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.

With H1N1 outbreak expanding in Delhi, India is witnessing an overwhelming increase in seasonal influenza cases. To compound to the public health issue, the flu vaccine that best matches the viruses currently circulating in the country is facing a supply shortage.

Therefore, the Indian Council of Medical Research (ICMR) has advised that another seasonal influenza vaccine can be used temporarily until the one preferred becomes available again.

The ICMR recommendation comes after influenza surveillance found that viruses circulating in India have a closer match with the strains included in this year’s Northern Hemisphere (NH) vaccine.

However, the Southern Hemisphere (SH) vaccine, which is available in India, can still provide protection against several viruses circulating in the country.

Why Is There A Shortage Of Flu Vaccine In The First Place?

According to ICMR, the NH vaccine would be the ideal choice because its composition closely matches the influenza viruses currently detected in India.

ICMR said, “Since the surveillance data indicates close resemblance of the circulating influenza strains in India with the Northern Hemisphere recommendations of WHO, it would be ideal to administer the NH vaccine.”

“However, in view of non-availability of NH vaccine, the available SH vaccine may be used, and SH vaccine be replaced with NH vaccine as soon as it becomes available,” it added.

According to several reports, the shortage is starting to affect hospital supplies, including government supply of the preferred vaccine.

The surge in demand, production timelines, limited imports and redistribution of vaccines globally could be the factors driving the shortage currently.

Also read: ICMR Study Shows Pune Dengue Mosquitoes Resistant To Insecticides: What It Means for Public Health

Does The Available Southern Hemisphere Vaccine Protect Against H1N1?

The current H1N1 virus circulating in India can be tackled by both the NH and SH vaccines. The difference is primarily in the strains of the other influenza viruses they target, particularly H3N2 and influenza B.

ICMR surveillance has detected H1N1, H3N2 and influenza B viruses circulating in India. The NH vaccine contains versions of H3N2 and influenza B that more closely match the strains currently being detected.

India's National Centre for Disease Control has also previously advised that when the latest recommended seasonal formulation is unavailable, the latest available trivalent or quadrivalent influenza vaccine may be used.

Also read: 98 Years After Penicillin, Are We Running Out Of Effective Antibiotics?

Should You Wait For The Preferred Vaccine?

People who are at higher risk of severe influenza, doctors say that said it may not be necessary to remain unvaccinated while waiting for the NH vaccine.

These include older adults, young children, pregnant women and people with chronic illnesses or weak immune system. Influenza can cause complications like pneumonia and can worsen existing medical conditions in vulnerable people.

HealthandMe spoke to Dr. Divya K S, Infectious Disease Specialist at Apollo Hospitals, Seshadripuram, Bangalore, about the efficacy of SH vaccine on H1N1. The doctor also explained if one should wait for NH vaccine.

The doctor explains, “People should take the Southern Hemisphere vaccine which is available for now rather than wait. Because waiting now means leaving people with no protection at all while active flu season is on. Bothe the vaccines do have some components in common. So taking the SH vaccine does give protection

The expert also clarified if SH vaccine offers complete adequate coverage on current H1N1 strain.

She added, “On H1N1 specifically, the SH vaccine offers full expected protection, because the H1N1 strain — A/Missouri/11/2025-like virus — is identical in both the NH and SH formulations this season. it is H3N2. B/Victoria strains that are different from the NH vaccine.”

India's influenza surveillance network continually tracks circulating strains and helps determine which vaccine is likely to offer the best match. This year's ICMR assessment is why the NH formulation is preferred, but the SH vaccine still remains a practical alternative while supplies are limited. Experts recommend taking it instead of staying unprotected.

One of the most effective ways to prevent rabies deaths could be by vaccinating dogs rather than just people before they are bitten. A new study published in The Lancet Regional Health – Southeast Asia modelled different strategies in Kerala for eradicating human rabies deaths between 2026 and 2035.

The study found that mass vaccination of dogs could bring the annual rabies deaths among people in Kerala close to zero within about three years even if 70% of the dog population were vaccinated.

On the other hand, vaccinating children before exposure to rabies was projected to prevent relatively few additional deaths at substantially higher cost.

India carries one of the worst largest rabies burdens. That's why the study could point towards a feasible and practical solution to eradicate the deadly infection.

Could Vaccinating Dogs Help?

Most human rabies deaths in India are linked to bites from infected dogs. This means that the disease can be tackled at its source by reducing transmission among dogs.

India records an estimated 9.1 million animal bites every year, with more than three-quarters caused by dogs. A 2024 estimate from the Indian Council of Medical Research's National Institute of Epidemiology estimates India's annual human rabies deaths to be about 5,726, which is an alarming public health issue.

The study puts emphasis on the fact that vaccinating a person after a bite protects that individual, whereas, vaccinating dogs reduces the probability that an infected dog will transmit rabies to many people in the first place.

Also read: Bhutan Eliminates Rabies While India Battles Persistent Deaths: What Can India Learn From Its Neighbour?

About The Study

Researchers from the University of Glasgow, Kerala's health and animal-husbandry departments, Kerala University of Health Sciences and the London School of Economics and Political Science used mathematical modelling to compare different strategies to combat rabies in Kerala.

One strategy was routine pre-exposure prophylaxis (PrEP) for children. Another focused on mass dog vaccination, while the model also considered improvements to post-exposure prophylaxis (PEP), the treatment given after a potentially rabid bite.

The researchers found that adding routine childhood PrEP provided minimal additional protection, preventing fewer than 10 deaths on average over a decade, while costing considerably more than strategies focused on controlling rabies transmission among dogs.

The model estimated that achieving 70% vaccination coverage among dogs could reduce annual human rabies deaths in Kerala to near zero within approximately three years.

Also read: Abhayrab Rabies Vaccine Batch Found Misbranded, ‘Not Of Standard Quality’: DCGI Alerts States

India's Alarming Rabies Situation

One of the study's striking findings was about the size of Kerala's stray-dog population. The researchers' modelling suggested that the state's actual stray-dog population could be around five times higher than official census estimates.

If vaccination programmes are based on an underestimated dog population, authorities could believe they have reached adequate coverage while a large proportion of dogs remain unvaccinated. That creates what epidemiologists call an immunity gap, allowing rabies transmission to continue.

Additionally, dog vaccination does not make human post-exposure treatment unnecessary. If a person is bitten or scratched by an animal that could have rabies, the wound should be washed thoroughly with soap and running water and medical care should be sought immediately.

Depending on the exposure, PEP can include rabies vaccine and rabies immunoglobulin (RIG). This is particularly important because rabies becomes extremely difficult to treat once symptoms begin.

The study also found that improving timely access to PEP could prevent more deaths than expanding routine pre-exposure vaccination of children.

The death of Lady Joan Branson, wife of billionaire entrepreneur Sir Richard Branson, has highlighted the risk of a blood clot after fractures that travels to the lungs.

Lady Branson, 80, died at Lister Hospital in London in November 2025 after being admitted following a fall at her home on Necker Island. An inquest heard that she had developed a deep vein thrombosis (DVT) and subsequently suffered a massive pulmonary embolism (PE).

The coroner, Professor Fiona Wilcox, concluded that her death could probably have been prevented if anti-clotting treatment had been given earlier. She said: “If this lady had been given [anti-clotting medication] early on ... her death, on the balance of probability, would have been prevented.”

What exactly happens after a fracture that can make a blood clot so dangerous?

Fracture Increases The Risk Of Blood Clots

A fracture can trigger several conditions that encourage the development of venous thromboembolism (VTE), the collective term for DVT and PE.

First, injury itself activates the body's clotting system. The body naturally increases clot formation after tissue damage to prevent bleeding.

Second, a person with a fracture may become significantly less mobile. When the leg muscles are not moving normally, the muscle pump that helps push blood through the veins becomes less effective. Blood can therefore pool in the deep veins, particularly in the legs. Hospitalisation, surgery, older age, previous blood clots and certain medical conditions can add further risk.

A clot that remains in a leg vein can cause swelling and pain. But when part of it breaks and gets away, it can travel through the bloodstream to the lungs, leading to a pulmonary embolism.

Also read: 9/11 Toxic Air Exposed Thousands: What New Records Reveal 25 Years Later

How Does A DVT Become A Pulmonary Embolism?

A clot forming in a deep vein, usually in the leg, can detach and travel through the veins into the right side of the heart. From there, it can enter the pulmonary arteries, which carry blood to the lungs.

If the clot is large enough, it can obstruct blood flow through the lungs and suddenly increase pressure on the right side of the heart.

A large or massive PE can therefore cause severe breathlessness, low blood pressure, cardiac arrest and sudden death.

This is why PE can sometimes appear dramatically, even when the original DVT produced few obvious symptoms.

Also read: Small-Cell Lung Cancer Is One Of The Hardest Cancers To Treat: What This New Drug Combination Could Change

Could Blood-Thinning Medication Have Prevented Lady Branson’s Death?

According to the inquest, Lady Branson had a history of blood clots dating back to 2010, and doctors heard evidence that she had previously used anti-clotting injections.

However, she was not given enoxaparin, a low-molecular-weight heparin commonly used to prevent or treat harmful blood clots, during her hospital stay.

One doctor, Dr Inaki Bovill, told the inquest that a venous thromboembolism risk assessment should have been carried out and that the medication should have been prescribed. He said: “It is to my great regret that I did not.”

Another doctor, Dr George Adams, a consultant haematologist at Imperial College London, told the inquest that earlier anticoagulation would have made cardiac arrest less likely in her particular case.

Lady Branson's daughter, Dr Holly Branson, disputed the suggestion that her mother had refused the injections because of previous pain or bruising. She told the inquest that this was “not consistent with my knowledge of her usual practice or attitude.”

What Are The Warning Signs Of A Blood Clot?

A DVT can cause:

• Swelling, usually in one leg
• Pain or tenderness in the calf or thigh
• Warmth or redness over the affected area

A PE may cause:

• Sudden unexplained breathlessness
• Chest pain, particularly pain that worsens when breathing
• Rapid heartbeat or breathing
• Coughing up blood
• Dizziness, fainting or collapse