Treatment of glandular fever
By Dr Ananya Mandal, MD
Glandular fever is caused by Epstein Barr virus most commonly. At present there is no cure for glandular fever.
However, the course of illness may be made better by home care and symptomatic treatment.
Treatment of glandular fever includes bed rest, adequate hydration and so forth. (1-6)
Glandular fever patients need plenty of rest for the first two to three weeks after onset of symptoms.
At present complete bed rest for the whole duration is not advised. However, patients are advised to take things easy for the initial period and keep their activity level low. Patients may return to school, college or work as soon as they feel better.
Simple precautions like avoiding kissing, sharing utensils and drinking containers and good hygiene can prevent spread of the infection at school or college.
Patients with glandular fever need to take in adequate fluids that includes water or unsweetened fruit juice. This helps relieve symptoms of sore throat and fever to some extent.
Alcohol should be avoided because of risk of liver damage that is already weakened by infection.
Pain relievers and fever relievers
Acetaminophen may be taken for relief of fever. Other pain relievers are Nonsteroidal anti-inflammatory drugs (NSAIDs). These include Ibuprofen and Diclofenac. They help relieve fever and pain.
Children below 15 should not be given Aspirin in glandular fever. This may trigger a life threatening rare condition that damages the liver and brain. It is called Reye’s syndrome.
Gargle with luke warm salt water
This helps relive the sore throat to some extent.
For patients over 16, an Aspirin may be dissolved in
the water for better relief. Aspirin should not be given to any patient below 16 years of age.
Antibiotics are not effective
Antibiotics are not effective in treating glandular fever because they do not work against viruses.
Antibiotics may still be prescribed to prevent bacterial infections that may occur secondarily in patients with glandular fever. Secondary infections like that of lungs (pneumonia) or that of the sac that surrounds the heart (called pericarditis) might occur in patients with glandular fever.
This is seen in people with a weakened immune system like those with HIV or AIDS or those on steroids or high-dose chemotherapy. These infections need therapy with antibiotics.
Steroids may be given in sever swollen tonsils, severe anemia, liver inflammation or nerve or brain related complications.
Avoidance of contact sports
Avoidance of contact sports for the initial six to eight weeks. This is important since glandular fever leads to an enlarged spleen. This makes the spleen more delicate than usual and may lead to spleen rupture.
This is an emergency and needs immediate hospitalization and surgical management.
Prevention of spread of infection
Prevention of spread of infection includes simple precautions like (1-6):
- Isolation during the initial fever phase - this period is the most infective period
- Good hand washing practices
- Covering mouth and nose while sneezing or coughing
- Adequate disposal of tissue that have been exposed to infected mucus and secretions
- Avoidance of kissing infected persons
- Avoidance of sharing unwashed utensils, spoons, forks, drinking containers with infected persons
- A vaccine against the Epstein-Barr virus is under development