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.

In a first for India, Maharashtra has allowed qualified homeopathy practitioners to prescribe certain modern medicines after completing a one-year Certificate Course in Modern Pharmacology (CCMP).

The decision has sparked strong opposition from the Indian Medical Association (IMA) and several doctors' bodies, which have announced protests, citing concerns over patient safety, medical education, and professional standards.

What Is The Debate All About?

Under a Government Resolution (GR) issued on August 3, Maharashtra has allowed BHMS graduates who have completed the one-year Certificate Course in Modern Pharmacology (CCMP) to register with the Maharashtra Medical Council (MMC). The registration allows eligible practitioners to prescribe specified modern medicines under the state's policy.

The MMC began registering CCMP-qualified practitioners on August 5. According to reports, one practitioner has been registered so far, while around 2,500 applications remain pending.

The IMA has warned of a nationwide strike if the Maharashtra government does not withdraw its decision. In a letter to Maharashtra Chief Minister Devendra Fadnavis, signed by IMA National President Dr. Anilkumar J. Nayak and Secretary General Dr. Sarbari Dutta, the association demanded immediate withdrawal of both the GR and the CCMP course.

Why Is the IMA Objecting?

The IMA has raised the following concerns:

• No approval from national regulators:

• Opposition to dual registration:

• Matter pending before the court

• Concerns over medical education

What Is the CCMP Course? Why Was It Introduced?

The Certificate Course in Modern Pharmacology (CCMP) is a one-year program introduced in Maharashtra in 2016 by the Maharashtra University of Health Sciences (MUHS). It is designed for BHMS (Bachelor of Homeopathic Medicine and Surgery) graduates and trains them in aspects of modern pharmacology and allopathic medicine.

The CCMP course was introduced following a major agitation by homeopathic associations, including a 13-day indefinite hunger strike in Nagpur in 2013, demanding legal rights to prescribe essential modern medicines.

According to the Maharashtra government, the objective was to strengthen healthcare delivery, particularly in areas facing shortages of doctors.

To facilitate the course, the state amended the Maharashtra Homoeopathy Practitioners' Act, 1960 and the Maharashtra Medical Council Act, 1965 in 2014, after the legislation was passed by both Houses of the State Legislature.

The IMA now argued that the situation in 2014 when the MMC Act was amended is very different from the situation now.

The medical body cited the cancellation of "bond system for MBBS graduates due to the nonavailability of vacant posts for them even in rural areas- signifying sufficient availability of MBBS doctors".

What Does the CCMP Course Include?

According to the government, the one-year CCMP curriculum was developed by expert committees at MUHS after comparing the BHMS and MBBS syllabi to bridge gaps in training.

The course includes:

• Training in modern pharmacology
• Practical laboratory procedures
• Rotational hospital training in clinical subjects of allopathy
• Teaching at government and private medical colleges
• Examinations conducted by the Faculty of Medicine, MUHS

The government says the program is intended to make registered homeopathic practitioners competent to prescribe specified modern medicines and improve access to healthcare in the state.

But the IMA has argued that such "short-term certification or bridge courses cannot substitute for comprehensive medical education". They also warned that permitting cross-practice would compromise patient safety.

What's Next?

The Maharashtra Association of Resident Doctors (MARD) began an indefinite statewide strike on August 3. On August 5, doctors across Mumbai withdrew routine outpatient department (OPD) services in protest against the government's decision.

Doctors from Pune are scheduled to join their counterparts in Mumbai for demonstrations at Azad Maidan on August 6. The IMA has warned of a nationwide strike if the Maharashtra government does not withdraw the decision. The IMA Kerala State Branch has also extended support to the Maharashtra doctors' protest.

A severe COVID-19 infection may awaken dormant viruses that remain hidden in the body for life, even in people with otherwise healthy immune systems, according to a study published in Nature.

The study, which analyzed more than 1,100 hospitalized COVID-19 patients, found that viral reactivation was common and may contribute to long COVID symptoms. Researchers said the findings suggest COVID-19 can disrupt the body's internal ecosystem of dormant viruses, creating a state they describe as "dysvirosis."

"This finding suggests that COVID-19 may not always act as a single viral infection and may disrupt the body's internal ecosystem of dormant viruses, creating a state of 'dysvirosis'," said lead author Cole Maguire from Dell Medical School at The University of Texas at Austin.

Which Dormant Viruses Were Reactivated?

Nearly half of the hospitalized patients had at least one dormant virus reactivate during their COVID-19 illness. The viruses identified included:

• Epstein-Barr virus (EBV), which causes mononucleosis
• Herpes family viruses
• Enteroviruses
• Cytomegalovirus (CMV)
• Herpes simplex virus-1 (HSV-1)
• Human herpesvirus-6 and -7 (HHV-6/7)
• Anelloviridae, a lesser-known family of chronic viruses

Also read: Lab Leak 'More Likely' Origin of COVID-19, Says Former Biden Adviser Dr. Ashish Jha

How Viral Reactivation Affects The Body

The researchers found that viral reactivation was more common in patients with severe COVID-19 and those who had longer hospital stays, and caused:

• Increase inflammation
• Worsened tissue injury
• Prolonged recovery

The study also noted that these viruses have previously been linked to autoimmune conditions such as multiple sclerosis and lupus.

Further, the study found that dormant viruses do not reactivate simultaneously after SARS-CoV-2 infection.

• Epstein-Barr virus and anelloviruses tended to reactivate early, shortly after hospital admission.
• Cytomegalovirus and herpes simplex viruses generally emerged around three weeks later, primarily in the respiratory system.

Not Limited to People With Weak Immune Systems

Earlier research had mainly observed viral reactivation in people with weakened immune systems. However, this study found that reactivation frequently occurred in people who were healthy before developing COVID-19.

According to the researchers, this suggests viral reactivation may be more common than previously believed and could contribute to worse outcomes even in otherwise healthy individuals.

How Are the Dormant Viruses Linked to Long COVID?

Read More: Can Long COVID Be Prevented Before It Starts? Study Suggests Early Paxlovid May Help

While the study does not prove that viral reactivation causes long COVID, it provides strong evidence that dormant viruses may contribute to the condition.

Researchers found that Anelloviridae appeared more frequently in patients with long COVID who experienced persistent fatigue and reduced physical function.

"Our findings have important implications for patient care. Tests already exist for several of the chronic viruses studied, and some viruses in the herpes family can be treated with existing antiviral drugs," said study principal investigator Melamed, assistant professor of neurology at Dell Medical School.

"The next step is determining whether identifying and treating reactivated viruses can improve outcomes for patients with acute COVID-19 and long COVID."

The study may also influence future treatment strategies. Researchers noted that, instead of targeting only SARS-CoV-2, clinicians may eventually be able to use existing antiviral drugs against reactivated viruses, particularly herpesviruses.

A Phase II clinical trial is already underway to evaluate antiviral therapies targeting herpesviruses in people with long COVID.

In a landmark decision, the US Food and Drug Administration (FDA) has approved Moderna's first mRNA-based seasonal influenza vaccine.

This makes it the first flu shot developed on messenger RNA (mRNA) technology to receive clearance in the United States.

The vaccine, branded mFlusiva, has been approved for adults over the age of 50 and older, paving the way for a new generation of influenza vaccines beyond the traditional egg-based approach.

Who Is Eligible To Receive The Vaccine?

The approval has given Moderna commercial drug built on the mRNA platform that powered its COVID-19 vaccine. The development is expected to strengthen the company's efforts to grow its respiratory vaccine portfolio.

According to the FDA, the following groups of people are eligible to receive mFlusiva:

• Traditional approval for adults aged 50 to 64 years.
• Accelerated approval for adults aged 65 years and older, requiring Moderna to conduct additional studies to confirm the vaccine's benefit in this age group.

Also read: Ebola Outbreak: Moderna Begins First Human Trial Of Bundibugyo Vaccine As Cases Rise to 3,748

What Did The Trial Show?

The approval was based on a late-stage clinical trial involving more than 40,000 adults aged 50 years and above. According to trial results, mFlusiva was:

• 26.6% more effective than a licensed standard-dose flu vaccine in preventing influenza.
• It also produced stronger immune responses than Sanofi's high-dose flu vaccine in adults aged 65 years and older, although Moderna will now need to verify whether this translates into better real-world protection for seniors.

Commenting on the approval, Moderna said, "Flu remains a significant public health challenge, and mFlusiva provides an important new option for America's seniors."

Earlier this year, Moderna CEO Stéphane Bancel had expressed confidence that the vaccine could become available ahead of the 2026-27 flu season if approved by regulators.

Also read: Protective Antibodies Fade After COVID-19 Vaccination- Should You Get A Booster Shot?

Why mRNA Could Revolutionise Flu Vaccination?

Unlike traditional flu vaccines, which are developed using viruses grown in chicken eggs, mRNA vaccines work by transmitting genetic instructions that alert the body's cells to produce harmless influenza proteins for an immune response.

Traditional flu vaccines must be designed and manufactured months before the flu season begins, requiring scientists to predict which influenza strains will circulate. If the circulating viruses keep evolving differently, the effectiveness of the vaccine can decline.

mRNA technology has a major advantage because it can potentially be updated and manufactured much faster, allowing vaccines to better match the strains that are spreading during a particular season.

In February 2026, the FDA initially declined to review Moderna's application, citing concerns that the company had compared its vaccine against a standard-dose flu shot rather than the high-dose vaccine commonly recommended for older adults.

After discussions with regulators, Moderna revised its submission, and the FDA agreed to proceed with the review under a condition that included additional studies for older patients.

Experts say the FDA's decision represents more than the approval of a single vaccine. It marks the first regulatory endorsement of mRNA technology for seasonal influenza, a milestone that could accelerate the development of next-generation vaccines against various infectious diseases.