Glandular fever

This leaflet is for patients who have been admitted to hospital with glandular fever. It explains what the condition is and how it can be treated. If you still have questions after reading this leaflet, please speak to a healthcare professional.

What is glandular fever?

Glandular fever is a viral infection that can affect people of all ages, but most cases affect teenagers and young adults. It gets better without treatment, but it can last for weeks and make you feel very ill.

What causes glandular fever?

Glandular fever is caused by the Epstein-Barr virus (EBV). This virus is found in the saliva of infected people and can be spread through:

• kissing – glandular fever is often referred to as the ‘kissing disease’

• exposure to coughs and sneezes, and

• sharing eating and drinking utensils, such as cups, glasses, and unwashed cutlery.

EBV may be found in the saliva of someone who has had glandular fever for several months after their symptoms pass. Some people may continue to have the virus in their saliva on and off for years.

If you have EBV, it’s a good idea to take steps to avoid infecting others while you are ill, such as not kissing other people.

What are the symptoms?

Symptoms of glandular fever may include:

• high temperature (fever)

• fatigue (extreme tiredness)

• swollen glands, which may be in your neck, groin, and armpits

• sore throat, and / or

• swollen ulcerated tonsils.

What are the risks?

Most people get better with no problems. But sometimes glandular fever may lead to other more serious problems.

• Liver conditions, such as hepatitis.

• Heart problems, such as inflammation of the heart.

• Kidney problems.

• Blood conditions, such as low levels of blood cells called platelets (thrombocytopenia) or sepsis.

• Neurological conditions, such as Guillain-Barré syndrome or Bell's palsy.

• A ruptured (burst) spleen.

• Long-term tiredness (chronic fatigue), which may last for several months.

If you develop one of these symptoms, we may admit you to hospital.

What will happen when I am admitted to hospital?

A doctor will assess you in the treatment area. They will explain:

• the reasons for your admission to hospital, and

• the tests you will need to confirm your diagnosis. These will include a blood test (Mono Spot or ABU.Ab). This test may not diagnosis glandular fever in the early stages. We may need to repeat the test at a later stage of our illness.

You will then be shown to your bed area. A nurse will discuss and plan the care you will receive during your hospital stay. Please use this time to ask any questions you may have.

The nurse will record your blood pressure, temperature, and pulse. Your doctor may prescribe you medication in the form of tablets or an injection, to reduce your pain or fever. If you are unable to eat or drink, due to a severe sore throat, you may be prescribed IV (intravenous) fluids to stop you becoming dehydrated.

What treatment will I receive in hospital?

There is no specific treatment for glandular fever.

• If needed, you should have plenty of fluids (drinks), rest, and painkillers (such as paracetamol).

• Antibiotics are sometimes given to prevent complications.

• Some patients also need steroids, to reduce their swollen tonsils.

How long will I stay in hospital?

This will depend on your condition and your response to treatment. Most patients stay in hospital for one or two days. You will discuss this with your doctor.

What should I do when I return home?

Patients who are not admitted to hospital, and who are recovering at home, can also follow this advice.

• If you have developed liver problems, do not drink alcohol until your liver function blood tests return to normal. Your GP will arrange these tests.

• It is important to continue to drink plenty of fluids.

• Rest is encouraged during your recovery.

• Continue to take any prescribed painkillers or anti-inflammatory tablets.

• Avoid rough or contact sports for at least eight weeks. If you have an enlarged spleen this could cause damage.

• Glandular fever is spread through spit, so you can get it through kissing or by sharing cups or cutlery. To stop the spread of glandular fever, avoid kissing or close body contact with other people whilst you are ill. You should also wash your hands regularly.

What if I have any concerns or questions about my condition?

Fatigue can last for several months; this is normal. Please contact your GP if you develop any further or unusual symptoms. They can also advise you on when you can return to school or work.

Further information

For more information and advice on self-care for glandular fever, please visit the NHS web site.