What is Pfeiffer's glandular fever (infectious mononucleosis)
More than nine out of ten adults carry the pathogen that causes mononucleosis. At some point, you have been infected with the contagious Epstein-Barr virus (EBV), which belongs to the herpes viruses. But many of them were unaware of this because the EBV infection did not produce any symptoms. The viral infection often goes unnoticed, especially in children. Noticeable signs of the disease in the form of mononucleosis usually only appear when the infection occurs later in life – often in 15 to 24-year-olds.
A consolation for all those affected: Once the disease has been overcome, in most cases there is lasting immunity and the Pfeiffer glandular fever does not break out again.
In Switzerland, around 44,000 to 70,000 people fall ill with Pfeiffer’s glandular fever every year (the best known is probably tennis player Roger Federer, who declared in 2008 that he was also one of those affected). As the infection is usually transmitted via saliva, Pfeiffer’s glandular fever is also known colloquially as “kissing disease”. Medically, the term “infectious mononucleosis” or “mononucleosis infectiosa” is more commonly used.
Causes: How does mononucleosis develop?
The cause of Pfeiffer’s glandular fever is the Epstein-Barr virus, which belongs to the group of herpes viruses. The incubation period (from infection to the appearance of the first symptoms) of infectious mononucleosis is usually ten days, but can also last up to eight weeks. Even if the infected person does not yet have any symptoms during this period, they can already infect others with mononucleosis.
Once the pathogenic viruses have entered the body, they first infect the mucous membranes in the mouth and throat. From here, they enter the bloodstream where they attack B lymphocytes, white blood cells that are responsible for producing antibodies in the immune system. The viruses also enter organs such as the liver and spleen via the blood.
Infection: How do you get infected with mononucleosis?
Pfeiffer’s glandular fever is contagious. The pathogens, Epstein-Barr viruses, are usually transmitted from person to person via respiratory secretions.
Epstein Barr virus: Infection
One route of infection for Pfeiffer’s glandular fever is the transmission of the infectious pathogens when kissing. The viruses of mononucleosis are also transmitted directly from one person to the next when sneezing or coughing. Theoretically, Epstein-Barr viruses can also be transmitted via contaminated objects such as toothbrushes or glasses. It is difficult to quantify how relevant this indirect transmission route is.
Symptoms: How does mononucleosis manifest itself?
Young children often have no or only mild symptoms of infectious mononucleosis. They often resemble a cold that heals again. Adolescents who have been infected with the Pfeiffer’s glandular fever virus, on the other hand, usually feel the consequences of infection more clearly. However, a mononucleosis infection can be particularly stressful for adults. The following therefore applies to mononucleosis: there is a wide range of possible symptoms and varying degrees of severity for this disease – ranging from no signs of infection to serious complications.
At the beginning, Pfeiffer’s glandular fever often resembles a cold or a flu-like infection. The following symptoms are typical:
- Fever (usually 38 to 39 degrees)
- Headaches and aching limbs
- Weakness, tiredness, fatigue
- Severe sore throat
- Severely swollen lymph nodes (usually in the neck area)
- inflamed throat
- Inflamed palatine tonsils with a whitish coating
Other symptoms/complications may also occur:
The disease can be associated with fatigue, which can sometimes last for several weeks or even months.
Diagnosis: How do you recognize mononucleosis?
Swollen lymph nodes, inflamed throat, coated tonsils, fever: at first glance, the symptoms of mononucleosis often resemble the symptoms of tonsillitis (angina) or flu. Some other diseases, such as cytomegalovirus, hardly differ in their appearance from infectious mononucleosis, i.e. Pfeiffer’s glandular fever. It is therefore not always easy to recognize this viral disease straight away. However, there are reliable methods that can help your doctor make a diagnosis:
Blood test
A blood test in the laboratory shows whether the number of lymphocytes (part of the white blood cells) has changed, which would indicate mononucleosis. Elevated liver values in the blood also indicate this disease.
Blood smear
An examination of blood under the microscope (a so-called blood smear) can detect “Pfeiffer cells”, which are activated lymphocytes.
ELISA test
The so-called ELISA test (pronounced “Eleisa”) detects EBV-specific antibodies in a blood sample.
Ultrasound examination
In addition to other tests, it is also possible to use sonography (an ultrasound examination) to detect enlargements of the liver or spleen. They can develop as a result of mononucleosis.
Your doctor may also take a swab of your throat. An examination of tissue cells from the tonsils or the mucous membrane in the mouth and throat reveals whether the redness and swelling there may not have been caused by Ebstein-Barr viruses, but by bacteria.
How does infectious mononucleosis progress?
In most cases it takes two to four weeks – then the symptoms caused by mononucleosis are over. And they never return.
Infections as a result of mononucleosis
Some patients suffer from the consequences of the viral infection for a long time or suffer serious complications as a result of glandular fever. For example, a ruptured spleen, neurological symptoms, pneumonia or anemia.
Chronic exhaustion as a consequence of mononucleosis
In some cases, those affected by infectious mononucleosis suffer from prolonged tiredness, weakness and fatigue. EBV is also discussed as a possible cause of chronic fatigue syndrome.
All forms of mononucleosis have one thing in common: once the symptoms have subsided, the viruses remain in the blood for the rest of the patient’s life – but the immune cells have now produced antibodies against the pathogens, which is why the disease does not normally recur. There is therefore permanent immunity.
Therapy: What to do with mononucleosis?
Mononucleosis is treated symptomatically, for example with painkillers and antipyretics prescribed by your doctor. Antibiotics against infectious mononucleosis are not only ineffective – they can even be harmful and cause a skin rash (exanthema), for example. However, this does not mean that you have to remain inactive if you have a Pfeiffer glandular fever infection. On the contrary: you can help your body (or that of your child) to recover from the illness as quickly as possible.
- Avoid any physical exertion and get plenty of rest.
- Drink plenty, especially if you have a fever, but avoid alcohol.
- Eat only easily digestible food.
- Consult your doctor about the choice of painkillers and antipyretics.
- If you have a high temperature, calf compresses or vinegar socks can bring relief.
Once you have recovered and the infectious mononucleosis is behind you, it is very unlikely that you will experience another outbreak of mononucleosis. However, the Epstein-Barr viruses that cause the disease have not all disappeared and will always remain in your body. It is possible that the pathogens that cause mononucleosis will continue to be excreted in your saliva for several months after you fall ill.
Details of the treatments
