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I’m excited for a New Year’s kiss, but I might be sick. What should I do?

The question: I'm looking forward to ringing in the new year with a smooch from my husband, but I've been feeling under the weather and my doctor thinks I may have the "kissing disease." Is this something to worry about?

The answer: With the merriment of the season, mistletoe in the air and sharing a kiss to ring in the new year, sometimes the risk of getting sick from this holiday closeness is the last thing on our mind. Before puckering up, consider a few precautions to avoid spreading infection so you can celebrate in good health.

Infectious mononucleosis (mono) is more commonly as the "kissing disease." It is caused by the Epstein Barr virus and, while it got its famous name because it can be passed through saliva, it can also be transmitted through a cough or sneeze, or by sharing utensils or drinking glasses with someone who is infected.

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Mono is most common in teenagers and young adults. The good news is that by our 30s and 40s, most of us have built up an immunity against the virus and are unlikely to be affected.

Symptoms of mono can include fatigue, sore throat, fever, swollen lymph nodes, headache and rash. While mono is generally of no major consequence, there are potential complications of the infection that can be more serious. In some cases, the spleen can become enlarged to a point where it is at risk of rupturing, which is a medical emergency. For this reason, if the spleen is enlarged after a mono infection, your doctor may advise you to avoid contact sports to minimize the risk of rupture.

The other significant complication of mono is persistent fatigue after the infection clears. In most cases, fatigue will resolve itself within a week or two, but for some, it can persist for months and can result in having to miss work.

Because mono is caused by a virus, antibiotics will not work. Mono is self-limited, meaning that it will eventually resolve on its own. The best things you can do are to allow your body to rest, drink plenty of fluid and allow your body to heal. To relieve symptoms of sore throat or fever, you can take over-the-counter anti-inflammatories (Advil, Motrin) or acetominophen (Tylenol) and gargle with salt water to soothe the throat.

Because your doctor has diagnosed you with possible mono, the safest thing would be to avoid sharing utensils and glasses, wash your hands regularly and avoid the kissing tradition until you're better. It is unclear how long someone who is infected with mono remains contagious, but there is some research that shows that the virus can remain in the saliva for several months. While a brief peck without exchange of saliva is unlikely to spread the virus, perhaps choosing a fist bump or hugging it out may be a healthier and safer way to ring in the new year with your loved ones.

Dr. Sheila Wijayasinghe is the medical director at the Immigrant Womens' Health Centre, works as a staff physician at St. Michael's Hospital in their Family Practice Unit and at Hassle Free Clinic, and established and runs an on-site clinic at Women's Habitat Shelter in Etobicoke.

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