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Incubation period

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Incubation period (also known as the latent period or latency period) is the time elapsed between exposure to a pathogenic organism, a chemical, or radiation, and when symptoms and signs are first apparent.[1] In a typical infectious disease, the incubation period signifies the period taken by the multiplying organism to reach a threshold necessary to produce symptoms in the host.

In some diseases, as depicted in this diagram, the latency period is shorter than the incubation period. After the latency period (but before clinical infection) the infected person can transmit the disease without signs of any symptoms. Such infection is called subclinical infection.

While latent or latency period may be synonymous, a distinction is sometimes made whereby the latent period is defined as the time from infection to infectiousness. Which period is shorter depends on the disease. A person may carry a disease, such as Streptococcus in the throat, without exhibiting any symptoms. Depending on the disease, the person may or may not be contagious during the incubation period.

During latency, an infection is subclinical. With respect to viral infections, in incubation the virus is replicating.[2] This is in contrast to viral latency, a form of dormancy in which the virus does not replicate. An example of latency is HIV infection. HIV may at first have no symptoms and show no signs of AIDS, despite HIV replicating in the lymphatic system and rapidly accumulating a large viral load. People with HIV in this stage may be infectious.

Intrinsic and extrinsic incubation period

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The terms "intrinsic incubation period" and "extrinsic incubation period" are used in vector-borne diseases. The intrinsic incubation period is the time taken by an organism to complete its development in the definitive host. The extrinsic incubation period is the time taken by an organism to develop in the intermediate host.[citation needed]

For example, once ingested by a mosquito, malaria parasites must undergo development within the mosquito before they are infectious to humans. The time required for development in the mosquito ranges from 10 to 28 days, depending on the parasite species and the temperature. This is the extrinsic incubation period of that parasite. If a female mosquito does not survive longer than the extrinsic incubation period, then she will not be able to transmit any malaria parasites.[citation needed]

But if a mosquito successfully transfers the parasite to a human body via a bite, the parasite starts developing. The time between the injection of the parasite into the human and the development of the first symptoms of malaria is its intrinsic incubation period.[3]

Determining factors

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The specific incubation period for a disease process is the result of multiple factors, including:[citation needed]

  • Dose or inoculum of an infectious agent
  • Route of inoculation
  • Rate of replication of infectious agent
  • Host susceptibility
  • Immune response

Examples for diseases in humans

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Due to inter-individual variation, the incubation period is always expressed as a range. When possible, it is best to express the mean and the 10th and 90th percentiles, though this information is not always available.

For many conditions, incubation periods are longer in adults than they are in children or infants.

Disease between and
Cellulitis caused by Pasteurella multocida 0 days[4] 1 day
Chicken pox 9 days[5] 21 days
Cholera 0.5 days[6] 4.5 days
Common cold 1 day[7][8] 3 days
COVID-19 2 days [9] 11.5[10]/12.5[11]/14 days
Dengue fever 3 days[12] 14 days
Ebola 1 day[13] 21 (95%), 42 (98%) days
Erythema infectiosum (Fifth disease) 13 days[14] 18 days
Giardia 3 days 21 days
HIV 2 weeks to months, or longer[15] 3 weeks to months, or longer
Infectious mononucleosis (glandular fever) 28 days[16] 42 days
Influenza 1 day[17] 3 days
Kuru disease 10.3 years (mean)[18] 13.2 years
Leprosy 1 year[19] 20 or more years
Marburg 5 days[20] 10 days
Measles 9 days[21] 12 days
MERS 2 days[22] 14 days
Mumps 14 days[23] 18 days
Norovirus 1 day[24] 2 days
Pertussis (whooping cough) 7 days[25] 14 days
Polio 7 days[26] 14 days
Rabies 1 months, but may vary from <1 week to rarely >1 year.[27][28] 3 months
Rocky Mountain spotted fever 2 days[29] 14 days
Roseola 5 days[30] 15 days
Rubella (German measles) 14 days[31] 21 days
Salmonella 12 days[31] 24 days
Scarlet fever 1 day[32] 4 days
SARS 1 day[33] 10 days
Smallpox 7 days[34] 17 days
Tetanus 7 days[35] 21 days
Tuberculosis 2 weeks[36] 12 weeks
Typhoid 7 days 21 days

See also

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Scholia has a profile for incubation period (Q193566).

References

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  1. ^ Lesson 1, Section 9: Natural History and Spectrum of Disease, Principles of Epidemiology in Public Health Practice, Third Edition, An Introduction to Applied Epidemiology and Biostatistics, Centers for Disease Control and Prevention, May 18, 2012
  2. ^ Sharara, A. I. (1997). "Chronic hepatitis C". Southern Medical Journal. 90 (9): 872–7. doi:10.1097/00007611-199709000-00002. PMID 9305294. S2CID 9838013.
  3. ^ Chan, Miranda; Johansson, Michael A. (Nov 30, 2012). "The Incubation Periods of Dengue Viruses". PLOS ONE. 7 (11): e50972. Bibcode:2012PLoSO...750972C. doi:10.1371/journal.pone.0050972. PMC 3511440. PMID 23226436.
  4. ^ Cellulitis, kidshealth.org. Accessed 2012-05-28.
  5. ^ "Chickenpox: Practice Essentials, Background, Pathophysiology". March 22, 2020 – via eMedicine. {{cite journal}}: Cite journal requires |journal= (help)
  6. ^ Azman, Andrew S.; Rudolph, Kara E.; Cummings, Derek A.T.; Lessler, Justin (2013). "The incubation period of cholera: A systematic review". Journal of Infection. 66 (5): 432–8. doi:10.1016/j.jinf.2012.11.013. PMC 3677557. PMID 23201968.
  7. ^ Lessler, Justin; Reich, Nicholas G; Brookmeyer, Ron; Perl, Trish M; Nelson, Kenrad E; Cummings, Derek AT (2009). "Incubation periods of acute respiratory viral infections: A systematic review". The Lancet Infectious Diseases. 9 (5): 291–300. doi:10.1016/S1473-3099(09)70069-6. PMC 4327893. PMID 19393959.
  8. ^ Common cold, The Mayo Clinic, mayoclinic.com. Accessed 2012-05-28.
  9. ^ Linton, Natalie M.; Kobayashi, Tetsuro G; Yang, Yichi; Hayashi, Katsuma M; Akhmetzhanov, Andrei R. E; Jung, Sung-mok; Yuan, Baoyin; Kinoshita, Ryo; Nishiura1, Hiroshi (2020). "Incubation Period and Other Epidemiological Characteristics of 2019 Novel Coronavirus Infections with Right Truncation: A Statistical Analysis of Publicly Available Case Data". J Clin Med. 9 (2): 538. doi:10.3390/jcm9020538. PMC 7074197. PMID 32079150.{{cite journal}}: CS1 maint: numeric names: authors list (link)
  10. ^ Lauer, Stephen A.; Grantz, Kyra H.; Bi, Qifang; Jones, Forrest K.; Zheng, Qulu; Meredith, Hannah R.; Azman, Andrew S.; Reich, Nicholas G.; Lessler, Justin (March 10, 2020). "The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application". Annals of Internal Medicine. 172 (9): 577–582. doi:10.7326/M20-0504. PMC 7081172. PMID 32150748.
  11. ^ Li, Qun; Guan, Xuhua; Wu, Peng; Wang, Xiaoye; Zhou, Lei; Tong, Yeqing; Ren, Ruiqi; Leung, Kathy S.M.; Lau, Eric H.Y.; Wong, Jessica Y.; Xing, Xuesen; Xiang, Nijuan; Wu, Yang; Li, Chao; Chen, Qi; Li, Dan; Liu, Tian; Zhao, Jing; Liu, Man; Tu, Wenxiao; Chen, Chuding; Jin, Lianmei; Yang, Rui; Wang, Qi; Zhou, Suhua; Wang, Rui; Liu, Hui; Luo, Yinbo; Liu, Yuan; Shao, Ge; Li, Huan; Tao, Zhongfa; Yang, Yang; Deng, Zhiqiang; Liu, Boxi; Ma, Zhitao; Zhang, Yanping; Shi, Guoqing; Lam, Tommy T.Y.; Wu, Joseph T.; Gao, George F.; Cowling, Benjamin J.; Yang, Bo; Leung, Gabriel M.; Feng, Zijian (March 26, 2020). "Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia". New England Journal of Medicine. 382 (13): 1199–1207. doi:10.1056/NEJMoa2001316. PMC 7121484. PMID 31995857.
  12. ^ Gubler, D. J. (1998). "Dengue and dengue hemorrhagic fever". Clinical Microbiology Reviews. 11 (3): 480–96. doi:10.1128/CMR.11.3.480. PMC 88892. PMID 9665979.
  13. ^ Are the Ebola outbreaks in Nigeria and Senegal over?, World Health Organization, who.int. Accessed 2014-10-21.
  14. ^ Erythema Infectiosum at eMedicine
  15. ^ Kahn, James O.; Walker, Bruce D. (1998). "Acute Human Immunodeficiency Virus Type 1 Infection". New England Journal of Medicine. 339 (1): 33–9. doi:10.1056/NEJM199807023390107. PMID 9647878.
  16. ^ Macnair, Trisha, Glandular fever, BBC, bbc.co.uk. Accessed 2012-05-28.
  17. ^ Seasonal Influenza (Flu), Centers for Disease Control and Prevention, cdc.gov. Accessed 2012-05-28.
  18. ^ Huillard d'Aignaux, J. N.; Cousens, S. N.; MacCario, J; Costagliola, D; Alpers, M. P.; Smith, P. G.; Alpérovitch, A (2002). "The incubation period of kuru". Epidemiology. 13 (4): 402–8. doi:10.1097/00001648-200207000-00007. PMID 12094094. S2CID 22810508.
  19. ^ "Leprosy Fact sheet N°101". World Health Organization. January 2014. Archived from the original on 2013-12-12.
  20. ^ Questions and Answers About Marburg Hemorrhagic Fever Archived 2016-03-03 at the Wayback Machine, Centers for Disease Control and Prevention, cdc.gov. Accessed 2012-05-28.
  21. ^ Measles, American Osteopathic College of Dermatology, aocd.org. Accessed 2012-05-28.
  22. ^ "MERS Clinical Features". CDC.gov. CDC. 2 August 2019. Retrieved 22 March 2020.
  23. ^ Mumps Disease, Questions & Answers Archived 2007-11-20 at the Wayback Machine, vaccineinformation.org. Accessed 2012-05-28.
  24. ^ Norovirus, Centers for Disease Control and Prevention, cdc.gov. Accessed 2012-05-28.
  25. ^ Pertussis, GPnotebook, gpnotebook.co.uk. Accessed 2012-05-28.
  26. ^ Polio, GPnotebook, gpnotebook.co.uk. Accessed 2012-05-28.
  27. ^ "WHO - Rabies". who.int.
  28. ^ "Rabies vaccines: WHO position paper – April 2018" (PDF). WHO. April 2018 – via apps.who.int.
  29. ^ Rocky Mountain Spotted Fever Archived 2016-03-04 at the Wayback Machine, About.com. Accessed 2012-05-28.
  30. ^ Roseola Infantum at eMedicine
  31. ^ a b Dermatologic Manifestations of Rubella at eMedicine
  32. ^ Scarlet Fever at eMedicine
  33. ^ World Health Organization (WHO), Severe acute respiratory syndrome, www.who.int. Accessed 2012-05-28.
  34. ^ Smallpox Disease Overview Archived 2013-04-02 at the Wayback Machine, Centers for Disease Control and Prevention, cdc.gov. Accessed 2012-05-28.
  35. ^ Tetanus at eMedicine
  36. ^ "Tuberculosis (TB)". MedicineNet. Retrieved 22 March 2020.
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