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Glandular fever

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 3 minutes read

Glandular fever is a throat infection caused by the Epstein-Barr virus and is also known as infectious mononucleosis. It usually affects teenagers and young adults but can affect people of any age. It gets better without treatment, usually after two or three weeks, although some people might feel extremely tired for many months.

It presents like any other viral infection with fever, cough, sore throat, and feeling generally unwell. You may notice your tonsils enlarge, and the glands you can feel on the outside of your neck get bulky and sore.

Antibiotics will not help treat this condition, as they do not affect viruses.

Doctor’s advice

Is it contagious?

Glandular fever is very contagious. It’s known as the kissing disease, as it’s passed on by saliva, so take care around sharing cups and cutlery, and, well, avoid kissing.

It can cause mild inflammation of your liver (hepatitis), and this may cause a slight yellowing of the skin – this will improve within a few weeks. It can cause your spleen to enlarge – this puts it at risk of rupturing if it’s jarred, so avoid contact sports such as rugby or football for at least six weeks.

Healthwords pharmacists' top tips

Any over-the-counter treatments aim to reduce the symptoms associated with glandular fever while your body fights the virus. Make sure you’re drinking plenty of fluids to help your immune system and avoid the dehydration associated with fever and illness – sip little and often.

An acetaminophen-based product such as Tylenol may help with general aches and mild fever. Anti-inflammatory products may also help with this, such as those containing ibuprofen (Advil) or (for adults) those containing aspirin (Bufferin). This may reduce swelling of the glands.

Using a medicated lozenge such as Sucrets may help to soothe sore throat symptoms, or if a spray is preferred, Chloraseptic Sore Throat spray may be useful.

A mild pick-me-up may help with the associated fatigue, as a product containing vitamins and a source of caffeine, such as One A Day Energy tablets, may help in the short term to improve energy levels.

Am I fit for work?

Most people will feel quite tired and unwell, so you’re unlikely to be fit for work (or school or university). People can generally return to normal work within a week or two.

When should I see my doctor?

If you think you may have glandular fever, book an appointment with your doctor for a blood test to confirm the condition and other tests to look at the health of the liver and spleen. If you are finding it difficult to swallow or to keep fluids down and think you are dehydrated or feel severely unwell, call your doctor immediately or call 911 outside of working hours.

The doctor will ask about your symptoms and examine you. Depending on the possible diagnosis, blood tests or imaging (X-ray, ultrasound, CT scan, MRI) could be carried out, or you may be referred to a specialist department. If glandular fever is suspected, a specific blood test will be done to confirm the diagnosis.

If you have glandular fever, your spleen (sitting to the left lower side of your abdomen) can swell – the doctor may be able to assess this by feeling your tummy – so it is important to avoid sports or activities that increase your risk of falling, in particular contact sports. Go to the Emergency Department if you have injured your tummy during this time.

You should seek urgent medical advice if you have sudden severe stomach pain, difficulty breathing, or swallowing, either by calling 911 or going to the Emergency Department.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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