Updated (April 6, 2020) brief overview of viruses, pandemics, influenza season and Covid 19 by Maria Ryan PhD

April 6, 2020

Prelude: This is a brief overview of how viruses are spread, pandemics and the current influenza season. For more in-depth information please go to the CDC.gov website.

Viruses

Viruses cannot replicate on their own. They take over cells within an animal or human or both called host cells.

Norovirus can easily contaminate food and water because it only takes a very small amount of virus particles to make you sick. Food and water can get contaminated with norovirus in many ways. Such as, an infected person touches food with their bare hands that have poop or vomit particles on them, food is placed on a counter or surface that has poop or vomit particles on it, tiny drops of vomit from an infected person spray through the air and land on the food, the food is grown or harvested with contaminated water, such as oysters harvested from contaminated water, or fruit and vegetables irrigated with contaminated water in the field

HIV can spread via certain body fluids—blood, semen, pre-seminal fluid, rectal fluids, vaginal fluids, and breast milk—from a person who has HIV can transmit HIV. These fluids must come in contact with a mucous membrane or damaged tissue or be directly injected into the bloodstream (from a needle or syringe) for transmission to occur. Mucous membranes are found inside the rectum, vagina, penis, and mouth. Either partner can get HIV through vaginal sex, though it is less risky for getting HIV than receptive anal sex. Sharing needles or syringes, rinse water, or other equipment (works) used to prepare drugs for injection with someone who has HIV. HIV can live in a used needle up to 42 days depending on temperature and other factors.

Brief History of Pandemics

1918 (H1N1-Avian origins)  It is estimated that a third of the world population or approximately 500 million people were infected.  Deaths globally: 50 million   Deaths in the United States  675,000. Remarkable that there was a global pandemic when travel wasn’t as prevalent.

Mortality was high in people younger than 5 years old, 20-40 years old, and 65 years and older. The high mortality in healthy people, including those in the 20-40 year age group, was a unique feature of this pandemic.

1957-1958 (H2N2) a new influenza A (H2N2), Avian flu virus emerged in East Asia. First reported in Singapore in February 1957, Hong Kong in April 1957, and in coastal cities in the United States in summer 1957. Deaths globally: 1.1 million.  United States: 116,000

1968 (H3N2) Comprised of a few Avian genes from 1957 along with other combinations from other viruses. H3N2 continues to circulate worldwide as a seasonal influenza A virus. Deaths globally: 1 million. United States: 100,000

2009 Novel (H1N1-Swine Flu) Comprised of elements not previously seen with other H1N1 viruses. Particularly attacked children and young adults. Is this because the older generation had some immunity to some elements of H1N1? Deaths globally 151,700 to 575,000. United States 12,469  60.8 million cases, Hospitalizations 274,304. 

2019 Novel Coronavirus Covid-19 is a new strain of coronavirus that was discovered in Wuhan, China in 2019 that had not been previously identified in humans.

Coronaviruses (CoV) are zoonotic, meaning they are transmitted between animals and people. Epidemiologists found that SARS-CoV was transmitted from civet cats to humans and MERS-CoV from dromedary camels to humans. Several known coronaviruses are circulating in animals that have not yet infected humans. 

Common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, acute respiratory distress syndrome (ARDS), kidney failure and even death. 

President Trump stopped travel to and from China early on and then subsequently a travel ban was imposed on Europe as well. This was a defining pre-emptive bold move that saved lives.

The President has asked all of us to follow a plan, Guidelines for America that is outlined on Whitehouse.gov. A large piece of this plan is limiting interaction with others for a 30 day period. ‘We’ are trying to slow down the spread of this virus. It is inevitable that you may get Covid 19, but if you are healthy you most likely experience mild symptoms and recover. We want to slow it in order to deal with the elderly or immunocomprised individuals who may need more advanced hospital support.

As of April 6, 2020

Globally 1,364, 737 confirmed Covid 19 cases and 76, 482 deaths.

USA 330,891 confirmed Covid 19 cases and 8,910 deaths

For up to date accurate information go to CDC.gov or Whitehouse.gov

Influenza season typically starts October 1 and goes to April.

Low Influenza season 2010-2011    12, 000 US deaths

High influenza season 2017-2018    79,000 US deaths

We are on the downslope of a moderate influenza season. 2019-2020

The United States of America has 39 million flu illnesses, 400,000 hospitalizations and 24,000 deaths of which 162 were children. Influenza B accounted for 102 pediatric deaths and Influenza A accounted for 60 deaths pediatric deaths.

Undoubtedly, the education provided by the White House coronavirus task force about how to prevent Covid 19 assisted in mitigating Influenza numbers in the latter half of this influenza season.

Remember, we will never know how many people have influenza and or Covid-19.

Typically when people are sick we advise them to stay home (without testing-since testing does not change treatment) , hydrate, treat fever with Tylenol/Motrin and get plenty of rest. Seek medical care if symptoms worsen. Communicate with your provider via email, phone call or telehealth. 

Preventative measures for influenza and Covid-19

•   Avoid sick people. Influenza and Covid-19 are predominantly spread through respiratory droplet nuclei when the infected person coughs or sneezes. 
• Wash your hands frequently with soap and water for at least 20 seconds. Hand sanitizer when soap and water are not available.
•  Disinfect high touch areas. Viruses can stay on surfaces for an extended period of time and can be transferred via this route.
• Stay physically healthy all year round. Avoid processed foods all year round
• Stay six feet away from others (physical distancing)
• Take frequent walks
• Have food and supplies on hand for at least a month
• Save a portion of your paycheck for emergencies

If you have a fever, cough or respiratory illness

• Stay home and call your provider
• Hydrate
• Rest
• Take Tylenol or Motrin for fever
•  Cough in a tissue or in your elbow (vampire cough) and immediately wash your hands
•  If you have to go out for an important need wear a mask.
•   Disinfect high touch areas.
• Communicate with your provider if symptoms worsen

Overall:

• Do not panic
•  During time of physical isolation stay social via telephone
• Take up a new hobby! Read a history book! Make something-be creative!