Subclinical infection

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File:Mallon-Mary 01.jpg
Typhoid Mary in a 1909 was a famous case of a subclinical infection of Salmonella enterica serovar Typhi, the infectious agent of typhoid fever

A subclinical infection is the asymptomatic (without apparent sign) carrying of an (infection) by an individual of an agent (microbe, intestinal parasite, or virus) that usually is a pathogen causing illness, at least in some individuals. Many pathogens spread by being silently carried in this way by some of their host population. Such infections occur both in humans and nonhuman animals. An example of an asymptomatic infection is a mild common cold that is not noticed by the infected individual. Since subclinical infections often occur without eventual overt sign, their existence is only identified by microbiological culture, or DNA techniques such as polymerase chain reaction.

Infection transmission

An individual may only develop signs of an infection after a period of subclinical infection, a duration that is called the incubation period. This is the case, for example, for subclinical sexually transmitted diseases such as AIDS and genital warts. Individuals with such subclinical infections, and those that never develop overt illness, creates a reserve of individuals that can transmit an infectious agent to infect other individuals. Because such cases of infections do not come to clinical attention, health statistics can often fail to measure the true prevalence of an infection in a population, and this prevents the accurate modeling of its infectious transmission.

Evolution of host tolerance

Fever and sickness behavior and other signs of infection are often taken to be due to them. However, they are evolved physiological and behavioral responses of the host to clear itself of the infection. Instead of incurring the costs of deploying these evolved responses to infections, the body opts to tolerate an infection[1] as an alternative to seeking to control or remove the infecting pathogen.[2]

Hidden costs

Subclinical infections are important since they allow infections to spread from a reserve of carriers. They also can cause clinical problems unrelated to the direct issue of infection. For example, in the case of urinary tract infections in women, this infection may cause preterm delivery if she gets pregnant without proper treatment.[3]

List of subclinical infections

The following pathogens (together with their symptomatic illnesses) are known to be carried asymptomatically, often in a large percentage of the potential host population:

Notes

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See also

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  • Müller J, Møller DS, Kjaer M, Nyvad O, Larsen NA, Pedersen EB (2003). "Chlamydia pneumoniae DNA in peripheral blood mononuclear cells in healthy control subjects and patients with diabetes mellitus, acute coronary syndrome, stroke, and arterial hypertension". Scand. J. Infect. Dis. 35 (10): 704–12. PMID 14606608. 
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  • Rivera EV, Woods S (2003). "Prevalence of asymptomatic Clostridium difficile colonization in a nursing home population: a cross-sectional study". J Gend Specif Med. 6 (2): 27–30. PMID 12813999. 
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