How Gut Bacteria Are Controlling Your Brain

(Image credit: Getty Images)

Looking after the multitudes of bacteria, fungi and other microorganisms living in our guts could help us think better and even offer new ways of treating mental health conditions. Your gut is a bustling and thriving alien colony. They number in their trillions and include thousands of different species.

Many of these microorganisms, including bacteria, archaea and eukarya, were here long before humans, have evolved alongside us and now outnumber our own cells many times over. Indeed, as John Cryan, a professor of anatomy and neuroscience at University College Cork, rather strikingly put it in a TEDx talk: “When you go to the bathroom and shed some of these microbes, just think: you are becoming more human.”

Collectively, these microbial legions are known as the “microbiota” – and they play a well-established role in maintaining our physical health, from digestion and metabolism to immunity. They also produce vital compounds the human body is incapable of manufacturing on its own.

But what if they also had a hotline to our minds? In our new book, Are You Thinking Clearly? 29 Reasons You Aren’t And What To Do About It, we explore the dozens of internal and external factors that affect and manipulate the way we think, from genetics, personality and bias to technology, advertising and language. And it turns out the microbes that call our bodies their home can have a surprising amount of control over our brains.

Over the last few decades, researchers have started to uncover curious, compelling – and sometimes controversial – evidence to suggest that the gut microbiota doesn’t just help to keep our brains in prime working order by helping to free up nutrients for it from our food, but may also help to shape our very thoughts and behaviour. Their findings may even  potentially bolster how we understand and lead to new treatments for a range of mental health conditions, from depression and anxiety to schizophrenia.

The picture is still very far from complete, but in the wake of the Covid-19 pandemic, which has had a deleterious impact on people’s mental health in many parts of the world, unpicking this puzzle could be more important than ever.

One of the research field’s key origin stories took place in the North American wilderness – and, be warned, it makes for some stomach-churning reading. The year was 1822 and a young trader named Alexis St Martin was loitering outside a trading post on what is now called Mackinac Island, in what is now Michigan, when a musket accidentally went off next to him, firing a shot into his side from less than a yard (91cm) away.

His injuries were so bad that part of his lungs, part of his stomach and a good portion of his breakfast that day spilled out through the wound in his left side. Death seemed certain, but an army surgeon named William Beaumont rode to the rescue and saved St Martin’s life, although it took the best part of a year and multiple rounds of surgery.

What Beaumont couldn’t repair, however, was the hole in his patient’s stomach. This persistent fistula would remain a grim and lasting legacy of the accident, but Beaumont wasn’t one to pass up a good opportunity – however unpleasant. Realising that the hole provided a unique window into the human gut, he spent years investigating the intricacies of St Martin’s digestion.

Exactly how willing a volunteer St Martin was is open to debate as Beaumont employed him as a servant while conducting research on him – the murky arrangement almost certainly wouldn’t be considered ethical today. Among the findings Beaumont uncovered during his studies of St Martin’s guts, however, included how they were affected by its owner’s emotions, such as anger.

Through this finding, Beaumont, who would go on to be lauded as the “father of gastric physiology“, had hit upon the idea of a “gut-brain axis” – that the gut and the brain aren’t entirely independent of one another but instead interact, with one influencing the other and vice versa. And now we know that the microorganisms within our gut make this process even more complex and remarkable.

“More and more research is revealing that the gut microbiome can influence the brain and behaviour across a variety of different animals,” says Elaine Hsiao, associate professor in integrative biology and physiology, at the University of California, Los Angeles (UCLA).

It’s important to remember that the microbes were here before humans existed, so we have evolved with these ‘friends with benefits’ – John Cryan

How exactly our microbiota might be influencing our mind is a growing, pioneering and still relatively novel field. But there have been advances over the last 20 years or so, particularly in animals. And, slowly, a case is being built to suggest that these microorganisms aren’t just a vital part of our physical selves, but also our mental and emotional selves, too.

“In medicine, we tend to compartmentalise the body,” says Cryan. “So, when we talk about issues with the brain, we tend to think about the neck upwards. But we need to frame things evolutionarily. It’s important to remember that the microbes were here before humans existed, so we have evolved with these ‘friends with benefits’. There has never been a time when the brain existed without the signals coming from the microbes.

Continue Reading..

By Miriam Frankel and Matt Warren

Source: How gut bacteria are controlling your brain – BBC Future

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Love Hormone Oxytocin May Increase Life Satisfaction, Empathy

A recent study links neurochemical oxytocin with empathy and life satisfaction in older people. INA FASSBENDER/AFP via Getty Images

A new study published in the journal Frontier in Behavioral Neuroscience shows that older individuals tend to release more oxytocin in response to social situations that arouse empathy. A larger oxytocin response was also associated with greater levels of helping behaviors and increased satisfaction with life.

These findings may explain why older individuals donate more to charity and perform more social work.“People who released the most oxytocin in the experiment were not only more generous to charity but also performed many other helping behaviors. This is the first time a distinct change in oxytocin has been related to past prosocial behaviors,” said Dr. Paul Zak, the study author and a professor at Claremont Graduate University.

Oxytocin and social behaviors

Oxytocin is a hormone responsible for uterus contractions during childbirth, lactation, and reproductive behaviors. Oxytocin also modulates the transmission of signals between brain cells and is involved in modulating social behaviors. Experiments in humans suggest that brain oxytocin reduces anxiety and promotes trust, cooperation, empathy, generosityTrusted Source, and social bonding.

Studies have shown that older individuals tend to donate more money to charity and are more likely to engage in volunteer work than younger people. A potential explanation for this increase in prosocial behaviors could be greater empathy in response to social situations in older people than in younger people.

Given the association between oxytocin and empathy, the study’s authors wanted to understand whether oxytocin mediated increased prosocial behaviors in old age.

Oxytocin and age

The present study’s authors recruited 103 individuals between 18 and 99 years old. Researchers divided the participants into three groups: young (18 to 35 years), middle-aged (36 to 65 years ), or older (over 65 years) adults.

They asked the participants to watch a short emotional video of a father narrating his feelings about coping with the imminent demise of his two-year-old son with terminal brain cancer.

The researchers collected blood samples from the participants before and after watching the video to measure oxytocin levels. Previous studies have shown that changes in blood and brain oxytocin levels tend to be correlated, allowing the researchers to estimate changes in brain oxytocin levels using blood samples.

The researchers found that older individuals showed a larger increase in oxytocin levels after viewing the video than younger individuals.

Oxytocin and kindness

After viewing the video, the participants were given a monetary reward for participating in an unrelated study and the option to donate part of the reward to a medical charity.The researchers found that individuals with a larger increase in blood oxytocin levels were likely to donate a greater fraction of the reward money.

Furthermore, older individuals donated a larger fraction of the reward money to the charity. Surveys conducted during the study revealed that older individuals also spent greater time volunteering and donated more to charity in the previous year.

Notably, a small increase in oxytocin levels in older individuals was associated with a similar donation amount as younger individuals with a larger oxytocin response.

The study also found that aging resulted in a more profound increase in donations to charity in older individuals with a smaller oxytocin response than a larger one. The findings suggest that aging and oxytocin response levels together influence the amounts donated to charity.

Satisfaction with life and religiosity  

Consistent with other studies, the researchers found that older individuals were more likely to participate in religious activities and had a greater sense of satisfaction with life. Studies have shown that older, more religious adults engage more in charity and volunteer work and express greater life satisfaction.

The researchers found that a larger oxytocin response to the video stimulus was associated with a greater sense of satisfaction with life, participation in religious activities, and increased levels of empathy and gratitude.

Study limitations

The authors cautioned that the study only correlates oxytocin release and prosocial behaviors and other traits. The findings are especially relevant since there is a bidirectional relationship between oxytocin release and prosocial behaviors, with engagement in prosocial behaviors associated with a subsequent increase in oxytocin levels.

The authors also noted that the study involved a small number of participants residing in California. Hence, more research involving a larger number of participants representing the broader demographic needs to be conducted.

Intranasal oxytocin

Other studies also suggest that using intranasal sprays to deliver oxytocin can improve mood and cognitive function, especially in older men. Although there is an interest in the therapeutic use of intranasal oxytocin, the effects of oxytocin vary by context and among individuals.

Dr. Natalie Ebner, a neuroscientist at the University of Florida, noted in a lecture, “There is a lot of evidence that oxytocin doesn’t always work the same way. It depends a little bit on what kind of situation you are in, if it’s a positive social situation it does one thing, if it’s a hostile situation suddenly it increases aggressivity. So there are a lot of interesting manipulations we can do by looking closer at contextual factors and we’re starting to see a lot is that not everyone responds in the same way.”

Source: ‘Love hormone’ oxytocin may increase life satisfaction, empathy

.

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Immunity Debt: Does It Really Exist?

Illustration by Klawe Rzeczy.

The deaths of at least 190 people, including 30 children, from the invasive bacterial infection group A streptococcus, or strep A, are the most extreme consequences of a wave of winter infections that have seemingly left most of the country coughing and sneezing. The parlous state of the nation’s health has prompted suggestions that we are now paying an “immunity debt” incurred by the reduction of common infections during the Covid-19 lockdowns of 2020 and 2021.

But experts seem divided about whether the debt concept is genuine, let alone whether it explains the prevalence of non-Covid afflictions. As with so many of the debates about the outcomes of the pandemic, there do not appear to be simple answers – but no shortage of self-proclaimed “experts” ready to give them anyway.

While there are good reasons to believe that the measures taken to reduce the spread of the coronavirus have broader implications for common infectious diseases, there is no one-case-fits-all explanation for the spate of winter bugs, much less any obvious conclusions to be drawn about pandemic management.

Are the infection rates really so unusual anyway? Cases of strep A and associated scarlet fever certainly seem unusually high, with 37,068 recorded cases of the latter up to 8 January, compared to 4,490 at the same point in the earlier high season of 2017-18. But whether there is an anomalous prevalence of common infections across the board is less clear. “For some of the infections, we don’t really know,” says Petter Brodin, professor of paediatric immunology at Imperial College London.

Every winter, there is an upsurge in common infections such as flu, colds (caused by various viruses) and respiratory syncytial virus (RSV), which produces cold-like symptoms. Bacterial infections follow a similar seasonality, according to Michael Levin, professor of paediatrics and international child health at Imperial because they tend to take opportunistic advantage of an immune system weakened by a virus. RSV in infants and young children, for example, sometimes leads to bronchiolitis, an infection of the respiratory tract that can be serious.

At this time of year, “having hospital beds filled with children and adults with viral disease and pneumonia is not unusual”, says Levin. But although there is as yet little hard data, he adds that “there is an impression that we are having an unusually severe winter with RSV, flu and adenovirus”, the last of which causes cold-like symptoms. He adds: “We’re seeing increased numbers of children with severe bacterial infections – there is definitely more streptococcal infection around.”

There are similar reports across North America, while unusually high levels of RSV in children reported in Australia and New Zealand in mid-2021 provoked the first mentions of Covid immunity debt. Brodin agrees that something seems unusual both in the timing and the numbers of infections. In Sweden, where he was working until moving to Imperial in October 2021, the incidence of RSV was markedly unusual last year too.

If that is the case, what is the cause? “Here we enter the realm of guessing and speculation,” says Levin. It’s not clear that there is a general answer. “Every bug has a different dynamic,” concurs Brodin. Flu surges across the globe, driven largely by temperature changes and people’s travel behaviour, whereas RSV is present all the time in the population and usually peaks about November to December in the UK. The incidence of such infections also depends on how many children are born each year, since newborns have essentially no immunity.

Our immune systems need exposure to pathogens to maintain a good level of resistance. Many common infections such as colds are caused by endemic viruses and bacteria that people often carry asymptomatically because their immune systems keep the pathogen in check. For example, many people carry the meningococcal bacteria that cause meningitis, but only about one in 50,000 were, before vaccines, at risk of getting ill from them. “The normal state for most of these things is asymptomatic carriage,” says Levin.

Such symptom-free, low-level infection can prime the immune system to ward off another infection months or even years later. “Children and adults do build up a repertoire of immunity from exposure,” Levin says – as every parent knows, young children in particular are constantly exchanging common pathogens. But such immunity generally wanes, so if you haven’t been exposed for some time, for example, because of social distancing and lockdowns during 2020 and 2021, you will be more susceptible.

“It’s plausible that we may now have a population that has met fewer common viruses and is therefore more susceptible,” says Levin. Moreover, if fewer people have such immunity, there will be more transmission in the population. “Children normally catch scarlet fever in their first year at school, if at all,” says Shiranee Sriskandan, professor of infectious diseases at Imperial. “Scarlet fever rates plummeted during 2020-2021.

Therefore, school-age children may not have built up immunity to strep A, so we now have a much larger cohort of non-immune children.” A study last June reported that, because of reduced transmission of common respiratory viruses during the pandemic, breastfeeding infants were being passed fewer protective antibodies from the mother.

But whether there is a generalised immunity debt is less clear. How long post-infection immunity lasts varies from one virus to another. And for flu viruses, infection in one season may or may not offer protection in the next, depending on how closely related the two strains are. Levin says that in many cases we don’t really know how much repeated exposure is needed to sustain immunity – for some diseases, such as smallpox and measles, just one infection generally gives lifelong protection.

Another reason that has been proposed for enhanced infections this season is that Covid-19, which most of the population has now experienced at least once, has itself weakened some people’s immune systems. But this will probably not be widespread, if it happens at all. While there is evidence of immune dysfunction persisting for many months in some people who catch Covid, this is not so much a weakening of immunity as a problematic overactivation.

A study published last January by Prof Gail Matthews, an infectious diseases physician at the University of New South Wales in Australia, and her colleagues showed overactive immune function up to eight months after Covid infection in some people. “The most likely reason for this is some level of viral persistence that the immune system is recognising as foreign and still reacting to,” Matthews says. But she doubts that there is any evidence of widespread Covid-induced immune impairment.

Lockdown was the right strategy for a new disease with a totally susceptible population and probably saved thousands of lives

Brodin has seen similar Covid-related immune dysfunction. He and his co-workers have studied children with multisystem inflammatory syndrome, a rare but serious condition in which an extreme response a few months after infection has to be treated with immunosuppressants. He says that for some people with long Covid too: “There is clearly something wrong with the way the immune system continues to be activated.”

But whether any such problems arise for the majority of people who have mild Covid symptoms is far less clear, he says. “There’s nothing that suggests that, although we can’t rule it out.” Lockdowns and social distancing do seem to have reduced infections such as flu and RSV during the pandemic. But if it turns out that those measures have contributed to higher rates of such infections now, what conclusions should we draw? Opponents of lockdowns say that it highlights another of their flaws, for which we are now paying a heavy price.

That position makes little sense. There is compelling evidence that lockdowns and social distancing saved lives, especially while vaccines were still not available. A day or two in bed with a bad cold seems a small price to pay for that. A small minority of researchers have, however, questioned whether lockdowns really made much difference to the spread of Covid.

Infectious-disease epidemiologist Sunetra Gupta of Oxford University asserted in the Daily Telegraph that lockdowns do little to slow the spread of an epidemic disease such as Covid-19 but have much more impact on endemic diseases such as colds and RSV. But Brodin is dismissive of such a crude division into epidemic versus endemic diseases. “It’s incredibly far-fetched to say that is the uniform solution,” he says.

Besides, he adds, how then to explain that RSV is also running riot now in Sweden, which famously eschewed lockdowns and kept schools open? Those who have noisily championed the Swedish approach to the pandemic can hardly argue that it would have made any difference to our alleged immunity debt now. In short, Brodin says, it is much too simplistic to say: “What we’re seeing in children’s hospitals is simply the result of lockdown.”

Besides, Levin adds: “Lockdown was an essential public health measure. It was the right strategy for a new disease with a totally susceptible population and probably saved thousands of lives.” A much more fruitful response to the surge in infections, says Brodin, is to “be thinking about how we develop better vaccines and get people to take them”. We should be developing and rolling out vaccines against flu (for which multistrain “universal” jabs are now being trialled) and RSV (for which a vaccine is on the near horizon) much faster, as well as thinking more seriously about non-pharmaceutical interventions such as wearing masks.

“It seems absolutely insane to me that we should get on a packed tube at rush hour and there will be people sneezing and coughing and not wearing a mask to protect others,” says Levin. “In Asian countries, you have always worn a mask if you have a cold.” He adds that we should also stop encouraging ill people to go to work and continue to advise hand washing and good hygiene. Flu, for instance, is spread mostly by people touching infected surfaces and then their eyes.

Such measures “could greatly reduce the burden of infection in the population”, he says. But vaccines are key. “Many of these severe diseases are vaccine-preventable and we should be ensuring that as many of the population as are susceptible are protected,” says Levin. If we rely on natural infection to build up immunity, though, isn’t that better than getting vaccinated? No, says Prof Peter Openshaw, who heads the infection programme of the Biomedical Research Centre at Imperial.

The immune response a vaccine awakens is “just as ‘natural’ as the response you get to the virus, sometimes even better, and certainly less dangerous”. “I can’t think of an example of a viral infection being better than getting vaccinated,” Openshaw adds. What’s more, the point of a vaccine is to protect those who would otherwise probably develop severe disease – and predicting who those people are is not always possible.

“We vaccinate all to protect the few, because we can’t identify the vulnerable,” says Levin. Covid should have taught us that. Casting this debate in terms of an immunity debt is therefore potentially misleading, as it implies that this is a zero-sum game: you have to keep paying with infections to stay in credit. Vaccines can simply cancel the “debt”. Who wouldn’t want that?

By:

Source: Immunity debt: does it really exist? | Science | The Guardian

.

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Hydration Linked With Lower Disease Risk, study finds

You may know that being adequately hydrated is important for day-to-day bodily functions such as regulating temperature and maintaining skin health. But drinking enough water is also associated with a significantly lower risk of developing chronic diseases, a lower risk of dying early or lower risk of being biologically older than your chronological age, according to a National Institutes of Health study published Monday in the journal eBioMedicine.

“The results suggest that proper hydration may slow down aging and prolong a disease-free life,” said study author Natalia Dmitrieva, a researcher in the Laboratory of Cardiovascular Regenerative Medicine at the National Heart, Lung and Blood Institute, a division of NIH, in a news release.

Learning what preventive measures can slow down the aging process is “a major challenge of preventive medicine,” the authors said in the study. That’s because an epidemic of “age-dependent chronic diseases” is emerging as the world’s population rapidly ages. And extending a healthy life span can help improve quality of life and decrease health care costs more than just treating diseases can.

The authors thought optimal hydration might slow down the aging process, based on previous similar research in mice. In those studies, lifelong water restriction increased the serum sodium of mice by 5 millimoles per liter and shortened their life span by six months, which equals about 15 years of human life, according to the new study. Serum sodium can be measured in the blood and increases when we drink less fluids.

Using health data collected over 30 years from 11,255 Black and White adults from the Atherosclerosis Risk in Communities study, or ARIC, the research team found adults with serum sodium levels at the higher end of the normal range — which is 135 to 146 milliequivalents per liter (mEq/L) — had worse health outcomes than those at the lower end of the range. Data collection began in 1987 when participants were in their 40s or 50s, and the average age of participants at the final assessment during the study period was 76.

Adults with levels above 142 mEq/L had a 10% to 15% higher chance of being biologically older than their chronological age compared with participants in the 137 to 142 mEq/L range. The participants with higher faster-aging risk also had a 64% higher risk for developing chronic diseases such as heart failure, stroke, atrial fibrillation, peripheral artery disease, chronic lung disease, diabetes and dementia.

And people with levels above 144 mEq/L had a 50% higher risk of being biologically older and a 21% higher risk of dying early. Adults with serum sodium levels between 138 and 140 mEq/L, on the other hand, had the lowest risk of developing chronic disease. The study didn’t have information on how much water participants drank.

“This study adds observational evidence that reinforces the potential long-term benefits of improved hydration on reductions in long-term health outcomes, including mortality,” said Dr. Howard Sesso, an associate professor of medicine at Harvard Medical School and associate epidemiologist at Brigham and Women’s Hospital in Boston, via email. Sesso was not involved in the study.

However, “it would have been nice to combine their definition of hydration, based on serum sodium levels only, with actual fluid intake data from the ARIC cohort,” Sesso added.

Biological age was determined by biomarkers that measure the performance of different organ systems and processes, including cardiovascular, renal (relating to the kidneys), respiratory, metabolic, immune and inflammatory biomarkers.

High serum sodium levels weren’t the only factor associated with disease, early death and faster aging risk — risk was also higher among people with low serum sodium levels. This finding is consistent with previous reports of increased mortality and cardiovascular disease in people with low regular sodium levels, which has been attributed to diseases causing electrolyte issues, the authors said.

The study analyzed participants over a long period of time, but the findings don’t prove a causal relationship between serum sodium levels and these health outcomes, the authors said. Further studies are needed, they added, but the findings can help doctors identify and guide patients at risk.

“People whose serum sodium is 142 mEq/L or higher would benefit from evaluation of their fluid intake,” Dmitrieva said. Sesso noted that the study did not strongly address accelerated aging, “which is a complicated concept that we are just starting to understand.”

“Two key reasons underlie this,” Sesso said. The study authors “relied on a combination of 15 measures for accelerated aging, but this is one of many definitions out there for which there is no consensus. Second, their data on hydration and accelerated aging were a ‘snapshot’ in time, so we have no way to understand cause and effect.”

Drink enough fluids every day

About half of people worldwide don’t meet recommendations for daily total water intake, according to several studies the authors of the new research cited.

“On the global level, this can have a big impact,” Dmitrieva said in a news release. “Decreased body water content is the most common factor that increases serum sodium, which is why the results suggest that staying well hydrated may slow down the aging process and prevent or delay chronic disease.”

Our serum sodium levels are influenced by liquid intake from water, other liquids, and fruits and vegetables with high water content.

“The most impressive finding is that this risk (for chronic diseases and aging) is apparent even in individuals who have serum sodium levels that are on the upper end of the ‘normal range,’” said Dr. Richard Johnson, professor at the University of Colorado School of Medicine, via email. He was not involved in the study.

“This challenges the question of what is really normal, and supports the concept that as a population we are probably not drinking enough water.”

More than 50% of your body is made of water, which is also needed for multiple functions, including digesting food, creating hormones and neurotransmitters, and delivering oxygen throughout your body, according to the Cleveland Clinic.

The National Academy of Medicine (formerly known as the Institute of Medicine) recommends women consume 2.7 liters (91 ounces) of fluids daily, and that men have 3.7 liters (125 ounces) daily. This recommendation includes all fluids and water-rich foods such as fruits, vegetables and soups. Since the average water intake ratio of fluids to foods is around 80:20, that amounts to a daily amount of 9 cups for women and 12 ½ cups for men.

People with health conditions should talk with their doctor about how much fluid intake is right for them.

“The goal is to ensure patients are taking in enough fluids, while assessing factors, like medications, that may lead to fluid loss,” said study coauthor Dr. Manfred Boehm, director of the Laboratory of Cardiovascular Regenerative Medicine, in a news release. “Doctors may also need to defer to a patient’s current treatment plan, such as limiting fluid intake for heart failure.”

If you’re having trouble staying hydrated, you might need help working the habit into your usual routine. Try leaving a glass of water at your bedside to drink when you wake up, or drink water while your morning coffee is brewing. Anchor your hydration habit to a location you’re in a few times per day, behavioral science expert Dr. B.J. Fogg, founder and director of the Stanford University Behavior Design Lab, previously told CNN.

Source: Hydration linked with lower disease risk, study finds | CNN

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Related contents:

The Impact of Hydration on Disease and Longevity Runners’ World

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Do You Have a Cold, Flu, Covid or Strep A?

Before you head home for Christmas, it’s worth working out whether that chesty cough is just a cold or a symptom of flu, Strep A or Covid. Health bosses are warning Brits not to travel to see elderly relatives if they’ve got a cough. As flu numbers continue to sore and Covid cases increase, we’re being told to swerve family Christmas celebrations yet again.

This comes after the surge in the numbers of children dying from the bacterial throat infection strep A earlier this month. It’s safe to say that following the Covid-19 pandemic, we’re all on edge when it comes to infectious illnesses, especially ones which are highly contagious.

So, we asked the experts for the lowdown how to know if you have a simple cold, strep A or Covid infection.

What is strep A?

“Strep A is a type of bacterium found in the throat and on the skin,” explains GP and director of Cosmedics Dr Ross Perry. “Group A streptococcus (GAS) is a common bacterium that lots of us carry it in our throats and on our skin and it doesn’t always result in illness.” So why the focus on it? Well, the concern is two-fold. Firstly, strep A bacteria can lead to more serious infections in rare cases.

Duncan Reid, pharmacist at Pharmacy2U, explains: “Streptococcus A (strep A) are a group of bacteria that cause scarlet fever and respiratory and skin infections such as strep throat and impetigo. Scarlet fever is usually a mild illness, but it is highly infectious. Symptoms of scarlet fever are a sore throat, headache and fever, along with a fine, pinkish or red body rash with a sandpapery feel. On darker skin, the rash can be more difficult to detect visually but will have a sandpapery feel.” Secondly, we’re currently seeing a steep rise in cases.

Why is there so much strep A around this year?

“We have seen a huge rise in cases since September,” says Dr Perry. “According to Dr Susan Hopkins (the chief medical advisor for the UK Health Security Agency) it is thought that this is due to greater social mixing than pre-pandemic, and the fact that children were less exposed to the bacterial infection during lockdown.”

This has led to a sharp uptick in cases, particularly among primary school children and several deaths have sparked concern among parents and the general public. It is important to remember, however, that for the majority of people, a strep A infection will be a mild illness.

“Outbreaks of group A strep do happen every few years,” Dr Zoe Watson, GP locum and founder of Wellgood Wellbeing, reassures us. “The current surge in cases actually still isn’t as high as the last outbreak in 2018, but the current levels are certainly higher than usual for this time of year, so experts are worried this may continue to rise. Currently, there is no evidence that a new strain group A strep is circulating. The increase is most likely related to high amounts of circulating bacteria and increased social mixing after relaxation of social distancing rules.”

How do you catch strep A?

“Strep A is spread through contact with droplets from an infected person when they talk, cough or sneeze,” explains Reid. “Some people can have the bacteria present in their body without feeling unwell or showing any symptoms of infections, and while they can pass it on, the risk of spread is much greater when a person is unwell. It is still possible to infect others for up to three weeks.”

As with any other infectious illness, it’s especially important to be thorough with handwashing, using a tissue to catch coughs and sneezes and staying away from others if you’re unwell – steps we’re all used to, after the last couple of years.

What are the symptoms of strep A?

You may not even know you have a strep A infection, but if you do become unwell, the chances are you’ll suffer from cold-like symptoms. “For some people, strep A may show no symptoms, but others can be very unwell with symptoms such as a high temperature, sore throat, swollen tonsils, temperature, skin rash and earache,” explains Dr Perry.

How can I tell if I have Covid, flu, strep A or a cold?

As the symptoms of all three are closely linked and extremely common in winter, it can be tricky to tell the difference. Children get three times as many colds per year than adults, so Reid advises: “It’s important to remember that most will have a common seasonal virus, which can be treated by keeping hydrated, and with paracetamol.”

Is it a cold?

“At this time of year, viral infections are very common and prevalent,” reassures Dr Perry. “A simple cold is a viral infection of the nose and throat and normally short-lived and harmless. You can expect a cold to last seven to 10 days, sometimes a little longer depending on lifestyle. The main symptoms of a cold will be runny nose, sore throat, congestion, raised temperature, fatigue, muscle aches and a mild cough.”

Or flu?

Flu is everywhere this year. Some symptoms are similar to those of a cold, including having a cough and sore throat, but others include high temperature, aching muscles, headaches and loss of appetite. In fact, it sounds a lot like Covid…

What about Covid?

“It is more common to have other symptoms present if it is Covid,” explains Dr Perry. “You’re more likely to have a cough, loss of smell and fever, fatigue and muscle aches, so if you feel it is more than just a cold, it’s best to take a Covid test to be sure.”

Or strep A?

Strep A generally presents as a prolonged sore throat with an accompanying rash, which feels like sandpaper, or strawberry tongue where white lumps appear. Look out for any problems breathing and swallowing and worsening symptoms which last longer than a couple of days and show no sign of improvement.

Since many people will have either no symptoms with strep A infections or feel cold or flu-like, the experts agree it is important to keep an eye on any worsening or persistent symptoms. “In rare cases, the group A bacteria can pass into the bloodstream, causing an illness known as invasive group A strep (iGAS),” explains Dr Perry. “Invasive disease happens when the bacteria get past your body’s immune defences. This can happen when you are already ill or are on treatments, such as some cancer therapies that affect your immune system.”

While still uncommon, there has been an increase in invasive group A strep cases this year, particularly in children under 10, as seen in the news headlines. According to Dr Perry, warning signs of invasive disease include a fever of above 38°C and severe muscle aches.

“You should monitor a rising temperature, particularly in children if they go over 39°C and for babies over 38°C,” advises Dr Perry. “Check for an accompanying rash which feels like sandpaper, or strawberry tongue where white lumps appear, any problems breathing and swallowing and worsening symptoms which prolong after two days and show no sign of improvement. Seek medical advice immediately from your GP and NHS 111 out of hours if you’re concerned.”

How is it treated?

“In general, a group A strep infection starts off as minor, or ‘non-invasive’ but can become more serious, or ‘invasive’ when the bacterium is able to infect areas where it is not usually found, such as the blood and the lungs,” explains Dr Watson. “This can happen if it’s not treated with antibiotics in a timely manner or if the infection simply becomes too overwhelming for the body to cope with, even with antibiotics on board.”

The good news is that when caught early enough, strep A responds well to antibiotic treatment. “Treatment with antibiotics will help you get better quicker, reduce the chance of serious illnesses, such as pneumonia,” advises Reid. “It also makes it less likely that you’ll pass the infection on to someone else.”

The advice is clear: trust your judgment when it comes to a poorly child. If you’re concerned, seek prompt medical attention and remember that, thankfully, strep A outbreaks do tend to be short-lived.

By:  for Wellbeing

Source: Do you have a cold, flu, Covid or Strep A?

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