Common Medical Conditions That Are Asymptomatic

Signs and Symptoms are technical terms to describe the extent of disease in a patient. A sign is an effect of the disease that can be observed by another person or elicited through certain manoeuvres while a symptom is an effect that is experienced only by the patient. 

What does being asymptomatic mean?

Being “asymptomatic” is when the patient does have the disease but does not experience any effects of the disease. In this article, we will be discussing 5 diseases where patients are usually asymptomatic in the early stages of the disease but as the disease progresses, it adds an increased burden on the body leading to more pronounced signs and symptoms.

The 5 diseases were selected because while there is no way for patients to know if they have the disease early on due to the lack of symptoms these diseases can be easily detected during health screening with your General Practitioner. Therefore, we hope to highlight the importance of your health screening in allowing your doctor to detect these diseases early and prevent the disease from progressing to a more severe state.

So just before you brush off that health screening appointment because “I feel OK” , have a read to see the benefits or early detection and treatment.


5 Diseases where patients are asymptomatic

Human Immunodeficiency Virus (HIV)

What it is?

HIV infection is a disease in which the virus attacks specific cells (CD4) in the immune system and uses the cells to create more copies of the virus, killing the host cells in the process. In the early stages of HIV, the rate of CD 4 cell production can still cope with the loss from the viral infection, therefore patients are mostly asymptomatic.

Over time as the virus replication picks up pace, the CD 4 cell numbers dwindle and the immune system becomes less effective in responding to environmental insults such as bacterial or fungal infections. Major risk factors for HIV infection include, IV drug use, unprotected casual sex and anal intercourse.

How do you test for it?

Point of Care testing can be done at most clinics in Singapore, this involves taking a sample of blood from a finger prick and placing it into a test kit. Currently, the earliest you can be tested for HIV is 30 days after infection. Early treatment of HIV prevents the virus from replicating and thus prevents the disease from worsening and progressing to Acquired Immunodeficiency Syndrome (AIDS).
HIV Testing Singapore
Anonymous HIV Testing Singapore

Chlamydia

What it is?

Chlamydia is a common bacterial infection in both Men and Women. Infection is usually found in the genital tract but also in the rectum, throat and even eyes. Up to 70% of women and 50% of men are asymptomatic. Left untreated, the bacteria can replicate further to eventually lead to an inflammatory state in the pelvis. This results in severe discomfort and particularly in women the risk of infertility is especially raised if chlamydia is untreated.

How do you test for it?

Chalmydia Rapid testing can be carried out to detect the presence of Chalmydia within 24 hours. A sample is taken from the region, a vaginal swab for women and a urine sample for men, and a Polymerase Chain Reaction is used to detect any chlamydial genetic material. Treatment of chlamydia can be as simple as a single dose of antibiotics if detected at an early stage.
Rapid STD Testing Singapore

Chronic Illnesses

High cholesterol

What it is?

Cholesterol can be thought of in 2 forms, a high density form (HDL) and a low density form (LDL). HDL lowers the total cholesterol in the body while LDL increases it. An increase in cholesterol and triglycerides (both from fatty foods) results in plaques developing within your blood vessels (Atherosclerosis). As the plaques increase in size, blood flow to your vital organs like your heart and brain are compromised thus increases the risk of heart attacks and strokes.

How do you test for it?

A blood test usually done at your health screening enables your doctor to determine the cholesterol levels in your body. Not all elevated cholesterol has to be treated with  medications because changes in diet and lifestyle can also lower cholesterol in some cases. 

Hypertension

What it is?

Hypertension is when your blood pressure is persistently elevated, the normal blood pressure should be below 140 systolic and 90 diastolic. There are myriad of causes for elevated blood pressure including, high salt intake, stress or kidney disease.

However, many people have Essential hypertension, which is when the blood pressure is found to be elevated for no particular cause. Even though the cause may not be determined in most cases of hypertension, patients with an elevated blood pressure have a higher risk of strokes. This is because, the increased pressure in the blood adds additional strain to the blood vessels, eventually, the blood vessels become weaker and are more likely to break, resulting in a stroke.

How do you test for it?

The diagnosis of hypertension in an asymptomatic patient involves a Blood Pressure diary where the patient measures her blood pressure at the start and end of the day for 2 weeks. A persistently elevated blood pressure may prompt the doctor to start treatment, however there are also non-pharmacological means of lowering blood pressure.

Diabetes

What it is?

Diabetes, in particular Type 2 Diabetes, is a condition where the body is unable to regulate carbohydrate metabolism. This results in wide spread effects on the patient because sugar derived from carbohydrate metabolism is essential to many cellular activities in the body. Although patients are mostly asymptomatic in the early stages of the disease, patients can eventually have a variety of pathologies as the disease progresses such as loss of sensation in the hands and feet, poor wound healing, reduced immunity and even blindness.

How do you test for it?

Testing for diabetes also involves a blood test to measure the sugar levels in a fasting state to gauge the current level of sugar metabolism in your body and the Haemoglobin A1c (HbA1c) which is a gauge of the long term extent of sugar metabolism in your body. Depending on the extent of your disease, treatment of diabetes can range of lifestyle modification to injectable medications.


Having a disease in its early stages sometimes means that you still feel “fine” and not experience any symptoms. However, if left untreated, these diseases can progress and lead to severe complications in your health. Getting checked regularly is essential for detecting disease in the asymptomatic phase and treating it early. This prevents the disease from progressing to a more severe state and allows us to lead better, healthier lives. Speak to your doctor today!


Other Asymptomatic Medical Conditions:

Also on this site: Wart Removal Singapore, STD Check Singapore

FAQs on the Novel Coronavirus (2019-nCoV)

FAQs on COVID-19 the Novel Coronavirus (2019-nCoV)


1. What is the Novel Coronavirus (COVID-19)? 

Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).

A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans. Coronaviruses are zoonotic, meaning they are transmitted between animals and people. Named for the crown-like spikes on their surfaces, they infect mostly bats, pigs and small mammals. They mutate easily and can spread from animals to humans, and from one human to another.

2. What do we know about the Novel Coronavirus (COVID-19) so far?

The outbreak is understood to have originated in December 2019 in Huanan Seafood Wholesale Market in Wuhan, the largest city in central China with a population of 11 million people. It is thought that wild animals are the source of the virus. 

Chinese scientists believe that the virus might have jumped from bats to snakes, which were then sold in the market, and subsequently transmitted to humans. However, some scientists are skeptical of this conclusion. The market has since been shut down and disinfected, which makes it more difficult to identify the source animal.

3. How does the Novel Coronavirus (COVID-19) spread?

According to the US Centres for Disease Control and Prevention (CDC), it is still unclear how easily or sustainably this virus is spreading between people. It is thought that the virus is likely to be spread via respiratory droplets produced by an infected person. Therefore, the spread can occur from close contact (approximately 2 metres) with an infected person over a period of 30 minutes or more.

4. Can the Novel Coronavirus (COVID-19) be transmitted by someone with no symptoms (asymptomatic)? 

It seems likely so. On Sunday (26th Jan 2020), Chinese Health Minister Ma Xiaowei said at a press briefing that they had found that people could spread the virus while asymptomatic. Two days later, a Chinese doctor repeated this at a press conference. The most recent case comes from Germany; German researchers described four business associates who became infected through asymptomatic transmission.

5. How long does the Novel Coronavirus (COVID-19) remain on surfaces such as tables, seats on public transport or gym equipment etc?

According to the US CDC, Coronaviruses generally do not survive long on inanimate surfaces. These viruses typically only survive on a surface for a few hours.

6. How different is this virus to a common case of influenza?

The virus strains are completely different. The Wuhan virus is a coronavirus whereas influenza (the flu) is caused by the influenza virus. There is an annual influenza vaccine available, but there is no vaccine against the Wuhan virus. 

This means that it is more difficult for vulnerable members of the population, such as elderly people or those with existing respiratory or immune problems, to protect themselves. There are antiviral medications eg. tamiflu is available to treat influenza, but there is no specific treatment for the Wuhan virus or pneumonia. Treatment is supportive.

7. What symptoms should we be monitoring for at home, prior to visiting a GP?   

The symptoms are the same as that of normal pneumonia.

  • Fever
  • Runny nose
  • Cough
  • Sore throat
  • Breathlessness

8. How to protect yourself against the Novel Coronavirus (COVID-19)?

  • Frequently clean hands by using alcohol-based hand rub or soap and water;
  • When coughing and sneezing cover mouth and nose with flexed elbow or tissue – throw tissue away immediately and wash hands;
  • Avoid close contact with anyone who has fever and cough;
  • If you have fever, cough and difficulty breathing seek medical care early and share previous travel history with your healthcare provider;
  • When visiting live markets in areas currently experiencing cases of novel coronavirus, avoid direct unprotected contact with live animals and surfaces in contact with animals;
  • The consumption of raw or undercooked animal products should be avoided. Raw meat, milk or animal organs should be handled with care, to avoid cross-contamination with uncooked foods, as per good food safety practices;
  • Wear a surgical mask if you have flu-like respiratory symptoms (you may wear the surgical mask even without any display of symptoms to protect yourself);
  • It is advised that surgical masks will suffice and there is no need to use N95 masks;
  • If you choose to wear a face mask, ensure the mask covers both your mouth and nose.

9. Are there any substitutes for hand sanitisers given that many places are sold out?

According to the US CDC, washing your hands with plain soap and water is the best way to maintain hygiene and prevent the spread of infections. If you wish to use hand sanitiser, you should use alcohol-based hand sanitisers, not just any regular ones. Alternatives would be alcohol (eg. isopropyl 70% or ethyl alcohol 70%) or bleach to disinfect surfaces.

10. Is it safe to travel to China? Is there anything we can do to protect ourselves when travelling?

Avoid non-essential travel, especially to China. Otherwise, the protective measures are exactly the same as mentioned above.


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新型冠状病毒知多少?- 新型冠状病毒

[See English Version of What You Need to Know About WuHan Virus]

目前,我们都听说了中国爆发了一种新的病毒,它已经感染了超过600人,且夺走了至少17个生命,同时疫情也在向其他国家蔓延。截至写这篇文章(1月24日)时,新加坡已经有3例被确诊为新型冠状病毒的患者。其他确诊了病例的国家和地区包括日本、韩国、泰国、美国、台湾地区、沙特阿拉伯和越南。伦敦帝国理工学院的疾病建模专家在周三(1月22日)发表的一份报告中指出,中国所报告的病例数量是较为保守的数目,目前可能有大约4000人被感染。

这一病例在我国的出现加剧了人们对致命流行病的恐惧,使人们联想起了2003年的SARS、2009年的H1N1流感和2012年的MERS。

以下是一些可能对你有帮助的信息:

这个新型冠状病毒是什么?它是如何发生的?

这个被称为新型冠状病毒的病毒属于冠状病毒的一种,冠状病毒家族中也包含着SARS和MERS。这些病毒由于其表面有冠状突起而被命名为冠状病毒,主要会感染蝙蝠、猪和小型的哺乳动物。但是这些病毒很容易变异,它可以从动物传染给人,也可以在人与人之间传播。

据了解,这一次的疫情早在去年12月就已在武汉的华南海鲜批发市场爆发。武汉是中国中部一个拥有着1100万人口的大规模城市,同时也是湖北省的省会。人们认为该病毒的来源是野生动物。中国科学家认为,病毒可能不是蝙蝠而是蛇,是由在市场上被售卖的野生动物传染给人类的。

新型冠状病毒 是如何进行传播的?

该病毒的传播方式与普通的流感相似,即通过飞沫和接触传播,比如咳嗽、接吻或者唾液接触。目前,病毒学家表示,该病毒的传染性可能比SARS弱,目前所报道的死亡率为2%。但有人担心这一病毒会进一步变异,从而变得更加致命。

新型冠状病毒有什么症状?什么情况下能够怀疑自己被感染?

如符合以下任何情况,请立即就医或前往急诊室:

1. 有发烧、咳嗽、上呼吸道症状或者呼吸困难的症状

2. 在过去14天内有去过中国大陆

3.  在发病前的14天内曾去过中国大陆的医院

4. 曾与新型冠状病毒的确诊者或者疑似病例有过密切接触

有什么可以治疗或者预防新型冠状病毒的药物或者疫苗吗?

目前还没有预防冠状病毒的疫苗。并且目前也没有可以治疗由冠状病毒引发的疾病的方法。患者将在医院接受支持性的治疗,通常会在一段时间后康复。

如果你要前往有确诊病例或者疑似病例的地区,应该考虑接种流感疫苗以防止出现流感的症状,以避免在温度检查点得到误导的结果。

我该如何保护自己?

1. 若有类似流感的呼吸道症状,应该戴上口罩

2. 即使没有任何症状,也可以在去公共场所和需要与人接触时时戴外科口罩

3. 使用外科口罩即可,无需使用N95口罩

4. 采取与预防流感相同的保护措施:勤用肥皂洗手,咳嗽或打喷嚏时用手或者纸巾捂住嘴,且远离病人

5. 感到身体不适时及时就医

我该取消前往中国的计划吗?

根据卫生部在1月23日发布的最新旅游建议,新加坡人应该避免前往武汉。中国已经对武汉进行了封城处理,所有出城的航班都已取消,火车、公共汽车和轮渡皆已经暂停运营。

卫生部提醒公众,在中国各地旅游时要保持谨慎,注意个人卫生。卫生部也建议所有旅客在返回新加坡后的两周内应该密切监控自己的健康状况,如有任何不适请立即就医,且告知医生相关的旅行史。

最后…

据世界卫生组织称,新型冠状病毒是中国的突发事件,但尚不是全球关注的突发公共健康事件。然而,随着疫情的迅速发展,所有人都应该继续跟进最新的情况和相关的新闻报道。

请保证自己的安全!

[See English Version of What You Need to Know About WuHan Virus]

What You Need to Know about Wuhan virus – 2019 novel coronavirus (2019-nCoV)

By now, we have all heard about the outbreak of a new virus in China that has infected more than 600 people and claimed at least 17 lives, while spreading to other countries around the world. As of today (24th Jan), Singapore has three confirmed cases of the 2019 novel coronavirus (2019-nCoV), also known as the Wuhan virus. Other countries which have confirmed cases include Japan, Korea, Thailand, the United States, Taiwan, Saudi Arabia and Vietnam. Disease modeling experts from Imperial College, London suggest that case numbers reported by China are conservative, issuing a report on Wednesday (22nd Jan) stating that 4000 people could currently be infected.

Its emergence on our shores has fueled fears of a deadly epidemic reminiscent of Severe Acute Respiratory Syndrome (SARS) in 2003, H1N1 influenza in 2009, and Middle East Respiratory Syndrome (MERS) in 2012. 

Here’s what you need to know about WuHan Virus:

What is the WuHan Virus and how did it happen?

The Wuhan virus belongs to a family of viruses known as coronavirus, which include SARS and MERS. These viruses, named for the crown-like spikes on their surfaces, infect mostly bats, pigs and small mammals. But they mutate easily and can spread from animals to humans, and from one human to another.

The outbreak is understood to have originated in December in Huanan Seafood Wholesale Market in Wuhan, the largest city in central China with a population of 11 million people. It is thought that wild animals are the source of the virus. Chinese scientists believe that the virus might have jumped from bats to snakes, which were then sold in the market, and subsequently transmitted to humans. 

How is the WuHan Virus spread?

The WuHan virus is believed to spread much like the common flu does – by droplet and contact, for example coughing, kissing or saliva contact. For now, virologists say that the Wuhan virus is likely not as infectious as the SARS virus, with a current reported 2% death rate. But there are concerns that the virus could further mutate to become more lethal.

What are the symptoms and when do you suspect that you have it?

Seek medical help or go to A&E immediately if:

  1. You have fever OR cough OR upper respiratory symptoms OR breathlessness, and
  2. You have travelled from mainland China within the past 14 days, or
  3. You have visited a hospital in mainland China 14 days before onset of illness, or
  4. You have had close contact with a confirmed or suspected case of Wuhan virus

Are there drugs or vaccines to treat or prevent Wuhan virus?

There is no vaccine to protect against coronaviruses. There is also no specific treatment to cure illnesses caused by coronaviruses. Patients receive supportive treatment at hospitals and generally recover on their own after some time. 

You should consider getting a flu vaccine if you are travelling to places where there are confirmed or suspected cases to prevent you from contracting influenza symptoms that may mislead screening authorities at temperature checkpoints.

What can I do to protect myself against the WuHan Virus?

  1. Wear a surgical mask if you have flu-like respiratory symptoms 
  2. Even if you have no symptoms, you can wear a surgical mask if you are going to be going out in public and having person-to-person contact
  3. It is advised that surgical masks will suffice and there is no need to use N95 masks
  4. Take the same protective measures you would take against the flu: wash your hands frequently with soap, cover your mouth with tissue paper or your hands when coughing or sneezing, and stay away from people who are sick
  5. See a doctor if you feel unwell

Should I cancel my trip to China?

According to the latest travel advisory issued on Thursday (23rd Jan) by the Ministry of Health (MOH), Singaporeans should avoid travelling to Wuhan. China has imposed a travel halt in Wuhan as all flights out of the city have been cancelled and trains, buses and ferries suspended.

MOH reminds the public to continue to exercise caution and pay close attention to personal hygiene when travelling to the rest of China. MOH advises that all travellers should monitor their health closely for two weeks upon return to Singapore and seek medical attention promptly if they feel unwell, and also inform their doctor of their travel history.

Lastly..

According to the World Health Organization, the Wuhan coronavirus is an emergency in China but is not yet a public health emergency of global concern. However, as the situation is rapidly evolving, all of us should continue to stay abreast with the latest updates and news reports. 

Stay safe!
[This article is written on 23rd January 2020]


中文版: https://www.dtapclinic.com/articles/武汉病毒知多少?-新型冠状病毒/

Monkeypox – What You Need to Know

What is Monkeypox?

Monkeypox is a rare virus that is typically transmitted from animals to humans. Documented human infections occurred mostly in areas of Central and West Africa near rainforests. Human cases outside of Africa are extremely rare.
The Monkeypox virus is very similar to the human smallpox virus but causes less severe symptoms.

What are the Symptoms of Monkeypox?

The symptoms of Monkeypox usually begin 6-14 days (ranges between 5 up to 21 days) after infection by the virus.
Initial symptoms (first 5 days) include fever, headaches, muscle aches (myalgia), fatigue and swollen lymph nodes.

Within 1-3 days

Within 1-3 days of the onset of fever, a skin rash develops, usually starting from the face then spreading to the body.

Next 1.5 weeks or so

Over the course of the next 1.5 weeks or so, the rash develops from flat reddish bumps (maculopapular) to fluid filled tiny blisters (vesicles) which enlarge to become pustular, before eventually crusting and healing.
The rash can involve the palms and soles of the feet, oral mucosa and the eyes as well.
The total illness duration ranges between 2-3 weeks.

Image from CDC Public Health Image Library

Image from CDC Public Health Image Library

Is the Infection Serious?

Monkeypox is generally a self-limiting illness and symptoms fully resolve by themselves by 21 days.  Treatment for monkeypox is supportive until the illness runs its course.
However, serious complications such as pneumonia (lung infection) and encephalitis (brain inflammation) can occur.
The severity of symptoms may differ between patients and more serious illnesses have been seen in younger patients, with a mortality rate between 1-10%.

How is it spread?

Monkeypox is transmitted from animals to humans through bites, scratches, consumption of bushmeat, or through direct contact with the blood/fluid/bodies of infected animals.
Human-to-human transmission is possible through respiratory droplets or physical contact with body fluids/rash, or contaminated surfaces or materials.
The virus enters the body through the respiratory tract, mucous membranes, and broken skin.
Infected individuals are contagious from the onset of fever until their skin lesions have crusted over completely.
 

What is the Situation in Singapore?

On 8 May 2019, MOH confirmed the first case of imported Monkeypox infection in Singapore. The patient is a 38-year-old Nigerian male who may have contracted the virus in Nigeria through the consumption of bushmeat.
He arrived in Singapore on 28 April 2019 and subsequently developed a fever and rash on 30 April. He was hospitalised on 7 May and confirmed to have the infection and currently warded at the National Centre for Infectious Diseases (NCID). His condition is stable.
MOH is in the midst of contact tracing. Close contacts have been referred to the National Centre for Infectious Diseases (NCID) for further assessment and will be quarantined for 21 days. Low-risk contacts will be kept under surveillance to monitor their health status.

When Should I be Concerned about Monkeypox?

If you develop a fever and vesicular rash AND have travelled to West or Central Africa within the last 21 days OR have been in contact with an infected person within the last 21 days, there is a high suspicion of monkeypox and you should see a doctor immediately.
Otherwise, there is no need for unnecessary panic as all necessary steps to control the situation are already being taken.

PRECAUTIONS TO TAKE WHEN TRAVELLING TO AREAS AFFECTED BY MONKEYPOX IN CENTRAL AND WESTERN AFRICA

• Maintain a high standard of personal hygiene, including frequent hand washing after going to the toilet, or when hands are soiled.
• Avoid direct contact with skin lesions of infected living or dead persons or animals, as well as objects that may have become contaminated with infectious fluids, such as soiled clothing or linens (e.g. bedding or towels) used by an infected person.
• Avoid contact with wild animals, and consumption of bushmeat.
• Returning travellers from areas affected by monkeypox should seek immediate medical attention if they develop any disease symptoms (e.g. sudden onset of high fever, swollen lymph nodes and rash) within three weeks of their return. They should inform their doctor of their recent travel history

Take Care!


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