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Asymptomatic Carriers Have A Fever

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Last Updated: 02 July 2021

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General | Latest Info

In early April, Centers for Disease Control and Prevention issued new face - mask guidance, encouraging everyone to wear cloth face coverings when in public. Reasoning: We now know from recent studies that a significant portion of individuals with coronavirus lack symptoms and that those individuals can transmit the virus to others. But in a statement in June, World Health Organization said that it believes asymptomatic transmission to be very rare, particularly among young, otherwise healthy people. Seemingly dramatic reversal from a few months ago, when social distancing was enacted largely as a precaution against asymptomatic transmission. Her comments led to a flurry of news items and some pushback from concerned health experts. In an attempt to clear up confusion, WHO held another press conference the next day, at which Dr. Maria Van Kerkhove, head of emerging Diseases and zoonoses unit, clarified that her statement was based on a small number of contact - tracing studies done in China. While experts still believe that most transmission occurs through people with coronavirus symptoms, she say, WHO estimates that 16 percent of asymptomatic infected people can transmit COVID - 19, and unpublished disease models suggest that number could be as high as 40 percent. While we dont know exactly how many people infected with coronavirus are truly asymptomatic, CDC has estimated that it is around 35 percent, and in June, Journal Nature Medicine published a report saying those WHO are asymptomatic might still sustain lung damage. The availability of testing continues to improve, though we still dont have a clear picture as to exactly how many American cases are asymptomatic, or what asymptomatic case could mean for one's future health. But here is what we know about asymptomatic carriers so far.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

What this means about transmission

Redfield told NPR that infected people are likely to shedding significant viruses about 48 hours before symptoms appear. This helps explain how rapidly this virus continues to spread across countries because we have Asymptomatic transmitters and we have individuals WHO are transmitting 48 hours before they become symptomatic, he add. A handful of recent studies and reports suggest that Presymptomatic and Asymptomatic Transmission is not unusual. A Report published April 13 in the New England Journal of Medicine examined Coronavirus Infections in pregnant women giving birth at two New York City hospitals between March 22 and April 4. Of 215 women tested for COVID - 19 33 were positive, but only four of them showed Coronavirus symptoms. A small study among Japanese ex - pats evacuated from Wuhan in February found that 31% of people WHO test positive show no symptoms. Research that examined Coronavirus cases in Singapore found that of 157 cases acquired locally, 10 involve Presymptomatic Transmission. Scientists conclude that most transmission from presymptomatic people occurs one to three days before person develops symptoms. Research from China in February found that 13% of 468 confirmed cases studied involved Presymptomatic Transmission. Los Angeles Times Report that three - quarters of group of singers WHO attend 60 - Person choir practice get COVID - 19 virus, even though none show symptoms at practice. Last month, 14 NBA players, coaches, and staff tested positive for Coronavirus. Half of them didn't have symptoms when they received their diagnosis, according to the Wall Street Journal. A biotech company in Iceland that has tested more than 9 000 people found that about half of those WHO test positive say they were Asymptomatic, researchers told CNN.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Background

Covid - 19 caused by SARS - CoV - 2, formerly 2019 novel Coronavirus or 2019 - nCoV, broke out in Wuhan, China in December 2019. Epidemics of COVID - 19 are now occurring worldwide. Since the first COVID - 19 case in Wuhan was identified on 12 December 2019, in less than 4 months, number of cumulative confirmed cases in the world has exceeded 800 000. On 30 January 2020, outbreak was declared an international public health emergency by the World Health Organization. Sars - CoV - 2 is not the first Coronavirus to threaten life and welfare of humans. The years 2002 and 2012 saw the emergence of SARS - CoV and MERS - CoV. Like SARS - CoV - 2, transmission of SARS - CoV or MERS - CoV is Person - to - Person, but they differ in crucial aspects. Most patients infected with SARS - CoV present with obvious clinical symptoms within a short period, disease progresses rapidly and peak viral shedding occurs in late stage; few patients with SARS are asymptomatic. Mers is primarily a zoonotic disease, and spread among humans was scattered and limit, symptoms were obvious and infection rarely precede symptom onset. Nosocomial transmission was more troublesome than community spread. In contrast, onset of SARS - CoV - 2 is insidious. When asymptomatic or early symptoms are mild, patients can move freely and transmit viruses with an incubation period that is long and infectious. These characteristics allow for easy spread, and infection sources can be difficult to identify and isolate. In addition, main routes of transmission are through respiratory droplets and contact, which is relatively easy to achieve. At present, almost all countries in the world have recognized the seriousness of the COVID - 19 pandemic and implemented various measures to curb its development, but asymptomatic patients are not always taken seriously by healthcare workers. Yet, asymptomatic infections of SARS - CoV - 2 are probably an important source of transmission. A person with asymptomatic confirmed case of infection has a normal body temperature or is only slightly indispose. These differences between COVID - 19 and SARS or MERS require change in epidemic response plan. Only by fully researching various characteristics and mechanisms of asymptomatic infections can we lay the theoretical foundation for deployment of next steps in its control. For that purpose, this review summarizes epidemic status, transmission characteristics and clinical features of asymptomatic patients with SARS - CoV - 2 infection.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Conclusion

The median contact time for patients was four days and that for family members was five days. Cardiovascular Disease accounts for 25% of original diseases of patients. Apart from hospital staffs, both patients and family members were isolated medically. During quarantine, seven patients plus one family member appear new respiratory symptoms, where fever was the most common one. Blood counts in most contacts were within the normal range. All CT images show no sign of COVID - 19 infection. No severe acute respiratory syndrome Coronavirus 2 infections were detected in 455 contacts by nucleic acid test. Statistics of 35 patients are displayed in Table 2. All patients also wore masks except for eating or drinking and were admitted to the infectious Department for Medical isolation. The median contact time was four days, whereas longest among them reach 21 days. The median age of patients was 62 years. Total of 57. 1% were males. All individuals had been to the ED of our Hospital for various diseases. Undoubtedly, acute cardiovascular events and digestive diseases were common, accounting for 25. 7% and 22. 9%, respectively. In terms of clinical symptoms, 16 patients were free of respiratory symptoms, which more than half of them appear inversely. Respiratory symptoms involve fever, cough, dyspnea and sputum. Among patients with fever, hyperthermia occur in one patient with chills after chemotherapy. Three individuals present slight fever, of whose temperature could return to normal without therapy. Two individuals were diagnosed with infective endocarditis and acute pancreatitis severally with causes of their symptoms including fever plus dyspnea and stomachache. Another five patients developed fever was considered as a complication of the original disease, mostly pulmonary infection, whether symptoms were new or persistent. Last but not least, all dyspnea was associated with heart failure. Blood counts in most patients were within the normal range. Lymphocytopenia appears in 34. 3% of patients and leukopenia in 8. 6%. One patient was also accompanied with neutropenia on account of myelosuppression after chemotherapy. In contrast, lymphocytosis was observed in patients with acute lymphoblastic leukemia. Besides one patient, died on quarantine 4 - day,ss 34 patients underwent multiple nucleic acid tests for SARS - CoV - 2. All results were negative, including the first time died. Of 35 patients that had more than once chest CT scan, CT abnormalities were reported in 68. 6%. The most common manifestations were inflammatory change and pleural effusion. Interstitial change was detected less. Pulmonary edema and nodules were seen in people with heart failure and lung cancer, respectively. Of particular concern, all CT findings were non - viral infections discussed professionally by radiologists. Normal CT image was found in 11 of 35 patients. According to evaluation from physicians, there were 19 infected patients. Of these 19 patients, 15 had pneumonia, which was bacterial, followed by pendulous and aspiration. Mediastina inflammatory and abdominal infection arisen in two patients with fistula. The other two patients had suffered from infection due to protopathy on admission. Above infected patients were administered empirical antibiotic treatment.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Summary

Even when there is isnt pandemic going on, many people walk around and go about their regular lives shedding viruses all while. In a 2018 study, Jeffrey Shaman, director of the climate and Health program at Mailman School of Public Health at Columbia University, and colleagues found that about 7 percent of people passing through New York City tourist attractions in February were shedding some kind of virus as they go. In the study, researchers asked people passing through popular attractions about how they were feeling and swabbed their noses. Of those who test positive for viral infections like human rhinovirus and influenza, about 65 to 97 percent do not report any symptoms. I want to note that asymptomatic is a very swirly definition, say Shaman, meaning that symptoms are self - reported and, therefore, subjective. But, in general, it means people who do not report feeling sick but do have proven viral infection.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Epidemiologic Evidence

Novel Coronavirus has resulted in an ongoing outbreak of viral pneumonia in China. 1 - 3 Person - to - Person Transmission has been demonstrate, 1 but, to our knowledge, transmission of Novel Coronavirus that caused Coronavirus Disease 2019 from Asymptomatic carrier with normal chest compute tomography findings has not been report. In January 2020, we enrol familial cluster of 5 patients with fever and respiratory symptoms who were admitted to Fifth Peoples Hospital of Anyang, Anyang, China, and 1 Asymptomatic family member. This study was approved by the local institutional review board, and write informed consent was obtained from all patients. Detailed analysis of patient records was perform. All patients underwent chest CT Imaging. Real - time Reverse transcriptase Polymerase Chain Reaction Tests for COVID - 19 nucleic acid were performed using nasopharyngeal swabs. Patient 1 20 - year - old woman, lives in Wuhan and travels to Anyang on January 10 2020. She initially met with Patients 2 and 3 on January 10. On January 13, she accompanied 5 relatives to visit another hospitalized relative in Anyang District Hospital. There was no report of COVID - 19 at this Hospital. After development of disease in her relatives, patient 1 was isolated and observe. As of February 11, she had no elevated temperature measure or self - reported fever and no gastrointestinal or respiratory symptoms, including cough and sore throat, reported or observed by physicians. Chest CT images on January 27 and 31 show no significant abnormalities. Her C - reactive protein level and lymphocyte count were normal. Results of RT - PCR testing were Negative on January 26, positive on January 28, and Negative on February 5 and 8. Patients 2 through 6 develop COVID - 19. Four were women, and their ages ranged from 42 to 57 years. None of the patients had visited Wuhan or been in contact with any other people who had travel to Wuhan. Patients 2 through 5 developed fever and respiratory symptoms between January 23 and January 26 and were admitted to hospital on the same day. All patients had RT - PCR test results positive for COVID - 19 within 1 day. Patient 6 develops fever and sore throat on January 17 and goes to local clinic for treatment. There was no report of COVID - 19 at the clinic. Her symptoms improved over the next few days but worsened on January 24, when she was admitted to hospital and confirmed to have COVID - 19 on January 26. Two patients developed severe pneumonia; other infections were moderate. All symptomatic patients had multifocal ground - glass opacities on chest CT, and 1 also had subsegmental areas of consolidation and fibrosis. All symptomatic patients had increased C - reactive protein levels and reduced lymphocyte counts. A familial cluster of 5 patients with COVID - 19 pneumonia in Anyang, China, had contact before their Symptom Onset with asymptomatic family member who had travelled from the epidemic Center of Wuhan. The sequence of events suggests that the Coronavirus may have been transmitted by asymptomatic carrier.


Asymptomatic carriers were reported

On 27 and 28 January 2020, Anyang Centre for Disease Control and Prevention Report familial cluster of cases of COVID - 19, which may be caused by asymptomatic carrier in Anyang, Henan province, China. Timeline of onset of symptoms and asymptomatic carrier of SARS - CoV - 2 that causes COVID - 19 patients in familial cluster is shown in Figure 1. On 10 January 2020, index case, who lives in Wuhan, returns to her hometown in Anyang city to celebrate Spring Festival with her family. This familial cluster of six cases was infected with COVID - 19, and only index case had been to Wuhan, and then her family members started to get sick one after another. However, index cases show positive RT - PCR test results but no symptoms and normal chest compute tomography for 19 days before January 29, which is comparatively long but still within the Report maximum incubation period of 24 days. Case 1 is the earliest confirmed case in Anyang city and the only case in a district of the city. Case 1 has neither links to Wuhan nor having any history of contact with confirmed cases in two weeks before onset, only history of close contact with index case, who has become the only evident source of infection. Similarly, other four cases had no epidemiological exposure in the 14 - day period prior to onset, except contact with index case, and case 2 and case 5 are the earliest two cases in district B of the city. Therefore, asymptomatic carrier has a relevant epidemiological history and it may be concluded that there is an asymptomatic spreader of COVID - 19. Bai et al. Report this familial cluster of cases and presume there was transmission of SARS - CoV - 2 by asymptomatic carrier in Anyang on 21 February 2020. Zhang et al. Report familial cluster of five cases that was Infect with COVID - 19 in Beijing on 27 March 2020. Zhang et al. Show that the index patient remained Asymptomatic for 42 Days, which was much longer than Report maximum incubation period. These two family clusters of COVID - 19 cases raise concerns about Asymptomatic carrier transmission.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Virologic Evidence

Currently, SARS - CoV - 2 Infection is primarily diagnosed by detection of viral RNA via reverse transcription PCR or by viral culture and demonstration of cytopathic effect. Although RT - PCR identifies viral RNA and cannot determine whether an infectious virus is present, infectiousness can be inferred from cycle threshold values. The Rt - PCR C T value represents the number of PCR cycles required to detect SARS - CoV - 2 RNA; lower values indicate higher viral load and imply higher infectiousness. Exact RT - PCR C T values associated with the presence of Infectious SARS - CoV - 2 is unknown, but the infectious virus has been isolated from specimens with RT - PCR C T of 34. Four reports document the presence of SARS - CoV - 2 RNA with lower C T values in samples collected from persons in whom symptoms of COVID - 19 never develop. Two reports describe specimens with low RT - PCR C T values among Presymptomatic and Asymptomatic residents of Nursing homes identified as AS as part of the same Outbreak investigation. Among these reports, RT - PCR C T values for SARS - CoV - 2 RNA in asymptomatically infected persons range from 14 to 40. Study with data on Presymptomatic infected Patients Report average RT - PCR C T value of 24. Two reports describe culture of infectious virus from persons with Asymptomatic and Presymptomatic SARS - CoV - 2 Infection. Although these reports do not identify actual virus transmission while presymptomatic or Asymptomatic, low RT - PCR C T values and ability to isolate Infectious SARS - CoV - 2 provide plausible virologic evidence for SARS - CoV - 2 Transmission by persons not demonstrating symptoms.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Sources

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

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