Glandular fever

Glandular fever is the common term used to describe an acute viral infection called infectious mononucleosis. In the past, it was commonly known as kissing disease or mono. The virus that causes glandular fever is known as Epstein-Barr virus. Glandular fever mainly affects young adults.

Symptoms of glandular fever

Fever and sore throat with exudate (deposits of fluid) around the tonsils and pharynx are typical symptoms of glandular fever. Other clinical features include:

• enlarged lymph nodes (lymphadenopathy)
• enlargement of the spleen (splenomegaly) – this occurs in 50 per cent of cases
• jaundice (yellow discolouration of the skin and eyes) – this affects approximately four per cent of people with glandular fever.

The symptoms usually develop four to six weeks after infection with the virus. In young children, glandular fever usually causes mild or no symptoms.

Most people are infected with Epstein-Barr virus at some point in their lives, but not all develop symptoms of glandular fever. Up to 50 per cent of people who are infected with the Epstein-Barr virus will develop symptoms.

Cause of glandular fever

Glandular fever spreads through close, personal contact and is transmitted by saliva. It is most common among high school and university aged students, but young children can also become infected by saliva on toys, shared cups or the hands of carers.

Excretion of the virus from the pharynx (throat) can occur for months, or even longer, after infection.

Diagnosis of glandular fever

If you think you have glandular fever, blood tests can show whether you have the infection.

Treatment for glandular fever

There is no specific treatment for glandular fever. You will not have to be isolated from other people. Once you have had glandular fever, you will develop a high resistance to further infection. However, if your immune system is weak, the virus may be reactivated. You cannot be immunised against glandular fever.

To prevent the spread of glandular fever:

• Make sure you use proper hygiene, including handwashing.
• Avoid sharing drink containers.
• Disinfect articles soiled with nose and throat discharges, for example, handkerchiefs.

Excluding children from childcare is generally not advised because:

• most people are infected by asymptomatic carriers (people who have no symptoms)
• it would be impractical, as the virus is excreted for many months after the initial illness.

Treating the symptoms of glandular fever

While glandular fever itself cannot be treated, you can treat the symptoms to try and remove some of the discomfort. Suggestions include:

• rest, as required
• stay well hydrated
• use over the counter medications such as paracetamol or ibuprofen, as directed on the packet, for management of fever or pain
• gargle with a glass of warm water to ease your sore throat; sucking on sugar-free lollies or lozenges may also help.

Where to get help

• Your GP (doctor)
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)