Glandular fever also known as ‘infectious mononucleosis’ mostly affects the individuals of the age group between 16 and 24 years. This age group mainly includes teenagers and young adults. It is also known as ‘kissing disease’. The disease gets its name because it spreads from person to person through saliva.1
Can You Get Glandular Fever More Than Once?
Glandular fever is caused by Epstein Barr Virus (EBV) which is also known as human herpes virus 4. It belongs to the herpes virus family. In fact, if the virus causes glandular fever in any individual in any stage of life, even after recovery, the virus remains in his/her body for life time.2 Usually that person will not get glandular fever again and will not cause illness. Hence these people are immune to the glandular fever for rest of their life.
How Does Glandular Fever Spread?
Glandular fever is usually spread in the following ways.
- Contact with Saliva. Among the children, this disease is spread when the saliva of the infected child comes in contact with a healthy child through the hands of care givers or by sharing the toys.
- Kissing Among Young Adults. This is the most common reason for spreading of glandular fever among young adults and hence, it is also known as kissing disease.
- Glandular Fever Spread through Air. This disease can also be spread through air when an infected person sneezes and coughs. Though this disease spreads through air also, the virus is unable to survive very well in the nature.
- Spread of Glandular Fever through Contaminated Things. It is also important to note that the spreading of this disease is most common when the things like utensils, drinking bottles are shared with the infected individuals.
- Glandular Fever Spreading through Semen and Blood. This way of spreading of this disease is less common; however, it is possible.3
Signs and Symptoms of Glandular Fever
The disease occurs in the individuals who have weakened immune system. In most of the young children, the disease is asymptomatic or if present might be mild. The symptoms can be observed in older children and young adults. Some of the symptoms are.
- Difficult to swallow fluids
- Sore throat (pharyngitis)
- Loss of appetite
- Muscular pain
- Intense abdominal pain
- Swollen glands
- Enlarged lymph nodes in the neck
- Jaundice with or without yellow color of skin and eyes
- Rashes may appear when antibiotics are advised for bacterial throat infection as a mistaken diagnosis
- In some cases, splenomegaly is seen
- Liver inflammation with jaundice if the severity is more.4
Diagnosis of Glandular Fever
Patients who show one or more symptoms are advised for the following tests for evaluation of the disease.
- Physical Examination. This evaluation is done by palpation to confirm for any swollen lymph nodes in the neck region and for enlargement of spleen.
- Blood Tests. There are different tests like monospot test, heterophile antibody test, serological tests, etc. Monospot test is not usually advised as it is not accurate.
- Heterophite antibody test can be done. It is more specific but not sensitive in particular. Serological tests may take a little more time but is more accurate. It is useful in detecting the EBV antibodies.
- Complete Blood Count for Diagnosing Glandular Fever. Doctors may advise a complete blood count test which is helpful to know the increase in white blood cells associated with glandular fever.5
Treatment for Glandular Fever
Glandular fever is caused by EBV virus and there is no antibody which works against virus. Hence, as such, the disease has no specific line of treatment. Though it is a self-limiting infection, some antibiotics are advised to address the secondary infections caused by bacteria. Some of the ways of treating this disease can be.
- Taking enough rest.
- Maintaining fluid content of the body by taking more fluids.
- Gargling with salt water many times a day may be helpful in getting rid of sore throat.
- Advising pain relievers, particularly nonsteroidal and anti-inflammatory drugs.
- Mild antipyretic drugs such as paracetamol can be given.6
Sometimes, the tonsils and severe sore throat are addressed by corticosteroids to reduce the severe pain.
What is the Recovery Period for Glandular Fever?
Although the incubation period of Glandular Fever is quite lengthy, the symptoms show more severity within one week after appearance of the first symptom. In most of the cases, the patients become normal within 2 to 3 weeks. The fatigue may be present in many patients for months together. As the spleen and liver are weak when the person is suffering from glandular fever, one must avoid sports and strenuous exercises in the first few months. Gradually the activities like going to school, light exercises can be started when the person starts feeling better. There is no specific time to stay away from school or day care when the child is suffering from glandular fever. As usual, during the period they should take enough rest and when once they feel better, they can go to day care and school.7
Complications of Glandular Fever
In most cases, the glandular fever will be cured without any much problem. Sometimes, it may lead to some complications due to late diagnosis. This may be when the individual is asymptomatic. The complications in those instances might be.
- Some blood related problems like anemia, thrombocytopenia
- Heart related problems such as myocarditis, pericarditis
- Rarely, some nervous system related problems like meningitis, Guillain-Barre syndrome or Bell’s palsy
- Ruptured spleen.8
Incubation and Infectious Period of Glandular Fever
Glandular fever is sometimes asymptomatic till some stage. It may take some time to develop symptoms after getting the infection. This period is called incubation period. The incubation period of Glandular fever may last for 4 to 6 weeks. Sometimes, it may take 4 to 8 weeks to get to know the presence of the virus.
The person may have the virus in the body for months even after recovery. Hence, it is most important to maintain hygiene to prevent the spread of infection from one person to another person. This period during which an infected person can infect others is called infectious period. Though the infectious period for glandular fever is not exactly known, it is believed that the disease may be spread through saliva for up to a year after recovery.
Prevention of Spreading of Glandular Fever
Prevention of any infectious disease is always better than cure. If a person follows some tips pertaining to health and hygiene, the spreading of disease can be avoided. Some of the tips to avoid spreading of glandular fever are.
- Avoiding close contact with others
- Avoiding sharing of drinking bottles, utensils or any sort of food with others
- Hands must be washed frequently
- Washing the bedding and clothes of infected persons frequently as they may have spit or saliva on them
- Avoid kissing because it is easily spread by kissing others.9
Glandular fever is an infectious disease. If a person gets this disease, he/she is not found to suffer again in his/her life time for the second time. Most of the times, it may be wrongly diagnosed as bacterial infection of throat. The disease can be confirmed after a blood test. As such, there is no cure for glandular fever. Since it is caused by a virus, there is no specific antibiotic for viruses. The patients have to recover by themselves. While giving medicines to relieve pain and fever, normal paracetamol can be given but aspirin must not be given for children under 16 years. This medicine may trigger a disease called Reye’s syndrome though it is very rare. Taking enough rest and drinking enough fluid would be more appropriate during the infection. Hygiene is of utmost importance to prevent the spreading of glandular fever.