Incubation period

Incubation period is the time elapsed between exposure to a pathogenic organism, a chemical, or radiation, and when symptoms and signs are first apparent. 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 longer than the incubation period. After the latency period (but prior to the infection period) 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 between incubation period, the period between infection and onset of the disease, and latent period, the time from infection to infectiousness. Which is shorter depends on the disease. A person may carry 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.[1] 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. These persons may be infectious.

Intrinsic and extrinsic incubation period

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.

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.

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.[2]

Determining factors

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

  • 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

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.

Diseasebetweenandperiod
Cellulitis caused by Pasteurella multocida01days[3]
Chicken pox921days[4]
Cholera0.54.5days[5]
Common cold13days[6][7]
COVID-19211.5[8]/12.5[9]/14days [10]
Dengue fever314days[11]
Ebola121 (95%), 42 (98%) days[12]
Erythema infectiosum (Fifth disease)1318days[13]
Giardia321days
HIV23weeks to months, or longer[14]
Infectious mononucleosis (glandular fever)2842days[15]
Influenza13days[16]
Kuru disease10.313.2years (mean)[17]
Marburg510days[18]
Measles912days[19]
MERS214days[20]
Mumps1418days[21]
Norovirus12days[22]
Pertussis (whooping cough)714days[23]
Polio714days[24]
Rabies13months, but may vary from <1 week to >1 year.[25]
Rocky Mountain spotted fever214days[26]
Roseola515days[27]
Rubella (German measles)1421days[28]
Salmonella1224hours[29]
Scarlet fever14days[30]
SARS110days[31]
Smallpox717days[32]
Tetanus721days[33]
Tuberculosis212weeks[34]
Typhoid721days
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See also

References
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  2. 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.
  3. Cellulitis, kidshealth.org. Accessed 2012-05-28.
  4. "Chickenpox: Practice Essentials, Background, Pathophysiology". March 22, 2020 – via eMedicine. Cite journal requires |journal= (help)
  5. 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.
  6. 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.
  7. Common cold, The Mayo Clinic, mayoclinic.com. Accessed 2012-05-28.
  8. 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.
  9. 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.
  10. 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.
  11. 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.
  12. Are the Ebola outbreaks in Nigeria and Senegal over?, World Health Organization, who.int. Accessed 2014-10-21.
  13. Erythema Infectiosum at eMedicine
  14. 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.
  15. Macnair, Trisha, Glandular fever, BBC, bbc.co.uk. Accessed 2012-05-28.
  16. Seasonal Influenza (Flu), Centers for Disease Control and Prevention, cdc.gov. Accessed 2012-05-28.
  17. 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.
  18. 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.
  19. Measles, American Osteopathic College of Dermatology, aocd.org. Accessed 2012-05-28.
  20. "MERS Clinical Features". CDC.gov. CDC. 2 August 2019. Retrieved 22 March 2020.
  21. Mumps Disease, Questions & Answers Archived 2007-11-20 at the Wayback Machine, vaccineinformation.org. Accessed 2012-05-28.
  22. Norovirus, Centers for Disease Control and Prevention, cdc.gov. Accessed 2012-05-28.
  23. Pertussis, GPnotebook, gpnotebook.co.uk. Accessed 2012-05-28.
  24. Polio, GPnotebook, gpnotebook.co.uk. Accessed 2012-05-28.
  25. "WHO - Rabies". who.int.
  26. Rocky Mountain Spotted Fever, About.com. Accessed 2012-05-28.
  27. Roseola Infantum at eMedicine
  28. Dermatologic Manifestations of Rubella at eMedicine
  29. "Food poisoning symptoms & treatments - Illnesses & conditions | NHS inform". Nhsinform.scot. 2020-02-26. Retrieved 2020-05-07.
  30. Scarlet Fever at eMedicine
  31. World Health Organization (WHO), Severe acute respiratory syndrome, www.who.int. Accessed 2012-05-28.
  32. Smallpox Disease Overview Archived 2013-04-02 at the Wayback Machine, Centers for Disease Control and Prevention, cdc.gov. Accessed 2012-05-28.
  33. Tetanus at eMedicine
  34. "Tuberculosis (TB)". MedicineNet. MedicineNet. Retrieved 22 March 2020.
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