Glandular fever - Treating glandular fever

There is currently no cure for glandular fever, but the symptoms should pass within a few weeks. There are things you can do to help control your symptoms.

Fluids

It is important to drink plenty of fluids (preferably water or unsweetened fruit juice) to avoid dehydration.

Avoid alcohol, as this could harm your liver, which may already be weakened from the infection.

Painkillers

Painkillers available over the counter, such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, can help reduce pain and fever.

Children under 16 years old should not take aspirin because there is a small risk it could trigger a rare but serious health condition called Reye's syndrome.

Regularly gargling with a solution of warm, salty water may also help relieve your sore throat.

Rest

It is important you take plenty of rest while you recover from glandular fever, although complete bed rest is no longer recommended because it may make the fatigue last longer.

You should gradually increase your activities as your energy levels return, but avoid activities you cannot manage comfortably.

For the first month after your symptoms begin, avoid contact sports or activities that put you at risk of falling. This is because you may have a swollen spleen that it is more vulnerable to damage, and a sudden knock could cause it to burst (rupture).

Preventing the spread of infection

There is no need to be isolated from others if you have glandular fever as most people will already be immune to the Epstein-Barr virus (EBV).

You can return to work, college or school as soon as you feel well enough. There is little risk of spreading the infection to others as long as you follow commonsense precautions while you are ill, such as not kissing other people or sharing utensils.

It is also important to thoroughly clean anything that may have been contaminated by saliva until you have recovered.

Antibiotics and steroids

Antibiotics are not effective in treating glandular fever because they have no effect on viruses, but they may be prescribed if you also develop a bacterial infection of your throat or lungs (pneumonia).

A short course of corticosteroids may also be helpful if:

• your tonsils are particularly swollen and are causing breathing difficulties
• you have severe anaemia (a lack of oxygen-carrying red blood cells)
• you have problems affecting your heart, such as pericarditis (inflammation of the sac that surrounds the heart)
• you have problems affecting your brain or nerves, such as encephalitis

Read more about the complications of glandular fever.

Hospital treatment

Most people are able to recover from glandular fever at home, but hospital treatment may be necessary for a few days if you or your child:

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

Treatment in hospital may involve receiving fluids or antibiotics directly into a vein (intravenously), corticosteroid injections and pain relief.

In a small number of cases, emergency surgery to remove the spleen (splenectomy) may be needed if it ruptures.