Glandular fever

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When to see the doctor

Go to the doctor if your child:

• has a sore throat that does not improve after three or four days
• complains of extreme tiredness which does not improve after a day or two of rest
• has any combination of the symptoms described below
• or if you are concerned or have any questions.

What causes it?

Glandular fever is caused by a virus called the Epstein-Barr virus which is commonly transmitted through saliva (hence its nickname of ‘the kissing disease’).

What are the symptoms?

The incubation period for glandular fever is from three days to two weeks. The onset of the illness is gradual and at first the child may just feel generally unwell and tired. A fever usually develops, followed by a sore throat and tender, swollen lymph glands. The sore throat tends to continue for a week or two, and does not respond to antibiotics. Occasionally your child may complain of upper abdominal pain due to enlargement of the liver and spleen.

A red, spotty rash may appear on the trunk. Symptoms, especially tiredness or general lethargy, can last for weeks or even months.

It is unusual to see complications with glandular fever, and most children recover completely with time. If the spleen is enlarged, it may be wise to avoid body contact sports, because of the increased risk of rupturing or tearing the spleen (although your child may be too tired to participate in sports). Other rare complications include hepatitis, meningitis and pneumonia.

Is there a test?

There is a blood test for glandular fever called Monospot or EBV serology.

How is it treated?

Glandular fever is a viral illness, so there is no specific treatment or cure. Antibiotics are ineffective against viruses, and ampicillin in particular may cause a nasty rash if taken by a child who has this infection. Treatment is geared towards the relief of symptoms, such as lowering the fever with paracetamol, and making sure that your child gets plenty of rest and eats well.

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