Thank you for sharing your expertise.
Here’s the COMPLETE literal English translation of the entire original thread
fyi @MarionKoopmans@mkeulemans
Big debate these days about PCR and #HantavirusAndes
But to understand when a PCR is useful (and when it’s not), first you need to understand the biological cycle of the virus inside the body.
Because a PCR does not “detect disease”: it detects virus in a specific place and at a specific moment.
1/ Exposure Phase (ASYMPTOMATIC) The virus enters by inhalation of contaminated aerosols and heads to the deep lung.
•What happens: initial focal infection in the lung, no symptoms, no systemic dissemination
•Where the virus is: deep lung (low load), blood: negative, nasopharynx: generally negative
•PCR: blood → negative; nasopharyngeal → negative or very low yield Here there is NO useful diagnostic window
2/ Advanced Incubation Phase (LATE ASYMPTOMATIC) The virus begins to replicate more actively.
•What happens: possible onset of intermittent viremia, still no clinical signs or very nonspecific
•Where the virus is: lung, onset of endothelial dissemination, blood: variable, nasopharynx: low load, inconsistent
•PCR: blood → may start to become positive, nasopharyngeal → low yield Diagnostic window begins in blood
3/ Initial Symptomatic Phase (PRODROMES) Here the patient is already sick.
•Clinical: fever, intense myalgias, headache, respiratory symptoms may or may not appear
•Biology: established viremia, endothelial dissemination
•Where the virus is: blood (key), vascular endothelium, lung
•PCR: blood → HIGH sensitivity (best diagnostic moment), nasopharyngeal → may be useful if there is respiratory clinical picture, but lower sensitivity than blood Blood remains the main sample
4/ Advanced Symptomatic Phase (CARDIOPULMONARY SYNDROME)
•Clinical: pulmonary edema, severe hypoxemia, shock
•Biology: the problem is mainly endothelial and immunological (edema and capillary leak)
•Where the virus is: systemic endothelium, blood: variable, respiratory tract: may contain viral material but it is not the dominant compartment
•PCR: blood → positive or fluctuating, nasopharyngeal → low diagnostic utility Here serology gains weight
5/ Resolution Phase
•Biology: decline in viremia, antibody response (IgM → IgG)
•PCR: blood �� progressive negativization, nasopharyngeal → negative Usual serological confirmation
6/ FINAL KEY IDEA
•Blood = main compartment for PCR (short, well-defined window)
•Nasopharynx = secondary utility, mainly if there is respiratory clinical picture, but overall lower sensitivity
The mistake is to think of a single COVID-type strategy In Andes hantavirus, the question is never just “PCR or no PCR”, but: in which phase is the virus and in which compartment am I looking for it?
7/ From this explanation come directly the recommendations of organizations such as @ECDC_EU
It is not a question of “doing more tests”, but of diagnostic yield and biological window.
That is why, in asymptomatic contacts: Indiscriminate PCR is NOT recommended
Because:
•the phase may be too early (false negatives)
•viremia may not have been established
•the nasopharynx is not a good compartment in this virus
In short: it is not a logistical limitation, it is a decision based on viral biology and diagnostic efficiency
Bibliography: https://t.co/0xQqFlIfUA
NO ENTIENDO POR QUÉ LA GENTE NO UTILIZA CHATGPT PARA BUSCAR EMPLEO.
Recibí 5 llamadas para entrevistas en 7 días, todas con ChatGPT como reclutador.
Aquí tienes 6 prompts que convertirán tu búsqueda de empleo en una estrategia.
[Guardar este hilo]
He comprado y pagado en #Allzone@AllZoneTienda un móvil Samsung Galaxy S25 ultra hace 3 semanas y el estado del pedido sigue en preparación. Lo necesito urgente y no dan explicación alguna sobre este pedido 386475
#Allzone
Vigilancia de Infección Respiratoria Aguda (gripe, COVID-19 y VRS). Semana 16-22 dic.
▶️ Casos sindrómicos en Atención Primaria: 665,5/100.000h
▶️ Casos graves en hospitales: 16,6/100.000h
Protégete y protege a tu entorno:
La CIÁTICA es uno de los dolores más invalidantes que existen.
Hoy te dejo una lista de consejos prácticos y 5 videos de ejercicios para prevenirla y aliviarla 🔥💯👇🏼
El estrés laboral representa millones en pérdidas económicas y también daños en el sistema nervioso, además de otras enfermedades
https://t.co/DdTFZUVSad
🚴♂️💨 Nuestros "Linces" son sanitarios de #ProtecciónCivil en bici que participan en eventos.
👨⚕️🚑 Portan material de primera atención y pueden moverse rápidamente.
Ayer, en menos de 4 minutos, estaban en el lugar de una PCR ayudando a salvar una vida. 💓🙌
📸: Paulino Ruano Diaz
Voluntarios de #ProteccionCivil junto a una agente de la Policia Local fuera de servicio han realizado las primeras maniobras de reanimación cardiopulmonar hasta la llegada de la UVI Móvil del dispositivo sanitario de la prueba junto a voluntarios de @CruzRojaEsp.
PCR recuperada
Los servicios de seguridad y emergencias han conseguido revertir la paraca cardiorespiratoria que ha sufrido un varón de 55 años que se encontraba realizando la subida a la Casa Alfonso.
El paciente ha sido trasladado al Hospital de Albacete en helicoptero #HEMS