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Infectious Mononucleosis: Tits and Bits about the ‘Kissing Disease’

By Ade Oluwasanmi

imagesKissing has never been more dangerous when it comes to this infection. Caused by Epstein-Barr virus (EBV) named after its discoverers, the disease has notoriously been termed kissing disease because of its transmission which is greatly enhanced during kissing. It is a disease more common among youths, especially between the age of 15 and 26 years, and it is called mononucleosis because of the increase number of mononuclear leukocytes in their blood during the infection.

Alternatively called ‘mono’, the causative virus has been repeatedly detected in saliva and throat washing of infected individuals indicating that the virus is been excreted for a prolonged period after infection and then either continuously or intermittently in most seropositive individuals. It is therefore assumed that primary infection occurs by the oral route, by close contact with a virus excreting individual.

Childhood infection probably occurs through salivary contact with family members or other children, whereas the peak of seroconversion in late adolescence, which coincides with the age at which new social contacts are often made, is likely to occur during kissing. What’s more? Most infections are asymptomatic, making detection of infected person almost impossible.

Isolation from the uterine cervix of some infectious mononucleosis patients and normal seropositive women and from semen from healthy males also suggests that sexual intercourse is a possible route of spread. It can also be acquired by transfusion of fresh blood or organ transplantation.

Symptoms of the primary infection include fatigue, fever, sore throat. loss of appetite and lymph nodes enlargement. Incubation period, which is period between exposure to the virus and displaying of symptoms, is 1 to 2 months. However, recurrent infection can occur, but it is not usually overt. Symptoms of recurrent infection are the same with the primary infection, and it is usually mistaken for malaria fever.

Infectious mononucleosis is a self-limiting illness, and its complications, though present, are rare. They include:

  • Chronic fatigue – some patients may suffer with tiredness and fatigue for weeks to months post acute EBV infection; this may or may not be accompanied with lymphadenopathy.
  • Rarely, an enlarged spleen may lead to splenic rupture, therefore patients are advised to refrain from contact sports until acute symptoms have subsided.
  • Guillain–Barre ´ syndrome is a rare post-infectious complication of EBV infection, and presents as an ascending motor paralysis due to an immune-mediated demyelination of the spinal cord.
  • Epstein–Barr virus associated malignancies, such as Burkitt’s lymphoma, nasopharyngeal carcinoma and lymphoproliferative disease (LPD)/lymphoma in immune-suppressed patients.
  • X-linked lymphoproliferative syndrome (Duncan’s syndrome) is due to a specific X-chromosome-linked recessive genetic defect, which leads to impaired antibody response to EBV alone. It affects the male members of a family who either die of an overwhelming EBV infection, or develop lymphoproliferative malignancies.

So lovers, how can you be sure your partner is not infected before kissing? I would say pretty difficult. Aside the general symptoms stated above, the more specific ones observed in reported clinical cases include fatigue, fever, rash, and swelling of lymph nodes, the spleen, and, in some patients, the liver, for long periods of time. Some have also reported formation of whitish coat on the tonsil and a temporary swelling of the two upper eyelids.

As there is no specific treatment for mono, general supportive treatments are provided to relieve the symptoms of sour throats, fever and fatigue. Rest, take pain relievers, avoid carrying heavy loads, stay away from contact sport, and all will be well. Except if there is complications…

Cheers!

PS.

Please avoid kissing kids and save them from being infected. They are innocent, you know.

Updated: January 30, 2014 — 11:34 am

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