The Kissing Disease

In the U.S. Naval Academy's hospital in Annapolis last week, a dozen midshipmen who did not seem critically ill were confined to bed and getting intensive care. In mid-February they had begun to feel lethargic. Then they had developed slight fevers, headaches and sore throats. The lymph glands in their necks and armpits swelled. Medical Officer Edward C. Keene was not surprised--he would have been surprised if he had not had a rash of cases. The ailing mids were victims of infectious mononucleosis, a mysterious disease that breaks out about six weeks after infection. And infection most commonly occurs during the Christmas-New Year holidays, when a young man's fancy is to kiss his girl.

One Pleasant Date. Doctors, confronted with a possible case of mononucleosis, often regard it as a mild infection. It is frequently more than that, says Colonel Robert J. Hoagland, who began studying mono in 1946 when he was medical officer at West Point (where, as at most colleges, the disease is common) and has continued at Fort Benning, Ga., since his transfer there.

Much of the confusion in diagnosing it is largely unnecessary, says Dr. Hoagland: the symptoms of a full-blown case follow a pattern like the midshipmen's. A blood test alone will neither prove nor disprove mononucleosis, but a blood test in combination with these symptoms is decisive.

And the disease is not to be taken lightly: it almost invariably results in inflammation of the liver--though a less dangerous form of hepatitis than the widespread infectious hepatitis or serum hepatitis (TIME, Nov. 14), which are caused by different viruses. And mono must be carefully doctored and nursed, says Colonel Hoagland, because in a few neglected cases it has caused rupture of the spleen, meningitis or heart block--and death.

No laboratory has yet isolated the cause of infectious mononucleosis. but it is universally believed to be a small virus. Probably it stays in its victims' bodies long after they have recovered, so they become "healthy carriers" and pass it on. The mechanism of transmission has aroused a storm of medical controversy.

Dr. Willard Dalrymple, chairman of the American College Health Association's committee on mono, who has observed 600 cases at Harvard and M.I.T., scoffs at the kissing theory. But Colonel Hoagland, who knows his West Point cadets, has pinned it down. Among 73 mono patients at West Point, no fewer than 71 had been dating six weeks earlier and had got as far as "deep kissing." A quick buss on the lips is probably not enough to transmit the virus.

Two Weeks in Bed. Mono victims, especially coeds, complain that the disease leaves them weak for months, and keeps recurring. Yet the best current medical opinion is that the severity of the disease depends on the victim's physical fitness--or unfitness. An athlete in training who is getting plenty of sleep may throw it off as nothing more than a bad cold. But even a well-trained cadet or midshipman, going short of sleep during the holiday social whirl and plunging into a tough round of studies, may be a pushover. Most susceptible are young women who are going short of food (to keep slim) or of sleep. They usually have the severest, longest-lasting cases.

As in all diseases caused by small viruses, mono has no cure. Patients are kept in bed. with absolute rest, to protect the spleen and liver. Some doctors believe that in severe cases drugs of the cortisone type help reduce the inflammation and therefore safeguard the liver. Two weeks in bed and another of complete rest are usually enough, with good doctoring, to ensure full recovery.

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