Japan could become one of the first countries in the world to end the HIV epidemic, says the president of Gilead Sciences Japan, Kennet Brysting. The idea for now could seem a little too ambitious, but it is not entirely unrealistic, given that the availability of medicines that can prevent transmission of HIV. Drugs are not the cure, but control over the spread of virus to the point where the disease is no longer a major public health threat.

What Is The Role Of Preventative HIV Medicines?

Gilead's have two key drugs, Truvada and lenacapavir. These two are playing a crucial role in prevention. Truvada is taken as a daily pill, while lenacapavir requires two injections per year. It can make the virus undetectable in infected individuals and prevent transmission to those who are not infected yet. In trials, lenacapavir showed 100% efficacy in preventing HIV infections. This is why it is describe as "almost a vaccine".

In 2024, Japan also approved Truvada for HIV prevention, but the country has yet to approve lenacapavir for the same. Until now, people in Japan had been importing generic versions of Truvada or purchasing it from clinics that source it from overseas.

HIV In Japan

Up until now, Japan reported around 25,000 HIV infections, whereas 669 new cases were reported in 2023. For seven consecutive years, the number of new infections remained under 1,000. The downward trend thus shows that the virus has been controlled, however, getting to zero new infections remains the ultimate goal.

Brysting too acknowledged that simply having effective drug is not enough. What is important is to have a proper implementation, access and healthcare support to make sure that these treatments are widely available and effective.

What Are The Challenges In Implementation?

The biggest challenges is testing rates. There is a need to increase testing rates. At this very moment, around 86% people infective with Japan have been tested, but the goal is to increase it up to 95%, with an ideal goal of 100%. Without widespread testing, many infected people may not even know that they are infected and it could transmit the virus.

Another measure issue is the cost of preventative medication. While Japan's health insurance covers treatments for diseases, it does not cover preventative drugs. Those who purchase Truvada for prevention, pay around $470 per month. Some clinics in Tokyo offer generic alternatives too, which is cheaper, but they are not ideal.

Better Healthcare Support

Brysting expressed concern that individuals importing medications might not be consulting doctors regularly, which is essential for monitoring HIV status and overall health. Truvada users need to be tested for HIV initially and every three months, along with screenings for other infections and kidney function checks. Without proper medical supervision, there is a risk of misuse and inadequate protection.

Gilead is in discussions with Japanese authorities to improve access and insurance coverage for Truvada, and progress is being made. Japan has shown efficiency in approving critical medicines, as seen during the COVID-19 pandemic when Gilead’s remdesivir was approved in just three days.

What Is The Way Ahead?

Gilead at this moment is not only focused on HIV and hepatitis C, but also expanding into oncology with innovative treatments like CAR-T cell therapy, which strengthens a patient's immune system to fight cancer.

However, Japan’s strict approval processes can slow down drug availability. Phase 3 clinical trials often need to be conducted within the country, and Japan tends to approve medicines much later than other regions. For instance, Truvada was approved for prevention in Japan 12 years after the U.S. and nearly 20 years after its approval for treatment. inancial factors also play a role. The Japanese government adjusts drug prices annually, often reducing them, which can make long-term investment challenging for pharmaceutical companies.

The US Food and Drug Administration (FDA) has announced a recall of mangoes sold at Walmart in at least four states because they may be contaminated with Salmonella.

New York-based Panorama Produce "is recalling 302 boxes of size 9 mangoes because they may be contaminated with Salmonella", according to the recall notice.

Recall Issued In Which States?

The mangoes were sold at select Walmart stores in four states:

• Connecticut,
• New Jersey,
• New York
• Pennsylvania.

How To Identify The Recalled Mangoes?

Also read: US FDA Recalls Injectables Over Fiberglass, Steel Particles: See Affected Drugs

The company said that the recalled mangoes are packaged in a Martina-branded case.

Individual mangoes can be identified by a light blue sticker bearing the labels Agrofepac, Produce of Mexico, PLU number 4584 and UPC 07503061948050.

Why Were The Mangoes Recalled?

The recall was initiated after FDA sampling found Salmonella in mangoes grown on the same farm, although those sampled mangoes were not distributed into US commerce.

The recalled mangoes and the sampled mangoes share the same source. Therefore, Panorama Produce initiated the recall. The company, however, stated that no illnesses have been reported to date in connection with the recalled product.

What To Do If You Have The Recalled Mangoes?

Read More: From Dog Food To Fruit Bars: Over 10 Products Recalled In US Over Contamination

The company advised consumers to use the product identifiers above to determine whether their mangoes are included in the recall.

Consumers who have the recalled mangoes should dispose of them or return them to the place of purchase. Anyone who believes they may have become ill should contact a healthcare provider.

Food Recalls In The US

Food safety has become a serious concern in the US in recent months, with a large number of products recalled over contamination, bacterial infections and other health risks.

The recalls involve food products ranging from rice and donuts to eggs and fruit bars, among a host of other products.

Experts blamed federal funding cuts under the Trump administration, which reduced budgets for food inspections by federal agencies and grants to state and local health departments that conduct traceback investigations to determine where outbreaks originate.

What Is Salmonella?

Salmonella is a bacterial infection that commonly causes diarrhea and gastrointestinal illness. Food contaminated with Salmonella bacteria does not usually look, smell or taste spoiled.

Common Symptoms

• Diarrhea
• Stomach cramps
• Vomiting
• Fever.

Anyone can become sick with a Salmonella infection. Most people recover without medical treatment. However, children, older adults and people with weakened immune systems may develop serious illness requiring medical care.

The bacteria can spread by eating contaminated food, through contact with contaminated environments or from person to person.

How To Stay Safe

Health officials have advised consumers to follow recall instructions and avoid eating affected products.

• Refrigerate items promptly
• Cook food products thoroughly
• Wash your hands
• Sanitize surfaces
• Check for recalls
• Wash food before use.

Type 2 diabetes may be the same disorder, but it may look quite different in men and women. A new study based on 28,720 people newly diagnosed with type 2 diabetes has found distinct patterns in the complications that come after diagnosis.

Men were more likely to follow a trajectory involving cardiovascular disease or end-stage kidney disease, while women were more likely to develop mental health conditions like anxiety, depression or somatoform disorders.

The study, published in PLOS Medicine, followed patients diagnosed between 2010 and 2020 using linked UK healthcare records.

Participants were followed for a median of 6.8 years, allowing researchers to examine not just which complications occurred, but also the order in which they developed.

Men Saw Stronger Heart And Kidney Disease Complications

Among men, 8.4% followed a trajectory involving cardiovascular disease or end-stage renal disease, compared with 5.3% of women. Men also tended to develop these complications earlier than women.

Hypertension, however, remained the most common complication across both sexes, affecting 21.1% of men and 20.2% of women.

The finding matters because type 2 diabetes can damage blood vessels over time, increasing the risk of cardiovascular disease and kidney problems. But the study suggests that the sequence and timing of these complications may not be identical in men and women.

Also read: US FDA Approves Eli Lilly’s Mounjaro To Reduce Cardiovascular Risk In Diabetics

Women Were More Likely To Develop Mental Health Conditions

8.1% of women developed a mental health condition compared with 5.3% of men. These included anxiety, depression and somatoform disorders.

Prof Ravinder Goswami, senior endocrinologist at AIIMS, told the Times of India that diabetes can affect men and women differently. He noted that men may develop diabetes at a younger age, while women with diabetes can lose the natural cardiovascular protection generally associated with the premenopausal period.

Also read: Lowering Cholesterol May Protect Your Brain As Study Links Statins To 15% Lower Dementia Risk

Why Could Diabetes Behave Differently In Men And Women?

Sex hormones, body-fat distribution, age at diabetes diagnosis, cardiovascular risk factors and differences in seeking healthcare can all influence how complications related to type 2 diabetes emerge.

The study found that women had higher average healthcare utilisation. On the other hand, lower healthcare engagement among some men could represent a missed opportunity to detect complications earlier.

The researchers also found that people who developed a mental health condition after their diabetes diagnosis had a shorter survival trajectory. Among people following the same disease pathway, men died on average nine years younger than women.

That does not mean depression or anxiety automatically shortens a person's life by nine years. Rather, the finding highlights how the combination of diabetes and subsequent health problems can identify a particularly vulnerable group.

Should Diabetes Be Treated Differently In Men And Women?

The researchers say their study supports sex-specific complications of diabetes and earlier intervention, rather than completely separate treatments.

For men, that could mean paying particular attention to cardiovascular and kidney health. For women, routine attention to mental health alongside physical complications is especially important.

The study is observational, so it cannot prove that being male or female directly causes a particular diabetes complication.

A visit to a petting zoo usually means excited children playing around with a few goats. But in North Carolina, an ordinary animal encounter has triggered a public health warning after four baby goats linked to a mobile petting zoo tested positive for rabies.

The goats belonged to Farm Adventures, a mobile petting zoo based in Harmony, North Carolina. Three goats tested positive for rabies at the North Carolina State Laboratory of Public Health on August 28, while a fourth was not tested but was presumed infected. All the four animals were euthanised.

Health officials are now urging anyone who touched or held the baby goats between July 28 and August 27 to contact their local health department and find out whether preventive treatment is needed. The animals had appeared at events across several North Carolina counties during that period.

A Skunk Could Have Been The Source

According to the North Carolina Department of Health and Human Services (NCDHHS), the goats were most likely exposed when a skunk entered their pen in late July.

The petting zoo said the goats were too young to receive rabies vaccinations at the time and staff did not know they had been bitten. The animals also showed no obvious signs of rabies, making the infection difficult to spot before testing.

That brings us to one of the most unsettling features of rabies. An infected animal does not necessarily look obviously sick at the time a person encounters it.

NCDHHS said the goats “may have been in direct contact with people at events while infectious” and is working with local health departments and event organisers to identify people who could have been exposed.

Also read: Bird Flu In US: Are Cats Spreading A Deadly Disease?

How Does Rabies Spread From Animals To Humans?

Rabies is caused by a virus that attacks the central nervous system. The most common route is an infected animal's bite, because the virus is present in saliva. Scratches contaminated with saliva can also pose a risk. Simply being near an infected animal does not mean you are exposed to rabies.

Once the virus enters the body, it can travel through peripheral nerves towards the brain and spinal cord. This helps explain why there can be a considerable gap between exposure and symptoms. It can last weeks to months, depending partly on where the exposure occurred and how far the virus has to travel to reach the brain.

Also read: Is There A Difference Between Zoonotic, Non-Zoonotic And Reverse Zoonotic Diseases

Why Is Rabies Almost Always Fatal Once Symptoms Begin?

This is where rabies becomes particularly dangerous. In the early stage, symptoms can resemble many ordinary illnesses, including fever, weakness and headache. There may also be pain, tingling or itching around the site of the bite.

But once the virus reaches the brain, the disease can progress to encephalitis, causing confusion, agitation, hallucinations, difficulty swallowing, excessive salivation, seizures and paralysis.

The CDC states that once clinical signs of rabies appear, the disease is nearly always fatal. There. By the time neurological symptoms appear, the virus has already established itself in the nervous system, where eliminating it becomes extremely difficult.

Window To Prevent Rabies Is Before Symptoms

Rabies is preventable even after an exposure, provided treatment is started promptly and before symptoms develop. Post-exposure prophylaxis, or PEP, generally includes thorough wound cleaning, rabies immune globulin for people who have never previously been vaccinated, and a course of rabies vaccine.

This is why North Carolina officials are not telling exposed visitors to wait for symptoms. Instead, NCDHHS says people who had contact with the goats should contact their local health department to determine whether medication is needed.