Infectious disease of the Mouth

8/14/2019 Infectious disease of the Mouth

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Infectious DiseasesOf the Oral Cavity,Respiratory Systemand GastroIntestinal(GI) Tract

Infectious diseases are caused by entry into thebody of infectious agents commonly called germs.

Alain Jon Candido


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2 |I n f e c t i o u s D i s e a s e o f t h e M o u t h

Common coldFrom Wikipedia, the free encyclopedia

Acute viral nasopharyngitis, oracute coryza, usually known as the common cold, is a highly

contagious,viralinfectious disease of the upperrespiratory system, primarily caused bypicornaviruses(including rhinoviruses) orcoronaviruses.

Common symptoms are sore throat,runny nose,nasal congestion, sneezing and cough; sometimesaccompanied by 'pink eye',muscle aches, fatigue,malaise, headaches, muscle weakness, and/orloss ofappetite.Feverand extreme exhaustion are more usual in influenza. The symptoms of a cold usuallyresolve after about one week, but can last up to two. Symptoms may be more severe in infants andyoung children. Although the disease is generally mild and self-limiting, patients with common coldsoften seek professional medical help, use over-the-counter drugs, and may miss school or work days.The annual cumulative societal cost of the common cold in developed countries is considerable interms of money spent on remedies, and hours of work lost.

The primary method to prevent infection is hand-washing to minimize person-to-person transmissionof the virus. There are no antiviral drugs approved to treat or cure the infection. Most availablemedications arepalliative and treat symptoms only.Megadoses of vitamin C, preparations fromechinacea, and zinc gluconate have been studied as treatments for the common cold although none hasbeen approved by theFood and Drug AdministrationorEuropean Medicines Agency.

Pathology

Epidemiology

Upper respiratory tract infections are the most common infectious diseases among adults and teens,who have two to four respiratory infections annually. Children may have six to ten colds a year (and upto 12 colds a year for school children). In the United States, the incidence of colds is higher in the fall

and winter, with most infections occurring between September and April. The seasonality may be dueto the start of the school year, or due to people spending more time indoors (thus in closer proximitywith each other) increasing the chance of transmission of the virus.

Virus

Common colds are most often caused by infection by one of the more than 100 serotypesofrhinovirus,a type ofpicornavirus. Other viruses causing colds arecoronavirus,human parainfluenza viruses,human respiratory syncytial virus,adenoviruses,enteroviruses, ormetapneumovirus. Due to the manydifferent types of viruses, it is not possible to gain complete immunity to the common cold.

Transmission

The common cold virus is transmitted between people by one of two mechanisms:

in aerosol form generated by coughing, sneezing.

from contact with the saliva or nasal secretions of an infected person, either directly or from

contaminated surfaces.

Symptoms are not necessary for viral shedding or transmission, as a percentage of asymptomaticsubjects exhibit viruses in nasal swabs.

The virus enters thecells of the lining of the nasopharynx(the area between the nose and throat), andrapidly multiplies. The major entry point is normally the nose, but can also be the eyes (in this casedrainage into the nasopharynx would occur through the nasolacrimal duct).
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SymptomsAfter initial infection, the viral replication cycle begins within 8 to 12 hours. Symptoms can occurshortly thereafter, and usually begin within 2 to 5 days after infection, although occasionally in as littleas 10 hours after infection. The first indication of a cold is often asore or scratchy throat. Othercommon symptoms arerunny nose,congestion,sneezing and cough. These are sometimes

accompanied by muscle aches,fatigue, malaise,headache, weakness, orloss of appetite. Coldsoccasionally cause feverand can sometimes lead to extreme exhaustion. (However, these symptomsare more usual ininfluenza, and can differentiate the two infections.) The symptoms of a cold usuallyresolve after about one week, but can last up to 14 days, with a cough lasting longer than othersymptoms. Symptoms may be more severe in infants and young children, and may include fever andhives.

PreventionThe best way to avoid a cold is to avoid close contact with existing sufferers; to wash hands thoroughlyand regularly; and to avoid touching the mouth and face. Anti-bacterial soaps have no effect on thecold virus; it is the mechanical action of hand washing with the soap that removes the virus particles.

In 2002, the Centers for Disease Control and Preventionrecommended alcohol-based hand gels as aneffective method for reducing infectious viruses on the hands of health care workers. As with handwashing with soap and water, alcohol gels provide no residual protection from re-infection.

The common cold is caused by a large variety of viruses, which mutate quite frequently duringreproduction, resulting in constantly changing virus strains. Thus, successful immunization is highlyimprobable.

Exposure to cold weatherAlthough common colds are seasonal, with more occurring during winter, experiments so far havefailed to produce evidence that short-term exposure to cold weather or direct chilling increasessusceptibility to infection, implying that the seasonal variation is instead due to a change in behaviors

such as increased time spent indoors at close proximity to others.With respect to the causation of cold-like symptoms, researchers at the Common Cold Centre at theCardiff University conducted a study to "test the hypothesis that acute cooling of the feet causes theonset of common cold symptoms." The study measured the subjects' self-reported cold symptoms, andbelief they had a cold, but not whether an actual respiratory infection developed. It found that asignificantly greater number of those subjects chilled developed cold symptoms 4 or 5 days after thechilling. It concludes that the onset of common cold symptoms can be caused by acute chilling of thefeet. Some possible explanations were suggested for the symptoms, such as placebo, or constriction ofblood vessels, however "further studies are needed to determine the relationship of symptomgeneration to any respiratory infection."

TreatmentAs there is no medically proven and accepted medication directly targeting the causative agent, there isno cure for the common cold. Treatment is limited to symptomatic supportive options, maximizing thecomfort of the patient, and limiting complications and harmful sequelae.

The common cold is self-limiting, and the host's immune system effectively deals with the infection.Within a few days, the body's humoralimmune response begins producing specific antibodiesthat canprevent the virus from infecting cells. Additionally, as part of the cell-mediated immune response,leukocytes destroy the virus throughphagocytosis and destroy infected cells to prevent further viralreplication. In healthy, immunocompetent individuals, the common cold resolves in seven days onaverage.
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Palliative care

TheNational Institute of Allergy and Infectious Diseases suggests getting plenty of rest, drinking fluidsto maintain hydration, gargling with warm salt water, using cough drops, throat sprays, orover-the-counterpain or cold medicines. Saline nasal drops may help alleviate congestion.

The American Lung Association recommends avoiding coffee, tea orcola drinks that contain caffeine

and avoiding alcoholic beverages, saying that both caffeine and alcohol cause dehydration. However, astudy reported in 2000, as well as the U.S. Institute of Medicine in 2004, say that caffeinated beveragesand non-caffeinated beverages equally meet the need for fluids.

Antibiotics

Antibiotics, targeted primarily tomicroorganisms likebacteria and fungus, do not have any beneficialeffect against the common cold. Their use in cases of common cold infection is ineffective as they haveno effect on viruses.

Antivirals

There are no approved antiviral drugs for the common cold.

ViroPharma and Schering-Plough are developing an antiviral drug,pleconaril, that targets

picornaviruses, the viruses that cause the majority of common colds.Pleconarilhas been shown to beeffective in an oral form. Schering-Plough is developing an intra-nasal formulation that may havefewer adverse effects.

Over-the-counter symptom medicines

There are a number of effective treatments which, rather than treat the viral infection, focus onrelieving the symptoms. For some people, colds are relatively minor inconveniences and they can goon with their daily activities with tolerable discomfort. This discomfort has to be weighed against theprice and possible side effects of the remedies.

analgesics such as aspirin orparacetamol(acetaminophen), as well as localised versions

targeting the throat (often delivered in lozenge form)

nasal decongestants such aspseudoephedrine oroxymetazoline which reduce the inflammation

in the nasal passages by constricting dilated local blood vessels

cough suppressants such asdextromethorphan which suppress the cough reflex.

first-generationanti-histamines such asbrompheniramine,chlorpheniramine, diphenhydramine

and clemastine(which reduce mucus gland secretion and thus combat blocked/runny noses butalso may make the user drowsy). Second-generation anti-histamines do not have a useful effecton colds.
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iki/Schering-Ploughhttp://en.wikipedia.org/wiki/Route_of_administrationhttp://en.wikipedia.org/wiki/Route_of_administrationhttp://en.wikipedia.org/wiki/Route_of_administrationhttp://en.wikipedia.org/wiki/Analgesichttp://en.wikipedia.org/wiki/Analgesichttp://en.wikipedia.org/wiki/Analgesichttp://en.wikipedia.org/wiki/Aspirinhttp://en.wikipedia.org/wiki/Aspirinhttp://en.wikipedia.org/wiki/Aspirinhttp://en.wikipedia.org/wiki/Paracetamolhttp://en.wikipedia.org/wiki/Paracetamolhttp://en.wikipedia.org/wiki/Paracetamolhttp://en.wikipedia.org/wiki/Lozengehttp://en.wikipedia.org/wiki/Lozengehttp://en.wikipedia.org/wiki/Lozengehttp://en.wikipedia.org/wiki/Pseudoephedrinehttp://en.wikipedia.org/wiki/Pseudoephedrinehttp://en.wikipedia.org/wiki/Pseudoephedrinehttp://en.wikipedia.org/wiki/Oxymetazolinehttp://en.wikipedia.org/wiki/Oxymetazolinehttp://en.wikipedia.org/wiki/Oxymetazolinehttp://en.wikipedia.org/wiki/Cough_medicinehttp://en.wikipedia.org/wiki/Cough_medicinehttp://en.wikipedia.org/wiki/Cough_medicinehttp://en.wikipedia.org/wiki/Dextromethorphanhttp://en.wikipedia.org/wiki/Dextromethorphanhttp://en.wikipedia.org/wiki/Dextromethorphanhttp://en.wikipedia.org/wiki/Anti-histaminehttp://en.wikipedia.org/wiki/Anti-histaminehttp://en.wikipedia.org/wiki/Anti-histaminehttp://en.wikipedia.org/wiki/Brompheniraminehttp://en.wikipedia.org/wiki/Brompheniraminehttp://en.wikipedia.org/wiki/Brompheniraminehttp://en.wikipedia.org/wiki/Chlorpheniraminehttp://en.wikipedia.org/wiki/Chlorpheniraminehttp://en.wikipedia.org/wiki/Chlorpheniraminehttp://en.wikipedia.org/wiki/Diphenhydraminehttp://en.wikipedia.org/wiki/Diphenhydraminehttp://en.wikipedia.org/wiki/Diphenhydraminehttp://en.wikipedia.org/wiki/Clemastinehttp://en.wikipedia.org/wiki/Clemastinehttp://en.wikipedia.org/wiki/Clemastine

Infectious disease of the Mouth

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