October 14, 2010

You’ve Been Kissing!

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Startled, I looked up to see my professor standing at the front of the class with a wry grin. “You’ve been kissing!” he repeated, more emphatically this time. The entire class was now paying attention.

“Just listen,” he implored, while cupping a hand to his ear.

With this gesture, it became quite obvious. A continuous bruit of coughs, sniffles and sneezes echoed throughout Uris Hall Auditorium. The majority of my peers were sick!

By now I also understood the point of his playful accusation. Previously, my professor had warned us about the “dangers” of kissing. We might get sick. We might miss (his) class. We might do poorly on the prelim. His recommendation? Don’t kiss anybody the entire semester. Apparently, my classmates and I had not followed his advice.

It’s been several years since then, and I’ve come to learn — both academically and anecdotally — that kissing is only part culprit. In reality, sharing some saliva with your S.O. won’t necessarily lead to a sick day, and there are certainly many other ways to catch an illness. Even so, there are still a few bugs you might want to know about before you next swap spit.

Infectious Mononucleosis

Perhaps better known as simply mono, infectious mononucleosis is also referred to as the dreaded “kissing disease.” Living up to this moniker, mono is caused by the Epstein-Barr virus, which is transmitted solely through human saliva. Interestingly, not everyone infected with EBV will develop the clinical syndrome we call mono, characterized by fever, sore throat and swollen lymph nodes. In fact, those infected as a child are usually spared, whereas up to 50 percent of newly infected young adults will fall ill.

Don’t despair though, as mono is usually as harmless as it is ubiquitous. Despite fatigue that may last for several months, most other symptoms resolve in a few weeks. Also, dangerous complications such as splenic rupture occur in less than one percent of people and are largely preventable.

Perhaps most distressing is that EBV is almost impossible to avoid. The virus results in a lifelong infection, with 95 percent of adults and 30-70 percent of college students testing positive. Furthermore, although mono only occurs once (or not at all) in those infected with EBV, the virus may be shed intermittently for decades from the mouths of otherwise healthy individuals. Couple this with a 30-50 day delay in symptom onset and you’ll probably never know who gave it to you.

Meningitis

College students beware, this one loves you! Second to infants, it is most commonly diagnosed among young adults living in close quarters (i.e. dorms). Though uncommon, this one’s too dangerous to ignore. Let me explain.

Bacterial meningitis is an infection of the meninges, a layer of tissue surrounding the brain and spinal cord. Not surprisingly, common symptoms include severe headache, neck stiffness, fever and sometimes rash. Moreover, bacterial meningitis is fatal more than 10 percent of the time and permanently disables up to 19 percent of survivors. It is spread via nasopharyngeal secretions, so this means kissing, coughing and sneezing are all fair game to make your life miserable.

It’s important to note that sharing beverages is kissing — pathogens don’t discriminate. Regardless, if you do feel obligated to defend your beer pong title this weekend (this writer does not endorse this), you can do something to lower your risk of infection. It’s strongly recommended that all college students be vaccinated against meningococcal disease. It will not protect you from every strain though, so be careful and see the doctor immediately if you have any of the symptoms described above. Rapid diagnosis and life-saving antibiotics are essential to a positive outcome!

Herpes Simplex

The majority of you have herpes. Yes, a recent JAMA study showed that 58 percent of adults have HSV-1, the virus most commonly associated with oral herpes.

Why am I saying this? Well, most people with herpes simplex never show any signs, namely cold sores. However, viral shedding can still occur in the absence of any symptoms, so it’s possible to catch the virus from someone who doesn’t even know they have it. Sure, you might get “lucky” and only become an asymptomatic carrier if infected. Then again, you’ll still have to deal with the consequences if and when your next kissing partner isn’t as fortunate as you. Also, don’t forget that HSV-1 and HSV-2 can both cause oral and genital herpes, so other types of “oral activity” are equally risky.

The Flu & Common Cold

Influenza is certainly the more virulent and dangerous of the two, but it’s actually the common cold that results in the greatest number of sick days every year. This is unfortunate news, as there is a vaccine for influenza but not the hundreds of viruses that cause the common cold. Truthfully, the flu vaccine is no panacea either, as it only protects against the current year’s expected strains — similar to a weather forecast, it may not be 100 percent correct. Simple avoidance is usually the best strategy, but this is also difficult. Sneezes and coughs can send infectious droplets airborne while the viral particles themselves can survive on surfaces such as keyboards for several hours. Interestingly, saliva does not play a large role in the transmission of these two illnesses. Nonetheless, even with kissing largely exonerated, it still only takes one cough or sneeze while you’re nearby to become ill.

The Bottom Line

In a few weeks, that familiar symphony of sneezes will makes its return in classes across campus. You don’t have to be a part of it, though. Make sure you’re vaccinated, wash your hands often and avoid sharing beverages. Also, if you must kiss somebody, make sure they’ll at least bring you a bowl of soup and a box of tissues when the kissing goes awry. It’s only fair.

David Roy is a third-year student at Weill Cornell Medical College. He may be contacted at dmr2002@med.cornell.edu. What’s Up, Doc? appears alternate Fridays this semester.

Original Author: David Roy