Mono, EBV, Glandular Fever Information

Glandular fever, otherwise known as infectious mononucleosis, is a kind of viral infection. Some of the signs and symptoms that are associated with glandular fever are fever, sore throat, fatigue, and lymph node and glandular swelling. Glandular fever is brought about by the Epstein-Barr virus, a kind of virus that commonly affects humans. EBV infections are oftentimes seen among children, producing very mild symptoms, if at all. The catch to this, though, is that when one is hit with the infection, the EBV will stay on in the body, particularly in the throat and blood stream, waiting for an opportunity to manifest itself. An EBV infection that manifests during adolescence and early adult years will bring about glandular fever. Indeed, there is a notable increase in the incidence of glandular fever in the 15 to 25 age group. This does not mean, however, that glandular fever is exclusive to the teenagers and young adults: anyone from any age group can be afflicted as well. The body mounts its defense against the infection by getting its immune system to produce corresponding antibodies. This process renders the body immune from succeeding episodes of glandular fever.

The Epstein-Barr virus is highly transmissible, as it can be easily be contracted from the saliva of an infected person. The most notorious manner by which the virus can be passed on is through kissing. Because of this, the infection has earned the monicker “kissing disease”. Other ways of transmitting the virus is being in close proximity with an infected person who is coughing or sneezing, and through the use of eating utensils such as spoon, fork, glass, plate, and the like. Once infected, a person stays contagious for an average of two months, although the virus has been demonstrated to be present in the saliva of infected subjects for up to eighteen months post-infection. Glandular fever has no known cure yet. However, the symptoms that the disease produces are self-limiting, all occurring within four to six weeks. For some patients, fatigue may linger a little longer, lasting for three months. Otherwise, many recover fully from the infection. Glandular fever rarely leads to complications, but when it does, it can be serious. Some of these grave complications are rupture of the spleen which is a surgical emergency, and a superimposed infection, like pneumonia. 

Glandular Fever Symptoms

Before enumerating the signs and symptoms of glandular fever, a clarification in the definition of terms is in order. A symptom is a subjective feeling, something that a patient reports to the doctor. A sign, on the other hand, can be observed even by a third party. An example of a symptom is headache, and an example of a sign is rash. Incubation time refers to the amount of time from the actual infection to the manifestation of signs and symptoms. The incubation period for glandular fever is around one to two months. This period may even be shorter among children.

• The patient may demonstrate symptoms seen in flu. Glandular fever usually presents with fever, headache, fatigue, and a general feeling of ill well-being.
• In some patients, a generalized, non-itchy skin rash may be present.
• Decrease in appetite
• Nausea
• Oftentimes, body malaise is present.
• Patients usually have sore throat. The throat is mildly tender but very sore, swollen, and reddened. The condition is similar to tonsillitis in its graver form.
• The spleen, which is the largest glandular organ in the body and located on the left upper portion of the abdomen, just beneath the ribs, is usually swollen. At times the spleen can even be felt on physical examination.
• There may also be some periorbital swelling, or swollen eye area in about one out of five patients. This condition, however, is self-limiting.
• The patient will have swelling of the glands. They become swollen as a result of the efforts of the immune system to combat the virus. Glandular fever can affect any lymph node in the body, although most of the swollen lymph nodes are palpable at the neck and armpit areas.
• The disease can at times be sub-clinical, i.e., no symptoms. Some patients end up unaware that they have already been infected.
• At times there is involvement of the liver. When the liver is affected, the patient may present with jaundice, or yellow discoloration of the skin and the sclera area of the eyes. This happens especially for patients who are 30 years old or more. Jaundice and other symptoms that can mimic hepatitis disappear once the patient gets well.

Sore throat and fever may be present for about two weeks, while lymph node swelling and easy fatigability may persist a little longer, lasting for some months.

What are the causes of glandular fever?

EBV, or Epstein-Barr virus, is the common offending entity in glandular fever. A person who has not built any immunity yet against the virus may get infected once he gets in contact with the saliva of an infected person. Once this happens, the lining of the throat will be the first to be affected. This will then send signals to the nearby B lymphocytes, which are white blood cells. The B lymphocytes then become vehicles for the virus to circulate in the body. CMV, or Cytomegalovirus, and Rubella virus (German measles) can also bring about glandular fever. Some of the symptoms of glandular fever can also manifest among patients with toxoplasmosis. Glandular fever that is not caused by EBV is usually the type of infection that can be deleterious to the development of the fetus. As such, exposed pregnant women may have to be given antibodies and antibiotics.

Diagnosis of Glandular fever 

• Physical examination – swollen lymph nodes, spleen, liver, and tonsils can be detected
• Blood tests – will have to be done in some cases for confirmation of diagnosis
• Antibody test – done to detect the Epstein-Barr Virus antibodies
• White blood cell test – can detect the presence of an infection. Elevated levels are indicative of an ongoing infectious process.
• Pregnancy tests – with confirmation of pregnancy, concurrent rubella and toxoplasmosis detections may then be performed. It should be kept in mind that EBV in itself does not harm the fetus.

Glandular Fever Treatment

There is no known cure for glandular fever at present. The symptoms, however, can be abated through the following measures:

• Plenty of rest. When a patient is adequately rested especially during the first month of onset of infection, his recovery will be quicker.
• Perform some light exercises to recover muscle tone and strength. This is a recommendation of the National Health Service (NHS) in theUK.
• Drink lots of water and fluids to combat dehydration. This should be done especially in the presence of fever.
• Address pain by administering analgesics. Ibuprofen or Paracetamol are over-the-counter drugs and can be used to control fever and provide relief for pain. Aspirin should not be given to patients who are below 16 years of age.
• Gargle as often as deemed needed. Gargling with salt water has been found by some patients to be helpful in the relief of symptoms of sore throat. There are a number of appropriate solutions which you may choose from with the help of a pharmacist.
• Antibiotics – Since glandular fever is a viral and not a bacterial infection, antibiotics are not often warranted, unless there is a secondary infection.
• Steroids – Steroids may be used for a short period of time when the tonsils are severely inflamed.