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Heart attacks and strokes are among the leading causes of death globally, with millions suffering from cardiovascular diseases (CVD) every year. There are more than seven million people in the UK alone, with about 100,000 patients experiencing heart attacks annually. However, a group of researchers at University College London (UCL) estimate that one 'polypill' taken daily day could eliminate a majority of these cases dramatically lowering death tolls.
The proposed polypill, a combination of a statin and three blood pressure-lowering drugs, has been under study for over two decades. Experts argue that introducing this pill universally for individuals aged 50 and above could be more effective than the current NHS Health Check, which assesses risk factors every five years for those aged between 40 and 74.
Studies have repeatedly proven the effectiveness of the polypill in preventing CVD. A groundbreaking 2019 study in The Lancet found that five years' use of the polypill cut the risk of heart attack and stroke by a third. In addition, previous modelling analyses have estimated that if given universally to people over 55, the polypill might be able to prevent 80% of heart attacks and strokes.
Today, the NHS Health Check follows a risk-based model in which patients are tested for CVD risk factors and treated with drugs accordingly. Yet, as per UCL's study, this system has serious flaws:
Low Uptake: Just 40% of those eligible for the NHS Health Check choose to have it, leaving a considerable number of at-risk patients undiagnosed and untreated.
Ineffective Prediction of Risk: The majority of heart attacks and strokes happen to people at average risk levels, thus making it challenging to identify the need for intervention effectively.
Limited Effectiveness: Even at maximum take-up, the NHS Health Check programme is predicted to have fewer health impacts compared to a polypill initiative applied to the whole population.
One of the big benefits of the polypill is that it is so easy. In contrast to the existing screening-based model, the polypill scheme would not involve complicated medical tests or lengthy risk assessments. Instead, people reaching 50 would just have to fill out a few questions to determine possible side effects before they were prescribed.
Professor Aroon Hingorani of the UCL Institute of Cardiovascular Science, one of the strongest proponents of this scheme, says:
"Finally, the time is now to do much better on prevention. A population approach would prevent a lot more heart attacks and strokes than is done today with a strategy of trying to target a smaller group only."
Aside from the possible health implications, the polypill is also an economic solution. The drugs used are off-patent, thus cheap to produce and distribute. With the vast economic cost of managing CVD-related illnesses, a preventive model could result in substantial cost-saving for the NHS in the future.
The polypill has been proven to be effective by numerous international trials. In 2019, a randomised trial in rural Iran discovered that participants who took the polypill for five years had a 34% reduced risk of having a heart attack or stroke compared to non-participants.
Likewise, modelling research has indicated that even if only 8% of people aged over 50 took up the polypill regimen, it would still be more beneficial to their health than the NHS Health Check programme.
One of the main objections to the polypill strategy is the suggestion that it might result in the unnecessary medicalisation of a significant proportion of the population. But, it is argued, it should be considered as a preventative measure, not as mass medication.
Professor Sir Nicholas Wald of UCL's Institute of Health Informatics explains:
"Instead of being a 'medicalisation' of a significant proportion of the population, a polypill programme is a prevention measure to prevent an individual from becoming a patient."
He compares it with public health measures like water fluoridation or compulsory seatbelts—interventions that have been shown to have a significant impact in reducing public health danger at low individual cost.
With the evidence in favour of the polypill's effectiveness and viability overwhelming, experts are calling on the NHS to act now. It is their belief that substituting the NHS Health Check with a polypill-based prevention program could be the UK government's flagship policy under its pledge to put disease prevention ahead of cure.
As Professor Hingorani points out, "The status quo is not a justifiable option." With CVD still a major cause of death globally, taking a population-wide polypill approach could be a turning point for preventative medicine, potentially saving thousands of lives annually. The question now is whether the NHS will take up this call and establish a policy with the potential to transform the prevention of cardiovascular disease on a national level.
Credit: CDC
The Cyclospora outbreak that has spread across the US for more than three months has turned deadly, with Michigan—the hardest-hit state—reporting the country's first two deaths linked to the diarrhea-causing parasite.
According to the Michigan Department of Health and Human Services (MDHHS), both individuals had significant underlying health conditions.
"Two deaths have been identified as part of the cyclosporiasis outbreak affecting Michigan. According to medical records, both individuals had significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration," the department said.
Health officials stressed that deaths from cyclosporiasis are rare, as the infection is generally not life-threatening. Michigan has reported 11,234 cases, including 193 hospitalizations.
The US Centers for Disease Control and Prevention (CDC) also confirmed the two outbreak-related deaths in Michigan. As of its July 28 update, the agency has recorded 6,707 laboratory-confirmed cases across 45 states since May 1, along with more than 11,500 suspected cases—primarily in Michigan and Ohio—that are yet to be laboratory confirmed. The outbreak has resulted in 423 hospitalizations.
The US Food and Drug Administration (FDA) has linked part of the outbreak to iceberg lettuce supplied by Taylor Farms de Mexico. The company voluntarily recalled affected products on July 17 and said it will no longer source iceberg lettuce from central Mexico for the rest of the growing season.
The recalled lettuce has been linked to illnesses in Indiana, Kentucky, Michigan, Ohio, and West Virginia. Separately, the CDC, FDA, and state health officials are investigating another Cyclospora outbreak linked to iceberg lettuce in nine states, which has sickened at least 1,947 people and hospitalized 98.
Officials are also investigating whether parsley and cilantro may be linked to the outbreak.
Cyclospora is a parasite that infects the intestines and is usually spread through contaminated food or water.
Most infections are mild and resolve without treatment. However, the illness can be prolonged or severe in people with weakened immune systems, who may require antibiotic treatment.
If you develop symptoms:
Doctors diagnose cyclosporiasis with a stool test that detects the Cyclospora parasite shed in stool.
Although some mild infections may resolve on their own, confirmed cases should be treated with antibiotics. The recommended treatment is the antibiotic trimethoprim/sulfamethoxazole (TMP-SMX).
Your doctor may also recommend:
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An 86-year-old sheep farmer from Wales recently shared how he unknowingly lived with a rare parasitic disease for years before experiencing what he described as "the worst pain" of his life.
The rare case has highlighted a little-known infection that experts say can remain hidden inside the body for decades.
Meredydd Jones, from Trecastle in Powys, was diagnosed with hydatid disease, a parasitic infection caused by the tapeworm Echinococcus granulosus.
He said that slow-growing cysts had been developing in his lungs for years before he was rushed to the hospital after he complained of severe pain in 2016.
"I hadn't been able to control the pain, and it was more intense than anything I had before," Jones recalled. He later underwent two surgeries in 2018 and 2019 to remove cysts from both lungs, while another cyst in his liver continues to be monitored.
The case comes as Public Health Wales raise concerns that the disease, though uncommon, remains a significant public health issue in sheep-farming regions.
Hydatid disease, also known as cystic echinococcosis, is caused by the larval stage of the Echinococcus tapeworm.
The parasite typically circulates between dogs and livestock such as sheep and cattle. Humans become accidental hosts after ingesting microscopic tapeworm eggs, usually through contact with infected dogs or contaminated food, water, or soil.
Unlike many infections, hydatid disease develops very slowly and gradually. The parasite forms fluid-filled cysts that most commonly affect the liver and lungs, although they can also develop in the brain, bones, or other organs.
According to Dr Chris Williams, consultant epidemiologist at Public Health Wales, the disease can remain hidden for an unusually long time.
"What happens is normally the tapeworm transmits between farm animals like sheep and cows to dogs, and the dogs excrete eggs," he explained. "Unfortunately, if humans ingest the eggs, they can then form cysts within humans."
He added that symptoms may not appear for 10 to 20 years, which is why infections are often discovered only after cysts become large enough to cause complications. Depending on where the cysts develop, people may experience:
Public Health Wales says hydatid disease is uncommon but can have serious health consequences if left untreated.
Researchers at Aberystwyth University are now studying dogs, livestock and farming practices to better understand whether the parasite is emerging again in parts of Wales.
The project includes analysing dog faecal samples and tracking farm dogs to understand how the parasite may spread between farms. Experts say prevention remains the most effective strategy.
Regular deworming of dogs, proper disposal of livestock carcasses, avoiding feeding dogs raw offal, and practising good hand hygiene after handling animals can significantly reduce the risk of infection.
Credit: AI image
The deadly and highly contagious disease smallpox, eradicated worldwide in 1980 through vaccination, was introduced to the Americas by Europeans, according to a new study that analyzed DNA from 500-year-old Inca mummies.
Smallpox, caused by the variola virus, played a major role in the devastating population decline among Indigenous people in the Americas following the arrival of Christopher Columbus in 1492.
Historians have long believed that smallpox reshaped societies and killed millions worldwide. However, direct genetic evidence linking European strains to outbreaks in the Americas had been lacking.
Dr. Shigeki Nakagome from Trinity College Dublin's School of Medicine said the findings provide "the first molecular confirmation that smallpox was carried to the Americas during the colonial period."
The researchers added that the findings could also help improve understanding of how pathogens evolve, with potential relevance for diseases such as influenza, COVID-19 and mpox.
Published in the journal Science, the researchers sequenced ancient smallpox DNA from two individuals buried in northern Chile between 1492 and 1631 CE, during the transition from the Inca to the colonial period.
The analysis showed that the viruses belonged to a now-extinct lineage of the variola virus, closely related to ancient European strains that disappeared before the 20th century. These are the earliest smallpox genomes recovered from the Americas, providing a clearer timeline of the virus's evolution.
Researchers also noted that skin lesions previously thought to result from arsenic exposure are consistent with smallpox infection.
The team identified the same viral strain in multiple individuals of Native American ancestry, suggesting local transmission within Indigenous communities during the colonial era.
The study also provides new insights into how the virus evolved over time.
"We found that the virus underwent a long period of genetic change up to the 16th century, but its evolution slowed markedly during the height of colonial expansion and major smallpox epidemics in the 17th and 18th centuries," said Dr. Lara Cassidy from Trinity College Dublin's School of Genetics and Microbiology.
She said the virus may have reached an evolutionary optimum, allowing it to spread efficiently with little further adaptation, likely aided by the lack of immunity in newly exposed populations.
The researchers also found evidence that this period of evolutionary stability may have ended in the 19th century as vaccination became widespread. As immunity increased, the pace of viral evolution appears to have accelerated again.
Bruno Romero González, a PhD student at Trinity College Dublin's School of Medicine, said the findings show how colonization, population change and vaccination likely shaped the evolution of one of humanity's most devastating infectious diseases.
The study also demonstrates the power of ancient pathogen genomics, showing how ancient DNA can uncover aspects of disease history that are not preserved in historical records.
Smallpox spread mainly through respiratory droplets released during coughing, sneezing or close contact. The disease caused fever followed by a characteristic rash that developed into fluid-filled blisters and scabs.
About 3 in 10 infected people died, while many survivors were left with permanent scars, particularly on the face. Some also lost their vision. Following a global vaccination campaign, smallpox was declared eradicated in 1980, with the last naturally occurring case reported in 1977.
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