Singer Jesy Nelson recently shared an emotional update regarding the complications she is experiencing in her pregnancy with twin babies. Former Little Mix singer Jesy, who is having twins with partner Zion Foster, announced that she has been diagnosed with pre-twin-to-twin transfusion syndrome (pre-TTTS). The condition, which is present in pregnancies involving twins with a shared placenta, has serious risks involved and needs intense medical supervision. As Nelson embarks on this difficult journey, her story enlightens us about a rare but dangerous condition many expectant parents may not know much about.

Twin-to-twin transfusion syndrome is a rare but dangerous condition that arises in monochorionic twin pregnancies, in which identical twins share a single placenta. The placenta supplies the developing babies with oxygen, nutrients, and blood flow, but in TTTS, there is an imbalance of blood vessels that interconnect the twins, and thus the vital resources are not evenly distributed. One twin, or the donor twin, shares excess blood with the other, referred to as the recipient twin. This leads to one baby becoming malnourished and possibly anemic, and the other in danger of heart problems due to too much blood.

Nelson described her diagnosis in a heartfelt Instagram video, explaining that she is currently in the pre-stage of TTTS and undergoing frequent monitoring. "I am being scanned twice a week, and each time, things have gotten a little worse," she shared, expressing her fears and hopes for the health of her babies.

Potential Risks of TTTS

If left untreated, TTTS can have devastating consequences. Medical research indicates that:

• 90% of the cases of untreated TTTS lead to loss of one or both twins.
• Despite treatment, only a 70% survival rate for both twins is assured.
• Severe forms can result in preterm labor, cardiac failure in the recipient twin, and organ failure in the donor twin.
• Complications in long-term survivors include neurological damage and developmental delay in surviving infants.

TTTS usually advances in stages, beginning with minimal changes in fluid levels and worsening as one twin continues to get an unequal share of blood. In extreme cases, fetal laser surgery, referred to as the Solomon technique, can be employed to divide the blood vessels and balance the twins.

Why Identical Twin Pregnancies Are More Complicated

Identical twins may develop differently, and their own unique form of placental sharing can have a dramatic effect on pregnancy risk. Jesy Nelson's twins are considered monochorionic diamniotic (mono/di), which means they share a placenta but have two amniotic sacs. This is the type of pregnancy in about 70% of identical twin pregnancies and carries an increased risk of complications like TTTS, umbilical cord entanglement, and growth restriction.

Conversely, dichorionic diamniotic (di/di) twins both have a separate placenta and amniotic sac, which greatly diminishes the threat of TTTS. Twin pregnancy type is normally identified by early ultrasound, with physicians being able to track future complications from inception.

Other Twin Pregnancy Health Risks

Twin pregnancies, even without the presence of TTTS, entail a variety of health risks to the mother as well as infants:

1. Premature Birth

Over 60% of twin pregnancies end in premature delivery, with birth usually taking place before 37 weeks. Premature infants can have immature organs and need neonatal intensive care (NICU) assistance to assist with breathing, feeding, and infection fighting.

2. Gestational Hypertension and Preeclampsia

Pregnant women with multiples are at increased risk of having high blood pressure during pregnancy. This, if left untreated, can result in preeclampsia, a serious complication of pregnancy that can result in damage to organs, preterm labor, and in some cases, maternal or fetal death.

3. Anemia

Pregnant women carrying multiples are twice as likely to experience anemia, a condition where the body does not produce enough healthy red blood cells. This can lead to fatigue, dizziness, and complications during delivery.

4. Birth Defects

According to John Hopkins Medicine, multiple birth babies are twice as likely to have congenital abnormalities compared to single births. These can include heart defects, neural tube defects, and gastrointestinal issues.

5. Amniotic Fluid Imbalances

When twins have to share a placenta, they are more likely to have polyhydramnios (excess amniotic fluid) or oligohydramnios (not enough amniotic fluid). Both result in distress to the babies during fetal development and can result in premature labor.

6. Postpartum Hemorrhage

Twins are at increased risk of excessive postpartum hemorrhage because their uterus is larger and there are greater blood supply needs.

Jesy Nelson's openness about her challenging experience is raising awareness for TTTS, a condition that few individuals—let alone expectant mothers and fathers—might be aware of. Through her tearful video, Nelson stressed the significance of knowing about twin pregnancies aside from the thrill of having multiples. "We had no idea that this type of thing occurs when you're having twins. We just desperately want to make people aware of this because there are so many people who aren't aware."

Her case reminds us of the intricacies involved in twin pregnancy and the significance of early identification and medical management. For mothers carrying twins, frequent ultrasounds and vigilance can become a life-and-death issue for early detection and better outcomes of both babies.

Through constant medical attention and care, she and her partner Zion Foster remain positive and get ready for their babies to be born. In other parents whose situations are no different, the story of Nelson highlights awareness, medical progress, and emotional encouragement in handling complicated pregnancies.

The expecting parents of twin siblings are advised to discuss TTTS screening and possible interventions with their physicians to give their babies the best chance.

Singapore will increase surveillance of three deadly infectious diseases from October 31, needing doctors and other healthcare professionals to report all suspected and confirmed cases to the authorities.

The diseases include Marburg virus disease, Lassa fever and Crimean-Congo haemorrhagic fever (CCHF). All the three can lead to severe illness, and in extreme cases, they can even be fatal.

However, Singapore's Communicable Diseases Agency (CDA) has said the current risk posed by these diseases to the country remains low.

So Why Is Singapore Monitoring These Three Diseases?

The move comes after amendments to Singapore's Infectious Diseases Act in September. The three diseases will be added to the list of prescribed infectious diseases, making notification of suspected and confirmed cases a legal requirement.

The authorities aim to detect these diseases earlier to foster a swift public health response, which includes isolation and tracing contacts.

The CDA said it has been monitoring the three diseases for some time, “as all three diseases are viral haemorrhagic fevers that can cause severe illness and have the potential for human-to-human transmission”.

A CDA spokeswoman told The Straits Times, “While there has been no change to the risk level from these three diseases, which currently remains low, they have been added to the IDA to strengthen our overall surveillance and preparedness efforts.”

From October 31, doctors and laboratories will be legally required to notify the authorities of suspected as well as confirmed cases of the three diseases. The CDA said it continuously monitors infectious disease developments both locally and internationally.

“As part of our preparedness efforts, CDA periodically reviews and updates the list of infectious diseases under the IDA to ensure that Singapore remains ready to respond to infectious disease risks,” the agency's spokeswoman said.

The three diseases will also be added to Singapore's list of “dangerous infectious diseases”, bringing the total to eight.

The five already listed are Ebola disease, Middle East respiratory syndrome coronavirus infection (MERS-CoV), plague, severe acute respiratory syndrome (SARS) and yellow fever.

Also read: People With Rare Diseases Have Higher Recorded COVID-19 Rates: UK Study Based On 62.5 Million People

More About The Three Diseases

Marburg virus disease, Lassa fever and Crimean-Congo haemorrhagic fever belong to a group of viral illnesses that can cause severe complications, including bleeding and organ complications in some patients.

Their routes of transmission differ, making timely diagnosis, reporting and anti-spread measures crucial.

According to the World Health Organization (WHO), there are currently no approved vaccines or specific treatments for any of the three diseases, but vaccine development is under way for Lassa fever and Marburg virus disease. The diseases also differ in their geographical distribution, typical severity and how they spread.

Crimean-Congo Haemorrhagic Fever

Crimean-Congo haemorrhagic fever is mainly transmitted through bites from infected ticks or contact with infected livestock. It can also spread through exposure to the blood or other bodily fluids of an infected person.

Symptoms can begin suddenly and include fever, muscle pain, dizziness, sore eyes and sensitivity to light. In severe cases, patients may develop liver, kidney or lung failure. According to WHO, the fatality rate can be as high as 40%.

Also read: GLP-1 Drugs May Lower Risk Of Heart Complications, Infections After Surgery

Lassa Fever

Lassa fever is mainly found in parts of West Africa. People can become infected through contact with food or household items contaminated with the urine or faeces of infected rodents. Human-to-human transmission can also occur through direct contact with an infected person's blood or bodily fluids.

Most infections cause no symptoms or only mild illness. Symptoms can include fever, sore throat, muscle pain, nausea, vomiting and diarrhoea. Severe cases may present with facial swelling, bleeding and low blood pressure.

The overall fatality rate is at around 1%, but it can rise significantly among patients hospitalised with severe illness.

Lassa fever can also have serious consequences during pregnancy. According to the information cited by The Straits Times, foetal death rates can exceed 80% in the third trimester, while maternal death rates can exceed 30%.

Hearing loss is another possible complication. Up to 25% of patients may experience hearing loss after recovering from the infection, and many do not regain their hearing.

Marburg Virus Disease

Marburg virus disease is a rare but severe illness. Egyptian fruit bats are considered its natural reservoir, and infection can occur after exposure to infected animals or environments contaminated by them.

The disease can also spread between people through direct contact with the blood or other bodily fluids of an infected person, or through contaminated materials.

Symptoms often begin with sudden high fever, severe headache and muscle aches. Some patients develop bleeding, confusion and other serious complications. The fatality rate is around 50%, according to the WHO.

Individuals diagnosed with rare diseases had higher COVID-19 rates than people who did not have them. As per a study analysing health records of 62.5 million people in England, there were significant differences in infections recorded across ethnic groups and individual rare diseases.

Published in Scientific Reports recently, the study analysed 406 rare diseases with the help of healthcare records from the National Health Service (NHS) in England.

Of the 62.5 million people included in the analysis, around 1.05 million, or 1.7%, had at least one of the 406 rare diseases.

COVID-19 infections were reported in around 32.8% of people with a rare disease, compared with 29% of those without one. Even though the difference between the two figures is not far from each other, it makes us stop and think.

According to the study researchers, the findings provide a country-wide picture of rare disease rates and incidence of COVID-19 infections across various ethnic groups.

COVID-19 Infection Rates Differed Across Rare Diseases

The study found that COVID-19 infection rates differed significantly depending on the rare disease. Among the 25 most common rare diseases, infection rates ranged from 24.6% to 41.2%.

Four conditions had recorded infection rates below 30%: congenital laryngomalacia, at 24.6%; retinopathy of prematurity, at 26.5%; polymyalgia rheumatica, at 27.1%; and infantile apnoea, at 29.9%. The remaining 21 conditions had recorded infection rates between 30% and 50%.

These differences highlight an important point that people with rare diseases should not be treated as one uniform group, especially when it comes to their COVID experience.

However, the study did not establish that every person with a rare disease had a higher risk of contracting the virus, nor did it show that rare diseases necessarily led to more severe COVID-19.

Also read: EXCLUSIVE: Ex-CDC Vaccine Advisor Says Measles Outbreak Bigger Than Reported, Slams RFK Jr’s ‘No-See Evil’ Approach

Infection Rates Differed By Ethnicity

The researchers also identified differences in COVID-19 infection rates among ethnic groups within the rare disease occurrence.

The highest rates were observed among people classified as White British, at 33.7%, and those in the broader White category used by the Office for National Statistics (ONS), at 33.5%.

Lower rates were recorded among several other groups, including Black African people, at 23.8%; Gypsy or Irish Traveller people, at 24.1%; Bangladeshi people, at 27.2%; and Pakistani people, at 27.7%.

The researchers said that this pattern was different from trends in the general population, where ethnic minority groups experienced an uneven burden of COVID-19.

Rare Diseases Varied Across Ethnic Groups

Apart from COVID-19 infection, the study mapped 406 rare diseases across various ethnic groups. The researchers found variations in how frequently each condition was recorded.

Some of these differences became clearer when broad ethnic categories were divided into more specific groups. For example, discoid lupus erythematosus was more prevalent among Black Caribbean people than among Black African people.

The researchers also found that polymyalgia rheumatica was more prevalent among White people than Asian or Asian British and Black or Black British populations.

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How Was The Study Conducted?

The researchers carried out a cross-sectional analysis using NHS England’s Secure Data Environment, linking primary care, hospital and mortality records for people alive on July 31, 2023.

They estimated the prevalence of 406 rare diseases and examined COVID-19 infections across the overall population, individual rare diseases and ethnic groups. The analysis used both six ONS ethnic categories and 19 more detailed NHS ethnicity classifications.

The study’s large population base allowed the researchers to examine conditions that can be difficult to investigate because each rare disease affects relatively few people.

The researchers said the national estimates provide a baseline for understanding rare disease rates and COVID-19 cases across different populations in England. The findings may help inform future research and support efforts towards earlier diagnosis and better healthcare.

Nearly 94% of tuberculosis (TB) patients in an Indian study conducted in Bengaluru reported anxiety symptoms, while 77.3% showed signs of depression. The findings focus on the mental health toll that comes with TB. It also sheds light on the need to include psychological support in routine treatment of tuberculosis.

The cross-sectional study, conducted with 66 adults at the Yeshwanthpur Tuberculosis Unit in Bengaluru, found that 56.1% had moderate to severe anxiety symptoms, while 46.9% had moderate to severe depressive symptoms. Nearly half of the participants experienced symptoms of both conditions.

The study was conducted by Dr. Pavithra Cheluvaraj, Dr. Vishnu C. Sudhakaran, Dr. Babitha Rajan and Anjana Sasikumar Nair from the Department of Community Medicine at Ramaiah Medical College.

The researchers examined the patients using the Patient Health Questionnaire-9 (PHQ-9) and the Generalised Anxiety Disorder-7 (GAD-7) scales.

Why Are TB Patients May Experience Anxiety And Depression?

Stigma linked with TB, fear of transmitting the infection to family members and existing health conditions may contribute to anxiety and depression among patients, Dr. Pavithra told Bangalore Mirror.

TB treatment can also entail a prolonged course of medication and regular follow-up. Psychological distress may make it harder for patients to continue treatment or seek timely care.

According to Dr. Pavithra, anxiety and depression if left untreated could affect the course of TB treatment. Patients experiencing psychological distress may delay starting treatment or stop taking their medication, which could compromising recovery and increasing the risk of drug resistance.

“If there is delay in diagnosis or treatment, the person can spread the disease,” she said.

Also read: You May Be Carrying TB, And Not Know Until It Gets Worse

How Was Mental Health Assessed In The Study?

The researchers used two standardised screening tools to assess symptoms of depression and anxiety.

The PHQ-9 measures depressive symptoms, while the GAD-7 tests for symptoms of anxiety. The study found that 51 of the 66 participants had symptoms linked with depression, and 62 had symptoms that indicated anxiety.

Moderate to severe symptoms were found in 31 participants for depression and 37 for anxiety. These screening results indicate the need for further clinical assessment. The findings are merely observations and they do not mean that every participant had a confirmed psychiatric diagnosis of anxiety and depression.

Additionally, the study was based on 66 adults in one tuberculosis unit in Bengaluru, so its findings cannot represent all TB patients in India.

But the high percentage of participants who reported symptoms of anxiety and depression suggest that there is need for better integration of mental health screening into TB treatment.

The researchers recommended routine screening for depression and anxiety when patients are diagnosed with TB and during follow-up visits. They also called for counselling and referrals for patients with more severe symptoms.

They say that identifying psychological distress early may help doctors connect patients with appropriate support while they receive treatment for the infection.

TB Is A Global Health Crisis

Even though this study is based on a small sample, it speaks about the long-term effects of the disease on mental health. TB is a global health crisis, which means this study warrants further investigation and action.

According to the WHO’s Global Tuberculosis Report 2025, in 2024, more than ten million people across the globe developed TB while more than 1.2 million lost their lives to the disease.

Currently, India bears the lion's share of TB burden compared to other countries. Uneven access to drug-resistant TB treatment, financial hardships, stigma, prolonged treatment are some of the factors that may contribute to deteriorating mental health of TB patients.