But for people who have had a stroke or traumatic brain injury (TBI), communicable diseases can be more precarious, can affect recovery more harshly than in the general population, and longer-lasting. The reasons behind are easy to understand: brain injury often reduces the brain’s ability to manage stress and fever and weakens the immune system.
Both stroke and TBI trigger what researchers call “stroke-induced immunosuppression” (SIIS), which increases susceptibility to stroke-associated infections Stroke-induced immunosuppression: implications for the prevention and prediction of post-stroke infections | Journal of Neuroinflammation | Full Text.
This immunosuppression occurs as “the nervous system suppresses systemic immunity to protect the brain from further inflammatory insult, yet this comes at the cost of increased susceptibility to infection” Ischemia, Immunosuppression and Infection—Tackling the Predicaments of Post-Stroke Complications – PMC. Even troubles swallowing (dysphagia) are very common after stroke and TBI, and can cause food, liquids, or saliva to enter the lungs, leading to aspiration.
There can be reduced movement so paralysis gives you a higher risk for pneumonia, infected pressure sores, and urinary tract infections. The hypothalamus which regulates body temperature may go unnoticed because if it gets too high, can injure the brain even further. Also. the risk of seizures might be inflated.
Six Major Transmission Routes:
1. Airborne through respiratory droplets and airborne particles
2. Direct contact through physical contact with infected people or surfaces
3. Vector-borne through insects, ticks, and other carriers
4. Food and Water-borne through contaminated food and beverages
5. Sexual transmission through sexual contact
6. Blood-borne through infected blood and body fluids
Prevention depends on early rehabilitation and swallow testing to rigorous device obligations and immunizations along with the latest immunological understanding that permit infection-prevention strategies.
What to do?
-
Practice good hand hygiene
-
Avoid contact with sick people
-
Clean mobility aids (wheelchair handles, walkers)
-
Drink enough fluids to prevent UTIs
-
Sit upright during meals (to reduce aspiration risk)
-
Watch for confusion, fever, or sudden weakness which are early signs of infection
- Twice-daily antiseptic mouth rinses to reduce dental plaque and lower ventilator-associated pneumonia risk
Vaccinations Are Critical
Recommended:
-
Flu (every year)
-
COVID-19 (updated boosters)
-
Pneumonia (especially over age 65 or with stroke history)
-
Shingles (over 50) and for never having chickenpox, get the chickenpox vaccine
-
Tdap tetanus, diphtheria, pertussis (when necessary)
-
Hepatitis B (if risk factors are present)
Checklist for Caregivers or Self-Monitoring
-
Coughing more
-
More confused than usual
- Has fever, chills, and/or fatigue
-
Trouble breathing or swallowing
-
Any changes in urine (color, smell)
Understanding these vulnerabilities is demanding for caregivers and healthcare providers to implement pertinent infection prevention strategies and oversee for early signs of communicable diseases in brain injury patients. The immune suppression can last for weeks to months after the original brain damage, requiring ongoing diligence for infections.
Now it comes time for the conclusion:
Person 1: Why can’t a roof get Chickenpox?
Person 2: It already has Shingles.
Oof!
And sticking to my less humorous side:
By the way, if you’ve never had chickenpox, the virus is not present in your body, and therefore cannot reactivate to cause shingles. While children typically get chickenpox, it can be more severe in adults. Adults who have never had chickenpox are at risk of contracting it if exposed, and it is recommended they get vaccinated against chickenpox, according to health resources.
And adults who have never had measles or who are unsure of their vaccination status should get vaccinated. Similarly, adults who have not received the whooping cough (pertussis) vaccine should also get vaccinated. Specifically, the MMR vaccine protects against measles, mumps, and rubella, and the Tdap vaccine protects against tetanus, diphtheria, and pertussis. Consulting with a healthcare provider is recommended to determine the most appropriate vaccination schedule and risk factors.
