Glandular Fever; Infectious Mononucleosis; The Kissing Disease

If you haven't heard of glandular fever, you may have heard of this disease by one of its other names: Infectious Mononucleosis (Mono for short) or the Kissing Disease.

Our experienced Private GP's at London Doctors Clinic outline the key features, symptoms and treatments for this illness.

Is it glandular fever?

Glandular fever most often affects young adults, with its presentation varying depending on the suffer's age.

If one of our private doctors suspects Glandular Fever, they'll likely start their investigations by asking these 4 key questions:

  1. Are you between 15 and 24 years of age?
  2. Do you have prolonged, mild fever?
  3. Are your neck glands (cervical lymph nodes) swollen?
  4. Do you have a terrible sore throat?

Glandular fever lymph nodes neck

A classic sign of glandular fever is enlarged neck lymph nodes

If you answered yes to most of these questions, you might have a classic case of the kissing disease. It's at this point, that our GP's may recommend the blood test for Glandular Fever, known the Paul Bunnell Monospot test. At LDC, we offer the most affordable private blood tests in London: this Glandular Fever blood test costs just £40, with results available next-day.

Other glandular fever symptoms you may experience include:

  • Extreme fatigue
  • Tiredness
  • Swelling around the eyes
  • Abdominal pain
  • Nausea
  • Vomiting
  • Headache
  • Enlarged tonsils (at back of throat) covered in a layer of yellow pusundefined

Swollen, pus-covered tonsils could be a sign  of glandular fever

Other signs which your doctor will look for include an enlarged spleen (splenomegaly) which can sometimes cause discomfort in the top left of your abdomen.


How does glandular fever present in older adults?

Glandular Fever can actually be trickier to diagnose in adults over 25, since the characteristic symptoms of a sore throat and swollen lymph nodes are less likely to appear. If you’re feeling tired all the time, experiencing an ongoing fever and have widespread aching muscles, you may have contracted glandular fever. Jaundice (yellowing of the skin) and hepatomegaly (an enlarged liver) are also more common in older people who get the disease.

Glandular Fever in kids

When it comes to children, it seems they get the best possible deal! They could have absolutely no symptoms at all and if they do, it’s most often just a simple flu-like illness or a mild sore throat. Hence it’s not that often that we diagnose glandular fever in young children.

Glandular Fever in kids\

Children rarely suffer severe symptoms of Glandular Fever


The Epstein-Barr virus

The bug causing glandular fever is the Epstein-Barr virus (EBV), which is a branch of the herpes virus family. If we think about the nasty work it does, the symptoms of glandular fever begin to make sense.

Viruses invade our cells and hijack our wonderful internal machinery to multiply. EBV first multiplies within the cells of our throat (epithelial cells), causing the sore throat!

The EBV virus then moves on and infects a type of immune cell circulating in our body – the B cells. This elicits a strong immune response and when there’s a strong immune response, tissues where immune cells grow and do their work tend to go into overdrive. These tissues are called lymphoid tissues and they include the spleen and lymph nodes (glands) – you can see why they enlarge!

Is Glandular Fever contagious?

Very simply: yes! Interestingly, Glandular Fever also goes by the name of infectious mononucleosis (IM), or simply mono, as well as the kissing disease which hints at the fact it’s spread through saliva. You may be thinking: "But I haven’t been kissing anyone lately?!" Well, there are other ways of spreading saliva such as through coughs and sneezes or sharing eating utensils.

Although the research is still unclear on this, it appears that a person is most likely to be contagious for six weeks after their initial infection. Now, if we say it may take 4-6 weeks from EBV infection until symptoms typically appear, generally by the time someone develops Glandular Fever symptoms, they may no longer be contagious!


Recovery from glandular fever

You’ll be glad to know glandular fever usually resolves all by itself. While no treatment is actually needed, painkillers such as paracetamol and ibuprofen are usually recommended to make the symptoms more manageable.

In addition to this, you should remember to drink plenty of fluids and get lots of rest. For a month following symptoms you should avoid contact sports or any other activities that could end with you falling over – a swollen spleen is very prone to damage. The mild fever, swollen lymph nodes and body aches can unfortunately persist well beyond one month, however most people feel fully recovered within 2 to 3 months.


Testing and diagnosis

Although Glandular Fever generally goes away on its own, it’s quite a debilitating infection and its effects can last for much longer than regular flu or a typical sore throat.

Hence, it can be useful to formally diagnose Glandular Fever as the cause of the illness – to rule out pathogens such as Cytomegalovirus or the parasite Toxoplasma gondii which may present with similar symptoms! When you know what’s making you ill, you can take appropriate action regarding treatment and recovery.

We offer a very wide range of affordable private blood tests (thousands!) at all six of our central London locations. So, if you’re worried you might be suffering from glandular fever, come along and get tested!

By Dawid Mobolaji Akala