JC Virus DNA, PCR Health Feed

Coronavirus: Brief Summary

• It is a rapidly evolving disease across all strata of society with increase death rate potential 
• Person to person spread is confirmed
• Clinical trials and investigations to learn more are ongoing. There is no treatment or vaccination at present. 
• Prevention is better than cure.
• Avoid unnecessary panic in society, awareness about the disease profile is key to prevention and cure.

Definition
Coronavirus disease COVID-19 as it is now known as by WHO (World Health Organization) has been defined as a potential severe acute respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2)

Clinical presentation is of respiratory infection with a symptom severity ranging from the mild common cold like illness to severe viral pneumonia leading to acute respiratory distress syndrome which is potentially fatal.

Nearly 80000 cases with 2800 death and mounting, have been reported in china (as of 1 March 2020). The outbreak has escalated rapidly across the globe with more and more number of a person becoming infected. Due to migration of population and overcrowded atmosphere, the spread has become easy and helped in the spread.

SARS-COV-2 belong to serbecovirus subgenus of the coronavirus family and its the seventh coronavirus known to infect humans.

A majority of patients in the initial stage of outbreak reported a link to the human south china seafood market, a live animal or wet market, suggesting the zoonotic origin of the virus, however, it's yet to be confirmed. Person to person spread has been confirmed in the community among close contact, in both family and hospital settings.

Transmission is through droplets produced when a person sneeze or cough. The contribution to transmission by the presence of the virus in other body fluids is unknown, but studies are going on to find out any relation. There is growing evidence that transmission from an infected but asymptotic person can occur in an endemic area. It's still unknown whether perinatal or through breastfeeding is possible.

As per current studies, incubation period is from 1-14 days. Median incubation period has been 5 days and transmission is possible during the incubation period. The high viral load has been detected in nasal and throat swab soon after the onset of symptoms. Even asymptotic patient has a similar viral load. 

Primary Prevention

The only way to prevent infection is to avoid exposure to the virus and maintain a high level of personal hygiene.

• Wash hands with soap and water properly and avoid touching face nose and mouth with unwashed hands.
• Avoid close contact with people. Minimum distance advocated is 1meter (3feet).
• Practice respiratory hygiene, covering nose and mouth while sneezing or coughing. Discard the handkerchief and wash hands.
• Avoid unprotected contact with live animals and avoid the consumption of raw or uncooked meat.
• Seek medical advice if you have fever, cough and difficulty in breathing, travel history is mandatory. Not all cases of URTI (upper respiratory tract infection) can be termed as coronavirus infected cases.

WHO does not recommend that people to wear a medical mask in a community setting if they do not have any symptoms as there is no evidence available on its usefulness to protect people who are not ill. Instead, it creates more panic and confusion in an otherwise healthy person.

Screening and Quarantine 
People travelling from high endemic or epidemic areas will be subjected to screening procedures. Upon receiving any positive information or symptoms by any such person will be quarantined to a period of 14 days, 

Such cases to be reported to local health authorities. All new cases need to be isolated to prevent transmission and confirmed cases to be subjected to treatment guidelines as issued by who and local health authorities. 

Infection prevention and control 
Triage all patients on admission and isolate suspected cases from confirmed cases.
Following basic principles of infection prevention and control as per who guideline to be implemented:-

•     Isolate all suspected cases from confirmed cases in an isolated area
•     Practice hand and respiratory hygiene 
•     Offer a medical mask
•     Wear protective clothing and equipment 
•     Prevent needle stick and sharp injury
•     Practice safe waste disposal management principles, environment cleaning and patient clothing sanitisation 
•     Use of single-use and disposable equipment.

Clinical Presentation
Clinical presentation resembles viral pneumonia and severity of illness range from mild to severe. Approximately 80% are mild, 14% severe and 5% critical.

The most common symptoms are:- fever, cough, dyspnoea, myalgia, fatigue
Less common are:- anorexia, sore throats, headache, confusion, dizziness, rhinorrhoea, chest pain, haemoptysis, abdominal pain, nausea vomiting and diarrhoea.

Laboratory Findings
The most common laboratory abnormalities inpatient hospitalised with pneumonia include leukopenia, lymphopenia, leucocytosis, and elevated liver transaminases. Neutropenia, thrombocytopenia, anaemia decreased albumin and renal impairment.
Oxygen saturation of less than 90% will be shown by pulse oximetry.

Blood and Sputum Culture
Chest x-ray and CT. Unilateral lung infiltrates found in 75% cases and bilateral in 25% cases.
Multiple mottling and ground glass appearance found in 14% cases.

Risk factors
Strong: - residence in or travel to the affected area prior to the onset of symptoms. And the history of close contact with an infected person.

Introduction to the ZIKA VIRUS:

After the deadly Yellow Fever and Ebola pandemics, Zika Virus is yet another disease borne out of the African soil and spreading across the world right now. Named after the Zika forest in Uganda, where it originated, this virus spreads through a mosquito bite - that of ‘aedes aegypti’ mosquito. It can also be passed on from mother to child, blood transfusion and sex.

What’s so deadly about ‘Aedes Aegypti’ Mosquito?
Zika Virus spreads via ‘aedes aegypti’ mosquito, same mosquito that also spreads Dengue and Chikungunya.These mosquitoes typically lay eggs in and near still water found in buckets, bowls, animal dishes, flower pots and vases. They are aggressive daytime biters, prefer to bite people, and live indoors and outdoors near people.
These mosquitoes become infected when they feed on a person already infected with the virus. Infected mosquitoes can then spread the virus to other people through bites.

Symptoms of Zika Virus Attack
A person bit by an infected mosquito takes about 2-7 days to show symptoms like:
- Mild fever
- Skin Rash
- Conjunctivitis
- Muscle and joint pain
- Weakness and Fatigue

However, it lasts no more than a week and is usually milder than its cousins Dengue or Chikungunya. Although it is not a fatal disease, the real reason behind the panic is for the women who are pregnant. Zika is found to be a major cause of microcephaly – a birth defect due to which children are born with visibly smaller heads, severely limiting their mental and physical abilities.

Should India Worry?
While it originated in the African continent, Zika has already taken South American countries like Brazil, and most others. Although the virus hasn’t reached Indian shores yet, we are very prone to mosquito borne diseases. The Dengue menace since last few years says it all. Since it is from the same family, we need to be all the more cautious.

Preventions and Precautions:
Since no vaccine exists to prevent Zika virus attack, it’s best to act with caution to prevent the spread.
1. Mosquitoes that spread Zika virus bite mostly during the daytime. Stay in places with air conditioning or that use window and door screens to keep mosquitoes outside.
2. Use Mosquito Repellents during the day when exposed to areas prone to mosquitoes and cover yourself very well.
3. Never allow water to stagnate in or around your habitation. Avoid letting the water stand for long eg: puddles, or water in buckets or potted plants, sewage etc.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Zika virus causes a deadly disease called Zika fever or Zika virus disease that spreads by the bite of the Aedes mosquito. The Zika virus is a member of the virus family FLAVIVIRIDAE and is closely related to the dengue, yellow fever, Japanese Encephalitis, and West Nile viruses. It was isolated in the Zika forest of Uganda in 1947 and is known to be prevalent in continents like Africa and Asia primarily, though it’s slowly making headway in the developed world and has spawned the deadly 2015-2016 Zika virus epidemic.

What are symptoms of Zika fever?
People with Zika virus disease can have symptoms which are similar to Dengue, like-

• Fever
• Diarrhea
• Red Eye 
• Muscle Pain
• Skin Rash
• Headache

These symptoms usually last for 2-7 days.

Complications of Zika virus disease
According to WHO, Zika virus infection during pregnancy causes congenital brain abnormalities like microcephaly. And the infection can also trigger the Guillain-Barré syndrome. Microcephaly is a condition where a child is born with a small head or the head stops growing after birth and the Guillain-Barré syndrome is a rare condition in which a person’s immune system attacks the peripheral nerves which control muscle movement and sensation.

Even as we read this, intense efforts are being expended to investigate the link between Zika virus and a number of other neurological disorders.

How does Zika spread?
The causes of Zika are:

1. The bite of the Aedes mosquito that is infected with the Zika virus. This mosquito is the same that spreads dengue, chikungunya, and yellow fever. It bites primarily in the daytime.
2. Unprotected sexual intercourse
3. Zika’s transmission through blood transfusion is being investigated.

How can you prevent Zika infection?
Protection against mosquito bites is the most foolproof ways to prevent a Zika virus infection. Other ways to prevent Zika infection via mosquito bites are:

1. Just like Dengue prevention, you must cover your body properly, especially during daytime
2. Use physical barriers such as window screens or closing doors and windows against the mosquitoes
3. Sleep under mosquito nets
4. Using insect repellents containing DEET, IR3535 or icaridin
5. Take extra care of young children, sick and  elderly people
6. Cover, empty or clean mosquito breeding sites in and around your house or colony like empty buckets, drums, flower pots and used tyres that can fill-up with water and breed mosquitoes
7. Encourage your family and community to support local government efforts to reduce mosquitoes in their localities
8. Insist on regular spraying of insecticide for mosquito control in your locality.

For stemming sexual transmission of Zika, the WHO recommends that sexually active men and women be counselled to practice safe sex using condoms. WHO also recommends that people who have come back after travelling from Zika virus zones should be extremely careful in practising safe sex or abstinence for the first 6 months at least, for preventing a pregnancy.

If affected, what is the treatment?
Zika virus disease is usually mild and requires no specific treatment as such.
Infected people are advised plenty of rest, asked to drink enough fluids, and treat pain and fever with common medicines like Ibuprofen. If you wish to discuss about any specific problem, you can consult a General Physician.