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.

Simplicity and Affordability of the Polypill Strategy

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.

Is This a Case of Over-Medicalisation?

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.

The World Health Organization (WHO) has validated El Salvador for eliminating trachoma, the world's leading infectious cause of blindness, as a public health problem.

El Salvador is the first country in Central America and the second in the Americas to achieve this milestone.

"I congratulate El Salvador on this remarkable achievement. It is a testament to the power of political commitment, strategic investment, and community engagement," said WHO Director-General Dr Tedros Adhanom Ghebreyesus.

"El Salvador's success is a vital step towards our global target of eliminating trachoma worldwide by 2030 and a clear signal that a healthier, more equitable future is within reach," he added.

El Salvador's Journey To Trachoma Elimination

Also read: US Appeals Court Revives Over 500 Tylenol Lawsuits Over Autism Claims

Between 2023 and 2026, El Salvador conducted targeted assessments in communities identified as at higher environmental and social risk. The surveys found no evidence of active trachoma transmission.

As per the WHO, "no cases of active disease were detected in children, and no adults were found to have advanced trachoma capable of causing blindness". These findings confirmed that trachoma is no longer a public health problem in the country, the UN health agency said.

El Salvador's achievement was supported by a coordinated approach that included:

• Strengthening primary healthcare services
• Improving water, sanitation and hygiene (WASH)
• Expanding eye health services, including adult vision screening
• Collaboration between government agencies, communities and international partners

The country has also established trained health personnel, integrated surveillance systems and the capacity to detect and treat trichiasis—the advanced stage of trachoma in which eyelashes turn inward and can lead to blindness.

What Is Trachoma?

Trachoma is a bacterial eye infection caused by Chlamydia trachomatis. It can spread from person to person through contaminated fingers, fomites and flies that could come into contact with discharge from the eyes or nose of an infected person.

Environmental risks like poor hygiene, overcrowded households, and inadequate access to water and sanitation facilities can also lead to trachoma.

Repeated infections can scar the inner eyelid, causing the eyelashes to turn inward—a condition known as trichiasis. Without treatment, the eyelashes scratch the surface of the eye, potentially leading to irreversible blindness.

Read More: Wegovy More Likely To Cause Rare Blindness Than Ozempic And Other Similar Drugs, Recent Study Finds

Trachoma Still Persists In Parts Of The Americas

Although El Salvador has eliminated trachoma as a public health problem, the disease remains endemic in rural and remote areas of Brazil, Colombia, Guatemala and Peru.

WHO recommends that countries maintaining elimination continue surveillance and ensure access to quality eye care services to prevent the disease from re-emerging.

WHO Criteria For Elimination

WHO defines elimination of trachoma as a public health problem based on three key criteria:

• Trichiasis prevalence of less than 0.2% among people aged 15 years and older.
• Active trachoma (trachomatous inflammation–follicular) prevalence of less than 5% among children aged 1–9 years in every previously endemic district.
• A functioning health system capable of identifying and managing new trichiasis cases.

With this achievement, El Salvador joins 64 countries worldwide that have been validated by WHO for eliminating at least one neglected tropical disease. Seven of these countries are in the Americas.

While there is no firm scientific evidence linking Tylenol use during pregnancy to autism, a US federal appeals court has revived more than 500 private lawsuits against the painkiller's maker, Kenvue, over claims that prenatal exposure to acetaminophen contributed to autism and attention-deficit/hyperactivity disorder (ADHD) in children.

The ruling does not determine that Tylenol causes autism or ADHD. Rather, it held that expert testimony supporting the plaintiffs should not have been excluded from the lawsuits.

What Did The US Appeals Court Say

On July 13, the 2nd US Circuit Court of Appeals in Manhattan overturned a December 2024 ruling by US District Judge Denise Cote, who had dismissed the lawsuits after rejecting the methodology of the plaintiffs' expert witnesses.

In its 64-page decision, the three-judge panel said the district court had improperly excluded expert testimony from three doctors presented by parents and guardians seeking to link prenatal Tylenol use with autism and ADHD.

Circuit Judge Guido Calabresi wrote that the experts' methods reflected approaches used by other scientists and "constitute acceptable interpretations of scientific evidence where scientists may, and in fact do, disagree."

Also read: Not Lyme Disease, Canada Sees Rise in Another Tick-Borne Infection As Temperatures Increase

Court Did Not Rule That Tylenol Causes Autism

The appeals court emphasized that it was not deciding whether acetaminophen causes autism or ADHD, nor was it making any public health determination.

Instead, the ruling focused solely on whether the expert testimony met the legal standards required to be considered in court.

The three experts whose testimony was reinstated include:

• Andrea Baccarelli, Dean of Harvard University's School of Public Health
• Eric Hollander, Professor of Psychiatry at Albert Einstein College of Medicine
• Brandon Pearson, Toxicologist at Columbia University

Ashley Keller, a lawyer representing the families, said the panel unanimously found that the experts had reliably applied accepted scientific methods.

Kenvue Defends Tylenol's Safety

Kenvue, which was spun off from Johnson & Johnson in 2023, said it continues to stand by the safety of Tylenol.

"We stand behind the safety of our product and will continue to defend these cases," the company said in a statement.

Several retailers and pharmacy chains—including CVS, Kroger, Target, Walgreens, and Walmart—have also been named as defendants.

Trump Administration's Remarks Sparked Debate

The lawsuits gained attention after President Donald Trump and Health and Human Services Secretary Robert F. Kennedy Jr. issued guidance last year discouraging pregnant women from using acetaminophen, citing it as a possible contributor to autism.

The remarks triggered concern among expectant mothers and prompted criticism from many healthcare experts and medical organizations, which said the evidence does not support such definitive claims.

Is Acetaminophen Linked to Autism or ADHD?

The scientific evidence remains inconclusive. Some observational studies have reported a possible association between prolonged acetaminophen use during pregnancy and an increased risk of autism or ADHD in children. However, many other studies have found no significant link.

Importantly, an association does not prove that acetaminophen causes these conditions. Researchers note that factors such as maternal illness, genetics, underlying medical conditions, and other environmental influences may also affect a child's neurodevelopment.

As a result, experts say more high-quality research is needed before any causal relationship can be established.

What Do Medical Experts Recommend?

Major medical associations continue to consider acetaminophen the preferred pain reliever and fever reducer during pregnancy when used appropriately.

Doctors advise pregnant women to:

• Use the lowest effective dose for the shortest necessary duration.
• Avoid prolonged or unnecessary use without medical advice.
• Consult their healthcare provider before taking any medication during pregnancy.

Medical societies have also cautioned against avoiding acetaminophen altogether, noting that untreated high fever or severe pain during pregnancy can pose risks to both the mother and the developing baby.

Michigan health officials say that they may have identified the possible source behind one of the largest Cyclosporiasis outbreaks the state has ever recorded. Thousands of people were sickened by a parasitic infection that can cause severe, watery, or even “explosive” diarrhea.

Source Behind Cyclospora Outbreak Traced

On July 13, the Michigan Department of Health and Human Services (MDHHS) announced preliminary findings from its investigation point to lettuce or other salad greens as the possible source of Cyclospora outbreak.

However, officials stressed that the investigation is in progress, and no specific product, grower, distributor, or supplier has yet been identified for certain.

Health officials also interviewed more than 1,000 patients to identify common exposures.

Early analysis also repeatedly identified lettuce and salad greens as foods consumed before illness, prompting the state to issue precautionary guidance while the investigation continues.

"Although we do not have a definite product identified as the source of the outbreak, we want to let Michiganders know what we have learned so far so they can take steps to protect their families," said Dr. Natasha Bagdasarian, Michigan's chief medical executive, in a state statement.

Also read: As Cyclospora Cases Surge In The US, Expert Explains Why India's Monsoon Raises Risk Of The Parasitic Infection

Cyclospora Cases Continue To Surge

The outbreak has continued to expand at an extraordinary pace since late June. As of July 13, Michigan reported 2,640 cases of Cyclosporiasis, with 44 hospitalizations.

No deaths have been reported so far. The number represents a dramatic increase from the state's usual annual number, which is around 40 to 50 cases.

Preventing Cyclospora

Cyclospora is a parasite that infects people after they consume food or water contaminated with human feces containing the parasite's eggs (oocysts).

Although the illness is usually not life-threatening, it can cause prolonged diarrhea, stomach cramps, nausea, fatigue, bloating, and weight loss.

According to recent reports, fresh produce like salad greens and lettuce are being considered the most common source of infection, though contaminated water can also spread the parasite.

Also read: Explosive Diarrhea Parasite Spreads Across US: Why CDC Is Unable To Find The Source?

Health officials have advised people to avoid fresh produce. Previous Cyclospora outbreaks in the US have frequently been linked to imported fresh produce, including:

• Basil

• Cilantro

• Mesclun lettuce

• Raspberries

• Snow peas

How To Clean Fresh Produce Safely?

While washing produce cannot eliminate all risks, experts say it can reduce contamination. They advised washing fruits and vegetables thoroughly under clean running water and washing hands before and after handling fresh produce.

According to the Michigan Department of Health and Human Services, cooking produce whenever possible during an active outbreak is crucial, as heating food to at least 158°F (70°C) kills Cyclospora.

For specific produce, it suggested:

• Cilantro and basil: Separate the leaves and rinse each thoroughly under running water.

• Green onions: Trim off the roots, remove the outer layer, and rinse well.

• Snow peas: Rub the surface gently while washing under running water.

• Raspberries: Because of their delicate, uneven surface, raspberries are difficult to clean thoroughly. Cooking them in pies or jams is safer. Freezing may reduce the number of parasites but is unlikely to eliminate them completely.

• Leafy greens: If possible, choose whole heads of lettuce instead of bagged salad mixes. Discard the outer leaves and wash the remaining leaves under running water before eating.