LivingMononucleosis: the disease of the kiss in depth

Mononucleosis: the disease of the kiss in depth

Kissing sickness is a viral condition caused by a herpes virus called Epstein-Barr virus (EBV). EBV is very common in healthy people, affecting more than 90% of people around the world . The age of initial infection has been found to differ based on socioeconomic factors such as crowding and poor sanitation. Most people appear to have positive antibodies for the virus by age 30.

What is mononucleosis?

Infectious mononucleosis, generally known as kissing disease, is an infectious disease that is usually caused by the Epstein-Barr virus (EBV), although it can also be caused by other viruses . It is especially prevalent among adolescents and young adults, affecting at least 1 in 4 young people infected with this virus.

EBV, which causes mononucleosis, is spread through saliva . It can be contracted by kissing someone who has it, but also by sharing a drink or a piece of food. Still, mononucleosis is not as contagious as other commonly known illnesses, including the common cold.

Characteristics of infectious mononucleosis are swollen lymph nodes , fever , sore throat, and excessive exhaustion . These symptoms usually appear within 4 to 6 weeks after infection, and do not last more than 4 months. People without symptoms can carry the virus in their saliva, making it highly transmissible and impossible to avoid.

Who is susceptible?

There are usually two peaks in incidence when people get EBV: when they are in elementary school and when they are in their teens/young adults. Mononucleosis is most common among teenagers and people in their 20s, although it can affect even young children. Infection can be influenced above all by sanitary conditions and hygiene.

A random individual has a good chance of being positive for antibodies to this virus by the time they reach a certain age. In developed countries with good sanitary conditions, people pass the virus either in childhood or in adolescence and youth. After this infection, as happens with Covid, the person generates antibodies against the virus, and since it is a fairly widespread virus, more than 90% of people in adulthood have antibodies against EBV.

As for the countries with the worst hygiene conditions, it is common for them to go through an infection of this virus earlier, so that the majority of the population already tests positive for antibodies after the first years of life.

Epstein-Barr is a type of herpes virus , but it is not the same as the herpes simplex virus (HSV), which is responsible for genital and oral herpes. Both viruses can be passed from one person to another through sexual contact. However, the probability of sexual transmission is relatively low for mononucleosis, and other methods of transmission, such as sharing drinks or kissing, are more likely to spread EBV.

What are the causes?

As we have already said, the Epstein-Barr virus (EBV) is the most common cause of infectious mononucleosis, but that does not mean that mononucleosis cannot be caused by other viruses. Cytomegalovirus (CMV) causes a milder form of mononucleosis than EBV infectious mononucleosis. The family of herpes viruses includes both EBV and CMV.

The Epstein-Barr virus has infected most adults between the ages of 35 and 40. It is a fairly common virus . When children are exposed to the virus, they usually show no signs or symptoms. Instead, uninfected adolescents and young adults who come into contact with the virus can develop an illness resembling infectious mononucleosis.

In adolescents and young adults, the Epstein-Barr virus (EBV) can cause infectious mononucleosis. Even when the signs of infectious mononucleosis have faded, EBV will remain dormant, as if inactive, in that person’s pharynx and blood cells for the rest of their life. However, the virus can regularly reactivate, usually without causing symptoms.

EBV detection

Symptoms are the most common way that healthcare professionals diagnose infectious mononucleosis. In most cases, laboratory tests are not required to diagnose infectious mononucleosis. However, in patients who do not present with a typical case of infectious mononucleosis, specific laboratory tests may be necessary to determine the etiology of the disease.

Patients with infectious mononucleosis caused by EBV infection may have abnormal blood test results.

How is it treated?

Infectious mononucleosis does not yet have a vaccine . Avoid kissing or exchanging drinks, food, or personal effects, such as toothbrushes, with people who have contagious mononucleosis. This can help safeguard you.

You can ease the symptoms of mononucleosis by: staying hydrated and consuming fluids, getting enough sleep, and using over-the-counter pain relievers and fever reducers.

You shouldn’t take any antibiotics , let alone self-administered, antibiotics do nothing against viruses. The treatment of any common virus consists of treating symptoms (pain relievers, lowering body temperature,…) and time.

Since infectious mononucleosis can cause the spleen to swell and enlarge, you’ll need to avoid contact sports until you’ve fully recovered. Contact sports are physically demanding and can trigger your spleen to rupture.


About Infectious Mononucleosis (2020). CDC.
‌Freepik(s.f.). Close-up of couple almost kissing and freckles [Free Photo]. Freepik.
Infectious Mononucleosis (s.f.). Johns Hopkins Medicine.
Kaye, K.M. (2021). Infectious Mononucleosis. MSD Manual.
Mononucleosis (Mono): Symptoms, Treatment & Diagnosis (2020). Cleveland Clinic.
Smatti, M. K., Al-Sadeq, D. W., Ali, N. H., Pintus, G., Abou-Saleh, H., & Nasrallah, G. K. (2018). Epstein-Barr Virus Epidemiology, Serology, and Genetic Variability of LMP-1 Oncogene Among Healthy Population: An Update. Frontiers in oncology, 8, 211.

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