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.

The US has reported 3,437 cases of the drug-resistant fungus Candida auris across 27 states so far this year, according to the latest data from the US Centers for Disease Control and Prevention (CDC).

The figure is about 1,000 fewer than the 4,290 cases reported during the same period last year.

The states reporting the highest number of cases this year are:

• California: 873
• Texas: 433
• Tennessee: 283

The CDC clarified that an increase in reported cases does not necessarily mean the fungus is spreading more rapidly than usual.

"An increasing number of cases does not mean the fungus is transmitting at a more rapid pace than usual," the CDC said.

The agency added that while C. auris cases continue to rise every year, the rate of increase has slowed since 2022.

Most Strains Resistant to Common Antifungal Drugs

A CDC analysis published earlier this year, based on 8,033 C. auris samples collected in 2022 and 2023, found:

• More than 95% were resistant to fluconazole, a first-line antifungal drug.
• 15% were resistant to amphotericin B.
• 1% were resistant to echinocandins.
• Fewer than 1% were resistant to all three major antifungal drug classes.

Why Is Candida auris a Concern?

Candida auris is a type of fungus that can cause serious infections in the human body. It was first identified in 2009.

The CDC said that the drug-resistant fungus continues to pose a major challenge for hospitals, nursing homes, and other healthcare facilities because it is difficult to treat and control.

"Candida auris is an emerging yeast that is frequently resistant to antifungal drugs. C. auris can cause invasive infections associated with high mortality and can colonize patients asymptomatically, which facilitates transmission in health care settings," the CDC said.

"Since it was first reported in the United States in 2016, C. auris has been identified in multiple states, with increasing numbers of cases reported annually. Monitoring national trends in cases identified through clinical testing and screening for colonization is critical to guide infection prevention and control efforts," it added.

Why Is Candida auris So Difficult to Control?

Unlike many other infections, Candida auris spreads easily through contaminated medical equipment and direct person-to-person contact. It can also survive for long periods on surfaces and is resistant to many commonly used disinfectants, making outbreaks difficult to contain once the fungus enters a healthcare facility.

Health officials say the steady rise in cases each year points to ongoing transmission in healthcare settings.

Symptoms and Health Risks

Candida auris can infect:

• The bloodstream
• Wounds
• Ears
• Other parts of the body

Symptoms vary depending on the site and severity of the infection. Some people may carry the fungus without showing any symptoms.

The CDC noted that most people who develop Candida auris infections are already seriously ill, making it difficult to determine how much the fungus contributes to death compared with their underlying medical conditions.

The fungus is particularly concerning in hospitals and nursing homes because it can survive on surfaces such as doorknobs, counters, and bed rails. Its resistance to multiple antifungal drugs makes infections difficult to treat and eliminate.

English actor and former Blue Peter presenter Peter Duncan recently urged health authorities to make focal therapy more available for prostate cancer patients. He said after describing the treatment as "life-changing" following his own diagnosis in 2019.

This comes as new evidence has been emerging that the minimally invasive approach can offer satisfactory cancer control compared to traditional treatments, while also significantly reducing long-term side effects.

The 72-year-old broadcaster revealed that he was initially offered a prostatectomy, a surgery that removes the entire prostate gland. Instead, he opted for focal therapy, a targeted treatment that destroys only the cancerous portion of the prostate while preserving healthy tissue.

"It was a complete success, and I've only experienced very minor after-effects, allowing me to continue with my life as before," Duncan said, while backing Prostate Cancer UK's campaign for wider NHS access to the treatment. "Many men aren't given the same chance I was, and that needs to change."

Importance Of Focal Therapy In Prostate Cancer Treatment

Also read: Tadalafil: Common Male-Potency Drug May Raise Glaucoma Risk In Men, Finds Study

Duncan's campaign comes amid growing clinical evidence supporting focal therapy for selected patients with localised prostate cancer.

A recent report from researchers at Imperial College London and Imperial College Healthcare NHS Trust found that focal therapy shows promise in cancer treatment compared to surgery and radiotherapy while causing far fewer complications in some patients.

Amy Rylance, Director of Health Services, Equity and Improvement at Prostate Cancer UK, said the delay in wider approval is leaving thousands of men with no access to treatments that could preserve their quality of life.

"Without a timeline from NICE, we simply don't know how long men will have to wait for approval on the NHS," she said. "Thousands of men will have to deal with life-changing side effects simply because of their postcode."

More About Focal Therapy

Also read: WHO Cancer Agency Flags 3 Common Medicines As Carcinogenic: What It Means For Millions Of Patients

Unlike prostatectomy or radiotherapy, focal therapy targets only the tumour inside the prostate. The treatment may use high-intensity focused ultrasound (HIFU) or cryotherapy to destroy cancer cells while preserving the surrounding healthy tissue.

Because the rest of the prostate and surrounding nerves are preserved, patients may generally face a much lower risk of urinary incontinence, erectile dysfunction and bowel problems.

Focal therapy is not suitable for everyone. Specialists say it is generally considered for men with localised, clinically significant prostate cancer where imaging and biopsy show that the tumour can be accurately targeted.

Patients still require long-term monitoring after treatment to ensure the cancer has not returned or progressed.

Can Focal Therapy Help?

Prostate cancer is the most commonly diagnosed cancer in men in the UK. According to Prostate Cancer UK, around one in eight men will be diagnosed during their lifetime, with the risk increasing with age, family history and Black ethnicity.

While surgery and radiotherapy remain the standard treatment options to treat prostate cancer, advocates argue that expanding access to focal therapy could help thousands of eligible men receive effective treatment with fewer long-term side effects.

Duncan hopes sharing his own experience will encourage both policymakers and patients to consider the option where appropriate.

In a first for India, Maharashtra has allowed qualified homeopathy practitioners to prescribe certain modern medicines after completing a one-year Certificate Course in Modern Pharmacology (CCMP).

The decision has sparked strong opposition from the Indian Medical Association (IMA) and several doctors' bodies, which have announced protests, citing concerns over patient safety, medical education, and professional standards.

What Is The Debate All About?

Under a Government Resolution (GR) issued on August 3, Maharashtra has allowed BHMS graduates who have completed the one-year Certificate Course in Modern Pharmacology (CCMP) to register with the Maharashtra Medical Council (MMC). The registration allows eligible practitioners to prescribe specified modern medicines under the state's policy.

The MMC began registering CCMP-qualified practitioners on August 5. According to reports, one practitioner has been registered so far, while around 2,500 applications remain pending.

The IMA has warned of a nationwide strike if the Maharashtra government does not withdraw its decision. In a letter to Maharashtra Chief Minister Devendra Fadnavis, signed by IMA National President Dr. Anilkumar J. Nayak and Secretary General Dr. Sarbari Dutta, the association demanded immediate withdrawal of both the GR and the CCMP course.

Why Is the IMA Objecting?

The IMA has raised the following concerns:

• No approval from national regulators:

• Opposition to dual registration:

• Matter pending before the court

• Concerns over medical education

What Is the CCMP Course? Why Was It Introduced?

The Certificate Course in Modern Pharmacology (CCMP) is a one-year program introduced in Maharashtra in 2016 by the Maharashtra University of Health Sciences (MUHS). It is designed for BHMS (Bachelor of Homeopathic Medicine and Surgery) graduates and trains them in aspects of modern pharmacology and allopathic medicine.

The CCMP course was introduced following a major agitation by homeopathic associations, including a 13-day indefinite hunger strike in Nagpur in 2013, demanding legal rights to prescribe essential modern medicines.

According to the Maharashtra government, the objective was to strengthen healthcare delivery, particularly in areas facing shortages of doctors.

To facilitate the course, the state amended the Maharashtra Homoeopathy Practitioners' Act, 1960 and the Maharashtra Medical Council Act, 1965 in 2014, after the legislation was passed by both Houses of the State Legislature.

The IMA now argued that the situation in 2014 when the MMC Act was amended is very different from the situation now.

The medical body cited the cancellation of "bond system for MBBS graduates due to the nonavailability of vacant posts for them even in rural areas- signifying sufficient availability of MBBS doctors".

What Does the CCMP Course Include?

According to the government, the one-year CCMP curriculum was developed by expert committees at MUHS after comparing the BHMS and MBBS syllabi to bridge gaps in training.

The course includes:

• Training in modern pharmacology
• Practical laboratory procedures
• Rotational hospital training in clinical subjects of allopathy
• Teaching at government and private medical colleges
• Examinations conducted by the Faculty of Medicine, MUHS

The government says the program is intended to make registered homeopathic practitioners competent to prescribe specified modern medicines and improve access to healthcare in the state.

But the IMA has argued that such "short-term certification or bridge courses cannot substitute for comprehensive medical education". They also warned that permitting cross-practice would compromise patient safety.

What's Next?

The Maharashtra Association of Resident Doctors (MARD) began an indefinite statewide strike on August 3. On August 5, doctors across Mumbai withdrew routine outpatient department (OPD) services in protest against the government's decision.

Doctors from Pune are scheduled to join their counterparts in Mumbai for demonstrations at Azad Maidan on August 6. The IMA has warned of a nationwide strike if the Maharashtra government does not withdraw the decision. The IMA Kerala State Branch has also extended support to the Maharashtra doctors' protest.