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Glandular fever: ‘I was going to bed at 6pm’

23 February, 2022 . 0

Commonly known as the “kissing disease”, glandular fever is caused by a virus that most Australian adults have already caught. Here’s what you need to know.

When Alicia Louise Lillington began feeling like going to sleep as soon as she got home from work in late 2020, she knew something wasn’t right.

“I’m a very active person, working about 50 hours a week as well as doing 30 hours of community work on top of that,” Alicia says.

“I started noticing I was extremely tired after a work day and felt like going to bed at 6 or 7pm, which was very unusual for me.”

Then aged 29, when a sore, stiff neck turned out to be a swollen gland and Alicia began having trouble swallowing and lost her appetite, she booked a doctor’s appointment.

“I was initially diagnosed with tonsillitis, but it didn’t go away and the medicine I’d been prescribed didn’t work at all.

“It took a few weeks to get the correct diagnosis, which was glandular fever.”

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What is glandular fever?

Also called infectious mononucleosis, glandular fever is a viral disease caused by the Epstein-Barr virus (EBV), a virus that’s spread through contact with saliva and remains in the body for life.

And it’s far more common than you probably think.

In fact, most people are infected with EBV during early childhood and by adulthood, nine out of 10 people are carriers, but far fewer than that develop glandular fever.

When EBV is picked up during childhood, it doesn’t usually cause noticeable symptoms or may simply seem like a mild cold, but when it’s caught during or after adolescence, around 50 per cent of people will contract glandular fever as a result.

Australian Medical Association NSW President Dr Danielle McMullen says it’s not clear why some people get glandular fever when they catch EBV and others don’t.

She says people with symptoms should take precautions like careful hand washing and not sharing drink bottles to avoid passing it on, but warns EBV is a “sneaky” virus.

“We’ve learned, particularly through Covid, that when you’re sick you should stay away from other people to avoid spreading a virus,” Dr McMullen says.

“And that’s true. But EBV is a bit sneaky in that, as well as causing no symptoms for many people, even if you develop glandular fever, you can shed the virus for months after you’ve recovered.

“That’s why most people who get glandular fever never know who they got it from.”

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Is glandular fever serious?

On top of the fatigue, sore throat, loss of appetite and swollen lymph glands in the neck or armpits that Alicia experienced, other symptoms of glandular fever include fever or chills, a fine, pink rash on the body and generally feeling unwell.

A swollen liver or spleen can also occur.

“For most people who get glandular fever, symptoms last for a couple or a few weeks,” Dr McMullen says.

“But for a smaller group of people, some symptoms – mainly fatigue – can last for up to six months or more.

“Either way, people do get better.

“It can be a slow recovery, but it’s usually a full recovery.”

Alicia says it took two months for the worst of her glandular fever symptoms to pass.

“I ended up in hospital due to my liver function and it took about 12 months to get back to where I was before glandular fever.

“I didn’t know how debilitating it would be and how tired I’d get.

“I still feel tired now and then, more so than before I had glandular fever, but I am much better now.”

In good news, once you’ve caught EBV, regardless of how severe the symptoms were or weren’t the first time around, it’s rare for EBV to cause symptoms again, even though the virus stays in your body forever.

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What to do if you think you have glandular fever

If you or a family member experience the common glandular fever symptoms and they persist longer than a typical cold or flu, see your GP.

“Generally, it’s quite easy to suspect it clinically, based on symptoms,” Dr McMullen says.

“We can also run blood tests to look at a person’s white blood cell count, as well as specifically looking for the Epstein-Barr virus.”

And if glandular fever is diagnosed, treatment simply involves rest.

“There’s no specific treatment for glandular fever, so it’s a matter of resting, keeping fluids up and being sensible about gradually getting back to normal activity.”