Every year, World Toilet Day is observed to raise awareness about the global sanitation crisis and encourage action to solve it. The goal set by the United Nation is to achieve safe toilets for all by 2023, as a part of their Sustainable Development Goals.

The UN also states that 3.5 billion people live without proper sanitation and many children also lose their lives due to poor sanitation and unsafe water. This is why World Toilet Day is observed to raise awareness on this issue.

Theme

This year, the theme for World Toilet Day 2024 is "Toilets - A Place for Peace'. This focuses on the growing threat to sanitation that is caused by conflict, climate change, disaster and neglect. When there is a threat to using toilets, it can lead to many health risks.

Not using toilets for too long may lead to Urinary Tract Infection or UTI. For many who do not have access to clean toilets do not drink enough liquid or hold pee for too long. Doctors suggest that holding in pee for too long can cause bacteria to multiply and lead to UTI. By not drinking enough water, your bladder fails to tell the body to pee often, and can cause the bacteria to spread through the urinary tract, which can lead to infection.

Symptoms of UTI:

• Burning or stinging feeling while urinating
• Pain in pelvis or lower abdomen
• Constant urge to empty the bladder
• Strong or foul smelling urine
• Consistently dark urine
• Blood in urine

Holding in pee for too long can also cause your bladder to stretch, making it difficult or even impossible for the bladder to contract and release pee normally. It can also damage your pelvic floor muscles or could lead to kidney stones.

World Toilet Day History And Significance

To prevent such conditions, it is important that everyone has access to clean and safe toilets. In terms of history, the day was established in 2001, by the World Toilet Organization (WTO), which was founded by Jack Sim. However, it was officially recognised by the UN in 2013. The Government of Singapore worked with WTO to create the first UN resolution called Sanitation for All.

India too promotes safe and hygiene toilet through its Swachh Bharat Yojna.

The US Food and Drug Administration (FDA) is investigating an outbreak of Salmonella Bovismorbificans infections in multiple states. According to reports, the at least infection cases are being linked to recalled broccoli sprouts across four states, including two hospitalisations. The outbreak hasn't resulted in any casualties yet.

The outbreak has been linked to broccoli sprouts grown by Evergreen Fresh Sprouts, LLC, based in Moyie Springs, Idaho. The FDA and the US Centers for Disease Control and Prevention (CDC) are investigating the outbreak with state and local health authorities.

The FDA has issued a clear warning: “Do not eat, serve, or sell recalled broccoli sprouts grown by Evergreen Fresh Sprouts, LLC.”

How Were The Broccoli Sprouts Linked To The Outbreak?

Also read: Granola Marketed For Nursing Mothers In US Recalled Over Potential Salmonella Contamination

According to the FDA, illnesses began between July 7 and August 26, 2026. Out of the 19 infected people who were interviewed by investigators, all 19 reported eating sprouts, while 17 specifically reported eating broccoli sprouts. That epidemiological pattern helped investigators identify sprouts as the likely driver of the infection.

Traceback investigations by the FDA and state partners then identified Evergreen Fresh Sprouts as the common grower of broccoli sprouts eaten by patients before they became sick.

On September 4, the company initiated a recall after Montana state officials found Salmonella in a sample of its broccoli sprout. Whole-genome sequencing showed that the Salmonella found in the product was the same strain causing illnesses in the outbreak.

The recalled products were sold in plastic bags or plastic clamshell containers and have expiration dates of September 7, 9, 11, 14 or 16, 2026.

Distribution has been confirmed in Idaho, Montana and Washington, although the FDA said the products may have reached additional states. The 22 cases are from Idaho, Montana, Utah and Washington.

What Is Salmonella And How Serious Can It Be?

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Salmonella is a group of bacteria that can cause salmonellosis, a gastrointestinal infection usually acquired by consuming contaminated food or water.

Symptoms typically begin 12 to 72 hours after exposure and can include diarrhoea, fever and abdominal cramps. Most people recover within four to seven days without specific treatment, but some infections can become severe.

Young children, older adults and people with weakened immune systems are at greater risk of serious complications from the infection. In severe cases, Salmonella can cause dehydration or allow the bacteria to enter the bloodstream, potentially leading to invasive infection and complications affecting other organs.

Why Can Raw Sprouts Carry Salmonella?

Sprouts are grown in warm, moist conditions, which help seeds germinate but can also provide favourable conditions for bacterial growth.

The seeds themselves can become contaminated before sprouting. Once bacteria are present, the warm and humid environment used to produce sprouts can allow them to multiply. Since sprouts are often eaten raw, there may be no cooking step to eliminate the bacteria.

The current FDA investigation involves broccoli sprouts, and it is separate from another ongoing US investigation involving Salmonella and E. coli infections linked to alfalfa sprouts.

Consumers, restaurants and retailers should not eat, sell or serve the recalled Evergreen Fresh Sprouts broccoli sprouts.

The FDA also advises people who purchased or received the recalled product to carefully clean and sanitise surfaces and containers that may have come into contact with the sprouts. This is important because Salmonella can spread through cross-contamination.

Anyone who develops symptoms resembling Salmonella infection after eating the recalled sprouts should contact a healthcare provider.

Col Anurag Upadhyay, a former Indian Army officer and Special Forces veteran, is living with locked-in syndrome, a rare neurological condition in which a person can remain conscious and aware while losing the ability to speak and move most muscles.

While there is currently no medicine or injection proven to reverse established locked-in syndrome, experts stress the importance of specialized neurorehabilitation, communication aids and appropriate assistive technologies.

Col Anurag’s Journey

A decorated Army officer and Special Forces veteran, Col Upadhyay suffered a severe posterior circulation stroke in August 2025. The stroke reportedly caused extensive neurological damage and left him with locked-in syndrome.

Despite being unable to move or speak normally, Col Upadhyay is conscious and aware. According to a social media post seeking medical and rehabilitation support for him, he communicates complete thoughts through eye movements and an alphabet-based scanning system.

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What Is Locked-In Syndrome?

Cleveland Clinic defines the syndrome as "a rare and serious neurological disorder that causes complete paralysis of all voluntary muscles except for the eyes, while leaving the person fully conscious and aware"

“Locked-in syndrome is one of the most devastating neurological conditions,” said Dr Sudhir Kumar, neurologist at Apollo Hospitals, Hyderabad, in a post on social media platform X.

The condition can leave a person unable to speak or move most muscles despite remaining conscious and aware.

It can severely affect communication and physical independence. However, the extent of impairment and potential for recovery can vary depending on the cause, location and severity of the brain injury, as well as whether the syndrome is complete or incomplete.

Is There A Medicine To Reverse It?

Dr Kumar said, “The honest answer is: There is currently no medicine or injection proven to reverse established locked-in syndrome.”

However, the absence of a proven medicine does not mean that supportive treatment and rehabilitation have no role.

Even after 13 months, Dr Kumar strongly recommended assessment at a specialised centre with experience in long-term neurorehabilitation and assistive technology.

Why Neurorehabilitation and Communication Matters

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Dr Kumar recommended a detailed reassessment by a multidisciplinary team that could include a neurologist, rehabilitation physician, physiotherapist, occupational therapist, speech and swallowing therapist, respiratory therapist, psychologist and specialist nurses.

Such an assessment can help identify even small voluntary movements that may have been missed or may have emerged over time.

He also recommended intensive, individualised neurorehabilitation focused on maintaining joint mobility, preventing contractures, improving head and trunk control, increasing sitting tolerance and supporting any residual voluntary movement.

“Even a small movement of a finger, thumb, head or eye can sometimes become functionally very important,” Dr Kumar said.

For people with locked-in syndrome, establishing a reliable way to communicate can be particularly important.

Dr Kumar stressed that “communication should be a top priority” and recommended considering an eye-gaze or eye-tracking communication system where appropriate.

“Restoring a reliable means of communication can dramatically improve autonomy and quality of life,” he said.

Swallowing, Respiratory Care And Mental Health

Dr Kumar also suggested “periodic reassessment of swallowing and bulbar function” and “speech-language therapy”, along with “chest physiotherapy, respiratory exercises, secretion management and periodic reassessment of ventilatory requirements”.

Emphasising the importance of mental health and quality of life, he said, “Never assume that a person with locked-in syndrome does not understand what is happening around them.”

What New Technologies Could Offer

Dr Kumar also highlighted “exciting ongoing research” into several technologies that could potentially improve communication, interaction and rehabilitation for people with severe paralysis.

These include:

1. Eye-tracking and advanced communication systems
2. Brain-computer interfaces (BCIs) that translate brain signals into computer commands
3. BCI-assisted communication for people with severe paralysis
4. Robotics and functional electrical stimulation
5. Virtual reality and technology-assisted rehabilitation
6. Non-invasive brain stimulation, such as transcranial direct current stimulation, currently being explored as an adjunct to rehabilitation

However, these technologies should not be presented as established treatments for locked-in syndrome.

“These technologies are promising, but it is important to be realistic: most are not yet proven treatments capable of reliably reversing locked-in syndrome,” Dr Kumar said.

For people living with locked-in syndrome, continued access to evidence-based rehabilitation, communication tools, assistive technologies and specialised care can remain important.

“For a man who has served our country, we owe him continued care, respect and access to every evidence-based opportunity for rehabilitation,” Dr Kumar said.

“There may not be a miracle medicine today. But there is still meaningful medicine to be practiced and meaningful hope to be offered.”

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.