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.

The currently used breast cancer screening referral criteria at the NHS are missing up to 95% of women under 50 who are at higher risk of developing breast cancer in the next decade, according to a new study.

Published in the British Journal of Cancer, the study found that a more comprehensive, personalized risk assessment could identify 8 times as many women at risk as the current NICE guidelines.

Current Screening Criteria

In England, women at higher risk of breast cancer are typically identified after being referred by their GP based on family history, following criteria set by the National Institute for Health and Care Excellence (NICE), under the NHS.

The researchers from the University of Cambridge and The Institute of Cancer Research, London, analyzed data from 1,258 women under the age of 50.

They found that the criteria would refer only 1.4% of women for specialist assessment and identify just 4.4% of women who went on to develop breast cancer within the next 10 years.

Why Personalized Assessment Is Better?

The researchers then evaluated BOADICEA, a multifactorial risk model that combines:

• Family history
• Lifestyle factors
• Reproductive history
• Genetic information

Using this model, 26.5% of women were classified as having above-average risk and referred for further assessment. This approach identified 34.8% of women who developed breast cancer within the following 10 years—around eight times more than the current NICE criteria.

One major reason for the gap is that 73% of women under 50 who developed breast cancer had no family history of the disease, making them unlikely to qualify for referral under existing guidelines.

"We need to get better at identifying women at highest risk of breast cancer so that we can intervene early, when there are more options for treating, or even preventing, their disease," said Dr Juliet Usher-Smith from the Department of Public Health and Primary Care at the University of Cambridge.

Proactive Screening Matters

A second study by the same research team found strong public support for proactive breast cancer risk assessments for women aged 30 to 49, instead of relying on women to seek GP referrals because of family history.

They found that women preferred:

• Proactive invitations for risk assessment
• Comprehensive risk models such as BOADICEA
• Genetic testing where appropriate
• Assessing all women rather than only those with a family history

Dr Sowmiya Moorthie, Senior Strategic Evidence Manager at Cancer Research UK, said broader risk assessment could help more women receive personalized care. However, she noted that further research is needed to understand the impact on NHS staffing, equipment, and patient experience, while ensuring any new approach remains accessible and equitable.

She also emphasized that maintaining a healthy weight, limiting alcohol intake, and seeking medical advice for any unusual breast changes remain important ways to reduce risk and improve outcomes through early diagnosis.

Global Breast Cancer Burden

Breast cancer is the most common cancer worldwide, with steady increases in incidence over the last few decades. It accounts for around one in four cases of cancer and 15 per cent of cancer deaths in women, and is one of the leading causes of death in women under 50.

Breast cancer is the most common cancer in the UK, with around 59,400 new cases diagnosed annually and roughly 11,200 deaths each year. About one in seven women in the UK develops the disease in their lifetime, though survival rates are high, with nearly 90% surviving for five years or more.

Health officials in New York have reported at least three suspected cases of tularemia, a rare bacterial illness also known as rabbit fever.

The disease can spread through the bite of infected ticks or deer flies, or through contact with infected animals, particularly rabbits and rodents.

The Suffolk County Department of Health said laboratory testing is required to confirm the suspected cases, a process that may take several weeks.

"Confirmation of a tularemia diagnosis requires a combination of laboratory testing and fulfillment of specific clinical or epidemiologic criteria," the department told ABC 7, New York.

"The laboratory testing to confirm a tularemia diagnosis may take several weeks."

Tularemia Cases in the US

Tularemia is most commonly reported between May and September, according to the US Centers for Disease Control and Prevention (CDC).

Fewer than 200 cases are reported annually in the US, based on CDC data from 2019 to 2023. Although still rare, reported cases have been increasing.

In Suffolk County, Long Island:

• 4 cases were reported in 2024
• 3 cases in 2023
• 1 case in 2022

What Is Tularemia?

Tularemia is a rare but potentially serious bacterial infection caused by Francisella tularensis, according to the CDC.

The disease can affect the skin, lymph nodes, eyes, throat, lungs, and other organs depending on how the bacteria enter the body.

Rabbit Fever: How Do Humans Get Infected?

People can become infected through:

• Bites from infected ticks and deer flies
• Direct contact with infected rabbits, hares, rodents, or other animals
• Handling infected animal carcasses
• Inhaling contaminated dust, such as while mowing over dead infected animals
• Eating contaminated food
• Getting contaminated water or animal fluids into the eyes.

According to the CDC, the case fatality rate is typically below 2%, though it can be higher depending on the bacterial strain and type of illness.

Types of Tularemia

There are six main forms of tularemia:

• Ulceroglandular tularemia: The most common type; causes a skin ulcer and swollen lymph nodes after a tick bite or contact with an infected animal.
• Glandular tularemia: Causes swollen lymph nodes without a skin ulcer.
• Oculoglandular tularemia: Occurs when contaminated material enters the eyes.
• Oropharyngeal tularemia: Results from eating contaminated food or water, causing sore throat and digestive symptoms.
• Pneumonic tularemia: Affects the lungs and can resemble pneumonia.
• Typhoidal tularemia: A severe form that causes high fever and widespread illness.

Symptoms

Symptoms vary depending on the type of infection but commonly include:

• High fever
• Skin ulcer or open sore
• Swollen, painful lymph nodes
• Watery or irritated eyes
• Sore throat
• Cough
• Muscle aches
• Loss of appetite
• Vomiting or diarrhea

Because tularemia is rare, it can be difficult to diagnose, and its symptoms often resemble more common illnesses.

Treatment

Tularemia is highly treatable with antibiotics when diagnosed promptly.

The CDC noted that a vaccine previously used to protect laboratory workers is currently under review by the US Food and Drug Administration and is not generally available.

How to Prevent Tularemia

The CDC recommends the following precautions:

• Use EPA-registered insect repellents containing DEET, picaridin, IR3535, Oil of Lemon Eucalyptus (OLE), PMD, or 2-undecanone.
• Wear long sleeves, long pants, and long socks in areas where ticks and deer flies are common.
• Remove attached ticks promptly.
• Avoid mowing over sick or dead animals.
• Wear gloves when hunting, trapping, or skinning wild animals.
• Cook game meat thoroughly before eating.

The Philippines has launched a fresh measles-rubella vaccination campaign in Eastern Visayas, aiming to vaccinate more than 445,000 children aged six to 59 months.

The intensified Measles-Rubella Supplemental Immunization Activity (MR-SIA) will run from August 10 to 28, with support from local governments, schools, community health workers and barangay officials.

The campaign comes as the country continues to recover from years of declining routine childhood immunisation, which left thousands of children at risk to vaccine-preventable diseases.

"Knowing that our past accomplishments in the country are not that high, the Department of Health decided to have an additional layer of protection for our children by coming up with the Measles-Rubella Immunization Activity," said Dr Exuperia Sabalberino, Regional Director of the Department of Health Eastern Visayas Center for Health Development.

According to the Department of Health (DOH), Leyte accounts for the largest target population, with more than 152,000 eligible children, while Biliran has the smallest.

Children under five years of age will be offered the vaccine regardless of their previous vaccination status if they fall within the campaign's eligibility criteria.

About The Campaign

Health authorities have been race to close immunity gaps and prevent new outbreaks of the highly contagious disease.

The latest push follows concerns over low routine immunisation coverage in several Philippine regions. During the 2023 MR-SIA campaign, Eastern Visayas achieved only 72.6% vaccination coverage, well below the level needed to maintain herd immunity.

Health officials warn that insufficient coverage increases the risk of measles and rubella outbreaks. "Vaccination is an extra layer of protection and also prevents outbreaks, as measles and rubella are highly contagious because one confirmed case can affect 12 to 18 people, especially those who are vulnerable and immunocompromised," said Chiradee R. Claridad, DOH-8 National Immunization Program Coordinator.

Also read: US Measles Cases Reach 2,371; RFK Jr Takes U-Turn, Urges Families to Vaccinate Kids

Measles Remains A Global Concern

Measles is among the world's most infectious viral diseases, spreading through respiratory droplets when an infected person coughs or sneezes.

It can lead to serious complications including pneumonia, brain inflammation, blindness and death, particularly in young children. Rubella is generally milder but can cause severe birth defects if a pregnant woman becomes infected.

The Philippines has experienced several major measles outbreaks in recent years, including the nationwide resurgence in 2019 and the Bangsamoro outbreak in 2024, both linked to poor vaccination coverage.

The Philippines has already made progress in recent months. Last month, the DOH announced that over one million children in Metro Manila had been vaccinated, achieving 87.1% coverage under the measles-rubella campaign.

The latest campaign also comes after measles gained global attention after several countries, including the United States and parts of Europe, reported outbreaks this year driven by falling childhood vaccination rates.

The United States has reported 2,371 in 2026m according to the latest data from the Centers for Disease Control and Prevention (CDC). Among these cases:

• 20% of cases are in children under 5; 49% are in those 5–19 years.
• 7% of patients have been hospitalized, compared with 11% in 2025.
• No deaths have been reported.
• 93% of cases are in people who are unvaccinated or have unknown vaccination status.