Causes of glandular fever

Glandular fever is caused by the Epstein-Barr virus. This virus usually spreads from person to person through saliva. That’s why this condition is sometimes called ‘the kissing disease’.

Glandular fever is also known as infectious mononucleosis.

Glandular fever symptoms

The incubation period for glandular fever is 30-50 days – that is, the virus infects children 30-50 days before symptoms appear.

Symptoms come on gradually. At first, your child might feel generally unwell and tired. Then she’ll 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 tiredness or general lack of energy. But most children get better completely with time.

Young children might be infected with the Epstein-Barr virus and suffer only mild symptoms, or even no symptoms at all. Only 50% of older children and teenagers infected with the virus will develop symptoms.

Complications with glandular fever are rare. These complications include liver infection (or hepatitis), meningitis and pneumonia.

More than 90% of adults have been infected with the Epstein-Barr virus. These adults will have antibodies to the virus, and so won’t usually have a second episode of illness caused by this virus. This means that if your child has had glandular fever, he more than likely won’t get it again.

When to see your doctor about glandular fever symptoms

You should take your child to the GP if your child:

  • has a sore throat that doesn’t improve after about five days
  • complains of extreme tiredness, which doesn’t improve after a day or two of rest
  • has swollen glands that remain swollen and/or painful for longer than a few days
  • has abdominal pain or tenderness for longer than a few days.

You should see your GP, go to hospital, or call an ambulance if your child has extreme abdominal pain at any time.

Also see the GP if you’re worried or have any other questions.

Tests for glandular fever

Your doctor might decide to confirm glandular fever by doing a blood test on your child.

Glandular fever treatment

There’s no specific treatment, cure or vaccine for glandular fever. Antibiotics don’t work against viruses, and some penicillin antibiotics like amoxicillin might cause a rash if taken by a child with glandular fever.

The best you can do for your child is treat the symptoms of glandular fever. This includes lowering the fever with paracetamol, and making sure your child gets plenty of rest, drinks lots of fluids and eats well.

If your child’s spleen is enlarged, it’s best for her to avoid contact sports. This is because contact sports increase the risk of rupturing or tearing the spleen. Your child might be too tired to do sport anyway.

Don’t give your child aspirin. It might trigger a rare but potentially fatal disorder known as Reye’s syndrome.

Controlling the spread of glandular fever

The Epstein-Barr virus spreads to other people through saliva.

If your child has glandular fever, encourage him to not share cups or toothbrushes with others. He should also avoid kissing people. It’s important to have good personal hygiene, particularly handwashing.

The Epstein-Barr virus can be spread by people whose symptoms have passed and even by people who’ve never had symptoms. These people are called ‘asymptomatic carriers’. 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, because more than 90% of adults have been infected by the virus. It’s also not practical to keep your child at home because the virus can spread for many months before and after your child shows symptoms.