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.

US President Donald Trump has signed an executive order aimed at changing childhood vaccine recommendations, including moving toward separating the measles, mumps and rubella (MMR) vaccine into individual shots.

The executive order, titled “Delivering Gold Standard Childhood Vaccine Recommendations for Americans,” has sparked debate over how childhood vaccines should be administered and whether combination vaccines should instead be given separately.

Amid criticism of the move, HealthandMe spoke to public health experts to understand whether splitting the MMR vaccine offers any proven health benefit and what it could mean for children and vaccination coverage.

What Does Splitting MMR Mean?

Dr. Sabine Kapasi, Global Health Strategist and a UN Advisor, told HealthandMe that combination vaccines are more than a matter of convenience.

“Combination vaccines are not simply a matter of convenience. They can reduce the number of injections and healthcare visits required, support timely vaccination and help health systems reach children who may otherwise be missed,” she said.

“The more fragmented the pathway becomes, the more important it is to understand its impact on uptake, completion and equity,” Dr. Sabine added.

Dr. Rajeev Jayadevan, former President of IMA Cochin and Convener of the Research Cell, Kerala, also highlighted the practical disadvantage of requiring parents to make additional clinic visits when vaccines that can be administered together are separated.

Is Splitting MMR Healthier?

There is currently no adequate scientific validation for the argument that giving the MMR components separately is inherently healthier, according to Dr. Rajeev.

“The argument that splitting the shots is a healthier option does not have adequate scientific validation, because the body’s immune system routinely encounters numerous antigens simultaneously and effectively in everyday life,” he told HealthandMe.

Dr. Sabine emphasized that any change to childhood immunization policy should be based on evidence rather than simply altering an established schedule.

“Any change to childhood immunization policy should therefore be grounded in transparent evidence, rigorous safety and effectiveness assessment, and real-world data on vaccination coverage and completion,” she added.

Could More Vaccine Visits Increase Hesitancy?

Separating combination vaccines could make vaccination more cumbersome for families by requiring additional visits.

Dr. Sabine said vaccination programs operate within different health systems, meaning even small changes in scheduling can have implications for access, logistics, costs and continuity of care.

“The priority should remain consistent: designing immunization systems that are evidence-led, accessible and resilient enough to protect children across populations—not simply changing the schedule for the sake of changing it,” she said.

In a post on X US Senator Bill Cassidy, a physician, also criticized the executive order and warned that breaking up combination vaccines could mean children need more shots to receive the same protection.

“It will increase hesitancy and make children less safe,” he said, urging parents to discuss vaccination decisions with their child’s pediatrician.

Former White House COVID-19 Response Coordinator Dr. Ashish Jha said European countries do not routinely split the MMR vaccine into three separate shots. “No European country splits the MMR vaccine as 3 separate shots,” he said in a post on X.

He added that Russia and Tajikistan were historical partial exceptions but have since moved to full MMR vaccination.

Are There Any Potential Advantages?

Dr. Rajeev said one potential advantage of the new approach is the separation of vaccines into essential and optional categories.

He said this could give parents greater clarity about which vaccines are considered the highest priority and potentially help address some forms of vaccine hesitancy. The expert also pointed to US policy around childhood COVID-19 and influenza vaccines, saying that making these vaccines a shared decision between doctors and parents could be viewed as a progressive step.

Dry or burning eyes are often brushed aside as side effect of ageing. But new research suggests that for postmenopausal women, the problem may be more than just eye irritation.

A recent study in Post Reproductive Health found that postmenopausal women had more severe signs of dry eye disease (DED) than both younger women and men in the same age range.

Researchers say the condition is caused largely by tear-film instability and dysfunction of the meibomian glands, the tiny glands in the eyelids that produce the oily layer of tears.

The study included 319 participants: 102 postmenopausal women, 105 age-matched men and 112 younger healthy women.

Researchers assessed symptoms, tear production, tear-film stability, damage to the eye surface and meibomian gland function.

Postmenopausal women had the highest rate of severe dry eye, affecting 24.5%, compared with 16.2% of age-matched men and 18.8% of younger women.

They also had higher scores for dry-eye symptoms, more straining of the of the ocular-surface, shorter tear-break-up time and greater meibomian gland dysfunction. 20.6% of postmenopausal women reported burning.

Effect Of Menopause On Eye Health

Also read: Experimental Menopause Drug Shows Promise Mid-Stage Trial, Reduces Hot Flashes By 83%

The connection between eyes and menopause lies in the significant hormonal changes women face as they enter menopause.

The ocular surface, lacrimal glands and meibomian glands are affected by sex hormones, including oestrogen and androgens. When hormone levels change during and after menopause, these tissues may also function differently.

One of the important consequences of menopausal hormonal shifts is the disruption of the tear film. The tear film is like a thin protective coating over the eye. It contains an oily outer layer that slows evaporation. The meibomian glands produce this oil.

When these glands do not work properly, tears can evaporate too quickly. Doctors call this condition evaporative dry eye.

Dry Eye Does Not Mean The Eyes Have Stopped Producing Tears

Also read: Post-Menopausal Women Face A Higher Risk Of Fatty Liver Disease: How Falling Oestrogen Levels Impact Liver Health

Dry eye does not necessarily mean the eyes have stopped producing tears. In many postmenopausal women, the tears may not remain stable on the eye for a long time.

As the oily layer becomes impaired, tears evaporate faster. This can increase tear concentration, trigger inflammation and damage the ocular surface, creating a cycle of dryness and irritation.

Hormonal changes during menopause may contribute to this process, although researchers are still working to understand exactly how individual hormones influence dry eye.

A 2026 review also highlights increasing evidence that hormonal changes may interact with immune and inflammatory pathways on the ocular surface, rather than simply reducing tear production.

What Symptoms Should Postmenopausal Women Watch For?

Persistent burning, itching, grittiness, redness, light sensitivity, watery eyes or fluctuating vision can all occur with dry eye disease.

The latest study also found that clinical signs of disease were more severe in postmenopausal women even though symptom scores did not always differ significantly from other groups. This finding makes eye examinations particularly important during and after menopause.

The researchers concluded that recognising these differences could improve diagnosis and help doctors better understand the hormonal contribution to dry eye disease.

About one in 20 adults in the US hospitalized with firearm injuries develop bacterial infections, according to a study.

The findings, published in JAMA Network Open as a research letter, showed that most infections occur during the initial hospitalization rather than after patients return home.

While firearm injuries are a major public health concern in the US, very little research has examined infectious complications that can occur after treatment.

"Firearm injury is a recognized risk for bacterial infection, but no large studies have described how often such infections occur and which patients are most at risk," said Jonathan D. Baghdadi, associate professor of epidemiology and public health at the University of Maryland School of Medicine (UMSOM).

Most Infections Emerged Early

To better understand the risks after gunshot injuries, researchers analyzed data from 24,024 adults hospitalized with firearm injuries at 323 hospitals across the country between January 2019 and May 2021.

The study found that 1,236 patients—about 5%—developed a bacterial infection. Most cases occurred during the initial hospitalization, with only 1.3% occurring during the 90-day follow-up period.

Researchers also found that patients who underwent surgeries involving the head, neck, spine, liver or lower abdomen faced the highest risk of developing bacterial infections.

Who Faced the Greatest Risk?

The risk was more common among patients undergoing head, neck, spine or lower-abdominal surgery were especially vulnerable to bacterial infections.

The team found that most commonly identified pathogens patients were Escherichia coli, Staphylococcus aureus and enterococci. These pathogens are known to acquire dangerous resistance, creating major challenges in hospitals and communities worldwide

Antibiotic exposure among patients who did not develop infections was generally low, which researchers said reflects current recommendations to limit preventive antibiotic use when there is no bacterial infection.

Bacterial infection was not independently linked to a higher risk of death among patients who survived at least one night in the hospital.

Study Limitations

The authors noted that the research relied on administrative hospital data and that complete follow-up information may not have been available for every patient.

Nonetheless, the large national dataset provided an opportunity to evaluate infection risk across a broad and diverse patient population.

"Recovery from firearm injuries can be complicated. Although our study focused on mortality, infections can impact recovery in multiple ways, contributing to long-term pain and disability," Baghdadi said.

"By identifying the patients most likely to develop these complications, we hope this work contributes to more informed clinical decision-making and ultimately better outcomes for patients."

Baghdadi hopes that by developing a definition to identify patients with bacterial infection after firearm injury using observational and administrative datasets, and demonstrating how to apply it, other researchers will use the approach to conduct studies targeting more specific clinical questions.