How the new Coronavirus Compares with the Influenza Virus

The new coronavirus outbreak has made headlines in recent weeks, but there’s another viral epidemic hitting countries around the world: flu season. But how do these viruses compare, and which one is really more worrisome?

So far, the new coronavirus has led to more than 218,000 illnesses and more than 8,000 deaths worldwide as of March 19, 2020. But that’s nothing compared with the flu also called influenza. In the U.S. alone, the flu has caused an estimated 34 million illnesses, 350,000 hospitalizations and 20,000 deaths this season, according to the CDC. That said, scientists have studied seasonal flu for decades. So, despite the danger of it, we know a lot about flu viruses and what to expect each season. In contrast, very little is known about the new coronavirus and the disease it causes, dubbed COVID-19, because it’s so new and is still being studied. This means COVID-19 is something of a wild card in terms of how far it will spread and how many deaths it will cause. 

“Despite the morbidity and mortality with influenza, there’s a certainty … of seasonal flu,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said in a White House press conference on Jan. 31. “I can tell you all, guaranteed, that as we get into March and April, the flu cases are going to go down. You could predict pretty accurately what the range of the mortality is and the hospitalizations [will be],” Fauci said. “The issue now with [COVID-19] is that there’s a lot of unknowns.” 

Scientists are racing to find out more about COVID-19, and our understanding of the virus that causes it and the threat it poses may change as new information becomes available. Based on what we know so far, here’s how it compares with the flu.

Image retrieved from the centers for Disease Control and Prevention https://www.cdc.gov/flu/resource-center/freeresources/graphics/images.htm

Symptoms and Severity

Both seasonal flu viruses (which include influenza A and influenza B viruses) and COVID-19 are contagious viruses that cause respiratory illness. 

Typical flu symptoms include fever, cough, sore throat, muscle aches, headaches, runny or stuffy nose, fatigue and, sometimes, vomiting and diarrhea, according to the CDC. Flu symptoms often come on suddenly. Most people who get the flu will recover in less than two weeks. But in some people, the flu causes complications, including pneumonia. So far this flu season, about 1% of people in the United States have developed symptoms severe enough to be hospitalized, which is similar to the rate last season, according to data from the CDC.

With COVID-19, doctors are still trying to understand the full picture of disease symptoms and severity. Reported symptoms in patients have varied from mild to severe, and can include fever, cough and shortness of breath, according to the CDC. 

 

In general, studies of hospitalized patients have found that about 83% to 98% of patients develop a fever, 76% to 82% develop a dry cough and 11% to 44% develop fatigue or muscle aches, according to a review study on COVID-19 published Feb. 28 in the journal JAMA. Other symptoms, including headache, sore throat, abdominal pain, and diarrhea, have been reported, but are less common. 

Another recent study, considered the largest on COVID-19 cases to date, researchers from the Chinese Center for Disease Control and Protection, analyzed 44,672 confirmed cases in China between Dec. 31, 2019 and Feb. 11, 2020. Of those cases, 80.9% (or 36,160 cases) were considered mild, 13.8% (6,168 cases) severe and 4.7% (2,087) critical. “Critical cases were those that exhibited respiratory failure, septic shock, and/or multiple organ dysfunction/failure,” the researchers wrote in the paper published in China CDC Weekly.

It’s important to note that, because respiratory viruses cause similar symptoms, it can be difficult to distinguish different respiratory viruses based on symptoms alone, according to WHO.

Death rate

The death rate from seasonal flu is typically around 0.1% in the U.S., according to according to the CDC, The death rate for COVID-19 appears to be more than ten times higher than that of the flu. 

In the study published Feb. 18 in the China CDC Weekly, researchers found a death rate from COVID-19 to be around 2.3% in mainland China. Another study of about 1,100 hospitalized patients in China, published Feb. 28 in the New England Journal of Medicine, found that the overall death rate was slightly lower, around 1.4%.

Still, the death rate for COVID-19 appears to vary by location and an individual’s age, among other factors. For instance, in Hubei Province, the epicenter of the outbreak, the death rate reached 2.9%; in other provinces of China, that rate was just 0.4%, according to the China CDC Weekly study. In addition, older adults have been hit the hardest. The death rate soars to 14.8% in those 80 and older; among those ages 70 to 79, the COVID-19 death rate in China seems to be about 8%; it’s 3.6% for those ages 60 to 69; 1.3% for 50 to 59; 0.4% for the age group 40 to 49; and just 0.2% for people ages 10 to 39. No deaths in children under 9 have been reported. 

Though the death rate for COVID-19 is unclear, most researches suggest it is higher than that of the seasonal flu.

Virus Transmission

The measure scientists use to determine how easily a virus spreads is known as the “basic reproduction number,” or R0 (pronounced R-nought). This is an estimate of the average number of people who catch the virus from a single infected person. The flu has an R0 value of about 1.3, according to the CDC

Researchers are still working to determine the R0 for COVID-19.  Preliminary studies have estimated an R0 value for the new coronavirus to be between 2 and 3, according to the JAMA review study published Feb. 28. This means each infected person has spread the virus to an average of 2 to 3 people.

It’s important to note that R0 is not necessarily a constant number. Estimates can vary by location, depending on such factors as how often people come into contact with each other and the efforts taken to reduce viral spread.

Risk of Infection

The CDC estimates that, on average, about 8% of the U.S. population gets sick with the flu each season. As of March 6 2020, there were 260 cases of COVID-19 in the U.S., including those detected through public health surveillance and 48 among Americans who were “repatriated” to the U.S. As of March 19 2020, more than 9,000 cases have been reported, including 150 deaths. Still, newly emerged viruses like this one are always of public health concern, according to the CDC. It’s unclear how the situation with this virus in the U.S. will unfold. Some people, such as health care workers, are at increased risk for exposure to COVID-19. 

Pandemics

It’s important to note that seasonal flu, which causes outbreaks every year, should not be confused with pandemic flu, or a global outbreak of a new flu virus that is very different from the strains that typically circulate. This happened in 2009 with the swine flu pandemic, which is estimated to have killed between 151,000 and 575,000 people worldwide, according to the CDC. There is no flu pandemic happening currently.

Prevention

Unlike seasonal flu, for which there is a vaccine to protect against infection, there is no vaccine for COVID-19. But researchers at the U.S. National Institutes of Health are in the early stages of developing one. Officials plan to launch a phase 1 clinical trial of a potential vaccine for COVID-19 within the next few months.

In general, the CDC recommends the following to prevent the spread of respiratory viruses, which include both coronaviruses and flu viruses: Wash your hands often with soap and water for at least 20 seconds; avoid touching your eyes, nose and mouth with unwashed hands; avoid close contact with people who are sick; stay home when you are sick; and clean and disinfect frequently touched objects and surfaces.

HIV/AIDS: EFFECTS ON HEALTH AND LIFESTYLE

What is HIV/AIDS?

HIV is an abbreviation that means Human Immunodeficiency Virus, while AIDS is an acronym that means Acquired Immunodeficiency Syndrome. HIV specifically refers to the virus which infects the body and damages the immune cells, thus making the person’s immune system become weaker (immunocompromised). AIDS is a severe disease complication that can arise in people infected with HIV, thus, one can refer to AIDS as the most advanced stage of the HIV infection. Note that not all people infected with HIV will develop AIDS.

Source: Independent News Nigeria. https://bit.ly/37Ht5KU

How does HIV cause harm to the body?

Once the virus gets into the body, it starts to infect the immune cells, and it specifically targets certain cells known as CD4+ cells (T-Lymphocytes). These cells are a very vital part of the immune system, as they serve to alert all other immune cells in the body about an infection. Once these CD4+ cells are damaged by the virus, other immune cells will not be alerted and thus, the virus can go on causing harm in the body while remaining undetected for long periods of time. As this progresses for long, most immune cells in the body will get destroyed by the virus, causing the immune system to be weakened. A very weak immune system cannot fight off other subsequent infections, thus, even the simplest pathogens that gain entry into the body can cause severe illnesses. This highly weakened state of the immune system, coupled with the increased rate of infections, is what eventually gives rise to AIDS, and is the major cause of death in HIV/AIDS patients.

How is HIV transmitted?

The virus can be transmitted through certain body fluids like blood, seminal, vaginal and rectal fluids, as well as breast milk. The transmission can occur through any of the following processes:

– Through sexual intercourse like vaginal, anal or oral sex (rarely). This is the most common route of transmission.

– By sharing sharp objects that come in contact with blood, such as needles and syringes, as well as certain haircut equipment and tattoo instruments that are not properly sterilized between uses.

– Through open exposure to the body fluids of an infected person, which is not very common (more likely among healthcare professionals).

– From mother to child (perinatally) during pregnancy and delivery, as well as during breastfeeding.

– Through blood transfusions and organ transplants, which only happens when proper testing and screening is not done before the transfusion or transplant process.

Note that HIV cannot be spread through plain physical contact like handshakes, hugs, skin touch and so on. Also, it cannot be spread through air or water, or by contact with surfaces that an infected person has touched. 

What are the signs and symptoms of HIV?

The symptoms of HIV vary widely among individuals. During the first few weeks after a person gets infected, the virus reproduces very rapidly in the body, and over the next month, the infected person may experience some slight ‘flu-like’ symptoms, which may be overlooked and not suspected as symptoms of an HIV infection. Some of these symptoms include fever and chills, headache, nausea, sore throat, general malaise, stomach aches and sometimes, a skin rash that comes and goes. This is called the ‘acute infection stage’, which eventually resolves after a few weeks or months. However, during this period, the viral load in the person’s bloodstream and body fluids is very high and they can easily transmit the infection to others through any of the earlier mentioned routes of transmission.

After the first few months, the infection enters a second stage called the ‘clinical latency phase’, which can last for a number of years. During this stage, infected persons might not experience any symptoms or they may experience symptoms that are not specific to any disease. Some of these symptoms include joint aches, recurrent fevers, swollen lymph nodes, mouth ulcers, nausea and vomiting, worsened rashes, diarrhea and weight loss, pneumonia, shingles and recurrent oral or vaginal yeast infections. These symptoms may gradually or rapidly progress over time and if left untreated for long, may eventually give rise to AIDS. When the infection develops into AIDS, the immune system becomes completely weakened and the individual begins to experience a wide array of symptoms due to infections from various pathogens. At this point, it becomes difficult to manage the disease, the person will be constantly ill and eventually, death can occur.

Source: CDC Website. https://bit.ly/37l6OMR.

How can HIV be diagnosed?

There are a number of tests that can be carried out to diagnose HIV, thus, advice from a healthcare provider is needed to determine which test is most suitable for a person. Antibody and Antigen tests check for signs of HIV antibodies and antigens in the bloodstream. These tests usually require blood samples or mouth swabs, which can be taken in the hospital or even done at home. These types of tests are the most commonly used and can produce results within 20 minutes to a few hours. The Nucleic Acid Test (NAT) is another method which is quite expensive but has a very high accuracy. This test screens for the virus itself and is mostly used for people with early symptoms of HIV. It takes about 5 to 21 days for the virus to be detected in the blood, thus, results are most accurate after this period of time.

How can HIV be treated?

So far, there is no cure for HIV and the disease remains throughout one’s lifetime. However, certain combination medications called ‘antiretroviral therapy’ are currently available, which can be used to manage HIV and allow the infected person to live a healthy lifestyle for many years. The drugs suppress the viral load, prevent the infection from progressing to AIDS, and reduce the chances of transmitting the infection to others. On the flip side, the medications have to be taken daily throughout a person’s life, because once the person stops taking them, the viral load will increase and the virus can start attacking immune cells again. If a person suspects that they have been recently infected with HIV, they can take certain drugs called ‘Post-exposure prophylaxis’(PEP), which can help clear out the virus and prevent it from reproducing rapidly, however, these drugs must be taken a maximum of 72 hours (3 days) after exposure to ensure effectiveness.

HIV positive individuals that regularly stick to their medications can greatly suppress the viral load to the point that they can have a healthy sex life without the risk of transmitting the virus to their partner. However, the partners of HIV positive persons can ensure extra safety by taking certain drugs called ‘Pre-exposure prophylaxis’ (PrEP), which prevent them from getting infected after sexual intercourse or other possible routes of transmission.

How does HIV affect a person’s lifestyle?

One of the major problems of living with HIV is the stigma attached to the disease, which can cause a lot of anxiety, depression and loss of self-esteem among infected persons. Despite the advances in treatment and awareness creation, a lot of people still discriminate against those infected with HIV, usually due to circulating myths and a lack of education about the disease. Another challenge of living with HIV is the need to constantly stick to a number of medications for years in order to suppress the viral load and live a healthy lifestyle. The constant intake of medications can produce some side effects such as headache, dizziness and nausea. Also, HIV positive individuals need to ensure extra hygienic practices and food safety in order to avoid exposure to a number of infectious pathogens that can cause opportunistic infections.

How can HIV be prevented?

No vaccine currently exists against HIV, though efforts are being made to develop one. One can help reduce the chances of infection via sexual intercourse by making use of condoms and other suitable barrier methods, or better still, avoid having multiple sexual partners. Also, precautions can be taken to avoid HIV infection through other routes by avoiding the multiple use and sharing of needles, syringes and other sharps, as well as ensuring adequate sterilization between uses. It is important to get tested for HIV in order for one to know their status. The use of pre- and post-exposure prophylaxis can also be employed by those that wish to prevent HIV infection before and after exposure to a transmission risk, such as having sex with a HIV positive individual.

References

WHAT YOU NEED TO KNOW ABOUT HEPATITIS

What is Hepatitis and what causes it?

Hepatitis basically refers to the inflammation of the Liver. A number of things can cause the Liver to be inflamed, like excessive alcohol intake, hard drugs and toxic chemicals, however, the most common cause of hepatitis is the ‘Hepatitis Viruses’. There are five types of hepatitis viruses, which are Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D and Hepatitis E viruses. All of them are RNA viruses except the Hepatitis B Virus, which is a DNA virus.

Characteristics of each Hepatitis Virus

Hepatitis A Virus (HAV) mainly causes an acute infection, which means that the onset of the disease is sudden. It is transmitted through the faecal-oral route, meaning that a healthy person can get infected by eating food or drinking water that has been contaminated by the faeces of an infected person. Hepatitis A is usually treated by managing the symptoms, eating enough food nutrients and getting proper bed rest. The illness eventually resolves on its own and rarely requires serious medication.

Hepatitis B Virus (HBV) causes both acute and chronic infection, meaning that it first starts out as a sudden infection, but when the body’s immune system is not able to effectively clear out the virus, it becomes prolonged and causes gradual but consistent harm to the body. It is transmitted through sexual intercourse, blood to blood contact (using infected needles) and perinatally (from mother to child). Treatment depends on the type of infection. When it is acute, the symptoms are managed and no specific treatment is required. If it becomes chronic, it can be treated with antiviral medications, but these are costly and may need to be taken over the course of several months or even years.

Hepatitis C Virus (HCV) also causes both acute and chronic infection, and it is transmitted through blood contact and perinatally (mother to child). It may also be transmitted through sex, but this is very rare. Antiviral medications are used to treat both the acute and chronic forms of infection. If the infection progresses to become chronic, it can cause liver cirrhosis, which is a very serious condition where the infected person’s liver becomes hardened and unable to function effectively. To treat this, the patient may require a liver transplant. It can also cause liver cancer.

Hepatitis D Virus (HDV) mainly causes a chronic infection. This particular virus needs the Hepatitis B Virus (HBV) in order to infect host cells. It does this in two ways:
– By co-infection, where it infects the body’s cells at exactly the same time as the Hepatitis B Virus.
– By superinfection, where it infects the body’s cells after the Hepatitis B Virus has already infected the cells and weakened them.

So basically, you can think of HDV as a sneaky virus that is powerless on its own and has to work with the Hepatitis B Virus in order to cause harm to the body. Like the HBV and HCV, it is also transmitted through sex, blood contact and perinatal route. Currently, no antiviral medications have been fully endorsed for the treatment of Hepatitis D, but if Hepatitis B is effectively treated or the infected person is vaccinated, then Hepatitis D will also resolve.

Hepatitis E Virus (HEV) causes an acute infection and it is transmitted through the faecal-oral route. It does not require any specific treatment, as the disease is acute and will eventually resolve with proper nutrition and adequate rest. So, it is very much similar to the Hepatitis A Virus (HAV).

So in summary, Hepatitis B, Hepatitis C and Hepatitis D are transmitted from mother to child (perinatally) and through blood contact. Hepatitis B and Hepatitis D are transmitted through sex. Hepatitis A and Hepatitis E are transmitted faecal-orally.

Note that if a person has Hepatitis D, it means the person also has Hepatitis B. Hepatitis D is just an ‘addition’ to Hepatitis B to cause more problems. Also note that Hepatitis B and Hepatitis C can be life-threatening and are capable of causing liver cirrhosis and cancer. 

Signs and Symptoms of Hepatitis

The regular symptoms of hepatitis include fever, headache, fatigue, nausea and vomiting, diarrhoea, and pain in the upper right side of the abdomen. Excessive vomiting and diarrhoea results in dehydration and weight loss. As the disease progresses and causes more damage, other signs like jaundice, hepatomegaly, production of dark-coloured urine and pale-coloured stools may also be observed.

Diagnosis of Hepatitis

This is done through lab tests such as Liver function tests (LFT), which determine the level of damage to the liver, and also, blood films from the patient can be examined for lymphocytosis, which is a condition where numerous abnormal white blood cells can be seen under the microscope during an active viral infection. These methods (LFT and Blood film examination) are simply indicators of liver damage and viral infection, but the actual confirmation of hepatitis is by Serological testing, which involves screening the suspected person’s blood sample for the presence of antibodies produced against the Hepatitis virus. If the person is confirmed to be Hepatitis positive, immediate treatment must begin to prevent further progression of the disease. 

Prevention of Hepatitis

Some preventive measures against the disease include ensuring that food and water sources are clean, sterilizing surgical equipment and instruments for drawing blood, avoiding contact with spilled blood, not sharing toothbrushes, and avoiding unprotected sex. However, the most effective method of prevention is by vaccination, which boosts immunity against the virus by about 97%. Note that all types of hepatitis have vaccines except Hepatitis C, which currently has no vaccine.

It is important that you get vaccinated against hepatitis, and it is even more important for healthcare professionals, because they are at the greatest risk of infection by direct contact with an infected patient’s body fluids.

References

World Health Organization (2019). Hepatitis. https://www.who.int/news-room/q-a-detail/hepatitis.
Centers for Disease Control and Prevention (2019). What is Viral Hepatitis? https://www.cdc.gov/hepatitis/abc/index.htm.

THE DISEASE CALLED DIPHTHERIA

What is Diphtheria?

Diphtheria is a rare, highly communicable disease known to man from as far back as the 5th Century BC, when it was first discovered and described by the Classical Greek Physician, Hippocrates. The disease is caused by a bacterial infection that causes inflammation of the mucous membranes of the upper respiratory tract. Diphtheria outbreaks commonly occur during spring and winter months, and is known to spread quickly, causing a history of epidemics in a number of regions worldwide, especially among children under the age of 15. Due to the presence of effective vaccines and medications, diphtheria is no longer considered a major public health threat, but case fatality ratios of up to 10% have been reported, especially in regions where the vaccine is unavailable and medications for treatment are scarce. 

What causes Diphtheria?

The disease arises from an infection caused by the bacteria Corynebacterium diphtheriae, which infects the mucous membranes of the upper respiratory tract, and can also cause a cutaneous infection of the skin. A similar bacterial specie called Corynebacterium ulcerans is also capable of causing diphtheria, but this is rare. The bacteria are known to produce a powerful toxin that causes localized inflammation and tissue destruction at the site of release (respiratory tract and skin), which can spread to other organs of the body through the lymphatic and circulatory systems. The infection can be transmitted to other persons through inhalation or contact with surfaces bearing respiratory droplets from the cough or sneeze of an infected person, through contact with respiratory secretions such as saliva and mucus, and also through direct contact with the skin lesions or sores of an individual with cutaneous infection. The toxin produced by the bacteria is actually as a result of a certain type of virus (bacteriophage) that they are usually infected with. The production of this toxin is responsible for the development of severe complications associated with the disease.

Source: VeryWell Health. https://bit.ly/3lWuc0L

What are the Signs and Symptoms of Diphtheria?

The signs and symptoms of diphtheria depend on the particular bacterial strain involved and the site of infection. The cutaneous infection which causes skin lesions or ulcers is more prevalent in the tropics and is not as severe as the respiratory infection. The respiratory infection is considered more serious as it is known to cause a severe illness and even death when left untreated. Upon infection, there is an average incubation period of about 5 days before symptoms begin to manifest. The early symptoms appear similar to the flu, but as the disease progresses, the symptoms become more uniquely pronounced. It starts out with a low fever, headaches, chills, malaise, nausea and vomiting, fast heart rate and nasal discharge. 12-24 hours after the onset of initial symptoms, a sheet of thick grey matter (pseudo-membrane) develops at the back of the throat around the tonsil area, causing a sore throat, difficulty swallowing and difficulty breathing.

If the pseudo-membrane extends down to the larynx and trachea, voice hoarseness and a deep barking cough may ensure, and the infected individual stands the risk of having their airways completely obstructed if adequate medical attention is not promptly administered. Continuous disease progression could lead to life-threatening complications if the toxin enters the bloodstream and spreads to other vital organs of the body. Such complications include swelling of the lymph nodes and soft tissues of the neck, inflammation of the heart muscle (Myocarditis), irregular heartbeat, cardiac failure, nerve damage, pneumonia and respiratory failure. The mucous membranes of other organs may become inflamed as well, such as the conjunctiva of the eye, the external ear and the female genital canal. In cutaneous infections, the complications are less severe, however, some disfiguring skin conditions may develop such as eczema, impetigo and psoriasis.

How can Diphtheria be diagnosed?

The diagnosis of diphtheria primarily takes into consideration the medical history and symptoms of the patient. Presence of the characteristic pseudo-membrane in the throat is a definite sign of diphtheria, which can be confirmed with clinical laboratory diagnosis involving sample collection from the nose and throat, culturing in the lab to identify the causative agent, and testing for toxicity. All patients suspected of diphtheria must be tested, along with any individuals they have had close contact with.

How can Diphtheria be treated?

Treatment is most effective when given early, hence, a quick diagnosis is important. There are two components administered in the treatment process, which are the Antitoxin and Antibiotics. The antitoxin acts to neutralize the diphtheria toxin released by the bacteria, and its administration at the initial stage of infection is vital, because once the toxin has bound to various tissues, localized tissue damage occurs and the antitoxin’s effect will be minimal. The antibiotics includes drugs such as Penicillin or Erythromycin, which serve to eradicate the bacteria and limit its spread. Patients with respiratory diphtheria complications require hospitalization for effective treatment and monitoring of recovery.

Source: iStock. https://bit.ly/3fRTAkn

How best can Diphtheria be prevented?

Infected persons should be isolated for treatment and monitoring to minimize the risk of spreading the infection to other people. Healthy, unvaccinated persons are required to avoid contact or close proximity with diphtheria patients, as the disease is highly contagious. Vaccination remains the most effective mode of prevention, as the vaccines are affordable and available in almost all countries worldwide. The vaccine (diphtheria toxoid) is usually incorporated into a vaccine mixture containing the Tetanus toxoid and Pertussis Vaccine, to yield a trivalent combination vaccine called ‘DTaP’ for the prevention of Diphtheria, Tetanus and Pertussis (whooping cough) in young children.

The infant version of the vaccine is administered in 5 doses with at specific age intervals from 2 months, 4 months, 6 months, 15-18 months and 4-6 years. The adult form of the vaccine (Tetanus-diphtheria (Td) toxoid vaccine) is administered every 10 years to maintain immunity. Widespread vaccination campaigns are necessary to suppress the prevalence of the disease in endemic regions, and ensure that herd immunity is achieved.

Reference

DENGUE FEVER: THE VECTOR-BORNE DISEASE

What is Dengue Fever?

Dengue Fever is a severe, painful disease with acute flu-like symptoms caused by a virus that is transmitted through the bite of a particular mosquito species. The disease is also called “breakbone fever” due to the intense pains it causes in the joints and muscles. The disease has a widespread prevalence in over 100 countries worldwide, though it mainly occurs in the tropics and sub-tropics (especially in Asia and Latin America), mostly in urban and semi-urban areas, where the conditions of rainfall and humidity are favorable for mosquito breeding.

The disease prevalence has been on a dramatic rise in recent decades, with about half of the world’s population currently at risk of infection, leading to an estimated 100-400 million cases of infection and over 22,000 deaths each year worldwide. The disease is known to easily cause epidemic outbreaks in regions with a high prevalence of the mosquito vector. Despite not having a very high fatality rate, the severe form of the disease can cause life-threatening complications. 

What causes Dengue Fever?

The disease is caused by the Dengue Virus (DENV), which is transmitted by the bite of an infected female Aedes mosquito of the species Aedes albopictus and Aedes aegypti. These mosquito species are also notorious for spreading the Zika and Chikungunya Viruses. They breed in areas with stagnant water sources where they lay their eggs, and tend to bite during the daytime. Vertical transmission may also occur from an infected mother to her child, and accidental needle prick cases with infected blood can cause dengue transmission. The Dengue Virus has four serotypes, which are DENV-1, 2, 3 and 4, each with its peculiarities, thus, an individual can be infected up to four times in their lifetime by the different serotypes.

Once the virus gets into the bloodstream of an individual, it proceeds to invade and destroy a number of immune cells, as well as liver cells (hepatocytes) and other body cells. This gives rise to the mediation of inflammation, which manifests as the various symptoms associated with the disease. In most cases, dengue fever may be asymptomatic or present with mild febrile illness that gradually resolves on its own. However, after about 7-10 days, a more severe form known as Dengue haemorrhagic fever or Dengue shock syndrome may develop, usually due to reinfection of the individual with a second DENV serotype. Severe dengue is a leading cause of advanced illness and death in a number of tropical regions, usually occurring when adequate medical attention is not given at the stage of onset.

What are the Signs and Symptoms of Dengue Fever?

In most cases, dengue symptoms are in-apparent or mild and can easily be mistaken for the flu or other forms of infection. Younger children and individuals without prior exposure tend to experience milder symptoms compared to older children, adults and persons with initial cases of infection. The symptoms usually manifest about 4-6 days after infection and may last up to 10 days. They include sudden high fever, severe headaches, nausea and vomiting, fatigue, pain behind the eyes, severe joint and muscle pain, and sometimes a skin rash. People with a weakened immune system or a second dengue infection are at a great risk of developing more severe symptoms and complications characterized by damage to the lymphatic and blood vessels, bleeding from the nostrils or gums, enlargement of the Liver (hepatomegaly) and cardiovascular failure. Without adequate medical attention, the symptoms may culminate into massive bleeding, shock and death eventually. This is known as Severe Dengue, but is also termed Dengue Haemorrhagic Fever or Dengue Shock Syndrome (DSS).

Source: Mosquito Magnet. https://bit.ly/3CBgJB8

How can Dengue Fever be diagnosed?

The common dengue fever symptoms are usually very similar to those of the flu, thus, such symptoms cannot be used as criteria for diagnosis, except in cases of severe dengue. A number of laboratory tests can be used to confirm dengue fever, such as detection of the virus itself or the antigens and antibodies specific to it using techniques such as Antibody-specific tests, Enzyme-Linked Immunosorbent Assay (ELISA), Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR), etc. Other indicatory tests can be carried out, such as complete blood cell count (CBC), serum protein levels, and panel tests for liver, metabolic and coagulation factors. Chest radiographs, CT scans and Ultrasonography can be used to detect fluid in the chest and abdominal cavities, as well as intracranial bleeding or cerebral oedema.

How can Dengue Fever be treated?

There is no specific medical treatment for dengue fever, and infected persons are treated by management of symptoms. This includes oral rehydration therapy for dehydrated patients (due to high fever and vomiting), blood and plasma transfusion for patients with severe bleeding symptoms, painkillers and anti-inflammatory drugs such as Ibuprofen and Aspirin, and the use of Acetaminophen to resolve severe headaches. With adequate medical care, the mortality rate of infections can be decreased from 20% to less than 1%, even in cases of severe dengue.

How best can Dengue be prevented?

The best strategy for curbing the spread of dengue infections is by killing the mosquito vectors directly or destroying their breeding habitats. Drainage of stagnant water sources and water storage containers, as well as spraying of insecticides can be done to get rid of the mosquito breeding sites and directly kill the mosquitoes. Avoidance of mosquito bites can also be achieved by wearing protective clothing outdoors, use of insect repellants and mosquito coils, installment of insect screens on the windows and doors, and sleeping under insecticide-treated mosquito nets.

A Dengue Vaccine known as Dengvaxia (CYD-TDV) has been licensed for vaccination against the disease; however, the vaccine is only used for individuals living in endemic areas who have had previous dengue infection. This is due to the observation that the vaccine may increase the risk of developing severe dengue upon subsequent infection in persons have not experienced Dengue fever before. The vaccine has been deemed safe and efficacious for only persons that have had prior dengue exposure, and as a result, countries utilizing vaccination as part of their dengue control measures must ensure that pre-vaccination screening is carried out to identify those with evidence of a previous dengue infection. Further research is being conducted to produce more vaccines that will be effective in all individuals regardless of prior exposure.

References

WHAT YOU NEED TO KNOW ABOUT THE COVID-19 VACCINE

Introduction

The COVID-19 outbreak remains one of the biggest public health threats ever experienced by mankind since the history of infectious diseases. Currently, over 216 million cases and 4.5 million deaths have occurred worldwide, causing a great deal of panic, decrease in healthcare access, and economic distress. No widely approved treatment currently exists for COVID-19; however, a vital tool currently being used to fight off the disease is vaccination. Vaccines are substances containing the weakened version of an infectious pathogen, usually given to healthy individuals to elicit a protective immune response that prevents them from getting infected even in subsequent encounter with that same pathogen. 

What exactly is the COVID-19 Vaccine?

The term “COVID-19 Vaccine” actually refers to an array of approved vaccines produced by successful, top pharmaceutical companies that have shown high efficacy against COVID-19 and are fit to be used as an effective preventive measure. Since the onset of the pandemic, a lot of vaccine development firms and laboratories have been in the race to produce a suitable COVID-19 vaccine. Most of the vaccines undergoing production include vaccine types such as Inactivated virus vaccines, Protein subunit vaccines, Viral vector vaccines and DNA/RNA vaccines.

Initially, over 165 vaccine candidates were under research and development, but to date, only about 22 of them have received emergency use authorization (EUA) by national regulatory authorities. Out of these, only about 7 of them have been approved for full or emergency use by stringent regulatory authorities recognized by the World Health Organization (WHO). Such vaccines include Pfizer BioNTech, Oxford-AstraZeneca, Moderna, Sinopharm-BBIBP, Johnson and Johnson, and Sinovac (Covaxin). So far, the most widely used of these are the Pfizer BioNTech, Oxford-AstraZeneca and Moderna vaccines, which are currently authorized for use in the United States.

The Food and Drug Administration (FDA) of the United States recently granted full authorization for the Pfizer BioNTech on August 23, 2021. This means that the vaccine has shown to be satisfactorily effective and safe for administration to all population types. The FDA only gives full authorization when it has been able to gather enough data on the efficacy of the vaccine and has also reviewed and approved the whole vaccine manufacturing process and facilities used. Note that emergency use authorization is only granted for certain vaccines when there is an urgent need to protect people against the spread of a highly infectious disease, and preliminary data from clinical trials have shown the vaccine to be effective, with very low adverse effects. This is done early in the vaccine review process, but over time, full authorization is granted when the FDA has amassed much more scientific evidence supporting the safety and efficacy of the vaccine for consistent use.

Since December 2020 when the first COVID-19 vaccine was approved for emergency use, over 5.2 billion vaccine doses have been administered worldwide, meaning that about 33.2% of the world’s population has received at least one dose of the COVID-19 vaccine so far. On average, about 38 million vaccine doses are administered each day, mostly to individuals from 16 years of age and above. 

Source: NPS Medicinewise. https://bit.ly/3kKjecb

How does the COVID-19 Vaccine work?

Generally, vaccines work by training the immune system to recognize and clear out disease-causing microbial pathogens. Vaccines contain either the weakened or killed versions of a virus, or a small part of the virus such as its spike proteins or nucleic acid. Basically, the vaccine mimics the actual viral pathogen, and when the vaccine is administered into a person, the immune system senses the virus or its proteins as harmful foreign bodies and elicits an immune response by producing antibodies against them. Antibodies are proteins produced by specific cells of the immune system that work by binding to pathogens and neutralizing them through a cascade of complex mechanisms. The vaccine acts to ‘sensitize’ the immune system against that pathogen in such a way that whenever the actual pathogen infects a person, the immune system immediately recognizes it without delay and neutralizes it before it can cause any harm. To put this in a simple way, you can think of a vaccine as a false alarm that alerts your immune system about a particular microbe, then when that microbe eventually enters your body, your immune system (which is already alert) will destroy it right away.

The COVID-19 vaccine specifically consists of either spike proteins from the surface of the virus, or Messenger RNA (mRNA) that take effect by stimulating the cells of the immune system to mount a protective immune response specifically against those COVID-19 viral proteins. The antibodies that are produced remain in the bloodstream for years and will immediately act to neutralize the COVID-19 virus if the person gets infected. This way, anyone who receives the COVID-19 vaccine is automatically protected from getting sick with the disease, even if the person gets infected by the virus. 

Why is it important to take the COVID-19 Vaccine?

It is important to know that vaccines are a great way to stay protected from getting infected by infectious pathogens. The use of vaccines have helped to greatly reduce the number of cases and mortality rates of many diseases. Diseases like Cholera, Smallpox, Polio and Ebola have been eradicated completely or to very minimal numbers, thanks to worldwide vaccination campaigns against these diseases. The lesser the number of infectious diseases we have to treat, the lesser the strain on our healthcare system. When people get vaccinated against COVID-19, it protects them from getting the infection and falling sick, and also serves to protect other people around by achieving herd immunity. Herd immunity is a phenomenon where a large percentage of the people in a community are immunized against a particular disease, which reduces the likelihood of disease transmission and automatically protects the few individuals that are not immunized. For herd immunity to be attained, about 80% of the community population has to be vaccinated, which is the reason why community and nationwide vaccination is important.

How effective is the COVID-19 Vaccine and what are the possible side effects?

Before any vaccine is approved for use, it must undergo a number of clinical trials (usually three stages) to confirm its safety and efficacy. From clinical trials conducted by the vaccine producers Pfizer and Moderna, it was affirmed that the COVID-19 vaccine is 95% effective against the virus. Concerning the safety of the vaccine for different age groups, there are more concerns about vaccine administration among children. So far, the Pfizer vaccine is the only vaccine approved by the U.S. Food and Drug Administration (FDA) for use among children between the ages of 12-17, which must be administered with full consent from the parent or guardian of the child.

Despite the high level of effectiveness of the COVID-19 vaccine, there have been some side effects observed in a very small percentage of the population. The observed side effects are a sore arm (mainly at the site of vaccine administration), and sometimes slight flu-like symptoms like fever, chills, headaches and tiredness for a day or two. These side effects are rare, they are usually not severe, and are simply a sign that the body is building an immune response against the virus. The likelihood of severe adverse reactions (anaphylaxis) is very low, estimated at about one person in every 90,000 people vaccinated. Regular surveillance is being carried out to monitor any side effects or reactions post-vaccination, and strategies are being implemented by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) to follow up with such cases of vaccine reaction. 

Reference

ALZHEIMER’S DISEASE: A BURDEN AMONG THE ELDERLY

What is Alzheimer’s Disease?

Alzheimer’s disease is a mental degenerative disorder common among elderly individuals and is characterized by gradual loss of memory, cognitive skills, speech and even loss of basic ability to carry out routine tasks. It is also referred to as Senile Dementia due to its prevalence among the older adults and the characteristic loss of cognitive function. It is ranked as one of the leading causes of death among elderly individuals worldwide. Alzheimer’s disease is classified among a group of diseases known as dementias, which are common causes of cognitive malfunction among the elderly. In a number of cases, the disease can get so severe that it affects the daily life of the person, causing them to rely heavily on external support for their routine activities. 

What causes Alzheimer’s Disease?

The pathophysiology of the disease is quite complex and the exact cause is not fully understood by Scientists. The disease develops from a complex interplay of several factors such as lifestyle, environment and genetics, which culminate into age-related adverse changes in the brain. On a basic level, Alzheimer’s disease is said to be caused by an abnormal accumulation of certain proteins in the brain, which are known as ‘amyloid’ and ‘tau’ proteins. The amyloid protein deposits tend to form plaques around the brain cells, while tau protein deposits form tangles within the brain cells. As the brain cells become damaged due to the buildup of these proteins, there is an accompanying decrease in certain chemical messengers in the brain called neurotransmitters, which are involved in signal conduction between brain cells. An example of such neurotransmitter is acetylcholine, which has been observed to be commonly depleted in the brains of persons with the disease. The damage to brain cells and depletion of acetylcholine over time eventually leads to destruction and shrinkage of brain tissue in various parts of the brain.

The process of development of the disease is known to take place many years (up to a decade) before the symptoms actually appear. There are a number of risk factors for Alzheimer’s disease, which include being above the age of 60 years, having a family history of dementia, being a sufferer of Down’s syndrome, having severe head injuries, and also having a cardiovascular disease. Other minor risk factors include living a sedentary lifestyle, loneliness or social isolation, untreated depression and having prior loss of hearing. 

Source: iStock. https://bit.ly/3za8dH9

What are the Signs and Symptoms of Alzheimer’s Disease?

The first symptoms of the disease vary widely among individuals. The most typical sign of Alzheimer’s disease is the development of memory problems, a condition called mild cognitive impairment (MCI). This includes temporary memory loss, impaired cognitive function (reasoning and comprehension), loss of sense of smell, vision/spatial problems, etc. Such persons typically experience difficulty answering questions without repetition, handling money and paying bills, signs of wandering and absentmindedness, and spending longer time to complete normal daily tasks. As the disease progresses to a moderate stage, the loss of memory and cognitive function worsens, along with confusion or delirium, hallucinations and delusions, inability to recognize family and friends, and difficulty carrying out multistep tasks such as dressing up or fixing a meal. As the disease progresses to the severe stage, the elderly persons lose their ability to communicate effectively, are unable to carry out any cognitive functions like reasoning or remembering concepts, and they become completely dependent on others for their care. At this stage, the brain tissue has shrunk significantly and brain damage is irreversible, leading to the shutdown of other body systems, and the individual becomes bedridden till the point of eventual death.

Source: New Scientist. https://bit.ly/3gn3xqg

How can Alzheimer’s Disease be diagnosed?

There are several methods employed in the process of determining if a person with memory problems has Alzheimer’s disease or not. The medical history of the patient plays a basic role, along with memory, language and cognitive skill tests to gauge their mental function. Standard medical diagnostic tests like blood and urine lab tests, as well as CT and MRI brain scans are used in the process of diagnosis to confirm if the individual is positive for Alzheimer’s disease or not. Such tests may be repeated periodically to give the doctor more information about how the person’s memory and other cognitive functions are changing over time.

How can Alzheimer’s Disease be treated?

The disease is complex and cannot easily be treated by any single specific drug or intervention, neither does it have any cure. The current methods of treating Alzheimer’s disease focus on helping the individual maintain mental function, treating the underlying disease process, and managing their behavioral symptoms. Some medications exist which are currently in use for treating the disease, such as Rivastigmine, Donepezil and Memantine. These drugs work by regulating neurotransmitters in the brain, with the aim of reducing the symptoms and helping with some behavioral problems. A certain drug called Aducanumab has been approved as a modification therapy for treating Alzheimer’s disease, as it has shown to be effective in reducing the accumulation of amyloid deposits in the brain and also helps to slow the progression of the disease. However, the medication has not yet been shown to affect clinical outcomes in improving cognitive skills or dementia. Several other disease-modifying medications are currently being manufactured and tested in clinical trials with elderly persons suffering mild cognitive impairment, to ascertain their effectiveness as potential treatments.

How can Alzheimer’s Disease be prevented?

There are no specific preventive measures that have been proven to be completely effective against the disease, but a number of factors exist that may play a role in reducing one’s risk of developing Alzheimer’s disease and other types of dementia. These factors revolve around living a healthy lifestyle and include regular exercise, avoiding smoking, maintaining proper mental health, eating a balanced diet, controlling cardiovascular risk factors like high blood pressure, and regularly utilizing cognitive and memory skills. Maintaining these factors is pivotal to ensuring the overall good health of elderly persons, and has a cumulative effect in reducing the risk of Alzheimer’s disease among the elderly.

Reference

THE DISEASE CALLED PNEUMONIA

What is Pneumonia?

Pneumonia is an acute respiratory infection that causes inflammation of the alveoli (air sacs) in the Lungs. The disease is mostly common among children and is the single largest infectious cause of child deaths worldwide, accounting for an average of about 15% of all deaths in children under five years of age. Despite having a global distribution, the disease is more prevalent in Southern Asia and Sub-Saharan Africa. Individuals at high risk for pneumonia include infants, young children, the elderly, and people with underlying medical conditions.

What causes Pneumonia?

The disease is caused by various infectious pathogens, including bacteria, viruses and fungi. Examples include Streptococcus pneumoniae (bacteria), Haemophilus influenzae (bacteria), Legionella pneumophilia (bacteria), Respiratory Syncytial Virus (RSV), Rhinoviruses, Influenza Virus and Pneumocystis jiroveci (fungi). Some of these pathogens (bacteria and viruses) exist as natural flora in the nasal airways or throat, and only become infectious when they descend and invade the Lungs. They can also be transmitted by inhalation of respiratory droplets from the cough or sneeze of an infected person suffering pneumonia. The causative fungi in fungal pneumonia can be contracted from the environment. Upon gaining entry into the Lungs, these pathogens release toxins that elicit inflammation of the respiratory air sacs (alveoli), causing them to become swollen with pus and inflammatory exudate (fluid). This makes breathing difficult and painful (because the alveoli are filled with pus), and limits the amount of oxygen inhaled, giving rise to a feeling of suffocation.

Source: VeryWell Health. https://bit.ly/3ywslDb

What are the Signs and Symptoms of Pneumonia?

The severity of the disease can range from mild to severe and life-threatening. The initial signs and symptoms of pneumonia appear mild and are similar to those of a cold or flu, such as fever, chills, headaches and fatigue. As the disease progresses, the symptoms worsen to result in repeated bouts of coughing with phlegm (thick mucus), difficulty breathing, shortness of breath, chest pain when taking a deep breath (pleuritic pain), high fever, fast heartbeat, nausea and vomiting, loss of appetite and restlessness. Convulsions and transient unconsciousness may occur in infants. The symptoms of viral and bacterial pneumonia are similar, however, viral pneumonia tends to have more symptoms, and wheezing (sharp whistling sound while breathing) is usually observed.
Children with a healthy immune system may be able to fight the infection and recover, while those with a weak or compromised immune system (malnourished children) tend to develop more severe symptoms and have a higher likelihood of fatality. Pre-existing medical conditions such as HIV, Measles and Asthma, as well as smoking, also increase the likelihood of severity and fatality. 

How can Pneumonia be diagnosed?

Pneumonia symptoms serve as a primary guide during diagnosis, however, a number of diagnostic techniques exist, which include Chest X-Ray (for signs of inflammation), Culturing of Sputum and Blood samples to identify the causative pathogen, Pleural aspiration of fluid (from the space surrounding the Lungs) for analysis, and the use of a Bronchoscope inserted via the throat and into the Lungs to inspect the respiratory airways.

How can Pneumonia be treated?

Treatment of pneumonia depends on the severity of the symptoms. Bacterial pneumonia is treated with antibiotics targeted at the causative bacteria, while viral pneumonia mainly requires rest and proper feeding, but antiviral medications can also be used. Fungal pneumonia is treated with appropriate antifungal medications. Asides medications against the causative pathogens, some over-the-counter (OTC) drugs like Aspirin, Ibuprofen and Paracetamol (Acetaminophen) may also be prescribed for patients to help manage the pneumonia symptoms. These drugs work by reducing the fever, weakness, headaches and chest pains, and also suppressing the cough to a zero or minimal level. In very severe cases, the patients may be hospitalized and treated with intravenous medications, along with supplementary oxygen therapy to aid breathing.

A key approach to treating pneumonia in addition to medications is eating a healthy diet, staying hydrated with lots of fluid (to thin out the thick mucus), and getting adequate bed rest for full recovery to take place. Most individuals recover from pneumonia within one to three weeks.

How best can Pneumonia be prevented?


General preventive approaches against pneumonia include washing hand regularly, maintaining a strong immune system by eating a healthy diet, exercising regularly and getting enough sleep, maintaining proper personal and environmental hygiene, avoiding contact with surfaces that may have been exposed to respiratory droplets from a pneumonia patient, and also refraining from smoking.

Vaccination still remains the most effective way of preventing pneumonia infections. Several approved vaccines exist that prevent the development of pneumonia from specific infectious pathogens. Some of them include Prevnar 13, Pneumovax 23, Influenza vaccine, Hib vaccine, Pertussis vaccine, and a number of others. These vaccines offer immunity to a wide range of pneumonia-causing pathogens. Although they may not always give 100% protection in all cases, vaccinated individuals who get infected subsequently will only experience very mild symptoms and a lower risk for complications.

Reference

ALL ABOUT MENINGITIS

What is Meningitis?

Meningitis is a severe disease caused by microbial infection of the fluid (cerebrospinal fluid) found in the protective layers surrounding the brain and spinal cord (meninges), leading to inflammation and swelling, along with a host of other symptoms. Meningitis is considered a major public health threat and has a cosmopolitan distribution, meaning that it occurs in various parts of the world and is not endemic to a particular region. The disease can occur in a range of situations, from individual infections to small clusters and even widespread epidemics, with a fatality rate as high as 50% when left untreated. The disease affects people of all ages, but some forms are more prevalent in children. 

What causes Meningitis?

The disease is caused by a variety of infectious microorganisms, ranging from bacteria to fungi, viruses and parasites. It may also be caused by non-infectious factors such as cancer, toxic drugs, brain surgery or injuries to the central nervous system (CNS), however, these are not very common. Among the various pathogens capable of causing meningitis, bacterial pathogens are the most common and cause the highest global burden of the disease compared to other pathogen types. Viral meningitis also has some level of prevalence, especially in countries such as the United States, but it presents less severe symptoms than bacterial meningitis. It is commonly caused by a group of viruses called Enteroviruses, along with other viruses such as Herpes Simplex Virus, Mumps Virus, West Nile Virus, etc. Meningitis caused by fungal and parasitic infections are rare, but may be life threatening in some circumstances.

A number of different bacteria capable of invading the central nervous system can actually cause bacterial meningitis. Some of these bacteria include Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, Listeria monocytogenes, and a number of others. It is the most common and most severe form of meningitis, having fatal consequences if not given adequate medical attention. Viral meningitis tends to be less severe than that caused by bacteria, and tends to have higher prevalence in children. Individuals with a strong immune system usually recover from the viral infection with little or no medical treatment. Fungal meningitis is caused by inhaling fungal spores from the environment, and is most likely to occur in individuals with a weakened immune system like HIV and Cancer patients. Examples of some fungi capable of causing meningitis include Cryptococcus, Coccidioides, Histoplasma and Blastomyces. Parasitic meningitis is much less common than the other forms of meningitis and is only caused by parasites that are capable of infecting the CNS. An example is the parasitic amoeba Naegleria fowleri, which is found in some water sources like ponds and swimming pools, thus, it is more likely to infect swimmers, usually through the nasal route when water enters a person’s nostrils. 

What are the Signs and Symptoms of Meningitis?

Meningitis caused by Bacteria and Viruses tends to have similar symptoms at the beginning of infection, but as the disease progresses, the symptoms of bacterial meningitis tend to be more severe than that of viral meningitis. General symptoms include nausea, vomiting, headaches, fever and chills, lethargy and sensitivity to bright light. As the disease progresses, the symptoms get more severe (in bacterial), along with symptoms such as having a stiff neck, seizures, delirium, loss of appetite or thirst, and sometimes, a peculiar skin rash may develop. In infants, some symptoms that may be observed include high fever, excessive sleepiness, constant crying, vomiting and poor feeding, inactivity, stiffness of the body and neck, and bulging of the fontanel (soft spot on the baby’s head).

Bacterial meningitis causes the most severe symptoms and can be fatal within a few days if immediate treatment with the appropriate antibiotics is not commenced. It is important to identify the specific cause of meningitis in an individual, so as to administer the befitting medical treatment. Delayed treatment increases the risk of permanent brain damage or death. 

How can Meningitis be diagnosed?

Diagnosis of Meningitis is primarily based on the individual’s health history and symptoms. A lumbar puncture is usually done at the abdominal portion of the patient’s spine, and cerebrospinal fluid is extracted to test for the presence of infectious pathogens in the fluid, which would help to confirm the type of meningitis, and the mode of treatment that would be best. Other additional tests can be carried out, such as blood culture to identify any bacterial species present in the blood, or a White blood cell count (WBC) to determine the proportion of white blood cells present in the blood, as a high number of white blood cells indicates the presence of an infection. A CT Scan of the Brain may also be carried out to detect cerebral abnormalities such as sinusitis or brain abscesses.

 

How can Meningitis be treated?

Treatment of meningitis depends on the type of infection. Bacterial meningitis requires immediate treatment with intravenous antibiotics (injected into the bloodstream) to ensure circulatory effectiveness. There is no specific antibiotic used, as the type of antibiotic to be used depends on the causative bacteria. Viral meningitis usually resolves on its own with management of symptoms, but advanced cases require treatment with intravenous antiviral drugs. Fungal meningitis is treated with injectable antifungal medications. Treatment of parasitic meningitis may involve treating just the symptoms or treating the actual infection, depending on the severity of the disease.

Source: World Health Organization. https://bit.ly/3xuTkOc

How best can Meningitis be prevented?

The microorganisms that cause meningitis (especially bacteria and viruses) are quite common in our environment and can be spread through sneezing, coughing, kissing, and sharing eating utensils or items like cups and toothbrushes. Meningitis infections can be prevented by maintaining hygienic practices such as washing hands properly, not sharing personal items with people and covering your mouth when sneezing or coughing. Maintaining a proper diet and getting adequate rest is important in order to ensure a healthy immune system.

The best mode of prevention for meningitis is by vaccination against the causative pathogens. A number of effective vaccines have been approved by the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) for protection against certain forms of bacterial meningitis. These vaccines include the Haemophilus influenzae type b (Hib) Vaccine, the Pneumococcal Conjugate Vaccine (PCV13), Pneumococcal Polysaccharide Vaccine (PPSV23) and the Meningococcal Conjugate Vaccine. These vaccines are effective against the major causative pathogens of bacterial meningitis, and have defined doses suitable for administration to both children and adults. 

Reference

ALL YOU NEED TO KNOW ABOUT MEASLES

What is Measles?

Measles is a highly contagious viral disease common among children under five years of age, with a known history of causing major epidemics in various parts of the world. Before the implementation of widespread measles vaccination campaigns, the disease recorded over 2.6 million worldwide infections yearly, with a global average of about 140,000 deaths each year. Measles has a number of distinguishable symptoms, and is known to cause life-threatening complications in infected individuals if left untreated. The disease has a worldwide distribution and is easily preventable with vaccination, but it remains common in many developing countries, especially in Africa and Asia, due to the prevalence of weak healthcare infrastructures and low per capita incomes in these regions.

What causes Measles?

The disease is also called “Rubeola” because it is caused by the Rubeola Virus, which belongs to a family of paramyxoviridae such as the Mumps Virus, Parainfluenza Viruses and Respiratory Syncytial Virus, all commonly transmitted by respiratory droplets or direct contact with infected persons. The Measles virus usually replicates in the nose and throat of infected persons, and can be spread to other persons through infectious droplets from a cough or sneeze. A healthy individual becomes infected by inhaling or coming in contact with surfaces that bear these respiratory droplets, as well as having direct body contact with infected persons. Due to its high infectivity, about 90% of healthy unvaccinated persons that are exposed to the virus will automatically become infected, hence, the reason why the disease is very contagious. Upon gaining entry into the body through the nose, mouth or eyes of an individual, the virus undergoes incubation for about 10-14 days without causing any symptoms. During this period, it rapidly multiplies and spreads to various parts of the body, where it elicits inflammation and the symptoms gradually begin to manifest.

Source: VeryWell Health. https://bit.ly/3yEpQif

What are the Signs and Symptoms of Measles?

The initial symptoms may be nonspecific and mild, characterized by fever, runny nose, persistent cough, sore throat and inflamed eyes (conjunctivitis), which may last about 4-7 days. Tiny white spots with a reddish background may develop inside the mouth, known as “Koplik’s Spots”. This is followed by a rash of small, slightly raised, red spots that occur in clusters, giving the skin an irregular reddish appearance. The rash appears about 14 days after exposure to infection and begins on the face, then it spreads to the arms, trunk, legs and feet over the next few days. This is accompanied by a very high fever, often as high as 40-41°C. During this period, specifically four days before the rash appeared and four days after the presence of the rash, the patient is highly contagious and can readily spread the infection to healthy persons through direct contact or respiratory droplets.

The rash lasts for about 5-6 days, then it gradually recedes and the symptoms fade with adequate medical attention. However, in malnourished children, especially those lacking sufficient Vitamin A, and individuals with weakened immune systems and underlying diseases, a number of serious complications may arise, which include severe diarrhoea, dehydration, blindness and swelling of the brain (encephalitis) when the virus crosses the blood-brain barrier to enter the brain. Unvaccinated children below five years of age are usually at the highest risk of developing measles complications and eventual death without adequate medical attention.

How can Measles be treated?

There is no specific antiviral medication used to treat measles. The symptoms of the disease can be managed by providing supportive care for patients through adequate nutrition with healthy foods, fluids and oral rehydration solution for cases of diarrhoea and vomiting. Vitamin A supplements are essential is the treatment process due to their efficacy in resolving complications of the disease (especially conjunctivitis and blindness), and also reducing the mortality rate associated with measles. Vitamin A supplements must be given to children in 2 doses, 24 hours apart, to restore low levels of Vitamin A due to malnutrition.

Source: News Medical. https://bit.ly/3lVdIWz

How best can Measles be prevented?

Some preventive measures against measles include isolation of infected persons to prevent transmission of the disease to other persons, and also ensuring complete avoidance of patients manifesting symptoms of measles, especially the rash. Unvaccinated persons are strictly advised to keep away from infected individuals, as they do not have an established immune response against the disease.

The easiest and most effective way of preventing measles is by getting vaccinated against it. The World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) recommend that all individuals above 6 months of age (infants) and adults with no history of measles infection should receive the vaccine in 2 doses – 4 weeks apart. Usually, the measles vaccine is incorporated with Rubella and Mumps vaccines to improve protective coverage for these diseases as well. The vaccine is completely safe, highly effective, and has helped to greatly reduce the global mortality rate of measles by 73% since year 2000 by successfully preventing an estimated 23.2 million deaths. Widespread vaccination campaigns are the most effective public health strategy against measles, and serves to provide herd immunity for the few individuals who are not yet vaccinated. 

Reference