Category: 8. Health

  • Half of the global population can’t afford healthy food

    A healthy diet costs in global average US$3.68 per day in 2021. This is considerably higher than the average food expenditure in almost all low income countries, where people have to do with a diet dominated by staples and oils, lacking protein and a number of micronutrients. The cost of healthy food is also out of reach for many people living above the World Bank’s extreme poverty line.

    A team of researchers have summarized data of the cost of a global ”Healthy food basket” which is closely aligned to a set of national public dietary guidelines. The healthy food basket is composed of six broad categories of food, starchy crops, oils, vegetables, fruits, legumes, nuts and seeds and animal foods. The researchers selected a small number of the cheapest food items in each category to calculate minimum cost of a healthy diet in the countries of the world. Notably, the healthy food basket has a considerably higher share of fruits and vegetables and a lower share of animal source foods (13% compared to 18%) than the average global consumption.

    It is well established that a healthy diet can be costly. Fruits, vegetables and animal foods are relatively expensive while starchy foods, oils and legumes are much cheaper when calculated in cost per energy unit. Oils give in average almost 20 times more food energy than vegetables. You eat vegetables for dietary variation, taste and micronutrients rather than to get sated. Meat is mostly eaten for protein and fat as well as taste and status. Still, meat gives much cheaper energy than both fruits and vegetables. The cost is also the reason for why poor people, mostly, eat very little greens, fruits and animals foods and a lot of staple foods like grain and root crops (see for instance in Pradhan et al 2013). Oils and other fats were traditionally in very short supply in most parts of the world, and most of the fat was of animal origin. The extreme expansion of vegetable oils, mostly palm oil and soy oil, has now made fat cheaper than starch as an energy source.

    The research is based on market prices and obviously both actual consumption and ”cost” will be different for the considerable part of the global poor that are farmers themselves. But even for them I believe it is clear that the poorest often eat a very starch-based diet, supplemented by purchased vegetable (palm) oil, sugar and salt (obviously there are some poor populations engaged in fisheries, livestock or the collection of wild plants that have a different diet). I worked many years in very poor countries and with poor farmers in East Africa and it was striking how seldom they consumed any quantity of vegetables. Those who did grow them did it mostly for the market, to get very much needed income.

    Smallholder Susan Mkandawire in Zambia cooks maize porridge with some salt, palm oil and pumpkin leaves to her family. She sells most of the vegetables she grows and the few chickens she raises to get much needed cash. Photo: Richard Mulonga

    The World Bank now defines extreme poverty by an income below $3 in PPP US dollars (Purchasing Power Parities) in low-income countries, $4.20 in lower-middle income countries and $8.30 in upper-middle income countries. The actual research is for the situation 2021, before most of the recent food price hikes. At that time, the World Bank poverty limit was $2.15. Realistically, around $1.35 of that could be used for food, which is more than one third of the cost of a healthy diet. The World Bank estimates that a little less than half of the global population live with a daily income below $8.30 in 2025. Considering that the bank increased the poverty line in upper-middle income countries from $6.85 to $8.30 between 2022 and 2025 it seems like a fair estimate that half of the global population can’t afford a healthy diet. This also calls into question of how the poverty lines are defined. Shouldn’t a person above the poverty line be able to eat healthy food?

    The researchers conclude that the so called Eat-Lancet diet is even more costly than the Healthy Diet Basket used in this study. This is due to the fact that the EAT Lancet diet has more categories of food and specify quantities of expensive foods such as nuts and fish. One can really question the relevance of making recommendations such as the Eat-Lancet diet when it is out of reach of most people. The Health Diet Basket would, according to this research cause slightly more greenhouse gas emissions than the Eat Lancet.

    Of course, one can’t draw too far reaching conclusions from this kind of research. In the end food is about a lot more than cost and calories and even if national data has been used, food consumption data is not particularly accurate and even less so in countries with high levels of self-provisioning.

    What constitutes a healthy diet is also vigorously debated and I don’t want to get into details about it here. My own opinion is that a mixed diet based on local foods will be fine, which means bigger variations than in the efforts to prescribe global diets. Where I live in the Sweden it will mean a diet with more animal foods than the global average and less fruit. In almost no countries of the world, people eat as much vegetables as is recommended in dietary recommendations and despite being a passionate vegetable grower since 1977 I am not convinced about the feasibility of increasing vegetable consumption to satisfy nutritional recommendation (Rundgren 2019).

    The research referred to here is not fine grained enough to cover all aspects, as the researchers point out themselves. In many cases the starch component will be refined (or be sugar) and not be whole grain for instance, and fish, various meats and dairy have different nutritional profiles and health reputation.

    In a coming article I will look into to what extent countries can feed their population with a healthy diet.


    References

    Herforth, A.W., Bai, Y., Venkat, A. et al. The Healthy Diet Basket is a valid global standard that highlights lack of access to healthy and sustainable diets. Nat Food 6, 622–631 (2025). https://doi.org/10.1038/s43016-025-01177-0

    Our World in Data 2025, Share in poverty relative to different poverty lines, World, https://ourworldindata.org/grapher/share-in-poverty-relative-to-different-poverty-thresholds

    Pradhan P, Reusser DE, Kropp JP (2013) Embodied Greenhouse Gas Emissions in Diets. PLoS ONE 8(5): e62228. https://doi.org/10.1371/journal.pone.0062228

    Rundgren, G 2019, Five dollars a day is not enough for five a day, Garden Earth https://gardenearth.substack.com/p/five-dollars-is-not-enough-for-five-day

    Rundgren, G 2022, Food and agriculture number crunching, part 3, Garden Earth

    World Bank 2025, Measuring Poverty. https://www.worldbank.org/en/topic/measuringpoverty

    Photo: Richard Mulonga. Author suppliled.

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  • Turkey shuts livestock markets to control foot and mouth disease

    Turkey shuts livestock markets to control foot and mouth disease

    File photo. [AP]

    Turkey said on Wednesday it will shut down all livestock marketplaces to control the spread of highly contagious foot and mouth disease.

    The Agriculture Ministry said it detected a new serotype of the disease that heightened the outbreak, due to animal movement after the Muslim religious holiday of Eid al Adha, which is typically marked by slaughtering livestock.

    The decision was taken to prevent further spread as teams continue to vaccinate animals against the disease, the ministry said. It will gradually lift the restrictions once the entire livestock population is vaccinated.

    The ministry also said the temporary closure will not disrupt supply and demand for meat and dairy products in Turkey.  [Reuters]


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  • Which Medications Increase Microscopic Colitis Risk?

    Which Medications Increase Microscopic Colitis Risk?

    TOPLINE:

    Earlier reports blamed several medications including nonsteroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors (PPIs), selective serotonin reuptake inhibitors (SSRIs), statins, and antihypertensive agents for triggering microscopic colitis. However, a Swedish study of adults aged 65 years or older found that most of these drugs didn’t increase the risk.

    METHODOLOGY:

    • Although medications are viewed as the main modifiable risk factors for microscopic colitis, research has been limited by nonpopulation-based samples, small and selective cohorts, and study designs vulnerable to immortal time, surveillance, and other biases.
    • Researchers analyzed prescription records, hospitalizations, medical diagnoses, and gut biopsy findings of more than 2.8 million Swedish individuals aged 65 years or older to determine whether any of the previously implicated medications increased the risk for microscopic colitis.
    • Target trials — one for each medication — were emulated by including only those without a history of inflammatory bowel disease or microscopic colitis, at least one healthcare encounter in the previous year, no use of a drug from the same class in the prior 180 days, and no known contraindications; the effect of initiating each medication with either not starting it or selecting an alternative therapy was compared.
    • The primary outcome was biopsy-verified microscopic colitis, with researchers estimating 12- and 24-month cumulative incidences for the risk for microscopic colitis.

    TAKEAWAY:

    • Both 12- and 24-month cumulative incidences for the risk for microscopic colitis were < 0.5% under all treatment strategies.
    • Estimated risk differences at 12 months and 24 months were close to null for the initiation of antihypertensive medications vs calcium channel blockers, initiation of NSAIDs vs noninitiation, initiation of PPIs vs noninitiation, and initiation of statins vs noninitiation.
    • However, the initiation of SSRIs vs mirtazapine showed an estimated 12-month risk difference of 0.04% (95% CI, 0.03-0.05); similar results were observed for the estimated 24-month risk difference.
    • The use of NSAIDs, PPIs, and SSRIs was tied to more colonoscopy exams with normal biopsy results, suggesting that the apparent rise in microscopic colitis after starting an SSRI may have reflected unmeasured bias from ongoing differences in medical care.

    IN PRACTICE:

    “Our study demonstrated that, contrary to the previous belief, it’s unlikely that medications are the primary triggers for microscopic colitis,” the lead author commented in a press release. “Clinicians should carefully balance the intended benefits of these medication classes against the very low likelihood of a causal relationship with MC [microscopic colitis],” the authors concluded.

    SOURCE:

    This study was led by Hamed Khalili, MD, MPH, Gastroenterology Unit, Department of Medicine, Massachusetts General Hospital in Boston. It was published online in the Annals of Internal Medicine.

    LIMITATIONS:

    The Swedish registries do not capture primary care visits, so any symptoms or diagnoses recorded there that might have prompted a colonoscopy went unmeasured. Incomplete colonoscopy records may have obscured why participants actually underwent the procedure. Furthermore, the absence of data on smoking status, body weight, laboratory results, and contraindications could have biased the findings.

    DISCLOSURES:

    This study was funded in part by the National Institutes of Health, the Swedish Research Council, and the Eric and Wendy Schmidt Center at the Broad Institute of MIT and Harvard. Some authors declared receiving consulting fees, serving on advisory boards, receiving financial support, and other ties with certain pharmaceutical companies.

    This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

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  • Emotional Response to Music May Enhance Memory Specificity

    Emotional Response to Music May Enhance Memory Specificity

    Music that evokes an emotional response may influence the specificity of memory recall, new research suggests.

    Investigators found that participants who were shown a series of images of everyday items before listening to music were more likely to remember only general details of the photos if they experienced a more emotional response to the music, while those who had a moderate emotional response were more likely to recall specific details.

    Stephanie L. Leal, PhD

    “Most people think that emotional things are better remembered, but they actually aren’t. It’s just parts of the memory that are affected, not the whole memory,” co-investigator Stephanie L. Leal, PhD, assistant professor in the Department of Integrative Biology & Physiology at the University of California Los Angeles (UCLA), told Medscape Medical News. “One size doesn’t fit all when it comes to music and memory.”

    Interestingly, familiarity with a song was not associated with either general or detailed memory.

    “We played the same songs for everybody, but importantly, everyone responded differently. So I think personalization and taking individual preferences into account is going to be important for interventions,” said Leal, who is also director of the Neuroscience of Memory, Mood, and Aging Laboratory at UCLA.

    The findings were published online on July 23 in The Journal of Neuroscience.

    Memory Complexities

    As previously reported by Medscape Medical News, previous research has shown that both music appreciation and participations are tied to improvement in executive function and memory.

    For this study, researchers wanted to dive into the complexities of memory, including the possible connection between music and differing aspects of memory.

    “We tend to remember more of the gist of something emotional that happened and not as much of the details. So we wanted to see if music could boost certain parts of memory but not all of the parts,” she said.

    Many previous music studies have included older individuals, especially those with dementia. For this project, investigators chose instead to assess a younger population because they wanted to use their data as a “baseline” before moving on to further research in groups that are older and/or have impaired conditions such as depression or Alzheimer’s disease, Leal said.

    “We wanted to see what happens in healthy people first and then apply it to other populations,” she said.

    The study included 130 healthy undergraduate students between the ages of 18 and 35 years from Rice University, Houston.

    During the initial phase of memory formation — called the “encoding” phase — each participant was shown 128 images of common household objects and asked to choose whether the object should be considered as an indoor or outdoor item.

    Participants then donned headphones and listened to 10 minutes of classical music pieces, ambient soundscapes, or silence while they filled out questionnaires about their medical history.

    After the music ended, participants spent about 20 minutes filling out additional questionnaires, including a rating of the music or sounds they heard on the basis of emotional arousal, positive or negative reaction, or familiarity.

    They then viewed a set of 192 images that included some they hadn’t seen before (foils) and others that were identical (targets) or similar (lures) to the photos viewed earlier. Participants were asked to classify an image as old or new, allowing the researchers to measure target recognition — a measure of general memory — or lure discrimination — a measure of detailed memory.

    Big-Picture Recall

    General recall of the images was greater among those who experienced either low or high emotional response to music than among those who experienced moderate changes in emotional arousal (P for both < .001).

    More detailed memories were reported by those who reported only a moderate emotional response to music than those who reported a low or high emotional response (P for both < .001).

    There were no significant associations between memory of the images and song familiarity or whether a song was happy or sad.

    “Overall, music modulated both general and detailed memory, but individual differences in emotional response were crucial — participants listened to the same music yet responded differently,” the investigators wrote.

    “These findings suggest that music interventions may not uniformly enhance memory, emphasizing the need for personalized approaches in treating memory and mood impairments,” they added.

    The research suggests that a high emotional response may cloud details more than a moderate response.

    “Yes, the idea is that if something is very emotionally arousing, maybe we don’t want to remember the details associated with it. Maybe we just want to remember that general feeling or the bigger impact of that event, whether it’s positive or negative,” Leal said. “Maybe we just want to take the ‘big picture’ from that.”

    Early Days

    Commenting on the findings for Medscape Medical News, Daniel L. Bowling, PhD, assistant professor in the Department of Psychiatry and Behavioral Sciences at the Stanford School of Medicine, Palo Alto, California, noted that the study “follows the general trend” of research that breaks down large concepts, such as memory, into specific features.

    photo of  Daniel Bowling
    Daniel L. Bowling, PhD

    Bowling, who is also director of the Music and Brain Health Lab at Stanford, was not involved with the current study.

    “This showed different levels of responses to music that were differentially related to varying types of memory that you might want to target,” Bowling said.

    For example, if a clinician’s purpose is cognitive training, with more of an emphasis on details, “you might want more moderate levels of [emotional] arousal. But if you want more big-picture stuff, which could be critical when asking people about their life, then higher levels of arousal may be better,” he added.

    He noted that because the researchers used almost a “pretreatment,” with music used before the recall task, it would be interesting to know if using such a pretreatment before taking a test could possibly improve performance.

    There are interventions, some of which Bowling is involved with, that are looking at supporting arousal and attention during studying. 

    A controlled study comparing these things and looking systematically into effects on different types of memory would be helpful, “but we’re really at the beginning of figuring all of this stuff out,” he said.

    Although the current study has some limitations and needs to be replicated, “any kind of talk toward systematic effects of different musical parameters or emotional modeling starts to help us bring this into the scientific-medical realm. And that’s a real strength here,” Bowling concluded.

    The investigators reported having no relevant financial relationships. Bowling reported consulting for and owning stock in Spiritune, an app that develops playlists for different purposes, including improved workflow.

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  • Pakistan records 14th polio case so far in 2025

    ISLAMABAD, July 2 (Xinhua) — As Pakistan continued to battle a crippling disease, the country recorded another polio case, increasing the overall tally to 14 so far in 2025, the Health Ministry said.

    The new case was reported from the northwest North Waziristan district of Khyber Pakhtunkhwa province as health officials confirmed the detection of type 1 wild poliovirus in a 19-month-old girl.

    So far, eight cases have been reported from the province, four from the southern Sindh province and one from the eastern Punjab province and the northern Gilgit-Baltistan region each.

    Special polio vaccination campaigns will soon kick off in 11 union councils of North Waziristan district, health officials said. Enditem

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  • WHO-backed integrated testing model strengthens response to mpox, HIV, and syphilis

    WHO-backed integrated testing model strengthens response to mpox, HIV, and syphilis

    As mpox cases rise again in parts of Central Africa, the Democratic Republic of the Congo is pioneering an integrated public health response for HIV and syphilis testing within national mpox management.

    This integrated approach, led by the Ministry of Health with technical support from WHO, aims to provide comprehensive care, reduce missed opportunities for diagnosis and treatment and support community protection. Clinicians working at mpox testing sites have welcomed the initiative.

    Growing evidence shows people with undiagnosed HIV and those living with HIV who are not virally suppressed are at increased risk of severe mpox illness and death. Co-infection with syphilis has also been documented among individuals affected by mpox, especially among key populations. Despite the availability of affordable and effective treatment, syphilis continues to be widely underdiagnosed and untreated, particularly in low-resource settings. It is now the second leading cause of stillbirth globally. Integrating syphilis screening into the mpox response not only addresses a major gap in maternal and newborn health but also reinforces broader efforts in surveillance, diagnosis and care of sexually transmitted infections (STIs).

    “We now know people with HIV, particularly those with a CD4 count under 200 cells/mm³, are at risk for severe disease and death from mpox,” said Dr Meg Doherty, Director of WHO’s Global HIV, Hepatitis and STI Programmes. “Ensuring early access to HIV and syphilis testing and treatment to all people with confirmed or suspected mpox, as well as timely access to mpox vaccines and antivirals, will save lives”.

    Implementation in Kinshasa

    In April 2025, the Democratic Republic of the Congo became the first country to implement WHO’s Standard Operating Procedure (SOP) for integrating HIV and syphilis testing services as part of the mpox response. With support from WHO, health workers were trained and began rolling out dual HIV/syphilis rapid diagnostic tests to improve detection among those with suspected mpox at designated treatment centres. 

    The approach was first launched in 5 mpox treatment centres and now covers 11 health zones. Between April 2025 and 7 June 2025:

    • 697 individuals with suspected mpox were tested for HIV and syphilis;
    • 36 (5%) tested positive for HIV, including 27 confirmed mpox co-infections;
    • 6 individuals (1%) tested positive for syphilis and were treated on-site; and
    • weekly testing volumes increased steadily, reaching over 120 tests per week.

    National coordination and scale-up

    This approach is now going national. On 3 June 2025, the National HIV/AIDS Control Programme, together with WHO, the Ministry of Health, the Centre d’opérations d’urgence de santé publique (COUSP), and the Divisions provinciales de la santé (DPS) reviewed progress and set priorities for expanding this integrated approach. Together, they have also: 

    • drafted a therapeutic protocol for managing HIV/mpox co-infection;
    • strengthened capacity at the Kinoise Mpox Treatment Centre;
    • integrated mpox services into 6 HIV care and treatment centres;
    • strengthened inter-programme coordination to address delays and optimize limited resources; and
    • prepared for geographic expansion to provinces with high mpox transmission and/or high HIV prevalence.

    Addressing real world challenges 

    Despite strong progress, the rollout has faced logistical and operational challenges, including stock-outs, expiration of HIV test kits and delays in mpox PCR test results, which affect timely treatment. There has also been limited capacity to manage severe mpox/HIV co-infection, with only one advanced care site (MSF Kabinda in Kinshasa) in operation.

    Looking ahead

    As the country continues to confront multiple health threats, including mpox, HIV, and syphilis, its integrated testing model offers a blueprint for action in resource-limited settings. Lessons learned can be applied in other neighbouring countries as part of emergency and outbreak response, as well as for future preparedness and planning. 

    WHO and the Democratic Republic of the Congo are now planning to continue to provide joint supervision and mentoring visits, in order to strengthen data reporting and monitoring and improving stock management so as to avoid future commodity shortages. Both remain committed to protecting and saving lives by linking outbreak response with essential HIV and STI services, ensuring that no one is left behind.

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  • Parasite-Specific Organelle Proteins as Antimalarial Targets

    Parasite-Specific Organelle Proteins as Antimalarial Targets


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    University of California, Riverside-led team has made an advance in the basic understanding of Plasmodium falciparum, the parasite responsible for the deadliest form of human malaria, that could make novel, highly targeted anti-malarial therapies possible.

    Led by Karine Le Roch, a professor of molecular, cell and systems biology, the team identified two key proteins inside the “apicoplast” — a unique, parasite-specific organelle found in P. falciparum — that control gene expression. These proteins belong to the RAP (RNA-binding domain Abundant in Apicomplexans) family of proteins. Far more numerous in parasites than in humans, RAP proteins play critical roles in regulating RNA molecules and translating them into proteins inside parasite organelles.

    Using advanced genetic tools, the team created knockdown strains of P. falciparum to selectively deactivate the two RAP proteins, PfRAP03 and PfRAP08. The team found the loss of either protein led to parasite death, confirming their essential roles.

    The researchers also discovered that PfRAP03 and PfRAP08 specifically bind to ribosomal RNA (rRNA) and transfer RNA (tRNA) molecules, respectively. These non-coding RNAs are fundamental to protein synthesis within the apicoplast.

    “This is the first time anyone has shown how RAP proteins in the apicoplast directly interact with rRNA and tRNA,” said Le Roch, who directs the UCR Center for Infectious Disease Vector Research. “We’ve now shown mechanistically how these proteins regulate translation in an organelle that’s completely foreign to the human body.”

    Le Roch explained that humans have six RAP proteins, but parasites like Plasmodium have more than 20.

    “This evolutionary expansion suggests that RAP proteins may perform parasite-specific functions, making them exciting drug targets,” she said.

    The study, published in Cell Reports, builds on the team’s previous research on RAP proteins in parasite mitochondria and represents the first detailed mechanistic analysis of their function in the apicoplast.

    Unlike any structure found in human cells, the apicoplast is unique to apicomplexan parasites — a large group of single-celled organisms that includes PlasmodiumToxoplasma gondii, and Babesia. This uniqueness makes it an ideal target for therapies that can eliminate the parasite without harming the human host.

    “While the focus of our paper is malaria, the implications extend to other apicomplexan diseases like toxoplasmosis — dangerous especially to pregnant women — and babesiosis, a growing tick-borne threat in the United States,” Le Roch said. “This work exposes vulnerabilities across an entire class of parasites, revealing the molecular machinery these parasites rely on. If we can take it apart, we can stop these diseases before they take hold.”

    Though no drugs currently target RAP proteins, Le Roch’s lab is working toward solving the 3D structure of these RNA-protein complexes, a crucial step toward structure-guided drug design.

    “Our research is a step toward future therapeutic strategies,” Le Roch said. “By targeting essential, parasite-specific proteins that have no human counterparts, we can develop drugs that are both effective and have minimal side effects.”

    Reference: Hollin T, Chahine Z, Abel S, et al. RAP proteins regulate apicoplast noncoding RNA processing in Plasmodium falciparum. Cell Rep. 2025;44(7):115928. doi: 10.1016/j.celrep.2025.115928

    This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source. Our press release publishing policy can be accessed here.

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  • As mosquito season peaks, officials brace for new normal of dengue cases

    As mosquito season peaks, officials brace for new normal of dengue cases

    As summer ushers in peak mosquito season, health and vector control officials are bracing for the possibility of another year of historic rates of dengue. And with climate change, the lack of an effective vaccine, and federal research cuts, they worry the disease will become endemic to a larger swath of North America.

    About 3,700 new dengue infections were reported last year in the contiguous United States, up from about 2,050 in 2023, according to the Centers for Disease Control and Prevention. All of last year’s cases were acquired abroad, except for 105 cases contracted in California, Florida, or Texas. The CDC issued a health alert in March warning of the ongoing risk of dengue infection.

    “I think dengue is here with us to stay,” said infectious disease specialist Michael Ben-Aderet, associate medical director of hospital epidemiology at Cedars-Sinai in Los Angeles, about dengue becoming a new normal in the U.S. “These mosquitoes aren’t going anywhere.”

    Dengue is endemic — a label health officials assign when diseases appear consistently in a region — in many warmer parts of the world, including Latin America, India, and Southeast Asia. Dengue cases increased markedly last year in many of those places, especially in Central and South America.

    The disease, which can spread when people are bitten by infected Aedes mosquitoes, was not common in the contiguous United States for much of the last century. Today, most locally acquired (meaning unrelated to travel) dengue cases in the U.S. happen in Puerto Rico, which saw a sharp increase in 2024, triggering a local public health emergency.

    Most people who contract dengue don’t get sick. But in some people symptoms are severe: bleeding from the nose or mouth, intense stomach pain, vomiting, and swelling. Occasionally, dengue causes death.

    California offers a case study in how dengue is spreading in the U.S. The Aedes aegypti and Aedes albopictus mosquitoes that transmit dengue weren’t known to be in the state 25 years ago. They are now found in 25 counties and more than 400 cities and unincorporated communities, mostly in Southern California and the Central Valley.

    The spread of the mosquitoes is concerning because their presence increases the likelihood of disease transmission, said Steve Abshier, president of the Mosquito and Vector Control Association of California.

    From 2016 through 2022, there were an average of 136 new dengue cases a year in California, each case most likely brought to the state by someone who had traveled and been infected elsewhere. In 2023, there were about 250 new cases, including two acquired locally.

    In 2024, California saw 725 new dengue cases, including 18 acquired locally, state data shows.

    Climate change could contribute to growth in the Aedes mosquitoes’ population, Ben-Aderet said. These mosquitoes survive best in warm urban areas, often biting during the daytime. Locally acquired infections often occur when someone catches dengue during travel, then comes home and is bitten by an Aedes mosquito that bites and infects another person.

    “They’ve just been spreading like wildfire throughout California,” Ben-Aderet said.

    Dengue presents a challenge to the many primary care doctors who have never seen it. Ben-Aderet said doctors who suspect dengue should obtain a detailed travel history from their patients, but confirming the diagnosis is not always quick.

    “There’s no easy test for it,” he said. “The only test that we have for dengue is antibody tests.” He added that “most labs probably aren’t doing it commercially, so it’s usually like a send-out test from most labs. So you really have to suspect someone has dengue.”

    Best practices for avoiding dengue include eliminating any standing pools of water on a property — even small pools — and using mosquito repellent, Abshier said. Limiting activity at dusk and dawn, when mosquitoes bite most often, can also help.

    Efforts to combat dengue in California became even more complicated this year after wildfires ripped through Los Angeles. The fires occurred in a hot spot for mosquito-borne illnesses. San Gabriel Valley Mosquito and Vector Control District officials have worked for months to treat more than 1,400 unmaintained swimming pools left in the wake of fire, removing potential breeding grounds for mosquitoes.

    San Gabriel vector control officials have used local and state resources to treat the pools, said district spokesperson Anais Medina Diaz. They have applied for reimbursement from the Federal Emergency Management Agency, which has not historically paid for vector control efforts following wildfires.

    In California, vector control agencies are often primarily funded by local taxes and fees on property owners.

    Some officials are pursuing the novel method of releasing sterilized Aedes mosquitoes to reduce the problem. That may prove effective, but deploying the method in a large number of areas would be costly and would require a massive effort at the state level, Abshier said. Meanwhile, the federal government is pulling back on interventions: Several outlets have reported that the National Institutes of Health will stop funding new climate change-related research, which could include work on dengue.

    This year, reported rates of dengue in much of the Americas have declined significantly from 2024. But the trend in the United States likely won’t be clear until later in the year, after the summer mosquito season ends.

    Health and vector control researchers aren’t sure how bad it will get in California. Some say there may be limited outbreaks, while others predict dengue could get much worse. Sujan Shresta, a professor and infectious disease researcher at the La Jolla Institute for Immunology, said other places, like Nepal, experienced relatively few cases of dengue in the recent past but now regularly see large outbreaks.

    There is a vaccine for children, but it faces discontinuation from a lack of global demand. Two other dengue vaccines are unavailable in the United States. Shresta’s lab is hard at work on an effective, safe vaccine for dengue. She hopes to release results from animal testing in a year or so; if the results are positive, human trials could be possible in about two years.

    “If there’s no good vaccine, no good antivirals, this will be a dengue-endemic country,” she said.

    Phillip Reese is a data reporting specialist and an associate professor of journalism at California State University-Sacramento.

    This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 




    This article was reprinted from khn.org, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF – the independent source for health policy research, polling, and journalism.

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  • Erenumab Not Effective for Chronic Cluster Headache

    Erenumab Not Effective for Chronic Cluster Headache

    TOPLINE:

    Preventive treatment with the calcitonin gene-related peptide (CGRP) receptor monoclonal antibody erenumab for 6 weeks was not associated with significant reductions in weekly headache attacks, pain severity, or attack duration in adults with chronic cluster headache (CCH), a new phase 2 placebo-controlled trial showed.

    METHODOLOGY:

    • The CHERUB01 phase 2 12-week, double-blind, placebo-controlled randomized clinical trial was conducted at 11 sites in Germany between 2021 and 2023.
    • About 81 adults with CCH (mean age, 49 years; 74% men) who failed to respond to standard prophylactic therapies were randomly assigned to receive either subcutaneous erenumab (280 mg at baseline, followed by 140 mg at week 4) or a matching placebo.
    • The primary endpoint was change in the mean number of weekly CH attacks from baseline to weeks 5 and 6.
    • Secondary endpoints included the proportion of patients achieving a ≥ 50% reduction in attacks and the number of participants with Patient Global Impression of Improvement (PGI-I) scores of 1 or 2 at week 6. Exploratory endpoints included reduction in CH attack duration and change in mean pain severity on the numeric pain rating scale.

    TAKEAWAY:

    • The primary endpoint was not met. Although there was a greater reduction in the mean number of weekly attacks for the erenumab group compared to the placebo group, the difference was not statistically significant (-7.3 vs -5.9 attacks per week; 95% credible interval, -5.7 to 2.8).
    • There was no significant difference between groups in the proportion of participants achieving a ≥ 50% reduction in weekly attacks, the number of patients with improved PGI-I scores, changes in attack duration, or change in pain severity.
    • Adverse events were more common in the erenumab group compared to the placebo group (66% vs 43%), with most considered to be mild or moderate.

    IN PRACTICE:

    “Erenumab failed to show a benefit over placebo in patients with CCH, indicating that blockade of peripheral CGRP receptors has no beneficial role in the prophylaxis of CCH,” the investigators wrote.

    “To date, all double-blind controlled trials in CCH using an mAb affecting the CGRP pathway were negative, leading to the conclusion that future research should revisit the role of CGRP in CCH,” they added.

    SOURCE:

    This study was led by Jasper Mecklenburg, MD, Charité – UniversitätsmedizinBerlin, Berlin, Germany. It was published online on June 17 in JAMA Network Open.

    LIMITATIONS:

    Data on patients who progressed from episodic headache to CCH were missing. Additionally, the onset timing of current CCH episodes was unclear, with no detailed records of past steroid responses or reasons for prior treatment failures with verapamil or lithium, which relied on patient recall.

    DISCLOSURES:

    This trial was funded by a grant from Novartis Pharma GmbH to Charité – UniversitätsmedizininBerlin. Several investigators reported having financial ties with various sources including the funding company. Full details are listed in the original article.

    This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

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