Glandular fever

Glandular fever is most common in people aged 15 to 24. The common symptoms are:

• a high temperature (fever)
• a very sore throat
• swollen glands in the neck
• fatigue (extreme tiredness)
• headache

Glandular fever can cause other symptoms too, including:

• feeling generally unwell
• aching muscles
• chills
• sweating a lot
• loss of appetite
• pain around or behind your eyes
• swollen tonsils and adenoids (small lumps of tissue at the back of the nose), which may affect your breathing
• a very red throat that oozes fluid
• small red or purple spots on the roof of your mouth
• a rash
• swelling or 'puffiness' around your eyes
• a tender or swollen tummy
• jaundice (yellowing of the skin and whites of the eyes)

You:

• develop a rasping breath (stridor) or have severe difficulty breathing
• can't swallow, even your own saliva
• develop intense stomach pain

Phone a doctor if you have:

• a very high temperature, or you feel hot and shivery
• a severe sore throat
• swelling on either side of your neck (swollen glands)
• extreme tiredness or exhaustion
• a sore throat that isn't getting better

To diagnose glandular fever, your doctor will start by asking about your symptoms. Then they will examine you, looking for signs of the illness such as swollen glands, tonsils, liver and spleen.

Your doctor may also suggest a blood test. It helps confirm that you have glandular fever, and it can rule out other infections that cause similar symptoms.

Glandular fever usually gets better without any treatment. While your body brings the infection under control, though, there are things you can do to ease the symptoms.

• drink plenty of fluids
• take over-the-counter painkillers, like paracetamol or ibuprofen
• get plenty of rest

Sometimes a doctor may prescribe antibiotics or corticosteroids if you develop complications of glandular fever. A few people have particularly severe symptoms, and they may need to be looked after in hospital for a few days.

Glandular fever is caused by the Epstein-Barr virus (EBV). The virus lives in the saliva of an infected person, and it can spread through:

• kissing
• exposure to coughs and sneezes
• sharing cups, glasses and unwashed cutlery
• sharing toothbrushes

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

You can pass on glandular fever for up to 7 weeks before you have any symptoms, and you may still be infectious for several months after you've been unwell. So if you have glandular fever, these steps help stop it spreading to others:

• wash your hands regularly
• wash anything that may have your saliva on it

• don't kiss other people
• don't share anything that goes into or near your mouth
• don't give blood while you have glandular fever

Complications of glandular fever are uncommon, but if they do happen they can be serious. They can include:

• liver conditions like hepatitis
• kidney conditions
• heart problems like inflammation of the heart
• blood conditions like sepsis
• a ruptured (burst) spleen, which may need to be treated with surgery
• long-term tiredness or fatigue