The term asymptomatic refers to the absence of symptoms. It can apply for an individual, a disease, or even a stage of a disease. A symptom is a sign of illness, such as having a fever or coughing. We could therefore think that asymptomatic people are not sick: this is not true.

What is the asymptomatic state?

An asymptomatic is a patient who ignores himself. An asymptomatic person will therefore often be able to transmit a disease, even if they themselves do not suffer the consequences. Not yet, in any case. Indeed, some diseases present a long asymptomatic stage, which delays its detection, before becoming symptomatic several years later.

Difference between asymptomatic and healthy carrier

The term asymptomatic can sometimes be confused with that of ” healthy carrier », Which designates a person who carries a virus or other micro-organism within him, without showing any symptoms. This French twist (which does not seem to exist in English), is sometimes used in the case of former patients, who continue to carry bacteria or viruses within them, but by controlling their population sufficiently so that they present no risk. . This is the case of former patients with typhoid fever, or more recently of asymptomatic people affected by SARS-Cov-2, of Covid 19 disease.

The different types of asymptomatic patients

There are therefore different types of asymptomatic patients, linked to the time of transmission of their diseases:

Incubation transmitters

It is the sick who carry a germ in them, and transmit it, before they themselves are affected by the symptoms. This is the case in the disease of Covid 19, where one can be contagious before presenting the disorders.

Convalescent transmitters

This time, the contagion takes place after the disease. Indeed, shortly after being sick, the bacteria or virus can still be in our body, and therefore be transmitted to others.

Asymptomatic transmitters

This is the “purest” version of the asymptomatic, linked to the term “healthy carrier”. This time, the contagious patient will never show any symptoms.

There are different diseases of which the existence of asymptomatic patients constitutes a large part. Often these diseases have an asymptomatic first stage. Here is an example of a disorder with a phase without noticeable symptoms:

• Zika virus
• Coronaviruses (such as Sars-Cov2 which has been rife since the end of 2019)
• Cancers (hence the importance of screening, especially for breast cancer)
• The VIH (Side virus)
• Tuberculosis
• Typhoid fever
• Chlamydia
• Epstein-Barr virus (EBV, or herpes virus)
• Hepatitis B and C
• Cholera

This list can extend to various STIs (Sexually Transmitted Infections), including chlamydia.

Between 1900 and 1907, Mary Mallon, originally from Ireland, worked as a cook in the United States. Without knowing it, she is asymptomatic with typhoid fever, an infectious disease caused by the presence of bacteria such as salmonella. The cook, while preparing her dishes, will contaminate more than 50 people, creating mini-homes in each place where she practices her profession.

It was only after 1907 that doctors understood that she was a “healthy carrier” of the disease, herself having never presented the slightest symptom of typhoid fever. An accusation that she will also fiercely deny having transmitted, until later resuming her work as a cook under a pseudonym! Following two deaths caused by her new infections, she will spend the rest of her life in quarantine.

Now the English remember her by the expression “Mary Typhoid”, used when a loved one is suspected of being a sick person who ignores himself.

One might think that being asymptomatic is a chance, who indeed wants to suffer the symptoms of a disease? However, this is misleading, a bit like for people who do not feel any pain: without an indicator, we expose ourselves to more serious dangers. Thus, several risks are possible:

Delay in diagnosis

An asymptomatic patient may one day develop symptoms, with more force than if they had started immediately. Sometimes, finding a disease as quickly as possible will be vital, as with cancer. Hence the importance of screening, to diagnose cancer even without symptoms.

Risks during pregnancy

If pregnant women take so many tests during their pregnancy, it is also to detect traces of asymptomatic diseases. Because if the mother is safe, the unborn child could develop symptoms from birth. This is the case, for example, for the Zika virus, which can reduce the development of the skull and brain capacity of infants.

Diagnosis without symptoms usually requires urine or blood tests to directly analyze the presence of bacteria or viruses in the individual.

When the symptoms are still emerging, it is important to know how to spot the most subtle signs. This is the case during breast cancer screening, where we look for the presence of abnormal elements even without the patient feeling discomfort or pain.