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.

When it comes to weight loss, many try their own ways to drop the extra kilos. While portion control is advised, there are many who turn to starvation just to drop the extra kilos. In 2016, Japanese scientist Yoshinori Ohsumi won the Nobel Prize for his findings on autophagy. These findings facilitated a better understanding of conditions like dementia and Parkinson's disease. Autophagy refers to natural regeneration, which occurs at a cellular level. It reduces the chances of contracting diseases while also increasing lifespan.

Since then, drugmakers have been working towards coming up with a drug that can stimulate the process; wellness and diet experts have been willing to find a way to naturally induce the process by restricting carbs, fasting, and engaging in high-intensity exercise.

What do scientists have to say?

Experiments were also conducted on mice, and it was found that the ones who were put on genetic tools, fasting, or drugs had a tendency to live longer and remain in better overall shape. However, it is still unclear how the same effect can be replicated in humans. In mice, for instance, the effects of fasting on the brain are evident within 24 hours. In other body parts, such as the liver, the effects occur more quickly. Despite knowing that fasting is good for health, experts are unsure about the ideal duration of fasting for maximum health benefits. Researchers say that fasting does not induce autophagy, but it does have other health benefits.

What is autophagy?

Autophagy is derived from "self" and "phagein," which means "to eat." The process involves cells degrading and recycling their components. It provides fuel for energy and building blocks for cell renewal. Post-infection, it can destroy viruses and bacteria. Cells use the process to get rid of damaged organelles and proteins, and it helps counteract the adverse effects of ageing.

Autophagy was discovered in the 1960s, but its importance was recognised after Yoshinori Ohsumi's research. Researchers said that what they discovered protected against diseases like Huntington's, Parkinson's, and some forms of dementia. It also seemed beneficial in the context of infection control, along with protecting against excessive inflammation. New lifestyle books now suggest that the process can be switched on by making changes to diet and lifestyle or by observing a fast.

The impact on muscle mass

A book titled Glow 15 by Naomi Whittel shares a 15-day programme including 16-hour fasts three times a week. It shares a plan that reduces protein intake on some days, involves eating carbs later, and combines all this with high-intensity exercise. In the basic tests themselves, volunteers at Jacksonville University in Florida experienced several health benefits. Some of the participants lost about 3.5 kilos in 15 days. Others saw improvements in lean muscle mass, blood pressure, and a reduction in fine lines. Researchers said that none of these changes could cause harm to health.

Is fasting safe for all?

Researchers note that fasting too much is not a good idea for anyone. Before making drastic or major changes to lifestyle or diet, it is advised to check with a doctor first. Experts look at autophagy with optimism, and studies show that proteins together form clumps in the nerve cells of Alzheimer's and Parkinson's patients.

Amid the rising concern over GLP drugs and their rampant misuse, India is set to tighten regulations around them.

The government is also trying to find out the potential side effects of using the drug. The authorities have instructed the citizens, especially the consumers and medical professionals, to report if they observe any negative reaction with the usage of any GLP-1 drugs, including semaglutide.

In India, there is a strict policy regarding drug standards. The Indian Pharmacopoeia Commission (IPC), an apex body under the health and family welfare ministry, is the organization that regulates drug standards.

Recently, the IPC issued a public notice for observing the safety of glucagon-like peptide-1 (GLP-1) drugs, including popular semaglutide, dulaglutide, liraglutide, and tirzepatide, the Mint reported.

Notably, Indian regulatory authorities, including the health ministry, the IPC, and the Central Drugs Standard Control Organisation (CDSCO), are making enormous efforts to monitor the potential risks of these weight loss medications.

As part of this, the IPC and other bodies are calling for post-marketing surveillance to ensure patient health, identify any previously undocumented side effects, and create a safety net for the citizens.

According to the Mint report, the IPC said in the document, “Apart from semaglutide, any adverse event caused by other GLP-1 receptor agonists (such as dulaglutide, liraglutide, tirzepatide) should also be reported to the PvPI – Pharmacovigilance Programme of India.”

The patients, consumers, and medical professionals can report adverse events (AE) and adverse drug reactions (ADRs) to ARD monitoring centres.

In addition, ADR forms are also available on the IPC website, and there is a toll-free number of 1800-180-3024. The mobile app ADR PvPI 2.0 is easily available on the Google Play Store and the ADRMS software.

Also Read: GLP-1 Drugs: Why India Needs Stricter Rules Now

What is the GLP-1 Drug Mainly Used For?

The GLP-1 drugs are a popular genre of medication that mimics the original GLP-1 hormone in the human body and is responsible for controlling blood sugar, slowing digestion, and increasing feelings of fullness. Several big names fall under the GLP-1 drug category, like semaglutide, dulaglutide, liraglutide, and tirzepatide.

What Are The Side Effects Of GLP-1 Drug?

There are several possible side effects related to the use of the GLP-1 drug:

• One of the most common side effects is vomiting and nausea.
• This medication can also cause general digestive disruption, thus causing diarrhoea or constipation.
• Some other possible side effects include fatigue, headaches, abdominal pain, bloating, and decreased appetite.
• In some rare cases, gastroparesis, pancreatitis, and thyroid C-cell tumors.

Spain’s Health Ministry has confirmed a hantavirus case in a person evacuated from the MV Hondius cruise ship and currently under medical quarantine in Madrid, taking the total number of cases to 13.

According to the ministry, this is the second hantavirus case among Spaniards who remain in quarantine at the Gómez Ulla Central Defence Hospital in Madrid. Around 12 people continue to remain under medical quarantine.

Hantavirus Detected During Routine PCR Testing

The new positive case involves one of the individuals identified as a close contact of the initial outbreak, who was already in isolation and under medical supervision in accordance with protocols established by the Early Warning and Rapid Response System. Health authorities said the case was detected during routine PCR testing and does not pose an increased risk to the general population, Euronews reported.

The remaining 12 Spaniards continue to stay in quarantine and under medical observation, while authorities maintain isolation measures until the 42 days outlined in international protocols have elapsed.

Also read: WHO Chief Warns Ebola Epidemic ‘Outpacing Us’; India Intensifies Screening At Airports

Hantavirus Outbreak Remains Stable: WHO

The new case comes after Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, stated during the 159th session of the Executive Board that no new deaths and infections linked to the rat-borne virus have been reported.

“The hantavirus outbreak is now stable, with one new case in the past two weeks, and no new deaths since May 2,” he said.

According to the WHO, the outbreak has resulted in 12 total cases, including 10 confirmed and two probable infections, along with three deaths.

“All passengers and crew remain in quarantine and under close monitoring to ensure they receive care if needed,” Tedros added.

Passengers And Crew Still Under Monitoring

All passengers have now been repatriated and will remain under monitoring until the quarantine period ends on June 21. Crew members will remain in quarantine until June 29.

A Dutch couple is believed to have first been exposed to the virus while visiting a birdwatching site in Argentina.

“There is no sign that we are seeing the start of a larger outbreak. But of course, that could change, and we urge all affected countries to continue monitoring the passengers and crew carefully. I thank the many countries involved in the response,” Tedros said.

What Is Hantavirus?

As per the WHO, hantaviruses are zoonotic viruses that naturally infect rodents and are occasionally transmitted to humans.

Globally, an estimated 100,000 to 200,000 hantavirus infections occur each year. The majority of these cases are in Asia, particularly China. Most are sporadic or occur in small clusters, linked to contact with infected rodents.

Infection in people can result in severe illness and often death, although the diseases vary by type of virus and geographical location.

The WHO has confirmed that the Andes strain of hantavirus — the only strain known to spread from person to person — is responsible for the outbreak. There is currently no vaccine available for the strain.

Notably, the WHO has not specified the type of hantavirus or syndrome in the cruise incident, but did mention respiratory risks.

The hantavirus is primarily spread by rodents through

• exposure to their urine,
• droppings,
• saliva,
• less commonly through a scratch or bite.