Common Causes of Illness

Common Causes of Illness

Common Cold, Conjunctivitis, Coxsackievirus, Influenza, and Pertussis

Common Cold

Common Causes

The common cold is an acute, self-limiting upper respiratory tract infection. This infection is caused by viruses and manifests as rhinorrhoea, nasal congestion, and sore throat, especially among adults. The most commonly implicated viruses in common cold infection include parainfluenza, respiratory syncytial virus, and human coronaviruses. These viruses do not elicit long-lasting immunity. Reinfection with the same serotype of the virus is common and cold attributable to these viruses and, therefore, tends to be seasonal (De Sutter et al., 2022). Other viruses implicated in common colds include adenoviruses, rhinoviruses, enteroviruses, and influenza viruses. Reinfection with the same serotype of these viruses is not common because they elicit serotype-specific immunity. However, these viruses have numerous serotypes and, therefore, remain a concern to many people.

Possible Complications

The common cold is self-limiting and thus tends to resolve within 14 days. The development of acute otitis media is a common complication in school-going children. This complication often manifests as earache and fever. Persistence of nasal congestion symptoms above ten days may also be indicative of secondary bacterial sinusitis. However, research findings have revealed that secondary bacterial sinusitis can occur even in the early phases of the infection. Bacterial pneumonia is rare but may occur in children, especially those with underlying reactive airway pathology such as asthma. Other rare complications include pharyngitis, conjunctivitis, and epistaxis.

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Management

The common cold is a self-limiting infection that tends to resolve on its own. Symptomatic relief with antihistamines such as cetirizine remains effective, although not warranted in children. Antihistamine use often lowers nasal discharge, nose blowing, and sneezing. Over-the-counter nasal decongestants such as phenylephrine, antitussives such as dextromethorphan, and expectorants such as guaifenesin maintain effectiveness in symptomatic relief (De Sutter et al., 2022). Adult and children preparations of these agents are available over the counter.

Conjunctivitis

Common Causes

Conjunctivitis is the inflammation of the conjunctiva. It is causal for eye discharge and redness. Notably, infectious conjunctivitis may be of bacterial, viral, fungal, or parasite origin. More than 80% of all conjunctivitis are of viral origin, with adenoviruses accounting for most viral conjunctivitis. Other viruses include herpes simplex, herpes zoster, and entero-viruses. Bacterial conjunctivitis is seen mostly in children (Azari & Arabi, 2020). The commonly implicated bacteria among adult infections include Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenza. Moraxella catarrhal, staphylococcus aureus and Haemophilus influenza are the most responsible for child infections. Other implicated bacteria include Neisseria gonorrhoea and Chlamydia trachomatis. Allergic conjunctivitis is also common and may result from exposure to toxins, allergens, and local irritants.

Complications

Complications from conjunctivitis are rare. Nonetheless, corneal complications may occur in patients with the Herpes Zoster virus. Uveitis has also been reported in this patient group. Corneal involvement and subsequent corneal perforations have been reported with Neisseria-related conjunctivitis.

Management

Conjunctivitis due to adenovirus is self-limiting. Symptom relief with artificial tears and cold compression is effective in viral conjunctivitis. Antiviral therapy with gancyclovir is required for herpes-related viral conjunctivitis (Azari & Arabi, 2020). Antibacterial eye drops such as ciprofloxacin can be used in managing severe bacterial conjunctivitis. Topical corticosteroids are only indicated for herpes-related conjunctivitis and not for bacterial and viral infections.

Coxsackievirus

Common Causes

Hand, foot, and mouth disease is a viral infection seen mostly in children and infants. It is caused by a coxsackievirus, an enterovirus of the Picornavirdiae family (Di Prinzio et al., 2022). Serotypes A16 and A71 are the most commonly implicated causal pathogens.

Complications

Most infected persons get better within ten days. However, fingernail and toenail loss, dehydration, viral meningitis, and encephalitis have been reported. Dehydration is common in infected children and often results from the inability to swallow fluids due to painful sores (Di Prinzio et al., 2022). Whenever they occur, encephalitis and meningitis may be fatal.

Management

Hand, foot, and mouth disease is a self-limiting disease. Most people will get better with ten days of infections. Symptomatic management with NSAIDS is effective in relieving pain. Mixture preparations of an antihistamine and an NSAID, such as diphenhydramine/ibuprofen gargles, can help with mouth ulcers. Ribavirin, amantadine, and quinacrine have been used off-label to treat A71-induced disease.

Influenza

Common Causes

Influenza is a viral infection of the upper respiratory tract. Both upper and lower airway passages are affected by this infection. Essentially, influenza is caused by a wide spectrum of influenza viruses. Serotypes A and B cause human disease and are responsible for the seasonal influenza epidemic. There are several subtypes of the Influenza A virus. These subtypes are stratified based on the combination of hemagglutinin and neuraminidase proteins expressed on their surfaces. Influenza B virus also has several subtypes and is classified based on its strains and lineages (Kalil & Thomas, 2019). Animal influenza can also affect humans whenever the antigenic characteristics of the virus change due to mutations. If human-to-human transmission becomes efficient, then an outbreak may be apparent. Avian influenza and bird flu outbreaks seen in the past were a result of animal-to-human and human-to-human transmissions.

Complications

Secondary bacterial pneumonia and acute respiratory distress syndrome are serious complications seen in influenza infections. These complications have been implicated in the mortalities seen in this disease. Other common complications of influenza include myocarditis, myositis, and multiorgan failure. Multiorgan failure is also life-threatening and has been implicated in many influenza-related deaths.

Management

Influenza infections are self-limiting and often resolve in healthy persons with non-comorbidities. Antiviral medications have been used in severe cases of the disease. Neuraminidase inhibitors such as oseltamivir, peramivir, and zanamivir are used in the treatment of Influenza A and B. Adamantanes, adamantine, and rimantidine are used in treating influenza A. In addition, oseltamivir has been used in chemoprophylaxis in persons one year or older in case of outbreaks (Kalil & Thomas, 2019). Annual influenza vaccines are currently available in the CDC-recommended immunization schedules. Annual influenza vaccines offer some protection against influenza.

Pertussis (Whooping Cough)

Pertussis is an infection characterized by a violent cough; it is caused by Bordetella pertussis and Bordetella parapertusis. Humans are the sole reservoirs of these pathogens. This infectious disease was a common cause of child morbidity and mortality before the advent of pertussis vaccines (Decker & Edwards, 2021). It is a highly contagious bacterial infection transmitted via air. It can affect non-immunized individuals.

Complications

Superimposed pneumonia that presents as a complication is a major cause of infant death. It is majorly due to gastric content aspirations during cough paroxysms (Decker & Edwards, 2021). The most implicated pathogens include Staphylococcus aureus, Haemophilus influenza, Streptococcus pneumonia, and Streptococcus pyogenes. Although rare, seizures and encephalopathy are CNS complications that may occur. Other complications include histamine hypersensitivity and hyperinsulinemia due to pertussis toxins, bradycardia, hypotension, and life-threatening pulmonary hypertension.

Management

Supportive treatment is the mainstay treatment in pertussis. Also, avoidance of respiratory irritants, suctioning and oxygen, as well as parenteral nutrition, are applied. Complications of superimposed pneumonia and CNS events warrant hospitalization. Antibiotic therapy with macrolide antibiotics maintains effectiveness in reducing bacterial carriage (Decker & Edwards, 2021). However, it has little impact in lessening the severity or duration of the infections.

References

Azari, A., & Arabi, A. (2020). Conjunctivitis: A Systematic Review. Journal of Ophthalmic and Vision Research. https://doi.org/10.18502/jovr.v15i3.7456

De Sutter, A., Eriksson, L., & van Driel, M. (2022). Oral antihistamine-decongestant-analgesic combinations for the common cold. Cochrane Database of Systematic Reviews, 2022(1). https://doi.org/10.1002/14651858.cd004976.pub4

Decker, M., & Edwards, K. (2021). Pertussis (Whooping Cough). The Journal of Infectious Diseases, 224(Supplement_4), S310-S320. https://doi.org/10.1093/infdis/jiaa469

Di Prinzio, A., Bastard, D., Torre, A., & Mazzuoccolo, L. (2022). Hand, foot, and mouth disease in adults caused by Coxsackievirus B1-B6. Anais Brasileiros De Dermatologia, 97(3), 321-325. https://doi.org/10.1016/j.abd.2021.03.012

Kalil, A., & Thomas, P. (2019). Influenza virus-related critical illness: pathophysiology and epidemiology. Critical Care, 23(1). https://doi.org/10.1186/s13054-019-2539-x

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Common causes of Illness (5) common cold, conjunctivitis (pink eye), Coxsackie virus (hand, foot, and mouth disease),

Influenza, and Pertussis Whooping cough)
Possible complications of the 5 illnesses
Management of illnesses