Epstein-Barr virus (EBV): symptoms, glandular fever, contagion and recovery

EBV infection most often shows up as glandular fever. The NHS says symptoms may include a high temperature, swollen glands, a sore throat, a rash (which may be harder to see on black or brown skin), headache and tiredness. The swollen glands may be in the neck, head, armpits, elbows or groin.

NHS inform lists more symptoms: feeling generally unwell, aching muscles, chills, sweating a lot, loss of appetite, pain around or behind the eyes, swollen tonsils and adenoids (which may affect breathing), a very red throat that oozes fluid, small red or purple spots on the roof of the mouth, puffiness around the eyes, a tender or swollen tummy, and jaundice.

Epstein-Barr virus is the virus that usually causes glandular fever. NHS inform says glandular fever is caused by EBV, which is found in the saliva of infected people. Glandular fever is also known as infectious mononucleosis, or mono.

The NHS describes glandular fever as a viral infection that mostly affects teenagers and young adults. It gets better without treatment, but it can last for weeks and make you feel very ill.

Yes. The NHS says glandular fever is spread through spit, so you can get it through kissing or by sharing cups or cutlery. NHS inform adds that it can be spread through exposure to coughs and sneezes, sharing glasses and unwashed cutlery, and sharing toothbrushes.

You are infectious for up to 7 weeks before you get symptoms, and you may be infectious for several months after being unwell. NHS inform says EBV may be found in the saliva of someone who has had glandular fever several months after their symptoms pass, and some people may continue to have the virus in their saliva on and off for years.

The NHS says you can go back to work or school as soon as you start to feel better. To stop it spreading, wash your hands regularly, wash anything that may have your spit on it, and do not kiss others, share cups or cutlery, or give blood.

The NHS says glandular fever should get better by itself and you should start to feel better within 2 to 4 weeks. NHS inform says it normally lasts for 2 to 3 weeks, but in some cases you can feel ill for months.

Tiredness is the symptom that often lingers. The NHS lists long-term tiredness (chronic fatigue) which may last for several months as a possible complication. If tiredness continues, the NHS ME/CFS pages explain the condition which also involves extreme tiredness and can be diagnosed when symptoms persist.

There is no specific treatment, and glandular fever normally gets better on its own. The NHS suggests resting, drinking plenty of fluids (small sips frequently if swallowing is painful) and taking painkillers like paracetamol or ibuprofen. Do not give aspirin to children under 16. It also says not to do strenuous activities such as heavy lifting or playing sports.

The NHS says a GP will not give you antibiotics because glandular fever is caused by a virus, so antibiotics will not work. NHS inform says that occasionally antibiotics or corticosteroids may be prescribed if you develop complications, and some people with particularly severe symptoms may need to be looked after in hospital for a few days.

A GP may order a blood test to confirm glandular fever and to rule out other illnesses such as tonsillitis. The NHS says the blood test will test for the Epstein-Barr virus, which usually causes glandular fever. NHS inform says the GP will first ask about symptoms and examine you, looking for swollen glands, tonsils, liver and spleen.

The NHS says most people get better with no problems, but glandular fever may sometimes lead to liver conditions such as hepatitis, heart problems such as inflammation of the heart, kidney problems, blood conditions such as low platelets or sepsis, neurological conditions such as Guillain-Barre syndrome or Bell's palsy, a ruptured spleen, and long-term tiredness.

NHS inform describes complications as uncommon but potentially serious.

See a GP if you have a very high temperature or feel hot, cold or shivery, a severe sore throat, swelling either side of your neck, extreme tiredness or exhaustion, or a sore throat that is not getting better.

Call NHS 111 if you have difficulty breathing or are more short of breath than usual, or difficulty and pain when swallowing. Call 999 if you cannot swallow, including your own saliva, have severe difficulty breathing (gasping, choking or not able to get words out), or have severe stomach pain. NHS inform also lists rasping breath (stridor) as a reason to call 999. Do not drive yourself to A&E.

Most people with glandular fever are managed by their GP with advice and, if needed, a blood test. Hospital care is only needed for severe symptoms or complications. Private GP services can also arrange the same blood test; the treatment advice is the same.