Yes, Glandular Fever is Caused by EBV
Glandular fever (infectious mononucleosis) is definitively caused by the Epstein-Barr virus (EBV) in the vast majority of cases. 1, 2
Etiological Relationship
- EBV is the sole causative agent of the acute illness in humans described as infectious mononucleosis (IM) or glandular fever 1
- The relationship between EBV and glandular fever was definitively established in 1968 by Henle and Henle, marking a critical breakthrough in understanding this disease 3
- EBV is a gamma-herpesvirus that infects over 90% of the human population worldwide and establishes lifelong latent infection in B cells 2, 4
Clinical Presentation
The classic triad of symptoms includes:
- Fever, pharyngitis (sore throat), and lymphadenopathy (swollen lymph nodes) 1, 4
- Additional common features include hepatosplenomegaly (enlarged liver and spleen), malaise, and debilitating fatigue 3, 2
- Follicular conjunctivitis can occur, typically unilateral with ipsilateral lymphadenopathy, though this is less common than the classic triad 5
Transmission and Age Distribution
- The virus is transmitted primarily through saliva (hence the colloquial term "kissing disease"), establishing replicative infection in the oropharynx 2, 4
- Primary infection in early childhood is typically asymptomatic, while infection delayed until adolescence or young adulthood commonly presents as clinical infectious mononucleosis 2, 4
- Most symptomatic cases occur in older teenagers and young adults 4
Important Clinical Caveat
While EBV is the predominant cause, it's worth noting that other pathogens can occasionally cause a mononucleosis-like syndrome with similar clinical features, though these represent a minority of cases 4. However, when clinicians refer to "glandular fever" or "infectious mononucleosis," they are specifically referring to the EBV-caused illness 1, 2.