Is Kissing Dangerous?

Provided by: Harvard Health Publications

“You’d better be careful whom you kiss,” I was told. I was in high school and infectious mononucleosis (also called mono) was “going around.” Kids missed school for a month; and everyone was told it was because “too many people were kissing too many people.” As it turns out, there were only two or three kids who had mono, and they didn’t even know each other. The rest of it was hysteria, rumor or myth. But I always wondered about “kissing disease,” as many called it. Was it really dangerous? Was kissing really so risky?

Mono is caused by infection with Epstein-Barr Virus (EBV). After exposure to EBV, there are usually no symptoms at all – in fact, up to 95 percent of adults have antibody evidence of past EBV infection even though the vast majority recalled no related illness. For reasons that remain unknown, only some people develop mono after exposure to EBV, with fatigue, headache, muscle or joint aches, fever, enlarged lymph nodes, and sore throat. While it is true that the virus is shed in the saliva and can be transmitted by kissing, mono is not a highly contagious illness and it can also be transmitted by other means, such as coughing or sneezing. Preventing the spread of EBV is not easy since there are often no symptoms. Even when there are, one may be contagious before the illness is recognized.

Other infections can cause illness resembling mono, including cytomegalovirus (CMV) and other viral infections. Blood tests usually can establish the diagnosis of mono when necessary.

There is no effective therapy for mono, although acetaminophen or ibuprofen and fluids can be helpful in relieving symptoms. The vast majority of people who have it recover completely within a week or two. Occasionally fatigue lasts more than month, but even then, a return to normal is expected. Because the spleen may become enlarged and could rupture if injured, persons with mono are advised to avoid contact sports for at least a month after recovery.

During any exchange of bodily fluids, there is a risk of transmitting infectious agents. However, the body has defense systems in place to prevent infection, though these work better for some infections than others. For example, HIV and hepatitis B are relatively easy to transmit through sexual intercourse, while hepatitis C is not as readily spread sexually.

Similarly, some infections are harder to transmit through kissing than others. HIV is rarely (if ever) transmitted through kissing; when it does occur it probably relates to open sores in the mouth that allow exposure to blood, not just saliva. On the other hand, many other viral infections are easy to transmit by kissing: herpes simplex virus, the cause of cold sores or fever blisters, is a common example. In fact, the illnesses commonly transmitted by kissing, including mono, have a minimal impact on overall health.

While it is true that EBV is easy to transmit from one person to another through kissing, there is usually no recognized illness associated with the infection. Even when mono does follow, complete recovery in a short period is the rule. While “kissing disease” is real, kissing is rarely a danger to your health.

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How Much Sleep Do You Really Need?

LAURA BLUE

Sleep is one of the richest topics in science today: why we need it, why it can be hard to get, and how that affects everything from our athletic performance to our income. Daniel Kripke, co-director of research at the Scripps Clinic Sleep Center in La Jolla, Calif., has looked at the most important question of all. In 2002, he compared death rates among more than 1 million American adults who, as part of a study on cancer prevention, reported their average nightly amount of sleep. To many his results were surprising, but they've since been corroborated by similar studies in Europe and East Asia. Kripke explains.

Q: How much sleep is ideal?

A: Studies show that people who sleep between 6.5 hours and 7.5 hours a night, as they report, live the longest. And people who sleep 8 hours or more, or less than 6.5 hours, they don't live quite as long. There is just as much risk associated with sleeping too long as with sleeping too short. The big surprise is that long sleep seems to start at 8 hours. Sleeping 8.5 hours might really be a little worse than sleeping five.

Morbidity, [or sickness,] is also "U-shaped," in the sense that both very short sleep and very long sleep are associated with many illnesses - with depression, with obesity, and therefore with heart disease and so forth. But the [ideal amount of sleep] for different health measures isn't all in the same place. Most of the "low points" are at seven or eight hours, but there are some at six and some even at nine. I think diabetes is lowest in seven-hour sleepers, [for example]. But these measures aren't as clear as the mortality data.

I think we can speculate [about why people who sleep 6.5 to 7.5 hours live longer], but we have to admit that we don't really understand the reasons. We don't really know yet what is cause and what is effect. So we don't know if a short sleeper can live longer by extending their sleep, and we don't know if a long sleeper can live longer by setting the alarm clock a bit earlier. We're hoping to organize tests of those questions.

One of the reasons I like to publicize these facts is that I think we can prevent a lot of insomnia and distress just by telling people that short sleep is OK. We've all been told you ought to sleep eight hours, but there was never any evidence. A very common problem we see at sleep clinics is people who spend too long in bed. They think they should sleep eight hours or nine hours, so they spend eight or nine hours in bed, with the result that they have trouble falling asleep and they wake up a lot during the night. Oddly enough, a lot of the problem [of insomnia] is lying in bed awake worrying about it. There have been many controlled studies in the United States, Great Britain and other parts of Europe that show that an insomnia treatment that involves getting out of bed when you're not sleepy, and restricting your time in bed, actually helps people to sleep more. They get over their fear of the bed. They get over the worry, and they become confident that when they go to bed they will sleep. So spending less time in bed actually makes sleep better. It is in fact a more powerful and effective longterm treatment for insomnia than sleeping pills.

(http://news.yahoo.com/s/time/20080610/hl_time/howmuchsleepdoyoureallyneed;Tue Jun 10, 4:00 PM ET)

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