Mononucleosis/Glandular fever

Infectious mononucleosis – also known as glandular fever or “MONO” – is a viral disease that is transmitted via saliva. It causes symptoms similar to influenza (the flu) that vary in severity and can persist for several weeks or longer. Almost anyone, at any age, can catch glandular fever, but it is often teens who suffer the worst, with prolonged symptoms such as high fever, swollen lymph nodes and severe exhaustion. Glandular fever usually gets better without treatment, but it can make you feel very ill and tired for weeks.


APPOTEK can help with glandular fever.


Glandular fever is caused by a herpes virus called Epstein-Barr (EBV) – a highly contagious herpes virus. The virus infects via saliva and affects mainly children and teenagers. It takes about 4-10 weeks from the time you are infected until you get sick. You can then infect others for a few weeks. If you have once been infected with glandular fever, you become immune and cannot be infected again.


It is mainly children and teenagers who get glandular fever, but the symptoms differ. Children rarely get any clear symptoms, but sometimes the disease can be similar to a cold. 


Teens tend to get sicker with problems similar to a severe laryngopharyngeal reflux. Sometimes adults can also be affected. It is common to feel tired for a long time after recovery.


Classic symptoms of Mono/glandular fever, include:


  • a very high temperature or you feel hot and shivery
  • a severe sore throat
  • swelling either side of your neck – swollen glands
  • extreme tiredness or exhaustion
  • tonsillitis that is not getting better


The liver and spleen tend to be temporarily enlarged in connection with glandular fever and can cause stomach pain, nausea and vomiting. Liver effects can sometimes also give yellow eye whites.

Prevention and protection

Mononucleosis is almost impossible to prevent. This is because healthy people who have been infected with EBV in the past can carry and spread the infection periodically for the rest of their lives.


Almost all adults have been infected with EBV and have built up antibodies to fight the infection. People normally get mono only once in their lives.


For prevention, practicing good hygiene is important. Wash your hands well and often, sneeze or cough into a tissue or your elbow (not your hands), and keep your drinks and eating utensils to yourself.


Important warning about Reye’s syndrome

Keep in mind that children and adolescents under the age of 18 should not use medication containing aspirin without a doctor’s recommendation. This is because there is a risk of suffering from Reye’s syndrome – a serious but unusual condition that affects children and teenagers who have been treated with acetylsalicylic acid during a fever virus with a fever. Shortly after they become healthy, they have inflammatory effects on the brain and liver. It provides symptoms such as consciousness, convulsions, abdominal pain and vomiting, and unconsciousness. Sometimes Reye’s syndrome has a fatal outcome.


To detect glandular fever, sampling is often required. There is no treatment, but the symptoms can be alleviated with pain-relieving and anti-fever drugs.


When you have glandular fever, it is important that you drink enough water, even if it hurts to swallow. 


Avoid physical activity in the next month as glandular fever causes enlarged spleen and liver. The body needs time for recovery. 


Mono can make the spleen swell for a few weeks or longer. An enlarged spleen can rupture, causing pain and bleeding inside the belly, and needs emergency surgery. So doctors recommend that teens who have mono avoid contact sports for at least a month after symptoms are gone. Don’t do any strenuous activities until your doctor says it’s OK.


In case of complications in the respiratory tract, low blood level or severe enlargement of the liver or spleen, you may need hospital care and be treated with medication.

When to consult a doctor

In most cases, mono symptoms go away in a matter of weeks with plenty of rest and fluids. If they seem to linger or get worse, or if you have any other questions, call your doctor.


You should go to your local accident and emergency (A&E) or call an ambulance if you have glandular fever and you: 


  • develop a rasping breath (stridor) 
  • have any breathing difficulties. 
  • find swallowing fluids difficult. 
  • develop intense abdominal pain.

How APPOTEK can help

If you think you or your child has Mono, APPOTEK can help. A doctor or nurse will make an initial diagnosis during the video consultation. They can also give prescriptions or refer you for further examination, if needed.


Vadym Diadiun, Doctor of Medicine, M.D.