What is a ‘kissing disease'?

What is a ‘kissing disease'?

Last Reviewed : 01/05/2021
What is a ‘kissing disease'?

Infectious mononucleosis, also known as kissing disease, mono, or glandular fever, is a viral illness caused by Epstein Barr Virus (EBV). EBV belongs to a group of the herpesvirus family. EBV was named after two scientists who discovered the virus, Anthony Epstein and Yvonne M. Barr. The term mononucleosis is given due to the increase in white blood cells, particularly the lymphocytes, seen during the active infection.

The virus is highly contagious during active infection and spreads through bodily fluids, saliva being the most common mode of transmission. So, it spreads through kissing, and sharing food and beverages. It can also spread through the droplets when an infected man coughs or sneezes. Less common ways of transmission are through blood transfusion and sexual contact.

Signs and Symptoms

The incubation period of the virus is 4-8 weeks. While some of the patients remain asymptomatic, others develop a wide range of symptoms. A patient with glandular fever may present with

  • Fever
  • Fatigue
  • Sore throat
  • Swollen Tonsils and Lymph nodes
  • Maculopapular rash all over the body
  • Enlarged spleen.

The EBV can infect anyone, but it is more commonly seen in individuals aged between 5 and 25 years. It is reported that every year 1-3% of college students are infected with EBV, and 80-90% of adults aged 40 years have been tested positive for EBV antibodies in their blood, implying a past infection. Most of the patients who acquire infection remain asymptomatic but develop antibodies against the virus conferring immunity to the individual.


Infectious mononucleosis may lead to complications such as hepatitis, spleen enlargement, and rupture. Other complications Include hemolytic anemia, thrombocytopenia, myocarditis, respiratory difficulty and dysphagia (due to enlarged tonsils), and encephalitis. Spleen rupture is the most common complication, so it is advised to avoid contact sports for 4-8 weeks or till the active infection subsides.


Glandular fever is often misdiagnosed as strep throat, which is a bacterial infection caused by streptococcus pyogenes. Due to the increased risk of antibiotic resistance, it is crucial to differentiate them. There are various tests to help in diagnosing Infectious Mononucleosis. A complete blood picture shows increased lymphocytes, a white blood cell, in the blood. Heterophile antibody test and Monospot test confirm the EBV infection by estimating the level of antibodies in the blood.


Just like any other viral illness, infectious mononucleosis resolves spontaneously without any treatment. No antiviral is effective in treating the infection. Supportive measures like adequate sleep, rest, and plenty of fluids are the best approaches for managing this viral illness.

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