If hand sanitisers kill 99.99% of germs, then who are those 0.01% who survive? There are three major kinds of germs which remain active even when you have used your sanitiser.

Norovirus

Among them, is the norovirus that causes diarrhoea and vomiting outbreaks in places like cruise ships and schools. It is superior to many other viruses because it has a protein capsid, which is resistant to the effects of alcohol.

Norovirus is a group of viruses that causes common illnesses and is also very contagious. It is especially active in the colder month and comes back seasonally. The first norovirus outbreak occurred in Norwalk, Ohio, USA, in a school in 1968, this is where it gets it name from.

Enterococcus faecium

The next on the list is enterococcus faecium, and it lives in the gut. As per a 2024 study titled Enterococcus faecium: evolution, adaptation, pathogenesis and emerging therapeutics, published in Nature journal, it is a Gram-positive bacterium that is a core member of the intestinal microbiota of humans and animals and an opportunistic pathogen that causes life-threatening infections, particularly among hospitalized patients. It mutates in a way that it absorbs carbohydrates and forms a gooey, slime-like substance called the biofilm, which makes it resistant to alcohol.

Clostridium Difficile

Another one is clostridium difficile. This is responsible for causing horrendous diarrhoea and vomiting in hospitalised patients. It also has a remarkable ability to respond to environmental stressors including alcohol gel by going to sleep. It produces spores and allows all metabolic activity.

Clostridium difficile (C. diff) is a type of bacteria that can cause colitis, a serious inflammation of the colon. Infections from C. diff often start after you've been taking antibiotics. It can sometimes be life-threatening.

Why Do You Label Read 99.99%?

Apart from the germs and pathogens, another reason why your label reads that it kills 99.99% is to avoid any legal hassles. If someone uses a specific product and falls sick, then the person cannot sue the company as the company did not give a 100% safety guarantee against the germs.

A better way to be healthy is always to clean your hands with soap and water and wear gloves wherever is possible.

The World Health Organization (WHO) recommended that vaccine manufacturers must completely change the three viral strains included in the vaccines for the Northern Hemisphere's next influenza season. This is in the backdrop of the new strain called the influenza A (H3N2) or the subclade k, also known as the super flu. This flu season's vaccine was manufactured before the new strain was detected, which is why there was a mismatch. However, this does not mean that the vaccine was ineffective. In order to achieve better immunization, the WHO has asked manufacturer to consider the viral strain for newer vaccines.

The United States also saw a hike in the numbers of flu patients, including hospitalization. As per the Centers for Disease Control and Prevention or the CDC data, the country saw a 48 per cent hospitalization increase in every week.

However, with the US exiting out of the WHO could be a hurdle for the US Foods and Drugs Administration or the FDA to approve the WHO updates. Furthermore, the vaccine overhaul too have removed influenza vaccine from the mandatory coverage.

What Does The New WHO Influenza Vaccine Mean For The US?

The latest flu vaccine recommendations from the World Health Organization come at a politically sensitive moment. They are the first issued since the United States formally withdrew from WHO on January 22. The US has long been one of WHO’s largest contributors, providing more than $680 million annually in recent years, according to the Department of Health and Human Services.

Despite the withdrawal, NPR reported that scientists from the Centers for Disease Control and Prevention attended the strain selection meeting virtually. The gathering took place in Istanbul, Turkey.

Daniel Jernigan, former head of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, said the newly announced vaccine composition underscores why continued engagement with WHO is essential. He noted that flu prevention depends on global cooperation. Through WHO’s network, the CDC gains access to virus samples from around the world, while WHO-affiliated labs benefit from the CDC’s specialized testing capabilities. According to him, the collaboration strengthens both sides.

Concerns had surfaced about how the US exit might disrupt flu vaccine production. Andrew Pekosz, a professor at the Johns Hopkins Bloomberg School of Public Health, acknowledged that many researchers were worried about potential ripple effects.

However, two of the strains selected for next fall’s flu vaccines are based on virus samples collected in Missouri and Pennsylvania. That detail suggests that US scientists remain actively involved in surveillance and strain identification. Jernigan pointed out that this is particularly important for improving protection against recently circulating flu B viruses, especially in children. He added that if the CDC were ever prevented from participating in WHO’s network, both the US and international partners would lose valuable data and expertise.

Pekosz explained that the global flu monitoring system was intentionally designed with redundancy. Independent laboratories worldwide collect and analyze viral samples before submitting them to centralized databases. Multiple facilities can grow and test these viruses, ensuring backup capacity if one lab encounters problems. This structure helps safeguard vaccine development from single-point failures.

Danuta Skowronski, MD, a flu researcher at the British Columbia Centre for Disease Control in western Canada, emphasized that these lab networks enable researchers to monitor the genetic makeup of circulating viruses in near real time. Academic centers and vaccine effectiveness networks also contribute data, reinforcing the global surveillance web.

Countries typically look to WHO guidance when deciding their own vaccine formulations. In the United States, the Food and Drug Administration has historically aligned its recommendations with WHO’s selections. The FDA’s Vaccines and Related Biological Products Advisory Committee is scheduled to meet March 12 to discuss upcoming flu shot recommendations.

Still, uncertainty remains over how US regulators will proceed. Jernigan questioned whether the FDA will follow WHO’s updates without introducing additional hurdles for manufacturers preparing this fall’s vaccines.

Over the past year, several public health decisions have surprised experts, including shifts in vaccine-related policies. Earlier this month, the FDA initially declined to consider Moderna’s mRNA flu vaccine, a technology that could potentially reduce production time from six months to as little as six to eight weeks. Such speed could allow manufacturers to respond more quickly to late-emerging viral strains. The agency reversed that decision a week later.

Further uncertainty surrounds Health and Human Services Secretary Robert F. Kennedy Jr., who has previously expressed skepticism about vaccines. He has made claims linking flu shots to his own spasmodic dysphonia, though there is no scientific evidence supporting that assertion.

Against this backdrop, experts stress that global coordination remains central to effective influenza prevention, regardless of shifting political landscapes.

A recent study by the Indian Council of Medical Research (ICMR) showed that more than 40 percent of prostate cancer patients in the country are diagnosed after the cancer has spread.

The 43 percent of late diagnosis cases indicates the significant burden of late detection of prostate cancer in the country. This can not only limit treatment options but also lead to poorer survival outcomes.

The study, published in the Indian Journal of Surgical Oncology, revealed that while more than 80 per cent began treatment within two months, but referral patients experienced longer delays.

Researchers from the ICMR’s National Centre for Disease Informatics and Research, in Bengaluru, stressed the need to strengthen referral pathways to ensure timely, stage-appropriate care.

“Our study indicates that over 80 percent of patients commence treatment within two months of diagnosis, but referral systems and delays in care persist,” said corresponding author Prashant Mathur, Director, ICMR-NCDIR, in the paper.

“To address these challenges, the healthcare system must prioritize improving referral efficiency, reducing administrative bottlenecks, enhancing coordination through digital health records, and multidisciplinary tumor boards,” the authors added.

Age, The Strongest Risk Factor For Prostate Cancer

The ICMR study is based on an analysis of 9,347 cases from 96 hospitals under the National Cancer Registry Program.

The researchers found that 75.6 percent of total prostate cancer cases occurred in the age group of 60–80 years, indicating that advanced age remains the biggest risk factor for the condition.

As life expectancy increases, more men reach the higher-risk age group, but awareness and screening practices have not scaled proportionately.

Adenocarcinoma was the most common pathology, constituting 77 percent of cases.

It is the most common form of prostate cancer, accounting for over 95 per cent of all cases. It develops in the gland cells that produce prostate fluid and typically grows slowly over several years.

Further, the ICMR researchers noted that about 57 percent of cases were diagnosed with localized (29.9 percent) or locoregional (27 percent) cancer.

Thirty percent underwent surgical treatment, and 22 percent received radiation therapy. Systemic therapy was the most common single modality treatment.

“Early detection and streamlined referral pathways are essential to improve prostate cancer outcomes in India,” the researchers said.

Prostate Cancer And Its Prevalence In India

Prostate cancer forms in the cells of the prostate -- a gland found only in males and a part of the male reproductive system. It lies below the urinary bladder and in front of the rectum.

Nearly all prostate cancers develop from glandular cells (adenocarcinomas).

Globally, prostate cancer is the most frequently diagnosed cancer among men in 112 countries and the leading cause of cancer death in 48 countries. In 2020, an estimated 1.4 million new cases of prostate cancer and 0.37 million deaths were reported worldwide.

In India, it is the second most common cancer among men, accounting for more than 60 percent of the prostate cancer burden in South-Central Asia. As per the ICMR data, the country reported 34,540 incidences of prostate cancer and 16,783 deaths.

Prostate cancer symptoms include urinary difficulty, a weak stream, or blood in the urine.

As prostate cancer is a slow-developing disease, it often causes no symptoms during the early-stage, leading to delayed medical consultation.

Other reasons for late detection in India include low awareness, limited routine screening -- PSA (prostate-specific antigen) programs; social stigma and hesitation due to embarrassment or cultural taboos.

Lack of access to specialist care, diagnostic facilities, and cancer centers, especially in rural populations, coupled with cost and referral gaps, also leads to delay in diagnosis.

Colon cancer develops from polyps in the colon or rectum, often taking years to show symptoms. The cancer begins when small growths called polyps form on the inner lining of the colon or rectum. Over time, changes in the DNA of these cells can cause the polyps to become cancerous.

As abnormal cells multiply, they replace healthy cells and eventually form a mass known as a tumor. This process develops slowly, often taking up to ten years for a precancerous polyp to turn into cancer and begin showing symptoms.

The American Cancer Society notes that colorectal cancer impacts around 1.9 million people every year.. In India, it is the fourth most common cancer among both men and women. In 2022, there were 64,863 new cases and 38,367 deaths.

Projections suggest that incidence will continue to rise by 2026, reflecting both lifestyle changes and improved detection.

Colon cancer can be difficult to detect because it often develops without obvious symptoms. However, Dr Jordan Karlitz, MD, of Exact Sciences, shared with The American Journal of Managed Care (AJMC) the three fundamentals of CRC prevention and early detection.

What Are The Three Tips For CRC Screening?

According to the expert, these are the three things you should do to protect yourself:

1. Timely risk screening

2. Knowing your cancer family history

3. Acting on early symptoms

"These are the 3 pillars that everybody needs to be aware of, because I think gaps in any of them could increase the risk of developing CRC and, unfortunately, lead to presenting with more advanced-stage disease," said Dr Karlitz.

Why Is Risk Screening Essential?

Timely screening for colon cancer is essential because it detects precancerous polyps early, allowing for their removal before they turn into cancer and identifies the tumors at highly treatable stages when survival rates are about 90 percent.

Screenings (like colonoscopies) can detect and remove pre-cancerous growths called polyps, preventing the development of cancer. The expert suggested that average risk screening now starts at the age of forty-five; you do not have to wait until age 50.

What Early Symptoms Should You Look Out For?

Colon cancer rarely announces its presence with dramatic symptoms. More often, it whispers — through changes in bowel habits, subtle abdominal discomfort, or unexplained weight loss.

Some of the most commonly missed early signs include:

• Persistent changes in bowel movements: Chronic constipation or diarrhea often dismissed as dietary effects.
• Blood in stool: Bright red or dark blood should not be ignored.
• Unexplained weight loss: Especially when unintentional.
• Abdominal cramps or bloating: Misinterpreted as common digestive issues.

Persistent changes in bowel habits, especially if they last more than a few days, must be taken seriously. Narrow or ribbon-shaped stools may indicate a tumor partially blocking the colon.