Mono (Infectious Mononucleosis) has always been dubbed as the "kissing disease" but maybe there is a new ouster.

Reports of severe allergic reactions occurring after a kiss have been published multiple times over the last several years but a recent warning raises further concern. Apparently waiting for hours, or thoroughly brushing your teeth may not be enough to protect some highly sensitive people with food allergy (especially those allergic to peanut or shellfish).

Dr. Sami Bahna, president of the American College of Allergy, Asthma and Immunology (ACAAI), explains that the saliva may excrete allergens from foods or drugs hours after being consumed.

The symptoms of an allergic reaction after kissing may include: itching and/or swelling of the lips, tongue or throat, itching of the skin, rash, hives and wheezing. Sudden throat closure, skin rash and or lightheadedness may signal anaphylaxis (a potentially fatal allergic reaction).

I don't think the majority of food allergic people have to worry about this but being aware of the possibility is important. I see several patients throughout the year, with unexplained hives, itching and occasionally, anaphylaxis, who are looking for what may be triggering their episodes. The last thought one might have is that their spouse or significant other is triggering their problem.

Our saliva may carry enough allergen of the food we consume such that contact with a sensitive individual could lead to an allergic reaction. Trace amounts of allergic material is all that is needed in some situations.

Does this mean no more "Goodnight Kiss"?

Well, not exactly. Recommendations are for the partner without allergy to brush their teeth, thoroughly rinse their mouth and avoid eating any food or drug the other person is allergic to for 16-24 hours. Then they can "probably" safely enjoy a kiss, but no guarantee.

I would add, making sure your plan of action is in place and epinephrine containing device is available (for peanut, nut or shellfish allergy, or history of anaphylaxis).

Did you know there were other ways your partner may cause you to have an allergic reaction? Dr. Bahna refers to some of them in the report. Some people are hypersensitive to colognes and lotions their partner may be wearing. Reports of allergy to seminal fluid proteins or sperm and latex condoms have also been published.

Final Comment

Seek consultation from a board certified allergist if you have unexplained allergic reactions or suspect you are reacting to a food, drug or your partner. The allergist will attempt to identify the source of the problem and formulate a plan of action.

I have yet to advise a patient who is allergic to something about their partner, to find another partner (although the thought has crossed my mind a few times).There is almost always something that can be avoided, or a way to suppress the reaction.