It is a self-limited disease, which means that it usually goes away on its own.
Glandular fever ( infectious mononucleosis ) is caused by the Epstein-Barr virus.
This virus can be spread from person to person through close contact (especially kissing).
It can also be passed on when sharing cups, toothbrushes, etc.
It can take up to six weeks for symptoms to develop after a person is first infected with this virus.
This is known as the incubation period.
Mononucleosis is more common in the young adult and adolescent population.
The immune system produces antibodies during infection . This generally provides lifelong immunity.
This means that it is rare to have more than one episode of mononucleosis.
The most common virus that causes infectious mononucleosis is the epstein-barr virus.
The epstein-barr virus is part of the herpes family, which contains 7 other viruses that infect humans.
Other viruses that can cause illness include HIV, cytomegalovirus, rubella, and hepatitis.
This virus is very common throughout the world, which means that an individual is likely to contract it at some point in their life.
Most people contract epstein-barr virus during childhood.
However, the virus usually causes very mild symptoms or no symptoms in children.
The epstein-barr virus can be transmitted through saliva, semen, and blood.
This means that you can catch it even sharing a glass with an infected person.
Infectious mononucleosis is often referred to as the “kissing disease.”
This is because kissing is the main method of transmission of the epstein-barr virus in young adults and adolescents.
Infectious mononucleosis is caused by the Epstein-Barr virus or cytomegalovirus, which are members of the herpes simplex virus family.
Cytomegalovirus is actually a group of viruses in the herpes simplex virus family that often causes cells to enlarge.
When children are infected with the virus, they generally do not experience any noticeable symptoms.
However, uninfected adolescents and young adults who come into contact with the virus can develop infectious mononucleosis in nearly 50 percent of exposures.
One or more of the following symptoms commonly occurs in about a week or so.
Symptoms usually set in gradually over another week.
Although this may be mild, the throat is often very sore, red, and swollen.
Glandular fever is generally suspected when tonsillitis is severe and lasts longer than normal.
Swallowing is often painful and saliva can collect in the mouth.
A sore throat can be caused by a number of conditions, from the flu to vocal tension.
A sore throat that occurs suddenly is a typical sign of infectious mononucleosis.
Many patients describe it as the most severe sore throat they have ever experienced.
Swollen lymph nodes
As your body’s immune system fights the virus, it causes the lymph glands to swell.
Any lymph gland in the body can be affected.
However, the glands in the neck are generally the most prominent.
Infectious mononucleosis can cause swollen lymph nodes and they can become quite large and tender.
Cervical lymph nodes in the neck region are most likely to be affected.
Usually, the lateral and posterior lymph nodes in the neck will also grow in size.
This symptom can give the appearance of swelling around the neck.
Like other viral infections, glandular fever often causes a high temperature (fever), muscle aches, and headaches.
A feeling of severe tiredness often develops with mononucleosis. This is often the last symptom.
Swelling around the eyes
About 1 in 5 people with mononucleosis have swelling around the eyes.
This is an organ located under the ribs on the left side of the abdomen.
It is part of the immune system. Like the lymph glands, it swells and can sometimes be felt under the ribs if you have mononucleosis.
Very occasionally, it causes mild pain in the left upper abdomen.
Severe fatigue can be a symptom of infectious mononucleosis.
Rest, a healthy diet, and avoiding stress can help reduce drowsiness or low energy levels.
Fatigue is generally not relieved by any of these practices and is often accompanied by a severe lack of energy.
Many people become infected with this virus but do not develop symptoms.
This is called a subclinical infection. This is more common in children and in people over the age of 40.
Infectious mononucleosis can cause a sensation, often described as myalgia.
Myalgia is the appearance of pain in the muscles or in a group of muscles.
These pains tend to appear gradually as the disease progresses.
The epstein-barr virus is the most common cause of infectious mononucleosis, yet it can remain inactive in your body for years.
If infection with the epstein-barr virus occurs, the body will harbor the virus for the rest of life.
It can be reactivated without symptoms and the epstein-barr virus can be passed on to other people.
Infectious mononucleosis is usually caused by a primary (first-time) infection with the epstein-barr virus.
The condition goes through the following stages:
Epstein-barr virus negative
If a person is negative for epstein-barr virus infection.
You are unlikely to develop infectious mononucleosis as a result of the epstein-barr virus
At this stage, you will not experience any symptoms. The incubation period is estimated to last approximately 6 weeks.
The epstein-barr virus begins to reproduce in the mouth. From there, the virus infects B cells, a type of white blood cell.
It can also lodge in the upper exposed area of your tonsils.
Occasionally, the epstein-barr virus will move into the blood. However, the precise mechanisms behind this transition are not fully understood.
The development of the disease
As the virus multiplies, your body will start making antibodies against it.
A blood test would show a very high viral load (amount of the virus) of the epstein-barr virus.
Similarly, there will be a significant increase in white blood cell production.
In this stage the symptoms of infectious mononucleosis manifest themselves and tend to last around the two-week mark.
However, fatigue and swollen lymph nodes can remain for up to 3 weeks or more.
Infectious mononucleosis is usually a transient condition. This means that the symptoms will go away on their own over time.
However, for some people, the disease is a precursor to chronic diseases, usually related to chronic fatigue.
People with lower rates of physical activity tend to be more prone to this problem.
The patient can still infect other people with the epstein-barr virus and remain contagious for an average of up to six months after the infectious mononucleosis outbreak.
The symptoms caused by mononucleosis are similar to the symptoms caused by other viruses.
Therefore, it can be difficult to diagnose mononucleosis with just a doctor who examines you.
Therefore, a blood test is done that can detect a particular antibody and confirm if you have mononucleosis.
This will reveal if heterophile antibodies are present, indicating that the epstein-barr virus is active.
A blood test for infectious mononucleosis will also look at the activity of your lymphocytes (white blood cells).
A very high number of lymphocytes together with a positive heterophile result will probably confirm the diagnosis.
If your blood test is negative but your doctor suspects you have mononucleosis, you may have a blood test several weeks later.
Unusual symptoms and complications
Most people with mononucleosis do not have complications or unusual symptoms. If complications do occur, they can include:
This is a serious but rare complication. A damaged spleen can occur after having mononucleosis.
In some people with mononucleosis, a generalized red rash occurs that is not itchy.
This usually wears off quickly.
Sometimes mononucleosis causes mild inflammation of the liver that causes a yellowing of the skin (mild jaundice).
Malaise and depression
It is common to feel tired and low for the duration of the illness and for a week or so afterward.
Some people develop “post-viral fatigue” for varying periods.
Other complications of infectious mononucleosis that do not occur often can include:
- Kidney inflammation.
- Hemolytic anemia.
- Nervous system problems, such as encephalitis, meningitis, and other conditions.
- Inflammation of the heart muscle.
- Heart rhythm problems
- Upper airway obstruction.
Treatment for mononucleosis
Treatment is primarily focused on controlling and reducing your symptoms.
Infectious mononucleosis can cause extreme fatigue and a general feeling of being unwell (sick).
Most doctors recommend adequate rest as the condition runs its course.
Usually no specific treatment is needed. However, it is important to drink plenty of fluids.
Staying hydrated is important for general well-being.
However, when you are sick, drinking enough water should be a priority.
Lack of fluid intake leads to dehydration, especially if you also have a high temperature.
Mild dehydration can make headaches and tiredness worse.
Your doctor will likely recommend taking acetaminophen or ibuprofen to relieve general pain, headache, and fever.
The spleen can swell while you have infectious mononucleosis.
In rare cases, it can break suddenly or due to external trauma.
Your doctor will likely recommend avoiding contact sports, such as hockey or basketball, for the duration of the illness.
To prevent spread, kissing and close body contact with other people should be avoided while sick.
It is also best not to share cups, towels, etc. while you are sick.
If you drink alcohol when you are sick with mononucleosis, you may feel much worse than normal due to the effect of mononucleosis on your liver.
Antibiotic medications are not usually used, as glandular fever is caused by a virus.
Occasionally, an antibiotic will be prescribed if a secondary throat infection develops caused by a germ (bacteria) that then responds to antibiotics.