How dangerous is whistling glandular fever in pregnancy?

The normal course of Pfeiffer’s glandular fever begins with a long incubation period, which even lasts for over a month. Fever, headache and fatigue then occur. Later, the lymph nodes swell up and the tonsils and throat become inflamed.

In addition to the lymph nodes, organs such as the spleen or liver can also swell, which can lead to serious complications. Overall, it can be said that the disease progresses more severely the older the person affected is. This is why children are usually completely fit again after a few weeks, while in adults the disease can drag on for several months.

The main symptoms are reduced performance and fatigue, which remain for a very long time. In about 5% of the affected persons, skin rashes also appear after about a week. These can also affect the mouth and palate.

The pathogen itself is still in the body of the affected person even after the actual illness and can remain there for years without becoming conspicuous. From time to time, the virus reactivates itself, which is not noticed by most people, but can sometimes manifest itself in the form of fever. In this phase the affected persons are again contagious and can transmit the virus via saliva.

How long is the incubation period?

The incubation period varies greatly in the case of Pfeiffer’s glandular fever and depends, among other things, on the age of the affected person. While children usually show the first symptoms within one week, at most within one month after infection, it can take much longer for adults. Here, an incubation period of several weeks to two months is more likely. According to the extended incubation period for adults, the disease also lasts longer.

Duration of the whistling glandular fever

By palpation, in addition to the swelling of the lymph nodes in the neck area, enlarged lymph nodes in the armpit and in the groin area can be found. During throat examination or endoscopy, the pharyngeal tonsils may be swollen red with a white-yellowish coating. Further diagnosis is based on blood count, positive Paul-Bunnel test and the detection of specific EBV antibodies.

In addition, liver enzymes in the blood serum are measured. In 40-100% cases the values are moderately elevated. Bilirubin, a breakdown product of the red blood pigment haemoglobin, is also elevated in one third of cases.

Blood count: The characteristic blood count first shows a decrease in white blood cells (leukopenia), but later an increase (leukocytosis) with about 80% atypical lymphocytes, T-lympocytes with characteristic changes, also called Pfeiffer cells.
Paul-Bunnel-Test: It detects non-specific (heterophilic) antibodies against red blood cells (erythrocytes) of sheep, cattle and horses, which are a characteristic immune phenomenon of whistling glandular fever, although they do not react with the Epstein-Barr virus itself. They are caused by the stimulation of B-lymphocytes by EBV.
Specific EBV antibodies: IgM anti-VCA antibodies are detectable at the onset of Pfeiffer’s glandular fever, which are formed against the virus capsid antigen produced in the late stage of multiplication. The virus capsid is the outer envelope of the virus.
In the second week these antibodies have their largest number. After that they are replaced by IgG and IgA anti-VCA antibodies. The IgG-anti-VCA-antibodies have their maximum number in the third week and remain for life.

Only temporarily occurring antibodies, so-called IgG-anti-EA (“early antigen”), occur in only 80-85% of patients.

Pfeiffer’s glandular fever can be diagnosed with the mononucleosis rapid test. This test determines whether antibodies against the Epstein-Barr virus have formed in the blood of the affected person. To obtain blood for the sample, affected persons must prick their fingertips with a so-called lancet (a small needle).

The drop of blood is then applied to the test strip. After a few minutes, the result can be read on the strip. The quick test is available without prescription for about 15€ on the Internet or in pharmacies. The cost of this test is not covered by health insurance. Although the test is easy to carry out at home, you should consult a doctor if you suspect that you have glandular fever.