Anxiety disorder

Everyone feels anxious from time to time, but people with anxiety disorders experience frequent and severe worry that disrupts their normal life.

What is anxiety?

Feeling anxiety before a specific event, such as a test, is normal.

Usually, anxiety is temporary. But someone with an anxiety disorder experiences regular, severe worry. The anxiety may be debilitating and prevent them from doing their normal activities.

Anxiety disorders are common. According to the National Institute of Mental Health, approximately 19.1% of adults in the United States have an anxiety disorder.

Types of anxiety disorder

Agoraphobia

Agoraphobia is the fear of space where it is difficult to escape or receive help if something goes wrong.People with this type of phobia tend to avoid specific places or situations. For example, they might avoid crowds or public transport. Some people may become housebound in severe cases.

Generalized anxiety disorder

Generalized anxiety disorder (GAD) involves constant worrying over everyday things. The anxiety might have no clear cause or trigger. This chronic condition can cause trouble sleeping, irritability, and muscle tension.

Obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) causes distressing, intrusive thoughts that a person may manage by carrying out repetitive behaviors that provide temporary relief.

Examples include compulsively washing the hands in fear of contamination. If a person does not perform the compulsion, they may feel more anxious as a result.

Phobias

Agoraphobia is one type of phobia, or fear. However, many other phobias exist. Some are common and relatively mild, such as a fear of spiders, or arachnophobia. Others may be more disruptive to a person’s life.

Panic disorder

Those with panic disorder are prone to panic attacks. These panic attacks cause physical symptoms similar to a heart attack.

Post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) can develop after a person experiences trauma. For example, someone may develop PTSD after an accident, assault, or a natural disaster.In some people, symptoms are temporary. But others will experience PTSD over long periods.

Selective mutism

People who have this rare disorder avoid speaking, despite having the ability to do so. Those with selective mutism are typically very shy. They fear social judgment and embarrassment.

Separation anxiety

Separation anxiety is common in children, but adults also experience it. People with this type of anxiety disorder have an intense fear of separation from the people who are close to them in their lives.

Social anxiety disorder

People with this anxiety disorder have an intense fear of social interactions. They typically fear social humiliation and worry about judgment from others.

What is an anxiety attack?

An anxiety or panic attack involves a sudden burst of intense anxiety that produces physical symptoms. The symptoms might include difficulty breathing, chest pain, and dizziness.

Some people use the terms anxiety attack and panic attack interchangeably. Panic attacks can last as long as anywhere from 5–30 minutes.

Having a panic attack is frightening, and people who experience them are usually fearful of triggering another. Some people go to great lengths to avoid certain situations that might produce another episode.

Symptoms of a panic attack

Symptoms of a panic attack are not life threatening despite their intensity. They include:

  • sweating
  • shaking
  • trembling
  • dizziness
  • panting and shortness of breath
  • nausea
  • heart palpitations
  • increased heart rate
  • depersonalization
  • hot and cold flushes

Some people experience these kinds of symptoms with their regular anxiety. What makes a panic attack different is how intense and sudden the physical sensations are.

Causes of anxiety

The causes of anxiety are complex. Some potential causes of an anxiety disorder might include:

  • Environment: A person’s life experiences, upbringing, and home environment have a significant impact on whether someone develops anxiety. A 2014 study suggests that some parenting styles increase the risk of anxiety disorders.
  • Genetics: People with a family history of anxiety disorders are more likely to develop one.
  • Health conditions: Some health problems might cause anxiety symptoms, such as thyroid or heart conditions.

Females are also more likely than males to develop an anxiety disorder.

Treatments

There are effective treatment options for anxiety disorders. The type of treatment will vary depending on the anxiety disorder.

Some anxiety treatments include:

Psychotherapy

Talk therapies, such as cognitive behavioral therapy (CBT), are a standard treatment for anxiety disorders. CBT teaches individuals with anxiety to approach their anxious feelings and thoughts differently. CBT can also involve exposure therapy for treating phobias, which means a person gradually and intentionally exposing themselves to their fear.

Medications

In some cases, medications, such as antidepressants and anti-anxiety medication, may help reduce the symptoms of an anxiety disorder. These are helpful for people who have severe symptoms.

A doctor may prescribe beta-blockers to someone with panic disorder. Beta-blockers can help with the physical symptoms of anxiety, such as rapid heartbeat and shaking.

Management

Some self-care strategies can help a person manage anxiety in their daily life. People with severe anxiety should not use these methods to replace help from a mental health professional.

Support groups

Support groups can provide people with anxiety a place to talk about their experiences with others who understand their condition. Additionally, being involved in spiritual groups that focus on compassion and forgiveness may help some people with anxiety.

Relaxation techniques

Activities that calm the nervous system can help ease anxiety, such as:

  • spending time in nature
  • meditation and mindfulness
  • activities a person finds fun

Lifestyle changes

Substances such as caffeine and some nutritional deficiencies can make anxiety worse. Additionally, getting enough exercise and eating a nutrient-rich diet can help to reduce it.

A person with an anxiety disorder may feel some benefits from:

  • reducing caffeine intake
  • focusing on eating whole foods, such as fruits, vegetables, and fish
  • getting regular exercise

Summary

Anxiety is a normal reaction to stress and change, but anxiety disorders are highly disruptive conditions. There are many types of anxiety disorder, including PTSD, OCD, GAD, and phobias.

Treatment for an anxiety disorder might include a combination of therapy and medication. People should seek help for anxiety that regularly affects their normal life.

smoking and vaping could increase the severity of COVID-19 due to blood vessel damage and a higher risk of stroke.

A recent report from a neurological hospital in the United Kingdom identifies cases of delirium, brain inflammation, nerve damage, and stroke in COVID-19 patients.

Reports of stroke in COVID-19 are particularly prevalent. Some reports estimate that 30% of critically ill COVID-19 patients experience blood clots. And if they occur in the brain, they may trigger a stroke.

Researchers from Texas Tech University Health Sciences Center previously found that smoking and vaping increases the risk of viral infection. They have now published a review on how these activities might affect the risk of neurological dysfunction in COVID-19, particularly from damage to blood vessels in the brain.

They found that both smoking and vaping could increase the risk of stroke in COVID-19 due to damage to the blood-brain barrier and a higher risk of blood clots.

Smoking causes well-known damage to the lungs and respiratory system. Previous research has shown that it also makes a person more vulnerable to influenza.

Smoking can also affect the vascular system in the brain, prompting the researchers to review the evidence on how this activity might influence the neurological symptoms of people who contract COVID-19.

They first looked at the evidence on SARS-CoV-2 and neurological disorders, including stroke. They found one study which showed that 36.4% of COVID-19 patients had neurological symptoms. Another paper found five cases of sudden stroke in COVID-19 patients aged 30–40 years due to abnormal blood clotting in their large arteries.

But how does this relate to smoking? The researchers explain that when the body is deprived of oxygen, which occurs with smoking, the amount of clotting factors in the blood increase.

In combination with COVID-19, which also increases blood-clotting proteins, the risk of stroke rises.

COVID-19 seems to have this ability to increase the risk for blood coagulation, as does smoke. This may ultimately translate in higher risk for stroke.”

Although there is less evidence around vaping, the authors found studies that show vape aerosol components can harm blood vessels in the brain.

Vaping also appears to affect the blood-brain barrier, the defensive structure which protects the brain from toxins and pathogens in the blood.

The researchers also found specific evidence that long-term vaping may increase the risk of stroke.

Vaping may also make a person more vulnerable to COVID-19 by increasing the number of ACE2 receptors expressed in the body, which are used by the novel coronavirus to infect cells. Smoking can also increase expression of the ACE2 receptor, and damages the blood-brain barrier.

Love hormone’ oxytocin could be used to treat cognitive disorders like Alzheimer’s

Alzheimer’s disease progressively degrades a person’s memory and cognitive abilities, often resulting in dementia. Amid efforts to find novel treatments for this disease, a recent breakthrough study by scientists from Japan shows that oxytocin―the hormone that we commonly know to induce feelings of love and well-being―can also effectively reverse some of the damage caused by amyloid plaques in the learning and memory center of the brain in an animal model of Alzheimer’s.

Alzheimer’s disease is a progressive disorder in which the nerve cells (neurons) in a person’s brain and the connections among them degenerate slowly, causing severe memory loss, intellectual deficiencies, and deterioration in motor skills and communication. One of the main causes of Alzheimer’s is the accumulation of a protein called amyloid β (Aβ) in clusters around neurons in the brain, which hampers their activity and triggers their degeneration. Studies in animal models have found that increasing the aggregation of Aβ in the hippocampus―the brain’s main learning and memory center―causes a decline in the signal transmission potential of the neurons therein. This degeneration affects a specific trait of the neurons, called “synaptic plasticity,” which is the ability of synapses (the site of signal exchange between neurons) to adapt to an increase or decrease in signaling activity over time. Synaptic plasticity is crucial to the development of learning and cognitive functions in the hippocampus. Thus, Aβ and its role in causing cognitive memory and deficits have been the focus of most research aimed at finding treatments for Alzheimer’s.

Now, advancing this research effort, a team of scientists from Japan, has looked at oxytocin, a hormone conventionally known for its role in the female reproductive system and in inducing the feelings of love and well-being. “Oxytocin was recently found to be involved in regulating learning and memory performance, but so far, no previous study deals with the effect of oxytocin on Aβ-induced cognitive impairment. Realizing this.

Oxytocin is known to facilitate certain cellular chemical activities that are important in strengthening neuronal signaling potential and formation of memories, such as influx of calcium ions. Previous studies have suspected that Aβ suppresses some of these chemical activities. When the scientists artificially blocked these chemical activities, they found that addition of oxytocin addition to the hippocampal slices did not reverse the damage to synaptic plasticity caused by Aβ. Additionally, they found that oxytocin itself does not have any effect on synaptic plasticity in the hippocampus, but it is somehow able to reverse the ill―effects of Aβ.

Text Alzheimers Disease appearing behind ripped brown paper in human brain drawing.

Pregnant during the COVID-19 crisis

The COVID-19 pandemic has changed the healthcare landscape for many patient populations — including pregnant women.

To mark Mental Health Awareness Month this May, we’re bringing you research-backed information to help support the mental well-being of you and your loved ones during this difficult time.

Altered hospital policies, concerns about contracting the SARS-CoV-2 virus, and changes to doctors’ office hours have all affected pregnancy.

Information regarding pregnancy and COVID-19 is continually evolving. This article will cover the currently available information relating to pregnancy during the pandemic.

Pregnancy can be an exciting time, but also one of uncertainty. The COVID-19 pandemic understandably adds further stress and may cause anxiety in some people.

During pregnancy, signs and symptoms of high stress include:

  • changes in appetite
  • frequent feelings of fear and worry about the pregnancy and delivery
  • poor quality sleep
  • problems concentrating

Pregnant women may wish to try the following stress-relieving practices and tips:

  • Refrain from looking at physical media or watching the news around the clock. Instead, limit the news to key times of the day, such as the morning or before dinner, leaving the evenings free for unwinding and promoting sleep.
  • Ask a doctor or midwife about online antenatal classes, which are excellent places to meet and talk to other pregnant women.
  • Try meditating, deep breathing, or gentle stretching.
  • Take care of key relationships by connecting with friends and family over the phone or through video conferences.
  • Get enough sleep by going to bed at a consistent time and limiting screen time beforehand.
  • Maintain a healthful diet and engage in regular exercise. Eating well and staying active can help the body stay healthy in times of mental ill health.
  • Take up a new hobby or rediscover an old one, such as playing an instrument, learning a language, or reading. People may also enjoy making blankets, clothes, or handmade toys for the coming baby, or decorating a nursery.
  • Make use of online support groups and forums for pregnant women and new parents.
  • Consider online counseling. Therapy can be helpful for anyone experiencing anxiety, depression, or stress.
  • Ask for extra help — this may mean that a partner takes a greater share of caring for the children, if applicable, or that a neighbor does the grocery shopping and drops the bags outside the door.

If a woman is experiencing significant mental distress, it is vital to speak to a doctor, midwife, or counselor.

Depression during pregnancy is common but treatable. Even if they are physical distancing, pregnant women do not have to face depression or other mental health concerns alone.

Physical distancing while pregnant

Avoiding contact with others, especially large groups of people, can reduce the transmission of the coronavirus.

Many areas have enacted shelter-at-home or safer-at-home policies that discourage people from going outside except for essential travel, such as going to the grocery store or pharmacy or making other necessary visits.

It is essential to keep attending prenatal appointments, but be aware that some of these appointments may occur over the phone.

Modern technology enables doctors’ offices to change the way in which they help people, including pregnant women.

The American College of Obstetricians and Gynecologists recommend that pregnant women talk with a doctor to determine how often they should go for in-person visits.

Our doctors offer online video call visits called telemedicine. They may recommend spacing out ultrasound appointments or other in-person visits to reduce a woman’s risk for transmission.

If possible, having a partner or delivery service secure key items can help reduce a pregnant woman’s exposure to the public.

People should always wash their hands when returning from the grocery store or a walk outside.

COVID-19 effects during pregnancy

As COVID-19 is a new and developing health crisis, experts have not yet identified its effects on pregnancy. They remain unsure whether pregnant women are more at risk of getting COVID-19 or experiencing more severe symptoms and whether they might pass the virus to the baby.

According to the World Health Organization (WHO), no evidence currently exists to suggest that pregnant women are at higher risk of experiencing severe COVID-19 symptoms than the general population.

A small study of nine pregnant women in their third trimester with COVID-19 and pneumonia symptoms in Wuhan, China, found that one baby tested positive for the virus 36 hours after birth.

However, tests of the woman’s placenta and umbilical cord were negative, which could mean that the newborn contracted the virus after birth, rather than in the womb. This sample size was very small, which makes drawing conclusions difficult.

Another study of 38 pregnant women testing positive for COVID-19 in China did not find that their symptoms were more severe than those affecting the general population.

The study did not report any maternal deaths or the transmission of COVID-19 to any babies.

When to self-isolate

If a pregnant woman has symptoms that resemble those of COVID-19, such as coughing, fever, or shortness of breath, she should call a doctor.

The doctor can make recommendations about whether or not COVID-19 testing is necessary.

If the woman’s symptoms are mild, a doctor will likely recommend that she self-isolate at home.

Home treatment includes taking acetaminophen for fever relief, resting, and drinking plenty of water.

A high fever or difficulty breathing are signs that urgent care is necessary. Try to call the hospital before arriving at the emergency room so that they can take any necessary precautions.

Do you have to give birth alone in the hospital?

Some hospitals in the United States have prohibited visitors for the foreseeable future — including during childbirth — to protect healthcare staff and other patients from the virus. The number of support people who may enter the delivery room can vary from hospital to hospital, however.

Questions to ask a doctor

The pandemic has resulted in many pregnant women experiencing changes to their birth plan, which can cause stress and uncertainty.

Having all the necessary information may help them feel in control and reduce anxiety.

Questions to ask a doctor include:

  • How may your office hours or accessibility change?
  • Are there online alternatives to antenatal classes where I can meet and talk to other pregnant women?
  • How can I ensure that I am safe when visiting my doctor’s office or going to the hospital?
  • How can I expect COVID-19 concerns at the hospital to affect my delivery?
  • Will there be changes in terms of the medications that I may receive or the number of people present in the delivery room?

A woman can also ask her doctor about any area-specific or condition-specific changes.

Summary

Pregnant women may feel additional stress, anxiety, or depression during the COVID-19 pandemic. But even if they are self-isolating, they do not have to face these problems alone.

It is best for pregnant women to focus on the elements that they can control, including self-care and physical distancing.

Keeping in regular contact with a doctor or midwife can also help alleviate worries about health and the birth.

Covid-19 patients recovering quickly after getting experimental drug remdesivir

COVID-19 patients on the antiviral remdesivir recovered about 30 percent faster than those on a placebo, the results of a major clinical trial showed Wednesday, as a top US scientist hailed the drug’s “clear-cut” benefit.

The patients taking part in a clinical trial of the drug have all had severe respiratory symptoms and fever, but were able to leave the hospital after less than a week of treatment, STAT quoted the doctor leading the trial as saying.

“The best news is that most of our patients have already been discharged, which is great.

“Partial data from an ongoing clinical trial is by definition incomplete and should never be used to draw conclusions about the safety or efficacy of a potential treatment that is under investigation.

There is no approved therapy for the Covid-19, which can cause severe pneumonia and acute respiratory distress syndrome in some patients. But the National Institutes of Health is organizing trials of several drugs and other treatments, among them remdesivir.

The drug, made by Gilead Sciences, was tested against Ebola with little success, but multiple studies in animals showed the drug could both prevent and treat coronaviruses related to Covid-19, including SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome).

Back in February, the World Health Organization said remdesivir showed potential against Covid-19.

Most of our patients are severe and most of them are leaving at six days, so that tells us duration of therapy doesn’t have to be 10 days.

However, the trial does not include what’s known as a control group, so it will be difficult to say whether the drug is truly helping patients recover better. With a control arm, some patients do not receive the drug being tested so that doctors can determine whether it’s the drug that is really affecting their condition.

Trials of the drug are ongoing at dozens of other clinical centers, as well. Gilead is sponsoring tests of the drug in 2,400 patients with severe Covid-19 symptoms in 152 trial sites around the world. It’s also testing the drug in 1,600 patients with moderate symptoms at 169 hospitals and clinics around the world.

Gilead said it expected results from the trial by the end of the month.

“We understand the urgent need for a COVID-19 treatment and the resulting interest in data on our investigational antiviral drug remdesivir,” the company said in a statement. But it said a few stories about patients are just that.

“The totality of the data need to be analyzed in order to draw any conclusions from the trial. Anecdotal reports, while encouraging, do not provide the statistical power necessary to determine the safety and efficacy profile of remdesivir as a treatment for Covid-19.

Who is at higher risk of CoronaVirus?

Early information out of China, where COVID-19 first started, shows that some people are at higher risk of getting very sick from this illness. This includes:

  • Older adults
  • People who have serious chronic medical conditions like:
    • Heart disease
    • Diabetes
    • Lung disease

Get ready for COVID-19 now

Take actions to reduce your risk of getting sick

If you are at higher risk for serious illness from COVID-19 because of your age or because you have a serious long-term health problem, it is extra important for you to take actions to reduce your risk of getting sick with the disease.

  • Stock up on supplies.
  • Take everyday precautions to keep space between yourself and others.
  • When you go out in public, keep away from others who are sick, limit close contact and wash your hands often.
  • Avoid crowds as much as possible.
  • Avoid cruise travel and non-essential air travel.
  • During a COVID-19 outbreak in your community, stay home as much as possible to further reduce your risk of being exposed.

Have supplies on hand

  • Contact your healthcare provider to ask about obtaining extra necessary medications to have on hand in case there is an outbreak of COVID-19 in your community and you need to stay home for a prolonged period of time.
  • If you cannot get extra medications, consider using mail-order for medications.
  • Be sure you have over-the-counter medicines and medical supplies (tissues, etc.) to treat fever and other symptoms. Most people will be able to recover from COVID-19 at home.
  • Have enough household items and groceries on hand so that you will be prepared to stay at home for a period of time.

Preparing for COVID-19: Priorities for the US


Three physicians from Johns Hopkins University, in Baltimore, MD, have joined efforts to write an article outlining key action points that the United States healthcare community should take in response to COVID-19.

Drs. Amesh A. Adalja, Eric Toner, and Thomas V. Inglesby wrote the paper, titled “Priorities for the U.S. Health Community Responding to COVID-19.”

The doctors are all from the Johns Hopkins Center for Health Security, as well as the university’s Department of Environmental Health and Engineering.

Appearing in the journal JAMA, the article draws from experiences with similar epidemics — such as the 2009 influenza pandemic, the SARS epidemic in 2003, and the avian influenza A epidemic in 2005 — to outline key measures that the U.S. government and healthcare sector should take to deal with the new coronavirus.

Hospitals, clinics, and other facilities

First, write the authors, healthcare institutions should update preparedness plans that had been developed for the previous epidemics.

“Broadly speaking, those plans addressed the protection of healthcare workers, how to deal with staffing shortages, surges in patient numbers, triage issues, and management of scarce resources,” write Dr. Adalja and colleagues.

Second, hospitals and clinics, which have “critical roles” in the response to COVID-19, must establish clear “protocols for triaging and isolating patients suspected of having infection in emergency departments and urgent care centers.”

Importantly, write the authors, “Similar procedures need to be established in outpatient clinics, dialysis centers, and other medical facilities — especially nursing homes, assisted living centers, and long-term care facilities with particularly vulnerable populations.”

This is to prevent COVID-19 from disrupting regular treatments in medical care units, which would “compound the direct morbidity and mortality of the disease.”

Healthcare workers and ICU units

Protecting healthcare workers is another key priority in the COVID-19 response. This will require the use of personal protective equipment, updated hospital administrative policies, and special training of hospital staff, the authors note.

A considerable number of patients are likely to be severely ill, so hospitals must pay specific attention to preparing their intensive care units (ICUs), Dr. Adalja and colleagues write, explaining: 

“This planning includes evaluation of ICU bed capacity, the ability to augment ICU-level bed space with alternative care sites such as step-down units and postanesthesia care units, mechanical ventilator stock and supply chains, and the logistics of isolating and cohorting patients.” 

“Many hospitals operate at or near capacity already, and even an above-average flu season can cause operational disruption,” the authors point out.

Finally, the team emphasizes that — even though too little is currently known about COVID-19, and healthcare professionals will have to adapt their clinical approaches as more information becomes available — sticking to existing guidelines for pneumonia, sepsis, and acute respiratory distress syndrome (ARDS) is the best course of action.

“This may include the use of investigational antiviral or monoclonal antibody therapy,” the authors note.

More diagnostic tests needed ‘rapidly’

Furthermore, they write, clinicians must “rapidly” extend their diagnostic testing.

“To better understand the burden of COVID-19, medical and public health experts need to expand testing to all patients who have unexplained ARDS or severe pneumonia and ultimately to patients who have mild symptoms consistent with COVID-19.”

The researchers explain that the Centers for Disease Control and Prevention (CDC) — which initially performed all diagnostic tests — and public health labs do not have the capacity to perform testing on the scale that is necessary right now.

“To reach a high level testing capacity will require the major clinical diagnostic companies to develop and manufacture testing kits at large scale. Diagnostic companies may simply be able to add SARS-CoV-2 to existing nucleic acid–based respiratory viral panels or create standalone tests. Ideally, such diagnostic tests would be rapid,” the article cautions.

Also, serological assays, blood tests for specific antibodies, are necessary to help determine an accurate case fatality rate and for monitoring purposes, the authors point out.

Public health and social distancing

“From the outset, SARS-CoV-2 posed a near-impossible challenge for containment,” the team writes.

This is because the virus transmits very effectively; the authors note that the virus was “surreptitiously spreading for at least 6 weeks” and that it has “an epidemic doubling time of about 1 week.”

“As more and more countries report cases, including those with no link to the disease epicenter, it is clear that there are many more unrecognized cases in the world and that community transmission is happening in many countries.”

– Dr. Amesh A. Adalja et al.

Public health measures such as providing rapid diagnoses and isolating people with the virus are the most important actions that can slow the spread of SARS-CoV-2.

Tracking the contacts of people with the virus and placing them in quarantine may also be effective at this early stage of the epidemic.

“However, beyond a certain threshold, it will no longer be feasible to track all contacts.” At this point, actions classified as “social distancing” may be necessary. These include “cancellation of large gatherings, telecommuting to work when feasible, and school closures.”

However, such measures would come at a cost that must be accounted for. For instance, school closures would mean that “Many children who depend on school meals will not receive them, and many single parents will be out of the workforce.”

Finally, in addition to communicating health measures that everyone should take to reduce the spread of the infection, “It will also be important to communicate […] that persons who test positive for this virus but who do not need hospital care should stay at home while they are ill and not go to hospitals.”

“Hospitals may have serious challenges in handling the number of people who do need acute care, so it will be important for those who are infected but otherwise well to not contribute to hospital demands.” Dr. Adalja and colleagues conclude:

“Preparation will take time, so healthcare and public health systems need to move quickly forward in their efforts to be ready to confront this disease around the country.”

For information on how to prevent the spread of coronavirus, this CDC page provides advice.

Coroavirus outbreak

The emergence and rapid increase in cases of coronavirus disease 2019 (COVID-19), a respiratory illness caused by a novel coronavirus, pose complex challenges to the global public health, research and medical communities, write federal scientists from NIH’s National Institute of Allergy and Infectious Diseases (NIAID) and from the Centers for Disease Control and Prevention (CDC). 

In response to the outbreak, the United States and other countries instituted temporary travel restrictions, which may have slowed the spread of COVID-19 somewhat, the authors note. However, given the apparent efficiency of virus transmission, everyone should be prepared for COVID-19 to gain a foothold throughout the world, including in the United States, they add. If the disease begins to spread in U.S. communities, containment may no longer be a realistic goal and response efforts likely will need to transition to various mitigation strategies, which could include isolating ill people at home, closing schools and encouraging telework, the officials write.

“The COVID-19 outbreak is a stark reminder of the ongoing challenge of emerging and re-emerging infectious pathogens and the need for constant surveillance, prompt diagnosis and robust research to understand the basic biology of new organisms and our susceptibilities to them, as well as to develop effective countermeasures,” the authors conclude.

Here’s what you can do:

Avoid close contact with people who are sick.

Avoid touching your eyes, nose, and mouth.

Stay home when you are sick.

Cover your cough or sneeze with a tissue, then throw the tissue in the trash.

Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

Keep your hands clean, and keep your distance from sick people

Unless you are already infected, face masks won’t help you

Stock up on home supplies, medicine and resources

Prepare your family, and communicate your plan

With your children, keep calm and carry on — and get the flu shot

About to go on vacation? Consider your destination and how you feel about risk

Blood test identifies risk of disease linked to stroke and dementia

MRI scans shows showing the average measurable difference in white matter brain damage in people with low inflammatory blood test scores (below median) and those with high scores (above median). 

A UCLA-led study has found that levels of six proteins in the blood can be used to gauge a person’s risk for cerebral small vessel disease, or CSVD, a brain disease that affects an estimated 11 million older adults in the U.S. CSVD can lead to dementia and stroke, but currently it can only be diagnosed with an MRI scan of the brain.

“The hope is that this will spawn a novel diagnostic test that clinicians can start to use as a quantitative measure of brain health in people who are at risk of developing cerebral small vessel disease,” said Dr. Jason Hinman, a UCLA assistant professor of neurology and lead author of the paper, which is published in the journal PLoS One.

CSVD is characterized by changes to the brain’s white matter—the areas of the brain that have a high concentration of myelin, a fatty tissue that insulates and protects the long extensions of brain cells. In CSVD, small blood vessels that snake through the white matter become damaged over time and the myelin begins to break down. This slows the communication between cells in the brain and can lead to problems with cognition and difficulty walking. And if the blood vessels become completely blocked, it can cause stroke.

The disease is also associated with a heightened risk for multiple forms of dementia, including Alzheimer’s disease.

Typically, doctors diagnose CSVD with an MRI scan after a person has experienced dementia or suffered a stroke. About a quarter of all strokes in the U.S. are associated with CSVD. But many cases of the disease go undiagnosed because of mild symptoms, such as trouble with walking or memory, that can often be attributed to normal aging.

In the new study, Hinman and colleagues focused on six proteins related to the immune system’s inflammatory response and centered on a molecule called interleukin-18, or IL-18. They hypothesized that inflammatory proteins that damage the brain in CSVD may be detectable in the bloodstream.

The researchers measured the levels of the proteins in the blood of 167 people whose average age was 76.4, and who had either normal cognition or mild cognitive impairment. As part of their voluntary participation in the study, 110 participants also underwent an MRI brain scan and 49 received a more advanced scan called diffusion tensor imaging.

People whose MRI or diffusion tensor imaging tests showed signs of CSVD had significantly higher levels of the six blood proteins, the researchers discovered. If a person had higher-than-average levels of the six inflammatory proteins, they were twice as likely to have signs of CSVD on an MRI scan and 10% more likely to very early signs of white matter damage. Moreover, for every CSVD risk factor that a person had—such as high blood pressure, diabetes, or a previous stroke—the inflammatory protein levels in their blood were twice as high, on average.

To confirm the results, the team performed the blood test in a group with a much higher risk for CSVD: 131 people who visited a UCLA Health emergency department with signs of stroke. Once again, the blood test results were correlated with white matter changes in the brain that were detected by an MRI.

“I was pleasantly surprised that we were able to associate blood stream inflammation with CSVD in two fairly different populations,” Hinman said.

In MRI reports, the changes in the brain’s white matter caused by CSVD are usually only categorized in general terms—as mild, moderate or severe. The blood test is a step forward, Hinman said, because it provides a more quantitative scale for evaluating the disease. That means the blood test can be used to follow the progression of the disease or to identify people who are candidates for prevention efforts or treatments for CSVD.

“We’re hopeful that this will set the field on more quantitative efforts for CSVD so we can better guide therapies and new interventions,” Hinman said.

What is the coronavirus illness blamed for multiple deaths in China?

Officials in China are racing to contain a deadly new strain of virus that has infected more than 2,700 people and left at least 81 dead. Chinese officials have blocked all transportation in and out of the city of Wuhan and surrounding areas, where the outbreak of the “2019 novel coronavirus” or “2019-nCoV” originated. 

Five cases of the illness have been confirmed in the United States — all in people who had recently traveled from Wuhan, China. U.S. health officials confirmed the first case on Tuesday, involving a man in his 30s in Seattle. The second case was confirmed Friday in a woman in her 60s in Chicago. Health officials said she was “doing well.” Over the weekend, two additional cases were confirmed in California and one in Arizona.

The U.S. Centers for Disease Control and Prevention said Friday that more than 60 people in 22 states were being monitored for possible infection.

  • China locks down cities in unprecedented effort to contain coronavirus

Health officials believe the virus was initially transmitted from animals to humans, but that human-to-human transmission of the flu-like illness is now occurring.

What is a coronavirus?

Coronaviruses are a large group of viruses that can cause illnesses as minor as a cold, or as serious as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), according to the World Health Organization. They often present with pneumonia-like symptoms.

The viruses can be transmitted from animals to humans; the virus that causes SARS, for example, was originally transmitted to humans from a cat-like animal called a civet. But in some instances, as appears to be the case with this new strain of coronavirus, they can also be transmitted between humans. 

The World Health Organization said there are multiple known coronaviruses circulating in animals that have not yet been transmitted to humans.

How did the new strain start?

The outbreak began in Wuhan, a city of 11 million people. Many of the early patients were reportedly linked to Hua Nan Seafood Wholesale Market, a large seafood and animal market in the city, according to CBS News’ Ramy Inocencio. But since then, a rising number of people have apparently contracted the virus without exposure to the market.

The market was closed on January 1, 2020 for “environmental sanitation and disinfection,” according to the World Health Organization. 

How many people have died?

At least 81 people have died from the illness, according to Chinese officials. Most of those deaths occurred in Wuhan, which is in the central Hubei province. The first death was reported January 9. 

Where is it?

While the virus originated around Wuhan, cases have also been reported in Thailand, Taiwan, Japan, South Korea, Vietnam, Malaysia, Nepal, Singapore, the U.S., Australia and France. 

How is it transmitted?

It’s well-established that coronaviruses can spread from animals to humans, according to the World Health Organization. But health officials confirmed there have been cases in which this virus has spread from human to human. 

Chinese state-run media quoted Zhong Nanshan, a scientist at the China’s National Health Commission, as saying such transmission was “affirmative.” The scientist did not say how many cases were the result of human-to-human transmission — but in one case, a hospital patient is said to have infected 14 medical workers, reports Inocencio.

What’s being done to stop the spread? 

The World Health Organization convened an emergency committee on the virus in Geneva, Switzerland. It said Thursday that the outbreak does not rise to the level of being designated an international public health emergency, but WHO will continue working with nations to contain it.

Meanwhile in the U.S., the CDC deployed public health workers to screen passengers arriving from Wuhan at five major ports of airline entry: New York-JFK, Los Angeles, San Francisco, Atlanta and Chicago-O’Hare.

The CDC said it has developed a test to diagnose the virus. Currently, that test must be administered at the CDC, but the organization is working to share the test with domestic and international partners.

In Hong Kong, which was ravaged by SARS in 2002 and 2003, hospitals upped their alert level to “serious” and implemented temperature checkpoints for inbound travelers.

While China has closed transportation in and out of Wuhan and 12 other cities, there are concerns that as hundreds of millions of people travel around the country to celebrate the Chinese New Year, the virus could spread even faster.