoid contact sports and heavy lifting for the first month after being unwell with glandular fever. This is to reduce the risk of damage to your spleen.

Rarely, glandular fever can lead to:

• trouble breathing because of swelling in your throat
• problems with your blood cells, such as anaemia

Sometimes people experience fatigue and sleepiness for more than 6 months after the infection.