In the medical literature, infectious mononucleosis is a disease caused by the Epstein-Barr virus, which is called EBV for short among people. EBV is transmitted primarily from person to person through close contact with the mouth, throat fluids, and body secretions. It is also called kissing disease because it is most commonly transmitted through saliva. It usually occurs in adolescents, but can be seen in people of all ages. Many people get kissing disease around the age of 1. However, in young children, the disease cannot be diagnosed in most cases, as the disease usually does not cause symptoms or progresses with very mild symptoms. Once the disease is over, it does not recur throughout life, as it is immunized. However, many children in developed countries do not have this infection in their early years, and therefore it is more common in adolescents. People with infectious mononucleosis often experience symptoms such as high fever, swollen lymph nodes, and sore throat. Spleen enlargement may occur in some patients. The majority of cases are mild and easily resolved with minimal treatment. The infection usually does not show severe symptoms and disappears spontaneously within one to two months.
What is kiss sickness?
Kiss disease, infectious mononucleosis, or mono disease for short, is a common infectious disease caused by the Epstein-Barr virus. However, some other viruses can rarely cause illness. The causative virus is often spread through the saliva during a kiss, which is why it is called kissing sickness. Mono is most common in teens and young adults. Whether a person has the disease can be shown with a blood test. Most people start to feel better within two to four weeks. However, after a few months, fatigue and weakness may continue to appear. Treatment is planned with a focus on controlling complaints such as pain and fever. For this purpose, warm salt water mouthwash, plenty of fluid intakes, bed rest, and some medications may be recommended.
What causes kiss sickness?
The factor that causes kiss sickness is a virus called EBV. EBV is a member of the herpes virus family, which includes the virus that causes cold sores. EBV is one of the most common viruses that infect humans worldwide. The virus is spread through direct contact with body fluids such as the mouth and blood of an infected person. Mononucleosis can also be transmitted through sexual contact and organ transplantation. Coughing, sneezing, kissing, or sharing food or drink with someone who has the disease can lead to person-to-person transmission of the virus.
What are the symptoms of kiss sickness?
After the virus is in the body, there may be a period of 4-8 weeks between the onset of symptoms. This period of time between the entry of the causative virus into the body and the time when symptoms begin to observe is called the incubation period. When the disease occurs in teens and adults, it causes obvious symptoms at the end of the incubation period in 35 to 50 percent of cases. In children, it usually does not cause any symptoms and usually heals unnoticed. It is estimated that complaints develop in only 10% of children infected with EBV. The disease is also rare in adults, probably because of the immunity the body has developed as a result of a previous infection. Most cases of infectious mononucleosis occur in the 15-24 age group. The symptoms typically last for one to two months, and the first symptoms often include:
- A general lack of energy and malaise
These first symptoms can last from one to three days before the more intense symptoms start. In the later stages of the disease;
- Resistant fever
- Pain and redness in the throat
- Swollen tonsils
- Swollen lymph nodes in the armpits and neck
- Symptoms such as night sweats are seen.
In at least a third of cases, the tonsils are covered with a whitish membrane. Kiss disease can sometimes present itself with a more severe picture with swelling in the spleen or liver. Liver enlargement occurs due to hepatitis. In this case, abnormalities can be detected in liver function tests. Some patients have a spotted rash on the body that looks the same as a measles rash. In the early period, including the first few days of the disease, a temporary swelling (edema) may occur in both upper eyelids.
It is difficult to distinguish the rarely fatal disease from other common viruses such as the flu. It is useful to consult a doctor if the symptoms do not alleviate after home treatment such as resting for a week or two, drinking enough fluid, and healthy eating.
What are the risk factors for kissing sickness?
Individuals in the risk group for kiss disease are:
- Teenagers and students aged 15-30
- Medical interns
- Patients using drugs that suppress the immune system, such as drugs used after chemotherapy or organ transplantation
- Those with diseases that suppress the immune system such as HIV or cancer
- Anyone who is in close contact with a large number of people on a regular basis.
High school and college students are often infected because they come in contact with a large number of people.
Complications related to kissing disease
Kiss sickness generally does not cause serious consequences. However, in rare cases, secondary infections such as tonsil or sinus infections may develop. Some patients may experience the following complications:
- An enlarged spleen
- Hepatitis (liver inflammation)
- Inflammation of the heart tissues
- Meningitis (inflammation of the membranes surrounding the brain)
How is the kissing disease diagnosed?
First of all, depending on the complaints of the patient, the presence of kissing disease is suspected by the doctor. Then, a detailed physical examination is performed and diagnostic blood tests are requested. Early in the disease, an increase in the number of white blood cells called lymphocytes can be seen in blood tests. Some of these increased lymphocytes are observed to have an unusual appearance when examined under a microscope. These are known as atypical lymphocytes.
Some more specific blood tests, such as monospot and heterophile antibody tests, may be preferred to confirm the diagnosis of mononucleosis. These tests are based on the measurement of antibodies produced by the body’s immune system against EBV. However, these antibodies may not be detected until the second or third weeks of the disease.
Inflammation and abnormalities in the liver can be revealed with a blood test. Diagnostic tests performed in the laboratory can be valuable to rule out other diseases that present similar symptoms.
How is kiss disease treated?
There is no specific treatment option for the disease. However, a variety of medications may be prescribed to reduce sore throat, fever, and tonsil swelling. Treatment is usually planned by your family doctor or pediatrician. However, symptoms usually resolve spontaneously within one to two months, even if no treatment is given to the patient. In case of complications or severe cases, other medical specialists such as infectious diseases specialists, hematologists, cardiologists, gastroenterologists, or neurologists may need to be involved. In cases such as rupture of the spleen, a surgeon undertakes the treatment of the patient.
Treatment is often aimed at alleviating the symptoms. The following methods that can be applied at home help speed up healing:
- Rest cure
- Abundant fluid intake
- Consumption of plenty of hot chicken soup
- Use of medications to reduce fever and relieve sore throat
In order to prevent rupture of the spleen in patients with an enlarged spleen, sports that require strong contact should be avoided during the disease and recovery phase. The long-term prognosis is good for most mono patients, and serious complications are rare.
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