A research letter published this week describes the case of a Chinese woman who spread COVID-19 to five people without any symptoms at all.
While international efforts are in full swing to curb the coronavirus outbreak, some view this recent finding as a cause for concern.
To date, there has been a vast majority of cases in China but the virus has now spread to 29 other countries.
Researchers have shown that the new virus, called SARS-CoV-2, is transmittable from human to human. Studies have also shown that some people may become infected with the virus but show few symptoms or no.
The recent paper, published in JAMA, is the first to describe a transmitting asymptomatic carrier of the virus to others.
Wuhan to Anyang
The paper details the observations of five individuals with respiratory symptoms and fevers admitted to Anyang’s Fifth People’s Hospital, China, and one family member without symptoms.
The asymptomatic individual is a woman, who lives in Wuhan, who is 20 years old. She traveled over 400 miles (645 kilometres) away to see the family in Anyang.
Five of her relatives exhibited SARS-CoV-2 symptoms after a few days, and she was isolated and put under observation.
Wuhan’s wife had no respiratory or gastrointestinal symptoms, and had no fever, cough, or sore throat. A CT scan showed no malfunctions.
After further testing, doctors found that her C-reactive protein levels were normal, meaning no inflammation occurred. The lymphocyte counts of the woman were also normal, suggesting no immune response.
However, reverse transcriptase polymerase chain reaction testing in real time confirmed she had been infected with SARS-CoV-2.
COVID-19 was developed by all five members of her family-four women and one man. None had ever visited Wuhan or had any other contact with anyone who had visited Wuhan.
What does this mean?
The researchers are confident that this case study describes an asymptomatic carrier that transmits the infection to others, but as it is the first report, one has to be careful when drawing conclusions.
The authors, in general, are concerned about the possibility, writing:
“If the findings in this report of presumed transmission by an asymptomatic carrier are replicated, the prevention of COVID-19 infection would prove challenging.”
A letter dated January 30 published in The The New England Journal of Medicine described a similar case. It reported that a woman from Shanghai who had no symptoms had passed the infection to a German man.
The writers of the letter wrote that “The fact that asymptomatic persons are potential sources of[ SARS-CoV-2] infection may warrant a reassessment of the current outbreak’s transmission dynamics.”
However, it turned out that the woman had, in fact, experienced mild symptoms, including that of the current outbreak. Before the material was published the authors had not managed to speak directly with the woman.
Information about this outbreak is being published thickly and quickly; during an epidemic, all are focused on getting data into the public domain.
In an interview with Science, Prof. Marc Lipsitch, an epidemiologist at the Harvard T.H. Chan School of Public Health in Boston, MA, explains how these situations can change the way in which scientific evidence is compiled and disclosed:
“I think peer review is lighter in the midst of an epidemic than it is at normal speed, and the quality of the data that goes into the papers is necessarily greater.
Overall, the current case study is convincing but it needs more analysis.
It should also be remembered that asymptomatic carriers do not sneeze or cough, which are some of the main ways the virus spreads. Because of this, it’s unclear how much of a role these individuals will play in SARS-CoV-2 transmission.
Types, symptoms, and treatments of cytomegalovirus
Cytomegalovirus is a typical herpes virus. Many people are unaware they have it since they show no signs or symptoms.
However, the virus can cause issues during pregnancy and in people with a compromised immune system because it remains dormant in the body.
The virus spreads through bodily fluids and can be passed on to an unborn child by a pregnant woman.
Cytomegalovirus, also known as HCMV, CMV, or human herpesvirus 5 (HHV-5), is the most frequent virus transmitted to a growing baby.
According to the Centers for Disease Control and Prevention (CDC), more than half of all people in the United States have contracted the virus by the age of 40. It affects both men and women equally, regardless of age or ethnicity.
Fluids such as saliva, sperm, blood, urine, vaginal fluids, and breast milk can spread acquired cytomegalovirus between people.
The virus can also be contracted by touching a virus-infected surface and then touching the interior of the nose or mouth.
The virus is most commonly contracted in childhood, at daycare centres, nurseries, and other places where children are in close proximity to one another. The immune system of a child at this age, on the other hand, is typically capable of dealing with an infection.
CMV can recur in people who have a compromised immune system as a result of HIV, organ transplantation, chemotherapy, or long-term use of oral steroids.
Congenital CMV develops when a female catches the virus for the first time during pregnancy or shortly before conception.
A dormant CMV infection might resurface during pregnancy, especially if the mother has a compromised immune system.
Depending on the type of CMV, the symptoms will vary.
The majority of people with CMV do not show any symptoms, however if they do, they may include:
- swollen glands
- joint and muscle pain
- low appetite and weight loss
- night sweats
- tiredness and uneasiness
- sore throat
After two weeks, the symptoms should be gone.
The symptoms of recurrent CMV differ depending on which organs have been affected by the infection. The eyes, lungs, and digestive system are all likely to be affected.
Among the signs and symptoms are:
- diarrhea, gastrointestinal ulcerations, and gastrointestinal bleeding
- shortness of breath
- pneumonia with hypoxemia, or low blood oxygen
- mouth ulcers that can be large
- problems with vision, including floaters, blind spots, and blurred vision
- hepatitis, or inflamed liver, with prolonged fever
- encephalitis, or inflammation of the brain, leading to behavioral changes, seizures, and even coma.
Any of these symptoms should be reported to a doctor by someone with a reduced immune system.
According to the National CMV Foundation, approximately 90% of kids born with CMV show no symptoms, but 10–15% will develop hearing loss during their first 6 months of life. The degree of hearing loss varies from mild to complete deafness.
The infection will affect only one ear in half of these children, but the other half will experience hearing loss in both ears. Hearing loss in both ears can increase the risk of speech and communication issues in the future.
If congenital CMV is present at birth, symptoms may include:
- enlarged spleen
- spots under the skin
- low birth weight
- Purple skin splotches, a rash, or both
- enlarged liver
Some of these signs and symptoms can be treated.
In roughly 75% of babies born with congenital CMV, the virus will affect the brain. This could lead to difficulties later in life.
They may be exposed to the following conditions:
- central vision loss, scarring of the retina, and uveitis, or swelling and irritation of the eye
- cognitive and learning difficulties
- deafness or partial hearing loss
- impaired vision
- problems with physical coordination
- small head
Scientists have been looking for a CMV vaccine, however there is no cure as of yet.
People with acquired CMV who encounter the virus for the first time can ease symptoms with over-the-counter (OTC) pain relievers like Tylenol (acetaminophen), ibuprofen, or aspirin, and should stay hydrated.
Antiviral drugs, such as ganciclovir, can be used to inhibit the spread of CMV in people who have it congenitally or on a regular basis.
These drugs have the potential to cause side effects. Hospitalization may be required if there is substantial organ damage.
It’s possible that newborns will need to be admitted to the hospital until their organ functions return to normal.
The following precautions may help minimise the risk of developing CMV:
- Hands should be washed with soap and water on a frequent basis.
- Kissing a small child should be avoided at all costs, including contact with tears and saliva.
- When passing around a drink, avoid sharing glasses and kitchen equipment.
- Diapers, paper handkerchiefs, and other such items should be disposed of with care.
- To prevent CMV from spreading through vaginal secretions and sperm, use a condom.
The Centers for Disease Control and Prevention (CDC) advises parents and caregivers of children with CMV to seek treatment as soon as possible, whether that means taking medication or attending all appointments for services such as hearing tests.
CMV infections are classified as either acquired, recurrent, or congenital.
- When a person contracts CMV for the first time, it is known as acquired or primary CMV.
- When a person already has CMV, it is referred to as recurrent CMV. The virus is dormant and then becomes active due to a weak immune system.
- When a person contracts CMV while pregnant and passes it on to the foetus, this is known as congenital CMV.
Except when it affects an unborn child or a person with a weakened immune system, such as a recent transplant recipient or someone living with HIV, CMV is normally not an issue.
CMV infection can cause organ failure, eye damage, and blindness in HIV patients. In recent years, advances in antiviral treatment have lowered the risk.
Immunosuppressants are used by people who have had organ and bone marrow transplants to suppress their immune systems so that their bodies do not reject the new organs. In these people, dormant CMV can become active and cause organ damage.
Antiviral medications may be given to transplant recipients as a prophylactic against CMV.
The virus can be passed to the foetus by a pregnant woman. This is referred to as congenital CMV.
According to the Centers for Disease Control and Prevention, about one in every 200 newborns is born with the virus.
The majority of these babies will show no signs or symptoms, but about 20% will have symptoms or long-term health issues, such as learning challenges.
Vision and hearing loss, small head size, weakness, trouble using muscles, coordination issues, and seizures are all possible symptoms.
A blood test can detect antibodies produced by the body as a result of the immune system’s response to the presence of CMV.
A pregnant woman faces a low risk of CMV reactivation affecting her unborn child. If a doctor suspects a pregnant woman has CMV, an amniocentesis may be recommended. To determine whether the virus is present, a sample of amniotic fluid is extracted.
The newborn will be tested within the first three weeks of life if the doctor suspects congenital CMV. Testing for congenital CMV after 3 weeks will not be definitive because the kid may have contracted the virus after birth.
Even if the virus is not active, anyone with a weaker immune system should get tested. Testing for vision and hearing issues will be done on a regular basis as part of the CMV complications monitoring.
CMV causes just a small percentage of healthy people to become very ill.
CMV mononucleosis, a condition in which too many white blood cells have a single nucleus, can occur in people with a weaker immune system.
Sore throat, swollen glands, swollen tonsils, fatigue, and nausea are some of the symptoms. It can cause hepatitis, or inflammation of the liver, as well as spleen enlargement.
Mononucleosis induced by the CMV is comparable to mononucleosis caused by the Epstein-Barr Virus (EBV). Glands fever is another name for EBV mononucleosis.
Other CMV problems include:
- gastrointestinal problems, including diarrhea, fever, abdominal pain, colon inflammation, and blood in the feces
- liver function problems
- central nervous system (CNS) complications, such as encephalitis, or inflammation of the brain
- pneumonitis, or inflammation of lung tissue.
Safe and effective home treatments for kidney infection
Kidney infections are caused by an overabundance of germs in the kidney. Another name for it is Pyelonephritis. Kidney infections can be serious enough to necessitate hospitalization, so home treatments are usually insufficient to treat them.
Because kidney infections have the greatest potential to harm the kidneys and spread to other parts of the body, they are often the most serious of all urinary tract infections (UTIs). Other UTIs can affect the bladder, ureters, or urethra, but they are less likely to cause harm.
Antibiotics are usually required to control the bacterial overgrowth that causes the condition. Home remedies, in addition to these, may aid in the body’s ability to remove the kidney infection as rapidly as feasible.
If someone feels they have a kidney infection, they should consult a doctor as soon as possible.
When to consult your doctor
If you experience any of the following signs of a possible kidney infection, you should consult a doctor immediately.
- a fever of more than 103 ℉
- In the urine, there is blood or pus, a thick white or yellow liquid.
- they are unable to keep fluids down due to acute vomiting.
If a person has a history of kidney disease or stones, they should seek medical help right away to avoid further kidney damage.
The following are signs that a person should see their doctor as soon as possible if they suspect they have a kidney infection:
- foul smelling urine
- frequent urination
- Is it safe to use home remedies?
- a burning sensation when urinating
- flank pain, or pain in the sides or back
If a person’s symptoms worsen while taking medications to treat a UTI, they should seek medical attention. This could indicate that their infection has spread to their kidneys.
Is it safe to use home remedies?
It is not a good idea to treat kidney infections with only home treatments.
A person will need antibiotics to treat a kidney infection since it can cause severe symptoms and lead to kidney damage.
Home treatments, on the other hand, can help a person’s recovery and lower the chances of a recurrence of the kidney infection.
Before using any supplements as a home remedy, a person should see their doctor to ensure that they will not interact with any other prescriptions they are currently taking.
Some home treatments and self-care practises that may help minimise kidney infection symptoms are as follows:
Drink plenty of water
When a person has a kidney infection, flushing bacteria from the kidneys is important. According to the National Institute of Diabetes and Digestive and Kidney Diseases, drinking at least six to eight 8-ounce glasses of water each day can assist.
If a person has kidney failure, their doctor may advise them to reduce the amount of fluid they drink.
Consume cranberry juice
Some specialists disagree with the premise of drinking cranberry juice to improve kidney health. However, some research suggests that cranberry juice may assist to reduce the quantity of bacteria in the body when a person has a urinary tract infection (UTI).
Mice with UTIs who drank cranberry juice had lower bacterial counts in their urinary tract, according to a 2018 study published in the journal Frontiers in Microbiology.
The researchers hypothesised that acids found in cranberry juice, such as malic, citric, and quinic acid, protect the urinary system.
While this cure may appear simple, it has advantages. After a kidney infection, getting lots of rest assists the body to mend.
Use warm, moist heat
Applying a heating pad or a warm water bottle to the area of flank pain might assist to relieve pain and relax irritated nerves.
To prevent the risk of burns, a person should always cover the burning object with a cloth. They should only use heat for 10 to 15 minutes at a time.
Heating pads can be found in stores and on the internet.
Drink green tea or take green tea extract
Green tea extract may have an antimicrobial effect on common bacteria strains that cause UTIs, according to a 2013 study published in the journal Frontiers in Microbiology.
Green tea extracts were administered to bacterial cells in the lab by the researchers. They discovered that green tea suppressed bacterial development over time.
It’s difficult to say whether the outcomes would be the same in humans because the study was conducted in a lab with samples. Green tea may, however, provide health benefits when a person has a urinary tract infection (UTI).
Green tea extract can be found in stores.
Use non-aspirin pain medications instead of aspirin.
Over-the-counter (OTC) pain medications like ibuprofen and acetaminophen can help with a kidney infection’s fever and discomfort.
Aspirin is a blood thinner that might cause high blood levels in a person’s urine, therefore it’s better to avoid it.
If a person is unsure whether or not they can use an over-the-counter pain treatment, they should consult their physician.
A kidney infection cannot be cured alone with home treatments.
If a person suspects they have a kidney infection, they should consult a doctor for an antibiotic prescription.
Treatments with medicine
In order to treat a kidney infection, doctors will usually prescribe antibiotics. If a person’s symptoms are severe, they may need to be admitted to the hospital for intravenous antibiotics.
Even if they are feeling better, a person should always finish their antibiotic course. This may help to prevent the infection from returning.
If a person has recurrent kidney infections, a doctor may need to examine them further to determine the cause.
Some men, for example, may have an enlarged prostate, which can clog the urinary path and allow bacteria to grow more easily. Others may have a kidney stone that is preventing urine flow.
To address any underlying condition contributing to recurrent kidney infections, doctors may prescribe medications or suggest surgical procedures.
Symptoms, treatment, and causes of ear infections
Infections in the middle ear can be caused by viruses or bacteria. These frequently cause in pain, inflammation, and fluid accumulation.
Before they become three years old, almost 75% of youngsters will have had at least one ear infection. The most common reason for a child’s visit to the doctor is an ear infection.
Glue ear, secretory otitis media, middle ear infection, and serous otitis media are all terms for ear infections.
Infections of the ear are widely understood, and their frequent recurrence necessitates ongoing investigation. This article discusses the symptoms and causes of ear infections, as well as the treatment choices and diagnostic methods available.
What is it?
A bacterial or viral infection of the middle ear is known as an ear infection. Inflammation and fluid buildup in the ear’s interior cavities are caused by this infection.
The middle ear is a space behind the eardrum that is filled with air. It has vibrating bones that translate sound from outside the ear into messages that the brain can understand.
Ear infections hurt because the swelling and accumulation of extra fluid puts pressure on the eardrum.
An ear infection can be acute or chronic. Chronic ear infections might harm the middle ear permanently.
An ear infection is frequently preceded by a cold, flu, or allergic reaction. These increase mucus in the sinuses, causing the eustachian tubes to discharge fluid slowly. The nasal passages, throat, and eustachian tubes will all be inflamed during the initial illness.
The role of eustachian tubes
The eustachian tubes run from the middle ear to the throat’s rear. These tubes’ ends open and reopen to control air pressure in the middle ear, restock air, and drain natural secretions.
The eustachian tubes can become blocked due to a respiratory infection or allergies, resulting in an accumulation of fluid in the middle ear. If this fluid becomes bacterially contaminated, infection may result.
Young children’s eustachian tubes are smaller and more horizontal than those of older children and adults. This implies that fluid is more likely to pool in the tubes instead of draining away, raising the risk of ear infection.
The role of adenoids
Adenoids are tissue pads found in the back of the nasal cavity. They respond to bacteria and viruses in the air and help the immune system function. The adenoids, on the other hand, can sometimes trap bacteria. The eustachian tubes and middle ear may get infected and inflamed as a result of this.
The adenoids are adjacent to the eustachian tube entrances and can cause the tubes to close if they expand. The adenoids in children are larger and more active than those in adults. Children are more likely to get ear infections as a result of these factors.
The signs and symptoms in adults are simple. Adults with ear infections suffer from ear pain and pressure, as well as ear fluid and hearing loss. Children are exposed to a broader spectrum of symptoms. These are some of them:
- ear pain, especially when lying down
- difficulty sleeping
- difficulty hearing
- lack of appetite
- tugging or pulling at the ear
- crying more than normal
- loss of balance
In general, there are three types of ear infections.
Acute otitis media (AOM)
The most common and least dangerous type of ear infection is AOM. The fluid beneath the eardrum gets infected and bloated, and the middle ear becomes infected and swollen. Fever is another possibility.
Otitis media with effusion (OME)
There may be some fluid behind the eardrum after an ear infection has cleared. Although a person with OME may not show symptoms, a doctor will be able to detect any lingering fluid.
Chronic otitis media with effusion (COME)
COME refers to fluid returning to the middle ear on a regular basis, whether or not an infection is present. This reduces your ability to fight other infections and has a detrimental influence on your hearing.
Ear infection testing is a simple procedure, and a diagnosis can often be determined solely on the basis of symptoms.
To examine for fluid behind the eardrum, the doctor will usually use an otoscope, which is a light-attached tool.
A pneumatic otoscope is sometimes used by a doctor to check for infection. This device uses a puff of air to check for retained fluid in the ear. The eardrum will move less than normal if there is any fluid behind it.
If the doctor is unsure, he or she may perform further tests to confirm a middle ear infection.
The doctor employs a device that shuts up the ear canal and changes the pressure inside it. The eardrum movement is measured by the instrument. This allows the doctor to determine the middle ear pressure.
The eardrum is bouncing sound against the eardrum in this technique. The amount of sound that bounces back shows the level of fluid buildup. The bulk of sound is absorbed by a healthy ear, whereas an infected ear reflects more soundwaves.
A clinician may employ tympanocentesis if an ear infection has not responded well to treatment. A small hole is made in the eardrum and a small amount of fluid is drained from the inner ear during this treatment. The infection’s cause can then be determined using this fluid.
Antibiotic treatment is required for infants under the age of six months to help prevent the spread of infection. Amoxicillin is frequently used as an antibiotic.
Unless the kid shows signs of a severe infection, doctors usually recommend monitoring the child without antibiotics for children aged 6 months to 2 years.
Ear infections usually go away on their own, and the only prescription required is pain relief. Antibiotics are only used in circumstances that are more serious or last longer.
The American Academy of Family Physicians (AAFP) advises patients to be on the lookout for:
- children aged 6 to 23 months who have experienced mild inner ear pain in one ear for less than 48 hours and a temperature of less than 102.2° Fahrenheit (39° Celsius)
- children aged 24 months and over with mild inner ear pain in one or both ears for less than 48 hours and a temperature of less than 102.2°F
Antibiotics are rarely recommended for children above the age of two. Antibiotic resistance develops as a result of overuse. Serious infections may become more difficult to treat as a result of this.
For persistent infections, the AAFP recommends acetaminophen, ibuprofen, or eardrops as pain relievers. These are useful for reducing fever and pain.
A warm compress, such as a towel, can help to relieve the pain in the affected ear.
If you have recurrent ear infections for several months or a year, your doctor may recommend a myringotomy. A surgeon creates a small cut in the eardrum to allow the build-up of fluid to be released.
To help air out the middle ear and prevent future fluid buildup, a very small myringotomy tube is implanted. These tubes are typically left in place for 6 to 12 months before falling out naturally rather than requiring manual removal.
- Ear infections are very frequent, particularly among children. This is linked to a developing immune system and variations in ear architecture. There is no surefire way to avoid infection, however there are a few things you can do to lower your chances:
- Ear infections are less common in children who have been vaccinated. Inquire with your doctor about immunizations for meningitis, pneumococcal disease, and the flu.
- Wash your hands, as well as your child’s, frequently. This can help your child avoid having colds and flu by preventing bacteria from spreading to them.
- Second-hand smoking should never be exposed to a child. Ear infections are more common in infants who spend time with people who smoke.
- If at all possible, breastfeed infants. This aids in the improvement of their resistance.
- Feeding a newborn from a bottle while sitting up reduces the risk of milk going into the middle ear. When a baby is lying down, do not allow them to sip on a bottle.
- Allow your child to play with ill children as little as possible, and limit their exposure to group care or big groups of children.
- Antibiotics should only be used when needed. Ear infections are more common in children who have had an ear infection in the last three months, especially if antibiotics were used to treat it.
Ear infections are a common occurrence in most children’s lives. They can be unpleasant and debilitating, but if appropriately handled, they pose very few long-term issues.