kissing disease (Infectious mononucleosis )

Kissing disease (Infectious mononucleosis )

kissing disease (Infectious mononucleosis ) is an infectious disease caused by EBV through oral transmission. Symptoms of infection with EBV include fever, malaise, and sore throat. The EBV can infect any person. The majority of people have become infected with the virus when  reach adulthood. Mono is most often diagnosed in adolescents and young adults, with a peak incidence at ages 15-17.

Infectious mononucleosis (also known as EBV infectious mononucleosis or Pfeiffer’s disease or Filatov’s disease and colloquially as kissing disease—from its oral transmission—or as mono in North America and as glandular fever in other English-speaking countries) is an infectious, very widespread viral disease caused by the Epstein-Barr virus (EBV), one type of herpes virus, to which more than 90% of adults have been exposed.EBV is a member of the herpesvirus family. Symptoms of infection with EBV include fever, malaise, and sore throat. The designation “mononucleosis” refers to an increase in one type of white blood cells (lymphocytes) in the bloodstream relative to the other blood components as a result of the EBV infection.

What is the cause of mono?

The EBV that causes mono is found throughout the world. By the time most people reach adulthood, an antibody against EBV can be detected in their blood. In the U.S., up to 95% of adults 35-40 years of age have antibodies directed against EBV. This means that most people, sometime in their lives, have been infected with EBV. The body’s immune system produces antibodies to attack and help destroy invading viruses and bacteria. These specific antibodies can be detected in the blood of people who have been infected.

What are the risk factors for mono?

The EBV can infect any person. As previously discussed, the majority of people have become infected with the virus by the time that they reach adulthood. Mono is most often diagnosed in adolescents and young adults, with a peak incidence at ages 15-17. However, it is also seen in children. Generally, the illness is less severe in young children and may mimic the symptoms of other common childhood illnesses, which may explain why it is less commonly diagnosed or recognized in this younger age group.

How is mono spread?

Mono is spread by person-to-person contact. Saliva is the primary method of transmitting mono. Infectious mononucleosis developed its common name of “kissing disease” from this prevalent form of transmission among teenagers. A person with mono can also pass the disease by coughing or sneezing, causing small droplets of infected saliva and/or mucus to be suspended in the air which can be inhaled by others. Sharing food or beverages from the same container or utensil can also transfer the virus from one person to another since contact with infected saliva may result.

Most people have been exposed to the virus as children, and as a result of the exposure, they have developed immunity to the virus. It is of note that most people who are exposed to the EBV don’t ever develop mononucleosis. The incubation period for mono, meaning the time from the initial viral infection until the appearance of symptoms, is between four and six weeks. During an infection, a person is likely able to transmit the virus to others for at least a few weeks.

What are the symptoms of mono?

The initial symptoms of mono are a general lack of energy or malaise, a loss of appetite, and chills. These initial symptoms can last from one to three days before the more intense symptoms of the illness begin. The more common intense symptoms include a severe sore throat, fever, and swollen lymph nodes (glands) in the neck area. It is typically the severe sore throat that prompts people to contact their doctor

What are the signs of mono?

In addition to a fever from 102 F-104 F, the most common signs of mono are

a very reddened throat and tonsils and swollen lymph glands in the neck. The tonsils have a whitish coating in at least one-third of the cases. The spleen (sometimes referred to as the body’s biggest lymph node) is an organ found in the left upper abdomen underneath the rib cage which becomes enlarged or swollen in about 50% of patients with mono. An enlarged liver may also occur. About 5% of patients have a splotchy red rash over the body, which has a similar appearance to the rash of measles.

How is mono diagnosed?

The diagnosis of mono is suspected by the doctor based on the above symptoms and signs. Mono is confirmed by blood tests that may also include tests to exclude other possible causes of the symptoms, such as tests to rule out Strep throat. Early in the course of the mono, blood tests may show an increase in one type of white blood cell (lymphocyte). Some of these increased lymphocytes have an unusual or “atypical” appearance when viewed under a microscope, which suggests mono.

What is the usual course and treatment of mono?

In most cases of mono, no specific treatment is necessary. The illness is usually self-limited and passes much the way other common viral illnesses resolve. Treatment is directed toward the relief of symptoms. Available antiviral drugs have no significant effect on the overall outcome of mono and may actually prolong the course of the illness. Occasionally, Strep throat occurs in conjunction with mono and is best treated with penicillin or erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone). Ampicillin (Omnipen, Polycillin, Principen) and amoxicillin (Amoxil, Dispermox, Trimox) should be avoided if there is a possibility of mono since up to 90% of patients with mono develop a rash when taking these medications. They may then be inappropriately thought to have an allergy to penicillin. Antiviral medications have not been shown to be of benefit in treating the symptoms of mono.A feeling of fatigue or tiredness may persist for months following the acute phase of the illness. It is recommended that patients with mono avoid participation in any contact sports for at least four weeks after the onset of symptoms to prevent trauma to the enlarged spleen. The enlarged spleen is susceptible to rupture, which can be life-threatening. Cortisone medication is occasionally given for the treatment of severely swollen tonsils or throat tissues which threaten to obstruct breathing.