Pakistan continues to be dealing with a polio outbreak as four fresh cases have emerged, pushing the national tally to 37 this year, according to health officials on October 19, 2024. Health officials said that the regional reference laboratory for polio eradication at the National Institute of Health in Islamabad confirmed wild poliovirus type-1 (WPV1) in two children-one from each Balochistan and Khyber-Pakhtunkhwa.

In recent cases, a girl has been affected from Pishin, and two boys from Chaman and Noshki of Balochistan, and a girl from Lakki Marwat in KP. These are the first detections of the virus within Noshki and Lakki Marwat this year; isolated cases of poliovirus were previously reported within Chaman and Pishin. The province of Balochistan was the worst hit with 20 cases, Sindh had 10, Khyber Pakhtunkhwa had five, and Punjab and Islamabad had one case each.

A gigantic fight against polio has been on going in Pakistan- especially in Balochistan and southern KP-over the last two years. Immunisation campaigns have often been suspended or delayed because of local protests, insecurity, and community boycotts. Consequently, quite a number of children did not get the necessary vaccinations, making existing patches of vulnerability for the virus to flow within those pockets.

Noshki, located near Afghanistan's border, and Lakki Marwat have also recently reported some positive environmental samples that confirm the virus is present here, said a local reference laboratory official. Samples of latest cases are currently under genetic sequencing for checking spread of virus and origin.

As the threat of polio continues to grow, Pakistan has vowed to mount a nationwide campaign against it beginning from October 28. With the zeal to tackle the menace in the most effective manner, over 45 million children under the age of five will be vaccinated across the country.

Today, Afghanistan and Pakistan remain one of the few countries where polio has not yet been eradicated. The WHO said the virus remains a potential serious public health threat in areas with low vaccination coverage and weak surveillance.

India On Alert Against Polio

The country declared itself polio-free since 2014 and has kept the disease on bay almost a decade with very robust vaccination programs; however, two cases of vaccine-derived poliovirus cases reported in recent days from Meghalaya create some amount of doubts over a possible resurgence. Experts observe that in India, despite these detections taking place, strong coverage of vaccination at 90-95% and mandatory surveillance measures keep the risk of this widespread outbreak at bay.

The experts point out, however, that such stable situation in India requires continued surveillance. "Countries like Pakistan and parts of Africa remain at a high risk because vaccination rates in those areas are much lower," Dr. Siddharth, public health expert, said. Vaccination is an indispensable act in order to avoid the spread of this incapacitating disease that manifests most importantly as a nervous system affliction leading to the paralysis of a long period.

With concerted efforts from health authorities, there is hope someday that the scourge of polio will be completely eradicated from the face of the earth and future generations will never suffer from its effects.

A US doctor infected with the Ebola virus, while treating patients infected with the deadly disease in Democratic Republic of the Congo has been admitted to Berlin's Charité hospital today.

The German Health Ministry acquiesced to a request from the United States for the patient to be treated in Germany rather than the United States due to the shorter travel time from Uganda and the Charité's experience in dealing with Ebola, Deutsche Welle reported.

The patient was flown to Berlin on a special medical aircraft and was then driven to the hospital in a specially designed vehicle escorted by police. The aircraft also carried six other people with whom the infected man had contact.

The German Health Ministry has reassured the public that there is no danger of the deadly virus spreading to the general population.

The Charité hospital specializes in the treatment of such cases and the patient is being housed in a completely isolated ward, separate from the rest of the clinic, the report said.

The German Health Ministry, however, noted that the mortality rate following modern treatment and specialist monitoring at a clinic like Berlin's Charité drops from around 60 per cent to 20 per cent-30 per cent.

Ebola Cases Rise To Over 130: WHO Considers Use Of Experimental Vaccines

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Tedros Adhanom Ghebreyesus said there had been at least 500 suspected cases of Ebola and 130 suspected deaths due to the Bundibugyo strain in DR Congo since the new outbreak began in April.

Global health leaders are also considering whether vaccines or medicines still in development could be used to fight Ebola. Dr Mesfin Teklu Tessema, senior director of health at the International Rescue Committee, which works in the DRC’s Ituri Province, where most cases have been reported, told the The Guardian he expected current known cases were “the tip of the iceberg”.

Spread across the porous border to South Sudan, he said, was probably “a matter of when”. He warned that a weak public health infrastructure there meant “we are actually flying blind”.

A WHO official in Ituri province said the outbreak could take a long time to bring under control.

“I don’t think that in two months we will be done with this outbreak,” Anne Ancia, the WHO’s representative for the DRC, told reporters in Geneva at the World Health Assembly, pointing to a recent Ebola outbreak that took two years to end. Nearly 2,300 people died between 2018 and 2020 in the deadliest outbreak in the DRC to date.

“At the international level, [we are] looking at what candidate vaccines or treatment are available and if any could be of use in this outbreak,” Ancia added.

Australia has seen more than 220 cases of diphtheria so far this year, the biggest outbreak of the disease since national records began in 1991.

The Northern Territory has the largest number of positive cases at 133, followed by 82 in Western Australia, six in South Australia, and fewer than five in Queensland.

In response to the outbreak, the federal and state governments have mobilized, and the Commonwealth is preparing a support package to bolster vaccination rates for a disease once considered almost eradicated, ABC News reported.

Authorities are also waiting on the outcome of an investigation into a reported diphtheria-related death in the NT, which would be the first death from the disease in almost a decade.

Federal health minister Mark Butler said the numbers were “very concerning.”

“To put that in context, we've been recording case numbers nationally for about 35 years, and this, by a very big distance, is the biggest outbreak of diphtheria we've ever seen,” he said.

The cases are rising amid falling vaccination rates on the continent.

“I want to say this is not just very serious in terms of its numbers, but the vast majority of new cases we're seeing are respiratory diphtheria, which is far more serious in terms of its potential — about 25 per cent of cases are being hospitalized,” Butler said at a press conference on the NSW Central Coast.

Also read: US Doctor With Ebola Admitted To Hospital In Germany

2 Different Diphtheria Strains Identified

Two strains of diphtheria have been identified in Australia: respiratory and cutaneous. While respiratory diphtheria can affect the nose, throat, and airways, cutaneous affects the skin, causing pus-filled blisters on the skin or large ulcers surrounded by red, sore-looking skin.

The respiratory strain also spreads through droplets from coughing or sneezing, or direct contact with infected wounds.

Even with treatment, one in 10 people with respiratory symptoms die, according to the Australian CDC.

What Is Diphtheria?

As per the World Health Organization (WHO), diphtheria is a disease caused by the Corynebacterium diphtheriae bacterium that affects the upper respiratory tract and, less often, the skin. It also produces a toxin that damages the heart and the nerves. While it is a vaccine-preventable disease, multiple doses are needed to produce and sustain immunity.

Diphtheria has remained a leading cause of childhood death globally. But vaccination has long prevented mortality among children.

Those who are not immunized remain at risk. WHO also mentions that diphtheria can be fatal in 30 per cent of cases, with young children at higher risk of dying if they are unvaccinated and are not receiving proper treatment.

In 2023, an estimated 84 per cent of children worldwide received the recommended 3 doses of diphtheria-containing vaccine during infancy, leaving 16 per cent with no or incomplete coverage.

According to Australia’s Department of Health and Aged Care, between 1926 and 1935, more than 4,000 Australians died from diphtheria.

Vaccination started in Australia in the 1930s, and the disease has rarely been seen since the 1950s. But vaccine coverage has waned since the COVID pandemic, leading to a rising number of cases.

Diphtheria: Signs And Symptoms

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Within 2 to 5 days after exposure to the bacteria. The symptoms include

• a sore throat,
• fever,
• swollen neck glands,
• weakness.

Diphtheria: How the Disease Is Treated

It is usually treated with diphtheria antitoxin as well as antibiotics. Antitoxin neutralizes the circulating toxin in the blood. Antibiotics stop bacterial replication and thereby toxin production, speed up getting rid of the bacteria, and prevent transmission to others.

How To Prevent Diphtheria

Diphtheria can be prevented by vaccines and routine immunization. The vaccine is given most often combined with vaccines for diseases such as tetanus, pertussis, Hemophilus influenzae, hepatitis B, and inactivated polio.

Cholesterol is not all that bad as long as it is in the right proportion. It is of two types — good and bad cholesterol, the former being HDL and the latter LDL. It is a fatty substance in the blood that is made of essential proteins. While several tests are conducted to ascertain cholesterol levels in the body, there are some types of cholesterol that are not usually detected during routine check-ups. It turns out that this hidden form of cholesterol can quadruple the risk of stroke and heart attack, even if everything else is done right. This form of cholesterol is known as lipoprotein(a), or Lp(a) — it carries fats and proteins in your blood.

How does lipoprotein(a) affect heart patients?

Experts note that roughly 20 per cent of people have high Lp(a). It is similar to LDL, which is often known as bad cholesterol. However, there is a protein known as apolipoprotein(a) that makes Lp(a) twice as harmful. The extra protein leads to plaque build-up that eventually clogs arteries, thereby raising the risk of blood clots.

Both factors mean that someone is more likely to suffer from a stroke or heart disease. Recent research from the National Institutes of Health (NIH), which evaluated blood samples from 20,000 adults aged 40 and above, noted that those with the highest Lp(a) levels were about 30 per cent more prone to suffering a major heart event. These participants were also 50 per cent more likely to die from heart disease and 65 per cent more likely to suffer a stroke.

What are the consequences of high Lp(a) levels?

Researchers found that higher levels of Lp(a) were linked to a higher risk of a heart attack. However, these links were stronger in people who had already suffered from heart disease. Experts also found that one can quantify the specific levels of Lp(a) that can lead to a heightened risk of a major heart event, such as a stroke or heart failure. Researchers noted that, regardless of age, patients can opt for low-cost blood tests to determine their risk of genetic conditions. Lp(a) is not regularly checked in a standard cholesterol test. Instead, experts rely on a specific test to spot this condition.

Should you get Lp(a) levels checked?

According to the British Heart Foundation, it is important to get Lp(a) levels checked if someone in your family has high levels of it, or if there is a family history of coronary heart disease at an early age. The study’s findings also suggest that patients dealing with high Lp(a) levels need aggressive management of heart disease risk factors. If detected, you must work on a routine religiously to lower LDL and manage risk factors as much as possible. Lp(a) in the blood is determined by genes. However, according to researchers at the University of Queensland, other risk factors are:

1. Hypertension
2. High LDL
3. Diabetes
4. Not exercising enough
5. Unhealthy diet
6. Smoking

The good news, however, is that Lp(a) levels can be reduced with the help of drugs available on the market. In early clinical trials, drugs developed by Eli Lilly and Novartis lowered Lp(a) levels by 80–90 per cent. Combining this with a healthy diet and lifestyle can go a long way in the process.