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  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Glandular Fever

GLANDULAR FEVER

 

Glandular fever, also known as infectious mononucleosis, is an infectious disease caused by the Epstein-Barr virus which attacks the white blood cells that fight infection in the body. Glandular fever can affect people of any age, including children, but it is most common in teenagers and young adults. The disease may sometimes be difficult to diagnose because of its similarities to other illnesses. Glandular fever used to be known as the ‘kissing disease’ because one of the ways in which it can be spread is through kissing. In other words, glandular fever can be transmitted through saliva. The disease has an incubation period between 2-4 weeks. Children who come into contact with the virus generally do not show any symptoms, while approximately half of teenagers and adults do develop symptoms after exposure to the virus. The Epstein-Barr virus remains hidden in the body in the blood cells and throat, which means that symptoms can develop again months or even years later. Glandular fever is considered to be contagious when your child has a high temperature (Collins, 2003; Great Ormond Street Hospital for Children NHS Trust, 2010).

 

Symptoms

·                The initial symptoms of the disease usually develop slowly and may include general malaise, headache, nausea, weight loss and loss of appetite, abdominal pain, tiredness and lethargy, and general aches and pains.

·                After 1-2 weeks the throat becomes extremely sore and may have the same presentation as a very bad case of tonsillitis. The throat looks very red, and the tonsils are often red, enlarged and covered in a white material.

·                A high fever (39-40°C) ensues. The fever may last for a few days or for several weeks.

·                The lymph nodes of the body, especially those in the neck just under the middle of the jaw and/or in the armpits and groin, become enlarged and tender.

·                The spleen may become enlarged, producing pain at the bottom of the ribs on the left side of the body. While the spleen is swollen, there is a small chance of its rupturing if it is bumped, e.g. when playing sport.

·                Glandular fever affects the liver (hepatitis), but generally does not produce jaundice (yellowing of the skin and the whites of the eyes). Hepatitis is probably responsible for some of the symptoms of glandular fever, such as general feelings of sickness, nausea and loss of appetite.

·                Some children with glandular fever develop a red, itchy rash.

·                The acute phase of glandular fever usually lasts for 7-10 days but the convalescence period may last for several weeks. Your child is likely still to experience tiredness and a lack of energy; energetic sports should therefore be avoided for a few weeks.

·                A few children go on to develop chronic fatigue syndrome (Children, Youth and Women’s Health Service; Collins, 2003; Leary, 1990).

 

Diagnosis

The most accurate way of diagnosing glandular fever is by means of a specific blood test known as the Paul-Bunnell test. The test looks for antibodies to the virus and for an increased number of monocytes, or the white blood cells that are responsible for giving the illness its name. The test also serves to rule out other possible infections that have similar symptoms. Glandular fever shares the same kind of muscle pains as influenza, a similar sore throat and infected tonsils to that produced by tonsillitis, and occasionally the illness starts with a rash that has a similar appearance to rubella (Collins, 2003).

 

Treatment

There is no way of treating the virus that causes glandular fever and therefore the disease needs to run its course. Since the infection is viral in origin, antibiotics will not be helpful and in some cases they may produce a rash that affects the whole body. Treatment is focused on symptomatic relief and there are several ways in which you can help alleviate some of your child’s symptoms:

·                Do not allow your child to get overtired; long periods of rest are important and activities should only be increased gradually. If your child is happier pottering around the house, allow him to do so. He are likely to rest when his body dictates.

·                Because of the enlargement of the spleen and the risk of rupture, sport should be avoided at the beginning of the illness (usually about 2-3 weeks). Check with your doctor.

·                Offer your child plenty of cool drinks to minimise the risk of dehydration.

·                Paracetamol and mefenamic acid (Ponstan), can be used to relieve discomfort and reduce fever.

·                Very close contact with other children should be avoided because the illness can be spread through saliva.

·                There are various ways to boost your child’s immune system so that he is better able to fight the virus. This includes offering him a healthy diet that includes 5 portions of fruit and vegetables daily and oily fish twice a week. A multivitamin and mineral supplement is recommended because deficiencies could exacerbate tiredness. Various homeopathic and herbal supplements are available that help to restore a healthy immune system by boosting the body’s natural ability to heal itself. The immunity enhancer echinacea can be taken continuously or rotated with other antiviral herbal treatments.

·                Stress can make recovery slower. Encourage your child to try some relaxation techniques, such as yoga and abdominal breathing. Keep the sessions short, regular and as child-friendly as possible. Therapeutic massage and other forms of touch therapy, such as aromatherapy or reiki, may help alleviate your child’s feelings of stress and tension and restore a sense of well-being. If your child is of school-going age and he is facing exams, contact your child’s teacher and obtain a medical certificate for special consideration. (Collins, 2003; Great Ormond Street Hospital for Children NHS Trust, 2008).

 

Possible complications

The most common complication of glandular fever is hepatitis. More rare complications can include pneumonia, rupture of the spleen, myalgic encephalomyelitis or chronic fatigue syndrome. Problems involving blood circulation and breathing may also develop (Collins, 2003; Great Ormond Street Hospital for Children NHS Fund, 2010).