Is It Bacterial or Viral ?

How can you tell the difference between a bacterial and a viral infection? It is hard to judge, based on symptoms, since they can cause similar outcomes such as coughing, fever, fatigue, inflammation, sneezing, headaches and even vomiting or diarrhea (https://www.webmd.com/a-to-z-guides/bacterial-and-viral-infections). Although bacteria and viruses are both categorized as microbes and can spread infections in the same manner (coughing, sneezing, skin contact etc.) , they are significantly different structurally and the treatments are not the same.

    Bacteria are complex, tough organisms, single-celled, and have rigid-walls with rubbery membranes for protection. An important difference from viruses is that bacteria can reproduce on their own. Also noteworthy is that most bacteria are harmless and many are beneficial; the bacteria on our skin and inside our body have a protective role and fight off disease. They can also survive extreme environments, whether it is variation in temperature or even radioactive waste materials. Bacteria have existed for over 3.5 billion years (https://www.webmd.com/a-to-z-guides/bacterial-and-viral-infections).
     
Viruses in contrast are small; they do not have a strong cell wall. They cannot survive on their own; they require a host in order to replicate and survive. Most viruses are harmful to humans, and these pathogens attack specific cells in the body such as the lungs, blood and liver.
     
Diagnosing: Is it a viral or bacterial in origin?  With some illnesses, such as colds, a distinction as to whether it is bacterial or viral in origin is not critical; you can “ride out the common cold.” Sometimes a simple examination can determine the source of an infection such as chicken pox (viral) or a staph skin infection (bacterial). Other times a good history can determine the likely infection: influenza during flu season. However, there are other times that a determination has to be made in order to treat a condition such as meningitis, pneumonia, or a serious gastrointestinal infection. The detection approaches are too complex to discuss here, but in general bacterial cultures are more routine since bacteria reproduce on their own and will continue to grow in the petri dish in the lab. Since viruses require a host to reproduce and survive, viral testing often involves eliciting an antibody response, by utilizing such tests as DNA/RNA (PCR) or antigen detection (https://ec.europa.eu/research-and-innovation/en/horizon-magazine/pcr-antigen-and-antibody-five-things-know-about-coronavirus-tests).
     
Treatments: Typically antibiotics are used for bacterial infections and antivirals are used for viral infections. Examples of familiar bacterial infections are: strep throat, Lyme disease, cellulitis, mycoplasma, bacterial meningitis, gonorrhea, TB and tetanus. Well-known viral infections include influenza, common cold, warts, HIV, chicken pox, viral meningitis, viral hepatitis, and of course, now we all know about Covid-19 (https://www.healthline.com/health/bacterial-vs-viral-infections#viral-infection-examples). Antibiotics fight off bacterial infection vs antivirals, which help to alleviate the symptoms but do not totally ward off the viral infection.
     
We tend to take antibiotic treatment for granted. Historically, the discovery of antibiotics was literally revolutionary. Prior to WWII, infections struck down children, the elderly and even adults in the prime of life (http://www.remappingdebate.org/article/return-our-old-enemies-untreatable-formantibiotics). But now we have to be careful with overuse because it can lead to the development of resistant organisms. Remember, bacteria have been around for billions of years. These antibiotic-resistant bacteria (now even stronger) can easily be transmitted to others, and for some people the result is severe disability or even death (https://www.hopkinsmedicine.org/health/wellness-and-prevention/antibiotics). We are in constant need of new antibiotics to counter this problem, but antibiotic development is not a big money-maker. Pharmaceutical companies profit with the production of drugs that have to be taken long-term (i.e., statins) rather than with antibiotics, which are taken predominantly on a short-term basis (https://hopkinsinfectiousdiseases.jhmi.edu/research/research-areas/antibiotic-resistance-and-stewardship/).
     
Here is a list of the most serious life-threatening infections that the Infectious Diseases Society of America (IDSA) has identified as a group of drug-resistant bacteria. The acronym – ESKAPE – is used to represent the fact that these pathogens are “escaping” the effects of antibiotics:
     E= Enterococcus faecium… causes a variety of wound, heart and urinary tract infections
     S= Staphylococcus aureus … causes MRSA
     K= Klebsiella Escherichia coli K pneumoniae… causes common urinary tract infections
     A= Acinetobacter baumannii… causes pneumonia and infections in the blood
P= Pseudomonas aeruginosa… causes pneumonia or infections in the body after surgery
     E= Enterobacter species…. causes colon, other intestinal and abdominal infections
    
Although there are vaccines for bacterial infections, we associate vaccine use with viruses. Vaccines are preventative; they are not a form of treatment like antibiotics or antivirals. Let’s go back to the beginning when I said that viruses (pathogens) need a host (like us for example) in order to live. “The pathogen’s job is to evade the immune system, create more copies of itself, and spread to other hosts.” (https://www.historyofvaccines.org/content/articles/viruses-and-evolution). We can build antibodies to fight off viral infections (like the common cold), but if mutations occur then the virus’ outer surface changes and the previously produced antibodies cannot fight the mutated virus. Because vaccines are given less frequently (prevention) than repeated antibiotic-usage, (treatment) there is not an overuse problem.
     
In contrast, to regular influenza, the Covid-19 virus is atypical because it jumped from the animal-to human kingdom and it has the potential to cause serious symptoms and death. As we know, the bad news is that this resulted in a pandemic; the good news is that  scientists at the National Institute for Health (NIH )Vaccine Research Center (VRC) were already carrying out vaccine studies for years in order to figure out how to develop protection against coronaviruses, which is what Covid-19 is (https://covid19.nih.gov/news-and-stories/vaccine-development). The outcome of those years of research was the development of an effective vaccine. Basically, the mRNA in these vaccines “teaches” our bodies how to build proteins, which triggers an immune response to fight the Covid-19 infection. Unlike other vaccines, no form of a virus (live or attenuated) is used. The mRNA is synthetically produced and cannot enter our body cells. Soon after the mRNA  “teaches” our body to produce an immune response against Covid-19, it dissolves. It cannot exist in body temperatures of 98.6 F; remember that these type of vaccines have to be stored in extremely cold temperatures or they begin to break down.
     
It helps to know how viruses and bacteria are different!
     
Charlotte Michos is a clinical nurse specialist who values personal-centered care and serves as a Healthcare Consultant in helping others make informed decisions. For more information, email her or call (845) 548-5980.