Polio Outbreak in Pakistan
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.
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.
Credit: Gilead Sciences
South Africa's National Department of Health has announced that it has received a first consignment of 37,920 doses of the groundbreaking, six-monthly HIV prevention injection, Lenacapavir.
Lenacapavir is the first twice-yearly injectable pre-exposure prophylaxis (PrEP) product that can help tackle the burden of HIV worldwide.
South Africa has the world's largest HIV-positive population of approximately 8 million people, with over 6 million currently on antiretroviral treatment.
“The department will, in the next few weeks, announce the official launch of this game changer where the phased implementation plan will be outlined,” said department spokesperson Foster Mohale, in a statement.
"Lenacapavir is preventive medicine, not a vaccine, considered one of the most exciting HIV prevention advances in years," Mohale said.
The Department noted that the medicine is expected to be sustain nearly half a million people in South Africa over the next two years, the statement said, adding that is will be officially rolled out in May.
Notably, the initial phase will target high-incidence districts and vulnerable groups.
Lenacapavir is a critical tool for reaching the Global AIDS Strategy goal of ending AIDS as a public health threat by 2030.
Lenacapavir injection as an additional PrEP option offers a highly effective, long-acting alternative to daily oral pills and other shorter-acting options.
With just two doses per year, lenacapavir is a transformative step forward in protecting people at risk of HIV -- particularly those who face challenges with daily adherence, stigma, or access to health care.
Marketed under the brand name Yeztugo, lenacapavir, developed by global pharma major Gilead Sciences, costs $28,218 per person per year.
However, it is being provided to South Africa through a $29-million USD grant from the Global Fund.
The shot was tested in two major studies involving high-risk groups: one with young women and teenage girls in South Africa and Uganda, and another with gay men and gender-diverse individuals in several countries. In both cases, the results were striking.
The women who received the shot had zero new HIV infections, compared to around 2% in those on daily pills. In the second study, the twice-yearly shot proved just as effective for men and gender non-conforming individuals.
“This really has the possibility of ending HIV transmission,” said Greg Millett of amfAR, The Foundation for AIDS Research.
Yeztugo is administered as two small injections in the abdomen, forming a medication "depot" that slowly releases the drug into the body over six months.
However, people must test negative for HIV before receiving it, as it doesn’t treat existing infections or prevent other sexually transmitted diseases.
Despite its potential, concerns remain over who will actually benefit from lenacapavir.
In the US, only about 400,000 people currently use any form of PrEP — a small fraction of those who could benefit. And structural issues like cuts to public health funding, limited insurance access, and stigma pose significant barriers.
Globally, the challenge is even greater. While Gilead has struck deals with six generic drug makers, including four Indian, to provide low-cost versions of the shot for 120 low-income countries, critics argue that middle-income nations have been left out.
UNAIDS Executive Director Winnie Byanyima noted that at current prices, the shot “will change nothing” for many who need it.
Credit: iStock
Rotavirus has been increasingly detected in wastewater in several California cities, sparking concerns about the risk of the deadly and highly contagious virus in young children.
The virus is highly contagious and known for causing fever, vomiting, and severe watery diarrhea among small children. Older children and adults with weakened immune systems also are vulnerable, according to the US Centers for Disease Control and Prevention (CDC).
As per data from WastewaterSCAN, “high concentrations” of rotavirus have been found in Marin, Redwood City, San Jose, and Santa Cruz, while moderate concentrations have been found in Sacramento, Davis, San Francisco, Sunnyvale, Fremont, Vallejo, and Novato, The Sacramento Bee reported.
"It's extremely contagious," Dr. Monica Gandhi, an infectious disease specialist at UC San Francisco, told SFGATE Thursday, explaining that rotavirus is one of the lesser-known gastrointestinal illnesses.
According to UCSF, approximately 50,000 children in the US are hospitalized with it each year.
Rotaviruses are the most common cause of severe diarrheal disease in infants and young children worldwide.
The virus, a member of the reovirus family, affects the vast majority of children worldwide before the age of 3 years, and in most developing countries before the first birthday.
The virus causing the infection was discovered in 1973, according to the National Institutes of Health. It causes severe diarrhea, often leading to dehydration, which can be severe, requiring hospitalization.
It is transmitted by
WHO-prequalified rotavirus vaccines have been available since 2008, and there are currently four vaccines available. They are all live, oral vaccines.
RotaTeq, Rotavac, and ROTASIIL should be administered in a 3-dose schedule, while a 2-dose schedule should be used for Rotarix. A minimum interval of 4 weeks should be maintained between doses, the WHO said.
In addition, key measures to prevent diarrhea include the following:
Credit: BBC/EPA
Resident doctors in the UK have launched a six-day strike in a dispute with the government over pay.
Tens of thousands of medics have walked out of the National Health Service (NHS) in England on Tuesday, in the 15th strike since March 2023. Their demand: “full pay restoration”.
The six-day walkout comes as the doctors’ group rejected an offer made by the government in March.
According to the British Medical Association (BMA), the government’s proposal failed to reverse years of pay erosion and staffing pressures.
The BMA represents about 55,000 of the resident doctors - formerly known as junior doctors - who make up nearly half of the medical workforce.
The strike is due to run until the morning of April 13, after a 48-hour ultimatum from Prime Minister Keir Starmer passed without agreement.
The BMA argues that doctors are still being paid a fifth less than they were in 2008, once inflation is taken into account. This is despite receiving pay rises worth 33 percent over the past four years.
Dr Jack Fletcher, chair of the BMA's resident doctor committee, told BBC Radio 4's Today program he was "genuinely very sorry" to patients who had care postponed due to the strike, but noted that such delays also occurred "without strike action" because of a lack of specialists and GPs.
"The way out of this is to get around the negotiating table, as we were for eight or so weeks, talk constructively to get a deal, to get us out of this.
Dr Emma Runswick, deputy chair of the BMA Council, told BBC Breakfast they had been close to reaching a deal but "the government decided to move the goalposts quite last minute to reduce the level of investment they were prepared to make".
The strike began at 07:00 BST on Tuesday and promises to cause significant disruption to services.
Dr Melissa Ryan, 45, a pediatric registrar, said she was frustrated that the government was cutting training places and some children were waiting years for assessments, the BBC reported.
The pediatrician who joined dozens of resident doctors in the six-day strike over jobs and pay has said the NHS may "end up without doctors" if the long-running dispute continues.
However, senior medics have being called in to provide cover in emergency settings, still some pre-planned treatments and appointments may get cancelled.
Meanwhile, the NHS has urged patients not to put off seeking help if needed, saying those with emergency and urgent needs should use 999 and 111 as normal, the BBC reported.
While GP services are largely unaffected, the NHS advised patients with prior appointments and treatments scheduled to attend unless told otherwise.
Health Secretary Wes Streeting told BBC Breakfast that 95 percent of appointments were still in place. He also apologized to people affected by cancellations, saying they "deserve better".
He criticized the BMA for not accepting the government’s latest offer and said the government had negotiated with the BMA "in good faith".
According to the British government, the strikes were costing the NHS £50m a day, meaning the health service had lost around £3bn since industrial action started in March 2023. However, a detailed breakdown of costs has not been set out.
Speaking on Times Radio on Tuesday, Streeting said resident doctors had secured the largest pay uplift of any public sector group under the Labour government, but had rejected the offer without putting forward a counter proposal.
© 2024 Bennett, Coleman & Company Limited