Glandular fever

Glandular fever is caused by the Epstein-Barr virus (EBV). You catch glandular fever through close person-to-person contact. This can include:

• kissing
• sharing cups, glasses or water bottles
• sharing eating utensils
• sharing toothbrushes.

Most people have been infected with EBV at some time, and many people have no symptoms. EBV will cause glandular fever in up to half of people who catch it. It is very rare to have glandular fever more than once.

You may not develop any symptoms despite being infected with the virus. If you have glandular fever, you will usually have some of the following symptoms for up to 3 weeks.

• Fever and flu-like symptoms, such as a high temperature, aching muscles and headaches.
• Sore, red and swollen throat. It may hurt to swallow, so you can get a lot of saliva in your mouth. Your healthcare provider is likely to suspect glandular fever if you have had a severe sore throat that lasts longer than usual.
• Swollen lymph glands. This happens because your immune system is fighting the virus. People often notice swollen glands around the neck, under the jaw. But you can have swollen glands in other areas of your body as well.
• Fatigue. Glandular fever can make you feel very tired. This is often the last symptom to go away and can last for several months after the initial infection.
• Swollen, painful spleen. This is less common. Your spleen is an organ under your ribs on the left side of your tummy. As with your lymph glands, glandular fever can make it swell. Your liver can also become inflamed.

Most people get better within a few weeks, but some people can take months to fully recover.

Most people do not have complications from glandular fever, but there are some possible complications.

• Ongoing tiredness, sometimes for months. This usually improves with time. You may need to start back at school or work for a few hours at a time and gradually ease back in to make sure you do not get too tired.
• A red, but not itchy, rash that covers a lot of your body. This usually goes away quite quickly.
• Yellow skin (jaundice). This can happen if you get an inflamed liver. It is not serious and usually goes away quickly, but if you notice it you should see your healthcare provider to make sure it is not caused by something else.
• A damaged spleen. This is very rare, but serious. It usually happens during contact sports if your spleen is enlarged. It is best to avoid contact sports and vigorous exercise for 4 to 6 weeks after having glandular fever.

Your healthcare provider will usually diagnose glandular fever without having to do any tests. If your symptoms continue, or the diagnosis is not clear, a blood test for EBV can check for glandular fever.

Glandular fever usually goes away by itself. As glandular fever is caused by a virus, antibiotics do not help.

You can help yourself by:

• avoiding strenuous activities, exercise and making sure you get lots of sleep
• taking pain relief, such as paracetamol or ibuprofen to ease your pain, headache and fever
• making sure you drink plenty of fluids to keep well hydrated — drink small sips frequently if it is painful to swallow
• gargling with warm salt water to help reduce throat pain
• avoiding alcohol — glandular fever can also affect your liver, and drinking alcohol can make you feel worse.

EBV is spread by close contact with the saliva or snot (nasal secretions) of infected people. This can happen by:

• touching hands
• touching toys
• sharing cups or toothbrushes
• kissing.

People can be infectious for up to 7 weeks before they get symptoms and for many months after their symptoms go away. It is important to avoid close contact with anyone who has, or has recently had, glandular fever.

Good hand hygiene prevents the virus spreading. Make sure you wash and dry your hands regularly and well.

Healthy habits to stop the spread of illnesses