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.

Health officials in England have confirmed that an adult with an underlying immunological condition has died from measles, marking the third measles-related death this year after two children died in June.

According to the latest figures from the UK Health Security Agency (UKHSA), England has recorded 883 confirmed measles cases between the start of the year and July 6. More than half of the cases have been reported in London, with most infections occurring in children aged 10 years and under.

All regions of England, including London (52 per cent), the West Midlands 17 per cent, and the North West 10 per cent, have now reported measles cases.

The UK was declared measles-free in 2017 but lost that status in 2019 after vaccination rates declined and outbreaks resumed.

In January, the World Health Organization (WHO) confirmed that the UK was no longer considered to have eliminated measles, citing stagnant vaccination coverage and rising case numbers.

NHS Launches Catch-Up Vaccination Drive

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In response to the surge in infections, NHS leaders have launched a nationwide catch-up campaign targeting children aged two to 11 years who have missed one or both doses of the measles, mumps and rubella (MMR) vaccine.

The program will contact around one million families whose children are not fully vaccinated.

• GPs will contact parents of children under six.
• Families with children aged six to 11 will be contacted through the NHS App, text message, email or letter.

Current figures show that 84.1% of five-year-olds in England had received both doses of the MMR vaccine during the first three months of the year—well below the 95% coverage recommended to prevent outbreaks.

"We urge all parents to ensure their children are up to date with their MMR or MMRV vaccines, giving them the best and safest protection against measles," said Dr Vanessa Saliba, consultant epidemiologist at UKHSA.

"Anyone who has missed their measles vaccines can catch up through their GP practice, whatever their age. Getting vaccinated also helps protect babies who are too young to be vaccinated and people who cannot receive the vaccine because of certain health conditions," Dr Saliba added.

What Is Measles?

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Measles (rubeola) is one of the world's most contagious viral infections. It spreads through respiratory droplets released when an infected person coughs or sneezes and can also spread by touching contaminated surfaces before touching the eyes, nose, or mouth.

Symptoms usually develop 7 to 14 days after exposure and include:

• High fever
• Cough
• Runny nose
• Red, watery eyes
• Small white spots inside the mouth (Koplik spots)
• A red rash that typically starts on the face before spreading across the body

While many people recover fully, measles can cause serious complications, including pneumonia, encephalitis (brain inflammation), hearing loss, and, in rare cases, death.

All About the MMRV Vaccine

The MMRV is a safe, live-attenuated immunizations that protect against severe viral infections. The shot combines Measles, Mumps, and Rubella, and also adds protection against Varicella (chickenpox).

According to the UKHSA, children receive:

• First dose: At 12 months, alongside MenB and pneumococcal (PCV) vaccines.
• Second dose: At 18 months, alongside the fourth 6-in-1 vaccine.

Children who miss these doses can receive a catch-up vaccination at their 3-year and 4-month appointment. The MMRV vaccine contains weakened forms of the measles, mumps, rubella, and chickenpox viruses, which stimulate immunity without causing disease.

Two MMRV vaccines are available:

• ProQuad (contains porcine gelatine)
• Priorix Tetra (does not contain porcine gelatine).

An outbreak of Cyclospora, a microscopic parasite that causes prolonged watery diarrhea, has sickened more than 1,400 people across the United States, with infectious disease experts describing the surge in cases as "definitely abnormal."

While the US Centers for Disease Control and Prevention (CDC) is still investigating the source, officials believe the outbreak is likely linked to multiple sources of contamination rather than a single food product.

Health officials in Michigan have reported 1,251 Cyclospora infections, a dramatic increase from around 170 cases recorded on June 30. The state typically reports only about 50 cases annually.

Ohio has confirmed nearly 200 cases, while New York, Illinois, Indiana, North Carolina, and Texas have also reported an increase in infections. More than 40 people have been hospitalized.

Dr. Thomas Moore, an infectious disease specialist and clinical professor of medicine at the University of Kansas School of Medicine-Wichita, described the spike as "definitely abnormal" and concerning, according to The New York Times.

Keith R. Schneider, professor of food safety at the University of Florida, noted that Cyclospora infections usually increase between May and August in the United States. However, he said the current surge—particularly in Michigan—is far beyond what is normally expected.

"Something is going on right now in that area," Schneider told The New York Times.

Experts also warned that the reported infections may represent only the "tip of the iceberg," with additional cases expected in the coming weeks, because the infection takes long to manifest.

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What Is Cyclospora And How Does It Spread?

Cyclospora is a microscopic parasite that infects people after they consume food or water contaminated with human feces containing the parasite's eggs (oocysts).

Unlike many foodborne bacteria, Cyclospora infections often takes two days to two weeks or more to cause illness after exposure, making it difficult for investigators to identify the original source.

Although the illness is usually not life-threatening, it can cause prolonged diarrhea, stomach cramps, nausea, fatigue, bloating, and weight loss.

Fresh produce is the most common source of infection, though contaminated water can also spread the parasite. Health officials have not advised people to avoid fresh produce, as investigators have not yet identified the exact food responsible for the current outbreak.

Yet, previous US Cyclospora outbreaks have frequently been linked to imported fresh produce, including:

• Basil
• Cilantro
• Mesclun lettuce
• Raspberries
• Snow peas

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Handwashing Matters More Than Hand Sanitizer

Experts emphasize that proper handwashing with soap and water remains one of the most effective ways to reduce the risk of infection.

Alcohol-based hand sanitizers do not kill Cyclospora, making soap and water essential after using the bathroom and before preparing or eating food.

"This type of parasite doesn't easily go away with alcohol-based hand sanitizer. So, good old handwashing is really key here," ABC News medical correspondent Dr. Darien Sutton said.

How To Clean Fresh Produce Safely

While washing produce cannot eliminate all risk, experts say it can reduce contamination. They advised washing fruits and vegetables thoroughly under clean running water, and washing hands before and after handling fresh produce.

According to the Michigan Department of Health and Human Services, cooking produce whenever possible during an active outbreak is crucial, as heating food to at least 158°F (70°C) kills Cyclospora.

For specific produce, it suggested:

• Cilantro and basil: Separate the leaves and rinse each thoroughly under running water.
• Green onions: Trim off the roots, remove the outer layer, and rinse well.
• Snow peas: Rub the surface gently while washing under running water.
• Raspberries: Because of their delicate, uneven surface, raspberries are difficult to clean thoroughly. Cooking them in pies or jams is safer. Freezing may reduce the number of parasites but is unlikely to eliminate them completely.
• Leafy greens: If possible, choose whole heads of lettuce instead of bagged salad mixes. Discard the outer leaves and wash the remaining leaves under running water before eating.

The UK has reported an outbreak of crusted scabies, a rare and highly contagious form of scabies, prompting the temporary closure of a hospital ward in Wales.

According to the Hywel Dda University Health Board, Steffan Ward at Glangwili Hospital in Carmarthen has been temporarily closed while the outbreak is managed under established infection prevention and control measures, according to the BBC.

Health officials said all patients and staff identified as close contacts have been informed and offered treatment, even if they are not showing symptoms. Enhanced infection control measures, including monitoring, treatment of identified contacts, and specialist support, have also been put in place.

Officials added that a recent rise in scabies cases across Carmarthenshire, Pembrokeshire, and Ceredigion has contributed to outbreaks in healthcare settings. The ward will reopen once it is deemed safe under infection control guidance.

What Is Crusted Scabies?

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Scabies is a highly contagious skin infestation caused by the microscopic mite Sarcoptes scabiei. The mites burrow into the upper layer of the skin, where they lay eggs, triggering an allergic reaction that causes intense itching and a rash.

However, the crusted scabies—previously known as Norwegian scabies—is a severe form of the infestation in which the skin develops thick, crusted plaques that may crack and become inflamed, according to the US Centers for Disease Control and Prevention (CDC).

Unlike classic scabies, patients with crusted scabies may not experience severe itching or develop the typical rash, making the condition more difficult to recognize. However, they can carry up to two million mites and eggs, making them extremely contagious.

Because of the heavy mite burden, crusted scabies can rapidly spread in healthcare facilities and long-term care homes if not identified and treated promptly. It may also lead to serious complications, including secondary bacterial infections and sepsis.

Who Is Most at Risk?

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People at increased risk of developing crusted scabies include:

• Older adults
• People with weakened immune systems, including those living with HIV/AIDS
• Individuals with conditions that reduce the ability to itch or scratch, such as spinal cord injuries, paralysis, loss of sensation, or severe neurological or behavioral disorders

How Can Crusted Scabies Be Prevented?

Preventing outbreaks requires rapid diagnosis, prompt treatment, and strict infection control measures.

Health authorities recommend:

• Identifying and treating all close contacts, including household members, caregivers, and sexual partners
• Isolating affected individuals when necessary
• Washing or decontaminating bedding, clothing, and towels used by infected patients
• Maintaining strict hygiene and environmental cleaning in healthcare settings

Why Early Diagnosis Matters

Early diagnosis is critical to preventing further transmission. Since crusted scabies may not present with the classic symptoms of itching and rash, healthcare professionals play an important role in recognizing the condition.

Only a qualified healthcare provider can confirm the diagnosis and prescribe appropriate treatment. Prompt medical care helps reduce the risk of complications and prevents outbreaks in hospitals, nursing homes, and other communal settings.