How bad is glandular fever for teenagers?

Marius is annoyed. The 13-year-old actually feels relatively fit again around a week after contracting glandular fever. Nevertheless, the seventh-grader is still not allowed to go to football training or karate for at least another two weeks. The doctor has not even allowed him to skateboard to school. The reason for this is a severe enlargement of the spleen, which is relatively typical of the disease.

Pfeiffer's glandular fever, also known as infectious mononucleosis, is caused by infection with the Epstein-Barr virus (EBV), which primarily affects the lymphatic system. EBV belongs to the group of herpes viruses and is extremely contagious. This is also due to the long incubation period - the time between infection and the outbreak of the disease - which can last between 10 and 50 days. During this phase, those affected can pass on the virus unknowingly.

Infection occurs primarily through direct contact with saliva, usually through kissing.

Julia Bielicki, Infectiologist

In Europe, almost everyone has been infected with EBV by the age of 30. «Infection occurs primarily through direct contact with saliva, usually through kissing or other close contact, but can also occur through coughing and sneezing,» says Julia Bielicki, Head Physician in the Department of Paediatrics and Infectiology at the University Children's Hospital Basel (UKBB). «Pfeiffer's glandular fever is therefore also known as kissing disease in English-speaking countries.»

The majority of patients contract the disease in infancy when playing closely with other children or their parents. The second peak of the disease occurs during puberty, when young people seek their first sexual contact and become more «kissy». The course of the disease is usually very mild to symptom-free in young children and is therefore often overlooked. In adolescents and young adults, on the other hand, the symptoms can be clear. «Typical symptoms include high fever, sore throat and pharyngitis with difficulty swallowing and white plaque, as well as sometimes very swollen lymph nodes in the neck and pronounced fatigue,» reports Julia Bielicki.

«Many parents initially think of the flu or a bacterial sore throat when they see these symptoms.» However, unlike influenza or angina, Pfeiffer's glandular fever is characterised by the often very noticeably enlarged neck lymph nodes. «The medical term for this is «Caesar's neck»,» emphasises the paediatrician. «At the same time, in around one in two patients with mononucleosis, the internal lymphatic organs also swell, especially the spleen and, in around ten per cent, the liver.»

Swelling of the spleen can occur during the acute phase of the disease, but sometimes only afterwards and can last for several weeks. «In most cases, however, the spleen is only slightly enlarged, which a doctor can easily palpate and is usually unproblematic,» emphasises Bielicki. «However, it can also happen that the spleen swells to such an extent that the organ protrudes from its natural position under the left costal arch.» It is then no longer optimally protected from mechanical impact.

In the event of a fall, blow or impact to the spleen area, which can easily occur when playing around or playing ball or contact sports, there is a rare but acute risk of a ruptured spleen. This can be life-threatening. «In these cases, the doctor will then recommend prolonged physical rest and will usually issue a sports suspension for two to four weeks,» explains the infectiologist.

Practical help from nature

The treatment of mononucleosis consists primarily of alleviating the unpleasant symptoms, as there is still no vaccination or other causal treatment for infectious mononucleosis. «I recommend that affected children and adolescents get plenty of rest during the acute phase, take painkillers such as ibuprofen if necessary, drink plenty of fluids in the form of water and tea and avoid acidic food and carbonated drinks,» says the specialist.

It is important to give the body enough time to recover after the initial infection.

Heide-Dore Bertschi-Stahl, naturopath

Therapy options from naturopathy can also help. «We always treat our patients individually according to their constitutional type,» explains Heide-Dore Bertschi-Stahl, federally qualified TEN alternative practitioner, director and lecturer at the QuintaMed Academy for Holistic Medicine in Gais AR.

«We observe difficult courses of Pfeiffer's glandular fever primarily in children and adolescents of the lymphatic-phlegmatic constitutional type.» According to Bertschi-Stahl, this constitutional type can be recognised by very pale, often slightly reddish shimmering skin, light hair and blue eyes. «These children and adolescents have a metabolism that often reacts to an initial infection with the Epstein-Barr virus with particularly severe symptoms. They are slow to recover from the disease,» says Bertschi-Stahl. «It is not uncommon for the illness to last three months or longer, with severe fatigue and symptoms that flare up again and again.»

For treatment, Bertschi-Stahl recommends various medicinal herbs, such as elderflower or lime blossom tea, to reduce the fever. The experienced naturopath swears by lemon compresses for severe sore throats. «Because the abdominal lymph is almost always affected, I advise making warm abdominal compresses with olive oil or giving a hot water bottle. The feet should also be kept warm,» emphasises Bertschi-Stahl. «A camomile roll is also very helpful.»

Repeated illness is possible

To support the body's self-healing process, the diet should also be changed. A cleansing, potassium-rich diet, such as warm vegetable soups made from potatoes, pumpkin, carrots, broccoli or similar, as well as small amounts of dried fruit, cashew nuts or organic nut spreads are particularly beneficial. On the other hand, Bertschi Stahl advises against milk, yoghurt, bananas and, above all, sugar, as she believes they tend to make the body more mucous.

Unfortunately, Pfeiffer's glandular fever cannot be cured in the traditional sense. This is because the Epstein-Barr virus, like many other herpes viruses, remains in the body in a kind of dormant state for life after an initial infection - whether with or without symptoms. «This also means that it can be reactivated under certain circumstances,» explains the naturopath. "It is therefore important to give the body sufficient time for a sustainable recovery after the initial infection in order to minimise the risk of reactivation at a later date.