Covid flu and other common viruses work in unfamiliar ways

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One month ago, the children were admitted to Yale New Haven Children’s Hospital with an astonishing range of seven respiratory viruses. They had adenovirus and rhinovirus, respiratory syncytial virus and human metapneumovirus, influenza and parainfluenza, as well as coronavirus – many experts blame for the abnormal uprising.

Thomas Murray, an infection control expert and associate professor of pediatrics at Yale, said: “It’s not typical for any time of the year and it’s not typical for May and June.” Some of the children admitted to the hospital were infected with two or three viruses, he said.

more than Two years after the coronavirus pandemic, familiar viruses are operating in unfamiliar ways. The respiratory syncytial virus, called RSV, usually restricts suffocation attacks during the winter months.

The rhinovirus, which causes the flu, rarely sends people to the hospital.

The flu, which appeared to be recurring in December, disappeared last year and disappeared again in January after the omicron version of the coronavirus intensified. Now the flow is back, but there is a common breed called Yamagata that has not been observed since the beginning of 2020. It could be extinct or it could be waiting for a dangerous attack on our immune system, researchers say.

Monitoring of coronavirus cases

The chaos is felt in hospitals and laboratories. Doctors are reconsidering routine routines, including spring and summer vaccinations. Researchers have rare possibilities, such as whether behavioral changes, such as staying at home, wearing a mask, and social distance, are responsible for the spread of the virus, and what evolutionary advantages SARS CoV-2 may have over its microscopic competitors.

“It’s a massive natural experiment,” said Michael Mina, an epidemiologist and senior researcher at the eMed digital health platform. According to me, the change in seasonality is mainly due to the fact that we are close to common viruses, which makes us vulnerable to their return.

For decades, doctors across hospitals across the country have been adjusting protocols that reflect the approximate cycle of illnesses that come and go when they are closed or when the weather changes.

“What time of year is it?” do you think ”said Peter Hotes, a molecular virologist and dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston.

Theresa Barton, head of the Department of Pediatric Infectious Diseases at the University of San Antonio, has been supporting the flu vaccine every fall for many years and has been easing her campaign in March and April when the flu has subsided. A new shift in the season has led to an increase in the number of flu cases last summer and then this spring.

“You said, ‘O man!’ in clinics. “Let’s get the flu vaccine,” Barton said.

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According to the Centers for Disease Control and Prevention, he and other infectious disease experts are reviewing the RSV’s response to the common virus, which hospitalizes about 60,000 children under the age of five each year. It can cause a lung infection that can lead to death in premature babies and other high-risk babies. A typical treatment for them is a monthly shot of monoclonal antibodies, palivvisumab, from November to February. However, RSV suddenly appeared last summer and is causing problems in May and June this year. Infectious disease experts are carefully monitoring the cases to be ready to revive the costly protocol.

“We control the number of cases, and if it exceeds the number, we are ready,” Murray said. Yale Hospital typically holds meetings from fall to spring to prepare for the uprising, preparing staff tired of the pandemic for off-season waves.

Richard Martinello, a respiratory virus specialist at Yale School of Medicine, says that even the common cold looks a little more dangerous and tolerable.

“When people catch a cold, they seem to get a little worse,” he said, noting that the evidence so far is mostly anecdotal.

The changes – and how and when they may return to normal – reflect changes in our behavior during a pandemic, as well as interactions between SARS CoV-2 and other viruses known as viral interference.

We have evolved with pathogenic microorganisms, and our regular contact with them usually allows our immune systems to respond without causing severe pain.

The system’s memory is “enough to make it look like a good heart lifter rather than a bad infection,” Mina said.

As in a pandemic, when you stop seeing the virus in this normal cadence, this natural balance is disturbed, Mina said. The special measures we have taken to limit the effects of the coronavirus — the steps needed to contain a new deadly enemy — have also limited the exposure to other viruses. If you are exposed to the virus again after a very long time, you will not be able to protect yourself, which will lead to off-season growth in the population and surprising viral infections for individuals.

According to Mina and others, this was when people took off their masks and gathered at home. The viruses began to spread off-season because the population’s immunity was low, although other conditions were not optimal for them.

“All of these decisions have consequences,” Murray said. “You do everything you can with the information you have.”

The same process of immune memory is well documented with other phenomena, Mina says, for example, people between the ages of 35 and 40 have cancer, which usually affects the elderly or people with weakened immune systems.

Prior to the advent of smallpox vaccines, people were exposed to a number of natural lifelong events that usually infected them as children and then re-boosted their immunity when they came in contact with infected friends, then their own children and friends of their children.

Now that those children are protected, they are not helping their parents naturally, making these adults once again vulnerable to the tumor-type virus.

This phenomenon is short-lived, young people protected by the smallpox vaccine and there is no risk of developing cancer.

While vaccines are disrupting the viral landscape by limiting the spread of infections, a completely new virus during the pandemic – SARS Cov-2 – is doing so by interacting with its competitors.

For example, it is unclear whether the decline in the number of flu cases in January was entirely due to human withdrawal, or whether the coronavirus pushed its widespread rival through another mechanism.

Xiaoyang Song, chief infectious disease specialist at the district’s National Children’s Hospital, said: “It’s a great question whether Micron took him out.” Kovid’s role in getting Yamagata out of the game is even more mysterious. When the flu returned this spring, the offspring were nowhere to be found.

Ellen Foxman, an immunobiologist at Yale School of Medicine, has been studying the interaction of viruses for many years and which genetic and environmental factors can cause one person to catch a cold and another to become seriously ill.

This high-tech enterprise, using cells from the nose and lungs, grows the tissue of the human respiratory tract in the laboratory before infecting it with viruses as well as environmental pollutants such as tobacco smoke.

Examination of the inner lining of the nasal passages has helped to understand what is called innate immunity. Once these cells detect the virus, they block other viruses and activate antivirus protection. This process will help explain why the long-awaited twinemia of coronavirus and other viruses, which was hampered by remote work and masks in the winter of 2020-2021, did not occur last winter, despite some infections.

A group of babies born in the last two years provides a lot of information. The virus usually appears in the nose of a child under 5 years of age at 26 to 50 weeks of age. Serious RSV and rhinovirus Infections in those early years were later associated with the development of asthma.

“Those children did not have an infection at a crucial time in their lung development,” Foxman said, making them the key to understanding the link between viral infection and asthma.

Still, it is uncertain what the future holds for us.

“It will take time, even years, to see what the new balance will look like,” Martinello said.

In my opinion, the coronavirus, like other respiratory viruses, is a pattern of seasonal circulation once the population is immune, reducing what is known as the “strength of infection”.

“The more people who are not immune, the less time it has. It’s like free governance, ”Mina said. The virus can “overcome seasonal barriers.”

According to Barton, these changes will be influenced by other environmental factors, as climate change will change the seasonal weather.

Despite this ongoing uncertainty, for many researchers, the unrest caused by the pandemic has strengthened certain strategies to prevent infection.

Scott Hensley, a microbiologist at the University of Pennsylvania’s Perelman School of Medicine, doesn’t believe the Yamagata flu is completely gone. He said he could still turn around and be unnoticed and at a very low level, ready to return to the stage. However, there is a tried and true way to protect ourselves – through vaccination.

“Even in years when vaccines don’t match, there is some level of protection,” Hensley said, “preventing hospitalizations and deaths.”

For laboratory scientist Foxman, the silver lining of the pandemic was the way science developed.

Although he continues to invest in high-tech experiments in his lab, Foxman says the biggest lesson the pandemic has taught him to stop the spread of viral infections stems from simple behavioral changes such as wearing a mask, which he says should continue strategically. circumstances.

“We need to move the lessons we’ve learned forward,” Foxman said.

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