Causes
Glandular fever, also known as infectious mononucleosis, is caused by the Epstein-Barr virus. This virus is commonly transmitted through saliva. This is why this condition is sometimes called ‘the kissing disease’.
Symptoms
The incubation period for glandular fever is between 30 and 50 days, with symptoms coming on gradually.
At first, your child might feel generally unwell and tired. She will then probably develop a fever, a sore throat and tender, swollen lymph glands, mainly in the neck (and often in the armpits and groin). The sore throat usually lasts for a week or two. Your child might occasionally complain of upper abdominal pain, which might be caused by an enlarged liver and spleen. A red, spotty rash might appear on your child’s trunk.
Glandular fever symptoms
can last for weeks or even months, especially the associated tiredness or general lethargy. Complications with glandular fever are rare, and most children get better completely with time.
If your child’s spleen is enlarged, it might be wise for him to avoid contact sports. This is because they increase the risk of rupturing or tearing the spleen. He might be too tired to do sports anyway.
Young children might be infected with the Epstein-Barr virus and only suffer mild symptoms, or even no symptoms at all. Only 50% of older and adolescent children infected with the virus will develop symptoms. More than 90% of adults have been infected with the Epstein-Barr virus and have antibodies to the virus, meaning they won’t usually be re-infected.
Rare complications of glandular fever include hepatitis, meningitis and pneumonia.
When to see your doctor
You should see your doctor if your child:
- has a sore throat that doesn’t improve after 3-4 days
- complains of extreme tiredness which doesn’t improve after a day or two of rest
- has any combination of the symptoms described below.
Also see the doctor if you’re worried or if you have any questions.
Tests
There’s a blood test for glandular fever called Monospot or EBV serology.
Treatment
There’s no specific treatment, cure or vaccine for glandular fever. Antibiotics don’t work against viruses, and ampicillin in particular might cause a nasty rash if taken by a child with this infection.
Treatment aims to relieve symptoms. It includes lowering the fever with paracetamol, and making sure your child gets plenty of rest, drinks lots of fluids and eats well.
Don’t give your child aspirin. It might trigger a rare but potentially fatal disorder known as Reye’s syndrome.
Controlling spread
The Epstein-Barr virus is transmitted to other people via saliva. If your child has glandular fever, encourage her to not share cups or toothbrushes with others. She should avoid kissing people. It’s also important to maintain good personal hygiene, particularly handwashing.
The Epstein-Barr virus can be spread by patients even months after the symptoms have passed. It can also be spread by asymptomatic carriers (people who’ve been infected with the virus but have never had any symptoms). Because of this, it can be difficult to control the spread of this virus. Keeping your child at home to control spread isn’t recommended, as more than 90% of adults have been infected by the virus. It’s also not practical to keep your child in quarantine because the virus can be spread over many months.
