What advice should I provide to patients regarding the duration of symptoms and recovery from glandular fever?

Advice on Duration of Symptoms and Recovery from Infectious Mononucleosis

Most symptoms of infectious mononucleosis usually last for 2 to 4 weeks. Patients should be informed that the illness typically follows this natural course, with gradual improvement over this period.

During the acute illness, patients should rest as needed and maintain adequate hydration. They should return to normal activities as soon as their energy levels allow, pacing themselves if fatigue persists. Bed rest is not normally recommended because it may lead to deconditioning, which can prolong symptoms and recovery time.

Patients may experience ongoing fatigue even after other acute symptoms have resolved. In such cases, advice on managing persistent fatigue should be provided, including pacing activities to avoid overexertion.

Patients should avoid heavy lifting and contact or collision sports for 3 weeks after symptom onset to reduce the risk of splenic rupture. Activities can be resumed if the person is asymptomatic and shows no signs of acute infection after this period.

There is no need for exclusion from work, school, or nursery as the risk of transmission in these settings is low once appropriate hygiene measures are followed.

Patients should also avoid excessive alcohol intake during the acute illness to support recovery.