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.

More than two hours of daily screen time could be associated with around 2.8 million healthy years of life lost to depression and 240,000 healthy years lost to obesity worldwide each year, according to a new three-paper series published in The Lancet.

However, the authors stressed that these are illustrative estimates, not precise measurements of the global health burden, because the certainty of the underlying evidence is low.

"Our global projections of how many healthy years could be lost to depression and obesity linked to excessive screen time are intended to be illustrative of the possible scale of harm," said Dr. Falk Müller-Riemenschneider of the National University of Singapore. "They should not be taken as an accurate measurement of harm."

The series, authored by 13 global experts, argues that simply limiting screen time may not be enough to protect children and young people from digital harms.

Why Screen-Time Rules May Not Be Enough

Also read: US Surgeon General Issues Advisory To Limit Children's Screen Time

The experts analyzed 121 reviews covering around 9 million people under 25.

They found consistent associations between problematic digital media use — defined as addiction-like patterns rather than simply time spent online — and:

• Common mental health problems
• Sleep problems
• Reduced physical activity

The review also found some potential benefits. Moderate digital media use was associated with higher well-being, while active video game use was associated with higher well-being and healthier lifestyles.

The authors therefore argue that what young people do online, how platforms are designed and how they are governed may matter as much as how long they spend online.

What is Driving Digital Health Risks

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Features such as infinite scroll, autoplay and personalized recommendation feeds are designed to capture attention and collect data, the authors said.

"Most digital platforms are designed by companies to capture attention and collect data, not to protect health," said Dr. Jay Shaw of the University of Toronto.

He added that more research is needed into how specific platform features influence digital media use rather than focusing only on time spent online.

Series chair Professor Ilona Kickbusch said governments must make children's health and online safety a global policy priority.

"Governments have let technology companies write their own rules, leading to business models built to capture attention and collect data, with health treated as an afterthought," she said.

What the Lancet Series Recommends

The authors call for coordinated action by technology companies, governments and international bodies rather than relying on a single intervention such as age limits.

Their recommendations include:

• Requiring companies to assess new products and features for potential health harms before release.
• Giving vetted public-interest researchers access to data on how platform features affect health.
• Establishing global standards through a WHO governance treaty.
• Creating an international body to monitor AI-related harms to children and young people.
• Using litigation as one route to hold technology companies accountable.

"A key recommendation of our series is that governments should require technology companies to share data on how their features affect users' health with vetted public-interest researchers," said series author Louise Holly.

The series also included a Youth Advisory Group of six young adults aged 23 to 30.

"The health risks and harms associated with digital systems are preventable," said Dr. Salman Fitrat Khan of India. "Governments shouldn't wait for 'perfect' evidence before acting for our generation and the ones coming after us."

A suspected plague case linked to the death of a lab worker at an anti-plague research facility in Russia has sparked questions about whether the incident could pose a wider pandemic threat.

However, Russian authorities have not confirmed plague. Russia's consumer safety watchdog, Rospotrebnadzor, said the woman's diagnosis was “pneumonia of unknown etiology.” Expanded testing of samples taken from her did not identify microorganisms associated with her professional activities, the agency said.

Nearly 200 people who may have come into contact with her remain under medical observation, but authorities have reported no symptoms or positive test results among those monitored.

Could This Become Another Pandemic?

Experts say comparisons with COVID-19 should be treated cautiously because pneumonic plague and viral respiratory diseases behave very differently.

Dr Simon Clarke, an expert from the University of Reading, said pneumonic plague is caused by Yersinia pestis, the bacterium responsible for plague.

“Pneumonic plague is particularly serious because it means the infection has reached the lungs and is nearly always fatal if not treated promptly,” said Clarke, associate professor in cellular microbiology in the School of Biological Sciences at varsity.

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Unlike bubonic plague, which is commonly associated with infected flea bites, pneumonic plague can spread between people through respiratory droplets during close contact. But there is an important difference from diseases such as COVID-19.

“Unlike many viral respiratory diseases, plague is caused by bacteria and is generally treatable with antibiotics if identified quickly,” Clarke said, in a post on the University's website.

Could Pneumonic Plague Spread Widely?

Pneumonic plague can spread from person to person, making rapid identification and contact tracing important. But that does not mean every suspected case carries pandemic potential.

Clarke said more information is needed to determine whether the Russian incident represents an isolated case, an occupational exposure or evidence of wider transmission.

“Transparency, rapid diagnosis and effective contact tracing would be the most important factors in managing an outbreak,” he said.

Dr Richard Hirschson, a specialist general physician at Sydney Adventist Hospital, said “a local Russian lab leak is a local issue, it will not become a global pandemic”.

In a post on social media platform X, he said isolation and preventive antibiotic treatment for exposed contacts can help limit transmission if pneumonic plague is confirmed.

Expert Says We Don't Even Know If This Is Plague

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Dr Krutika Kuppalli, an infectious disease specialist and Associate Professor in the Department of Internal Medicine at University Texas Southwestern Medical Center, urged caution over the growing speculation.

“But right now, we have an unexplained death from pneumonia—not confirmation of plague and certainly No evidence of a plague outbreak,” Kuppalli said on X.

“It’s appropriate to watch closely and ask questions. It’s not helpful to fill gaps in information with speculation and sensationalism. Good outbreak response starts with the same thing every time: -- follow the evidence,” she added.

Kuppalli also stressed the importance of public health preparedness in responding to emerging infectious threats.

“Infectious disease threats don’t follow political calendars,” she said. “This is why public health matters and why weakening our surveillance, expertise and response capacity should concern everyone. Pathogens aren’t political. Preparedness matters.”

What We Know About Pandemic Risk

As of now, there is no confirmed evidence of a plague outbreak or sustained person-to-person transmission linked to the Russian case.

The immediate priority is to determine what caused the woman's pneumonia while continuing to monitor potential contacts.

Even if plague is eventually confirmed, experts say its bacterial nature, antibiotic sensitivity and transmission pattern make it fundamentally different from the respiratory viruses that can spread silently and extensively through populations.

For now, the evidence supports close surveillance and investigation—not a conclusion that a new pandemic is emerging, the experts said.

Punjab is implementing routine screening for HIV, Hepatitis B and Hepatitis C at government de-addiction and rehabilitation centres, highlighting the importance of testing for three major blood-borne infections in addiction patients.

The initiative, referred to as 'Triple H' screening, is being introduced under the state government’s Yudh Nashean Virudh campaign. The aim is to spot infections earlier, ensuring people undergoing treatment for substance use receive appropriate medical care when needed.

The initiative is meant to curb risks of HIV and Hepatitis B and C, especially in people who inject drugs and share contaminated needles and syringes. It is crucial as infections can also remain undetected for years.

Punjab Is Changing Its Screening Approach

Also read: H. pylori, HPV Among Five Infections Behind 1 In 8 Cancers Worldwide: Lancet

Until now, HIV and hepatitis screening at de-addiction facilities was largely conducted through medical camps, which were often held around every two months. While these camps provided testing opportunities, officials said that there was limited scope to track who had been tested, who had missed screening, and who needed further care.

Under the new system, screening will be integrated into the de-addiction and rehabilitation process. This could give people ample opportunities to get tested and allow those with positive results to be referred for intensive testing, treatment, and timely medical care.

Announcing the initiative, Health and Family Welfare Minister Dr. Balbir Singh spoke about the importance of early detection of blood-borne infections in those at high risk.

Dr. Singh said, “People with a history of injecting drug use face an increased risk of blood-borne infections, and that early detection is important for timely medical care and counselling.”

He also said that the initiative goes beyond treating patients struggling with drug addiction. The minister emphasised that this could indirectly help build better lives for themselves.

He added, “Under the leadership of Chief Minister Bhagwant Mann, Yudh Nashean Virudh is leading a revolution towards a stronger, healthier and prosperous Punjab. Our goal is not simply to help people overcome addiction, but also to enable them to lead healthier lives and contribute to society. By integrating HIV, Hepatitis B and Hepatitis C screening into de-addiction services, the Government is taking another important step towards ensuring that recovery leads to a meaningful and brighter future.”

Also read: 8-Weekly HIV Injections Keep Virus Suppressed Better Than Daily Pills In Adolescents: Lancet Study

Punjab Had Already Intensified HIV Screening

The latest announcement comes months after Punjab ordered HIV screening for people registered at its Outpatient Opioid Assisted Treatment (OOAT) centres.

In May, the state had 455 operational OOAT centres with 3,09,918 registered clients undergoing treatment for substance use.

That move came after findings from the National AIDS Control Organisation showed that Punjab recorded a 58.7% increase in annual new HIV infections between 2010 and 2024.

The report also found that 56% of newly detected HIV-positive cases in Punjab were linked with contaminated syringe use.

The state has also said testing for HIV, Hepatitis B and Hepatitis C is available free of cost at Aam Aadmi Clinics.

Earlier in August, Punjab announced the adoption of Nucleic Acid Testing (NAT) and Chemiluminescence Immunoassay (CLIA) technologies to strengthen the early detection of infections that are transmitted through infusions and improve blood safety.