Zika: Could virus spread via contact with sweat, tears?

In a letter to the New England Journal of Medicine, doctors discuss a rare case of the death in the United States of a patient infected with Zika virus, and how another patient may have contracted the virus by coming into contact with the first patient’s sweat or tears.


The researchers discuss the possibility that Zika may spread through contact with tears of sweat from a highly infectious patient.

The first patient, a 73-year-old man, died in June of this year at the University of Utah hospital in Salt Lake City – the first known case of Zika virus-related death in the continental U.S.

He began experiencing symptoms of Zika virus infection 8 days after returning from a trip to southwest Mexico, a Zika-infected area.

At first, his symptoms were abdominal pain and fever. By the time he was admitted to the hospital, he also had watery, inflamed eyes, low blood pressure, and a rapid heart rate. He developed septic shock, his kidneys, lungs, and other organs shut down, and he died shortly after.

The second patient, “a previously healthy 38-year-old man with no known coexisting illnesses,” visited the first patient in hospital and reported wiping away his tears and helping nurses to reposition him in the hospital bed.

He came to the attention of one of the authors during a discussion about what happened to the first patient a week after he died; they noticed he had red, watery eyes, a common symptom of Zika infection.

Tests confirmed the second patient was infected with Zika, but his symptoms were only mild and resolved within a few days.

Case continues to puzzle health experts

Two aspects of this case continue to puzzle health experts. First, why did the first patient die? It is very rare for Zika infection to even cause severe illness in adults – much less, death.

Fast facts about Zika

  • Health authorities say the best way to prevent Zika is to prevent mosquito bites
  • Pregnant women are advised not to travel to areas with Zika
  • Couples with a partner who lives in or has been to a Zika area should take protective measures during sex.

Only nine other cases of deaths linked to Zika virus have been reported worldwide, note the researchers from the University of Utah School of Medicine, together with colleagues from ARUP Laboratories, also in Salt Lake City.

The second point that remains a mystery is how did the second patient contract Zika? He did nothing that was known at the time to put himself at risk.

In their letter, the researchers suggest unusually high levels of Zika virus in the first patient’s blood may have been the cause of his death.

This may also explain why the second patient may have become infected with the virus – through touching tears or sweat from the first patient. The authors note this is the first time such a transmission route has been documented.

Corresponding author Sankar Swaminathan, a professor of internal medicine at the University of Utah School of Medicine, remarks:

“This rare case is helping us to understand the full spectrum of the disease, and the precautions we may need to take to avoid passing the virus from one person to another in specific situations.”

‘Viral load 100,000 times higher’

The researchers ran several tests to show there were no other infections that could explain the first patient’s illness. One of these is called Taxonomer, which rapidly analyzes all genetic material from infectious agents in a patient’s sample.

They found the Zika virus the first patient was infected with was 99.8 percent identical to that identified in a mosquito collected from the area he had visited – southwest Mexico – in the weeks before falling ill.

In discussing how the second patient became infected, the authors note that the species of mosquito that carries Zika has not been found in Utah, he had not traveled to a Zika-infected area, and a reconstruction of events ruled out any other known means of transmission.

The researchers suggest the reason the second patient become infected was because the first patient had unusually high levels of virus in his body – 200 million particles per milliliter. This could have overwhelmed his system and made him extremely infectious.

Prof. Swaminathan, who is also chief of infectious diseases at the School of Medicine, describes his reaction:

“I couldn’t believe it. The viral load was 100,000 times higher than what had been reported in other Zika cases, and was an unusually high amount for any infection.”

The researchers say they still do not know what led to such an unusually severe infection. Did something in the first patient’s biology or health history make him particularly vulnerable? Was the particular strain he had – there were tiny genetic differences to other known strains – particularly aggressive?

Prof. Swaminathan says we may never see another case like this, and it shows we still have a lot to learn about Zika.

“This type of information could help us improve treatments for Zika as the virus continues to spread across the world and within our country.”

Prof. Sankar Swaminathan

 


Sara Cox talks about the lenses that change everthing

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Sara Cox, radio and TV presenter and busy mum to three children, is the new ACUVUE® Brand Ambassador. She recently mentioned on her radio show that she thought her eyesight had changed. ACUVUE® Brand Contact Lenses interviewed her to find out more. She said she was having difficulties “reading the very small print up close”. She was concerned that contact lenses might no longer work for her and she might have to get some reading glasses. When we asked her about it, Sara said: “I thought I might have to get a small pair of spectacles, perhaps on a pearl chain around my neck – that wasn’t necessarily the look I was going for!” Sara has developed presbyopia. If you have started struggling to read the small print or find the text on your phone doesn’t seem big enough anymore, you might have presbyopia too. But don’t worry, it’s normal.

 

What is presbyopia?

Put simply, presbyopia is when the lens in the eye stiffens and thickens with age. This makes it harder to see things at close range. As we get older, our eye’s lens becomes stiffer and less able to change shape making focusing more challenging. Presbyopia is particularly common in people over the age of 40 and eventually happens to almost everyone.

What can I do about presbyopia?

The good news is there are many solutions for people with presbyopia. They can wear varifocal glasses, wear both contact lenses and reading glasses, or even have surgery. But even better news: now innovative technology brings you 1-DAY ACUVUE® MOIST Brand MULTIFOCAL Contact Lenses.

Why contact lenses?

Contact lenses don’t get in the way, or obscure your face, like glasses. Thanks to ACUVUE® , you can have a contact lens that gives you clear vision – near, far and in between – so you can maintain the active lifestyle you’ve always had. You don’t have to stop living your life the way you want to. As Sara Cox says: “I don’t wear glasses to the gym…EVER”. Unlike varifocal glasses, multifocal contact lenses fit seamlessly into your busy life whether for work or play, going to the gym or out with friends. If, like Sara, you have recently developed presbyopia, 1-DAY ACUVUE® MOIST MULTIFOCAL Contact Lenses may be the perfect solution! Forget reading glasses! See clearly without glasses getting in the way or steaming up. You won’t have to fiddle around with reading glasses to view the menu or get a message on your phone!

For Comfort

As with all 1-DAY ACUVUE® MOIST Contact Lenses, 1-DAY ACUVUE® MOIST MULTIFOCAL Contact Lenses have exclusive LACREON® technology, that embeds a moisturerich wetting agent in the lens for extremely comfortable wear and a fresh feeling all day and all night long. As Sara says, she doesn’t “really know that they’re in, you just feel like you’ve got your old eye sight back”.

For Convenience

Whether you wear contact lenses every day or just occasionally, 1-DAY ACUVUE® MOIST MULTIFOCAL Contact Lenses make it easy. No need to clean and store contact lenses every day – just take a new pair for all day freshness. Contact lenses are easy to handle, convenient and comfortable and give you clear vision, near, far and in between.

Get Protection!

All ACUVUE® Brand Contact Lenses have UV blocking for protection from the transmission of UV radiation*.

Ask us for a free trial† today!

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†terms and conditions apply contact us for more information.


Contact Lens Basics

Contact lenses are an excellent choice for nearly anyone who needs vision correction but doesn’t want to wear spectacles full time or undergo Lasik Surgery.

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Here are the basics you should know about contact lenses before seeing your optician if you are interested in wearing contacts.

 

Contact Lens Materials

The first choice when considering contact lenses is which lens material will best satisfy your needs. There are five types of contact lenses, based on type of lens material they are made of:

CONTACT LENS MATERIAL

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  • Soft lensesare made from gel-like, water-containing plastics called hydrogels. These lenses are very thin and pliable and conform to the front surface of the eye. Introduced in the early 1970s, hydrogel lenses made contact lens wear much more popular because they typically are immediately comfortable. The only alternative at the time was hard contact lenses made of PMMA plastic (see below). PMMA lenses typically took weeks to adapt to and many people couldn’t wear them successfully.
  • Silicone hydrogel lensesare an advanced type of soft contact lenses that are more porous than regular hydrogel lenses and allow even more oxygen to reach the cornea. Introduced in 2002, silicone hydrogel contact lenses are now the most popular lenses prescribed in the UK
  • Gas permeable lenses— also called GP or RGP lenses — are rigid contact lenses that look and feel like PMMA lenses (see below) but are porous and allow oxygen to pass through them. Because they are permeable to oxygen, GP lenses can be fit closer to the eye than PMMA lenses, making them more comfortable than conventional hard lenses. Since their introduction in 1978,gas permeable contact lenses have essentially replaced nonporous PMMA contact lenses. A significant advantage GP contacts have over soft or silicone hydrogel lenses is sharper optics due to the rigid nature of the lens material.
  • Hybrid contact lensesare designed to provide wearing comfort that rivals soft or silicone hydrogel lenses, combined with the crystal-clear optics of gas permeable lenses. Hybrid lenses have a rigid gas permeable central zone, surrounded by a “skirt” of hydrogel or silicone hydrogel material. Despite these features, only a small percentage of people in the UK wear hybrid contact lenses, perhaps because these lenses are more difficult to fit and are more expensive to replace than soft and silicone hydrogel lenses.
  • PMMA lensesare made from a transparent rigid plastic material called polymethyl methacrylate (PMMA), which also is used as a substitute for glass in shatterproof windows and is sold under the trademarks Lucite, Perspex and Plexiglas. PMMA lenses have excellent optics, but they do not transmit oxygen to the eye and can be difficult to adapt to. These (now old-fashioned) “hard contacts” have virtually been replaced by GP lenses and are rarely prescribed today.

 

Silicone hydrogel contact lenses are the most popular lenses in the UK, accounting for 68 percent of new contact lens fittings and refittings in 2015.

Contact Lens Wearing Time

Until 1979, everyone who wore contact lenses removed and cleaned them nightly. The introduction of “extended wear” enabled wearers to sleep in their contacts. Now, two types of lenses are classified by wearing time:

  • Daily wear— must be removed nightly
  • Extended wear— can be worn overnight, usually for seven days consecutively without removal

“Continuous wear” is a term that’s sometimes used to describe 30 consecutive nights of lens wear

 

When To Replace Your Contact Lenses

Even with proper care, contact lenses (especially soft contacts) should be replaced frequently to prevent the build-up of lens deposits and contamination that increase the risk of eye infections.

Soft lenses have these general classifications, based on how frequently they should be discarded:

LENS REPLACEMENT FREQUENCY

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  • Daily disposable lenses— Discard after a single day of wear
  • Disposable lenses— Discard every two weeks, or sooner
  • Frequent replacement lenses— Discard monthly or quarterly
  • Traditional (reusable) lenses— Discard every six months or longer

Gas permeable contact lenses are more resistant to lens deposits and don’t need to be discarded as frequently as soft lenses. Often, GP lenses can last a year or longer before they need to be replaced.

Contact Lens Designs

Many lens designs are available to correct various types of vision problems:

  • Sphericalcontact lenses are the typical, rounded design of contact lenses, which can correct myopia (nearsightedness) or hyperopia (farsightedness).
  • Bifocalcontact lenses contain different zones for near and far vision to correct presbyopia
  • Orthokeratologylenses are specially designed to reshape the cornea during sleep, providing lens-free daytime wear.
  • Toriccontact lenses correct for astigmatism, as well as for myopia and hyperopia

 

All of these lenses can be custom made for hard-to-fit eyes. Many other additional lens designs are available. Typically these are less common and fabricated for use in special situations, such as correcting for keratoconus.

 

More Contact Lens Features

Bifocal contacts for astigmatism. These are advanced soft contacts that correct both presbyopia and astigmatism, so you can remain glasses-free after age 40 even if you have astigmatism.

 

Contacts for dry eyes. Are your contacts uncomfortably dry? Certain soft contact lenses are specially made to reduce the risk of contact lens-related dry eye symptoms.


Coloured lenses. Many of the types of lenses described above also come in colours that can enhance the natural colour of your eyes — that is, make your green eyes even greener, for example. Other colored lenses can totally change the colour of your eyes, as in from brown to blue.

Special-effect lenses. Also called theatrical, novelty, or costume lenses, special-effect contacts take coloration one step further to make you look like a cat, a vampire, or another alter-ego of your choice.

 

Prosthetic lenses. Coloured contact lenses also can be used for more medically oriented purposes. Opaque soft lenses called prosthetic contacts can be custom-designed for an eye that has been disfigured by injury or disease to mask the disfigurement and match the appearance of the other, unaffected eye.

 

Custom lenses. If conventional contact lenses don’t seem to work for you, you might be a candidate for custom contact lenses that are made-to-order for your individual eye shape and visual needs.

 

UV-inhibiting lenses. Some soft contact lenses help protect your eyes from the sun’s ultravioletrays that can cause cataracts and other eye problems. But because contacts don’t cover your entire eye, you still should wear UV-blocking sunglasses outdoors for the best protection from the sun.

 

Scleral lenses. Large-diameter gas permeable lenses called scleral contacts are specially designed to treat keratoconus and other corneal irregularities, as well as presbyopia.

 

Myopia control contacts. Special contact lenses are being developed to slow or stop the progression of nearsightedness in children.

 

Which Contact Lens Is Right for You?

First, your contacts must address the problem that is prompting you to wear lenses in the first place. Your contact lenses must provide good vision by correcting your myopiahyperopia,astigmatism, or some combination of those vision problems.

Second, the lens must fit your eye. To do that, lenses come in tens of thousands of combinations of diameter and curvature. Of course, not every lens brand comes in every “size.”

Your Opician is skilled in evaluating your eye’s physiology, and your eyesight, to determine which lens best satisfies the two criteria above.

 

Third, you may have another medical need that drives the choice of lens. For example, your Optician might pick a particular lens if your eyes tend to be dry.

Finally, consider your “wish list” of contact lens features — colors, for example, or overnight wear.

Contact Lens Wear and Care

Caring for your contact lenses — cleaning, disinfecting and storing them — is much easier than it used to be.
A few years ago, you would have needed several bottles of cleaning products, and perhaps enzyme tablets, for proper care. Today, most people can use “multipurpose” solutions — meaning that one product both cleans and disinfects, and is used for storage.

People who are sensitive to the preservatives in multipurpose solutions might need preservative-free systems, such as those containing hydrogen peroxide. These do an excellent job of cleaning contacts, but it’s very important to follow the directions for using them. The solution should not come into contact with your eyes until soaking is complete and the solution is neutralized.Of course, you can avoid lens care altogether by wearing daily disposable contact lenses.

Contact Lens Problems

Trial and error often is involved in finding the perfect lens for you. People react differently to various lens materials and cleaning solutions.

Also, the correct “parameters” of your lens — that is, power, diameter, and curvature — can be finalized only after you’ve successfully worn the lens. This is especially true for more complex fits involving extra parameters, such as with bifocals or toric contact lenses for astigmatism.

If you experience discomfort or poor vision when wearing contact lenses, chances are that an adjustment or change of lens can help.

 

Today, more contact lens choices than ever are available to provide comfort, good vision, and healthy eyes. If your eyes or lenses are uncomfortable or you are not seeing well, remove your lenses and visit your eye care professional to explore available remedies for contact lens discomfort.

Source: Liz Segre