By Stacy Kess
Flu season wrapped up March 30 with 39 cases of influenza-associated hospitalizations in Delaware County and 3,197 statewide, but Ohioans are now concentrating on a mumps and measles outbreaks around the state.
Mumps cases, which continue to be present mostly in Delaware and Franklin counties, now number 303 individuals affected. ODH reported 32 cases have been identified in Delaware County as of Wednesday afternoon.
ODH also reported 30 cases of measles statewide, 20 of which are in Knox County.
The three illnesses may not sound like they have much in common, but they do: all three are caused by viruses.
“Virus are very misunderstood by the general public because often times the terms virus and bacteria are used interchangeably,” said Dr. Joseph Gastaldo, an infectious disease doctor at Grady Memorial Hospital and Riverside Infection Consultants in Columbus.
Both bacteria and viruses can cause illnesses, but they are vastly different.
“The simplest way to describe a virus when compared to bacteria is a virus isn’t alive,” said Eric Vela, PhD, a virologist and senior scientist with Battelle. “It needs a cell to replicate. It needs to hijack the cellular system to do all of its processes.”
In basic terms, viruses consist of a piece of genetic material inside a shell made of proteins. It attaches to a cell by a “tail” on the shell.
That cell can be a human or animal cell, a plant cell or even a bacteria.
Once attached to the cell, the virus injects its genetic material and uses the cell’s system to replicate.
“What happens with that cell?” Vela said. “The virus’ intent isn’t to destroy that cell, but the cell is eventually burdened so much with doing the viruses processes.”
In the end, the cell is destroyed.
Gastaldo said there are two basic types of viruses that affect humans.
The first type of virus will run its course, Gastaldo said. These viruses include the rhino viruses that causes “the common cold,” the influenza viruses that cause the winter respiratory illness commonly called the flu and gastrointestinal viruses that cause nausea and vomiting, along with measles and mumps. A person’s immune system will attack the virus and the body will eventually rid itself of the invader.
When the immune system attacks the virus, it creates “a memory”: specific antibodies for later use if the virus shows up again. Unfortunately, these viruses can mutate and re-enter the body or have many similar viruses — just different enough to cause another cold or flu. Over a long period of time, that antibody memory may also wane.
The second type of virus includes everything from HIV, Hepatitis C and Herpes to the virus that causes mononucleosis (Epstein Barr). These viruses are never completely destroyed by the immune system. The virus lays dormant in the system, occasionally “flaring up” to cause symptoms or slowly work against the body.
Gastaldo said Vericella-Zoster is a perfect example. When the body first sees the virus, it causes symptoms called chicken pox. After the body gets the symptoms under control, the virus silently sticks around; if it comes back, it causes shingles.
In the case of HIV, the virus actually attacks the immune system.
The problem, Gastaldo said, is preventing and treating viruses is far from a perfect science.
“In the era of infection, we don’t have that technology,” he said. “For viruses, unlike bacteria, we don’t have the same arsenal of medicine to treat infections.”
Some viruses can be prevented with vaccines, but there are few antiviral medications to help control or destroy the virus.
“We are years behind on antivirals,” Vela said.
That’s not what patients want to hear when they visit the doctor with flu or cold symptoms — or when they hear about outbreaks of measles or mumps.
“I tell patients that their symptoms are a result of the immune response,” Gastaldo said. “And the immune response is a good thing, whether it be a fever or inflammation or a cough.”
Gastaldo said patients often ask for antibiotics not knowing that antibiotics won’t work on viruses. He said that’s when doctors turn to treating the symptoms: acetaminophen or ibuprofen for the fever and aches, and medicine to quiet the cough at night and cough out the infection during the day.
For those viruses such as measles, mumps, rubella, Vericella-Zoster and influenza, Gastaldo said the best medicine is still prevention: a vaccine.
Stacy Kess can be reached at 740-363-4166, ext. 312, or on Twitter @StacyMKess.