• Published on: Jul 07, 2020
  • 1 minute read
  • By: Dr Rajan Choudhary

Asymptomatic Carriers Of COVID

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Why Asymptomatic carriers of COVID are as dangerous as symptomatic patients

 

Many countries have now begun enforcing masks for everyone to wear when out in public, in enclosed spaces, or on public transport. There is good evidence to support these measures, but unfortunately, some still show resistance to the idea. Whilst some reasons put forward are non-sensical (masks do not cause any noticeable or measurable decrease in oxygen delivery to the body), other people feel like they shouldn’t wear a mask because they do not have symptoms of COVID. And thus would not spread anything. Here we look at a recent publication in Nature, one of the most esteemed peer-reviewed scientific journals in the world, and what it shows us about the transmission of COVID in a population.

This study by Lavezzo et al looked at the suppression of the SARS-CoV-2 outbreak in the Italian municipality of Vo’. This municipality is 50 kilometers west of Venice with a population of just 3,416 people. It experienced its first casualty of COVID on the 21st of February, after which it underwent lockdown for 14 days. During this time data was collected on the clinical presentation and hospitalization of COVID patients, as well as other citizens through the contact tracing network.

In total 2,812 residents were tested in late February, with another 2,343 tests performed two weeks later at the end of lockdown. Nasal and throat swabs were taken to identify infected individuals. The study found only 2.6% of people were positive for COVID at the start of lockdown, which reduced to 1.2% two weeks later.

Out of this infected population, 42.5% were asymptomatic. They had no symptoms at the time of swab testing nor did they develop symptoms afterwards. When the viral load was measured between symptomatic and asymptomatic patients, there was little difference.

Evidence has pointed to a large asymptomatic population, and previous studies have shown it to be as high as 50% in some cases. Many would assume if a patient has no symptoms then they must have fought the infection before it became an issue, or had a very low viral load and therefore were not likely to spread it. This study shows it is simply not true. Asymptomatic carriers of COVID are likely to contribute to the transmission and spread of COVID amongst the population.

If you are asymptomatic you have as high a viral load as someone who is symptomatic. But there is no way to tell without a swab. You have as much of a potential to spread the infection to the vulnerable. Even in people who became symptomatic the height of transmission was found to be before the patient showed any symptoms.

So what does this mean? If you have COVID you are likely to spread it before you show any symptoms or any symptoms at all. We know masks are effective at significantly reducing the spread of COVID, by catching the water droplets that carry the SARS-CoV-2 Virus. Now that shops and public places are re-opening, the risk of spread is high.

Wear a mask. Stop the spread.

https://www.nature.com/articles/s41586-020-2488-1_reference.pdf suppression of a SARS article

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Monkeypox

Monkeypox Virus Symptoms: Early Signs, Disease Progression, and When to Seek Care

Monkeypox, now commonly referred to as mpox, is a viral infection that has gained global attention due to outbreaks beyond traditionally affected regions. Understanding monkeypox virus symptoms is essential for early detection, timely isolation and prevention of further spread.

According to the World Health Organization and Indian public health authorities, awareness of symptom patterns plays a critical role in controlling outbreaks and protecting vulnerable populations.

What Is the Monkeypox Virus?

Monkeypox is caused by the monkeypox virus, a member of the Orthopoxvirus family, which also includes smallpox. While generally less severe than smallpox, monkeypox can still cause significant illness and discomfort.

The virus spreads primarily through close physical contact.

 

Incubation Period of Monkeypox

After exposure, symptoms typically appear within:

  • 5 to 21 days

  • most commonly 6 to 13 days

Individuals may feel well during this period but can become infectious once symptoms begin.

 

Early Monkeypox Virus Symptoms

Fever

Fever is usually the first symptom and may be:

  • sudden in onset

  • moderate to high grade

  • accompanied by chills

Fever signals the start of systemic infection.

 

Headache and Body Aches

Patients often experience:

  • severe headache

  • muscle aches

  • back pain

These symptoms resemble many viral illnesses.

 

Fatigue and Weakness

Marked tiredness and low energy levels are common and may limit daily activities.

 

Swollen Lymph Nodes

Swollen lymph nodes are a distinguishing feature of monkeypox.

Common sites include:

  • neck

  • armpits

  • groin

This helps differentiate monkeypox from chickenpox or smallpox.

Development of Monkeypox Rash

The skin rash usually appears:

  • 1 to 3 days after fever onset

It may begin on the face or genital area and spread to other parts of the body.

 

Stages of Monkeypox Rash

The rash progresses through well-defined stages:

Macules

Flat red spots on the skin.

Papules

Raised, firm bumps.

Vesicles

Fluid-filled blisters.

Pustules

Pus-filled lesions that are painful.

Scabs

Lesions crust over and eventually fall off.

Complete healing occurs once scabs detach.

 

Distribution of Rash

Rash commonly affects:

  • face

  • hands and feet

  • mouth

  • genital and anal areas

The number of lesions can vary widely.

 

Pain and Discomfort

Rash lesions may be:

  • painful

  • itchy during healing

Pain severity differs between individuals.

 

Other Possible Symptoms

Additional symptoms may include:

  • sore throat

  • cough

  • nasal congestion

These reflect upper respiratory involvement.

 

Duration of Illness

Monkeypox symptoms typically last:

  • 2 to 4 weeks

Recovery occurs gradually as lesions heal.

 

Who Is at Higher Risk of Severe Illness?

Higher risk groups include:

  • children

  • pregnant women

  • individuals with weakened immunity

  • people with chronic illness

Early care is crucial in these groups.

 

Complications of Monkeypox

Though uncommon, complications may include:

  • secondary bacterial skin infections

  • dehydration

  • pneumonia

  • eye involvement

Prompt medical guidance reduces risk.

 

How Monkeypox Is Transmitted

Transmission occurs through:

  • direct skin-to-skin contact

  • contact with lesions or bodily fluids

  • respiratory droplets during close contact

  • contaminated clothing or bedding

Understanding transmission helps prevent spread.

 

When to Seek Medical Care

Seek medical evaluation if:

  • fever is followed by rash

  • lymph nodes become swollen

  • rash appears in genital or facial areas

Early diagnosis supports isolation and care.

 

Diagnosis and Testing

Diagnosis may involve:

  • clinical examination

  • laboratory testing of lesion samples

Public health authorities guide testing protocols.

 

Prevention and Control Measures

Preventive steps include:

  • avoiding close contact with infected individuals

  • maintaining good hand hygiene

  • isolating during illness

  • following public health guidance

Vaccination may be recommended for high-risk groups.

 

Role of Public Awareness

Awareness of symptoms:

  • enables early detection

  • reduces stigma

  • supports timely care

WHO emphasises community education in outbreak control.

 

Conclusion

Monkeypox virus symptoms typically begin with fever, body aches and swollen lymph nodes, followed by a characteristic rash that progresses through defined stages. While most cases are self-limiting, early recognition, medical evaluation and isolation are essential to prevent complications and reduce transmission. Staying informed and acting promptly protects both individual and public health.

 

References

  • World Health Organization (WHO) – Mpox (Monkeypox) Clinical and Public Health Guidance

  • Indian Council of Medical Research (ICMR) – Emerging Viral Infections Reports

  • National Centre for Disease Control (NCDC), India – Monkeypox Advisories

  • Lancet – Clinical Features and Outcomes of Mpox

  • NITI Aayog – Public Health Preparedness and Infectious Disease Control

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