After mpox outbreak, Africa is under the threat of yet another virus outbreak, this is the Marburg virus outbreak in Rwanda. So far, six people have died from the outbreak, confirmed the health minister. Most victims were the healthcare workers in the hospital's intensive care unit. As per reports, 20 cases have been identified since the outbreak was confirmed on Friday.

What Is Marbug Virus?

With the fatality rate of 8% it is the same virus family as Ebola. The main carrier is from fruit bats which spreads to humans then through the contact of bodily fluids of infected individuals, it spreads to others.

Common Signs And Symptoms

The common signs and symptoms of the Marburg virus include fever, pain, diarrhoea, vomiting and in the case of extreme blood loss, death too can happen.

So far, there is no specific treatment or vaccine for the virus. However, treatments like drugs and immune therapy are being developed as per the World Health Organisation (WHO).

Call Of Action

Rwanda says that it has intensified its contact tracing, surveillance and testing to contain the spread. It has also tracked about 300 people who had come into contact with individuals affected by the Marburg virus.

The health minister has urged people to stay vigilant and avoid any physical contact and to wash their hands with clean water, soap or sanitiser and report any suspected case.

As of now, most of the cases have spread to the capital in Kigali. In light of this, the US Embassy in the city has advised its employees to work remotely for the next week.

This is the first time Rwanda has confirmed for Marburg cases, before this, in 2023, Tanzania confirmed the outbreak, whereas three people had died of this in Uganda in 2017.

History Of Marburg

As per WHO, this virus kills half of the people it infects. In the previous outbreaks, it has killed between 24% to 88% of the patients.

The virus was first detected in 1976 after 31 people were infected, out of which 7 died in simultaneous outbreak in Marburg and Frankfurt in Germany, and Belgrade in Serbia.

The source was traced to African green monkeys who were imported from Uganda. However, other animals too are linked to the virus spread, including bats.

In the past, the virus outbreaks have happened in countries like Equatorial Guinea, Ghana, the Democratic Republic of the Congo, Kenya, South Africa, Uganda, and Zimbabwe. In 2005, this virus killed 300 people in Angola.

However, for the rest of the world, only two people have died from the virus in the rest of the world, with one of them being in Europe, and the other in the US. These both have been on expeditions to caves in Uganda.

Melatonin is often opted to treat a bad night's sleep. But new research is raising an important question about what happens when the sleep supplement becomes a long-term habit.

A large preliminary study found that people with chronic insomnia who used melatonin for at least 12 months had a roughly 90% higher risk of developing heart failure over five years compared with similar people who did not use it.

The findings were presented at the American Heart Association's Scientific Sessions and are based on health-record data. Researchers have stressed that the study does not conclusively prove that melatonin causes heart failure.

About The Study

The researchers observed adults with insomnia and compared those who used melatonin for 12 months or more with those who didn't.

Over a period of five years, 4.6% of long-term melatonin users developed heart failure, compared to 2.7% of non-users. That translated into approximately a 90% higher risk.

Researchers found a similar association when they used a stricter definition of long-term use, looking at people who had filled at least two melatonin prescriptions at least 90 days apart. In that analysis, the risk was 82% higher.

So, it does not mean that 90 out of 100 people taking melatonin will develop heart failure. It means the relative risk was about 90% higher in the long-term melatonin group than in the comparison group.

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How Does Melatonin Help Sleep Better?

Melatonin is a hormone naturally produced by the body, mainly in response to darkness. It helps regulate the sleep-wake cycle, essentially telling the body that night time has arrived. Melatonin supplements are therefore used to help with sleep problems.

But chronic insomnia itself is not harmless. Poor sleep can be associated with high blood pressure, obesity, diabetes, and cardiovascular disease. And that creates a major problem in interpreting this study.

Also read: How To Read Your Blood Test Results: A Simple Guide To What Your Numbers Mean

Melatonin Or Insomnia: What Is Causing Heart Risk?

People taking melatonin long term may have more severe or persistent insomnia than people who do not take it. That underlying sleep disorder could itself contribute to cardiovascular problems.

There may also be other differences between the two groups that a medical-record study cannot completely account for. This is why the researchers have described the findings as preliminary and say more research is needed to understand whether melatonin itself has a harmful cardiovascular effect.

Talking about heart failure, it simply does not mean that the heart suddenly stops working. It means the heart has become unable to pump blood efficiently enough to meet the body's needs. People may develop symptoms like:

• Breathlessness, particularly when lying down or exercising
• Persistent tiredness
• Swelling of the legs, ankles or feet
• Rapid weight gain from fluid retention
• A persistent cough or congestion
• Reduced ability to exercise

Does This Mean You Should Stop Taking Melatonin?

The research is merely observational, so it cannot establish cause and effect. It also does not show that short-term melatonin use causes heart failure.

The American Heart Association described the findings as raising “new questions about the safety of taking melatonin for extended periods.”

If someone has been taking melatonin every night for months or years, particularly because of persistent insomnia, it may be worth discussing the underlying sleep problem with a doctor rather than simply continuing the supplement indefinitely.

Statins have long had the job of lowering LDL cholesterol and protecting the heart. But new a study has emerged stating that these medicines may have another significant benefit for the brain.

A 15-year Danish study involving more than 132,000 people with type 2 diabetes found that those who started taking statins earlier had a 15% lower risk of developing dementia compared with those who started treatment later. Even later, statin use was associated with a 10% lower risk.

The researchers suggest that the timing of treatment is key as prolonged exposure to high cholesterol and other cardiovascular risk factors could contribute to damage that accumulate over many years.

The findings, presented at the European Society of Cardiology Congress and published in The Lancet Regional Health – Europe, come as researchers are constantly exploring the connection between cholesterol, blood vessels, and brain health.

Connection Between Cholesterol And Brain

The brain is an enormous delivery network in which billions of cells depend on a constant supply of oxygen and nutrients delivered through tiny blood vessels.

High levels of LDL cholesterol can contribute to atherosclerosis, where fatty deposits build up inside arteries. Over time, this can damage blood vessels and restrict blood flow.

Damage to the brain's blood vessels can contribute to vascular cognitive impairment and vascular dementia, while strokes can also increase the risk of subsequent cognitive decline.

Also read: Hormone Replacement Therapy May Lower Dementia Risk In Women, Shows Study

Statins Were Not Proven To Prevent Dementia

This study merely observed the correlation between statins and dementia risk, meaning it did not establish a definite cause-and-effect relationship. People who start statins earlier may also differ from those who start later in other ways, including their overall management of diabetes and cardiovascular risk.

The researchers therefore say more work is needed to determine whether statins have a direct protective effect on the brain.

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Does Lower Cholesterol Mean Better Brain Health?

It is important to note the difference between treating unhealthy LDL cholesterol levels and assuming that everyone should aggressively lower cholesterol to prevent dementia. Statins remain as the medication to reduce cardiovascular risk.

Their potential brain benefits are an additional area of research. So, people must not blindly start popping statins to lower the risk of neurodegenerative diseases like dementia.

There is another reassuring point for people already taking statins. The concerns that these medicines may result in the increase of dementia risk have not been supported by the strongest available evidence.

A large review of randomised trials earlier this year found that most reported statin side effects were no more common than with placebo, including reported memory problems.

The most interesting takeaway may not be that “statins prevent dementia.” The evidence isn't strong enough to make that claim yet. It is that heart health and brain health are deeply intertwined.

Managing cholesterol, blood pressure, diabetes and other cardiovascular risk factors, along with regular physical activity and a healthy diet, may help protect the blood vessels that keep the brain functioning.

The Maharashtra Food and Drug Administration (FDA) has recently sparked headlines for bringing several known brands under its tight scrutiny. Cipla was one of them after the drug regulator cancelled one of its facility’s licenses over alleged violations associated with Reactin Plus tablets.

Soon after that, the Bombay High Court questioned the manner in which the action was taken, prompting the Maharashtra Food and Drug Administration (FDA) to withdraw its cancellation order.

The dispute has now become more about how far a regulator can go while enforcing drug safety rules, and whether due process was followed before cancelling the license.

Why Did Maharashtra FDA Cancel Cipla Facility’s License?

Maharashtra FDA recently conducted an inspection of Cipla Pharma & Life Sciences’ carrying and forwarding facility at Wadki in Pune.

During an inspection in June, FDA officials found that the packaging of Reactin Plus, a Schedule H prescription medicine, described it as an “analgesic and antipyretic”. The FDA said this amounted to unauthorised advertising of a prescription drug and violated provisions of the Drugs and Cosmetics Act and Rules.

The regulator seized Reactin Plus stock worth around Rs 11.19 lakh and instructed that the product be recalled.

But the FDA said the recall directions were not fully complied with. A subsequent inspection also found discrepancies between physical stock, computerised records and purchase and sales data.

Medicines were reportedly found stored directly on the floor, with inadequate proper storage arrangements. Deficiencies were also identified in the handling of expired medicines.

Based on these findings, the FDA cancelled the drug-sale licenses of the facility with effect from August 27.

Maharashtra FDA Commissioner Tukaram Mundhe said, “The Food and Drug Administration will not show any leniency regarding the safety of medicines and the health of citizens.”

He added, “Any entity within the pharmaceutical manufacturing and distribution system found violating regulations will face stringent legal action.”

Also read: FSSAI Proposes Red Front-Of-Pack Warning Labels On Junk Food: How Will This Benefit Consumers’ Health?

Why Did The Bombay High Court Step In?

Cipla challenged FDA's action before the Bombay High Court. On August 30, the court criticised the regulator's approach, describing it as “high-handed” and saying the FDA had gone “overboard”. The court also questioned whether the principles of natural justice had been followed.

During the hearing, the court asked, “Do you feel you are a Lord and you can do anything?”

The court's concern was not necessarily that the FDA should not regulate Cipla. Instead, it questioned the manner and procedure through which the license was cancelled.

Following the court's intervention, the Maharashtra FDA withdrew the cancellation order and said it would issue a fresh show-cause notice before passing an order.

So, the license has been restored for now, but that does not mean the underlying regulatory concerns have disappeared.

Also read: Everest Hing Sale Prohibited By FSSAI; 3 Other Masalas Flagged For Violations

What Does Cipla Say?

Cipla has maintained that the matter is under judicial consideration and therefore declined to comment in detail. The company said the FDA order relates to the operations of a C&F warehouse, rather than allegations concerning the medicine's safety or effectiveness.

According to mint, Cipla said, “Cipla has been a trusted healthcare organization for nine decades and continues to uphold the highest standards of quality, regulatory compliance, and patient safety.”

The company also clarified that the FDA order “does not allege any concerns relating to the safety, quality or efficacy of its products”.

Reactin Plus Is Safe

The FDA action focuses on violations related to labelling, recall compliance, storage, inventory records and distribution practices.

It did not establish that Reactin Plus was unsafe, ineffective, or contaminated. Cipla has specifically said the order did not concern the product's safety, quality, or efficacy.