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.

World Asthma Day is observed on May 5 every year, an event that is focused on spreading awareness about the causes, symptoms, and management of asthma. And for people living in India, this is a bigger cause of concern because the country is home to the world's hottest and most polluted cities. This year, on the occasion of World Asthma Day, experts shed light on the impact of severe heatwaves on asthma patients. Dr. Sandeep Kadian, Senior Consultant Pulmonologist and Intensivist, AIMS Hospital, Dombivli, in an interview with Health and Me, spoke about the impact of asthma on patients during a severe heat wave.

How does a heatwave affect asthma patients?

Summer heat, dust, and pollution can trigger asthma symptoms like cough and breathlessness. Hence, it is the need of the hour to take extra care during the warmer months. Here, the expert also highlights the vital tips to stay healthy. Cough and breathlessness are frequently experienced by asthma patients, and a heatwave can make these symptoms far more severe.

Dr Kadian explains that asthma is also a common occurrence in summer. While many people associate it with winter, summer can also be a challenging time for those living with asthma. So, the rising temperatures, increased air pollution, dust, pollen, and humidity can irritate the airways and trigger symptoms. People may experience coughing, wheezing, shortness of breath, and a feeling of tightness in the chest. During summer, hot air can cause the airways to become dry and sensitive.

At the same time, outdoor allergens like pollen and dust are more common. Air conditioners, if not cleaned regularly, can circulate dust and mold, further worsening symptoms. For children and adults alike, understanding these triggers and taking simple precautions can help prevent flare-ups and keep breathing under control. Even dehydration is another factor that can worsen asthma. When the body lacks fluids, the airways may become more irritated. Sudden temperature changes, like moving from extreme heat outside to very cold indoor air, can also trigger breathing problems.

Tips to manage asthma in summer

Dr Kadian shared some simple tips to help asthma patients deal with the symptoms amid a heatwave. Make sure to stay hydrated by drinking enough water; avoid extreme heat and high-pollution areas; wear a mask; keep the house clean, dust- and mold-free, and well-ventilated. Service air conditioners from time to time and prevent dust and mold buildup. Carry prescribed inhalers and use them as advised by the doctor. It is also necessary to take a bath and change clothes after coming from outdoors. Also, it is essential to take the flu and pneumococcal vaccines as advised by the doctor and stay healthy.

Asthma can be managed with awareness and simple daily care. Staying cautious and prepared is the key to breathing easy even in the heat. This summer, prioritise your respiratory health.

There have been six suspected cases of hantavirus — a rare but potentially deadly virus transmitted primarily by rodents — of which three have died, said the World Health Organization (WHO).

The suspected hantavirus outbreak occurred on the MV Hondius cruise ship, Oceanwide Expeditions, in the Atlantic Ocean. It was travelling to the Canary Islands via Cape Verde from Argentina. The three people dead include a Dutch husband and wife, as well as a German national, according to the operator of the ship.

Speaking to the media, Maria Van Kerkhove, Director (a.i) Epidemic and Pandemic Preparedness and Prevention, WHO, said that the WHO is working with countries involved in the response to the hantavirus cases onboard a ship off Cabo Verde, as well as the ship's operators, and carrying out risk assessments to guide next steps.

“As of the fourth of May, there have been six suspected cases reported. Three cases have unfortunately died. One patient is currently ill in the ICU in South Africa, while two patients remain on board and will be evacuated for medical treatment. About a hundred and fifty people, including passengers and crew, are on the ship,” Van Kerkhove said.

The patient in the ICU is a 69-year-old UK national.

“The patient is still in critical condition in isolation but receiving medical attention,” according to a statement by South Africa’s Department of Health (DoH).

The WHO noted that it is working with countries to evacuate the two sick people on board to the Netherlands for medical care.

“At present, there are no other symptomatic people on the ship, but this is being carefully monitored,” Van Kerkhove said.

Adding that laboratory tests are also ongoing, she stated that “based on current information and what we know about the virus from previous outbreaks, the overall risk to the public is low.”

Also Read: Hantavirus Kills 3 on Cruise Ship: Symptoms, Risks, and Prevention

Hantavirus: How did the outbreak begin?

Some of the passengers onboard the Oceanwide Expeditions, travelling to the Canary Islands via Cape Verde from Argentina, with some 150 passengers, began experiencing serious health complications while the ship was travelling past South African shores. Initially, it was considered a severe acute respiratory infection; later, three people died.

“[The] first patient was a 70-year-old male passenger who suddenly became ill on the ship en route from Ushuaia to St Helena Island. Unfortunately, he passed away on arrival at St Helena Island. His mortal remains are in St Helena, awaiting repatriation to the Netherlands,”," South Africa’s DoH said.

The initial symptoms included:

• fever,
• headache,
• abdominal pain,
• diarrhea.

Hantavirus Alert: 890 US Cases

Meanwhile, the Centers for Disease Control and Prevention (CDC) noted that by the end of 2023, 890 cases of hantavirus disease were reported in the United States since surveillance began in 1993.

Hantavirus pulmonary syndrome (HPS) became a nationally notifiable disease in 1995 in the US.

Read More: CDC Flags Surge in US Tuberculosis Outbreaks, Cases Double Since 2017

What Is Hantavirus?

Globally, an estimated 100,000 to 200,000 hantavirus infections occur each year. The majority of these cases are in Asia, particularly China. Most are sporadic or occur in small clusters, linked to contact with infected rodents.

“Hantaviruses are a group of viruses carried by rodents that can cause severe disease in humans. Infection with hantaviruses is found in many parts of the world. Thousands of infections are estimated to occur each year," Van Kerkhove said.

Infection in people can result in severe illness and often death, although the diseases vary by type of virus and geographical location. In the Americas, infection has been known to lead to hantavirus cardiopulmonary syndrome (HCPS), a rapidly progressive condition affecting the lungs and heart, while in Europe and Asia, hantaviruses have been known to cause hemorrhagic fever with renal syndrome (HFRS), which primarily affects the kidneys and blood vessels.

Notably, the WHO has not specified the type of hantavirus or syndrome in the cruise incident, but did mention respiratory risks.

The hantavirus is primarily spread by rodents through

• exposure to their urine,
• droppings,
• saliva,
• less commonly through a scratch or bite.

According to the CDC, symptoms can appear one to eight weeks after exposure, initially presenting fatigue, fever, and muscle aches. As the disease progresses, it can cause coughing, shortness of breath, and chest tightness as fluid accumulates in the lungs.

The CDC reports that about one-third of individuals who develop respiratory symptoms from the disease may not survive.

Hantavirus: How Can You Reduce Your Risk?

You can reduce your risk by eliminating and minimizing your contact with rodents in your home, workplace, or campsite.

Other effective measures include:

• keeping homes and workplaces clean
• sealing openings that allow rodents to enter buildings
• storing food securely
• using safe cleaning practices in areas contaminated by rodents
• avoiding dry sweeping or vacuuming rodent droppings
• dampening of contaminated areas before cleaning
• strengthening hand hygiene practices.

In an ever-evolving world, people are always looking for something more convenient. Thanks to this never-ending search for an easier way out, even the ways of using medicine have changed. From popping pills to now using nasal sprays for decongestion, the way we deal with a cold or the flu has also changed. But just like all other aspects of life, one must know where to stop. Unsurprisingly, cases of nasal spray addiction have come to light, and the consequences are not pretty.

What happens when nasal sprays are used in excess?

In the UK, the Medicines and Healthcare products Regulatory Agency (MHRA) has stated that excessive use of nasal spray can lead to ‘rebound congestion’ and other major side effects. While people were mindlessly using nasal sprays for seven days in a row, a new advisory limits use to just five days. Brits are reportedly becoming addicted to nasal sprays because of excessive use to relieve blocked noses, thereby causing damage to the tissues inside.

What are the symptoms of overuse of nasal sprays?

Decongestant sprays constrict inflamed blood vessels in the nasal passages, thereby relieving congestion. In the short term, they work well. However, if used too much, the blood vessels in the nasal passages become sensitive to ingredients like xylometazoline and oxymetazoline. These passageways also start to swell when the medication wears off. In the long run, addiction or overuse of nasal sprays can lead to the following symptoms:

1. Damage to the sensitive lining of the nose
2. Dependence on the spray
3. Crusting
4. Dryness in the nose
5. Sleep problems
6. Palpitations
7. Anxiety
8. Irritation
9. Reduced effectiveness of the spray

Consequences of nasal spray addiction

In an interview with Health and Me, Dr Samir Garde, Director of the Department of Pulmonology and Lung Transplant at Gleneagles Hospital, Parel, said, “Many people have a habit of using nasal sprays mindlessly. So, even though they tend to provide that much-needed relief, they can take a toll on well-being. Using nasal sprays too often, particularly decongestant sprays, can do more harm than good. While they give quick relief from a blocked nose, overuse can lead to a problem called rebound congestion. This happens when the nose becomes even more blocked once the effect wears off. This can make people dependent on the spray and even cause addiction. Moreover, excessive use also dries out the nasal lining, causing irritation, burning, or even small nosebleeds.”

Some people may experience headaches or a constant feeling of stuffiness that can disturb peace of mind and interfere with daily routine. In the long run, it can damage the sensitive tissues inside the nose and reduce the spray’s effectiveness. So, use nasal sprays strictly as per a doctor’s advice. Do not overdo it. Anything done in excess can be harmful to health. Take charge of your wellbeing and follow medical advice carefully.