Dry Cough in Kids: Causes and Remedies
A New COVID-19 Variant Is Rapidly Spreading Around The Globe, Other Pandemic Threats Exist – What Are The Choices For Treatment?
Colds, flu and RSV aren't the only viral illnesses people have to worry about this winter. A new variant of COVID-19 is rapidly spreading, reminding the world of just how dangerous this virus is. Dubbed JN.1, the omicron variant is highly contagious and accounts for more than 85% of the reported cases nationwide. It is now the dominant strain in the U.S. And around the world and according to the U.S. Centers for Disease Control and Prevention, and it could be "intensifying" the spread of COVID-19. At the same time JN.1 is spreading, COVID hospitalizations are rising, prompting some healthcare facilities to require masks again.
The new variant is also responsible for what is already called the second-largest surge, following the omicron breakout in late 2021 and early 2022. That surge infected more people than at the start of the pandemic in March of 2020. Meanwhile, long COVID-19 is still largely a mystery to doctors and scientists who have seen patients suffer from fatigue and other symptoms that last months after the illness is over.
Many existing viruses continue to make circuits of epidemics around the world.
Disease X On The HorizonIf that isn't bad enough, scientists are warning of another global pandemic that could be 20 times worse than COVID-19. Called Disease X, scientists at the World Health Organization believe the next pandemic could be caused by a new pathogen, not a variant of a current disease. If those predictions prove true, It would have a huge negative impact on healthcare systems and economies around the world since not enough has been done to prepare for future pandemics.
Sure, the World Bank established the Pandemic Fund, which is focused on helping low and middle-income countries strengthen their pandemic preparedness, but it may not be enough. To date, the fund mobilized $2 billion but some estimates call for the need for upwards of $10 billion a year to tackle new outbreaks. The Global Preparedness Monitoring Board (GPMB), an independent body that assesses the world's preparedness for pandemics and other health emergencies, warned that in the wake of COVID-19, the world is woefully unprepared to deal with potential new pandemics.
Limitations Of Vaccines And Antibodies Are Now Well KnownThe COVID-19 pandemic clearly demonstrated the deficiencies of the current way of responding to the pandemic. Vaccines and antibodies, always considered reliable workhorses, can be readily escaped by viruses and become less and less useful if not completely useless.
Nor is the current approach of developing one or more drugs for each potential viral threat a satisfactory one. Firstly, it is very expensive in terms of the costs of drug development and approval, and later on to keep the stockpiles going, and secondly, it requires that the scientists know the causative agent years ahead of the pandemic.
And none of these approaches would work in responding to a Disease X scenario.
A novel approach is clearly needed. One approach that could work is a drug that works against many viruses of different kinds, so even as the virus changes in the field, it will not escape the drug.
Is that even possible?
Think of antibiotics. Before the discovery of penicillin, there were no drugs that could treat the myriads of bacterial infections that were killing people. And the one penicillin works against many of those bacteria. That led to an explosion of developments to find similar drugs and modified penicillins that provided the ability to take the drug by mouth instead of injection, improve their effectiveness, etc. Amoxicillin, discovered in 1958, is even today the most commonly used oral antibiotic for children, over 65 years later! That is the great thing about such super-broad-spectrum drugs.
So, is any company working on such a dream drug for viruses? Or is it just science fiction?
Novel Drug To Fight Many Viruses Is In The WorksIt is science fiction until it becomes reality, right? There is one company that reports it has made great strides and is now very close to the goal of bringing that science fiction to everyday reality.
Imagine the same antiviral drug that works against almost all important respiratory viruses, including the cause of COVID-19, other coronaviruses, RSV and possibly many other respiratory diseases (for example, hMPV – human metapneumovirus – which is closely related to RSV). There is one company that says it has already made it possible. The company we are talking about is NanoViricides, Inc. NNVC. This clinical-stage drug company is developing nanomedicine drugs to fight viruses including COVID-19, RSV and shingles.
NV-CoV-2, its leading drug candidate, is based on the company's nanoviricide active pharmaceutical ingredient NV-387, which the company says blocks the reinfection cycle of the viral disease. It binds to the virus and fuses with the virus surface, uprooting the glycoproteins required for the virus to bind to the human cell – rendering it incapable of infecting a cell. While antibodies can only cover the virus, NV-387 is a chemical nanomachine that completely disrupts the virus. NanoViricides has shown in electron microscopic pictures of viruses that their drugs do indeed disrupt the virus particle. The company likens its drug ingredient to antibiotics in that it can be used to treat a variety of viruses.
NanoViricides has already proven in demanding animal studies that NV-387 is highly effective against coronaviruses, RSV and even Smallpox/Mpox! Thus, the NanoViricides platform technology could be poised to revolutionize the fight against viruses just as antibiotics revolutionized the fight against bacterial infections. And the company is already advancing its first drug through clinical trials toward regulatory approval to make this all real.
No Adverse Effects In Phase 1 TrialTowards that end, the company just completed phase 1 human clinical trials in healthy subjects, using two oral formulations: NV-CoV-2 Oral Syrup and NV-CoV-2 Oral gummies in India. Both include its nanoviricide active agent NV-387. Karveer Meditech Pvt. Ltd., the company's licensee and collaborator, is the drug sponsor in India and has the rights to develop and commercialize the drugs in India.
All 36 healthy human subjects have completed the clinical trial. This included single dosing studies, which were completed around the end of November, and now multiple dosing studies, which the company said were completed just recently. No adverse events or serious adverse events were reported during the entire phase 1 trial in healthy subjects, which indicates that both of the formulations are safe in humans. These results are consistent with the company's preclinical safety/toxicology animal studies that indicated the drug NV-387 is very safe.
There are currently very few, if any safe drugs in the antiviral space. Almost all antiviral drugs have limitations due to dose-limiting toxicities or side effects. This includes the remaining approved COVID-19 drugs, namely Paxlovid® by Pfizer PFE and Remdesivir, Veklury® by Gilead GILD. As such, the safety demonstrated by NV-387 is noteworthy.
The JN.1 COVID-19 variant rapidly spreading around the world is a wake-up call. This virus isn't going away, and the potential for even more dangerous ones is ever-present. The world isn't prepared, but NanoViricides wants to change that. It is working hard to develop a new class of drugs that can not only fight COVID-19 and other viral illnesses but prevent them from spreading.
With the completion of the phase 1 clinical trial that demonstrated safety and tolerability in human subjects, NanoViricides is now one step closer to realizing a dream drug that works against many different viruses.
Featured photo by CDC on Unsplash.
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Virus Soup: Many Respiratory Viruses Peaking In Early 2024
Jan. 19, 2024 – The familiar symptoms are back again – a runny nose, coughing, aches, congestion, and maybe a fever. When the at-home COVID-19 test comes back negative, you head to the doctor to see if they can figure out what you've caught. At the doctor, though, the typical COVID and flu tests also come back negative. It could seem like a new mysterious respiratory illness is making the rounds.
Instead, several typical respiratory viruses seem to be peaking at once. Doctors are reporting high levels of COVID, the flu, and respiratory syncytial virus (RSV), as well as other "flu-like illnesses" that cause similar symptoms, such as the common cold, other coronaviruses, and parainfluenza viruses (which cause typical respiratory symptoms such as a fever, runny nose, coughing, sneezing, and a sore throat).
"Respiratory viruses are still very high right now, as you would expect at this time of year," said Brianne Barker, PhD, who researches viruses and the body's immune response as an associate professor of biology at Drew University in New Jersey. "Also, a fair number of patients seem to have multiple infections at once, such as flu and strep, which may cause confusion when patients consider their symptoms."
So, what should you do? Wear a mask in public if you think you have symptoms, Barker said. Stay home if you feel sick, particularly if you have a fever over 100.4 F and signs of contagiousness, such as chills and muscle aches. Antiviral medications – such as Tamiflu for the flu and Paxlovid for COVID – may help if you catch it soon enough, but otherwise, it's most important to stay hydrated and rest at home.
"The big picture is we're in the heat of respiratory virus season, and the big player at the hospital right now is the flu, which seems to be superseding everything else," said Dhaval Desai, MD, director of hospital medicine at Emory Saint Joseph's Hospital in Atlanta. "I'm not sure if certain viruses are more aggressive or different this year, so it's hard to say exactly what's going on, but we've certainly seen an uptick since mid-December, and it hasn't stopped."
What Are the Latest Trends?
The current COVID-19 surge appears to be at the highest point since the Omicron variant infected millions in December 2022, according to the CDC's COVID wastewater data. Test positivity appears to be stabilizing after increasing since November, the CDC's COVID Data Tracker shows, though the rate was still high at 12.7% positivity during the first week of January.
At that time, COVID-19 emergency department visits began declining, though hospitalizations were still on the rise and deaths were up 14.3% from the previous week. As of Jan. 6, the JN.1 variant is driving most of the spread, accounting for 61.6% of COVID-19 cases in the U.S., according to CDC variant data.
"COVID doesn't seem as bad right now as in the days of Omicron, but the problem is that it's tough to compare because COVID cases aren't reported in the same way as before, and we don't have that state data," said Bernard Camins, MD, an infectious disease specialist and medical director of infection prevention at Mount Sinai Health System in New York City.
The good news, he said, is that hospitalization rates are lower than last year, considering the number of people getting infected, "so there's some immunity to it now."
"The other good news is we have treatments for COVID, such as Paxlovid, that most people can take as long as they talk to their doctor as soon as possible after they get infected."
Influenza rates, which dropped during the height of the COVID pandemic, appear to be back at typical levels, Camins said. This flu season started earlier than usual in 2023 and will likely peak in the next few weeks. The CDC's FluView shows that test positivity – now at 14% – is increasing, and hospitalizations and deaths are trending upward as well.
Similarly, the CDC's national trends data for RSV shows that cases rose as high as last year's peak in recent weeks but appear to be declining now, especially in the Northeast and South.
Other viruses are circulating as well, such as adenovirus, which can cause a cold, sore throat, diarrhea, pinkeye, and other symptoms. Parainfluenza viruses peaked in late November and saw another jump at the end of December. Rhinoviruses, which cause the common cold, also returned to normal peak levels alongside the flu this season, Camins said.
"I haven't gotten sick since 2021 and recently got rhinovirus, and it went through my household. The symptoms weren't severe, but I still have a lingering cough," he said. "The trick is that people weren't getting exposed in previous years due to masking and other precautions, but now people are getting exposed to many of these viruses."
What Should We Expect Next?
Peak respiratory virus season will likely continue throughout January and February and then begin to fade as the weather warms up, allowing for outdoor activities, better ventilation, and higher humidity.
"One of the reasons why we see so many infections at this time of year is related to humidity, when the respiratory droplets containing these viruses stay in the air longer and the immune response in our nose actually works less well in dry air," Barker said. "Evidence indicates that having increases in humidity can help get rid of some of the viruses in the air and help our immune response."
In the meantime, Barker suggests taking precautions, stocking up on at-home tests, and staying home when you're sick. She recently recovered from an upper respiratory infection and has decided to wear a mask in public places again. She tested negative on every possible test at her doctor's office and doesn't want to repeat the experience.
"It reminded me how much I don't enjoy having an infection," she said. "I'm willing to wear a mask at the grocery store if I don't have to go through that again. I'm taking care of myself and others."
In addition, don't hesitate to get tested, Desai said, especially if an antiviral could help. After getting a respiratory virus in November, he had a high fever and sweating and decided to go to his doctor. He tested positive for influenza A, or H1N1, which the CDC's FluView says was the most frequently reported flu strain at the end of December.
"It kicked me harder than other illnesses in recent years, but I did take antivirals, and it was out the door in about 4 days," he said. "My mom, who is immunocompromised and in her 70s, also got it but took an antiviral even sooner and got over it in about 24-36 hours."
For the next couple of months, it's also not too late to get vaccinated against the most prevalent viruses, especially COVID, the flu, and RSV. The most vulnerable groups, such as young children and older adults, could especially benefit from vaccination, Camins said.
"With RSV, for instance, there are vaccines for pregnant women to protect their infants," he said. "And although we don't have great data to say whether the current COVID vaccine is protective against infection, we know it still protects against severe disease and death."
As 2024 continues, experts said they're looking forward to more effective at-home tests for COVID and the flu, better flu vaccines, and new research on the body's immune response to these respiratory viruses.
"Disease prevention is key, irrespective of what's surging and what we're dealing with right now," Desai said. "Think about your risk factors and what you're doing overall this year for your health and wellness – whether routine physical exams or cancer screenings, based on your age. There's power in staying healthy and advocating for ourselves when we're feeling well."
What To Know About Post-viral Syndrome
Post-viral syndrome refers to a sense of tiredness and weakness that lingers after a person has recovered from a viral infection, such as the flu. Doctors may also refer to post-viral syndrome as "post-viral fatigue."
People may experience post-viral symptoms, such as fatigue, for weeks or months after an infection. Some treatments and home remedies may relieve fatigue and help people manage their energy levels.
Post-viral syndrome may appear similar to other health issues, but it is important to work with a doctor to resolve it if the symptoms last too long.
This article provides an overview of post-viral syndrome, including its causes and symptoms. It also explains how to treat it and when to contact a doctor.
As the name suggests, post-viral syndrome typically occurs after a person experiences the effects of a virus. It can develop even after seemingly simple bouts of the flu or the common cold.
Once the person's body has removed the virus, post-viral syndrome may make them feel drained of energy and generally unwell. This feeling may linger for days to months after a viral infection.
The trigger for post-viral syndrome appears to be a reaction to the virus itself. Many doctors will treat post-viral syndrome in the same way as they treat chronic fatigue syndrome (CFS), as the two can have a similar presentation.
However, while CFS causes symptoms for no apparent reason, the symptoms of post-viral syndrome appear to have their origins in the infection.
The medical community is not sure why the symptoms arise. Some experts believe it may be due to the lingering effects of the virus as the body continues to clear it out.
A 2018 study notes that another theory is the virus overloads the immune system, causing a reaction that triggers symptoms similar to those of CFS.
The authors of an earlier study suggest that the symptom of fatigue after a viral infection is due to inflammation in the brain.
Viruses cause the immune system to respond and attack them. This response causes stress and inflammation in the body. The effects of this response often leave people feeling down, fatigued, and sometimes depressed.
Almost any viral infection can trigger post-viral syndrome, including:
Post-viral syndrome may be more prevalent or apparent in people with weakened immune systems.
The symptoms of post-viral syndrome may vary from person to person, but most people describe feeling fatigued and generally unwell. This feeling persists no matter how many hours of sleep the person gets or how well they take care of themselves.
Post-viral syndrome may cause additional symptoms, such as:
In some cases, it may be that the body is simply taking extra time to clear the virus completely. However, if symptoms such as these linger for longer than a few weeks, a person should talk with a doctor.
As members of the medical community have different opinions on post-viral fatigue, it can be difficult for them to agree on how to treat it, and recommendations will differ.
In some cases, the person will require no treatment, and managing the symptoms until they feel better will be enough.
To this end, doctors may recommend taking vitamins, eating a nutritious diet and keeping with other healthy lifestyle practices along with some simple symptom management tools, such as over-the-counter pain relievers to treat headaches or other general aches and pains.
Some lifestyle tips may help support the body as it works through post-viral syndrome and may help reduce recovery time. These include:
Some people may also feel more rested after trying stress reduction techniques.
The American Myalgic Encephalomyelitis and Chronic Fatigue Syndrome Society notes that almost 50% of people with myalgic encephalomyelitis (ME) and CFS — both of which can cause symptoms similar to those of post-viral syndrome — use alternative therapies, such as meditation, yoga, and acupuncture, to help them cope.
Getting a massage may also help some people relax and deal with muscle pain.
The recovery time for people with post-viral syndrome can vary widely. A 2017 study noted that recovery time appears to be better the more quickly a person receives their diagnosis.
Post-viral syndrome is temporary. Although the effects may linger, many people can expect their symptoms to resolve within a few weeks.
In some cases, symptoms may last for longer, even up to several months.
A smaller, older study reported that 31% of people experienced prolonged fatigue of longer than 6 months following treatment for West Nile virus. The average duration of this symptom among these individuals was 5 years.
After a time, doctors may diagnose a person with a separate disorder, such as CFS. They will then order any necessary treatments and possibly give the individual some additional tips on how to manage their symptoms.
Recovering from a viral infection can drain the body. Yet, even after the body clears the virus, the symptoms, including fatigue, may linger.
The medical community is not sure exactly what causes post-viral syndrome. Some people believe it is a condition in its own right, whereas others think the virus may have triggered another condition, such as CFS or depression.
Some people with post-viral syndrome — often those who receive an early diagnosis — may get better in a few weeks. However, some cases may last a few months, and doctors may offer other treatment options for people who experience symptoms for a longer period.
Anyone experiencing symptoms for more than a few weeks after recovering from the virus should contact a doctor for a diagnosis.
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