Medical Hypotheses 74 (2010) 222–224

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Kissing as an evolutionary adaptation to protect against Human Cytomegalovirus-like teratogenesis
C.A. Hendrie a,*, G. Brewer b
a b

Institute of Psychological Sciences, University of Leeds, Leeds, LS2 9JT, United Kingdom School of Psychology, University of Central Lancashire, Lancashire, PR1 2HE, United Kingdom

a r t i c l e

i n f o

s u m m a r y
Mouth to mouth sexual kissing is seen in more than 90% of human cultures. Various theories have been put forward to account for this but none offer a full explanation within an evolutionary framework. As mouth to mouth sexual kissing exposes each participant to the diseases of the other, it must confer significant benefit. Human Cytomegalovirus (HCMV) is a ubiquitous infection that carries a severe teratogenic risk if primary infection is acquired during certain critical periods. As HCMV is present in salivary gland epithelial cells and sheds from periodontitis induced lesions, female inoculation with a specific male’s HCMV is most efficiently achieved through mouth to mouth contact and saliva exchange, particularly where the flow of saliva is from the male to the typically shorter female. The current hypothesis proposes that mouth to mouth sexual kissing enables females to control when they become infected with a particular male’s HCMV and so protect their offspring from the threat of teratogenesis from primary infection during vulnerable times in their development. Females only gain this benefit if they also avoid becoming infected by other males. Hence HCMV induced teratogenesis is a strong viral pressure towards the development of monogamy as well as kissing as a behavioural strategy to protect against it. Ó 2009 Elsevier Ltd. All rights reserved.

Article history: Received 14 September 2009 Accepted 17 September 2009

Introduction Kissing is seen in more than 90% of the human cultures studied [8] and involves a variety of different behavioural postures which include an individual’s lips coming into contact with another person’s face or body. Whilst engaging in this behaviour the mouth postures range from closed mouth to wide open mouthed behaviours where the tongues of both individuals come into close contact with consequent exchange of saliva and other material contained in the mouth. Mouth to mouth or lip to lip contact is seen in a wide variety of animals and this serves a range of functions. For example, many fish species use this in bouts of aggressive behaviour to assess the physical abilities of potential opponents [16] and numerous bird species use mandible tapping to beg food from their parents and as part of their courtship rituals (e.g. [25]). Within primates, lip to lip contact is commonly seen in species such as Bonobos (Pan baniscus), but as this usually only involves lip touching, it is clearly different in form from human sexual kissing [7]. Sexual kissing of the type involving full tongue contact and saliva exchange would therefore appear to be unique to our species.

Earlier theories Several theories relating to the function of kissing have been proposed, with one of the earliest, having echoes of the mandible touching patterns seen in birds. That is, the maternal premastication of food hypothesis [17]. This purports that sexual kissing developed from mouth to mouth contact between mother and child during the oral exchange of food in infancy. Whilst this theory has found some acceptance there is little empirical evidence to support this. Only very few cultures exhibit this behaviour and there is no historical record to demonstrate that it was once a widespread activity. Indeed, in the few isolated cultures where this kind of food exchange has been documented, such as those on Papua New Guinea and the San of South-West Africa, the reports are that sexual kissing did not occur until after the arrival of Europeans [3]. Sexual kissing has also been held to promote pair bonding [19]. In humans the maintenance of pair bonds are required because of the demands of altricial offspring that are born several months prematurely compared to those of our close primate relations. Mechanisms for the maintenance of pair bonds that promote this long term investment are therefore essential. Neuropeptides such as Oxytocin have been implicated [4], however, Oxytocin release occurs in response to a variety of stimuli including those associated with the close proximity required to make mouth to mouth contact (e.g. touch, holding, hugging) [15]. Kissing per se is therefore not

* Corresponding author. Tel.: +44 113 343 5736; fax: +44 113 343 5749. E-mail address: (C.A. Hendrie). 0306-9877/$ - see front matter Ó 2009 Elsevier Ltd. All rights reserved. doi:10.1016/j.mehy.2009.09.033

in spite of many pregnancies being terminated if infection is detected [9]. the exchange of saliva containing the male’s HCMV. Kissing is not however a prerequisite for this to occur. when any adverse consequences of having these infections are usually seen and an asymptomatic lytic phase where the virus has been contained but not eradicated by the host’s immune system. infection with viruses from the Herpes family (Herpesviridae) is extremely widespread within the human species. Such risks render the premastication of food hypothesis unlikely since this would increase the risk of mothers becoming infected with a different strain at exactly the time in which they are losing the contraceptive effects of breast feeding. a female’s only viable strategy is to control when she becomes infected with her partner’s HCMV. by inference. cerebral palsy. The common characteristic of these viruses is that they have an active phase. depending upon the exact virus species and sub-type. Each virus also has a variety of forms that differ in the severity of symptoms they produce which.24]. increasing up to 50% if the mother is pregnant when primary infection occurs [2]. Nonetheless. this cannot be the explanation for its development. the expected frequency of open mouthed kissing increased significantly. The final main theory is that kissing is used as a mechanism to assess the quality of a potential mate [11]. There are not only sex differences in the expectation of sexual activity following kissing [12] but prostitutes rarely kiss their customers [5]. microcephaly. Hence.26]. children present a major threat of new HCMV infection because of their frequent contact with other children [1. Human courtship patterns typically involve a period where interest is indicated prior to engaging in full sexual activity. by the time of the first sexual encounter there had been significant amounts of saliva exchange following the initial limited exposure. This not only allows females to assess the male’s disease state. show high levels of hepatomegaly. to ensure that primary infection with that particular strain does not occur during pregnancy. Behavioural strategies Under the circumstances of inevitable infection. Human Cytomegalovirus The hypothesis presented in the current manuscript proposes that although kissing does indeed expose an individual to the risk of oral infection. mental retardation. periodontitis. G. As saliva exchange. oral candidiasis etc. range from mild discomfort. Between 0. This hypothesis holds that saliva exchange enables a potential partner’s health and reproductive status to be determined. Behavioural consequences It remains to be determined whether kissing does indeed transfer HCMV and so give females the postulated protection against the teratogenic effects of primary infection during pregnancy. which can inflict a mortality rate as high as 30%. its main function is to confer protection from diseases with far more serious consequences. One of the most harmful of the Herpes viruses is Human Cytomegalovirus (HCMV) which has severe teratogenic properties when in its active phase. Within families. Avoiding infection therefore presents females with a particular problem when engaging in the sexual activity necessary to become pregnant. The risks to foetuses are therefore very severe. although there was an expectation of significant face to face contact and kisses directed to the cheek or closed mouth. disease state. as the disease only signals its presence during the active phase. Infected neonates not killed by the virus. even between healthy individuals. . with the greatest harm being inflicted by primary infection during the first trimester [21]. splenomegaly. mononucleosis-like syndrome. female inoculation with a specific male’s HCMV is most efficiently achieved through mouth to mouth contact and saliva exchange.. gingivitis. Preliminary findings The predictions concerning patterns of kissing have been examined in pilot studies where young males and females (n = 100) were asked to report on the development of kissing within ‘typical’ relationships. motor disability. parasite loading and of course personal physical and oral hygiene can all be gained solely from close physical proximity. These data showed that in the early stages of these hypothetical dating scenarios (where sexual activity was not expected to occur) most people envisaged very little open mouthed kissing of the sort that would allow full exchange of saliva.5% and 2. reproductive condition. It is here that kissing confers its advantage. However. As this can be a danger to their as yet to be conceived/ born siblings children are afforded special treatment by adults with regard to hygiene and their exclusion from kissing of the sort that involves saliva exchange. As HCMV is present in salivary gland epithelial cells and sheds from periodontitis induced lesions [14].18. Brewer / Medical Hypotheses 74 (2010) 222–224 223 required to stimulate Oxytocin release and if this is indeed the mechanism by which pair bonds are maintained.C. This may explain why premastication has only been reported in isolated communities prior to contact with HCMV infected Europeans. Within this context. Small amounts of the virus delivered in the very early stages of a relationship allows the female to become infected whilst reducing the risk of developing the full range of symptoms associated with the mononucleosislike syndrome that could otherwise result. it clearly carries a significant risk. It is therefore proposed that kissing has evolved in humans as a consequence of a female need to protect against primary HCMV infection whilst pregnant and to maintain this protection throughout the duration of the relationship. involves exposure to organisms that can cause dental caries. HCMV is readily transmitted through saliva. As the hypothetical relationship progressed towards the point where sexual activity was likely. through to death. Hence the small amount of additional information gained from kissing is an unlikely pressure for its development. particularly where the flow of saliva is from the male to the typically shorter female [10]. Timing is also of importance as full protection from the teratogenic effects of HCMV is not gained until at least six months after the primary infection [23].5% of foetuses become infected if there is a maternal history of infection prior to pregnancy [6. and seizures [9. smell. females cannot be certain of their partner’s HCMV status or the risk they pose to any developing foetus. as did. Further.20]. given the extreme likelihood that such an exchange does occur there are several reasons to suggest that the entire human courtship pattern is at least in part influenced by the need to control the timing of HCMV infection. in addition to that produced by the Human Papilloma virus [13]. Hendrie.A. In the US 8000 infants are damaged by HCMV each year. It has been further suggested that sexual kissing stimulates sexual activity. urine and semen [22]. information concerning body tone. it allows them to control when they become inoculated with their partner’s HCMV and the dose they are initially exposed to. Females only gain benefit from acquired infection from a particular male if they also avoid becoming infected by other males which provides another viral pressure towards the development of monogamy.

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