Glandular Fever

A bad sore throat, fever and swollen glands, then weeks of feeling wiped out. Glandular fever is most common in teenagers and young adults. It gets better on its own, but recovery takes patience and a break from contact sport.

What it is: an infection with the Epstein-Barr virus (EBV). By adulthood, 90 to 95 in 100 people have had EBV, often without symptoms as a young child. Teenagers and young adults, mostly aged 15 to 24, are most likely to get the full illness.

How it spreads: through saliva, such as kissing or sharing cups and cutlery. Symptoms start 4 to 6 weeks after catching it. The virus can be in saliva for months afterwards.

Symptoms: fever, sore throat, swollen glands (especially in the neck), headache and tiredness. Some people get a rash or tummy pain.

Recovery: most people feel better within 2 to 4 weeks, but tiredness can last several months.

The recovery ladder

There’s no antiviral that works, and antibiotics don’t help. Rest, fluids and pain relief, plus protecting the spleen, are the treatment.

1. Step 1 · Self-careRest, fluids and pain reliefRest when you need to, drink plenty (small sips if swallowing hurts), and use paracetamol or ibuprofen for fever and sore throat. Return to school or work when you feel up to it.

   Works

   Helps you feel better while the virus runs its course; most people recover in 2 to 4 weeks

   Cost

   Free, plus a few dollars for pain relief

   How long

   Weeks; tiredness can last months

   Watch for

   Don’t give aspirin to children.

   The fastest recovery plan includes the couch.

2. Step 2 · Self-careNo contact sport or heavy lifting for at least a monthThe spleen is often enlarged and can rupture with a knock. Avoid contact sport, heavy lifting and strenuous exercise for at least the first 3 to 4 weeks, then build up gradually once you feel well.

   Works

   The spleen is enlarged in about half of people. Rupture is rare (about 1 in 200), most often between days 4 and 21

   Cost

   Free

   How long

   At least 4 weeks

   Watch for

   Ask your GP before returning to contact sport.

   Missing a few games beats losing a spleen.

3. Step 3 · GPConfirm with a blood testYour GP may do a blood test to confirm glandular fever and rule out other causes such as tonsillitis.

   Works

   Confirms the diagnosis and avoids unhelpful antibiotics

   Cost

   Medicare rebates for the visit; blood tests usually covered

   How long

   Results in a few days

   Watch for

   Tell your GP about severe tummy pain or yellow skin.

   Knowing it’s a virus saves you from the wrong treatment.

4. Step 4 · HospitalSteroids for severe swellingFor rare complications such as throat swelling that affects breathing, or certain blood problems.

   Works

   Used for complications, not for routine glandular fever

   Cost

   Free in Australian public hospitals

   How long

   Days

   Watch for

   Can’t swallow your own saliva or struggling to breathe: call 000.

   Rarely needed. Urgent when it is.

Costs are rough Australian prices in November 2026 and vary by pharmacy and provider. PBS co-payment: $25, or $7.70 with a concession card. Results vary between people.

Save your money

Popular, heavily marketed or often asked about, but the evidence is weak or says no.

• AntibioticsThey don’t work against the virus. Amoxicillin often causes an itchy rash in people with glandular fever.
• Antiviral medicinesNo antiviral has been shown to work for glandular fever.
• Rushing back to the gym or fieldStrenuous activity in the first weeks risks injuring an enlarged spleen.

What you can do

• Rest, and build activity up slowly as you recover.
• Avoid kissing and sharing cups, cutlery or drink bottles while unwell.
• Wash your hands and anything with saliva on it.
• Don’t donate blood while you are unwell.
• Plan study or work around a slower recovery if you need to.
• If tiredness drags on, see our tired all the time fact sheet.

See your GP if

• A very high temperature, or feeling hot and shivery
• A severe sore throat, or one that isn’t improving
• Swelling on both sides of the neck
• Extreme tiredness, or tiredness that isn’t improving after a month
• Yellow skin or eyes

Call 000 (Australia) or your local emergency number if you can’t swallow (including your own saliva), are struggling to breathe, or have severe tummy pain. Don’t drive yourself.

Helpful resources

• NHS: Glandular feverSymptoms, self-care and warning signs. Free, UK.
• SA Health: Glandular feverSpread, treatment and exclusion. Free, Australia.
• Sore throat and tonsillitis fact sheetOther causes of a sore throat. Free, from us.

Evidence and more information

• NHS: Glandular fever
• SA Health: Glandular fever
• US Pharmacist: Infectious mononucleosis (review)
• healthdirect: Fatigue

Reviewed 4 November 2026. General education, not personal medical advice. Treatment depends on your situation, so talk to your GP, physio or pharmacist.

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