Kissing Disease

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What is Kissing Disease?

Kissing Disease, medically known as Infectious Mononucleosis, or Mono for short, is a viral illness that presents as fever, sore throat, enlarged neck lymph nodes, and fatigue (severe tiredness). Mono is very common, affecting children, adolescents and adults. In the United States, about half of the children population have had the infection, usually mild, before age five. The incubation period (time from exposure to Mono to appearance of symptoms) is from 30 to 50 days.

Is this caused by kissing?

No, kissing is not the cause Mono. The illness is caused by a virus called Epstein-Barr Virus (EPV), one of the herpes viruses, which can be transmitted by a person with Mono to another person through mouth-to-mouth kissing or through intimate contacts. Persons who are not infected with the virus can kiss all they want, French kissing and all, and be as intimate as they want, and not catch Mono.

Why is Mono transmitted by kissing?

The Epstein-Barr virus abounds in the saliva of a person that is infected with Infectious Mononucleosis, and mouth to mouth kissing transfers the virus from the mouth of the infected person to the mouth of partner. The mucus membrane (inner lining of our mouth) absorbs the virus into the body.

Can the virus be transmitted by hand-holding or hugging?

No, physical skin-to-skin contact alone does not transmit the virus, unless the skin is contaminated by EPV infected saliva. The virus is NOT very contagious. However, since Mono could be very debilitating, it is best to be prudently careful when dealing with someone with this condition. Washing hands is a simple and yet very effective way of preventing many infectious illnesses.

How does the illness start?

Among children under five years old there are usually no symptoms. In other age groups, there may or may not be symptoms either. Mono usually starts as a feeling of malaise (being sick) that lasts for several days, followed by fever, sore throat and enlarged lymph nodes, most notably in the neck. The fever could peak to 103 F in the afternoon or early evening, and there could be pus-like material at the back of the throat. Fatigue is usually marked in the first 14 to 21 days. The acute phase is about 14 days, after which the individual can usually go back their daily routines. In some cases, fatigues could continue for several more weeks.

Is Mono fatal?

No. While there are rare reports of deaths from Mono (around 1%), usually these are caused by the complications like asphyxia (airway obstruction), encephalitis (inflammation of the brain), meningitis (inflammation of the lining of the brain) or rupture of the spleen. This is most seen among those with impaired immune system like transplant patients or persons with AIDS. In general, most Mono patients recover fully.

Why the airway obstruction?

In a few cases, airway obstruction with dyspnea (difficulty breathing), and asphyxia in more severe situations, occurs as a result of the swelling of the lining of the throat and breathing pipe. In these cases, corticosteroids are prescribed by the attending physician.

Does Mono cause cancer?

Infectious Mononucleosis does not cause cancer. The EBVirus is reportedly associated with Burkitt's lymphoma, a form of malignancy that is seen in Africa. In those patients with impaired immune system, it could cause B Lymphocyte tumors, and some cancers of the throat and nose. The role of the EBV in these conditions is not clear.

What can a partner of one who has Mono do?

Both partners must totally abstain from mouth-to-mouth kissing and intimate contacts for at least 2 months from the onset of the acute phase. Since kissing mouth to mouth and sex are two of the most pleasurable romantic expressions among humans, especially among adolescents, the total prevention of Mono may be difficult. But since prevention is the key, as with other human diseases, this is the only prudent option a concerned partner can take if this viral infection is to be avoided.

Is Mono the same as Chronic Fatigue Syndrome?

While Chronic Fatigue Syndrome (CFS), which is twice more common in females and mainly happens to adults (20 to 40 years old), is an entity whose cause is unknown. Hence, a syndrome. The EBV has been implicated before but there is no scientific proof today that EBV is causally related to this syndrome. Severe and debilitating tiredness, and lack of concentration, are features of this condition. In some cases, there is a low-grade fever and swelling of lymph glands.

Any other similar conditions?

Other illnesses that can be confused with Infectious Mono are CMV (Cytomegalovirus disease), Toxoplasmosis, and even some side-effects from some drugs can mimic the symptoms of Mono. A blood test can confirm the presence of Infectious Mono and rule out the other suspected illnesses. This is the reason why consultation with a physician is essential, if only to make sure the symptoms are not due to a more serious disease.

Is rest important in the treatment?

Yes, rest is very important because use the patient usually has severe fatigue and malaise for 2 to 3 weeks. Since the spleen in this individual is congested and enlarged, contact sports, heavy lifting and other strenuous activities should be avoided for at least 2 months to prevent rupture and hemorrhage.

Does the drug Acyclovir help?

While the drug Acyclovir minimizes the production of the Epstein-Barr virus in the body of the patient, this medication has insignificant effect on the clinical presentation of the patient with Infectious Mononucleosis.

Is aspirin used in Mono?

In adults, acetylsalicylic acid (aspirin) may be used as antipyretic (to lower the fever) and as an analgesic (pain killer), but aspirin is no longer prescribed for children, because of the possibility of the occurrence of Reye's Syndrome, which can be fatal. Important warning: Aspirin should never be given to children unless specifically prescribed by a Pediatrician for a distinct medical reason.

©2003Raoul R. Diez, M.A.O.D.