Glandular fever is a throat infection caused by the Epstein-Barr virus, and is also known as infectious mononucleosis. It usually affects teenagers and young adults but can affect people of any age. It gets better by itself without treatment, usually after two or three weeks, although some people might feel extremely tired for many months after. It presents like any other viral infection with fever, cough, sore throat and feeling generally unwell. You may notice your tonsils enlarge and the glands you can feel on the outside of your neck get bulky and sore. Antibiotics will not help treat this condition, as they have no effect on viruses.
Glandular fever is very contagious. It’s known as the kissing disease, as it’s passed on by saliva, so take care around sharing cups and cutlery, and, well, avoid kissing. It can cause mild inflammation of your liver (hepatitis), and this may cause a slight yellowing of the skin – this will improve within a few weeks. It can cause your spleen to enlarge – this puts it at risk of rupturing if it’s jarred, so avoid contact sports such as rugby or football for at least six weeks.
The aim of any over-the-counter treatments is to reduce the symptoms associated with glandular fever, while your body fights the virus. Make sure you’re drinking plenty of fluids to help your immune system and avoid the dehydration associated with fever and illness – sip little and often. A paracetamol-based product such as Panadol Advance or similar may help with general aches and mild fever. Anti-inflammatory products may also help with this such as those containing ibuprofen (Nurofen express) or (for adults) those containing aspirin (Beechams powders, or Anadin extra). This may reduce swelling of the glands. Using a medicated lozenge such as Strepsils Honey and Lemon may help to soothe symptoms of a sore throat, or if a spray is preferred, Covonia Throat spray which contains an anaesthetic (lidocaine) to reduce pain and a mild antibacterial agent (chlorhexidine) may be useful. Other throat sprays such as Difflam Throat Spray has more of an anti-inflammatory action to reduce swelling, and may be used as an alternative to anti-inflammatory tablets. A mild pick-me-up may help with the associated fatigue, such as a product containing vitamins, and a source of caffeine such as Wayk tablets may also help in the short term to improve energy levels.
Most people will feel quite tired and unwell so it’s unlikely you’re fit for work (or school or university). People are generally able to return to normal work within a week or two.
If you think you may have glandular fever, book an appointment with your doctor for a blood test to confirm the condition, and other tests to look at the health of the liver and spleen. If you are finding it difficult to swallow or to keep fluids down and think you are dehydrated, or you feel severely unwell, call your doctor urgently within working hours, or call 111 outside of working hours, for advice. The doctor will ask about your symptoms and examine you. Depending on the possible diagnosis, blood tests or imaging (X-ray, ultrasound, CT scan, MRI) could be carried out, or you may be referred to a specialist department. If glandular fever is suspected, a specific blood test will be done to confirm the diagnosis. If you have glandular fever, your spleen (sitting to the left lower side of your abdomen) can swell – the doctor may feel be able to assess this on feeling your tummy – so it is important to avoid sports or activities that increase your risk of falling, in particular contact sports. Attend the Emergency Department if you have an injury to your tummy during this time. You should seek urgent medical advice if you have sudden severe stomach pain, difficulty breathing or severe difficulty swallowing, either by calling 111 or attending the Emergency Department.