Feeling utterly exhausted with a throat so sore you can barely swallow? While many associate glandular fever with teenagers, glandular fever symptoms in adults are more common than you might expect and can be particularly debilitating. This viral infection, caused by the Epstein-Barr virus, affects thousands of adults across the UK each year. At Abbey Wood Hospital’s GP Services, we provide rapid diagnosis and expert guidance to help you recover as quickly as possible.
In This Article
- What Is Glandular Fever?
- Glandular Fever Symptoms in Adults
- Is Glandular Fever Contagious?
- How Long Does Glandular Fever Last?
- Glandular Fever Diagnosis and Blood Tests
- Glandular Fever vs Tonsillitis
- Treatment and Recovery
- Complications to Watch For
- Frequently Asked Questions
- When to See a Private GP
Understanding the distinction between glandular fever and other viral infections is essential for appropriate management. While the illness typically resolves without specific treatment, knowing what to expect and when to seek medical attention can prevent complications and speed your return to normal life.
What Is Glandular Fever?
Glandular fever, medically known as infectious mononucleosis, is a viral infection primarily caused by the Epstein-Barr virus (EBV). According to NHS guidance on glandular fever, it most commonly affects people aged 15 to 24, though adults of any age can develop the condition.
The infection is often called the “kissing disease” because it spreads through saliva. However, you can also contract it by sharing cups, cutlery, or toothbrushes with an infected person. Remarkably, approximately 95% of adults carry the Epstein-Barr virus by the time they reach adulthood, though many never experience symptoms or realise they have been infected.
Glandular Fever Symptoms in Adults
Recognising glandular fever symptoms in adults can be challenging because they often mimic other common illnesses. The condition typically begins with a few days of mild symptoms before the main indicators appear.
Primary Symptoms
The most common symptoms include a severely sore throat that may be worse than any you have experienced before, with swollen, reddened tonsils sometimes covered in a white coating. Swollen glands (lymph nodes) in the neck are characteristic, though they may also appear under the armpits or in the groin. A high temperature typically accompanies these symptoms, along with extreme fatigue that can be overwhelming.
Additional Symptoms
Adults may also experience headaches, muscle aches and general body pain, loss of appetite, and night sweats. Some people develop a faint red rash, though this is more common if antibiotics (particularly amoxicillin) are mistakenly prescribed. Mild swelling around the eyes, abdominal discomfort from an enlarged spleen, and mild jaundice (yellowing of the skin or eyes) can also occur in some cases.
How Symptoms Differ in Adults
Interestingly, glandular fever symptoms in adults over 40 may present differently. Older adults are less likely to have the classic sore throat and swollen glands. Instead, they may experience prolonged fever, fatigue, and general malaise as their primary symptoms. Liver involvement causing jaundice is also more common in this age group.
Is Glandular Fever Contagious?
Yes, glandular fever is contagious and spreads through saliva. The virus can be transmitted through kissing, sharing drinks or eating utensils, coughing, and sneezing. One particularly important point is that you are infectious for up to seven weeks before symptoms appear, which explains why the infection spreads so easily.
After recovering from the acute illness, the virus remains in your saliva for several months. Some people continue to shed the virus intermittently for years. However, glandular fever requires close contact for transmission and is not spread through the air in the same way as colds or flu. You can return to work or school as soon as you feel well enough, though you should avoid kissing others and sharing personal items during this time.
How Long Does Glandular Fever Last?
Most people begin feeling better within two to four weeks, though the glandular fever recovery time varies considerably between individuals. The sore throat is typically most severe for three to five days before gradually improving over the following week or two.
Fatigue is often the most persistent symptom. According to Bupa’s guidance on glandular fever, approximately 10% of people experience tiredness lasting several months. This prolonged fatigue can significantly impact work and daily activities, making it important to pace yourself during recovery and gradually increase activity levels.
Glandular Fever Diagnosis and Blood Tests
If you suspect glandular fever, a GP will examine you and may arrange a blood test to confirm the diagnosis. At Abbey Wood Hospital’s Imaging and Diagnostics department, we offer rapid blood testing with quick results.
The most common test is the Monospot (or heterophile antibody test), which detects antibodies produced in response to the Epstein-Barr virus. This test is usually positive from the second or third week of illness. However, it can be negative in the early stages, so a repeat test may be needed if initial results are inconclusive.
More specific Epstein-Barr virus antibody tests can identify whether you have a current infection, a recent infection, or have been infected in the past. A full blood count may also show an increase in certain white blood cells called lymphocytes, which is characteristic of the condition.
Glandular Fever vs Tonsillitis: Key Differences
Distinguishing glandular fever from simple tonsillitis is important because management differs. While both cause a sore throat and swollen tonsils, glandular fever typically causes more severe and prolonged symptoms. The extreme fatigue associated with glandular fever is usually absent in straightforward tonsillitis.
If tonsillitis lasts longer than expected or does not respond to antibiotics, glandular fever should be considered. Widespread swollen glands (not just in the neck), an enlarged spleen, and the characteristic prolonged fatigue all point towards glandular fever rather than bacterial tonsillitis.
Treatment and Recovery
There is no specific cure for glandular fever because antibiotics do not work against viral infections. Treatment focuses on managing symptoms while your immune system fights the virus. Rest is essential, particularly during the first few weeks when symptoms are most severe. Drink plenty of fluids, even if swallowing is painful, and take paracetamol or ibuprofen to reduce fever and ease pain.
Avoid strenuous physical activity, contact sports, and heavy lifting for at least four to six weeks. This precaution protects the spleen, which often enlarges during infection and is more vulnerable to injury. In severe cases where breathing is affected by swollen tonsils, a short course of corticosteroids may be prescribed.
Complications to Watch For
While most people recover fully, glandular fever can occasionally lead to complications. The most serious is a ruptured spleen, which causes sudden severe abdominal pain and requires emergency treatment. Seek immediate medical attention through our London Urgent Care Centre or call 999 if you experience sudden stomach pain.
Other potential complications include secondary bacterial throat infections, hepatitis (liver inflammation), and rarely, neurological conditions such as Guillain-Barré syndrome. Chronic fatigue lasting several months affects a minority of patients but can be particularly challenging for working adults.
Frequently Asked Questions
Can you get glandular fever twice?
It is extremely rare to get glandular fever more than once. After infection, your immune system develops antibodies that provide lifelong protection. While the Epstein-Barr virus remains dormant in your body, it very rarely causes symptoms again in healthy individuals.
Can adults over 30 get glandular fever?
Yes, adults of any age can develop glandular fever if they have not previously been infected with the Epstein-Barr virus. However, glandular fever symptoms in adults over 40 may present differently, with less prominent sore throat and more liver involvement.
When can I return to work after glandular fever?
You can return to work as soon as you feel well enough. Most people need one to two weeks off, though some require longer. Listen to your body and return gradually, as pushing yourself too hard can prolong recovery.
Why do I feel so tired with glandular fever?
The extreme fatigue results from your immune system working hard to fight the viral infection. This energy-intensive process, combined with the virus affecting multiple body systems, explains why tiredness can persist for weeks or even months after other symptoms resolve.
When to See a Private GP
Consult a GP if you have a severely sore throat that is not improving after a few days, extreme tiredness alongside other symptoms, swollen glands in your neck or elsewhere, or difficulty swallowing fluids. Seeking a same-day private GP appointment allows for rapid diagnosis and blood testing, helping you understand your condition and plan your recovery.
At Abbey Wood Hospital, our experienced GPs provide thorough assessment, on-site blood testing, and clear guidance on managing glandular fever symptoms in adults. We can rule out other conditions, monitor for complications, and provide medical certificates if needed for work.
To book a same-day private GP appointment at our North London clinic, contact Abbey Wood Hospital on 020 8358 7100 or book online.
Please note: This article provides general health information and is not a substitute for professional medical advice. If you experience difficulty breathing, severe stomach pain, or cannot swallow fluids, seek urgent medical attention immediately.