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.

Tozorakimab, an investigational drug developed by AstraZeneca, reduced moderate-to-severe flare-ups of chronic obstructive pulmonary disease (COPD) in two late-stage trials, the company has announced.

Presented at the ongoing European Respiratory Society Congress in Barcelona, the results showed that patients receiving tozorakimab experienced about 29% to 34% fewer COPD exacerbations over one year compared with placebo, when added to standard inhaled therapy.

The results, also published in the New England Journal of Medicine, showed that the drug was generally well tolerated, with injection-site reactions reported as the only adverse drug reaction.

Researchers from the University of Pittsburgh who led the trials said the findings highlight tozorakimab’s potential as a treatment for people with COPD who remain at risk of exacerbations despite standard inhaled therapy.

What Is Tozorakimab?

Tozorakimab is a potential first-in-class monoclonal antibody targeting interleukin-33 (IL-33).

The drug is designed to inhibit signalling from both the reduced and oxidised forms of IL-33, with the potential to reduce inflammation and disrupt the cycle of mucus dysfunction that contributes to COPD worsening.

AstraZeneca is developing tozorakimab as an add-on maintenance treatment for adults with COPD.

What Did the COPD Trials Find?

The findings come from two replicate Phase 3 trials, OBERON and TITANIA, which included a total of 2,306 adults with symptomatic COPD who were current or former smokers and had a history of exacerbations despite stable standard-of-care inhaled maintenance therapy.

Tozorakimab 300 mg, given once every four weeks, reduced moderate-to-severe COPD exacerbations among former smokers by:

• 29% in OBERON

• 34% in TITANIA

In the overall population of current and former smokers, exacerbations were reduced by:

• 30% in OBERON

• 29% in TITANIA

The reductions were compared with placebo while patients continued inhaled standard-of-care treatment.

A pooled analysis of the two trials also showed clinically meaningful reductions across all prespecified patient subgroups, including those defined by blood eosinophil count (BEC).

Patients with a baseline BEC below 150 achieved a 23% reduction in moderate-to-severe exacerbations, while those with a BEC of 150 or higher achieved a 34% reduction. Among patients with a BEC of 300 or higher, the reduction was 43%.

“Today’s groundbreaking tozorakimab results, from two replicate trials, set a new standard for COPD treatment outcomes in a broad population of patients. AstraZeneca has clinically validated the novel approach of targeting the signalling of the two forms of IL-33 to both decrease inflammation and disrupt the cycle of mucus dysfunction. With our FDA Priority Review, we look forward to bringing this treatment to patients as quickly as possible,” said Sharon Barr, Executive Vice President, BioPharmaceuticals R&D, AstraZeneca.

What Happens Next?

The Biologics License Application for tozorakimab 300 mg, administered once every four weeks, has been accepted by the US Food and Drug Administration for Priority Review as an add-on maintenance treatment for adults with COPD.

Tozorakimab is also under regulatory review for COPD in major markets, including the EU and China.

The drug is being studied in a Phase II trial for severe asthma and a Phase III trial for severe viral lower respiratory tract disease. It received FDA Fast Track Designation for severe viral lower respiratory tract disease in November 2023 and for COPD in December 2024.

Why COPD Flare-Ups Matter

COPD is the third leading cause of death worldwide, excluding COVID-19. It is a progressive respiratory condition characterized by persistent airflow limitation and chronic inflammation of the airways.

Common symptoms include breathlessness, chronic cough, and excess mucus production.

COPD exacerbations can worsen these symptoms and contribute to ongoing inflammation and bronchoconstriction, making it difficult to breathe. They can also accelerate disease progression, increase hospitalizations and raise the risk of future cardiopulmonary events, including heart attacks.

In the US, COPD exacerbations cause more than 2,500 emergency department visits each day. Only 50% of COPD patients live more than 3.5 years after their first severe exacerbation.

Bangladesh was once close to eliminating measles but is now battling what has been described as the world’s largest measles outbreak. With close to 1,000 suspected and confirmed measles-related deaths since March 2026, the country is grappling with its worst outbreak.

According to Bangladesh health ministry data cited by Reuters, 999 deaths have been associated to the measles outbreak, including 100 laboratory-confirmed measles fatalities.

More than 166,000 suspected cases have been reported, including nearly 20,000 laboratory-confirmed infections. More than 146,000 suspected patients have also been hospitalised.

Bangladesh, who is already battling a worsening dengue crisis, is dealing with enormous strain on its healthcare system.

How Did Bangladesh Go From Near Elimination To A Massive Outbreak?

Measles is one of the world’s most contagious infectious diseases. It spreads through respiratory droplets and airborne particles when an infected person coughs, sneezes or breathes. But measles is also highly preventable through vaccination.

For much of the past decade, Bangladesh maintained measles vaccination coverage at or above the 95% level recommended by the World Health Organization (WHO) for preventing long-term transmission.

The vaccine coverage dropped during the COVID-19 pandemic, but the country had otherwise made substantial progress toward elimination.

The political upheaval in 2024 and 2025 disrupted routine immunisation which contributed to the current crisis.

Bangladesh’s health minister, Sardar Md. Sakhawat Husain, told parliament that changes in vaccine procurement contributed to shortages.

A vaccination programme was postponed in 2024, while a nationwide measles-rubella campaign planned for the following year was cancelled, according to Reuters. That left growing numbers of children without adequate immunity.

“Bangladesh missed its measles elimination target because of vaccination gaps in 2024 and 2025,” said Professor Mahmudur Rahman, an epidemiologist and former director of the Institute of Epidemiology, Disease Control and Research.

Also read: RFK Jr. Accepts Pennsylvania Child’s Measles Death After Questioning It: Here's Why

Young Children Bearing The Brunt

Children under five have been particularly affected, making up for about 80% of cases during the initial stages of the outbreak.

Infants are especially vulnerable because babies younger than nine months may be too young to receive the routine measles vaccine, according to the country’s vaccine schedule.

When vaccination coverage falls in older children and adults, the virus can circulate more widely, increasing the chances that infants will encounter it before they are protected.

Measles itself can cause high fever, cough, runny nose and the characteristic rash. But the danger comes from its complications.

Children can develop pneumonia, severe dehydration, ear infections and encephalitis, or inflammation of the brain. Malnutrition can make severe disease more likely.

“To my knowledge, Bangladesh has never witnessed so many children dying from measles. Nor have we ever seen such a high number of patients in a single year. This is a truly terrible situation, and the saddest part is that the victims are children,” Rahman said.

Also read: HHS Announces US FDA’s First AI Chief: Here’s What It Means For The Future Of Drug Regulation

Bangladesh Has Started A Massive Vaccination Response

The government launched an emergency measles-rubella vaccination campaign in April, supported by international health agencies.

More than 19.7 million children have been vaccinated through the campaign, according to Reuters. But public health experts say emergency campaigns alone cannot solve the problem.

The country also needs to restore routine childhood immunisation, identify children who missed earlier doses and close the immunity gaps that allowed the virus to spread so rapidly.

UNICEF had already warned in April that the outbreak was disproportionately affecting young children. Its early situation report recorded nearly 10,000 suspected cases and 128 suspected measles-related deaths by April 7, highlighting how quickly the outbreak escalated.

Aedes aegypti mosquitoes that spread dengue, chikungunya and Zika are showing resistance to permethrin, a commonly used pyrethroid insecticide, in parts of Pune, according to a new ICMR-National Institute of Virology (NIV) study.

The finding, published as preprint in the International Journal of Tropical Insect Science, raises concerns about the effectiveness of insecticide-based mosquito control, particularly during outbreaks.

Researchers collected Aedes aegypti mosquitoes from nine Pune Municipal Corporation wards — Pashan, Susgaon, Khadki, Yerawada, Warje, Hadapsar, Kondhwa, Kothrud and Dhankawdi — between February and May 2024.

They exposed the mosquitoes to 0.75% permethrin, the standard dose used in WHO susceptibility testing.

Resistance was detected in mosquitoes from six of the nine localities, while mosquitoes from three wards remained susceptible.

Genetic Mutations Linked to Resistance

The researchers then used PCR amplification and Sanger sequencing to look for genetic changes associated with pyrethroid resistance.

They identified four previously reported mutations:

• S989P and V1016G in Pashan and Kondhwa
• F1534C in Khadki, Susgaon, Warje, Yerawada and Hadapsar
• T1520I exclusively in Hadapsar

The D1763Y mutation, which can occur alongside V1016G, was not detected. The differences in mutations across wards suggest that resistance mechanisms may vary between mosquito populations.

Why Are Mosquitoes Becoming Resistant?

Pyrethroid resistance can develop through metabolic changes, target-site mutations, or both. Target-site changes, known as knockdown resistance (kdr) mutations, can reduce the ability of pyrethroids to act on the mosquito's voltage-gated sodium channel.

Pyrethroids have been widely used in India for mosquito control since the 1980s. Reduced susceptibility to deltamethrin, lambda-cyhalothrin and permethrin has also been reported in several states, including Assam, Delhi, West Bengal and Rajasthan.

The researchers noted that the widespread use of pyrethroid-based household mosquito-control products, including vaporizers, mats and coils, could potentially contribute to resistance.

What Does This Mean for Public Health?

According to the WHO South-East Asia Region Epidemiological Bulletin which reported 22,938 dengue cases in India through June 2026.

When mosquitoes develop resistance, more of them can survive exposure to insecticides that would normally kill susceptible mosquitoes. This could make controlling Aedes aegypti more difficult, particularly during dengue outbreaks.

Importantly, insecticide resistance does not mean the mosquitoes cause more severe dengue. The concern is that commonly used mosquito-control measures may become less effective.

The researchers called for regular resistance surveillance, insecticide rotation and locally tailored integrated vector-management strategies.

Did Insecticide Spraying Cause the Resistance?

The researchers noted that areas reporting more dengue cases may have experienced more frequent insecticide spraying, which could potentially be associated with higher resistance.

However, the study did not directly track insecticide use in these areas and did not establish that spraying caused the resistance.

The researchers stressed the need for continued surveillance to track resistance and adapt mosquito-control strategies to local conditions.

Future research could examine resistance genes through genetic mapping, transcriptomic profiling and CRISPR-Cas9 studies, while studying behavioral changes that may help mosquitoes survive insecticide exposure.