What is glandular fever?

Glandular fever is an infectious disease that is common in teenagers and young adults. It is caused by the Epstein Barr virus.

It is also called infectious mononucleosis and is sometimes known as the ‘kissing disease’ because it is spread through saliva.

What are the symptoms of glandular fever?

Many people in Australia are exposed to the virus that causes glandular fever but never develop any symptoms. This is especially true of children.

In those who do develop glandular fever, it usually starts like most throat infections with:

• a high temperature (fever) of 38ºC or above
• swollen lymph glands, usually in the neck or armpits
• sore throat
• weakness and fatigue
• loss of appetite
• night sweats
• abdominal (tummy) pain
• jaundice

Other problems may include:

• a fine pink rash on the body, especially if antibiotics have been taken
• enlargement of the spleen (a large organ in the upper left side of the abdomen) — this usually does not cause symptoms, although in rare cases the spleen may rupture
• a swollen and painful liver, which can lead to the skin becoming yellow through jaundic

Glandular fever symptoms can last weeks to months, especially fatigue and lack of energy. Most people make a complete recovery.

What causes glandular fever?

The Epstein-Barr virus is transmitted through saliva, and can be passed from person to person through:

• kissing
• coughing and sneezing, which spread the virus in airborne droplets
• sharing utensils and drinking containers

It takes 4 to 6 weeks from the time of infection for glandular fever to develop. A person with glandular fever is contagious for months after the infection, so it is important for them to follow good hygiene so others do not get infected.

When should I see my doctor?

A sore throat usually lasts just a few days, but if it is glandular fever you may still have a sore throat and other symptoms for 2 to 3 weeks.

If the symptoms are prolonged and you feel unwell or concerned, it is best to see your doctor.

How is glandular fever diagnosed?

A doctor will talk about the symptoms and will usually confirm glandular fever with a blood test to see if you have antibodies to the Epstein-Barr virus.

How is glandular fever treated?

There is no specific treatment for glandular fever. The symptoms will normally go away on their own after a few weeks. It is a viral illness, so antibiotics do not work (they work only against bacterial infections).

The main treatment is to get plenty of rest, look after yourself and drink plenty of fluids. The more you rest, the quicker you will recover. Talk to your doctor about when it is appropriate to return to normal life.

Pain relief medication such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) may help to relieve pain and fever. Children under the age of 16 years should not take aspirin, because it may cause a serious condition called Reye's syndrome.

People with glandular fever should avoid contact sports, vigorous activities and heavy lifting while unwell to reduce the risk of rupturing their spleen.

Most people recover from glandular fever after a week or 2, but in some people tiredness and swollen lymph nodes can persist for several weeks. Some people may not fully recover for a few months.

A person who has had glandular fever usually becomes immune to it for the rest of their lives, so a second bout of it is unlikely.

Can glandular fever be prevented?

As with other infectious diseases, the spread of glandular fever can be reduced. People who have glandular fever, or those who come into contact with people with glandular fever, should:

• carefully wash their hands with soap and running water, especially after sneezing and coughing, and before touching other people
• avoid sharing eating and drinking containers and utensils
• avoid saliva contact with people who have, or may have, glandular fever (and if you have glandular fever, avoid saliva contact with others)

Complications of glandular fever

The main complication of glandular fever is an enlarged spleen (a gland in the upper left-hand part of the abdomen). Sometimes the spleen can rupture (split). Seek medical attention right away if you have glandular fever and notice a sharp pain under the left chest, feel lightheaded or confused, have blurred vision, or faint.

Sometimes people experience fatigue and sleepiness for more than 6 months after the infection.

Illness can be more severe in those who have lowered immunity, such as people who have had an organ transplant.

Resources and support

There are a number of resources and services available if you need help or more information on glandular fever:

• Download a fact sheet on glandular fever from NSW Health.
• Information on glandular fever in children from the Raising Children Network.