Tagged Throat

Weekly Health Quiz: Exercise, Body Temperature and a Covid Vaccine Mystery

1 of 7

An 11-minute program of calisthenics and rest, done three times a week for six weeeks, had this effect on out-of-shape young men and women:

It increased their fitness levels

It improved their endurance by 7 percent

It increased their leg power slightly

All of the above

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Which statement about body temperatures is not true?

Worldwide, average body temperatures seem to be decreasing

Body temperatures tend to rise during and after exercise

Older people tend to have lower body temperatures than younger people

Body temperature tends to be higher in the morning than in the evening

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Health authorities are investigating the death of a 56-year-old doctor in Florida who developed this blood clotting disorder days after receiving the Covid vaccine:

Hemophilia

Pernicious anemia

Acute immune thrombocytopenia

Myelodysplastic syndrome

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Creutzfeldt-Jakob disease, sometimes called mad cow disease, is thought to be caused by this type of infectious organism:

Bacteria

Virus

Fungus

Prion

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Which statement about throat cancers is not true?

Most throat cancers are caused by human papillomavirus, or HPV

Having oral sex at a young age increases the risk of developing throat cancer

HPV-associated throat cancers are more common in women than men

HPV-associated throat cancers are more common in whites than in African-Americans

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Being overweight during pregnancy was tied to this fertility issue, Danish researchers report:

Mothers who are overweight during their first pregnancy are at increased risk of fertility problems during subsequent pregnancies

Daughters born to overweight mothers were at increased risk of having fertility problems

Sons born to overweight mothers were at increased risk of being infertile

All of the above

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Diets rich in this vitamin were tied to a lower risk of developing Parkinson’s disease:

Vitamin A

B vitamins

Vitamins C and E

Vitamin D

How Our Sex Habits May Affect Our HPV and Cancer Risk

How Our Sex Habits May Affect Our HPV and Cancer Risk

Certain sex practices, at certain ages, increased the risk of throat cancers related to human papillomavirus.

Credit…Getty Images
Nicholas Bakalar

  • Jan. 12, 2021, 5:00 a.m. ET

Human papillomavirus, or HPV, is a leading cause of throat cancer, and it is sexually transmitted. But how the timing, number and types of sexual behaviors affect the risk, and why some people develop cancer and others don’t, are still open questions. Researchers are beginning to suggest some possible answers.

HPV causes about 70 percent of oropharyngeal cancers — tumors of the back of the throat, the base of the tongue and the tonsils. According to the Centers for Disease Control and Prevention, there are about 3,500 new cases of HPV-associated oropharyngeal cancers diagnosed in women and 16,200 in men every year in the United States. These cancers are more common among white people than among African-Americans, Asian-Americans, Hispanics, or American Indians and Native Alaskans.

There are many types of HPV, only some of which cause cancer. In addition to throat cancer, HPV is a cause of cervical, vaginal, vulvar, penile and anal cancers. It can take years, even decades, after infection for cancer to develop.

To try to sort out the risk factors for HPV-associated throat cancer, researchers compared 163 patients with cancer with 345 cancer-free controls. Patients and controls ranged in age from 18 to 89, but more than 95 percent of them were over 40. At the start of the study, all of the participants provided a blood sample, and the scientists obtained tumor samples from the patients with cancer. None of the participants had had the HPV vaccine, which was introduced in the United States in 2006 and recommended primarily for preadolescents, teenagers and young adults.

Using a self-interview administered on a computer, the participants also answered detailed questions on lifetime and recent sexual behavior, including number of partners, age of sexual initiation, types of sexual acts, extramarital sex and the use of alcohol and recreational drugs during sex. The scientists also had data on income, education, sexual orientation, and any history of sexually transmitted and other diseases. The study is in the journal Cancer.

Taken together, the various cancers caused by HPV are slightly more common in women, but HPV-associated oropharyngeal cancers are almost five times as common in men. Exactly why is unclear.

“There is some evidence that cunnilingus is more infective than fellatio,” said the senior author, Gypsyamber D’Souza, a professor of epidemiology at Johns Hopkins. “But that’s a surrogate for more nuanced behavior. Many patients have not engaged in high-risk sex behavior and are unlucky enough to still get this. It’s not just sexual partners, but the timing, the kind of practice, the nature of the partners and other factors, plus aspects of our own immunological response that are all involved in this.”

The cancer patients in the study were about 80 percent more likely than those without cancer to have ever performed oral sex on a partner. They were also younger when they first did so — 37 percent of patients were younger than 18 the first time they performed oral sex, compared with 23 percent of controls — and they were more likely to have performed oral sex at their sexual debut.

Why having oral sex at a first sexual encounter would raise the risk is unknown. Is there a different immune response if a person has had other forms of sex before having oral sex? Does the initial site of exposure affect your risk? “We don’t have good answers yet,” Dr. D’Souza said.

Almost 45 percent of patients had had more than 10 sexual partners during their lifetimes, compared with 19 percent of the cancer-free controls. People under 23 who had a sexual partner at least 10 years older were more likely to be infected, possibly because older people have had longer exposure to the virus.

Deep kissing was also associated with increased risk. Those who had 10 or more deep-kissing partners were more than twice as likely to have an HPV-related cancer as those who had none or one.

People who reported that their partners had extramarital affairs, and those who even suspected that their partners had had affairs, also had an increased risk of HPV-associated throat cancer. There was no association of HPV-related throat cancer with smoking, alcohol consumption or substance use.

The study had limitations. It depended on self-reports, which are not always reliable, and because more than 95 percent of the participants described themselves as heterosexual, there was not enough data to draw conclusions about the effects of sexual orientation on HPV and cancer risk. But the analysis had carefully matched controls, HPV tumor data, and a confidential questionnaire, all of which contribute to its strengths.

Dr. Jason D. Wright, an associate professor of gynecologic oncology at Columbia who was not involved in the research, believes the work could be useful in clinical practice. “This is one of the first studies to provide in-depth details for patients about how specific practices influence your long-term risk,” he said. “A higher exposure, more partners, oral sex early on — these are all risk factors. These are important things to think about in talking to patients.”

The lead author, Dr. Virginia E. Drake, a resident physician at Johns Hopkins, said that explaining the infection to patients can be difficult. “If people get this infection, they’re going to ask, ‘Why me?’” she said. “How this information will change things clinically, we don’t know. But we can give patients a better understanding of the disease process and how someone gets it.”

Still, she said, “It’s complex, more complex that just the number of sexual partners. We don’t have the exact answers on this, and we’re still figuring out the complete picture.”

How Does the Coronavirus Variant Spread? Here’s What Scientists Know

How Does the Coronavirus Variant Spread? Here’s What Scientists Know

Contagiousness is the hallmark of the mutated virus surfacing in the U.S. and more than a dozen other countries.

The first infection with the new variant in the United States was traced to a National Guardsman who was working at the Good Samaritan Society, an assisted living facility in Simla, Calif.
The first infection with the new variant in the United States was traced to a National Guardsman who was working at the Good Samaritan Society, an assisted living facility in Simla, Calif.Credit…Matthew Staver for The New York Times
Apoorva Mandavilli

  • Dec. 31, 2020, 3:37 p.m. ET

A more contagious form of the coronavirus has begun circulating in the United States.

In Britain, where it was first identified, the new variant became the predominant form of the coronavirus in just three months, accelerating that nation’s surge and filling its hospitals. It may do the same in the United States, exacerbating an unrelenting rise in deaths and overwhelming the already strained health care system, experts warned.

A variant that spreads more easily also means that people will need to religiously adhere to precautions like social distancing, mask-wearing, hand hygiene and improved ventilation — unwelcome news to many Americans already chafing against restrictions.

“The bottom line is that anything we do to reduce transmission will reduce transmission of any variants, including this one,” said Angela Rasmussen, a virologist affiliated with Georgetown University. But “it may mean that the more targeted measures that are not like a full lockdown won’t be as effective.”

What does it mean for this variant to be more transmissible? What makes this variant more contagious than previous iterations of the virus? And why should we worry about a variant that spreads more easily but does not seem to make anyone sicker?

We asked experts to weigh in on the evolving research into this new version of the coronavirus.

The new variant seems to spread more easily between people.

Many variants of the coronavirus have cropped up since the pandemic began. But all evidence so far suggests that the new mutant, called B.1.1.7, is more transmissible than previous forms. It first surfaced in September in Britain, but already accounts for more than 60 percent of new cases in London and neighboring areas.

The new variant seems to infect more people than earlier versions of the coronavirus, even when the environments are the same. It’s not clear what gives the variant this advantage, although there are indications that it may infect cells more efficiently.

It’s also difficult to say exactly how much more transmissible the new variant may be, because scientists have not yet done the kind of lab experiments that are required. Most of the conclusions have been drawn from epidemiological observations, and “there’s so many possible biases in all the available data,” cautioned Muge Cevik, an infectious disease expert at the University of St. Andrews in Scotland and a scientific adviser to the British government.

Scientists initially estimated that the new variant was 70 percent more transmissible, but a recent modeling study pegged that number at 56 percent. Once researchers sift through all the data, it’s possible that the variant will turn out to be just 10 to 20 percent more transmissible, said Trevor Bedford, an evolutionary biologist at the Fred Hutchinson Cancer Research Center in Seattle.

Even so, Dr. Bedford said, it is likely to catch on rapidly and become the predominant form in the United States by March. Scientists like Dr. Bedford are tracking all the known variants closely to detect any further changes that might alter their behavior.

Apart from greater transmissibility, the variant behaves like earlier versions.

The new mutant virus may spread more easily, but in every other way it seems little different than its predecessors.

So far, at least, the variant does not seem to make people any sicker or lead to more deaths. Still, there is cause for concern: A variant that is more transmissible will increase the death toll simply because it will spread faster and infect more people.

“In that sense, it’s just a numbers game,” Dr. Rasmussen said. The effect will be amplified “in places like the U.S. and the U.K., where the health care system is really at its breaking point.”

The routes of transmission — by large and small droplets, and tiny aerosolized particles adrift in crowded indoor spaces — have not changed. That means masks, limiting time with others and improving ventilation in indoor spaces will all help contain the variant’s spread, as these measures do with other variants of the virus.

“By minimizing your exposure to any virus, you’re going to reduce your risk of getting infected, and that’s going to reduce transmission over all,” Dr. Rasmussen said.

A drive-through Covid testing site at Dodger Stadium in Los Angeles on Wednesday.
A drive-through Covid testing site at Dodger Stadium in Los Angeles on Wednesday.Credit…Mario Tama/Getty Images

Infection with the new variant may increase the amount of virus in the body.

Some preliminary evidence from Britain suggests that people infected with the new variant tend to carry greater amounts of the virus in their noses and throats than those infected with previous versions.

“We’re talking in the range between 10-fold greater and 10,000-fold greater,” said Michael Kidd, a clinical virologist at Public Health England and a clinical adviser to the British government who has studied the phenomenon.

There are other explanations for the finding — Dr. Kidd and his colleagues did not have access to information about when in their illness people were tested, for example, which could affect their so-called viral loads.

Still, the finding does offer one possible explanation for why the new variant spreads more easily. The more virus that infected people harbor in their noses and throats, the more they expel into the air and onto surfaces when they breathe, talk, sing, cough or sneeze.

As a result, situations that expose people to the virus carry a greater chance of seeding new infections. Some new data indicate that people infected with the new variant spread the virus to more of their contacts.

With previous versions of the virus, contact tracing suggested that about 10 percent of people who have close contact with an infected person — within six feet for at least 15 minutes — inhaled enough virus to become infected.

“With the variant, we might expect 15 percent of those,” Dr. Bedford said. “Currently risky activities become more risky.”

Scientists are still learning how the mutations have changed the virus.

The variant has 23 mutations, compared with the version that erupted in Wuhan, China, a year ago. But 17 of those mutations appeared suddenly, after the virus diverged from its most recent ancestor.

Each infected person is a crucible, offering opportunities for the virus to mutate as it multiplies. With more than 83 million people infected worldwide, the coronavirus is amassing mutations faster than scientists expected at the start of the pandemic.

The vast majority of mutations provide no advantage to the virus and die out. But mutations that improve the virus’ fitness or transmissibility have a greater chance to catch on.

At least one of the 17 new mutations in the variant contributes to its greater contagiousness. The mechanism is not yet known. Some data suggest that the new variant may bind more tightly to a protein on the surface of human cells, allowing it to more readily infect them.

It’s possible that the variant blooms in an infected person’s nose and throat, but not in the lungs, for example — which may explain why patients spread it more easily but do not develop illnesses more severe than those caused by earlier versions of the virus. Some influenza viruses behave similarly, experts noted.

“We need to look at this evidence as preliminary and accumulating,” Dr. Cevik said of the growing data on the new variant.

Still, the research so far suggests an urgent need to cut down on transmission of the variant, she added: “We need to be much more careful over all, and look at the gaps in our mitigation measures.”