Eight-month-old twins from Hayward Heath, West Sussex, recently met the surgeon who saved their lives even before they were born. The BBC reports how their mother, Katerina Ahouansou, at six months pregnant, during a routine scan, uncovered a serious issue with their development and blood supply.

Doctors diagnosed the twins with twin-to-twin transfusion syndrome or TTTS. It is a condition where one twin received more blood and nourishment than the other due to uneven blood vessel distribution in the placenta. In case there is no medical intervention, it could be fatal for both the twins.

A Specialist Steps In

This is when Ahouansou was referred to Professor Kypros Nicolaides at King’s College Hospital in London. Professor Nicolaides is a pioneer in fetal medicine and he specializes in a laser procedure that redistributes blood supply between twins in cases of TTTS.

When Ahouansou was scanned, Nicolaides observed that one of the twins were significantly smaller than the other. "There was a very high chance that if we did not intervene, both twins could die," he recalled.

An Operation No Less Than A Miracle

The life-saving laser surgery was performed and within a week the doctors saw an improvement with the twin who was smaller in size. When the twins were born, they weighed 1.5kg and 1.7kg. To recognize the efforts by the surgeon, Ahouansou named them Kai Kypros and Asher Nicolas after Professor Kypros Nicolaides.

Ahouansou also expressed deep gratitude for the professor's expertise and called him "proof that miracles can be performed by people who are devotees to their profession."

Professor Kypros Nicolaides has been at King’s College Hospital since 1980 and is widely regarded as a leader in fetal medicine. His groundbreaking research and development of screening and surgical techniques have saved countless lives.

Through his dedication, Professor Nicolaides has given many families hope, demonstrating how medical advancements continue to improve survival rates for complex fetal conditions like TTTS.

More about Twin-to-twin Transfusion Syndrome

As per the John Hopkins Medicine, TTTS is a rare pregnancy condition that affects identical twins or other multiples. It happens in pregnancies where twins share one placenta and a network of blood vessels that supply oxygen and nutrients essential for development in the womb. These pregnancies are known as monochorionic.

Sometimes, the blood vessels in the placenta are unevenly distributed, causing an imbalance in blood flow between the twins. The donor twin loses more blood than it receives, leading to malnutrition and potential organ failure. Meanwhile, the recipient twin gets an excess of blood, putting strain on the heart and increasing the risk of cardiac complications.

Impact on the Donor Twin

The donor twin loses blood volume (hypovolemia), reducing kidney function and urine production. This leads to low amniotic fluid levels (oligohydramnios) or, in severe cases, a complete absence (anhydramnios). Without proper blood circulation, the donor twin faces cardiovascular issues, increasing the risk of death.

Impact on the Recipient Twin

The recipient twin experiences excess blood volume (hypervolemia), causing increased urination and excessive amniotic fluid (polyhydramnios). The overworked heart struggles to handle the surplus blood, leading to cardiovascular dysfunction, heart failure, and, in extreme cases, death.

World Thalassemia Day is observed every year on May 8 to raise awareness about the inherited blood disorder caused by faulty genes.

The day was initiated in 1994 by the Thalassaemia International Federation in memory of George Englezos, the son of the federation’s founder, who succumbed to the disease.

This year’s theme, “Together for Better Care and Equal Access,” highlights the need for universal screening, safe blood availability, and advanced therapies.

The disorder, which often requires blood transfusions every fortnight, affects approximately 1.3 million people living with severe forms of thalassemia worldwide. About 1.5 percent of the global population is carriers, and the disease claims nearly 11,000 lives annually.

More than 40,000 infants are born each year with severe thalassemia, predominantly in low- and middle-income countries. Although mortality rates have declined, they remain high in developing regions, particularly in Southeast Asia.

What Is Thalassemia?

Thalassemia is an inherited hemoglobin disorder caused by defective synthesis of alpha or beta globin chains.

In β-thalassemia major, reduced or absent beta-chain production leads to ineffective erythropoiesis, severe anemia, bone marrow expansion, splenomegaly, growth retardation, and iron overload due to repeated blood transfusions.

Patients often present in early childhood with pallor, jaundice, recurrent infections, and characteristic facial bone deformities.

Thalassemia Screening

With 10,000–15,000 babies born with Thalassemia Major every single year in India, the country remains one of the global hotspots for the blood transfusion-dependent disease.

HealthandMe spoke to doctors who emphasized that carrier screening, premarital counseling, and antenatal diagnosis remain crucial preventive strategies in India, often referred to as the “thalassemia capital of the world”, as nearly one in every eight thalassemia patients globally lives in the country.

Experts stressed that normalizing conversations around screening is key to reducing the disease burden.

Dr. Ajay Sharma, Director and Head of Hematology and Hemat-Oncology at Paras Health Panchkula, said thalassemia is a preventable genetic disorder, but continues to go undetected until it is too late.

This is because “thalassemia screening, which is one of the simplest yet most overlooked preventive steps in India,” said Dr. Vishnu Hari, Associate Director and Head of Haematology & BMT at Sarvodaya Hospital, Faridabad.

“Every couple, especially those planning marriage or pregnancy, should undergo basic carrier screening. The challenge is not the availability of tests, but the lack of awareness and social hesitation around genetic conditions,” Dr. Hari said.

Also read: Reused Syringes Infect Over 330 Children in Pakistan With HIV: Report

When To Get Screened?

Screening should ideally be done early, as early detection helps informed decision-making and prevents severe health complications in children. Experts recommend screening:

• At the premarital stage
• At the start of pregnancy

What Will the Screening Find?

Carrier detection is possible with a complete blood count and a test called High Performance Liquid Chromatography (HPLC). Indicators include:

• Low haemoglobin (~9 g/dL)
• Low MCV (Mean Corpuscular Volume, ~65)
• HbA2 levels above 3.5%

“If both partners are carriers, timely genetic counselling during the antenatal phase becomes critical,” he said.

While cultural stigma and low prioritization of preventive healthcare often delay this step, the integration of routine thalassemia screening into premarital check-ups and early pregnancy care can help significantly reduce the number of affected births in India.

What Could Be Done To Manage Thalassemia?

Dr Parveen Yograj, a General Surgeon from Jammu, in a post on the social media platform X, shared that treatment for thalassemia has evolved remarkably over recent decades.

“Regular blood transfusions combined with iron chelation therapy using agents like Deferasirox and Deferiprone have significantly improved survival. Curative therapy through bone marrow transplantation is now increasingly successful, especially in children with matched donors.

"Recent breakthroughs in gene therapy and CRISPR-based genome editing offer new hope for a long-term cure by correcting defective globin gene expression,” he said.

Public health officials in South Wales, UK, have issued an alert on a localized outbreak of hepatitis A, and have urged residents to maintain hygiene as well as vaccinate children.

Cases of hepatitis A involving the same strain have been identified in three separate households in Barry, according to Public Health Wales.

The health body, in a statement, said the strain’s characteristics “suggest the infection may be spreading locally.” Investigations into the “small number” of cases are ongoing.

To curb the outbreak, the officials have also issued an urgent appeal to parents to ensure their children remain “vigilant with their handwashing.”

Those infected are “receiving appropriate care and are recovering well,” Public Health Wales said. As a precaution, close contacts of the affected individuals have also been offered vaccination.

What Is Hepatitis A?

Hepatitis A is a viral liver infection caused by the hepatitis A virus (HAV). It spreads mainly through contaminated food or water, or through close personal contact with an infected person.

The infection can lead to liver inflammation, jaundice, extreme fatigue, and stomach pain. In most cases, it is a short-term illness that clears on its own without specific treatment, although severe cases can occur. Unlike hepatitis B or C, hepatitis A does not usually cause long-term liver damage.

According to the World Health Organization (WHO), vaccination remains the most effective way to prevent infection.

Also read: Hepatitis Infections Claims 1.3 Million Lives Worldwide, India Among Top Contributors: WHO

Symptoms of Hepatitis A

Symptoms usually appear a few weeks after exposure to the virus, although some people may not develop noticeable signs. According to the Cleveland Clinic, symptoms can include:

• Persistent fatigue and weakness
• Sudden nausea, vomiting, or diarrhea
• Pain or discomfort in the upper right side of the abdomen near the liver
• Pale or clay-colored stools
• Reduced appetite
• Mild fever
• Dark-colored urine
• Joint pain
• Yellowing of the skin and eyes (jaundice)
• Severe itching

Can Hepatitis A Be Prevented?

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“The best way to prevent the spread of hepatitis A is to wash hands thoroughly with soap and water. This is important after using the toilet, changing nappies, and before preparing or eating food,” said Susan Mably, Consultant in Health Protection for Public Health Wales.

Vaccination against hepatitis A is also highly effective in preventing the disease.

Doctors recommend the vaccine for:

• Children older than 12 months
• Adults at risk of exposure at home or work
• Travelers visiting regions where the virus is more common
• People with existing liver conditions

• drinking boiled or bottled water,
• avoiding food from unhygienic sources,
• peeling fruits at home and not getting pre-cut from stores.

If someone in the household is infected, cleanliness becomes even more important. Surfaces should be disinfected, food prepared carefully, and personal items not shared.

Safe sexual practices also matter, as the virus can spread through oral-anal contact. On a broader level, preventing future outbreaks requires more than short-term fixes. Improving water quality, repairing sewage systems, and strengthening public health surveillance are essential to stop the cycle from repeating.

The rates of resistance to recommended antibiotics are rising among newborns in the US, according to an analysis of invasive Escherichia coli samples.

E coli is a major neonatal pathogen in the United States and a leading cause of sepsis and mortality in newborns.

“Mortality due to E. coli sepsis remains high, especially in preterm newborns. Resistance to beta-lactams and aminoglycosides, the most common empiric treatments for E. coli sepsis, is worsening,” said researchers from the University of Missouri.

They called for tailoring treatment regimens against neonatal E. coli sepsis according to evolving antibiotic resistance trends.

“Neonatal sepsis isolates are characterized by specific genomic traits indicative of virulent phenotypes that need continued surveillance,” they added in the research published in the Open Forum Infectious Diseases journal.

What Are the Key Findings?

The researchers identified and analyzed E coli isolated from blood cultures of newborns at the hospital from 2006 to 2021. They intended to investigate the clinical characteristics of newborns with E coli bacteremia (bacteria in the blood), and the pattern of antibiotic resistance in E coli isolates over time.

“This knowledge is crucial to develop effective preventative and treatment strategies for this devastating disease,” the researchers wrote.

Of the 54 newborns identified with E coli bacteremia

• 7 developed early-onset sepsis (within 72 hours of birth or less),
• 12 were treated for E coli meningitis,
• 2 had necrotizing enterocolitis.
• Five of the newborns died, including three who were born preterm.

Antibiotic susceptibility analysis found 54 per cent of E coli isolates overall were non-susceptible to ampicillin and 11 per cent were non-susceptible to gentamicin—the two antibiotics recommended for first-line treatment in newborns with sepsis.

Also read: US CDC Links Recent Salmonella Outbreak To Backyard Poultry

Meanwhile, nonsusceptibility to ampicillin rose from 46 per cent to 61 per cent between 2006-2013 and 2014-2021.

The percentage of isolates that were non-susceptible to cefazolin, an alternative therapy, rose from 8 per cent to 36 per cent.

Whole genome sequencing revealed that the most prominent E coli sequence types (STs) were

• ST95 (17 per cent),
• ST69 (11 per cent),
• ST131 (7 per cent),
• 43 per cent of isolates contained the K1 capsule, which plays a crucial role in disease progression.

“Understanding genomic traits and molecular epidemiology trends of neonatal E. coli invasive strains is also crucial to develop novel preventative and treatment strategies that are urgently needed,” they wrote.

What Is Antibiotic Resistance?

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According to the National Foundation for Infectious Diseases, antibiotic resistance happens when bacteria learn to withstand the medicines(antibiotics) that are supposed to kill them. It's like the bacteria have developed a suit of armor against the drug.

When this happens, doctors have to switch to different antibiotics. These backup medicines might not work as well or might cause more side effects. Sometimes, a bacteria can become resistant to all available drugs, which leaves the patient with a dangerous infection that doctors have no way to treat. The alarming thing is that these tough, drug-resistant bacteria can spread from one person to another, both in hospitals and at home.

A 2025 report from the World Health Organization (WHO) stated that one out of every six serious infections confirmed in labs worldwide in 2024 could not be killed by the antibiotics meant to treat them.

The report noted that the standard, first-choice antibiotic is failing against over 40 per cent of E. coli.