Viral infections can be transmitted by various routes. At one extreme, airborne or droplet viral infections (e.g., varicella zoster, ebola) are highly contagious. Most viruses can be spread by touching surfaces contaminated by the virus and then touching the mouth or eyes. Mass gatherings, clinical and chronic care facilities may be hotspots for virus spread when transmission is via aerosols, droplets, or fomites (contaminated surfaces).
Kissing may spread viral agents from person-to-person if the recipient is susceptible. Various viruses habitually colonize the human mouth and may be present in saliva in quantities sufficient to infect other inpiduals. Humans can be reservoirs of viruses; asymptomatic shedding before clinical disease or where the infection is (undiagnosed or symptomless) is a major factor in their spread.
Adenoviruses (HAdV)
Adenoviruses are usually spread from an infected person to others through close personal contact, such as touching or shaking hands, the air by coughing and sneezing, touching an object or surface with adenoviruses on it, then touching your mouth, nose, or eyes before washing your hands.
At least 69 HAdV genotypes are recognized. HAdV are a common cause mainly of respiratory infections , urethritis and conjunctivitis. Respiratory infection caused by HAdV in immunocompetent people is typically caused by HAdV-3, mild and self-limited. However, more recently HAdV-55 in particular has been found to cause severe community-acquired pneumonia and acute respiratory distress syndrome in immunocompetent adults, mainly from China. HAdV pneumonia typically is found in neonates, immunocompromised people, and school or military camp populations. HAdV infections in immunocompromised inpiduals can be severe and life-threatening. Adenoviruses can survive a long time on objects and spread easily.
Coronaviruses (CoV)
Viruses such as coronavirus can also be spread through the mouth to mouth contact.Coronaviruses are common viruses that can infect humans, and animals. There are a number of Human coronaviruses and they usually cause respiratory infections—mostly mild illnesses such as the common cold. However, several coronaviruses including the Middle East Respiratory Syndrome (MERS), especially seen in Saudi Arabia or visitors to that area, and Severe Acute Respiratory Syndrome (SARS), seen mainly in China and travelers from there, can cause more severe and sometimes life-threatening human infections. Coronaviruses that cause severe acute respiratory infections have >50% mortality rates in older and immunosuppressed people.
People living with or caring for someone with a coronavirus infection are most at risk of developing the infection themselves.
Researchers have discovered the mouth plays an important role in not only infecting multiple areas of the body with SARS-CoV-2, but also in transmitting the virus to the lungs or digestive system via saliva. Kissing can transmit the virus (you obviously would be in very close contact with the infected person).
Colds – also known as upper respiratory tract infections. Many different viruses can cause the common cold. Colds are thought to be spread by direct contact with the virus. You could catch the cold from airborne droplets or by direct contact with secretions (fluids and mucous) from the infected person’s nose and throat.
Influenza
Influenza is spread from person to person, usually via droplets made when people with the flu cough, sneeze or talk. People can infect others with the flu virus one day before they have symptoms and up seven days after becoming sick.
Enteroviruses (EV)
Enteroviruses could be transmitted through saliva or via kissing. Enteroviruses are highly contagious, spread mainly by oral–oral and fecal–oral routes, and typically affect children under 10 years old.
At least 70 serotypes of EV that can infect humans have been identified, including mainly, Coxsackieviruses , ECHOviruses, and polioviruses. Enteroviruses are implicated in a range of diseases, some of which may affect the mouth, including herpangina and hand-foot and mouth disease which are common and in which complications including pneumonia, meningitis, or encephalitis are seen but rarely.
Children with Coxsackie A2 infections mostly present with herpangina only, and have fewer central nervous system complications and a better outcome than those with Enterovirus 71 (EV71) infections.
Hand, Foot, and Mouth Disease (HFMD) is an exanthem on the hands and feet with associated fever and oral lesions. HFMD, is typically a mild illness, caused mainly by Coxsackievirus A16 or EV71, occasionally by Coxsackieviruses A4–7, A9, A10, B1–B3, or B5. Indeed, over 100 serotypes of enterovirus species may cause HFMD.
Poliomyelitis, which is potentially lethal, is now extremely rare. Poliovirus was found in secretions from the upper respiratory tract and salivary swabs of household contacts of patients with virologically proven poliomyelitis.
Herpesviruses
Human herpesvirus (HHV) infections are common, seen especially in younger people subclinically or producing fever and mucocutaneous lesions, and then remain latent but can be reactivated if immunity wanes. Many can be oncogenic. Oral disease associations examined have ranged from carcinogenesis to periodontitis.
Herpes Simplex Virus Type 1 (HSV-1) is typically acquired early in life, usually from direct contact with infected saliva or skin vesicles. HSV can cause oral lesions mainly as gingivostomatitis, with recurrences usually as herpes labialis. HSV type 1 DNA can be found in most cases of recurrent herpes labialis, both before and after the appearance of clinical lesions. Furthermore, viral shedding with viral loads sufficient to be transmitted is more frequent than previously thought, even in otherwise healthy HSV-seronegative inpiduals.
HSV ulceration and recurrences and almost certainly shedding are increased and often more extensive in immunocompromised people such as those with HIV/AIDS or posttransplantation and after oral surgical procedures.
HSV can survive up to 88 hours in dry gauze and 1.5 hours on hard surfaces and has the potential to be spread by fomites. From 2% to 10% of adults without clinical signs of disease have HSV-1 in their saliva. HSV-1 transmission via saliva is thought to be common and it has been transmitted by mouth-to-mouth ventilation.
Epstein–Barr Virus (EBV)
Primary EBV infection in young children is usually subclinical. EBV clinical infection—infectious mononucleosis (glandular fever)—is seen mainly in children older than 10 years, adolescents, and young adults, who present mainly with lymphadenopathy and sore throat.
Patients with infectious mononucleosis can shed EBV in saliva for months. EBV-DNA loads in saliva during convalescence are high and associated with continued infectivity. There is a high prevalence of EBV in saliva and throat washings from healthy children and adults in some geographical regions and by adulthood, at least 90% of all people are seropositive to EBV. EBV may particularly be found in saliva when it is reactivated in immunocompromised people such as those with HIV/AIDS or posttransplantation and in oral hairy leukoplakia.
EBV replicates in oropharyngeal epithelial cells and can be spread through saliva. EBV can be transmitted by kissing; prospective epidemiological studies in undergraduate university students have confirmed salivary transmission of EBV though some authors criticized the study methods used. EBV is also called “the Kissing Virus.” One anecdote is of a man with infectious mononucleosis who, for 12 hours, had shared a train carriage compartment with a woman whom he had not met before and whom he never saw again but during the time in the train, they had repeatedly kissed intimately and some weeks later she developed infectious mononucleosis. A large EBV viral load may be acquired during sexual intercourse and presumably it can also be transmitted from carriers who cough.
Prevention Tips While Kissing
Since there is a worldwide breakout of coronavirus, it is a good idea to avoid kissing anyone other than your long-time partner. There are a number of things you can do to reduce the risk of passing on, or catching, an infection while kissing. You should try toavoid kissing when you or the other person is sick.
Avoid kissing anyone on the lips when you, or the other person, have an active cold sore, warts or ulcers around the lips or in the mouth.
Maintain good oral hygiene and visit your dentist regularly.
See your doctor about immunizations. Vaccines are available to prevent some infectious diseases, such as chickenpox and hepatitis B.
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