Glandular Fever (commonly known as 'mono')

Glandular fever is becoming increasingly common. It is sometimes known as the kissing disease and, by the professionals, as infectious mononucleosis (IM). It is also known as EBV infectious mononucleosis, Pfeiffer's disease or Filatov's disease, or just plain mono. Nil Filatov described the syndrome as an infectious process in 1887. Independent of that, Emil Pfeiffer came to the same conclusion in 1889.

It is an acute, viral condition caused by the Epstein-Barr virus (EBV). This is one type of herpes virus to which over 90% of adults have been exposed as children. It is spread through contact with saliva but can also be caught from sharing cups or utensils. It has also been linked to chronic fatigue syndrome.

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It is suspected that glandular fever has been on the rise since the 1970s. Because of better hygiene in developed countries, fewer children under four years are being exposed to the virus. At that age, it may go unnoticed or only cause mild illness with flu-like symptoms.

However for those aged 14 to 21 the disease may be mistaken for tonsillitis in its early stages. Glandular fever is extremely debilitating and patients can take weeks or months to recover.

Glandular fever can only be diagnosed with a blood test. Symptoms include fever, sore throat, fatigue, headache, nausea, weight loss, vomiting, loss of appetite and swollen glands. Diagnosis is generally by observation of symptoms but can be confirmed by diagnostic tests. Adults are less likely to present with a sore throat or swollen glands but may have enlarged livers and jaundice.

It isn't uncommon for those suffering with glandular fever to be misdiagnosed with a streptococcal pharyngitis. If given ampicillin or amoxicillin for such a condition, 80 to 90% of patients with acute EPV will develop a red rash.

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If jaundice is present, it will generally indicate swelling of the spleen or liver. Even when the initial sickness has run its course, ongoing lethargy can continue well after an observed recovery. Research has shown that it is the body's reaction to the EBV that causes such severe symptoms, not EBV itself.

The immune system goes into a hyperactive state. This is known as a cytokine storm and it is this that causes people to become so sick. The period from infection to appearance of the symptoms is about six weeks. Glandular fever is more common in adolescents and young adults. If it does strike older people, it is likely to be more severe. Once a person has had glandular fever, the EBV stays in the body for life.

Of the Australian population it is believed that 80% of the population is carrying EBV but not all will develop symptoms. When the EBV infection occurs in younger people, glandular fever results in 35 to 50% of cases. It is possible to pass on the EBV virus on even when no symptoms are evident.

The incubation period is four to seven weeks. It is usual for symptoms to persist for 2-3 weeks but fatigue can last much longer. The period of contagion is not known to any degree of exactness but is generally stated as being six weeks after the beginning of symptoms. However some studies have indicated that contagion lasts for much longer, many months after the disappearance of the symptoms.

During the acute phase of the infection, rest is recommended. Serious complications with the disease are uncommon. When the acute symptoms disappear they often do not return. However the sufferer carries the virus for the rest of their life. The virus may reactivate periodically but usually without any symptoms of illness.

Apart from rest, some naturopaths recommend a combination of herbs to treat glandular fever such as echinacea and andrographis. A B-complex vitamin as well as vitamin C and magnesium are recommended. A healthy intake of colourful vegetables, fruits and high-quality proteins will help boost the immune system.  Drink plenty of water but avoid alcohol, sugar, dairy products and fatty foods.

There seems to be little that can be done to avoid infection by EBV. Hopefully it will not always develop into glandular fever.