Glandular fever

Glandular fever is a type of viral infection that mostly affects young adults.

It is also known as infectious mononucleosis, or "mono".

Common symptoms include:

• a high temperature (fever)
• a severely sore throat
• swollen glands in the neck
• fatigue (extreme tiredness)

While the symptoms of glandular fever can be very unpleasant, most of them should pass within two to three weeks. Fatigue, however, can occasionally last several months.

Read more about the symptoms of glandular fever.

When to seek medical advice

You should contact your GP if you suspect that you or your child has glandular fever.

While there is little your GP can do in terms of treatment, they can provide advice and support to help you control your symptoms and reduce the risk of passing the infection on to others.

You should go to your local accident and emergency (A&E) department or dial 999 for an ambulance if you have glandular fever and you:

• develop a rasping breath (stridor) or have any breathing difficulties
• find swallowing fluids difficult
• develop intense abdominal pain

These symptoms can be a sign of a complication of glandular fever that may need to be treated in hospital.

What causes glandular fever?

Glandular fever is caused by the Epstein-Barr virus (EBV). This virus is found in the saliva of infected people and can be spread through:

• kissing – glandular fever is often referred to as the "kissing disease"
• exposure to coughs and sneezes
• sharing eating and drinking utensils, such as cups, glasses and unwashed cutlery

EBV may be found in the saliva of someone who has had glandular fever for several months after their symptoms pass, and some people may continue to have the virus in their saliva on and off for years.

If you have EBV, it's a good idea to take steps to avoid infecting others while you are ill, such as not kissing other people, but there's no need no need to avoid all contact with others as the chances of passing on the infection are generally low.

Read more about the causes of glandular fever.

Who is affected?

Glandular fever can affect people of all ages, but most cases affect teenagers and young adults.

Most EBV infections are thought to occur during childhood and cause only mild symptoms, or no symptoms at all.

However, if a person develops an EBV infection during early adulthood, they can develop glandular fever.

Once you have had glandular fever, it is unlikely you will develop it again. This is because people develop lifelong immunity after the initial infection.

How glandular fever is diagnosed

To diagnose glandular fever, your GP will first ask about your symptoms before carrying out a physical examination. They will look for characteristic signs of glandular fever, such as swollen glands, tonsils, liver and spleen.

Your GP may also recommend a blood test to help confirm the diagnosis and rule out infections that can cause similar symptoms, such as cytomegalovirus (CMV), rubella, mumps and toxoplasmosis.

How glandular fever is treated

There is no cure for glandular fever, but there are a number of simple treatments and measures that can help reduce the symptoms while you wait for your body to control the infection.

These include:

• drinking plenty of fluids
• taking over-the-counter painkillers, such as paracetamol or ibuprofen
• getting plenty of rest and gradually increasing your activity as your energy levels improve

Occasionally, antibiotics or corticosteroids may be used if you develop complications of glandular fever.

Some people with particularly severe symptoms may need to be looked after in hospital for a few days.

Read more about treating glandular fever.

Possible complications

Complications associated with glandular fever are uncommon, but when they do occur they can be serious. They can include:

• further infections of other areas of the body, including the brain, liver and lungs
• severe anaemia (a lack of oxygen-carrying red blood cells)
• breathing difficulties as a result of the tonsils becoming significantly swollen
• a ruptured (burst) spleen, which may need to be treated with surgery

Read more about the complications of glandular fever.