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.

A fast-spreading new flu variant driving a sharp rise in infections across the state is bringing with it symptoms that differ from what many people usually associate with influenza.

With flu activity now classified as “very high” in Illinois, health experts say a mutated and highly contagious strain known as subclade K is changing how the illness shows up, particularly when it comes to fever patterns. One of the biggest differences doctors are seeing is how intense and long-lasting fevers have become, especially among children.

“There’s more fever with the flu this year than people are used to,” said Dr. Mark Loafman, chair of Family and Community Medicine at Cook County Health, speaking to NBC Chicago. “The fever can last five to seven days, and that’s concerning. You feel sick, you don’t feel like you’re improving, and that can be worrying.”

Adding to the concern, Dr. Juanita Mora, national spokesperson for the American Lung Association, as per NBC News, said some patients are finding that common fever-reducing medicines such as Tylenol or Motrin are not working as effectively. “This strain is causing very high fevers,” Mora said. “There’s also a severe cough that just doesn’t go away, a lot of phlegm, vomiting, diarrhoea, and significant joint and muscle pain.”

Influenza Flu Symptoms To Watch For

Vomiting has never been among the most typical flu symptoms, though it does occur more often in children. What doctors are now noticing with this strain is an increase in gastrointestinal symptoms among adults as well.

“Kids with the flu often experience nausea or vomiting,” Loafman explained. “Adults usually don’t as much, but we are hearing more reports of GI symptoms in adults who have this subclade K strain.” Because of this, he said flu should not be ruled out just because stomach symptoms are present.

“If you have GI issues along with body aches, fever, and respiratory symptoms, flu is still very much a possibility,” he said, adding that at-home flu tests can be useful if someone suspects they are infected.

Warnings have already been issued by the Illinois Department of Public Health and several county health departments as flu-related hospital admissions and positive test results continue to climb.

According to the latest state update released Monday, flu activity has reached “very high” levels, the most severe category used by the CDC to track respiratory illness trends.

Health officials say most emergency room visits and hospital admissions related to respiratory illness are currently being driven by flu cases.

Common Flu Symptoms To Know

Flu symptoms typically appear one to four days after exposure, according to the Cleveland Clinic.

The CDC lists the following common symptoms:

• Fever or feeling feverish, along with chills
• Cough
• Sore throat
• Runny or blocked nose
• Muscle or body aches
• Headaches
• Fatigue
• Vomiting and diarrhoea, which are more common in children than adults

Not everyone with the flu will develop a fever. However, health officials note that gastrointestinal symptoms are being reported more often in adults with the new strain.

Influenza Flu Warning Signs To Watch For

Because this variant is linked to higher and longer-lasting fevers, Mora said it is crucial to recognise when medical care is needed.

“High fevers that don’t come down are one warning sign,” she said. “Another is trouble breathing, including wheezing, chest muscle use, or a cough that won’t stop. And dehydration is a major concern, especially if someone is barely eating or drinking.”

The CDC outlines different warning signs for children and adults.

In children:

• Rapid or laboured breathing
• Bluish lips or face
• Ribs pulling in with each breath
• Chest pain
• Severe muscle pain or refusal to walk
• Signs of dehydration such as no urine for eight hours, dry mouth, or no tears when crying
• Lack of alertness or interaction
• Seizures
• Fever above 104°F that does not respond to medication
• Any fever in infants under 12 weeks
• Symptoms that improve and then worsen
• Worsening of existing medical conditions

In adults:

• Difficulty breathing or shortness of breath
• Ongoing chest or abdominal pain
• Dizziness, confusion, or difficulty waking
• Seizures
• Little or no urination
• Severe muscle pain
• Extreme weakness or unsteadiness
• Symptoms that return or worsen after improving
• Worsening of chronic illnesses

How Long Is Flu Contagious?

According to the CDC, people can spread the flu starting about one day before symptoms appear and up to seven days afterward. Most people are most contagious around three days into the illness. Young children and those with weakened immune systems may remain contagious longer.

“It’s usually about five to seven days from when symptoms start before people stop shedding high levels of the virus,” Loafman said. “Ten days is very cautious, but not always necessary.”

He advised masking around vulnerable people during the first week, practicing good hand hygiene, and staying home whenever possible. “If you can stay in, stay home,” he said, as per NBC News.

Environmental and public health scientists have begun warning against the dangers of having free living amoeba in water systems that are capable of triggering severe diseases in humans.

In a recent perspective article published in Biocontaminant, the researchers noted that climate change, deteriorating water infrastructure and limited systems for monitoring and detection are the key factors that have allowed these pathogens to spread and persist.

Corresponding author Longfei Shu of Sun Yat sen University explained: "What makes these organisms particularly dangerous is their ability to survive conditions that kill many other microbes.

"They can tolerate high temperatures, strong disinfectants like chlorine and even live inside water distribution systems that people assume are safe."

The scientists also emphasized that not only can amoebae spread illnesses on its own, it can also act as hidden carriers for other harmful microbes.

By sheltering bacteria and viruses inside their cells, amoeba these unicelled organisms protect these pathogens from disinfection and help them persist and spread in drinking water systems. This so-called Trojan horse effect may also contribute to the spread of antibiotic resistance among humans.

How Dangerous Is Amoeba?

Amoeba are single-celled organisms that naturally live in soil and water. Most species do not cause harm yet some can prove to be fatal.

Some of the diseases caused by this kind of bacteria include Amebiasis (Amoebic Dysentery), an intestinal infection by Entamoeba histolytica, causing diarrhea, cramps and potential liver abscesses as well as Primary Amoebic Meningoencephalitis (PAM) from Naegleria fowleri, a rare but nearly always fatal brain infection from contaminated water entering the nose.

Effects of amoeba-caused infections range from intestinal issues (liver abscesses, anemia, peritonitis) to severe neurological damage (coma, seizures, death) from brain-eating types, with Acanthamoeba causing eye infections (keratitis).

Experts recommend thoroughly washing your hands after toilet use and before handling food, drinking clean water especially in unsanitary conditions and avoiding getting water up your nose in warm freshwater to prevent such infections.

The Indore Crisis

This comes days after the recent Indore sewage water controversy which has claimed the lives 10 people and left over 1,400 people hospitalized, according to Indore Mayor Pushyamitra Bhargava.

However, locals claim that the outbreak has instead caused the death of 17 residents, including a six-month-child. The situation has also left Parvati Bai, 67, with kidney failure, a brain stroke and symptoms of Guillain-Barré Syndrome, or GBS.

GBS is a rare condition where your immune system attacks the nervous system and can cause paralysis as well as death, in certain cases.

The outbreak occurred due to lapses in civic infrastructure. Investigation revealed that a toilet constructed directly above a main drinking pipeline near a police outpost, without a mandatory safety tank resulted in the sewage mixing with drinking water.

The US Food and Drug Administration has approved the use of a blood test which can help diagnose Alzheimer’s disease in adults aged 55 and above.

The blood test, known as Lumipulse, can detect amyloid plaques associated with Alzheimer’s disease and has proven to be a “less invasive option” that “reduces reliance on PET scans and increases diagnosis accessibility.”

FDA Commissioner Martin A. Makary said of the landmark decision, "Alzheimer’s disease impacts too many people, more than breast cancer and prostate cancer combined.

"Knowing that 10% of people aged 65 and older have Alzheimer's, and that by 2050 that number is expected to double, I am hopeful that new medical products such as this one will help patients."

It remains unclear when this test will be available for commercial use across the world.

What Is Alzheimer’s Disease?

About 8.8 million Indians aged 60 and above are estimated to being living with Alzheimer's disease. Over seven million people in the US 65 and older live with the condition and over 100,00 die from it annually.

Alzheimer's disease is believed to be caused by the development of toxic amyloid and beta proteins in the brain, which can accumulate in the brain and damage cells responsible for memory.

Amyloid protein molecules stick together in brain cells, forming clumps called plaques. At the same time, tau proteins twist together in fiber-like strands called tangles. The plaques and tangles block the brain's neurons from sending electrical and chemical signals back and forth.

Over time, this disruption causes permanent damage in the brain that leads to Alzheimer's disease and dementia, causing patients to lose their ability to speak, care for themselves or even respond to the world around them.

While there is no clear cause of Alzheimer's disease, experts believe it can develop due to genetic mutations and lifestyle choices, such as physical inactivity, unhealthy diet and social isolation.

Early symptoms of Alzheimer's disease include forgetting recent events or conversations. Over time, Alzheimer's disease leads to serious memory loss and affects a person's ability to do everyday tasks.

There is no cure to this progressive brain disorder and in advanced stages, loss of brain function can cause dehydration, poor nutrition or infection. These complications can result in death.

How Does The Test Work?

As explained by Dr Abhay Moghekar, an associate professor of neurology at Johns Hopkins University School of Medicine, who helped study and evaluate the test for FDA approval, "If this test is positive, there’s a greater than 90% chance that you have amyloid plaque in your brain.

"Getting a blood test is gonna be far easier, quicker and cheaper,” he said. “It’s going to allow early access to therapy, so it is going to revolutionize care of patients with dementia."

However, the federal agency also noted certain limitations associated with the test such as it can only be used for patients 55 and older who are already experiencing memory problems.

The FDA also cautions that the test is not intended as a standalone diagnostic tool for Alzheimer’s and results should be interpreted based on the patient’s medical history and other assessments, such as cognitive testing.