Glandular Fever
Your health expert: Dr Ekundayo Ajayi-Obe, Consultant General Paediatrician
Content editor review by Rachael Mayfield-Blake, March 2023
Next review due March 2026
Glandular fever (infectious mononucleosis) is an infection caused by a virus. It causes a sore throat, swollen glands and tiredness and is most common in teenagers and young adults. Most people recover from the infection within two to four weeks.
About glandular fever
Glandular fever is most common in people aged between 15 and 24.
Glandular fever usually gets better on its own without treatment. Many people don’t know they have had the infection, because they don’t have symptoms (particularly children).
Causes of glandular fever
Glandular fever is usually caused by infection with the Epstein–Barr virus (EBV), which is one of the herpes viruses. Once you’re infected with EBV, you’ll carry it in your body for the rest of your life, although you may not have any symptoms of glandular fever. The virus will lie inactive (dormant) in your body. Around nine out of 10 people carry EBV in their body by the time they become adults.
The EBV virus is spread from person to person in saliva. So, this is why it’s sometimes called the kissing disease. The virus can stay in your saliva for a year or more after you get infected.
You catch the virus by kissing, or sharing food or drink from a cup, glass or cutlery that someone with the virus has used. Young children can get infected if they chew on toys that have the virus on them.
Symptoms of glandular fever
It’s possible that you can have EBV infection, but not have any glandular fever symptoms.
After you’ve been infected, the symptoms of glandular fever can take between four and seven weeks to develop. Glandular fever symptoms include:
- extreme tiredness and lack of energy
- sore throat – this can be mild or severe and can lead to infected tonsils (tonsillitis)
- fever
- swollen lymph glands – you’ll notice these in your neck but other lymph glands may be affected, for example under your arms or in your groin
- weight loss
- feeling sick
- muscle and joint aches
- a rash
Most glandular fever symptoms will usually start to get better around two weeks after they start. But tiredness and lack of energy can last for longer. You may still feel tired and run-down for some weeks or months afterwards.
Get medical help straightaway if you:
- have difficulty breathing or wheezing when you breathe
- have difficulty swallowing liquids
- feel very unwell
- have pain in your tummy (abdomen)
Diagnosis of glandular fever
A GP will ask about your symptoms and examine you. They may give you a blood test to confirm that you have the infection. Sometimes, if the illness is early on, the blood test may not show up the virus so you’ll need another test a week or two later. If the blood test remains negative, the GP may test for other viruses.
Self-help for glandular fever
There are things that you can do to help relieve the symptoms of glandular fever. These include the following.
- Get plenty of rest during the early stages when your symptoms are most severe.
- Drink plenty of fluids.
- If you need pain relief or to treat a fever, you can take over-the-counter painkillers, such as paracetamol or ibuprofen.
- Try gargling with soluble aspirin if you have a sore throat (children under 16 shouldn’t take aspirin).
- Don't drink alcohol.
Treatment of glandular fever
Glandular fever usually gets better on its own. There isn’t any specific medicine that you can take to treat glandular fever and because it’s a virus, antibiotics won’t work. Antibiotics only fight bacteria. The main aim of glandular fever treatment is to ease your symptoms.
If your tonsils swell and get larger and this affects your breathing, or if your symptoms are severe, a GP may refer you to hospital and you may be prescribed steroid medicines. These help to reduce swelling and inflammation. If your tonsils also become infected by bacteria during your illness, your GP may give you antibiotics to treat this additional infection.
Always read the patient information that comes with your medicine and if you have any questions, ask a pharmacist or GP for advice.
You don’t generally catch glandular fever from normal, day-to-day contact with people. So, you don’t need to stay away from work, or keep your children away from school, unless you or your child feels too unwell to go.
Complications of glandular fever
Complications of glandular fever include the following.
- Glandular fever can cause your tonsils to swell and get larger. This can potentially block your airway, and cause breathing problems. If this happens, a GP may refer you to hospital where you may be given steroid medicines to help reduce the swelling.
- Around half of all people who have glandular fever get an enlarged spleen. Your spleen is an organ on the left side of your tummy (abdomen) and is part of your immune system. An enlarged spleen usually develops in the first few weeks of glandular fever and it can rupture (break or tear), although this is rare. But if this happens, it can be life-threatening and you may need to have an emergency operation to repair it. For this reason, don’t play contact sports, such as rugby, or lift heavy objects in the first month of having glandular fever.
- Occasionally glandular fever may lead to an inflamed liver (hepatitis). This can cause yellowing of your skin and the whites of your eyes (jaundice).
- Very rarely, glandular fever can lead to problems with organs in your body, such as your heart and kidneys, and with your nerves.
- The tiredness that can be a long-term effect of glandular fever may lead to depression or long-lasting (chronic) fatigue.
Prevention of glandular fever
You can help to prevent getting or spreading glandular fever by washing your hands often. And by cleaning anything that comes into contact with saliva, such as cups, glasses and cutlery.
The main cause of glandular fever is the Epstein–Barr virus (EBV), which is a herpes virus. You catch it by kissing, or sharing food or drink from a cup, glass or cutlery that someone with EBV has used.
See our section: causes of glandular fever above for more information.
Yes, glandular fever is contagious. It’s caused by a herpes virus called the Epstein–Barr virus (EBV). The EBV virus is spread from person to person in saliva. You can help to prevent getting or spreading glandular fever by washing your hands often. And clean anything that comes into contact with saliva, such as cups, glasses and cutlery.
See our sections: causes of glandular fever and prevention of glandular fever above for more information.
It’s impossible to say what the fastest way to recover from glandular fever is because there isn’t any specific medicine to treat it. Antibiotics won’t work because glandular fever is a virus. The aim of glandular fever treatment is to ease your symptoms, and with time, it will get better. Get plenty of rest, particularly during the early stages. Most people recover from the infection within two to four weeks.
See our section: treatment of glandular fever above for more information.
Over-the-counter painkillers
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- Infectious mononucleosis. BMJ Best Practice. bestpractice.bmj.com, last reviewed 21 November 2022
- Glandular fever (infectious mononucleosis). NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised July 2021
- Infectious mononucleosis. Patient. patient.info/doctor, last edited 16 February 2021
- Ear, nose, and throat. Oxford handbook of general practice. Oxford Academic. academic.oup.com, published June 2020
- Mononucleosis. Mohseni M, Boniface MP, Graham C. www.ncbi.nlm.nih.gov, last update 8 August 2022
- Spleen anatomy. Medscape. emedicine.medscape.com, updated 13 January 2014
- Jaundice in adults. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised November 2020
