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Washington, D.C., 3 July 2025 (PAHO) – A total of 7,132 confirmed cases of measles and 13 deaths have been reported in the Region of the Americas as of mid-June 2025, according to the latest epidemiological update from the Pan American Health Organization (PAHO). This represents a 29-fold increase compared to the 244 cases reported during the same period in 2024.

Nine countries have reported cases in 2025, with Canada (3,170 cases, 1 death), Mexico (2,597 cases, 9 deaths) and the United States (1,227 cases, 3 deaths), accounting for the majority. Other countries reporting cases include Bolivia (60), Argentina (34), Belize (34), Brazil (5), Peru (4) and Costa Rica (1). The outbreaks originated from importations from countries both within and outside the Region. The most affected age groups are children under 5 and adolescents aged 10 to 19 years.

The rise in cases underscores the urgent need to address gaps in routine immunization. PAHO is calling on countries to reach and sustain 95% coverage with two doses of measles-containing vaccine, especially in communities with low coverage or active outbreaks.

PAHO is providing technical cooperation to most countries to strengthen epidemiological surveillance, train healthcare workers, and engage with communities to ensure timely detection and an effective response. To contain the outbreaks and prevent the spread of this vaccine-preventable disease, the Organization recommends the urgent implementation of intensified vaccination campaigns in affected areas and in those areas at risk of spread. PAHO does not recommend implementing restrictions on international travel.

The upward trend mirrors the global situation, where surveillance data from the World Health Organization (WHO) has recorded 188,355 suspected cases and 88,853 confirmed in 168 countries as of 6 June 2025. The Eastern Mediterranean Region accounts for the highest share (35%), followed by the African Region (21%) and the European Region (16%).

There are distinct gut microbiota and metabolic signatures associated with premature endometrial aging and adverse pregnancy outcomes in patients with polycystic ovary syndrome (PCOS), according to a study presented at the 41st Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE).¹

Key microbial and metabolic differences identified

In PCOS patients, Parabacteroides merdae (P. merdae), a benefitial gut bacterium, was reduced, while branched-chain amino acids (BCAAs) were more prevalent. This may lead to worse endometrial function and adverse reproductive outcomes in this population.

“In clinical practice, we noticed that even younger women with PCOS who achieved pregnancy still faced unexpectedly high rates of miscarriage and other complications”, said Aixia Liu, MD, lead study author.

Systemic risks of PCOS

PCOS presents in up to 20% of reproductive-aged women worldwide and is a major driver of infertility. Fertility treatment reduces these risks, but the odds of complications such as gestational diabetes, miscarriage, and preterm birth are still higher in these patients. According to investigators, the factors behind this risk have remained unknown.

Symptoms of PCOS include hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology.² Increased rates of type 2 diabetes mellitus, gestational diabetes, cerebrovascular and cardiovascular events, endometrial cancer, and other adverse health outcomes have been reported in PCOS patients, highlighting the need for tailored treatment.

Comparing PCOS and non-PCOS cohorts

Across 44 cities in China, 220 women aged under 35 years were recruited for the trial.¹ Of these, 110 had PCOS and another 110 were matched controls. Investigators profiled differences between these cohorts through both gut microbiome sequencing and metabolomics.

Ageing and decidualization were evaluated through laboratory studies on endometrial stromal cells (ESCs). Overall, PCOS patients presented with significantly reduced microbial diversity. Investigators noted this population had less P. merdae, which has been linked to metabolic health.

BCAAs were also reported in serum metabolomics of patients with PCOS vs those without PCOS, with this trend especially pronounced for isoleucine. PCOS patients also presented with reduced levels of short-chain fatty acids.

Increased pregnancy risk and endometrial dysfunction

The odds of an adverse pregnancy outcome were increased 1.95-fold in the PCOS group vs the non-PCOS group. These included miscarriage, preterm birth, low birth weight, macrosomia, hypertensive disorders, gestational diabetes, and perinatal death.

Endometrial tissue also had increased isoleucine levels in PCOS patients. Additionally, investigators exposed ESCs to isoleucine in the lab and found increased markers of cellular senescence, alongside a weakened ability for decidualization.

Implications for early uterine aging and personalized interventions

According to Liu, this indicated ageing-like changes in the uterus far sooner than expected. Therefore, even women aged under 35 years may experience adverse impacts on endometrial health.

This data indicated possible efficacy of P. merdae and BCAAs as biomarkers for identifying patients with high-risk PCOS and providing personalized care. Liu recommended future research to assess the impact of dietary interventions, probiotics, and BAAA-restricted diets on these effects and pregnancy outcomes.

“The study provides compelling evidence that metabolic and microbial imbalances in PCOS are not only systemic but may directly impair endometrial receptivity, even in younger women,” said Anis Feki, MD, PhD, Chair-Elect of ESHRE.

References

1. Gut bacteria and amino acid imbalance linked to higher miscarriage risk in women with PCOS. European Society of Human Reproduction and Embryology. June 29, 2025. Accessed July 2, 2025. https://www.eurekalert.org/news-releases/1088637.
2. Azziz R, Carmina E, Chen Z, et al. Polycystic ovary syndrome. Nature Reviews Disease Primers. 2016. doi:10.1038/nrdp.2016.57

Adolescents who experience both loneliness and low resilience are much more susceptible to developing anxiety and depression as adults.

It has long been known that loneliness is a risk factor in the development of anxiety and depression. However, the association itself has been less well studied. This is especially true during the transition from adolescence to adulthood.

Our research team investigated how loneliness in adolescence, both in isolation and in interaction with low resilience, affects anxiety and depression in young adulthood.”

Nayan Deepak Parlikar, PhD candidate, Norwegian University of Science and Technology (NTNU’s) Department of Public Health and Nursing

Adolescents who experience both loneliness and low resilience are at significantly greater risk of developing anxiety and depression compared with other groups.

Individuals with low resilience are less able to cope with stress, adversity and other emotional challenges compared with others.

These new findings have now been published in Social Psychiatry and Psychiatric Epidemiology.

Worst combination

This is the second article that Parlikar has written on the risk of developing anxiety and depression as an adult. It concentrates on the long-term consequences for young people, and on the link between loneliness and low resilience.

“Adolescents who experience both loneliness and low resilience are at significantly greater risk of developing anxiety and depression compared with other groups,” said Parllikar.

The study compared groups of adolescents who reported high resilience and low levels of loneliness with groups of adolescents who reported high resilience and high levels of loneliness, and adolescents with low resilience and low loneliness.

“We found that the combination of loneliness and low resilience considerably increases the risk of developing symptoms of anxiety and depression together compared with exposure to only one of the factors,” continued Parlikar.

The results have a number of consequences.

Preventive measures become important

“Health professionals working with young people should concentrate on identifying individuals with both loneliness and low resilience at an early stage. Once they have been identified, it is important to intervene quickly,” said Parlikar.

The work may include screening in schools and health services to identify young people who are at risk.

“It may also help to introduce programmes that promote social skills and build resilience. This can help to reduce the risk of developing anxiety and depression,” she added.

Professionals treating the young people can adapt cognitive behavioural therapy (CBT) and other therapeutic approaches to address both loneliness and low resilience in adolescents.

“Therapists should be aware that, when combined, these factors have a particularly high risk. Health professionals can receive special training in identifying people with low resilience.”

More groups needed

Group therapy can help cement networks and thus reduce loneliness. Involving the family can both strengthen resilience and reduce loneliness.

With a school service that is under pressure, screening at the individual level is an expensive approach. So perhaps the best solution is to target all pupils, while still working to identify and help individuals who are particularly vulnerable or at risk.

Collaboration across sectors is important for children and young people’s mental health.

“It is important that schools, clubs and communities work together to prevent loneliness and exclusion, and to create a safe and inclusive environment. A sense of belonging has a huge impact on children and adolescents’ health and quality of life,” explained supervisor Unni Karin Moksnes.

She is a professor at the Department of Public Health and Nursing at NTNU.

“School plays a particularly important role, because it is an arena where all children and young people meet. Here, we can build communities that promote well-being, learning and good mental health.”

Initiatives to promote good mental health among children and young people offer many benefits in both the short and long term. They can help improve many people’s wellbeing and better enable them to overcome challenges. Eventually, this could lead to cuts in school dropout rates, increase participation in working life, and result in fewer cases of mental illness. In other words, it is a good investment – for individuals and society alike.