Infectious mononucleosis, commonly known as glandular fever, is a viral infection that is caused by the Epstein-Barr virus (EBV). The disease is characterised by a sore throat, swollen lymph nodes (usually in the neck) and extreme fatigue. Young people aged between 10 and 25 years are most vulnerable to glandular fever. The treatment is to ease the symptoms, and the illness usually passes without serious problems.
Once exposed, the Epstein-Barr virus deactivates (known as latency). EBV may be reactivated later in life and factors which will make this more likely include stress, weakened immune function and hormonal changes. The virus may interact with genes and increase the risk of developing autoimmune diseases. EBV is strongly linked to autoimmune disorders such as multiple sclerosis (MS) and systemic lupus erythematosus (SLE or lupus).
There is growing research that suggests that infection with SARS-CoV-2 (covid-19) virus may precipitate reactivation of the Epstein Barr virus, which potentially increases symptom severity of covid-19 and may be a factor in the development of long covid.
Transmission
The virus is transferred from one person to another via saliva. Kissing is one obvious way by which the disease can be transmitted (hence being known as “the kissing disease”), but the infection can also be spread via airborne droplets. The incubation period from infection to when the symptoms first appear is between 30-50 days.
Symptoms
It is possible to contract glandular fever and to develop no symptoms (known as a subclinical infection). An infected person may display symptoms more akin to the flu for one to two weeks prior to displaying full-blown symptoms of glandular fever. Once apparent, symptoms may include:
- A sore throat, with swollen tonsils that are heavily covered by a white coating
- Fever
- Severe fatigue
- Muscle pains
- Swelling and puffiness may develop around the eyes, settling after one to two days – this occurs in around 20% of cases
- Headache
- Tendency to sweat
- Enlarged spleen (splenomegaly). If this occurs, it may be palpable below the ribs and may occasionally cause mild pain
- Swollen and sore lymph nodes in the neck, armpits and groin
- The liver may become enlarged and jaundice may develop
- There may be a non-itchy widespread, red rash that quickly disappears
Diagnosis
Definitive diagnosis is via a blood sample and a throat swab.
Palliative treatment
- Hot drinks can relieve the sore throat
- High intake of fluids is important during a fever
- Plenty of rest and sleep
- Resume physical activities slowly
- Wait at least eight weeks before resuming exercise and activities that involve heavy physical strain
- Avoid alcohol for six weeks, while recovering from glandular fever
Complications of glandular fever are rare but may include:
- The respiratory passages may become partially blocked and require a short course of oral steroid therapy to help to reduce the inflammation
- Secondary pneumonia
- Anaemia
- The number of blood platelets may decrease (known as thrombocytopaenia)
- The spleen may rupture – this happens in only 0.1-0.2% of all cases
- Very rarely, the central nervous system may be infected by the virus and can lead to meningitis or encephalitis
- Rarely, the disease may lead on to chronic fatigue
Additional advice
A short fast can help activate the immune system to fight the virus. Drink plenty of fresh fruit and vegetable juices, water with a dash of fresh lemon juice and herbal teas for 24 hours. Over the next 24 hours continue with the fluids and eat only fruit, salads, lightly steamed vegetables, small amounts of wholegrain cereals and a little fish and poultry for protein. Exclude all refined and sugary foods from the diet and avoid alcohol and caffeine until recovery is complete.
To support the immune system and relieve aches and pains take an aromatic bath using 6 to 8 drops of any of the following essential oils, or a combination of 2 or 3: lavender, juniper berry, tea tree (6 drops max), Scots pine (6 drops max), rosemary, helichrysum.
To ease a sore throat and help kill the virus, gargle with the following 2 to 3 times a day, making a fresh mixture each time: 1 teacup warm water, 2 tsp apple cider vinegar, 1 drop lemon essential oil, 1 drop tea tree, ½ to 1 tsp clear honey. Stir well.
Topical treatments
- Rub the following mixture into the skin after a bath: 25 ml grapeseed or sweet almond oil, 3 drops tea tree, 4 drops lavender
- Add 2 drops tea tree, 2 drops lemon, 4 drops helichrysum (or rosemary) to 2 tsp carrier oil and apply to swollen lymph nodes (glands) 2 to 3 times a day. This mixture is quite strong, so do not apply to the whole body
Nutritional supplement treatment options
Vitamin A plays an important role in immune system function and helps mucous membranes – including those in the lungs – resist invasion by microorganisms.
Vitamin C has antiviral activity and may help prevent viral infections and / or reduce the severity and duration of an infection.
Multi-vitamin/mineral –In a double-blind study, supplementation with a multiple vitamin and mineral preparation for one year reduced the risk of infection by more than 80%, compared with a placebo.
Zinc –double-blind studies of healthy people have shown that a daily supplement of zinc for one year significantly reduced the frequency of infections. Long-term zinc supplementation should be monitored carefully due to its antagonistic reaction with copper.
Botanical treatment options
Echinacea taken orally stimulates the function of a variety of immune cells, particularly natural killer cells. The bulk of research to date suggests that Echinacea speeds recovery from a viral infection by stimulating the immune system (as opposed to killing the virus directly). Echinacea should not be taken for long periods of time without a break.
Asian (Panax) Ginseng has a long history of use in traditional herbal medicine for preventing and treating conditions related to the immune system.
Cat’s Claw – Substances found in Cat’s claw, called oxyindole alkaloids, have been shown to stimulate the immune system.
Barberry is both immune supportive and antimicrobial.
Green Tea is known to directly attack microbes.
Other herbs that support the immune system against microbes and directly attack microbes include the following: elderberry, goldenseal, licorice, Oregon grape, astragalus and wild indigo.
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Article contributed by Dr Tracy S Gates, DO, DIBAK, L.C.P.H., Consultant, Pure Bio Ltd. Copyright © Pure Bio Ltd 2023. All rights reserved. Pure Bio Ltd are a leading UK supplier of the highest quality PURE nutritional supplements, based in Horsham, West Sussex.
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