The Epstein-Barr virus causes the glandular fever. It is passed on via the saliva and the mucus produced in the nose and throat of the infected person. People who are suffering from glandular fever are most infectious when they have fever. As the disease is spread mainly via the saliva and close contact, it is also referred to as the 'Kissing Disease'. Hence, close contact and using the same towel and spoons with the infected person should be avoided.
The virus affects the cells of the salivary glands and a certain part of the white blood cells which are known as B-lymphocytes which are actually responsible for producing the antibodies against diseases. The infection begins in the salivary glands and large amount of the virus is released in the saliva. The virus then spreads to the B-lymphocytes where they multiply causing the lymph nodes to swell up and become very painful.
At the onset of the mononucleosis infection, the symptoms pass off as that of flu for about two weeks. The health practitioner usually suspects otherwise after some time has elapsed and there is no improvement in the condition of the patient. Some of the common symptoms seen in glandular fever are:
- Fever along with severe fatigue
- A sore throat along with swollen tonsils which are heavily covered with a white coating
- Headache and muscle pain
- Excessive tendency to sweat
- Sore and swollen lymph nodes in the throat, armpits and the groin
- Enlargement of liver along with jaundice
- Development of rash on parts of the body especially the trunk and limbs
- Stomach pain along with signs that the spleen has enlarged
The spleen which is present under the ribs on the left side at the back can sometimes become enlarged because of glandular fever. This is usually a very rare complication and the spleen can get swollen to a point that it can rupture. In such cases, an emergency surgery to remove the spleen will have to be performed as the ruptured spleen can cause heavy internal bleeding. This would be associated with abdominal pain along with the sudden deterioration in the patient.
Further, in theory there is also the risk of damaging the spleen if the patient who is recovering from the infection takes part in heavy physical activities. Therefore the patients are strongly advised not to exercise for four weeks after the disease has ended.
Apart from the inflammation of the spleen, the rare complications that are seen in patients with glandular fever include damage to the nervous system like inflammation of the brain, hepatitis, pneumonia and anemia. Further, it has also been estimated that about 10% of the people who have glandular fever develop long term chronic fatigue syndrome accompanied with occasional fever, the respiratory canal can become partially blocked, the number of platelets in the blood may decrease and lymph node enlargement.
There is no set path of treatment. People suffering from this fever usually recover completely in a couple of weeks. The treatment is only prescribed for the symptoms if they become very troublesome:
- Fluids: It is very important to consume plenty of fluid during the infection. Swallowing the liquid can be rather painful during a sore throat but not drinking can lead to dehydration especially if the patient also has fever. Further, mild dehydration can also make the tiredness and headache worse.
- Antibiotics: Antibiotics does not kill the virus that causes the glandular fever. However, in some cases, people develop a secondary bacterial infection on the inflamed tonsils which the antibiotics will be able to treat.
- Paracetamol: can be prescribed to ease the pain, headache and fever.
- Steroids: As steroids help in reducing the inflammation, a short course of the steroids can be prescribed to reduce the throat inflammation. However, the use of steroids is very rare.