Glandular fever is the popular term for infectious mononucleosis. It is caused by a virus of the herpes family, called the Epstein-Barr virus. When caught in early childhood, the infection usually is mild or may not be apparent at all, so it is most noticeable in teenagers and young adults. One attack ensures immunity for life.
The infection is most commonly spread by close contact and by kissing, as there are high levels of the virus in saliva during the infectious period.
Infectious mononucleosis is usually diagnosed by a blood test, which takes a few days for results.
Symptoms
The incubation period is four to seven weeks. The symptoms begin with headache, sore throat, fever, general malaise and an enlargement of the lymph nodes in the neck, armpits, elbows, groin and behind the knees. The spleen becomes enlarged and the liver may also enlarge. In about 10 per cent of cases there is a rash of small, red, raised spots. More unusually, there may be chest pain, a cough and difficulty in breathing, and the liver may also be affected, causing jaundice.
Usually recovery takes place within a month. One tenth of affected people, though, complain of fatigue for weeks or months afterwards, and may seem depressed. Occasionally there may be a recurrence of fever or other symptoms in the next year. Symptoms eventually disappear and the body returns to normal.
Treatment
There is no specific treatment, but it is advised to rest during the acute phase, especially when the spleen is enlarged. Children should stay at home while they feel unwell and if they feel run-down after the initial fever, should avoid strenuous activity such as competitive sports and lifting. Paracetamol can be taken for fever or pain, and it is a good idea to drink plenty of water or fruit juice.