Glandular fever - Mononucleosis

Infection with the Epstein-Barr virus which mostly attacks the lymph nodes - especially in young people. Symptoms: malaise, loss of appetite, fever, tonsillitis, and swollen glands. The symptoms last 1 - 2 weeks, but the tiredness may last longer.

The Latin name for glandular fever is mononucleosis infectiosa - rightly implying that it is a viral disease in which special kinds of mononuclear cells in the blood are stained in a certain way. The popular name of glandular fever refers to the characteristic large number of swollen glands - especially lymph nodes - all over the body and the accompanying fever.

The disease is caused by a certain virus, the Epstein-Barr virus (EBV) - a herpes virus which affects humans. It can be found in all communities, and in children, the disease most often proceeds without symptoms. In the Western world, approximately 50% of the population have had the disease before reaching their teens. In young people and adults, about 25 - 70% of those infected with the Epstein-Barr virus develop the collection of symptoms called glandular fever.

The infection is transmitted via saliva so it is not very infectious - if you avoid kisses, that is! The virus is secreted into the saliva for up to 18 months after the outbreak of the disease and periodically afterwards. Glandular fever most often affects young people of 14 to 18 years - an age at which kissing flourishes, although, luckily, few people get too old to kiss. Most adults have had the disease so there is no reason for not kissing the ones you love on account of a fear of infection.

Besides fever and swollen glands, the symptoms are a violent case of tonsillitis with large coatings on the tonsils appearing 4 - 8 weeks after being infected. In the beginning, there is often a feeling of uneasiness, headache, loss of appetite, and shiverings. The liver will often be affected, but there will seldomly be liver damages after the termination of the disease.

In about half of the people affected, the spleen will be enlarged. There will also often be changes in the blood with a reduction in the number of normal white blood cells and platelets. This, however, will normally pass off by itself in a matter of 3 - 6 weeks.

Some people have symptoms originating in the nervous system - probably because of viral attacks on the brain, the cerebellum, and the cerebral nerves. In the vast majority of cases, these symptoms disappear by themselves. In more rare cases, severe leukemia-like blood changes will appear caused by severe disturbances in the immune system. These changes exclusively affect men and in particularly those suffering from a weakened immune system.

The tonsillitis usually lasts 5 - 10 days and the fever 1 - 2 weeks which is far longer than in normal tonsillitis. The swelling and soreness of the glands rarely last more than three weeks. Many viral diseases, and in particular mononucleosis, are followed by a period in which you can experience pronounced tiredness and difficulties concentrating. For this reason, a small part of the affected people can have problems keeping up with school and studies for months after the attack.

The diagnosis can be made by examining a blood sample in a microscope. Normally, the disease is very characteristic, but there might be reason to culture a sample from the throat since it might also be a case of streptococci - sometimes even in combination with the mononucleosis.


You should eat a healthy and varied diet and take a daily supplement of vitamins and minerals. The body strains its own depots of vitamins during disease, and extra antioxidants such as vitamin C and -E, selenium, and zinc increase the resistance to vira. Moreover, a supplement of the amino acid lysine has a good effect in case of viral infections.

It is best to totally avoid alcohol a couple of months after the disease. In the time after the disease it is also a good idea to avoid stress and make sure to get plenty of sleep at night and rest during the day.

The treatment consists of rest - but not necessarily confinement to bed. It is important to avoid being strained as this seems to be able to initially worsen the disease. It is also recommended to avoid large exertions for the first 2 months as there - however rarely - is a risk of rupturing the spleen which, as mentioned, is often enlarged in relation to the disease.

The pains in the throat are conventionally treated with ordinary analgesics. Penicillin should normally be avoided - especially the new broad-spectrum penicillins like ampicillin which can provoke a violent, red rash.


Consult a doctor before starting self-treatment.


Also see "Tonsillitis", "Herpes simplex", "Tiredness", and "Viral infection".

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