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Sep 7, 2008

Is Kissing Dangerous?

“You’d better be careful whom you kiss,” I was told. I was in high
school and infectious mononucleosis (also called mono) was “going
around.” Kids missed school for a month; and everyone was told it was
because “too many people were kissing too many people.” As it turns
out, there were only two or three kids who had mono, and they didn’t
even know each other. The rest of it was hysteria, rumor or myth. But I
always wondered about “kissing disease,” as many called it. Was it
really dangerous? Was kissing really so risky?

Mono is caused
by infection with Epstein-Barr Virus (EBV). After exposure to EBV,
there are usually no symptoms at all – in fact, up to 95 percent of
adults have antibody evidence of past EBV infection even though the
vast majority recalled no related illness. For reasons that remain
unknown, only some people develop mono after exposure to EBV, with
fatigue, headache, muscle or joint aches, fever, enlarged lymph nodes,
and sore throat. While it is true that the virus is shed in the saliva
and can be transmitted by kissing, mono is not a highly contagious
illness and it can also be transmitted by other means, such as coughing
or sneezing. Preventing the spread of EBV is not easy since there are
often no symptoms. Even when there are, one may be contagious before
the illness is recognized.

Other infections can cause illness
resembling mono, including cytomegalovirus (CMV) and other viral
infections. Blood tests usually can establish the diagnosis of mono
when necessary.

There is no effective therapy for mono, although
acetaminophen or ibuprofen and fluids can be helpful in relieving
symptoms. The vast majority of people who have it recover completely
within a week or two. Occasionally fatigue lasts more than month, but
even then, a return to normal is expected. Because the spleen may
become enlarged and could rupture if injured, persons with mono are
advised to avoid contact sports for at least a month after recovery.

Infections related to kissing

During
any exchange of bodily fluids, there is a risk of transmitting
infectious agents. However, the body has defense systems in place to
prevent infection, though these work better for some infections than
others. For example, HIV and hepatitis B are relatively easy to
transmit through sexual intercourse, while hepatitis C is not as
readily spread sexually.

Similarly, some infections are harder to
transmit through kissing than others. HIV is rarely (if ever)
transmitted through kissing; when it does occur it probably relates to
open sores in the mouth that allow exposure to blood, not just saliva.
On the other hand, many other viral infections are easy to transmit by
kissing: herpes simplex virus, the cause of cold sores or fever
blisters, is a common example. In fact, the illnesses commonly
transmitted by kissing, including mono, have a minimal impact on
overall health.

The bottom line

While it
is true that EBV is easy to transmit from one person to another through
kissing, there is usually no recognized illness associated with the
infection. Even when mono does follow, complete recovery in a short
period is the rule. While “kissing disease” is real, kissing is rarely
a danger to your health.

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