Glandular fever, also known as infectious mononucleosis, is a common viral illness caused by the Epstein-Barr virus. This virus is transmitted through saliva, hence the common nickname “kissing disease”. It primarily affects teenagers and young adults, but can occur at any age.
The main symptoms of glandular fever include fever, fatigue, and swollen lymph nodes in the neck, armpits, and groin. Other symptoms may include sore throat, tonsillitis, muscle aches, headache, and night sweats. The symptoms usually take a few weeks to appear after the initial infection and can last for several weeks or even months.
Diagnosing glandular fever is often done through blood tests, which can detect the presence of antibodies to the Epstein-Barr virus. Treatment for glandular fever involves rest, staying hydrated, and managing symptoms such as pain and fever with over-the-counter medications. In some cases, antiviral medications may be prescribed to help reduce the severity of symptoms.
It is important to note that glandular fever is a self-limiting illness, meaning it will typically resolve on its own without specific treatment. However, it is essential to take care of oneself and allow the body time to recover. If you suspect you have glandular fever, it is recommended to see a healthcare professional for a proper diagnosis and guidance on managing the symptoms.
Glandular Fever: Causes, Symptoms, and Treatment
Glandular fever, also known as infectious mononucleosis or the kissing disease, is a viral infection caused by the Epstein-Barr virus (EBV). It is primarily transmitted through saliva, hence its nickname.
- EBV: The main cause of glandular fever is the Epstein-Barr virus, a member of the herpes virus family.
- Transmission: The virus is spread through close contact with contaminated saliva, such as kissing, sharing utensils, or drinking from the same glass.
- Sore Throat: One of the main symptoms of glandular fever is a severe sore throat, which can make swallowing painful.
- Tonsillitis: Inflammation of the tonsils is common in glandular fever, leading to swollen and red tonsils.
- Headache: Many individuals with glandular fever experience headaches, often accompanied by sinus congestion.
- Fatigue: Fatigue and weakness are common symptoms of glandular fever, with some patients experiencing extreme tiredness that lasts for weeks or even months.
- Night Sweats: Some patients may experience excessive sweating during sleep, leading to wet sheets and disrupted sleep patterns.
- Fever: Glandular fever is usually accompanied by a high fever, which can persist for several days.
- Rest: Getting plenty of rest is crucial in recovering from glandular fever, as it allows the body to focus its energy on fighting the infection.
- Fluids: Staying hydrated by drinking plenty of fluids helps to ease symptoms and prevent dehydration.
- Pain Relief: Over-the-counter pain medications, such as acetaminophen or ibuprofen, can help relieve sore throat, headache, and fever.
- Antiviral Medication: In severe cases, antiviral medications may be prescribed to help reduce the duration and severity of the illness.
- Complications: It is essential to monitor for potential complications, such as an enlarged spleen, and consult a doctor if any concerning symptoms arise.
If you suspect you have glandular fever, it is important to see a healthcare professional for an accurate diagnosis and appropriate treatment. Remember to practice good hygiene, such as washing hands regularly and avoiding close contact with others, to prevent the spread of the virus.
Causes of Glandular Fever
Glandular fever, also known as mononucleosis, is most commonly caused by the Epstein-Barr virus (EBV). This virus is highly contagious and can be easily transmitted through saliva, hence its nickname “the kissing disease”.
Once the Epstein-Barr virus enters the body, it primarily affects the B lymphocytes, which are a type of white blood cell. These infected B lymphocytes then spread the virus throughout the body.
The symptoms of glandular fever are triggered by the body’s immune response to the Epstein-Barr virus. The immune system produces antibodies to fight off the virus, leading to symptoms such as fatigue, fever, headache, and sore throat.
In some cases, glandular fever may also be caused by other viruses, such as the cytomegalovirus (CMV) or the human herpesvirus 6 (HHV-6). These viruses can also lead to similar symptoms, including swollen lymph nodes and tonsillitis.
To avoid contracting or spreading glandular fever, it is important to practice good hygiene, such as washing hands regularly and avoiding sharing utensils or drinks with infected individuals.
If you suspect you have glandular fever, it is important to seek medical advice for an accurate diagnosis and appropriate treatment. Rest, plenty of fluids, and over-the-counter pain relievers can help alleviate symptoms and promote recovery.
Symptoms of Glandular Fever
Glandular fever, also known as infectious mononucleosis, is caused by the Epstein-Barr virus (EBV). This viral infection primarily affects young adults and teenagers. It is characterized by a variety of symptoms, including:
One of the common symptoms of glandular fever is a severe sore throat. The throat may be red and inflamed, and swallowing can be painful. This symptom is often one of the first signs of the infection.
Swollen Lymph Nodes
Glandular fever can cause the lymph nodes in the neck, armpits, and groin to swell. These swollen lymph nodes are usually tender to the touch and can be felt as small lumps under the skin.
Many people with glandular fever experience headaches, which can range from mild to severe. These headaches may be accompanied by other symptoms such as fatigue and body aches.
Sweating, especially at night, is another common symptom of glandular fever. This excessive sweating can disrupt sleep and lead to feelings of discomfort and fatigue.
Glandular fever can cause inflammation and swelling of the tonsils, leading to a condition known as tonsillitis. This can result in a sore throat, difficulty swallowing, and an uncomfortable sensation in the throat.
Extreme fatigue and tiredness are hallmark symptoms of glandular fever. Many individuals with this infection experience a prolonged period of exhaustion that can last for several weeks or even months.
If you are experiencing any of these symptoms, it is important to consult a healthcare professional for an accurate diagnosis and appropriate treatment.
Diagnosis of Glandular Fever
The diagnosis of glandular fever, also known as infectious mononucleosis, is based on a combination of symptoms, physical examination, and laboratory tests. The symptoms of glandular fever can be similar to those of other conditions, such as tonsillitis or strep throat, making diagnosis challenging.
During the physical examination, the doctor will look for specific symptoms that are commonly associated with glandular fever. These may include swollen lymph nodes in the neck, armpits, or groin, a red rash, and an enlarged spleen or liver. Examination of the throat may reveal inflamed tonsils or a sore throat.
To confirm the diagnosis of glandular fever, the doctor may order laboratory tests. The most common test is the monospot test, which looks for antibodies to the Epstein-Barr virus, the virus that causes glandular fever. A positive result indicates a current or recent infection.
In some cases, additional tests, such as a complete blood count (CBC), may be ordered to assess the levels of white blood cells and to rule out other conditions. A blood test may also be done to check for an increase in liver enzymes.
If the diagnosis remains uncertain, the doctor may recommend further tests, such as a throat swab or a test to detect the Epstein-Barr virus itself.
It is important to note that self-diagnosis based on symptoms alone is not recommended. Other conditions, such as a viral infection or flu, can cause similar symptoms like fever, fatigue, headache, and night sweats. Therefore, it is necessary to consult a healthcare professional for an accurate diagnosis and appropriate treatment.
Complications of Glandular Fever
Glandular fever, also known as infectious mononucleosis, is a viral infection caused by the Epstein-Barr virus. While most cases of glandular fever resolve on their own without complications, in some cases, there can be complications that require medical attention.
Sorethroat and Tonsillitis
One common complication of glandular fever is a persistent sore throat or tonsillitis. The infection can cause severe inflammation of the throat and tonsils, leading to pain and difficulty swallowing. In severe cases, the tonsils may become so enlarged and inflamed that they obstruct the airway, requiring emergency medical intervention.
Swollen Lymph Nodes
Glandular fever can cause swelling of the lymph nodes, particularly in the neck, underarms, and groin. This can lead to discomfort and tenderness in these areas. In some cases, the swelling can be severe and may require medical treatment to reduce the inflammation and ease the symptoms.
|Complications of Glandular Fever
|Sorethroat and Tonsillitis
|Persistent sore throat, difficulty swallowing
|Swollen Lymph Nodes
|Swelling and tenderness in neck, underarms, and groin
|Severe headache, often accompanied by fever
|Nausea and Vomiting
|Feeling of nausea, potential vomiting
|Fatigue and Weakness
|Extreme tiredness, lack of energy
|Sweats and Chills
|Night sweats, cold chills
A severe headache is another possible complication of glandular fever. This headache can be persistent and may be accompanied by a high fever. It is important to manage the headache with appropriate medication and seek medical attention if it becomes severe or prolonged.
Other complications of glandular fever can include nausea and vomiting, extreme fatigue and weakness, as well as night sweats and chills. These symptoms can be debilitating and may require supportive care and treatment.
If you experience any complications or worsening of symptoms associated with glandular fever, it is important to seek medical attention for proper diagnosis and management.
Treatment for Glandular Fever
The treatment for glandular fever, also known as infectious mononucleosis, focuses primarily on managing symptoms and providing supportive care. As glandular fever is caused by the Epstein-Barr virus, antibiotics are not effective in treating the virus itself.
For individuals with glandular fever, rest is key to recovery. It is important to get plenty of sleep and avoid strenuous activities during the acute phase of the illness. This allows the body to focus its energy on fighting the virus.
Several over-the-counter medications can help alleviate symptoms associated with glandular fever. Pain relievers such as acetaminophen or ibuprofen can help reduce fever, relieve headache, and alleviate muscle aches.
For individuals experiencing a sore throat, soothing remedies such as drinking warm liquids, gargling with saltwater, or using throat lozenges can provide temporary relief.
In rare cases, complications may arise from glandular fever, such as tonsillitis or swollen lymph nodes. If these complications occur, further treatment may be necessary.
In some instances, individuals with glandular fever may experience night sweats or extreme fatigue. In such cases, it is advised to consult with a healthcare professional for further guidance and support.
|Treatment for Glandular Fever
|Get plenty of rest
|Take over-the-counter pain relievers
|Use soothing remedies for sore throat
|Seek medical attention for complications
|Consult with a healthcare professional for extreme fatigue or night sweats
Rest and Sleep
Rest and sleep are crucial for individuals with glandular fever. This viral infection, caused by the Epstein-Barr virus, can lead to a variety of symptoms, including sweats, swollen lymph nodes, fever, fatigue, headache, tonsillitis, and more.
Getting ample rest allows the body to focus its energy on fighting off the virus. It is important for patients to prioritize rest and take the time to recover fully.
Importance of Rest
Rest is essential as it helps boost the immune system and gives the body a chance to recuperate. By avoiding strenuous activities and getting sufficient sleep, the body can better repair and heal itself.
Moreover, rest can alleviate symptoms such as fatigue and headache that are commonly experienced with glandular fever. By taking it easy and allowing the body to rest, individuals can manage their symptoms more effectively.
Tips for Better Sleep
During glandular fever, it is common to experience difficulty sleeping due to discomfort or other symptoms. However, there are ways to improve sleep quality:
- Establish a routine: Going to bed and waking up at the same time each day can help regulate the body’s sleep-wake cycle.
- Create a calming environment: Keep the bedroom dark, quiet, and cool to promote better sleep. Using sleep aids such as eye masks or earplugs can also be helpful.
- Avoid stimulating activities before bed: Engaging in screens or vigorous exercise close to bedtime can make it harder to fall asleep. Opt for relaxing activities, such as reading or listening to soothing music.
- Practice relaxation techniques: Activities such as deep breathing, meditation, or gentle stretching can help calm the mind and prepare the body for sleep.
By prioritizing rest and sleep, individuals with glandular fever can support their recovery process and improve their overall well-being.
Fluids and Nutrition
Proper hydration and adequate nutrition are crucial factors in the management of glandular fever. When infected with the Epstein-Barr virus, it is important to drink plenty of fluids to prevent dehydration and help alleviate symptoms such as fever, sweats, and fatigue.
As glandular fever often presents with symptoms of tonsillitis and sore throat, it is important to consume soft and easily swallowable foods to avoid further irritation to the throat. Cold foods such as ice cream, yogurt, and smoothies can help soothe the throat and provide temporary relief.
Additionally, maintaining a balanced diet rich in vitamins and minerals can help boost the immune system and aid in the recovery process. Including foods such as fruits, vegetables, lean proteins, and whole grains can provide the necessary nutrients to support the body’s healing process.
It is also important to listen to your body’s hunger and fullness cues. Glandular fever can often cause a loss of appetite, but it is vital to eat small, frequent meals to ensure adequate nutrition. Avoiding excessive consumption of sugary and processed foods is also recommended, as these can impair the immune system and prolong the recovery period.
In some cases, the swelling of lymph nodes may make swallowing difficult. In such situations, consulting a healthcare professional or a registered dietitian can be beneficial in developing a personalized nutrition plan to ensure optimal nutrient intake.
|Fluids and Nutrition Tips:
|– Drink plenty of fluids to prevent dehydration
|– Consume soft and easily swallowable foods
|– Include cold foods to soothe the throat
|– Maintain a balanced diet rich in vitamins and minerals
|– Listen to your body’s hunger and fullness cues
|– Eat small, frequent meals
|– Avoid excessive consumption of sugary and processed foods
|– Consult a healthcare professional for personalized nutrition advice
If you are experiencing symptoms of glandular fever such as swollen lymph nodes, fever, or fatigue, there are several over-the-counter medications that can help provide relief. It is important to note that these medications can only help manage the symptoms and cannot cure the underlying cause, which is usually the Epstein-Barr virus.
If you are experiencing sore throat, headaches, or general body aches, over-the-counter pain relievers such as acetaminophen or ibuprofen can help alleviate these symptoms. These medications can also help reduce fever and relieve discomfort.
If you have a persistent cough or throat irritation, over-the-counter cough suppressants can provide relief. These medications can help calm the cough reflex and reduce coughing fits, allowing you to rest and recover more comfortably.
It is important to read and follow the instructions on the packaging of any over-the-counter medications you choose to take. If symptoms worsen or persist, it is recommended to consult a healthcare professional for further evaluation and guidance.
Glandular fever, also known as infectious mononucleosis, is a viral infection caused by the Epstein-Barr virus. It is characterized by symptoms such as a fever, swollen lymph nodes, tonsillitis, sore throat, sweats, and headache.
When dealing with the pain caused by glandular fever, it is important to get proper pain relief. Over-the-counter pain medications such as ibuprofen or acetaminophen can help reduce fever and relieve headaches. These medications can also help with throat pain and reduce inflammation in the lymph nodes.
In addition to over-the-counter medications, using warm saltwater gargles can provide temporary relief for a sore throat. It helps reduce inflammation and soothes the throat. Drinking warm liquids such as herbal tea or warm water with honey can also alleviate pain and discomfort.
Rest and Hydration
Resting is crucial during glandular fever as it allows the body to heal and recover. It is important to avoid strenuous activities and get plenty of sleep. Adequate hydration is essential to prevent dehydration and to help flush out toxins from the body.
A nutritious diet can support the immune system and aid in recovery. Eating foods rich in vitamins, minerals, and antioxidants can help boost immunity and reduce the severity of symptoms. It is recommended to consume foods such as fruits, vegetables, whole grains, lean proteins, and healthy fats.
|Pain Relief Methods for Glandular Fever
|Over-the-counter pain medications (ibuprofen, acetaminophen)
|Warm saltwater gargles
|Drinking warm liquids (herbal tea, warm water with honey)
|Resting and getting plenty of sleep
|Maintaining proper hydration
|Eating a nutritious diet
Avoiding Contact Sports
If you have been diagnosed with glandular fever, it is important to avoid contact sports until you have fully recovered. Glandular fever, caused by the Epstein-Barr virus, can lead to various symptoms including sweats, swollen lymph nodes, fatigue, fever, headache, and tonsillitis. Engaging in contact sports can increase the risk of injury and complications, as your body may be weakened and more susceptible to infections during this time.
Participating in contact sports can put additional strain on your body and may prolong the recovery process. The fatigue and weakness associated with glandular fever can make it difficult to perform at your usual level, increasing the risk of accidents and injuries. Additionally, contact sports involve close physical contact with others, increasing the chances of spreading the virus to others or contracting secondary infections.
It is recommended to avoid contact sports until your symptoms have completely resolved and you have received clearance from your healthcare provider. During this time, focus on gentle exercises and activities that do not put excessive strain on your body. Walking, swimming, or light stretching can help maintain your fitness levels without exacerbating symptoms or risking further complications.
Remember to listen to your body and prioritize your health during the recovery process. Take the time to rest and recuperate, allowing your body to heal and regain its strength. Consult with your healthcare provider for personalized recommendations and guidance on when it is safe to resume contact sports.
Stress can be a major factor in the development and worsening of glandular fever symptoms. When the body is under stress, the immune system becomes compromised, making it easier for the Epstein-Barr virus to cause symptoms and complications. Here are some tips for managing stress to help alleviate symptoms and aid in recovery:
1. Mindfulness and Relaxation Techniques
Practicing mindfulness and relaxation techniques can help reduce stress levels and promote a sense of calm. This can include activities such as deep breathing exercises, meditation, yoga, or listening to calming music. Allow yourself the time and space to relax and unwind.
2. Support Systems
Building a strong support system can be beneficial in managing stress. Talk to trusted friends or family members about your concerns and feelings. Sometimes just having someone to listen can help ease the burden. Consider joining a support group or seeking professional counseling if needed.
Remember that stress can exacerbate symptoms such as sore throat, sweats, headache, and swollen lymph nodes. By managing stress effectively, you may be able to reduce the severity and duration of these symptoms.
Preventing the Spread of Glandular Fever
Glandular fever, also known as infectious mononucleosis, is caused by the Epstein-Barr virus and is highly contagious. It is important to take precautions to prevent the spread of this virus to others. Here are some steps you can take:
1. Practice good hygiene:
- Wash your hands frequently with soap and water, especially after coughing, sneezing, or blowing your nose.
- Use hand sanitizer if soap and water are not available.
- Avoid touching your face, especially your eyes, nose, and mouth.
2. Cover your mouth and nose:
- Use a tissue or your elbow to cover your mouth and nose when coughing or sneezing.
- Dispose of used tissues properly and immediately wash your hands.
- Avoid close contact with others, especially those who are at higher risk for complications, such as young children, elderly individuals, and pregnant women.
3. Avoid sharing personal items:
- Do not share utensils, cups, or bottles with others.
- Avoid sharing towels, toothbrushes, or any other personal items that could spread the virus.
4. Clean and disinfect frequently touched surfaces:
- Clean and disinfect surfaces that are frequently touched, such as doorknobs, light switches, and countertops.
- Use a household disinfectant that is effective against viruses.
5. Stay home when you are sick:
- If you experience symptoms of glandular fever like headache, sore throat, fever, swollen lymph nodes, sweats, and fatigue, stay home and avoid close contact with others.
- Rest, drink plenty of fluids, and take over-the-counter pain relievers to alleviate symptoms.
By following these preventive measures, you can significantly reduce the spread of glandular fever and protect yourself and others from this contagious virus.
Recovery from Glandular Fever
Recovering from glandular fever can take a significant amount of time and varies from person to person. The duration of recovery depends on factors such as the severity of the infection, the patient’s overall health, and their ability to rest and manage symptoms effectively.
One of the main symptoms of glandular fever is fatigue, which can persist for several weeks to months after the initial infection. Patients may feel unusually tired and find it challenging to engage in regular activities. It is important to listen to your body and give yourself plenty of rest during this recovery phase.
The virus responsible for glandular fever, Epstein-Barr virus (EBV), can cause symptoms such as night sweats and a persistent fever. These symptoms may continue for some time as the body fights off the infection. If fever persists or worsens, it is important to consult a healthcare professional for further evaluation.
Headaches are another common symptom of glandular fever, and they can linger during the recovery phase. Over-the-counter pain relievers and practicing good hydration can help manage headache discomfort. However, if headaches persist or become severe, medical advice should be sought.
The swelling of lymph nodes is a classic symptom of glandular fever. This symptom may take several weeks to resolve completely and can sometimes come and go during the recovery period. If the swelling becomes tender, red, or unusually large, it is essential to consult a healthcare professional, as this may indicate a secondary infection such as tonsillitis.
During the recovery phase, it is crucial to prioritize self-care and take steps to support the body’s healing process. This includes:
- Getting plenty of rest and allowing the body the time it needs to heal
- Staying hydrated by drinking plenty of fluids, especially water
- Eating a balanced diet that includes foods high in vitamins and minerals
- Avoiding strenuous physical activity until cleared by a healthcare professional
- Practicing good hygiene to prevent the spread of the virus to others
- Managing symptoms with over-the-counter pain relievers as advised by a healthcare professional
After recovering from glandular fever, it is recommended to schedule a follow-up appointment with a healthcare professional. They can assess the patient’s overall health and ensure that there are no lingering complications. It is also important to discuss any concerns or questions about the recovery process during this appointment.
|Several weeks to months
|May continue during recovery
|May linger during recovery
|Swollen Lymph Nodes
|Several weeks to resolve completely
It is important to remember that recovery from glandular fever is a gradual process and may take time. Patience, proper rest, and adequate self-care are essential in supporting your body’s healing and returning to full health.
Returning to Normal Activities
Once you have been diagnosed with glandular fever, it is important to take the time to rest and allow your body to recover. This is because glandular fever, also known as infectious mononucleosis, is caused by the Epstein-Barr virus and can leave you feeling extremely fatigued.
During the acute phase of the illness, which typically lasts around two to three weeks, it is advised to avoid strenuous physical activity and take time off from work or school. This is because overexertion can prolong your recovery time and potentially lead to further complications.
As the fever subsides and symptoms such as sore throat, swollen lymph nodes, headache, and night sweats improve, you can slowly begin to reintroduce normal activities into your routine. However, it is important to listen to your body and not push yourself too hard.
Gradual Return to Exercise
When starting to exercise again, it is best to begin with low-impact activities such as walking or gentle stretching. Gradually increase the intensity and duration of your workouts as your energy levels improve.
It is also advisable to avoid contact sports or activities that may put strain on the spleen, as glandular fever can cause this organ to become enlarged and more susceptible to injury.
Returning to Work or School
Once your symptoms have significantly improved, you can consider returning to work or school. However, it is important to communicate with your employer or teachers about your condition and potentially make adjustments to your workload or schedule if needed.
If you still experience fatigue or other lingering symptoms, it may be necessary to gradually increase your hours or take additional rest days until you are fully recovered.
Remember, everyone’s recovery time can vary, so it is essential to listen to your body and not rush the process. If you have any concerns or your symptoms persist, it is always best to consult with your healthcare provider for further guidance.
Long-Term Effects and Outlook
Generally, glandular fever, also known as infectious mononucleosis, caused by the Epstein-Barr virus (EBV), is a self-limiting illness with no long-term effects. Most individuals recover completely within a few weeks to a couple of months.
However, in some cases, lingering symptoms and fatigue can persist for several months after the initial infection. This condition is known as post-viral fatigue syndrome or chronic fatigue syndrome (CFS). The exact cause of CFS is not fully understood, but it is believed to be a combination of factors including viral infection, immune dysfunction, and psychological stress.
One of the common long-term effects of glandular fever is the enlargement of lymph nodes in the neck, armpits, and groin. The lymph nodes might remain swollen for several months even after the acute symptoms, like fever and sore throat, have resolved.
In rare cases, the Epstein-Barr virus can cause complications such as tonsillitis or swelling of the liver and spleen. These complications usually resolve with proper treatment and rest.
It is important to note that while most individuals recover fully from glandular fever, the virus can remain dormant in the body for the rest of their lives. Reactivations of the virus are rare but can occur during times of lowered immunity or high stress. This reactivation usually does not cause symptoms, but it may lead to contagiousness and transmission of the virus to others.
If you have experienced glandular fever, it is crucial to take care of your overall health and well-being. This includes getting plenty of rest, eating a balanced diet, and managing stress levels. If lingering symptoms or complications persist, consulting a healthcare professional is recommended for further evaluation and treatment.
What is glandular fever?
Glandular fever, also known as infectious mononucleosis or mono, is a viral infection caused by the Epstein-Barr virus (EBV). It is characterized by extreme fatigue, fever, sore throat, and swollen lymph nodes.
How is glandular fever transmitted?
Glandular fever is mostly transmitted through saliva, hence it’s often referred to as the “kissing disease.” It can also be spread through coughing, sneezing, or sharing utensils or drinking glasses with an infected person.
What are the symptoms of glandular fever?
The symptoms of glandular fever include extreme fatigue, fever, sore throat, swollen lymph nodes in the neck and armpits, swollen tonsils, headache, loss of appetite, and a rash (in some cases). Joint pain and liver or spleen enlargement can also occur.
How long does glandular fever last?
The duration of glandular fever varies from person to person, but most people start feeling better within a few weeks, while some may experience fatigue for several months. The acute phase of the illness usually lasts about two to three weeks.
What is the treatment for glandular fever?
There is no specific treatment for glandular fever. It usually resolves on its own with plenty of rest, fluids, and over-the-counter pain relievers for symptom relief. It’s important to avoid contact sports and strenuous activities to prevent complications like splenic rupture. In severe cases, hospitalization may be required.
What is glandular fever?
Glandular fever, also known as infectious mononucleosis, is a viral infection caused by the Epstein-Barr virus.