Kissing Disease (Glandular Fever)

Kissing Disease, also known as glandular fever, is a contagious viral infection frequently observed in young children or adolescents. The clinical term for this condition is known as infectious mononucleosis. It is referred to as the ‘kissing disease’ because it can spread quickly through the saliva of an infected person. Around 90% of Americans are infected with this virus once in their lifetime, although many individuals do not have an active infection.

Glandular fever or infectious mononucleosis is caused by Epstein Barr Virus (EBV). More than 90% of the cases of glandular fever result from infection by EBV. The virus enters your system through contaminated saliva. It may remain in an incubation period for about 4 to 6 weeks. You may transfer the virus to a healthy person during this period by kissing, sharing drinks, or using the same toothbrush.

Some cases of glandular fever may also be caused by cytomegalovirus, adenovirus, herpes simplex virus, and a few other common viruses. Glandular fever is not as contagious as other viral diseases such as the common cold, but it is still necessary to take precautions if you’re infected.

Once infected, the symptoms may appear after the incubation period is over. They are not much pronounced in children and are often mistaken for other common infections such as flu, strep throat, etc. The virus may also remain inactive for a long duration, during which you’ll be the carrier of this disease.

In adolescents or young adults, common symptoms experienced during this infection may include:

• Fever - usually mild and lasts for around 2 weeks
• Sore throat - severe during initial days, can be painful
• Swollen lymph nodes - can be noticed in the neck or armpit region
• Spleen enlargement - may be painful in some cases
• Fatigue - may last for a month or more
• Headache or dizziness
• Nausea or vomiting
• Generalized muscle weakness
• Body rash
• Loss of appetite

The severity of these symptoms may vary in different adults. Symptoms like fever, sore throat, and swollen lymph nodes last for a short time, but tiredness and muscle weakness may last for months. If the symptoms are left untreated, this infection may cause your spleen to rupture in rare cases. It may also affect your liver, heart, and nervous system, leading to further complications.

Glandular fever is generally diagnosed based on its history and presenting symptoms. Your doctor may conduct a physical examination to look for strep throat, swollen lymph nodes, and enlarged spleen.

A conformational diagnosis requires a blood test and antibody test. A complete blood count (CBC) may indicate an increased number of white blood cells, which is the sign of an active infection. A heterophile antibody test is done to diagnose the presence of EBV. This test gives quick results but may not detect the virus during the incubation period. Other serologic tests may be required to confirm the diagnosis of glandular fever. 

Treatment of glandular fever is usually symptomatic. There is no antiviral medication to cure this disease. The symptoms of this disease are managed until they are relieved.

The mainstay of treatment is to rest and avoid overworking yourself. Tiredness and weakness caused by this infection may limit your work efficiency, so it is essential to rest as much as possible. Avoid strenuous activities such as exercise or lifting heavyweights. Drink fluids and maintain a healthy diet because the energy demand is increased to fight off this infection.

For severe fever, acetaminophen is recommended. If fever is accompanied by pain, NSAIDs such as ibuprofen, diclofenac, naproxen, etc., may provide relief. A sore throat can be relieved by the use of saline water gargles. It is preferred to gargle for 5 to 8 minutes before you sleep.

The majority of the cases of glandular fever recover well within a few months. Preventive measures are necessary to limit the spread of this disease to your family or close ones. Emergency medical attention may be required if a complication occurs.