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Subway Monkeypox case "really concerning"

A photo of a man who very clearly had Monkeypox and is standing in close proximity to others has gone viral. The image was shared to <a href="https://mobile.twitter.com/arturohenriques/status/1553322937402507264" target="_blank" rel="noopener">Twitter</a> by a Spanish doctor Arturo Henriques who “cautiously” approached the man and questioned why he was not isolating if he had Monkeypox. He said the man was only told to wear a mask by his doctor and nothing else to which Dr Henriques tried to explain that lesions on the body were most contagious. Dr Henriques then asked a nearby passenger if she was worried about catching Monkeypox which she laughed off saying she wasn’t gay and straight people don’t need to be concerned. This prompted a response from Paul Griffin, Director of Infectious Diseases at Mater Health Services, Associate Professor of Medicine at the University of Queensland. Professor Griffin said it was “really concerning” to see people not taking the disease seriously and need to isolate if they have it. "It's really disappointing, isn't it? I mean, it's actually really concerning," he told <a href="https://au.news.yahoo.com/disturbing-monkeypox-photo-train-warning-virus-myth-005219552.html" target="_blank" rel="noopener">Yahoo News Australia</a>. "But if people don't take that seriously and don't isolate themselves, well, that can certainly facilitate the spread and make something that we should be able to control much more challenging. "While it's really important, we identify who is at greatest risk and we try and modify that risk by approaching those groups and giving them the right advice, we need to be really careful that we don't be discriminatory or stigmatising.” Monkeypox spreads through close skin-to-skin physical contact with someone who has symptoms, such as when you are having sex, or by direct contact with contaminated objects, such as bedding, towels or clothes. Many of the cases are in men who have sex with men and have been acquired overseas. Some of the symptoms include: rashes, lesions or sores, particularly in areas that are hard to see such as the genitals, anus or anal area or on the face, arms and legs, ulcers, lesions or sores in the mouth, fever, headache, muscle aches, backache, swollen lymph nodes, chills and/or exhaustion. Image: Twitter

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How contagious is the Wuhan coronavirus and can you spread it before symptoms start?

Cases of the Wuhan coronavirus have increased dramatically over the past week, prompting concerns about how contagious the virus is and how it spreads. According to the <a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports">World Health Organisation</a>, 16-21% of people with the virus in China became severely ill and 2-3% of those infected have died. A key factor that influences transmission is whether the virus can spread in the absence of symptoms – either during the incubation period (the days before people become visibly ill) or in people who never get sick. On Sunday, <a href="https://www.bbc.com/news/world-asia-china-51254523">Chinese officials said</a> transmission had occurred during the incubation period. So what does the evidence tell us so far? Can you transmit it before you get symptoms? Influenza is the <a href="https://www.infectiousdiseaseadvisor.com/home/topics/respiratory/influenza/transfluas-study-asymptomatic-influenza-transmission-in-acute-health-care/">classic example</a> of a virus that can spread when people have no symptoms at all. In contrast, people with <a href="https://www.nhs.uk/conditions/sars/">SARS</a> (severe acute respiratory syndrome) only spread the virus when they had symptoms. No published scientific data are available to support China’s claim transmission of the Wuhan coronavirus occurred during the incubation period. However, <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30154-9/fulltext">one study published in the Lancet medical journal showed</a> children may be shedding (or transmitting) the virus while asymptomatic. The researchers found one child in an infected family had no symptoms but a chest CT scan revealed he had pneumonia and his test for the virus came back positive. This is different to transmission in the incubation period, as the child never got ill, but it suggests it’s possible for children and young people to be infectious without having any symptoms. This is a concern because if someone gets sick, you want to be able to identify them and track their contacts. If someone transmits the virus but never gets sick, they may not be on the radar at all. It also makes airport screening less useful because people who are infectious but don’t have symptoms would not be detected. How infectious is it? The Wuhan coronavirus epidemic began when people exposed to an <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext">unknown source at a seafood market</a> in Wuhan began falling ill in early December. Cases remained below 50 to 60 in total until around January 20, when numbers surged. There have now been <a href="https://flutrackers.com/forum/forum/-2019-ncov-new-coronavirus/823378-2019-ncov-confirmed-case-list-by-country-w-links-to-sources-total-cases-4-576-total-deaths-106-as-of-9-40-et-january-27-2020-disclaimer-we-do-not-endorse-any-of-these-numbers">more than 4,500 cases – mostly in China – and 106 deaths</a>. Researchers and public health officials determine how contagious a virus is by calculating a reproduction number, or R0. The R0 is the average number of other people that one infected person will infect, in a completely non-immune population. Different experts have <a href="https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/news--wuhan-coronavirus/">estimated</a> the R0 of the Wuhan coronavirus is anywhere from 1.4 to over five, however the <a href="https://www.bmj.com/content/bmj/368/bmj.m308.full.pdf">World Health Organisation believes</a> the RO is between 1.4 and 2.5. If the R0 was higher than 2-3, we should have seen more cases globally by mid January, given Wuhan is a travel and trade hub of 11 million people. How is it transmitted? Of the person-to-person modes of transmission, we fear respiratory transmission the most, because infections spread most rapidly this way. Two kinds of respiratory transmission are through large droplets, which is thought to be short-range, and airborne transmission on much smaller particles over longer distances. Airborne transmission is the most difficult to control. SARS was considered to be transmitted by contact and over short distances by droplets but can also be transmitted through smaller aerosols over long distances. In Hong Kong, <a href="https://academic.oup.com/cid/article/58/5/683/365793">infection was transmitted</a> from one floor of a building to the next. Initially, most cases of the Wuhan coronavirus were assumed to be from an animal source, localised to the seafood market in Wuhan. We <a href="https://jglobalbiosecurity.com/articles/51/">now know</a> it can spread from person to person in some cases. The Chinese government announced it can be spread by touching and contact. We don’t know how much transmission is person to person, but we have some clues. Coronaviruses are respiratory viruses, so they can be found in the nose, throat and lungs. The amount of Wuhan coronavirus appears to be <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext">higher in the lungs</a> than in the nose or throat. If the virus in the lungs is expelled, it could possibly be spread via fine, airborne particles, which are inhaled into the lungs of the recipient. How did the virus spread so rapidly? The continuing surge of cases in China since January 18 – despite the lockdowns, extended holidays, travel bans and banning of the wildlife trade – could be explained by several factors, or a combination of: <ol> <li> increased travel for New Year, resulting in the spread of cases around China and globally. Travel is a major factor in the spread of infections </li> <li> asymptomatic transmissions through children and young people. Such transmissions would not be detected by contact tracing because health authorities can only identify contacts of people who are visibly ill </li> <li> increased detection, testing and reporting of cases. There has been increased capacity for this by doctors and nurses coming in from all over China to help with the response in Wuhan </li> <li> substantial person-to-person transmission </li> <li> continued environmental or animal exposure to a source of infection. </li> </ol> However, with an incubation period as short as <a href="https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200127-sitrep-7-2019--ncov.pdf?sfvrsn=98ef79f5_2">one to two days</a>, if the Wuhan coronavirus was highly contagious, we would expect to already have seen widespread transmission or outbreaks in other countries. Rather, the increase in transmission is likely due to a combination of the factors above, to different degrees. The situation is changing daily, and we need to analyse the transmission data as it becomes available.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/130686/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/c-raina-macintyre-101935">C Raina MacIntyre</a>, Professor of Global Biosecurity, NHMRC Principal Research Fellow, Head, Biosecurity Program, Kirby Institute, <a href="https://theconversation.com/institutions/unsw-1414">UNSW</a> This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-contagious-is-the-wuhan-coronavirus-and-can-you-spread-it-before-symptoms-start-130686">original article</a>.

Travel Trouble

Why coronavirus may be more contagious than initially thought

The new coronavirus has now reached 13 countries, with the outbreak “spreading quicker than SARS”. More than 3,000 cases and 82 deaths have been reported globally. <a href="https://www.sbs.com.au/news/fifth-australian-coronavirus-case-confirmed-as-21-year-old-unsw-student">Five people in Australia</a> have been confirmed to have contracted the 2019-nCoV virus. Experts from the Chinese University of Hong Kong suggest the outbreak, which began in China’s Hubei province, could be more contagious than originally thought. In <a href="https://www.biorxiv.org/content/10.1101/2020.01.23.916395v1.abstract?%3Fcollection=">a study</a> based on data collected between January 10 and 21, Shi Zhao and colleagues found that each infected person could pass the virus to three to five other people. According to Robin Thompson, mathematical epidemiologist at University of Oxford, the virus may be more potent than expected. “If the virus is able to spread before symptoms show, that could certainly explain why the virus is spreading quicker that SARS,” Thompson told <a href="https://www.newscientist.com/article/2231453-new-coronavirus-may-be-much-more-contagious-than-initially-thought/">New Scientist</a>. SARS, or severe acute respiratory syndrome, infected more than 8,000 people across 37 countries in 2003. Both viruses came from the same family and could cause pneumonia. “SARS took several months to cause a thousand cases,” said Thompson. “This has caused [almost] 3000 cases in three weeks.” The World Health Organization (WHO) recommended the general public to <a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public">protect themselves against the disease</a> by frequently cleaning hands, practicing food safety, and avoiding close contact with anyone with cold or flu-like symptoms. Australia’s chief medical officer Professor Brendon Murphy told the <a href="https://www.abc.net.au/news/2020-01-27/coronavirus-schools-urge-students-to-be-checked/11902702">ABC</a> over the weekend the general public should not panic. “There is no risk to Australian population other than people with that travel history or who have been in contact with those people,” he said. Dr Michael Mina, an epidemiology researcher at Harvard’s T.H. Chan School of Public Health told <a href="https://www.latimes.com/science/story/2020-01-24/china-coronavirus-panic">Los Angeles Times</a> evidence has yet to suggest that coronavirus is “more virulent” than the common flu. “Most people, with proper medical attention, will do just fine.”

Travel Trouble

Why loneliness is contagious

Loneliness is a <a href="https://tinkering.exploratorium.edu/sites/default/files/pdfs/Science-2011-Miller-138-401.pdf">common condition affecting around one in three adults</a>. It damages your brain, immune system, and can lead to depression and suicide. Loneliness can also increase your risk of dying prematurely as much as smoking can – and even more so than obesity. If you feel lonely, you tend to feel more stressed in situations that others cope better in, and even though you might get sufficient sleep, you don’t feel rested during the day. Loneliness has also increased <a href="http://science.sciencemag.org/content/331/6014/138.full?sid=6039e2dc-1bcf-4622-ae54-1e5b2816a98d">over the past few decades</a>. Compared to the 1980s, the number of people living alone in the US has increased by about one-third. When Americans were asked about the number of people that they can confide in, the number dropped from three in 1985 to two in 2004. In the UK, 21 to 31 per cent of people report that they feel lonely some of the time, and surveys in other parts of the world report <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4391342/">similarly high estimates</a>. And it’s not just adults who feel lonely. Over a tenth of kindergarteners and first graders report feeling lonely in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865701/">school environment</a>. So many people feel lonely these days. But loneliness is a tricky condition, because it doesn’t necessarily refer to the number of people you talk to or the number of acquaintances you have. You can have many people around you and still feel lonely. As the comedian <a href="https://www.imdb.com/title/tt1262981/quotes">Robin Williams</a> put it in the film World’s Greatest Dad: <blockquote> I used to think the worst thing in life was to end up all alone. It’s not. The worst thing in life is to end up with people who make you feel all alone. </blockquote> What is loneliness? Loneliness refers to the discrepancy between the number and quality of the relationships that you desire and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4391342/">those you actually have</a>. You can have only two friends, but if you get along really well with them and feel that they meet your needs, you’re not lonely. Or you can be in a crowd and feel all alone. But loneliness is not just about how you feel. Being in this state can make you <a href="https://tinkering.exploratorium.edu/sites/default/files/pdfs/Science-2011-Miller-138-401.pdf">behave differently</a>, too, because you have less control over yourself – for example, you’re more likely to eat that chocolate cake for lunch instead of a meal or order take-out for dinner and you will also feel less motivated to exercise, which is important for mental and physical health. You’re also more likely to act aggressively towards others. Sometimes people think that the only way out of loneliness is to simply talk to a few more people. But while that can help, loneliness is less about the number of contacts that you make and more about how you see the world. When you become lonely, you start to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874845/">act and see the world differently</a>. You begin noticing the threats in your environment more readily, you expect to be rejected more often, and become more judgemental of the people you interact with. People that you talk to can feel this, and as a result, start moving away from you, which perpetuates your loneliness cycle. <a href="https://tinkering.exploratorium.edu/sites/default/files/pdfs/Science-2011-Miller-138-401.pdf">Studies have shown</a> that (non-lonely) people who hang out with lonely people are more likely to become lonely themselves. So loneliness is contagious, just as happiness is – when you hang out with happy people, you are more likely to become happy. There is also a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865701/">loneliness gene</a> that can be passed down and, while inheriting this gene doesn’t mean you will end up alone, it does affect how distressed you feel from social disconnection. If you have this gene, you are more likely to feel the pain of not having the kinds of relationships that you want. It’s particularly <a href="http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0190033&type=printable">bad news for men</a>. Loneliness more often results in death for men than for women. Lonely men are also less resilient and tend to be more depressed than lonely women. This is because men are typically discouraged from expressing their emotions in society and if they do they are judged harshly for it. As such, they might not even admit it to themselves that they’re feeling lonely and tend to wait a long time before seeking help. This can have serious consequences for their mental health. How to escape it To overcome loneliness and improve our mental health, there are certain things we can do. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874845/">Research has looked</a> at the different ways of combating this condition, such as increasing the number of people you talk to, improving your social skills, and learning how to compliment others. But it seems the number one thing is to change your perceptions of the world around you. It’s realising that sometimes people aren’t able to meet up with you, not because there is something inherently wrong with you, but because of other things going on in their lives. Maybe the person that you wanted to have dinner with wasn’t able to accept your invitation because it was too short notice for them and they had already promised someone else they would have drinks. People who aren’t lonely realise this and, as a consequence, don’t get down or start beating themselves up when someone says no to their invitations. When you don’t attribute “failures” to yourself, but rather to circumstances, you become much more resilient in life and can keep going. Getting rid of loneliness is also about letting go of cynicism and mistrust of others. So next time you meet someone new, try to lose that protective shield and really allow them in, even though you don’t know what the outcome will be.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/94376/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> Written by Olivia Remes, PhD Candidate, University of Cambridge. Republished with permission of <a rel="noopener" href="https://theconversation.com/loneliness-is-contagious-and-heres-how-to-beat-it-94376" target="_blank">The Conversation</a>.

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Subway Monkeypox case "really concerning"

How contagious is the Wuhan coronavirus and can you spread it before symptoms start?

Why coronavirus may be more contagious than initially thought

Why loneliness is contagious