Mononucleosis: Symptoms, Infection & Treatment

Mononucleosis: Symptoms, Infection & Treatment

The causative agent of glandular fever is distributed worldwide. However, initial contact with the virus does not always lead to illness or only triggers mild symptoms. Many people become infected with the pathogen, but most of the time, they do not notice it or dismiss the disease as a sore throat. Only very rarely does it lead to a severe course with complications. What symptoms can occur with glandular fever, how contagious is the disease, and how is it treated? You will find out in this article.

What is glandular fever? Definition & Cause

Kissing is healthy – it’s even been scientifically proven. But it can also transmit diseases. The infection with glandular fever owes its popular name to this fact: kissing disease or, assuming that students* have close physical contact more often, student fever. In medicine, glandular fever is also called “infectious mononucleosis”.

Mononucleosis is a viral disease. It is caused by the Epstein-Barr virus (EBV for short). This belongs to the group of herpes viruses. Since the viruses are widespread, most people come into contact with the pathogen in their lives – by the age of 30, 95 per cent of the population in Europe have already contracted the disease.

The virus primarily affects the mucous membranes in the nose, mouth and throat and a subset of white blood cells called B lymphocytes. Frequently, there are no or only slight symptoms, so the infection goes (almost) unnoticed. However, the antibodies against the EB virus can be detected in the blood for life. Corresponding persons are referred to as “seropositive”.


Is glandular fever contagious?

EBV is transmitted through saliva, which has given the disease its colloquial name kissing disease. However, droplets scattered by coughing or sneezing can also result in infection.

After infection, it takes another week to 50 days for the first signs of the disease to appear. The incubation period can, therefore, be very different. Nevertheless, you can already be contagious at this time.

Humans produce antibodies during infection. As a result, there is usually no recurrence of the disease. However, the Epstein-Barr virus remains in the body for life after infection and, in rarer cases, can also reappear in the saliva. In this respect, all people who have come into contact with EBV are potentially contagious for life. However, the risk of infection is significantly higher in acutely ill people with symptoms because more viruses are formed during this time.

What are the symptoms of glandular fever?

As mentioned, many people do not experience symptoms when they first encounter the Epstein-Barr virus. However, the typical signs of the infection can also appear, especially in adolescents and younger adults. In young children, however, there are often no signs of illness.

Typical symptoms of glandular fever include:

  • Tiredness, general feeling of illness, loss of appetite (often the first signs)
  • Sore throat
  • Swelling of the lymph nodes in the neck (with tenderness of the lymph nodes)
  • Fever (usually up to 39 degrees) that can alternately rise and fall
  • Cough
  • nausea
  • chills
  • Rash that looks like red patches from measles, scarlet fever, or rubella
  • Petechiae (tiny bleeding) on ​​the palate
  • in inflammation of the tonsils (monocyte angina), pain when swallowinghoarsenessbad breath, grey-white coating on the tonsils

The duration of the disease is up to three weeks. Glandular fever almost always heals without complications.


Mononucleosis: Complications

If the course is average, glandular fever usually heals without long-term effects, even if fatigue and exhaustion lasting months can follow. Whether the disease is related to myalgic encephalomyelitis/chronic fatigue syndrome (MECFS) has not yet been clarified.

The infection rarely takes a more severe course and affects the lymph nodes in the neck region and the liver and spleen. This leads to nausea and upper abdominal pain as well as impaired liver function and even jaundice.

The spleen swells, which can lead to a (life-threatening) spleen rupture. The infection rarely spreads to the brain, causing inflammation (encephalitis). Other organs, such as the lungs, heart or kidneys, can also be affected by inflammation, and there can be a lack of blood cells (e.g. reduction in leukocytes or red blood cells). The disease can be particularly severe in patients with a weakened immune system.

Epstein-Barr virus is also associated with certain cancers and other diseases. For example, the presence of the virus in the body could promote the development of lymphoma and multiple sclerosis. According to current knowledge, however, other causes, such as genetic factors, also play a role, so these diseases are not the sole late effects of an EBV infection.

Mononucleosis: Diagnosis

In addition to the signs of the disease, blood tests are essential for the diagnosis. In particular, so-called Pfeiffer cells (glandular fever cells) are typical. These are altered white blood cells, more precisely altered T-lymphocytes. In general, the number of white blood cells increases in glandular fever.

In cases of doubt, a particular antibody test or a test for EBV antigens can also be carried out with the blood serum. In addition to rapid tests, the so-called “ELISA method” (“Enzyme-Linked ImmunoSorbent Assay”) is the safest method available, with which even the amount of antigens can be determined.

An ultrasound scan can be performed to assess the condition of the liver and spleen. Liver enzymes can also be checked with a blood test.

What therapy is there for glandular fever?

There is no particular drug against the Epstein-Barr virus. Therefore, only the symptoms of the disease can be treated. These include, in particular, the fever and the pain. In addition to remedies for treating sore throats and coughs, such as tablets or throat sprays, antipyretic and pain-relieving drugs, such as ibuprofen, help against the main symptoms. Since the liver breaks down paracetamol, it should not be taken if you have glandular fever to be on the safe side.

In about ten per cent of those affected, there is also bacterial inflammation of the tonsils, which is treated with antibiotics . Doctors will avoid penicillins, as they can lead to skin rashes, especially in mononucleosis.

If complications occur, they must also be treated symptomatically; a ruptured spleen requires emergency surgery.


What can I do on my own?

In the case of an acute infection with the Epstein-Barr virus, it is essential to drink enough fluids, especially if you have a fever. Since the sore throat can make swallowing difficult, herbal teas (e.g. sage, chamomile, thyme ) are particularly recommended for glandular fever. These not only balance the fluid balance but also inhibit inflammation.

The sore throat can also be relieved with warm neck wraps and mouthwashes (e.g., sage or thyme). Ready-made preparations with nasturtium and horseradish are available in pharmacies.

The most important thing is physical rest, especially in the first few weeks of the illness. Full resilience is often only restored after several months. If the spleen is swollen, physical work or sports can already lead to a rupture of the spleen.

How can you prevent infection?

Since the virus is widespread, it is difficult to protect yourself from infection. The only way is to avoid close physical and especially salivary contact with the sick. However, the sick person does not have to be isolated.

A vaccine is currently being developed to protect against an outbreak of glandular fever with the help of replica virus particles. This could prevent the immune system from overreacting to the pathogen. Researchers suspect that this overreaction is one of the possible reasons for the later development of cancer and multiple sclerosis.

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