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.

On September 3, 1928, Scottish scientist Alexander Fleming returned to his laboratory after a holiday. He famously noticed the antibacterial effect of mold contaminating a Staphylococcus culture.

Fleming identified the mold as belonging to the Penicillium genus and found that it produced a substance capable of inhibiting bacterial growth, which he named penicillin.

However, Fleming’s discovery was only the beginning. Penicillin proved difficult to isolate, purify and mass-produce. During World War II, scientists Howard Florey and Ernst Chain built on Fleming’s work to develop large-scale production methods, converting penicillin into a life-saving medicine and ushering in the modern antibiotic era.

How Did Penicillin Resistance Develop?

As penicillin came into widespread medical use in the 1940s, resistance to the drug also emerged.

“Penicillin acts through a beta-lactam ring, which targets the bacteria, but then the organisms started producing an enzyme known as beta-lactamase,” Dr NK Ganguly, former Director General of the Indian Council of Medical Research (ICMR) told HealthandMe.

“This beta-lactamase broke the ring, so various derivative varieties of penicillins were synthesized,” he explained.

But as new penicillin derivatives were developed, bacteria also evolved or acquired mechanisms, including different beta-lactamases, that could break down these drugs.

As a result, penicillin became less effective against many bacteria. However, it remains effective against certain organisms and infections, including:

• Syphilis
• Group A beta-haemolytic Streptococcus
• Streptococcus pneumoniae (pneumococcus)

“Penicillin remains the gold standard for certain infections and indications, including neonatal sepsis, childhood pneumonia, rheumatic heart disease prophylaxis and resurging cases of syphilis,” Dr Ganguly said.

The Growing Threat Of Resistance

The story of penicillin resistance is an early example of a much broader problem the world is grappling with today: antimicrobial resistance (AMR), which threatens the effectiveness of modern healthcare.

Decades after antibiotics transformed medicine, the bacteria these drugs were designed to target have evolved significant resistance. This threat has been further compounded by the misuse and overuse of antibiotics across sectors.

According to the World Health Organization (WHO), approximately 1 in 6 laboratory-confirmed bacterial infections worldwide were resistant to antibiotic treatments in 2023.

Low- and middle-income countries bear the heaviest burden of infectious disease but face severe shortages of specialized antibiotics.

A global study covering 82 countries, led by the Murdoch Children’s Research Institute (MCRI), found that antibiotic resistance increased across every region between 2004 and 2022. As a result, critical treatments for routine childhood infections are becoming increasingly ineffective.

“The discovery of antibiotics is perhaps the most significant, life-changing breakthrough in the history of medicine,” Dr. Rajeev Jayadevan, Ex-President of IMA Cochin and Convener of the Research Cell, Kerala, told HealthandMe.

“However, bacteria possess natural evolutionary mechanisms to resist antibiotics as part of their survival machinery. Unfortunately, overuse in human healthcare, veterinary medicine and agriculture has allowed bacteria to continuously adapt and evade treatment,” he added.

Major Drivers Of Antimicrobial Resistance

Antimicrobial resistance is driven by a combination of clinical, agricultural, industrial and environmental factors:

1. Inappropriate syndromic and empirical prescribing
   • Viral infections
   • Unnecessary STD treatment
2. Self-medication and suboptimal adherence
3. Informal healthcare providers
4. Substandard and falsified medicines
5. Agricultural and veterinary misuse
   • Growth promoters in animal feed
   • Use of human-critical antibiotics in livestock
6. Industrial and environmental contamination
   • Manufacturing effluents
   • Fermentation and industrial waste
   • Effluents and sewage
7. Lack of public awareness

What Can Be Done?

So, are we running out of effective antibiotics? Not entirely, yet "the development of newer antibiotics has not kept pace with bacterial evolution" Dr Rajeev said.

Resistance is also making some infections increasingly difficult to treat. To counter, stronger national policies are needed the unnecessary antibiotic prescribing while ensuring that patients who genuinely need specialized antibiotics can access them.

Improving access will require coordinated action at both local and national levels. This includes:

• Ensuring quality-assured antibiotics are available and affordable in frontline healthcare settings
• Procuring the right antibiotics in adequate quantities
• Strengthening surveillance of antibiotic use
• Setting country-specific prescribing targets based on local disease burden and public health needs.

“Beyond discovering new drugs, the long-term solution lies in regulating antibiotic use globally—because antimicrobial resistance knows no boundaries. A resistant organism originating in one region can rapidly spread worldwide,” Dr Rajeev said.

A new experimental vaccine could offer protection against several forms of Streptococcus pneumoniae, showing promise for a future vaccine that will not have to fight each bacterial strain separately.

The bacterium, commonly called pneumococcus, can live in the nose and throat without causing any symptoms. But when the body's defenses are compromised and weakened, it can target other parts of the body and cause symptoms like pneumonia, meningitis, bloodstream infections and other serious diseases.

About The Study

One of the primary challenges of preventing these infections is that S. pneumoniae exists in more than 100 serotypes, or distinct versions of the bacterium. The current vaccines available to fight them only cover a selection of these types.

A new study published in Science Advances has found a different strategy. Instead of developing the vaccine around the sugar coating that differs between serotypes, researchers targeted proteins that is shared across pneumococcal strains.

Also read: H5N1 Detected In Captive Mink In US For First Time: Should You Be Concerned?

Current Pneumococcal Vaccines Have A Limitation

Existing pneumococcal vaccines work by instructing the immune system to recognise some components of the bacterium's outer shell.

Pneumococcal conjugate vaccines, or PCVs, combine these bacterial sugars with a carrier protein to produce a stronger immune response. Vaccines that target multiple serotypes have helped reduce invasive pneumococcal disease significantly.

But when vaccination reduces the prevalence of the serotypes that is included in a vaccine, other serotypes that are not covered can become more common. This phenomenon is known as serotype replacement.

Some of these replacement strains can also acquire antibiotic-resistance genes, which becomes another challenge.

This is why researchers have been exploring a vaccine that could provide protection across almost all pneumococcal serotypes, rather than having to continuously expand the list of strains covered.

Also read: Fall Vaccines 2026: US Doctors Issue COVID, Flu And RSV Jab Guidance

How Is The New Vaccine Developed?

Researchers opted for a reverse strategy to develop this universal vaccine. Instead of growing the bacterium and looking for useful components, researchers started with its genetic information.

They studied thousands of S. pneumoniae genomes to identify proteins that were conserved across different serotypes. The team looked for proteins that would:

• Be present on or accessible from the bacterial surface
• Be sufficiently different from human proteins
• Be capable of producing a strong immune response

From this analysis, researchers selected three proteins: zinc metalloprotease B (ZmpB), pneumococcal adherence and virulence factor A (PavA), and a YfhO-like protein.

These were combined with two immune-stimulating ingredients, CpG and chitosan, to create the experimental vaccine called ZPY-CpG-Ch.

Also read: 84% Cancer Patients Report Benefit From Ivermectin-Mebendazole: What The Study Found & Why More Trials Are Needed

Effects Of The Vaccine On Mice

Researchers tested the vaccine in both adult and mice to compare its performance with the 13-valent pneumococcal conjugate vaccine, PCV13.

In one experiment, vaccinated mice were exposed to serotype 1, a highly virulent strain of S. pneumoniae. The experimental vaccine produced 80% to 100% survival. The researchers also tested the vaccine against serotypes that are not covered by PCV13.

ZPY-CpG-Ch provided complete protection against serotypes 11A and 33F, while protection against serotype 8 was 50%.

The study found that the vaccine's protective effect was associated largely with a type of immune response that is be important in defense against pneumococcal infection.

The researchers also found that antibodies produced after vaccination could help kill pneumococci in laboratory experiments.

When these antibodies were transferred into unvaccinated mice, they provided protection against a lethal pneumococcal strain.

Despite the promising results, the researchers are not claiming that ZPY-CpG-Ch is ready for people.

The biggest limitation is that the work is still preclinical. The vaccine has been tested in mice but not in human clinical trials. The researchers also challenged the animals with only a small number of pneumococcal serotypes.

If the vaccine eventually proves to be safe and effective in humans, it could lead to wider protection against pneumococcal diseases.

A team of US scientists is beginning a human trial of a new form of proton therapy that could potentially deliver cancer-killing radiation in less than a second.

Known as FLASH proton therapy, the treatment requires fewer sessions — just five over about 10 days — and could potentially reduce the risk of treatment-related side effects.

FLASH Proton Therapy: The First Human Trial

The Phase I clinical trial at the Abramson Cancer Center of the University of Pennsylvania represents the first time the “conformal,” or precise 3D-targeting, version of the technique is being tested in human patients in the United States.

According to the University, the study will enroll 10 patients with recurrent head and neck cancer who have previously received radiation treatment and are not candidates for surgery.

Patients with recurrent head and neck cancer typically face a difficult prognosis. While radiation therapy can help treat the cancer, it can also cause side effects in areas involved in important functions such as eating, drinking and swallowing.

Patients in the trial will receive FLASH proton therapy five times in total, with each exposure lasting less than a second. They will complete all five sessions in less than two weeks.

Penn Medicine recently completed a FLASH proton therapy clinical trial in pet dogs with cancer. The canine study used the same technology for head and neck cancer that will be used in the human trial.

How Does FLASH Proton Therapy Work?

Proton therapy is an advanced form of radiation therapy that uses high-energy protons, or positively charged particles, to damage the DNA of cancer cells and destroy them.

Conventional radiation therapy is typically delivered in smaller doses, or fractions, over several weeks to target the tumour while limiting exposure to healthy tissue.

For patients with head and neck cancer, this typically means 25–35 radiation fractions, delivered once a day, five days a week, over five to six weeks.

Constantinos Koumenis, Professor of Radiation Oncology at Penn Medicine, explained that FLASH uses a larger dose and reduces the amount of time the patient is exposed to radiation.

The total effective radiation dose remains the same, but it is divided into fewer fractions, with each delivered in a large, lightning-fast dose.

What Is ConformalFLASH Proton Therapy?

The type of FLASH proton therapy being tested in this clinical trial is known as ConformalFLASH proton therapy.

The Penn clinical trial is designed to test the safety and feasibility of the approach. Researchers hope it could improve patients’ quality of life by reducing the time they spend in hospitals and travelling for treatment.

If successful, the approach could be expanded to other cancer types and studied in larger Phase II and Phase III clinical trials focused on treatment outcomes, the researchers said.