What’s the difference between ‘strep throat’ and a sore throat? We’re developing a vaccine for one of them
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What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.
It’s the time of the year for coughs, colds and sore throats. So you might have heard people talk about having a “strep throat”.
But what is that? Is it just a bad sore throat that goes away by itself in a day or two? Should you be worried?
Here’s what we know about the similarities and differences between strep throat and a sore throat, and why they matter.
How are they similar?
It’s difficult to tell the difference between a sore throat and strep throat as they look and feel similar.
People usually have a fever, a bright red throat and sometimes painful lumps in the neck (swollen lymph nodes). A throat swab can help diagnose strep throat, but the results can take a few days.
Thankfully, both types of sore throat usually get better by themselves.
How are they different?
Most sore throats are caused by viruses such as common cold viruses, the flu (influenza virus), or the virus that causes glandular fever (Epstein-Barr virus).
These viral sore throats can occur at any age. Antibiotics don’t work against viruses so if you have a viral sore throat, you won’t get better faster if you take antibiotics. You might even have some unwanted antibiotic side-effects.
But strep throat is caused by Streptococcus pyogenes bacteria, also known as strep A. Strep throat is most common in school-aged children, but can affect other age groups. In some cases, you may need antibiotics to avoid some rare but serious complications.
In fact, the potential for complications is one key difference between a viral sore throat and strep throat.
Generally, a viral sore throat is very unlikely to cause complications (one exception is those caused by Epstein-Barr virus which has been associated with illnesses such as chronic fatigue syndrome, multiple sclerosis and certain cancers).
But strep A can cause invasive disease, a rare but serious complication. This is when bacteria living somewhere on the body (usually the skin or throat) get into another part of the body where there shouldn’t be bacteria, such as the bloodstream. This can make people extremely sick.
Invasive strep A infections and deaths have been rising in recent years around the world, especially in young children and older adults. This may be due to a number of factors such as increased social mixing at this stage of the COVID pandemic and an increase in circulating common cold viruses. But overall the reasons behind the increase in invasive strep A infections are not clear.
Another rare but serious side effect of strep A is autoimmune disease. This is when the body’s immune system makes antibodies that react against its own cells.
The most common example is rheumatic heart disease. This is when the body’s immune system damages the heart valves a few weeks or months after a strep throat or skin infection.
Around the world more than 40 million people live with rheumatic heart disease and more than 300,000 die from its complications every year, mostly in developing countries.
However, parts of Australia have some of the highest rates of rheumatic heart disease in the world. More than 5,300 Indigenous Australians live with it.
Why do some people get sicker than others?
We know strep A infections and rheumatic heart disease are more common in low socioeconomic communities where poverty and overcrowding lead to increased strep A transmission and disease.
However, we don’t fully understand why some people only get a mild infection with strep throat while others get very sick with invasive disease.
We also don’t understand why some people get rheumatic heart disease after strep A infections when most others don’t. Our research team is trying to find out.
How about a vaccine for strep A?
There is no strep A vaccine but many groups in Australia, New Zealand and worldwide are working towards one.
For instance, Murdoch Children’s Research Institute and Telethon Kids Institute have formed the Australian Strep A Vaccine Initiative to develop strep A vaccines. There’s also a global consortium working towards the same goal.
Companies such as Vaxcyte and GlaxoSmithKline have also been developing strep A vaccines.
What if I have a sore throat?
Most sore throats will get better by themselves. But if yours doesn’t get better in a few days or you have ongoing fever, see your GP.
Your GP can examine you, consider running some tests and help you decide if you need antibiotics.
Kim Davis, General paediatrician and paediatric infectious diseases specialist, Murdoch Children’s Research Institute; Alma Fulurija, Immunologist and the Australian Strep A Vaccine Initiative project lead, Telethon Kids Institute, and Myra Hardy, Postdoctoral Researcher, Infection, Immunity and Global Health, Murdoch Children’s Research Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Why is pain so exhausting?
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One of the most common feelings associated with persisting pain is fatigue and this fatigue can become overwhelming. People with chronic pain can report being drained of energy and motivation to engage with others or the world around them.
In fact, a study from the United Kingdom on people with long-term health conditions found pain and fatigue are the two biggest barriers to an active and meaningful life.
But why is long-term pain so exhausting? One clue is the nature of pain and its powerful effect on our thoughts and behaviours.
simona pilolla 2/Shutterstock Short-term pain can protect you
Modern ways of thinking about pain emphasise its protective effect – the way it grabs your attention and compels you to change your behaviour to keep a body part safe.
Try this. Slowly pinch your skin. As you increase the pressure, you’ll notice the feeling changes until, at some point, it becomes painful. It is the pain that stops you squeezing harder, right? In this way, pain protects us.
When we are injured, tissue damage or inflammation makes our pain system become more sensitive. This pain stops us from mechanically loading the damaged tissue while it heals. For instance, the pain of a broken leg or a cut under our foot means we avoid walking on it.
The concept that “pain protects us and promotes healing” is one of the most important things people who were in chronic pain tell us they learned that helped them recover.
But long-term pain can overprotect you
In the short term, pain does a terrific job of protecting us and the longer our pain system is active, the more protective it becomes.
But persistent pain can overprotect us and prevent recovery. People in pain have called this “pain system hypersensitivity”. Think of this as your pain system being on red alert. And this is where exhaustion comes in.
When pain becomes a daily experience, triggered or amplified by a widening range of activities, contexts and cues, it becomes a constant drain on one’s resources. Going about life with pain requires substantial and constant effort, and this makes us fatigued.
About 80% of us are lucky enough to not know what it is like to have pain, day in day out, for months or years. But take a moment to imagine what it would be like.
Imagine having to concentrate hard, to muster energy and use distraction techniques, just to go about your everyday tasks, let alone to complete work, caring or other duties.
Whenever you are in pain, you are faced with a choice of whether, and how, to act on it. Constantly making this choice requires thought, effort and strategy.
Mentioning your pain, or explaining its impact on each moment, task or activity, is also tiring and difficult to get across when no-one else can see or feel your pain. For those who do listen, it can become tedious, draining or worrying.
Concentrating hard, mustering energy and using distraction techniques can make everyday life exhausting. PRPicturesProduction/Shutterstock No wonder pain is exhausting
In chronic pain, it’s not just the pain system on red alert. Increased inflammation throughout the body (the immune system on red alert), disrupted output of the hormone cortisol (the endocrine system on red alert), and stiff and guarded movements (the motor system on red alert) also go hand in hand with chronic pain.
Each of these adds to fatigue and exhaustion. So learning how to manage and resolve chronic pain often includes learning how to best manage the over-activation of these systems.
Loss of sleep is also a factor in both fatigue and pain. Pain causes disruptions to sleep, and loss of sleep contributes to pain.
In other words, chronic pain is seldom “just” pain. No wonder being in long-term pain can become all-consuming and exhausting.
What actually works?
People with chronic pain are stigmatised, dismissed and misunderstood, which can lead to them not getting the care they need. Ongoing pain may prevent people working, limit their socialising and impact their relationships. This can lead to a descending spiral of social, personal and economic disadvantage.
So we need better access to evidence-based care, with high-quality education for people with chronic pain.
There is good news here though. Modern care for chronic pain, which is grounded in first gaining a modern understanding of the underlying biology of chronic pain, helps.
The key seems to be recognising, and accepting, that a hypersensitive pain system is a key player in chronic pain. This makes a quick fix highly unlikely but a program of gradual change – perhaps over months or even years – promising.
Understanding how pain works, how persisting pain becomes overprotective, how our brains and bodies adapt to training, and then learning new skills and strategies to gradually retrain both brain and body, offers scientifically based hope; there’s strong supportive evidence from clinical trials.
Every bit of support helps
The best treatments we have for chronic pain take effort, patience, persistence, courage and often a good coach. All that is a pretty overwhelming proposition for someone already exhausted.
So, if you are in the 80% of the population without chronic pain, spare a thought for what’s required and support your colleague, friend, partner, child or parent as they take on the journey.
More information about chronic pain is available from Pain Revolution.
Michael Henry, Physiotherapist and PhD candidate, Body in Mind Research Group, University of South Australia and Lorimer Moseley, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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When You Know What You “Should” Do (But Knowing Isn’t The Problem)
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When knowing what to do isn’t the problem
Often, we know what we need to do. Sometimes, knowing isn’t the problem!
The topic today is going to be a technique used by therapeutic service providers to help people to enact positive changes in their lives.
While this is a necessarily dialectic practice (i.e., it involves a back-and-forth dialogue), it’s still perfectly possible to do it alone, and that’s what we’ll be focussing on in this main feature.
What is Motivational Interviewing?
❝Motivational interviewing (MI) is a technique that has been specifically developed to help motivate ambivalent patients to change their behavior.❞
Read in full: Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice
It’s mostly used for such things as helping people reduce or eliminate substance abuse, or manage their weight, or exercise more, things like that.
However, it can be employed for any endeavour that requires motivation and sustained willpower to carry it through.
Three Phases
Motivational Interviewing traditionally has three phases:
- Exploring and understanding the issue at hand
- Guiding and deciding importance and goals
- Choosing and setting an action plan
In self-practice, maybe you can already know and understand what it is that you want/need to change.
If not, consider asking yourself such questions as:
- What does a good day look like? What does a bad day look like?
- If things are not good now, when were they good? What changed?
- If everything were perfect now, what would that look like? How would you know?
Once you have a clear idea of where you want to be, the next thing to know is: how much do you want it? And how confident are you in attaining it?
This is a critical process:
- Give your answers numerically on a scale from 0 to 10
- Whatever your score, ask yourself why it’s not lower. For example, if you scored your motivation 4 and your confidence 2, what factors made your motivation not a lower number? What factors made your confidence not a lower number?
- In the unlikely event that you gave yourself a 0, ask whether you can really afford to scrap the goal. If you can’t, find something, anything, to bring it to at least a 1.
- After you’ve done that, then you can ask yourself the more obvious question of why your numbers aren’t higher. This will help you identify barriers to overcome.
Now you’re ready to choose what to focus on and how to do it. Don’t bite off more than you can chew; it’s fine to start low and work up. You should revisit this regularly, just like you would if you had a counsellor helping you.
Some things to ask yourself at this stage of the motivational self-interviewing:
- What’s a good SMART goal to get you started?
- What could stop you from achieving your goal?
- How could you overcome that challenge?
- What is your backup plan, if you have to scale back your goal for some reason?
A conceptual example: if your goal is to stick to a whole foods Mediterranean diet, but you are attending a wedding next week, then now is the time to decide in advance 1) what personal lines-in-the-sand you will or will not draw 2) what secondary, backup plan you will make to not go too far off track.
The same example in practice: wedding menus often offer meat/fish/vegetarian options, so you might choose the fish or vegetarian, and as for sugar and alcohol, you might limit yourself to “a small slice of wedding cake only; coffee/cheese option instead of dessert”, and “alcohol only for toasts”.
Giving yourself the permission well in advance for small (clearly defined and boundaried!) diversions from the plan, will stop you from falling into the trap of “well, since today’s a cheat-day now…”
Secret fourth stage
The secret here is to keep going back and reassessing at regular intervals. Set your own calendar; you might want to start out weekly and then move to monthly when you’re more strongly on-track.
For this reason, it’s good to keep a journal with your notes from your self-interview sessions, the scores you gave yourself, the goals and plans you set, etc.
When conducting your regular review, be sure to examine what worked for you, and what didn’t (and why). That way, you can practice trial-and-improvement as you go.
Want to learn more?
We only have so much room here, but there are lots of resources out there.
Here’s a high-quality page that:
- explains motivational interviewing in more depth than we have room for here
- offers a lot of free downloadable resource packs and the like
Check it out: Motivational Interviewing Theory & Resources
Enjoy!
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Can We Drink To Good Health?
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Can we drink to good health?
We asked you for your thoughts on alcohol and heart health, and we got quite an even spread of results!
If perchance that’s too tiny to read, the figures were:
- 32% voted for “Alcohol is a relaxant, reduces stress, and can contain resveratrol too. It’s good for the heart!”
- 32% voted for: “Moderate alcohol consumption can be at least neutral for the health, if not positive ⚖️”
- 36% voted for: “Alcohol is bad for pretty much everything, including heart health ✋”
One subscriber who voted for “Alcohol is a relaxant, reduces stress, and can contain resveratrol too. It’s good for the heart!” added the following thoughts:
❝While it isn’t necessary to consume alcohol, moderate amounts can be beneficial and contribute to well-being through social activity, celebrations, etc.❞
That’s an interesting point, and definitely many people do see alcohol that way! Of course, that does not mean that one will find no social activities, celebrations, etc, in parts of the world where alcohol consumption is uncommon. Indeed, in India, wedding parties where no alcohol is consumed can go on for days!
But, “we live in a society” and all that, and while we’re a health newsletter not a social issues newsletter, it’d be remiss of us to not acknowledge the importance of socialization for good mental health—and thus the rest of our health too.
So, if indeed all our friends and family drink alcohol, it can certainly make abstaining more of a challenge.
On that note, let’s take a moment to consider “The French Paradox” (an observation of a low prevalence of ischemic heart disease despite high intakes of saturated fat, a phenomenon accredited to the consumption of red wine).
As it happens, a comprehensive review in “Circulation”, a cardiovascular health journal, has suggested the French Paradox may not be so paradoxical after all.
Research suggests it has more to do with other lifestyle factors (and historic under-reporting of cardiovascular disease by French doctors), which would explain why Japan has lower rates of heart disease, despite drinking little wine, and more beer and spirits.
So, our subscriber’s note may not be completely without reason! It’s just about the party, not the alcohol.
One subscriber who voted for “Moderate alcohol consumption can be at least neutral for the health, if not positive ⚖️” wrote:
❝Keeping in mind, moderate means one glass of wine for women a day and two for men. Hard alcohol doesn’t have the same heart benefits as wine❞
That is indeed the guideline according to some health bodies!
In other places with different guiding advisory bodies, that’s been dropped down to one a day for everyone (the science may be universal, but how government institutions interpret that is not).
About that wine… Specifically, red wine, for its resveratrol content:
While there are polyphenols such as resveratrol in red wine that could boost heart health, there’s so little per glass that you may need 100–1000 glasses to get the dosage that provides benefits in mouse studies. If you’re not a mouse, you might even need more.
To this end, many people prefer resveratrol supplementation. ← link is to an example product, but there are plenty more so feel free to shop around
A subscriber who voted for “Alcohol is bad for pretty much everything, including heart health ✋” says:
❝New guidelines suggest 1 to 2 drinks a week are okay but the less the better.❞
If you haven’t heard these new guidelines, we’ll mention again: every government has its own official bodies and guidelines so perhaps your local guidelines differ, but for example here’s what that World Health Organization has to say (as of January this year):
WHO: No level of alcohol consumption is safe for our health
So, whom to believe? The governments who hopefully consider the welfare of their citizenry more important than the tax dollars from alcohol sales, or the World Health Organization?
It’s a tough one, but we’ll always err on the side of the science.
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Hazelnuts vs Cashews – Which is Healthier?
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Our Verdict
When comparing hazelnuts to cashews, we picked the hazelnuts.
Why?
It’s close! This one’s interesting…
In terms of macros, hazelnuts have more fiber and fats, while cashews have more protein and carbs. All in all, all good stuff all around; maybe a win for one or the other depending on your priorities. We’d pick hazelnuts here, but your preference may vary.
When it comes to vitamins, hazelnuts have more of vitamins A, B1, B2, B3, B5, B6, B9, C, and E, while cashews have more vitamin K. An easy win for hazelnuts here, and the margins weren’t close.
In the category of minerals, hazelnuts have more calcium, manganese, and potassium, while cashews have more copper, iron, magnesium, phosphorus, selenium, and zinc. This is a win for cashews, but it’s worth noting that cup for cup, both of these nuts provide more than the daily requirement of most of those minerals. This means that in practical terms, it doesn’t matter too much that (for example), while cashews provide 732% of the daily requirement for copper, hazelnuts “only” provide 575%. So while this category remains a victory for cashews, it’s something of a “on paper” thing for the most part.
Adding up the sections (ambivalent + clear win for hazelnuts + nominal win for cashews) means that in total today we’re calling it in favour of hazelnuts… But as ever, enjoy both, because both are good and so is diversity!
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
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How Your Sleep Position Changes Dementia Risk
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This is not just about sleep duration or even about sleep quality… It really is about which way your body is positioned.
Goodnight, glymphatic system
The association between sleeping position and dementia risk is about glymphatic drainage, which is largely powered by gravity (and thus dependent on which way around your head and neck are oriented), and very important for clearing toxins out of the brain—including beta-amyloid proteins.
This becomes particularly important when the glymphatic system becomes less efficient in midlife, often 15–20 years before cognitive decline symptoms appear.
The video’s thumbnail headline, “SCIENTISTS REVEAL: THE WAY YOUR SLEEP CAN CAUSE DEMENTIA” is overstated and inaccurate, but our adjusted headline “how your sleep position changes dementia risk” is actually representative of the paper on which this video was based; we’ll quote from the paper itself here:
❝This paper concludes that 1. glymphatic clearance plays a major role in Alzheimer’s pathology; 2. the vast majority of waste clearance occurs during sleep; 3. dementias are associated with sleep disruption, alongside an age-related decline in AQP4 polarization; and 4. lifestyle choices such as sleep position, alcohol intake, exercise, omega-3 consumption, intermittent fasting and chronic stress all modulate* glymphatic clearance. Lifestyle choices could therefore alter Alzheimer’s disease risk through improved glymphatic clearance, and could be used as a preventative lifestyle intervention for both healthy brain ageing and Alzheimer’s disease.❞
…and specifically, they found:
❝Glymphatic transport is most efficient in the right lateral sleeping position, with more CSF clearance occurring compared to supine and prone. The average person changes sleeping position 11 times per night, but there was no difference in the number of position changes between neurodegenerative and control groups, making the percentage of time spent in supine position the risk factor, not the number of position changes❞
Read the paper in full here: The Sleeping Brain: Harnessing the Power of the Glymphatic System through Lifestyle Choices
*saying “modulate” here is not as useful as it could be, because they modulate it differently: side-sleeping improves clearance; back sleeping decreases it; front-sleeping isn’t great either. Alcohol intake reduces clearance, exercise (especially cardiovascular exercise) improves it; omega-3 consumption improves it up a degree and does depend on omega-3/6 ratios, intermittent fasting improves it, and chronic stress worsens it.
And for a more pop-science presentation, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
How To Clean Your Brain (Glymphatic Health Primer)
Take care!
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In Praise Of Walking – by Dr. Shane O’Mara
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At 10almonds we talk often of the health benefits of walking, so what’s new here?
As the subtitle suggests: a new scientific exploration!
Dr. Shane O’Mara is a professor of experimental brain research—and a keen walker. Combining his profession and his passion, he offers us a uniquely well-grounded perspective.
While the writing style is very readable, there’s a lot of science referenced here, with many studies cited. We love that!
We begin our journey by learning what we have in common with sea squirts, and what we have different from all other apes. What we can learn from other humans, from toddlers to supercentenarians.
As one might expect from a professor of experimental brain research, we learn a lot more about what walking does for our brain, than for the rest of our body. We’ve previously talked about walking and cardiovascular health, and brown adipose tissue, and benefits to the immune system, but this book remains steadfastly focused on the brain.
Which just goes to show, what a lot there is to say for the science-based benefits to our brain health, both neurologically and psychologically!
One of the things at which Dr. O’Mara excels that this reviewer hasn’t seen someone do so well before, is neatly tie together the appropriate “why” and “how” to each “what” of the brain-benefits of walking. Not just that walking boosts mood or creativity or problem-solving, say, but why and how it does so.
Often, understanding that can be the difference between being motivated to actually do it or not!
Bottom line: if there’s a book that’ll get you lacing up your walking shoes, this’ll be the one.
Click here to check out “In Praise of Walking” on Amazon, and start reaping the benefits!
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