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.

Eli Lilly has launched Lormalzi, the Indian version of the US FDA-approved donanemab, for the early treatment of Alzheimer’s disease in the country. The drug can also be used for people with mild cognitive impairment and mild dementia.

Dementia affects around 8.8 million people in India, and Alzheimer’s accounts for the majority of cases. The number is expected to nearly double by 2036.

The once-monthly therapy, administered as an intravenous infusion, targets amyloid plaques in the brain and may help slow disease progression in selected patients with mild cognitive impairment or early dementia.

“For 35 years, Lilly has been a global pioneer advancing research of therapies and diagnostics for people with Alzheimer’s disease,” said Winselow Tucker, President and General Manager of Eli Lilly India. He added that Alzheimer’s imposes a major emotional and economic burden on patients, caregivers, and healthcare systems.

What Is Lormalzi?

Lormalzi is a monoclonal antibody therapy designed to target amyloid-beta plaques in the brain — one of the hallmark features associated with Alzheimer’s disease.

The drug works by helping the immune system remove these abnormal protein deposits, which are believed to contribute to memory loss and cognitive decline.

The FDA approved the therapy in 2024 under the brand name Kisunla. Globally, Kisunla is sold in countries including the US, Japan, and parts of Europe.

Lormalzi: Who Can Get The Treatment?

Donanemab is best suited for people with:

• Early symptomatic Alzheimer’s disease
• Mild cognitive impairment (MCI) due to Alzheimer’s
• Mild Alzheimer’s dementia
• Amyloid-positive patients (confirmed by amyloid PET/CSF or blood biomarkers)

It is not meant for those who have already progressed to advanced stages.

Moreover, while the drug can dissolve the build-up of amyloid-beta protein in the brain, it cannot reverse the damage that has already occurred.

Also read: AI Can Fast-track Better Diagnostics, Cure For Alzheimer’s, Says OpenAI’s Sam Altman

Lormalzi: How Much Does It Cost In India?

Eli Lilly has priced Lormalzi at Rs 91,688 for a 350 mg vial in India. Reports suggest the treatment duration may extend up to 18 months, potentially making it expensive for many patients.

Lormalzi’s Safety And Efficacy: Are There Any Side Effects?

Clinical trial data from Eli Lilly’s Phase 3 TRAILBLAZER-ALZ 2 study showed that donanemab slowed cognitive and functional decline.

The study, involving 1,736 patients — 860 of whom received the infusion every four weeks until amyloid clumps cleared — found that donanemab slowed cognitive decline in early Alzheimer’s patients by 35.1 per cent over 76 weeks.

However, the drug is known to cause amyloid-related imaging abnormalities (ARIA), including swelling or bleeding in the brain, most of which are asymptomatic. The study showed that 24 per cent of participants experienced ARIA involving brain swelling, while 19.7 per cent experienced brain bleeds. Three treatment-related deaths were also reported.

Symptoms may include headache, confusion, visual disturbances, and, in rare cases, seizures. Hence, MRI monitoring is essential during treatment.

Notably, the risk may be higher in people with APOE ε4 carriers and patients on blood thinners, Dr. Sudhir Kumar, neurologist at Apollo Hospitals, Hyderabad, shared in a post on social media platform X.

Lecanemab vs Lormalzi

Read More: Another Norovirus Outbreak Confirmed Aboard Cruise Ship In France; Over 1,700 People Trapped

Leqembi (lecanemab) is not yet formally registered or widely marketed for general sale in India. While it is on track for introduction in the country, the Alzheimer’s therapy can reportedly be accessed through specialised import channels (Named Patient Supply) with a valid prescription.

Lecanemab is a disease-modifying therapy for early Alzheimer’s disease, administered via intravenous infusion every two weeks to slow cognitive decline.

In contrast, donanemab is administered once every four weeks.

Additionally, treatment with donanemab can be halted after a certain level of amyloid protein clearance is achieved, with patients in the study switching to placebo thereafter.

“In the absence of amyloid PET imaging, which is currently not available in India, the evidence-based approach is to treat patients with donanemab for 18 months,” the company said.

How Does The Treatment Work?

“Donanemab is a newer anti-amyloid antibody designed to slow progression of Alzheimer’s disease by clearing amyloid plaques from the brain,” Dr. Sudhir said.

He noted that “donanemab represents an important scientific advance because it targets underlying Alzheimer pathology rather than only symptoms”.

According to an Eli Lilly spokesperson, treatment in India is expected to continue for 18 months (76 weeks) in most patients because amyloid PET imaging, often used internationally to assess plaque clearance, is not yet widely available in India.

Treatment may be stopped earlier if:

• Serious safety concerns develop
• Patients experience adverse effects
• The disease progresses to moderate Alzheimer’s disease

Lormalzi: Is It A Cure For Alzheimer’s?

Dr. Sudhir stated that “not all dementia patients benefit”. He added that Lormalzi “is not a cure; it does not reverse established dementia”.

“The benefit is modest, but clinically meaningful in selected patients.” He also stressed the need for carefully selecting patients for the therapy.

“Lifestyle measures, cognitive engagement, vascular risk control, sleep, hearing correction, and caregiver support remain extremely important,” Dr. Sudhir said, adding that “Alzheimer’s care is still much more than a single drug”.

Hot on the heels of the hantavirus outbreak onboard MV Hondius and a norovirus outbreak on a Caribbean cruise, France has now reported another suspected norovirus outbreak and confined more than 1,700 passengers and crew members to a cruise ship docked in Bordeaux.

The Ambition cruise ship, carrying 1,233 passengers — most of them British or Irish nationals — arrived in Bordeaux on Tuesday.

French health officials stated that 80 people had suffered from “symptoms consistent with an acute digestive infection” since Monday, Radio Télévision Suisse reported.

Further tests confirmed that a simple “episode of gastroenteritis” was affecting those onboard.

“The results of the epidemiological analysis and biological samples taken at the Bordeaux University Hospital confirm that this is indeed an outbreak of viral gastroenteritis (norovirus), transmitted from person to person or through the environment. At this stage, no serious cases have been reported,” the Gironde prefecture and the regional health agency (ARS) said in a statement.

Sick Passengers Isolated Onboard

The doctor on board the ship isolated sick passengers in their cabins as soon as they showed symptoms, while the remaining passengers were allowed to move around onboard but were not permitted to disembark at the docks.

The situation was reported Tuesday evening after the ship and its 514 crew members arrived at the port of Bordeaux, where it remains moored in the city center.

Authorities later stated that the “disembarkation ban” affecting passengers and crew since the vessel’s arrival at dawn would be lifted for asymptomatic individuals. However, those who are ill must remain in isolation.

On Monday, “digestive symptoms appeared” while the ship was stationed in Brest, said Dr. Karim Tararbit, medical adviser to the ARS, during a press briefing.

Also Read: Why The Norovirus Outbreak On A Caribbean Cruise Ship Is Not A Cause for Panic

Passenger Death Reported

According to the Grand Port Maritime de Bordeaux, the body of the deceased is being kept onboard “in accordance with the provisions of international conventions”.

What Does The Cruise Operator Say

“We would like to reassure guests that we take any illnesses aboard our fleet extremely seriously. Enhanced sanitation and prevention protocols were immediately implemented across the ship in line with established public health procedures following the initial reports of illness,” the cruise operator said in a statement.

“The comprehensive health and safety measures introduced include increased cleaning and disinfection in public areas, assisted service in selected dining venues, and ongoing guidance to guests regarding hand hygiene, including regular hand washing, use of hand sanitizers, and prompt reporting of any symptoms to the onboard medical team.”

The company added that medical consultations related to gastrointestinal illness were being provided free of charge.

Authorities in Bordeaux requested a routine review of the ship’s health status and records, the operator said, adding that a specialist medical team and sanitation consultants had also been dispatched to the vessel.

Norovirus Case On Caribbean Cruise

Last week, a cruise ship sailing from Florida with over 3,000 passengers reported a major norovirus outbreak, affecting more than 100 passengers and crew members who fell ill with vomiting and diarrhea. as the cause.

According to the cruise operator Princess Cruises, enhanced cleaning protocols were implemented immediately after the outbreak was detected. Sick passengers and crew were isolated, and hygiene measures across dining and public areas were intensified.

Read More: India Better Prepared For Hantavirus Outbreaks After COVID-19 Experience, Says Dr NK Ganguly | Exclusive

What Is Norovirus?

Norovirus is a highly contagious virus that causes gastroenteritis, leading to inflammation of the stomach and intestines.

Speaking to HealthandMe, epidemiologist Dr. Amitav Banerjee, professor at DY Patil Vidyapeeth, Pune, described the norovirus as “notorious because it spreads very fast”.

“It can spread through fomites like handles and knobs, and even a very low infectious dose — around 18 viral particles — can cause infection. So it spreads very fast,” he said.

Norovirus illnesses usually last between two and three days. Symptoms usually begin suddenly within 12 to 48 hours of exposure and may include:

• Nausea
• Vomiting
• Watery diarrhea
• Stomach cramps
• Low-grade fever
• Headache and body aches
• Fatigue

What You Can Do To Stop Its Spread

Because of how fast viruses spread, experts highly recommend preventive actions such as:

• Wash your hands frequently with soap and warm water, especially after using the toilet or before preparing food.
• Avoid visiting hospitals or care homes if experiencing symptoms.
• Stay home for at least 48 hours after symptoms subside to prevent spreading the virus.

Amid the scare of hantavirus infection, US health officials informed that they are investigating a potential case in an Illinois resident.

The Illinois Department of Public Health (IDPH) noted that the incident is not linked to the MV Hondius cruise ship outbreak.

MV Hondius had 18 American nationals, and all have been medically evacuated back to the US. While 16 people are in Nebraska at the nation's only national quarantine unit, two people are being monitored in Atlanta.

In a statement, the IDPH said that the person “lives in Winnebago County, has not travelled internationally, and has not come in contact with individuals associated with the MV Hondius outbreak”.

Officials suspect that the possible hantavirus infection in the Illinois person to be a case of the North American strain of the virus while cleaning a home where rodent droppings were present.

“Unlike the Andes strain of Hantavirus responsible for the cruise outbreak, the North American strains are not known to spread from person to person. The risk of contracting Hantavirus of any kind remains very low for Illinois residents,” the officials said.

However, they added that the CDC is conducting additional testing to confirm that the resident is positive for Hantavirus. CDC staff told IDPH its confirmatory test result could take up to 10 days to complete.

Hantavirus Cases In The US

Excluding this latest potential case, Illinois has had 7 positive cases of Hantavirus since 1993, most recently in March 2025.

Since surveillance began in 1993, the US has recorded 890 cases of Hantavirus over 30 years (1993-2023)

The Hantavirus strain most commonly seen in the US is caused by exposure to rodent droppings and is NOT contagious from person to person.

The rodent species (long-tailed pygmy rice rat) known to carry the Andes strain of the virus in South America does not live in the U.S.

First Case Of Hantavirus Diagnosed In Israel

Also read: Donald Trump Says Hantavirus Is 'Under Control'; Questions Grow Over CDC Research Cuts

Earlier, a case of hantavirus was also reported from Israel, that was not linked to the MV Hondius ship.

The case in Israel, reported by the local newspaper Maariv, is believed to have been infected during a stay in Eastern Europe several months ago. It is reportedly not linked to the ongoing outbreak linked to the MV Hondius cruise ship in the Atlantic Ocean.

The patient underwent an antibody test after the symptoms appeared, which showed exposure to hantavirus, the report said. A PCR (polymerase chain reaction) test was then conducted to detect the virus’s genetic material, confirming the infection, the report said.

The patient was said to be in stable condition, not in need of intensive care or strict isolation, and was being kept under medical observation.

Details about the patient and the medical center where the diagnosis was made could not yet be published, but have been reported to the country's Health Ministry.

Will Hantavirus Become A Public Health Threat?

Also read: Fact Check: Can Ivermectin Help Treat Hantavirus?

Hantavirus is primarily transmitted through contact with infected rodents or exposure to their urine, droppings, and saliva, though rare cases of person-to-person transmission have also been reported.

According to the World Health Organization (WHO), 11 cases — including three deaths — have been confirmed so far. However, additional suspected and confirmed cases are continuing to emerge across countries.

“At the moment, there is no sign that we are seeing the start of a larger outbreak,” said Tedros Adhanom Ghebreyesus, WHO Chief, in the latest media briefing.

However, he said that the situation could still change.

“Given the long incubation period of the virus, we might see more cases in the coming weeks,” he said.