Kissing disease is a viral infection that is mainly caused by the Epstein-Barr virus (EBV). It is often transmitted through saliva, for example when kissing, but also by sharing drinks or cutlery. The disease mainly occurs in adolescents and young adults, but can also affect children and older adults.

Symptoms

Symptoms can vary depending on age. In children, they are often mild or absent, while adolescents and young adults typically have a sore throat, fever, swollen lymph nodes, fatigue, muscle aches and sometimes an enlarged spleen or liver. These symptoms can last for several weeks and are similar to other infections, making diagnosis difficult.

Laboratory medical determination

Diagnosis often begins with a physical examination, during which the doctor looks for signs such as swollen glands or an enlarged spleen. Several tests are available for laboratory diagnosis:

• The monospot test is a rapid screening test that detects heterophilic antibodies that occur in EBV infections. It is simple but not always reliable, especially in the early stages or in children under 4 years of age, where it is often negative.
• More specific tests are the EBV antibody tests, which measure different antibodies, such as VCA IgM (indicating an acute infection) and EBNA antibodies (indicating a past infection). These help to determine the phase of the infection.
• A blood count may show an increased number of lymphocytes and atypical lymphocytes, which is typical of kissing disease. Sometimes liver function tests are also performed, as the liver may be affected.

These tests together allow an accurate diagnosis, especially if the monospot test is unclear

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