Medical News Today: What is kernicterus and what are the symptoms?

Kernicterus is brain damage caused by severe, untreated jaundice or high blood levels of a substance called bilirubin. The condition is typically associated with severe, untreated cases of jaundice in newborns.

Globally, 60 to 80 percent of newborns experience jaundice. In industrialized countries, only 0.4 to 2.7 of every 100, 000 children develop kernicterus or a condition called acute bilirubin encephalopathy. This is where bilirubin levels are so high they spread to the brain and damage the central nervous system tissues.

Currently, kernicterus refers specifically to severe damage to the nervous system caused by jaundice. However, all types of damage related to severe jaundice are also considered to be forms or stages of kernicterus.

In this article, we examine the symptoms of kernicterus, along with its causes and risk factors. We also take a look at how the condition is diagnosed, and what can be done to treat it.

What are the main symptoms?

Baby receiving light therapy for jaundice. Untreated jaundice may cause kernicterus
Untreated jaundice in newborns may lead to kernicterus.

Kernicterus develops from severe, untreated jaundice.

Common symptoms of jaundice, particularly in infants, include:

  • yellow or orange-tinted face, whites of the eyes, and gums
  • mild difficulty sleeping or being woken up
  • reduced urine production or dark-colored urine
  • trouble breast-feeding, suckling a bottle, or eating
  • mild fussiness and difficult to soothe

Babies with mild to moderate jaundice often have no symptoms besides the yellow tint to their eyes and skin.

In severe jaundice, the change in color that affects the face, whites of the eyes, and gums in mild jaundice progress to the rest of the body, moving down through the chest, belly, legs, and arms.

Common symptoms of severe jaundice and kernicterus include:

  • stiff, limp, or floppy body
  • high-pitched, continual crying
  • strange or uncoordinated eye movements
  • body arching like a bow, with the head, neck, and heels bent backward, and the rest of the body angled forward
  • seizures
  • bulging of the soft spot on the top of a baby’s head

People should seek immediate medical attention any time they suspect symptoms of severe jaundice or kernicterus.

What is bilirubin?

The body produces bilirubin when old red blood cells are broken down.

Once free in the bloodstream, bilirubin is taken up by the liver, made water-soluble, then excreted into bile salts.

Bilirubin is then broken down by intestinal bacteria. It then either leaves the body in the feces or is transported to the kidneys and removed from the body in urine.

In newborns, the organs may not be developed enough to process bilirubin, especially in the first few hours and days of life. This can result in jaundice.

High blood levels of bilirubin, beyond the newborn stage, are often a sign of disease or damage to the liver, as this organ is primarily responsible for clearing bilirubin from the blood.

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Premature baby
Significant jaundice may be caused by a premature birth.

Kernicterus occurs when bilirubin levels in the blood become so high that it crosses the blood-brain barrier and damages the brain tissue. The condition is almost always related to severe jaundice.

Common causes of significant jaundice include:

  • underdeveloped, diseased, or damaged liver
  • destruction of red blood cells, often when the mother’s blood type does not match her baby’s
  • premature birth, typically before 37 weeks of gestation or pregnancy
  • increased bilirubin production
  • Gilbert’s syndrome, a condition that leads to high bilirubin levels
  • bile duct obstruction or blockage

Risk factors

Though mild jaundice is very common in newborns, some factors are known to increase the risk of severe jaundice and kernicterus significantly.

Risk factors for kernicterus include:

  • mother and child not sharing a blood group
  • lack of glucose-6-phosphate dehydrogenase (G6PD), an enzyme that helps red blood cells to work properly
  • low birth weight
  • premature birth
  • sepsis
  • meningitis
  • dark skin color, as yellowing skin is hard to notice
  • feeding trouble or poor appetite
  • bruising or bruising conditions
  • family history of jaundice
  • bruising or injuries from a difficult birth

Though many of these conditions can increase a baby’s risk for severe jaundice, prompt treatment of high bilirubin levels can almost always prevent kernicterus.

Does it affect adults and children differently?

Cases of kernicterus involving adults are considered very rare, and only a few have been reported.

Kernicterus is usually considered far more likely to impact infants because their blood-brain barrier is not fully developed.

Infants are also more prone to severe jaundice and kernicterus because their livers are not fully developed and are less capable of removing bilirubin from the blood.

What are the complications?

Kernicterus can cause serious, permanent, health complications related to brain damage.

A 2014 study followed 128 individuals treated for severe jaundice at birth for 30 years. The authors found that 45 percent experienced behavior impairments and problems related to the ability to think when children. These difficulties continued into adulthood.

Complications associated with kernicterus include:

  • hearing loss or difficulty processing sounds
  • vision problems
  • undeveloped teeth and jaw bones
  • movement disorders caused by brain damage
  • intellectual and developmental disabilities, including dyslexia
  • stained baby teeth
  • autistic spectrum disorders
  • epilepsy
  • inattention and hyperexcitability disorders, especially in early childhood

If left untreated, kernicterus can lead to coma and death.

How is it diagnosed?

Bilirubin test
A bilirubin blood test may help to diagnose jaundice.

In newborns, a nurse or doctor will often initially test for jaundice by placing a light meter on the baby’s forehead. Doing so gives them a transcutaneous bilirubin (TcB) level reading. If the TcB level is high, a blood test will be done.

In infants, doctors usually perform a bilirubin blood test by taking a blood sample from the heel.

This enables the doctor to obtain a reading for the total serum bilirubin (TSB) level.

In most hospitals, it is routine to test a newborn’s TcB levels every 8 to 12 hours in the first 48 hours of life, and at least once more at 3 to 5 days old.

Though the standard varies between hospitals and doctors, newborns are diagnosed with jaundice when they have bilirubin blood levels greater than 85 micromoles per liter (μmol/L). This translates to 5 milligrams per deciliter (mg/dl).

Bilirubin blood levels are usually the highest when a baby is between 3 and 5 days old.

If jaundice is diagnosed, additional blood samples may be required every few hours to check the condition’s progress and to see how effective treatment is if it is needed.

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Can it be treated?

How aggressively jaundice is treated depends on the baby’s age measured in hours, and how high bilirubin levels have risen. Kernicterus is always treated in a hospital immediately.

Most babies with jaundice at levels that warrant treatment, and all babies with kernicterus, are placed in an incubator, under special lights with their eyes covered.

The baby will also require more milk or formula, often with feedings every 2 hours. In some cases, a feeding tube may be placed in the child’s throat to allow direct feeding. Hydrating fluids are also commonly given through a vein.

For severe cases of jaundice, and usually all cases of kernicterus, a blood transfusion is immediately done to lower the amount of free bilirubin in the blood.

Once kernicterus has developed, the specific treatment options depend on the symptoms.

Common treatments used for the complications of kernicterus include:

  • physiotherapy
  • speech therapy
  • educational coaching, advising, or alterations
  • cochlear implantation if hearing loss occurs
  • orthopedic devices or procedures
  • medications for muscle or movement problems
  • Botox injection
  • medications for attention deficit hyperactivity disorder


Jaundice is easily treatable when diagnosed and treated early enough, or while still in its mild forms. Once kernicterus has occurred, however, the resulting problems are usually permanent, though some may lessen or go away with therapy, medication, or in adulthood.

People should seek immediate medical attention anytime that the symptoms of jaundice or kernicterus occur. It can take less than 24 hours for serious cases of jaundice to progress to kernicterus.

New technologies are being developed to help make it easier for parents and caregivers to detect jaundice in newborns earlier. These include a mobile phone app called the BiliScan.

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Medical News Today: Children with autism may benefit from being bilingual

In the first study of its kind, scientists show that bilingual children with autism spectrum disorders can switch mental gears more easily than those who can only speak one language.
Bilingual flash cards
Being bilingual may improve cognitive flexibility in children with autism.

Autism spectrum disorder (ASD) is a growing concern in the United States, affecting an estimated 1 in 68 children.

Despite the prevalence and years of research, there are still several unanswered questions about how and why ASD develops, and how best to manage it. Researchers are looking at these queries from all angles.

A new study gains fresh insight by approaching from an interesting direction; the researchers set out to understand whether or not being bilingual might provide improved cognitive flexibility in children with ASD.

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The mental benefits of being bilingual

There is growing evidence to suggest that being bilingual enhances executive functions, which are a set of cognitive processes including attentional control, inhibiting behavior, and working memory.

Executive functions also include cognitive flexibility, referred to as set-shifting. This is the topic of interest in the current study.

The improvement in executive function is believed to happen because using two languages means that a person has to switch between mental modes smoothly and quickly. Over time, with practice, this switching of linguistic systems may limber up overall cognitive performance.

Although there have been a number of studies investigating improvements in executive function in people who are bilingual, not all have found a significant effect.

Also, some researchers assign any reported improvements in cognitive flexibility to other factors, such as socioeconomic group or better memory skills. There remains much discussion on the matter.

Children with ASD tend to find it harder to “switch gears” when changing tasks, as their cognitive flexibility is impaired. Some of the common features of ASD mirror this issue. For instance, they tend to have a narrower focus, a desire to keep things unchanged, and inflexible daily routines.

The authors of the current study wanted to discover whether being bilingual is of benefit to children with ASD, as far as cognitive flexibility is concerned.

The authors set out the question they want to answer: “Can being bilingual mitigate the set-shifting impairment observed in children with ASD?”

The team was headed up by senior author Prof. Aparna Nadig, from the School of Communication Sciences and Disorders at McGill University in Montreal, Canada. The findings are published in the journal Child Development.

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Studying cognitive flexibility

The study included 40 children, of whom 20 were typically developing children (10 monolinguals and 10 bilinguals) and 20 were diagnosed with ASD (10 monolinguals and 10 bilinguals). None of them had intellectual disabilities.

Each participant carried out a computer-based task that involved sorting objects. During the task, they were presented with a range of objects and were asked to sort them by color. Then, after a while, they were asked to switch to sorting by shape.

This switching can be challenging for children with ASD, and they tend to perform less well.

It was found that the bilingual children with ASD managed the cognitive switching more easily than monolingual children with ASD. However, as expected, working memory was equivalent between the groups.

It is critical to have more sound evidence for families to use when making important educational and child-rearing decisions, since they are often advised that exposing a child with ASD to more than one language will just worsen their language difficulties.”

First study author Ana Maria Gonzalez-Barrero, Ph.D.

Gonzalez-Barrero continues, “But there are an increasing number of families with children with ASD for whom using two or more languages is a common and valued practice and, as we know, in bilingual societies such as ours in Montreal, speaking only one language can be a significant obstacle in adulthood for employment, educational, and community opportunities.”

Although the findings are intriguing, the study has some shortfalls. For instance, it included just 40 children (only 10 of whom were bilingual children with ASD). For this reason, much larger trials are needed.

The research throws out a wealth of new questions. Hopefully, future studies will provide us with a fuller picture. The authors plan to follow the participants of the current study over the next 3 to 5 years to see how they develop.

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Medical News Today: The nutrient mix that could boost women’s energy levels

Some specialists say that young women are more prone than men to nutritional deficiencies, which can impact their energy levels and keep them from fulfilling their athletic potential. A study claims to have found the right supplement mix to address that issue.
woman jogging in the park
A new dietary supplement can help women run faster – could it be the energy booster we’ve been waiting for?

Much research lately has been dedicated to showing how changing our dietary habits and doing regular aerobic exercise — such as running or biking — can improve our physical and mental health.

Still, some nutritionists say that, despite efforts to lead healthier lifestyles, women’s energy metabolism, in particular — their ability to produce energy out of the nutrients they consume — may be impaired, and through no fault of their own.

Robert DiSilvestro — a nutritionist and researcher at the Ohio State University in Columbus, OH — in collaboration with other researchers, may now have pinpointed the supplementary “shake” of minerals and essential nutrients that could give women the daily energy boost they need.

We know that young women, in particular, often have micro-deficiencies in nutrients and that those nutrients play a role in how cells work during exercise. They tend to eat less meat than men, and menstruation also plays an important role in mineral loss.”

Robert DiSilvestro

The recipe for success that the researchers tested consists of three minerals — iron, zinc, and copper — and two essential nutrients — carnitine and phosphatidylserine — which, they say, women tend not to absorb enough of.

Their results were published in the Journal of the International Society of Sports Nutrition.

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The mix that makes us faster runners

DiSilvestro and team conducted two consecutive experiments, over a period of 1 month each. The participants’ athletic performance was, in each case, measured once at the start, and once at the end of the study period.

For the first experiment, the researchers recruited 28 female participants aged between 18 and 30; half of these were assigned to take the supplement, while the other half were given a placebo and acted as the control group.

The women who were given the supplement would take it by stirring it twice daily into a drink of their choice. “I decided to start with minerals that are commonly low — or thought to be low in many diets — and brought in some of the supporting cast,” explains DiSilvestro.

“These two nutrients [carnitine and phosphatidylserine], which are needed for cell function, are made by our bodies but also come from food we eat,” he notes.

As part of the experiment, the women were asked to engage in a range of aerobic activities: first a 3-mile run, then stationary biking for 25 minutes, and, finally, a test involving stepping on and off a bench.

While all the women were amateur athletes and regularly engaged in running, they did not normally perform the other two exercises they were asked to do during the study.

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The researchers explain that this requirement was added on purpose, to understand whether the energy benefits potentially derived from the supplement would extend to a wider rage of physical activities, beyond just running.

Following this first experiment, DiSilvestro and team found that the 14 women who drank their nutritionally packed “shake” ran significantly faster than before, and also compared with their counterparts in the control group. They covered the 3 miles in 25.6 minutes on average, compared with their previous performance of 26.5 minutes on average.

Their performance was also improved in the other two types of exercises. In 25 minutes on the stationary bike, the supplement-takers increased their calculated distance from an average of 6 miles — measured at the beginning of the experiment — to 6.5 miles per average.

They also increased the number of steps in the step test to about 44 from approximately 40 steps in 90 seconds.

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Dosage is important

In the follow-up experiment, the researchers were interested in seeing if they could reproduce this effect with a slightly modified version of their dietary supplement, which contained a lower dose of carnitine.

This time, the researchers recruited a new group of women — 36 in total — who were split in the same way and asked to engage in the same exercises. Also, the nutritional supplement was administered in capsule form on this occasion.

In this experiment, the researchers noted a mean decrease of 41 seconds in running time.

These differences are particularly interesting to DiSilvestro, who aims to eventually produce a reliable supplement that could help women to correct their nutritional deficiencies and thus improve their athletic performance.

The researchers note that the dosage of each of the nutrients used in all versions of the supplement were well below dangerous levels, capable of causing undesirable side effects. They also add that, indeed, no side effects were observed at any stage.

DiSilvestro claims that men do not usually experience the same nutritional deficiencies noted in women, but he says that future studies might focus on testing the benefits of such a supplement in the case of vegetarian men, or as an energy-booster for long-distance runners.

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Medical News Today: How can we make better cancer drugs? Study sheds light

Research published in Cell Chemical Biology uses a new method to shed light on how drugs bind to a new cancer target.
Cancer enzyme discovery
By using an innovative combination of chemical and computer analysis, researchers are one step closer to designing better cancer drugs.

Killing cells is not difficult. Killing cancer cells while leaving healthy cells intact, however, is another matter.

The hunt for anticancer drugs that specifically shut off enzymes that allow cancer cells to survive but do not cause havoc in healthy tissues is ongoing.

Researchers from Uppsala University and the Karolinska Institute in Stockholm, both in Sweden — along with colleagues at the University of Oxford in the United Kingdom — may have done just that by developing a new technique that shows how drugs inhibit the new cancer target dihydroorotate dehydrogenase (DHODH).

Michael Landreh, Ph.D. — an assistant professor in the Department of Microbiology, Tumor and Cell Biology at the Karolinska Institute — told Medical News Today about the team’s research.

“The possibility to selectively kill cancer cells while leaving healthy tissue unaffected was recently discovered by the lab of Sonia Lain [… at the] Karolinksa Institute who identified DHODH inhibitors in an unbiased screen […] for broad anticancer activity,” he said.

But studying which drugs effectively turn off membrane-bound proteins, such as DHODH, is technically very challenging. The team had to develop a new technique to overcome these difficulties.

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Chemistry and computer simulation

DHODH is an enzyme located in the membranes of mitochondria, the cells’ powerhouses. Here, it is involved in the synthesis of new building blocks for DNA, the genetic code. This process is vital for cell division, and shutting it off has been shown to effectively kill breast cancer cells.

Using a chemical technique called native mass spectrometry allowed the research team to determine which molecules bind to DHODH.

Scientists often test new drug compounds on enzymes after they are isolated from cells. However, cell membranes contain a diverse array of lipids — or fat molecules — so Prof. Landreh and his colleagues studied DHODH in combination with lipids from mitochondria.

The team’s findings show that the potential cancer drug brequinar inhibits DHODH much more strongly in the presence of lipids.

“To our surprise, we saw that one drug seemed to bind better to the enzyme when lipid-like molecules were present,” says Prof. Landreh.

Next, Erik Marklund, Ph.D. — from the Department of Chemistry at Uppsala University — and his team used molecular dynamics simulations to show how these interactions between DHODH, lipids, and brequinar take place.

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Drug mimics natural substrate

The coenzyme Q10 activates DHODH. Marklund’s analysis showed just how Q10 binds to DHODH: lipids are needed to stabilize the interaction between the two partners.

“Our simulations show that the enzyme uses a few lipids as anchors in the membrane. When binding to these lipids, a small part of the enzyme folds into an adapter that allows the enzyme to lift its natural substrate out of the membrane,” Marklund explains.

“It seems that the drug, since it binds in the same place, takes advantage of the same mechanism,” he adds.

In the paper, he further recommends that DHODH inhibitors should be designed to specifically capitalize on this interaction between the enzyme and lipids.

Commenting on the impact of the research, co-author Prof. Sir David Lane, from the Karolinska Institute, says, “The study helps to explain why some drugs bind differently to isolated proteins and proteins that are inside cells.”

By studying the native structures and mechanisms for cancer targets, it may become possible to exploit their most distinct features to design new, more selective therapeutics.”

Prof. Sir David Lane

How does the team plan to use this discovery in the fight against cancer?

“The group now aims to exploit the specific membrane binding ability of DHODH to better tailor their inhibitors to allow more specific inhibition of the enzyme in cancer cells.” Prof. Landreh told MNT.

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Medical News Today: What to know about a black line on the nail

Very often, a person’s fingernails can provide some insight into what is going on with their body as a whole.

When a person has black or dark stripes running down their nails, the explanations can range from something normal through to severe, such as melanoma.

A person should not ignore changes to their nails, especially if they are painful, bleeding, and without explanation.

What are the causes?

Person with black lines on the nails clipping nails.
In some cases, black lines on the nails may be caused by melanoma.

Most commonly, dark stripes down a person’s nail are due to a symptom known as linear melanonychia. According to the United Kingdom’s National Health Service, these stripes commonly occur in those of African-American descent who are age 20 and older.

Linear melanonychia is considered a normal fingernail color variation. The condition occurs when pigments in the nail known as melanocytes make excess pigment. This causes the nail beds to darken.

According to an article in the journal Podiatry Today, an estimated 50 percent of African-Americans have this condition.

Less common causes of nail melanonychia exist. These include:

Another cause of black lines on the nails is a splinter hemorrhage, which occurs when blood vessels under the fingernail are damaged, often due to injuries, such as hitting.

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More seriously, a black line or lines on the nails can indicate the presence of melanoma, a dangerous form of skin cancer.

Melanoma under a fingernail is known as subungual melanoma. One of the melanoma types is known as acral lentiginous melanoma (ALM).

According to clinical guidelines published in the Journal of Foot and Ankle Research, about half of all melanomas on the hands and feet are due to ALM.


Typically, healthy fingernails will have small vertical ridges in them, are curved downward from the nail, and do not crack or break easily. However, there are times when a person may experience black lines on the nail.

Linear melanonychia

When a person has linear melanonychia, they may see dark stripes running down the nails. They may have color variations that range from black to deep brown and gray. These lines will normally appear on 2 to 5 fingernails, but not necessarily all 10.

Subungual melanoma

When a person has subungual melanoma, they will usually notice a stripe on one fingernail only. Often, they cannot link the stripe’s appearance back to an injury.

Typically, a black stripe from subungual melanoma will darken or widen with time. Sometimes, the nail will be painful or bleed.

The pigmentation may also extend to the area where the fingernail meets the cuticle. This is known as Hutchinson’s sign, which is often an indicator of melanoma. The stripe can occur on either the fingernails or toenails.

According to the journal Podiatry Management, an estimated 40 to 55 percent of cases of subungual melanoma occur on the foot.

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Splinter hemorrhage

Splinter hemorrhages appear as small black or deep-red lines and are caused by injuries to the small blood vessels under the nail beds. They usually heal on their own within a few days.

If a person has multiple splinter hemorrhages across several different nails, it could indicate an underlying condition.

Getting a diagnosis

Person having fingernails inspected by a doctor.
A doctor may ask questions about a persons medical history to diagnose the cause of black lines on the nails.

The diagnostic process for dark lines under the fingernails usually starts with a persons’ medical history.

Questions a doctor may ask include:

  • How long have the lines been present?
  • When were you first aware of the lines?
  • Have you noticed any recent changes to the lines?
  • Have you had a trauma to the nails that may have caused these changes?

A doctor will also ask about medications. If a person has a history of taking blood thinners, such as warfarin or aspirin, this could explain splinter hemorrhages.

Sometimes a doctor will take a biopsy or sample of the nail area. They will send this biopsy to a pathologist, who can identify if any cancerous cells might be present.

What are the treatments?

Most causes of black lines on the nail do not require treatment. Melanoma is an exception. A doctor will usually first remove the area of melanoma as well as the skin under the fingernail.

A doctor can perform a skin graft over the fingernail to improve the finger’s appearance post-surgery.

If the melanoma had spread to the bone, a doctor might recommend amputating the finger to stop the melanoma spreading.

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When to see a doctor

It is especially important to see a doctor if a person has a nail that is bleeding and painful or has changes without a known cause.

A person should see their doctor if they notice changes to the quality of the nail itself, such as thinning, cracking, or differences in the shape.


Most black lines on the fingernails and toenails are harmless. However, if a person has melanoma, the earlier the condition is diagnosed, the better their prognosis.

According to the Journal of Foot and Ankle Research, melanoma that occurs in the foot or toenail has a poorer prognosis than melanoma in other locations, as it may not always be diagnosed early.

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Medical News Today: ‘Just breathing’ is enough to spread flu

Just breathing out — without coughing or sneezing — is enough for a person with the flu to spread the virus, according to new research led by the University of Maryland in College Park.
a man breathing in cold temperatures
Researchers say that simply breathing out is enough to spread the flu virus.

“People with flu,” explains senior author Donald K. Milton, professor of environmental health at the University of Maryland, “generate infectious aerosols (tiny droplets that stay suspended in the air for a long time) even when they are not coughing, and especially during the first days of illness.”

The common belief is that flu is spread through coughs and sneezes from infected individuals and from touching surfaces contaminated with the virus.

However, the new study reveals that people with the flu can shed the infectious virus into the air around them just by breathing.

“So,” Prof. Milton urges, “when someone is coming down with influenza, they should go home and not remain in the workplace and infect others.”

He and his colleagues report their findings in the Proceedings of the National Academy of Sciences.

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Seasonal flu varies widely

Flu, or influenza, is an infectious respiratory disease that is caused by viruses. The illness ranges from mild to severe and can lead to hospitalization and even death.

People at higher risk of serious complications from the flu include young children, the elderly, pregnant women, and people with certain conditions, such as cancer, HIV/AIDS, heart disease, stroke, asthma, and diabetes.

The burden of seasonal flu in the United States varies widely from year to year, depending on which viruses are circulating, when the season starts and finishes, how well the vaccine is working, and how many people have it.

Since 2010, the number of people who have caught flu every year in the U.S. has varied from 9.2 million to 35.6 million; the number hospitalized has ranged from 140,000 to 710,000, and the number who have died has been between 12,000 and 56,000.

The Centers for Disease Prevention and Control (CDC) advise everyone aged 6 months and older in the U.S. receive a flu shot every year to prevent the spread of seasonal flu.

In the new study, the researchers assessed flu virus in 142 individuals who were confirmed to have influenza. They took samples from each participant during the first 3 days after their symptoms emerged.

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Flu spreads without coughing, sneezing

In all, the team was able to use viable data from 218 samples of exhaled breath and 218 “nasopharyngeal swabs,” where samples are taken through the nose or the back of the nose and throat. The samples of exhaled breath included samples taken during natural breathing, spontaneous coughs, and sneezes.

To collect the exhaled breath samples, the researchers invited the participants to breathe normally into a cone-shaped aerosol sampler for 30 minutes while they recited the alphabet once at 5, 15, and 25 minutes. They collected two types of aerosol samples: coarse and fine.

Of the 23 fine aerosol samples collected during normal breathing without coughing, the analysis showed that 11 samples — or nearly half — contained detectable traces of viral RNA, including eight with infectious virus. This suggests that normal breathing is a considerable contributor to aerosol shedding of flu virus through exhaled breath.

Also, the participants did not sneeze very much, and when they did, the sneezes were not especially associated with greater presence of viral RNA, either in coarse or fine aerosol samples. This suggests that sneezing is not a big factor in aerosol shedding of flu virus through exhaled breath.

From these results, the researchers conclude that “sneezing is rare and not important for — and that coughing is not required for — influenza virus aerosolization.”

We found that flu cases contaminated the air around them with infectious virus just by breathing, without coughing or sneezing.”

Prof. Donald K. Milton

They suggest that their findings could help to improve computer models that analyze risks of flu transmission through airborne means. This could eventually also improve the effectiveness of influenza public health initiatives to control and reduce pandemics and epidemics.

The results also suggest that improving ventilation in offices, schools, and other public places — such as subway cars — might also help to reduce the spread of flu.

The following video from the University of Maryland School of Public Health sums up the study:

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Medical News Today: Can weight gain be caused by tamoxifen?

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Medical News Today: What to know about swollen taste buds

Taste buds are the small sensory organs that allow a person to enjoy different flavors, from sweet to salty and savory.

The taste buds typically regenerate themselves about every 1 to 2 weeks. However, there are times when they can become damaged, burned, or swollen.

There are many potential causes of damage to the taste buds, and these will determine the choice of treatment.


Taste buds on person's tongue.
Swollen taste buds may be caused by a number of factors, including a dry mouth, or acid reflux.

Inside the papillae are small, hair-like projections known as microvilli that have sensory cells. These cells transmit messages to the brain. Disruption to these can affect a person’s ability to taste foods.

Several conditions can irritate the taste buds enough to result in swelling. These include:

  • acid reflux that causes acid to rise up the throat and burn the taste buds in the back of the throat
  • burns, cuts, or injuries to the mouth that can result in inflammation and swelling
  • a dry mouth
  • eating very spicy or sour foods
  • exposure to extremely hot or cold foods
  • history of or exposure to radiation of the head and neck
  • infection, such as a cold, flu, fungal, or bacterial illness
  • poor oral hygiene or dental problems
  • smoking
  • taking medications that are very acidic on the tongue

Sometimes an inflamed taste bud can signal a more severe problem, such as tongue cancer, which can cause inflammation that leads to tongue and taste bud swelling.

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What do they look like?

The papillae may appear white or bright red. Some may also have little fluid-filled blisters that are known as pustules on the tongue.

Normally, however, a person should not be able to see their taste buds with the naked eye.

When to see a doctor

Because the body grows new taste buds all the time, most people’s swollen taste buds resolve quickly. Either someone will treat the underlying condition they have, or the damage to their taste buds heals with time.

However, there are an estimated 200,000 Americans who seek treatment each year for disorders related to their sense of taste, according to the National Institutes of Health.

If a person notices chronically swollen taste buds or feels their sense of smell is affected, they will usually make an appointment to see an otolaryngologist, who is an ear, nose, and throat (ENT) specialist.

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Doctor inspecting tongue and throat of patient.
A physical examination is usually conducted to diagnose swollen taste buds.

An ENT specialist will start by taking a health history, reviewing a person’s medical conditions, and the medications they take. They will consider the symptoms and do a physical examination. The doctor can also conduct taste tests by applying specially-flavored substances to a person’s tongue.

If a doctor suspects a person could have tongue cancer, they may take a biopsy or sample of tissue. A specialist known as a pathologist will then view the cells under a microscope to look for cancerous cells.

What are the treatments?

A person may be able to reduce their swollen taste buds by treating the underlying cause. This could include taking antibiotics for a bacterial infection or gum problem.

Sometimes a doctor may prescribe alternate medications to reduce the effects of tongue or taste bud swelling.

Quitting smoking can also help a person who smokes and has problems with taste.

Other steps include:

  • brushing and flossing the teeth at least twice daily.
  • using a special mouth rinse and toothpaste if a chronic dry mouth is a cause
  • gargling with warm salt water several times daily
  • holding small amounts of ice chips on the tongue to reduce swelling
  • taking medications to reduce acid reflux, such as proton pump inhibitors and H2 receptor blockers

A person can also talk to their doctor about individual treatments that may benefit them.

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Damage taste buds might mean someone is unable to taste spoiled foods. A sense of taste that is compromised could also affect a person’s appetite and enjoyment of their food.

These problems with food consumption can result in unwanted weight loss if not dealt with quickly. Ideally, a person can seek medical treatment to identify underlying causes of taste bud swelling, so their taste sensations return.

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Medical News Today: What age do boys stop growing?

Growth during puberty happens over an extended period, so it can be difficult to know when it has finished. We explain what to expect and how to know when boys are likely to stop growing.

Every individual grows at different rates, and puberty begins and ends at different times for everybody. Puberty can last anywhere from 2 to 5 years, so it is not always easy to predict when it will end.

A boy’s body goes through many changes during puberty. These changes can be embarrassing or confusing, but the process happens to everyone and knowing what to expect can help.

When do boys typically fully mature?

3 teenage boys
On average boys start puberty around the age of 12 and it can last from 2 to 5 years.

Puberty is the process of growth and change that happens in the body as boys become adults.

Puberty is different for everyone and can start at any age between 8 and 14. The average age for boys to show the first signs of puberty is around 12 years old, about 1 year after girls begin puberty.

The fastest rate of growth is usually 1 to 2 years after puberty has started.

Developing physically into an adult takes 2 to 5 years. Most boys will stop growing taller by age 16 and will usually have developed fully by 18.

Onset of puberty and ethnicity

There is more research on the age that puberty begins in girls than there is for boys. However, a study by the American Academy of Pediatrics found that African-American boys were likely to start puberty earlier than Hispanic or Caucasian boys.

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What are the genetic factors?

Genes play a role, and parental height is a good indicator of how tall a child will be.

A way to judge roughly how tall a boy will become is to:

  • add together the height of the mother and father in inches
  • divide this number by 2
  • add 2.5 inches

This calculation is approximate and, in general, it is not possible to predict height accurately. Growth does tend to follow a curve, however, so if a person regularly plots a boy’s height on a graph throughout their childhood, it may be possible to track where the line is likely to end up.

Chronic illnesses, such as severe arthritis, and genetic conditions, such as Down syndrome, can cause a person to be shorter in adulthood than would otherwise be expected.

Average height in boys

two boys of differing heights
Boys may need reassurance that growing takes time and everyone is different.

Average height varies across the world. In the United States, the average height for an adult man is 5 feet 9 inches or 70.8 inches.

This average is found by adding the height measurements of a group of people together and then dividing by the number of people surveyed.

It does not mean that people above or below this height are unusually tall or small. It is important to remember that everyone is different.

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Questions and answers

Puberty can be a very confusing time for young people, and the following is a list of questions that people may ask.

At what age do the genitals finish growing?

For boys, one of the first signs of puberty is the growth of the testicles and development of pubic hair. The genitals grow throughout puberty.

Because puberty ends at different ages for different people, there is no set age at which the genitals will have completely developed. Once puberty is complete, the genitals are usually fully developed. Puberty usually takes around 4 years.

The key stages of development of the genitals for boys:

  • after 1 year of puberty, the penis and testicles begin to grow in size
  • the genitals continue to grow for a further 1 to 2 years
  • around 4 years after puberty begins, the growth of the genitals should be complete

When does body hair growth stop?

Pubic hair usually grows first, followed by underarm hair after about a year. Facial hair and other body hair will develop after around 2 years of puberty. Development of body hair will usually stop at the end of puberty.

What might impair growth rates?

Factors such as diet and environment can affect growth. Worldwide, children with diets that cause nutritional deficiencies or malnutrition may not grow to be as tall or strong as those who have had plentiful and balanced meals.

Illnesses, genetic conditions, and use of some medications, such as corticosteroids, can all slow or limit growth.

An imbalance of hormones in the body might slow or speed up growth. A parent or caregiver may wish to seek advice from their doctor if a boy:

  • is growing much faster or slower than expected
  • is much shorter or taller than other children their age
  • is growing very tall despite having shorter parents
  • has not started puberty by age 14

An X-ray of the hand and wrist can help judge how much more a child will grow.

Tips to ensure the best possible growth

young boy highfiving basketball teacher
Eating healthfully and keeping active will help a young person reach their full potential height.

All individuals have a maximum potential height. Some things can be done to ensure a person reaches their full potential height, but a person cannot grow beyond this by using supplements or eating certain foods.

Eating a healthful diet and getting enough sleep and exercise is essential. There are many ways to stay active, from joining a sports team to helping with household chores.

Teenagers need 8 to 10 hours sleep a night. A healthful sleep pattern means going to bed at around the same time each night and not staying up too late.

During puberty, boys may be shorter or taller than other boys their age. This can be hard to deal with. Understanding the changes their body is going through and being able to find information about puberty can help.

Boys should be reassured that growing takes time and that everyone is different. Developing good self-esteem through positive family relationships, friendships, hobbies, and interests can all help boys to cope with puberty.

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Medical News Today: Hydrosalpinx: Symptoms, fertility, and treatment

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