For over 15 years, Dr Anthony Shum, a pulmonologist at the University of California, San Francisco has been studying a rare genetic disorder called the COPA Syndrome. It stands for coatomer subunit alpha and is a rare, inherited disorder that affects the lungs, joint, and kidney. The National Organization for Rare Disorder also notes that it is a genetic autoimmune disorder that is caused by mutations in the COPA gene. This disease affects families unpredictably—some individuals with the mutation develop severe lung damage early in life, while others remain completely healthy. Now, Shum’s team has discovered a protective genetic variant that may offer new hope for treatment.

A Breakthrough

Researchers found that some relatives of COPA Syndrome patients stayed healthy despite carrying the same COPA gene mutation that causes the disease. The key difference? These unaffected individuals had a protective version of another gene called HAQ-STING.

When scientists introduced HAQ-STING into diseased lung cells from COPA patients, the cells returned to a balanced state, suggesting that this gene could be used as a therapy.

“We really think HAQ-STING could be a gene therapy tool and a step toward a cure,” said Shum, whose findings were published in the Journal of Experimental Medicine.

Families Who Solved The Mystery

Shum’s journey into COPA Syndrome research began in 2011 when he treated a young woman, Letasha, who had severe lung bleeding. Her mother, Betty Towe, mentioned that Letasha’s sister, Kristina, had suffered from similar symptoms. Over the years, Betty had taken both daughters on a four-hour trip to UCSF for treatment. After tracing their family history, Shum discovered that their distant relatives in Texas and Oakland also had lung problems and arthritis. In 2015, Shum, along with scientists from Baylor College of Medicine and Texas Children’s Hospital identified the COPA gene mutation. They realized that it was the common factor behind the illness. However, only some of the 30 individuals with the mutation actually developed symptoms, leaving a major question unanswered.

The Domino Effect

It was established that it occurs when a mutated COPA gene causes another gene STING to go overdrive. The STING that helps fight infections in COPA patients, remain permanently active, which leads to chronic inflammation that damages the lungs, kidneys, and joints. In 2020, while studying STING’s role in the disease, researchers discovered a key variation: HAQ-STING. This version of STING, present in about one-third of the population, appeared to neutralize the harmful effects of the COPA mutation.

To confirm their theory, the scientists needed both affected and unaffected family members to participate in the testing. Letasha, Kristina and Betty immediately volunteered. The researchers then analyzed DNA samples from 26 COPA patients and their healthy relatives. They also conducted CT scans and blood tests to ensure that unaffected members did not have any hidden symptoms. When the findings were all clear, it was revealed that all the healthy individuals had HAQ-STING, while none of the COPA patients did. This was the first known case of a common gene variant completely protecting against a severe genetic disease.

Encouraged by this discovery, researchers tested HAQ-STING’s effects in a lab setting. They introduced it into diseased lung cells from COPA patients, and the cells returned to normal function.

Way Ahead

Shum believes HAQ-STING could lead to game-changing treatments, including:

• Prenatal gene therapy for babies diagnosed with COPA Syndrome before birth
• Aerosol delivery of HAQ-STING for adults, directly targeting the lungs

Before publishing their findings, Shum called Betty with the news—her own HAQ-STING gene had protected her from the disease. He also informed Letasha and Kristina, who were overwhelmed with relief and joy.

“We always believed Dr. Shum would get to the bottom of it,” said Letasha. “This discovery is going to change lives.”

Non-alcoholic fatty liver disease (NAFLD) is the commonest non-communicable disease in Indian women, with a prevalence rate of 35%. Globally, 30% of the population is suffering from NAFLD, and this projection is expected to progress to 56%, in a similar range to diabetes and obesity.

In India, the high rate of NAFLD is driven by the adoption of a westernized lifestyle, associated comorbidities like diabetes, obesity & hypertension. Fatty liver is known to progress to cirrhosis (end-stage liver disease) or liver cancer (hepatocellular cancer) if left untreated, which affects the survival rates and implicates a poor prognosis.

Unfortunately, it’s a silent disease and often presents at an advanced stage, leading to serious complications.

Why Women Face Different Risks Than Men

Women tend to have different outcomes with fatty liver disease when compared to men. Women may have a higher risk of life secondary to NAFLD when compared with men of the same age group. Conditions like age of menarche (first menstrual period), menopause status, alteration in reproductive hormones, and sarcopenia (muscle loss) may affect the development of NAFLD. Hormonal issues like oestrogen deficiency and Polycystic Ovarian Disease (PCOD) increase the risk of developing NAFLD. Women with type 2 diabetes, obesity, and larger waist circumference (metabolic syndrome) are more prone to NAFLD.

Besides physiological and hormonal factors, there are social and cultural factors like limited autonomy for women, hierarchy based on earning potential, and poor literacy levels (especially in rural regions), which may create health neglect or gender bias towards women’s health, and conditions like NAFLD can go neglected or ignored.

Fatty Liver Disease Is Preventable and Reversible

The urban populace has its own share of modern problems like alcohol, smoking, and a sedentary lifestyle. Fatty liver is totally preventable and reversible if diagnosed at an early stage with simple lifestyle modifications. Studies show that a diet high in protein and low in carbohydrates, or a diet with fruits and vegetables and whole grains combined with exercise for 30 minutes a day and 5 days a week, can significantly reverse fatty liver and liver cell inflammation.

There are no gender-based guidelines to treat or prevent this problem. In general, reducing the cardiovascular and metabolic risk remains the cornerstone to treat NAFLD in both men and women.

Weight Loss Can Significantly Improve Liver Health

Research shows that up to 10% weight loss can reduce liver scarring and inflammation, whereas between 5-10% weight loss can reduce liver fat significantly.

There is some evidence that suggests black coffee (without sugar), Vitamin E, and Omega-3 fatty acids help prevent and reverse NAFLD. Specific and early consultation with a specialist (e.g. cardiologist, endocrinologist, or a gynecologist) can control the morbidity and mortality around the problem. Fatty liver has reached an epidemic level problem and therefore needs mass screening & awareness programs.

Early Diagnosis Is the Key

Early diagnosis is key and can be achieved by simple USG of the liver or Fibro scan combined with simple blood tests, liver LFT’s (liver function tests). Unfortunately, there’s no pill to replace exercise or a healthy lifestyle; otherwise, it would have been a blockbuster medicine.

However, the good news is this deadly and silent disease has a simple and inexpensive solution: a healthy diet and plenty of exercise, which is accessible to all. There is also an urgent need to increase awareness in women on NAFLD and ways to combat it, so they can get access to life-saving treatment at the earliest.

For decades, thalassemia has been synonymous with lifelong blood transfusions, frequent hospital visits, and the persistent risk of iron overload. For patients and families, it has largely meant managing a chronic condition rather than truly treating it. That narrative, however, is beginning to change.

The recent approval of oral drugs for thalassemia by the US Food and Drug Administration marks a historic milestone. These oral, disease-modifying pyruvate kinase activators improve anemia in adults with non-transfusion-dependent (NTDT) and transfusion-dependent (TDT) \(\alpha\)- or \(\beta\)-thalassemia. For now, they are approved in the US and Saudi Arabia for adults with thalassemia, with European review ongoing.

It is offering a fundamentally different approach, one that targets the disease at its biological core rather than simply managing its complications. Yet, as this new era unfolds, a critical question remains: are patients being diagnosed early enough to benefit from it?

A shift from supportive care to targeted therapy:

Until recently, thalassemia management has depended heavily on blood transfusions and iron chelation therapy. While these interventions are life-saving, they do not correct the underlying defect in red blood cell production. Over time, repeated transfusions can lead to complications affecting vital organs such as the heart, liver, and endocrine system.

Oral drugs, however, work by activating pyruvate kinase in red blood cells, improving energy (ATP) production, and enhancing red cell survival. In simple terms, it helps the body produce more functional and longer-lasting red blood cells, leading to an increase in hemoglobin levels, reduced transfusion requirements, and improved quality of life, particularly with respect to fatigue, one of the most debilitating symptoms of the disease. Oral therapy working across a broader disease spectrum marks a significant advance.

India’s Hidden Burden

India bears one of the highest burdens of thalassemia globally, with an estimated 10,000–15,000 affected children born each year and a carrier frequency of approximately 3–4% in the general population. Despite this, a large number of cases remain undiagnosed or are diagnosed late, particularly in individuals with milder forms who may live for years with unexplained anemia.

Delayed diagnosis has far-reaching consequences. Patients may develop preventable complications, families miss opportunities for genetic counseling, and access to emerging therapies is delayed or entirely missed. In the era of precision medicine, such delays are no longer acceptable.

The Problem Of Misdiagnosis

A major challenge in India is the frequent misdiagnosis of thalassemia as iron deficiency anemia, especially in primary care settings. Many patients receive repeated courses of iron supplementation without clinical improvement, while the underlying genetic disorder remains unrecognized.

Certain clinical clues should prompt further evaluation: persistent microcytic anemia unresponsive to iron therapy, a family history of anemia or transfusion dependence, and a disproportionately high red blood cell count relative to hemoglobin levels. Diagnostic confirmation is straightforward with hemoglobin analysis using HPLC or electrophoresis; however, these tests are not always utilized at the appropriate time.

Diagnosis And Screening

The approval of oral drugs underscores a fundamental shift, from managing symptoms to modifying disease biology. However, these benefits are maximized when therapy is initiated early, before irreversible organ damage occurs, for which timely diagnosis is pivotal.

Thalassemia diagnosis begins with a complete blood count demonstrating microcytic anemia with low mean corpuscular volume and a relatively high red cell count. Peripheral smear findings include target cells and anisopoikilocytosis. Confirmation is achieved through hemoglobin analysis using HPLC or electrophoresis, which typically shows elevated HbA₂ in β-thalassemia trait. Molecular testing further identifies specific gene mutations, enabling definitive diagnosis and prenatal counseling.

Screening programs play a pivotal role. Carrier detection through HbA₂ estimation, premarital and antenatal screening, and cascade testing within families are essential strategies, particularly in high-prevalence populations like India.

The mutation spectrum in India is well characterized. The most common β-thalassemia mutation is IVS-I-5 (G→C), accounting for nearly half of cases, followed by IVS-I-1 (G→T), codon 41/42 deletion, codon 8/9 insertion, and the 619 bp deletion. In α-thalassemia, the –α³․⁷ deletion predominates. This knowledge allows for cost-effective targeted molecular screening.

For years, the central question in thalassemia was: how do we manage this disease?

Today, it is shifting to: how early can we treat it effectively? Oral drugs represent a major therapeutic advance; however, cost considerations, accessibility, and long-term real-world outcomes will influence their widespread adoption. Nevertheless, the direction is clear: thalassemia care is entering a transformative era. In modern medicine, early diagnosis is no longer just beneficial; it is truly transformative.

While the confirmation of the Andes strain of hantavirus behind the outbreak aboard the cruise ship MV Hondius in the South Atlantic has raised significant concerns of human-to-human transmission, experts from the International Hantavirus Society, as well as the World Health Organization (WHO), stated that the situation does not raise the risk of a pandemic.

So far, eight cases have been reported, including three deaths. The WHO has also confirmed that six cases have tested positive for the Andes virus, which can spread from person to person, through PCR testing.

The International Hantavirus Society, in a statement, warned that the virus differs significantly from most other hantaviruses because it can spread between people.

Founded in 2001, the Hantavirus Society is a global organization of scientists, clinicians, and researchers focused on studying hantaviruses, including their ecology, pathogenesis, and prevention.

“The virus on board the MV Hondius is the Andes strain of hantavirus. It is serious,” said the WHO chief Tedros Adhanom Ghebreyesus, in an open statement on the social media platform X.

However, the WHO and the members of the Hantavirus Society maintained that the current outbreak is not another COVID-19 outbreak.

So, first, let us understand all about the Andes Virus.

What Is Andes Virus

The Andes virus is a rare but highly dangerous pathogen of hantavirus, found primarily in Argentina and Chile. It is the only type of hantavirus known to man to spread among humans.

Unlike many hantaviruses seen in Europe, Asia, and North America, which are typically transmitted from infected rodents to humans, the Andes virus has repeatedly shown evidence of person-to-person spread.

As per experts, transmission usually occurs in situations involving prolonged or close contact. But how close is a question that has been recurring. The Hantavirus Society answers this.

“Over the past decades, multiple outbreak investigations, household clusters, nosocomial events, and genomic analyses have provided convincing evidence that ANDV can be transmitted between individuals under specific close-contact conditions. These may include household exposure, intimate contact, caregiving without suitable personal protective equipment, and prolonged exposure in poorly ventilated or crowded settings,” it said.

Pointing out decades of outbreak investigations, hospital clusters, and genetic studies, experts emphasized: “Human-to-human transmission of Andes virus should no longer be considered hypothetical”.

The scientists stressed that current evidence does not suggest the virus spreads easily through casual community interaction in the way diseases like measles, influenza, or COVID-19 do.

Also Read: Hantavirus Outbreak: How MV Hondius Passengers Will Be Screened And Evacuated

Andes Virus: High Fatality Rate A Concern

But the Andes virus is associated with hantavirus pulmonary syndrome (HPS) — a severe respiratory illness that can rapidly become fatal. Reported fatality rates range from 20% to 40%, depending on the outbreak setting, quality of medical care, and surveillance capacity.

Recent surveillance data highlight the seriousness of the disease:

• Argentina reported 86 confirmed hantavirus cases in 2025, including 28 deaths.
• Chile reported 35 confirmed cases, including 7 deaths.

Why Continuous Monitoring Is Important?

The first major indication of person-to-person transmission emerged during the 1996 El Bolsón/Esquel outbreak. More recently, the 2018–2019 Epuyén outbreak infected 34 people after a single index case attended crowded social gatherings while symptomatic.

Strict public health interventions — including isolation, quarantine, and active contact tracing — reduced transmission.

Read More: Hantavirus: Israel Confirms 1st Case as UK, Spain Probe Suspected Infections; Should You Be Worried?

The Hantavirus Society noted that a confined environment aboard the MV Hondius means that passengers and crew may still be within the virus’s incubation period.

The scientists thus warned, "A negative PCR test shortly after exposure does not necessarily rule out future infection.” They recommend “ongoing monitoring, repeat testing where necessary, and antibody testing for close contacts”.

Experts are also examining whether transmission could occur during early or minimally symptomatic stages, rather than only after obvious illness begins.