Glandular fever (infectious mononucleosis) EBV

Glandular fever or mononucleosis infection in medical terms is a common infection in children and teenagers although it can develop in adults as well. It is an unpleasant condition which in a few cases may lead to chronic fatigue syndrome.

This viral infection causes a sore throat amongst other symptoms.

Causes of glandular fever

This is caused by the Epstein-Barr virus which attacks two types of cells within the human body. These include cells in the salivary glands and ‘B lymphocytes’or white blood cells.

This infection starts in the salivary glands which releases large amounts of this virus into the saliva and the rest of the body. This virus then infects the B lymphocytes which cause them to rapidly multiply. This results in swollen, painful lymph glands.

One thing to remember with this infection is that once you have been infected it then remains dormant within your cells for the rest of your life. Every now and then the virus can become active again but is usually assymptomatic. This viral infection spreads easily via close contact or the exchange of saliva.

Epstein-Barr virus or EBV for short, belongs to the herpes virus family. Most individuals (over 90% of individuals over the age of 35) will have been infected with EBV during some stage in their life and it is probably the most common viruses to infect humans. Babies are vulnerable to EBV once the maternal antibody that is usually present at birth is lost. Most children that are infected with EBV do not notice any symptoms other than that of a mild illness or being run down. However during adolescence infection with EBV causes glandular fever (infectious mononucleosis) in over 35% of cases.

Symptoms of glandular fever

This infection has an incubation period of around 35 to 40 days. Symptoms of this include:

• Sore throat
• High temperature
• Headache
• Muscle pains or aches and pains
• Weight loss usually following a loss of appetite
• Swollen glands in the neck and other areas of the body
• Fatigue
• Swelling around the eyes (occasional)
• Red rash (occasional)
• Enlarged spleen (occasional)

Many people find that they develop a very painful sore throat which affects their ability to swallow. Even swallowing saliva is difficult to do. The throat will narrow as a result of swollen glands in the neck which is many cases can be seen.

The symptoms of this are very similar to those of the flu –which is equally debilitating.

How is EBV or glandular fever transmitted?

Most people that come into contact with people that are suffering from glandular been infected with EBV in the past and are not at any risk of developing infectious mononucleosis. In order to contract glandular fever the transmission of EBV requires intimate contact with the saliva of the individual that is affected and as such has been called the Kissing disease / virus by many. It usually takes around 4 weeks before the transmitted virus starts to have symptomatic effects. The transmission of the EBV is almost impossible to prevent because of how common it is and also the fact that it is present in the saliva of many health individuals.

How is glandular fever diagnosed ?

Glandular fever is usually diagnosed with clinical signs such as swollen lymph nodes/glands a raised temperature, sore throat and age. For conclusive confirmation a blood test would be needed which would show an increase in the number of white blood cells, an increase in the proportion of atypical white blood cells. In addition to this a confirmed mono spot test result.

Treatment for glandular fever

There are no known specific medications or treatments for glandular fever such as vaccines or antiviral drugs. In some cases a course of steroids can help to control and reduce swelling of the throat. Antibiotics will not work in this situation as this is a viral infection unless it has worsened and led to a bacterial infection.

If you develop this infection then get plenty of rest, keep warm and drink plenty of fluids. Take painkillers such as ibuprofen or paracetamol to ease any pain which can also help if you have a fever.

The main factor in this is rest. This infection often lasts for several weeks or in some cases, several months which means that you will be lacking in energy during this time. Do not overdo things. Take it easy and get as much rest as you can.

Vitamin and supplements and plenty of fresh fruit and vegetables will help to boost your immune system which will be taking quite a battering at this time.

If your throat is too sore or swollen to allow you to eat as normal then have fruit smoothies, soups and milkshakes instead.

This infection is contagious so ensure that it does not spread to other people in your home. Avoid personal contact with others or sharing utensils that you have previously handled.

Do you need to see your GP?

If this infection persists for a long period of time or your symptoms worsen then consult your GP. He or she will investigate this further by taking a throat swab or performing a blood test.

If he or she suspects that you have developed a bacterial infection then a course of antibiotics will be prescribed.

Complications can occur as a result of this infection although they are rare. They include chronic fatigue syndrome, pneumonia and hepatitis which require medical attention.

Speak to your GP if you are concerned.