Understanding Glandular Fever: A Close Look at the “Kissing Disease”

It was a quiet morning in the clinic when a 16-year-old boy, Lucas, walked in with his mother. His usual vibrant energy was replaced with a pale complexion and sluggish steps. He sat down gingerly, rubbing his neck and letting out a tired sigh.

“Dr. Priya, Lucas has been feeling exhausted for weeks. He’s had a fever on and off, and now he’s complaining of a sore throat and swollen glands,” his mother explained. “We thought it was just a bad flu, but it’s not going away.”

I nodded sympathetically. “Let’s check him out and see what’s going on.”

What is Glandular Fever?

After a brief examination, I explained that Lucas’s symptoms were consistent with glandular fever, also known as infectious mononucleosis. This viral illness is caused by the Epstein-Barr virus (EBV) and is often nicknamed the “kissing disease” because it spreads through saliva.

“It’s not just from kissing,” I clarified with a smile. “Sharing drinks, utensils, or even being coughed on by someone with the virus can spread it.”

Glandular fever primarily affects teenagers and young adults, with most people contracting the virus at some point in their lives.

Research Insight: Studies suggest that 95% of adults worldwide have been infected with EBV by the age of 40, though not everyone develops glandular fever.

What Are the Symptoms?

Lucas’s mother nodded as I listed the classic symptoms:

• Fatigue: Often profound and lasting weeks to months.
• Fever: Typically mild but persistent.
• Sore Throat: Can resemble tonsillitis, with red or white patches on the tonsils.
• Swollen Glands: Particularly in the neck, armpits, and groin.
• Blocked Nose and Puffiness: Around the eyes.
• Headache: A common accompanying symptom.
• Enlarged Spleen or Liver: Rare but possible in severe cases.

“These symptoms explain why Lucas has been feeling so wiped out,” I said. “Fatigue is often the most debilitating part.”

How is Glandular Fever Diagnosed?

I ordered a blood test to confirm the diagnosis. “We’ll check for abnormal white blood cells and antibodies against EBV,” I explained.

Key Diagnostic Indicators:

• Mononucleosis Spot Test: Detects EBV-specific antibodies.
• Blood Smear: Reveals atypical lymphocytes, characteristic of EBV infection.
• Liver Function Tests: May indicate mild liver inflammation.

Research Insight: A 2020 study highlighted that the monospot test has a 70-90% accuracy rate, but it’s less reliable in younger children.

How Long Does Glandular Fever Last?

Lucas’s mother looked concerned. “How long will it take him to recover?”

I reassured her that most symptoms resolve within 2 to 3 weeks, but fatigue can linger for months. “This is why it’s essential to rest and not push too hard too soon,” I said.

Chronic glandular fever is rare, but prolonged symptoms can sometimes lead to conditions like chronic fatigue syndrome.

Research Insight: A systematic review published in the Journal of Infectious Diseases found that up to 12% of individuals experience prolonged fatigue lasting six months or more after glandular fever.

How Common is the Problem?

I explained that glandular fever is more common than many realize. “Most people are infected with EBV at some point, but not everyone develops glandular fever. When they do, it’s usually during adolescence or early adulthood.”

Research Insight: The Centers for Disease Control and Prevention (CDC) notes that about 25% of adolescents and young adults infected with EBV develop glandular fever symptoms.

What Are the Risks?

“Is it dangerous?” Lucas’s mother asked.

“Not usually,” I said. “But there are potential complications if it’s not managed properly.”

Possible Complications:

1. Splenic Rupture: Rare but serious; caused by an enlarged spleen.
2. Liver Inflammation: Can lead to jaundice in severe cases.
3. Secondary Infections: Such as bacterial throat infections.
4. Autoimmune Reactions: Rare conditions like hemolytic anemia.

Research Insight: The risk of splenic rupture is about 0.1-0.2% in patients with glandular fever, typically occurring in the first 3 weeks. A case study published in the British Medical Journal emphasized the importance of avoiding strenuous activity during recovery to minimize this risk.

What is the Treatment?

“Since it’s a viral illness, there’s no specific cure,” I explained. “Treatment focuses on relieving symptoms and supporting the body’s recovery.”

Do’s:

• Rest: The most important treatment.
• Hydration: Drink plenty of fluids like water and fruit juices.
• Pain Relief: Use paracetamol or ibuprofen to ease fever and throat pain.
• Gargling: Saltwater or soluble aspirin can soothe a sore throat.

Don’ts:

• Avoid Alcohol: It can strain the liver.
• No Contact Sports: For at least 4-6 weeks to protect the spleen.
• Don’t Push Through Fatigue: This can prolong recovery.

Lucas’s mother appreciated the clear guidelines. “We’ll make sure he rests and takes it easy,” she said.

How is it Prevented?

Prevention can be challenging because EBV spreads easily. I shared some tips to minimize risk:

1. Avoid Sharing Utensils and Drinks: Especially with someone who’s unwell.
2. Good Hygiene Practices: Handwashing and disinfecting surfaces.
3. Healthy Immune System: A balanced diet and adequate sleep can help reduce susceptibility.

Research Insight: A study in Clinical Infectious Diseases found that maintaining good hygiene practices reduces the risk of EBV transmission by 30%, particularly in households with young children.

Lucas’s Path to Recovery

Two weeks later, Lucas returned for a follow-up. He still felt tired but was no longer feverish, and his sore throat had resolved. “I’ve been resting a lot, like you said,” he told me.

“That’s great to hear,” I replied. “Continue taking it easy, and you’ll be back to your old self soon.”

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