BAY Health & Wellbeing

with Dr Chris Johns

Some useful medical advice from Dr Chris Johns who has been a GP in Sketty and Killay Medical Centres for 25 years and is Clinical Lead for Swansea Acute GP Unit in Singleton Hospital.

Glandular Fever

Happy New Year to everyone! I hope 2015 is a prosperous and healthy one for all! I always look out for subjects I can share with readers of TheBAY and here are a couple of problems I have been asked about in the last few weeks. 

FEV2015DrChrispic1-GlandularFever

Glandular fever is a type of viral infection that mostly affects young adults. It is also known as infectious mononucleosis, and occasionally the “kissing disease”!

Common symptoms include:

a high temperature (fever)

a severely sore throat

swollen glands in the neck

fatigue (extreme tiredness)

While the symptoms of glandular fever can be very unpleasant, most of them should pass within two to three weeks. Fatigue, however, can occasionally last several months.

Glandular fever can also cause:

a general sense of feeling unwell

aching muscles

chills

sweats

loss of appetite

pain around or behind your eyes

swollen tonsils and adenoids (small lumps of tissue at the back of the nose), which may affect your breathing

the inside of your throat to become very red and ooze fluid

small red or purple spots on the roof of your mouth 

a rash swelling or “puffiness” around your eyes 

a tender or swollen tummy

jaundice (yellowing of the skin and whites of the eyes)

Some of these symptoms may develop a few days before the main symptoms mentioned above.

How is glandular fever contracted?

The infection is caused by the Epstein-Barr virus that’s transferred from one person to another in saliva. Kissing is one obvious way by which the disease can be transmitted. But the infection is also spread via airborne droplets.

The incubation period from infection to when the symptoms first appear is between 30 and 50 days.

How glandular fever is diagnosed

To diagnose glandular fever, your GP will first ask about your symptoms before carrying out a physical examination. They will look for characteristic signs of glandular fever, such as swollen glands, tonsils, liver and spleen.

Your GP may also recommend a blood test to help confirm the diagnosis and rule out infections that can cause similar symptoms, such as cytomegalovirus (CMV), rubella, mumps, and toxoplasmosis.

What treatment is available for glandular fever?

Most people with glandular fever will require no specific treatment. Antibiotics do not help this type of infection as it is a virus.

Your doctor will only prescribe antibiotics if you have another infection present e.g. tonsillitis. Most people will make a complete recovery in 2-4 weeks. However, because of the extreme fatigue it may be several months before you feel perfectly fit. Complete rest is the best treatment for glandular fever, though some symptoms can be relieved with the following:

Paracetamol – taking

paracetamol to the maximum dose (as directed by a doctor/

pharmacist) can help relieve the sore throat and bring the temperature down.

Fluids – it is vital to drink plenty of fluids such as water and fruit juices.

Aspirin gargles – soluble aspirin dis-solved in water and then gargled for a few minutes often relieves sore throats, follow the instructions indicated on the packet or as directed by a doctor/pharmacist (Aspirin should not be taken

by children under 16 years of age).

Steroids – it is unlikely that steroids will be prescribed, but if they are, it is usually to help reduce severe inflammation of the throat so avoiding any difficulties in breathing or swallowing.

What are the complications of glandular fever?

Complications are very rare, though you may feel extremely tired and run down for some time after the infection has cleared up. Rare complications you may have with glandular fever include:

Enlarged Spleen – the spleen is an organ situated under the ribs on the left side of the abdomen. Like the lymph glands the spleen may swell up and it can sometimes be felt below the ribs, causing mild pain. The spleen will return to normal after the infection has gone.

Jaundice – this is a result of mild liver disease. This is not serious and is quickly resolved.

Anaemia.

Enlarged tonsils – if the tonsils become very enlarged, breathing may become difficult.

Pneumonia.

Good advice

Hot drinks can relieve the sore throat.

Drink plenty of fluids when you run a fever.

Rest when you’re tired or are running a fever.

Resume physical activities slowly.

Wait at least eight weeks before resuming activities, involving heavy physical strain. It’s sensible to avoid drinking alcohol for six weeks, while recover-ing from glandular fever.

Can I exercise while I am ill?

Theoretically, there’s a risk of damage to the spleen while particip-ating in heavy physical activities – such as those involving body contact. Therefore, it’s recom-mended not to exercise until four weeks after the disease has ended.

Because of the severe fatigue, it may take several months before the patient is perfectly fit again after glandular fever. But the majority of people recover much more quickly.

Shingles

I have had a number of people ask me about this recently and why this new NHS vaccination programme is delivered in a certain way. Here are some answers to most of the questions copied from the NHS  website information.

FEV2015DrChrispic2-Shingles

How is the shingles vaccine given?

It’s given as an injection into the upper arm.

Who will be able to have the shingles vaccination?

It is available to all 70-year-olds (and 78 and 79-year-olds as a temporary catch-up measure).

How do I get the shingles vaccination?

You don’t need to do anything. Your GP will invite you to the surgery for the vaccination. You can have it at the same time as your flu jab in the autumn if you wish.

Do you need to have the shingles vaccination

every year?

No, it’s a one-off single injection.

Will there be any side effects from the shingles vaccination?

It’s quite common to experience redness and discomfort at the vaccination site as well as headaches, but these side effects shouldn’t last more than a few days. See your GP if you have persistent side effects, or if you develop a rash after having the shingles vaccination.

What about people who aren’t yet 70? Will they get the shingles vaccine?

People under the age of 70 will get the shingles vaccine during the year following their 70th birthday. It’s not

available on the NHS to younger people, be-cause shingles is more common in the over-70s.

What about people aged 71 to 77. Can they have the vaccine?

Not at the moment. The shingles vaccine is available on the NHS only for people aged 70 (and to people aged 78   

or 79 as a catch-up). The shingles vaccination programme is being staggered this way as it would be im-practical to vaccinate every one in their 70s in a single year.

Why can’t I have the shingles vaccination if I’m over 80?

The vaccine doesn’t work as well as people get older.

Which people shouldn’t have the shingles vaccine?

You shouldn’t have the vaccine if you’ve had a serious allergic reaction, such as an anaphylactic reaction, in the past to any of its ingredients, such as neomycin (your GP can tell you if this applies to you), or if you have a weakened immune system (again, your GP can advise you).

Will the shingles vaccine stop me getting shingles?

It won’t guarantee that you won’t get shingles, but it will reduce your chances. And, if you do get shingles, the vaccine will likely make the symptoms milder and the illness shorter. You’ll also be less likely to get shingles complications such as postherpetic neuralgia.

Do I need the shingles vaccine if I’ve never had chickenpox?

Yes. The chances are that you have had chickenpox at some point without knowing

it. Some people have chickenpox without displaying any of the typical chickenpox symptoms like rash.

Should I have the shingles vaccine if I’ve already had shingles?

Yes. The shingles vaccine works very well in people who have had shingles before and it will boost your immunity against further shingles attacks.

Can I get the shingles vaccine privately?

The shingles jab is available privately for anyone over the age of 50. It’s expensive and in very short supply, though. Expect to pay between £100 and £200. Your GP can advise on whether it’s safe for you to have, but you may need to visit a private clinic to arrange.

See you next month in TheBAY!!!

Chris

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