Polio Outbreak in Pakistan
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.
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.
Credit: Canva
Three cases of meningitis have been reported among schoolchildren in the Weymouth area in the UK, health officials said.
According to the UK Health Security Agency (UKHSA), of the three cases, two are pupils at Budmouth Academy, Weymouth, and the third attends Wey Valley Academy. The authorities have now rolled out meningitis vaccinations to young people in the region.
The latest outbreak comes after a meningitis outbreak was reported in the Kent region in March, which affected more than 30 people, leaving one sixth-form pupil and a university student dead.
As per the UKHSA, the new cases were confirmed between 20 March and 15 April and are not linked to the deadly Kent outbreak.
The two pupils at Budmouth Academy are contacts of each other, but it is reportedly not epidemiologically linked with the Wey Valley Academy case.
The three cases in Weymouth have been confirmed as Meningitis B (MenB) and are the same sub-strain type, but a different sub-strain to the one detected recently in Kent.
Notably, all pupils in years 7 to 13 in Weymouth, Portland, and Chickerell are to be offered antibiotics and the MenB vaccination.
Close contacts of the cases have already been offered antibiotics as a precaution.
Also read: Meningitis claimed 259,000 lives globally in 2023: The Lancet
According to UKHSA deputy director Dr Beth Smout, "it is possible that we will see further cases linked to these latest cases in Weymouth".
He stated that the authorities are widening the "offer of antibiotics and vaccination" as "an additional precaution" to reduce the risk of the infection spreading.
"School pupils and staff should attend school as normal if they remain well," the official said.
Meningitis is a serious medical condition that affects the protective membranes covering the brain and spinal cord, the meninges. While fever is not always present, it is usually considered one of the classic symptoms of meningitis.
It is important to know the varied symptoms, causes, and treatments of meningitis for early diagnosis and proper management of the disease.
Also read: Unique Symptoms Of Meningitis That Caused An Outbreak In Kent University
Smout urged everyone to be alert to the signs and symptoms of meningococcal meningitis. Common symptoms of meningitis
"If the disease is suspected, you should seek immediate medical attention as the disease can progress rapidly," Smout said.
"The most important short-term thing and the quickest way for people to protect themselves is the antibiotic.
"The vaccine offers longer-term protection. There are two doses, four to six weeks apart, and you are only protected after the second dose," the official said.
Type-2 diabetes patients who are also obese rely upon GLP-1 drugs for sugar management and weight loss. (Photo credit: iStock)
A 2026 target trial emulation has found that glucagon-like peptide, also known as GLP-1, which is used by type-2 diabetes patients, can raise the risk of suffering from erectile dysfunction. According to a report published in the European Medical Journal, the impact of GLP-1s on sexual health outcomes in diabetic men has been inconsistent and limited. Erectile dysfunction, however, has been a prominent complication affecting 50 per cent of men with type-2 diabetes over their lifetime.
For this, researchers analysed the electronic health records of men aged 18 years and above with type-2 diabetes in the US from January 2019 to September 2024. Participants were started on treatment with either dipeptidyl peptidase-4 inhibitors (DPP4i) or GLP-1, with 5,524 and 4,910 individuals, respectively. Men with a history of erectile dysfunction diagnosis or end-stage renal disease were not part of the study population. The mean age of these men was 63 years, and the average BMI was 32.8—55 per cent of participants were White, and 23 per cent were Black. GLP-1 users were younger and had a higher prevalence of obesity compared to DPP4i users.
Experts involved in the study found that the incidence of erectile dysfunction in the GLP-1 group was about 35 cases per 1,000 person-years. In the case of DPP4i users, the number dropped to 28 per 1,000 person-years. Hence, people in the GLP-1 cohort had a 26 per cent higher risk of developing erectile dysfunction over a three-year follow-up period. Results were consistent across subgroups; however, they lacked statistical significance after adjustment for negative outcomes.
Researchers noted that the findings of the target trial emulation suggest that sexual health outcomes must be considered in diabetic men, especially those dealing with type-2 diabetes and undergoing treatment with GLP-1 drugs. These findings also highlight the need for randomised trials with standardised erectile dysfunction assessments to further investigate biological pathways.
Type-2 diabetes can cause the following complications in men:
Modern guidelines recommend women undergo breast cancer risk assessment at 35 years itself. (Photo credit: iStock)
New global guidelines have just been released for breast cancer screening, and they involve the introduction of artificial intelligence in the process. Breast cancer is one of the most commonly diagnosed forms of tumour in women globally. In India, it is the most common form of cancer detected in women living in metro cities. According to the National Comprehensive Cancer Network (NCCN), a non-profit alliance of 33 cancer treatment centres in the US, women aged 35 years and above should be eligible for AI-powered mammogram risk assessment rather than at a later stage.
The NCCN aims to boost the diagnosis rates of breast cancer by paving the way for accurate predictions of risks. This will, over time, help achieve timely screening. As per experts, this change in global breast cancer screening guidelines, especially the integration of AI in the process, marks a paradigm shift—from a detection-first to a prediction-first approach. Historically, mammograms were used after the age of 40 for the detection of existing cancers. The modern guidelines, however, recommend that women get screened from the age of 35 onwards, with AI algorithms used to predict future risks.
Experts say that this shift is important for India. In India, breast cancer is the most prevalent form of tumour among women, and delayed diagnosis is one of the reasons responsible for the current mortality rate. Breast cancer is also often diagnosed late because of the unavailability and limited accessibility of screening facilities. Introducing AI in this process can help bridge the gap in several ways.
Doctors say that the introduction of AI in the breast cancer screening process will help facilitate the identification of high-risk patients, regardless of their family history or the presence of genetic markers. This is important because most cases of breast cancer do not arise from these factors. This helps provide screening in a way that does not require universal testing.
Traditionally, cancer screening largely depends on family history and age. AI, however, can now analyse large volumes of imaging data, clinical history, breast density, and genetic factors for a more personalised approach and targeted diagnostic methods. The adoption of AI-driven risk assessment can help improve patient outcomes, as per doctors.
Women at high risk of breast cancer can make detection easier for themselves by making use of advanced modalities such as MRI. An MIT-developed AI-based breast cancer risk model can detect tumours up to five years in advance using mammographic data alone. This AI-based risk assessment technique has also been recommended by global experts and is published in The Lancet. The study found consistent favourable outcomes.
© 2024 Bennett, Coleman & Company Limited