Category: 8. Health

LivaNova has published 24-month data from the 3-year CORE-VNS study (NCT03529045) in Epilepsia, showing sustained reductions in generalized tonic-clonic (GTC) seizures among patients with drug-resistant epilepsy (DRE) following treatment with vagus nerve system (VNS) Therapy. The company noted that participants from CORE-VNS have been followed through the 36-month study interval, and it is in the process of publishing those outcomes.^1,2

Among 115 patients with drug-resistant epilepsy and generalized seizures at baseline, the median reduction in GTC seizure frequency was 73.9% at 12 months, with 37% of participants reporting seizure freedom from GTCS for the 3 months prior to the 12-month follow-up. Treated patients remained stable at 24 months, with a median GTCS reduction of 77%. In addition, 42.6% of patients reported seizure freedom for the 3 months prior to the 24-month visit.

“GTC seizures can be some of the most severe and debilitating seizures a patient can experience,” lead author Ana Suller Marti, MD, assistant professor of neurology at Western University in London, Ontario, Canada, said in a statement.¹ “The observed reductions in seizure frequency and severity, as well as the achievement of complete seizure freedom in some cases, are key findings that clinicians should be aware of.”

READ MORE: Fenfluramine Meets End Points in Phase 3 GEMZ Study of CDKL5 Deficiency Disorder

The CORE-VNS study assessed comprehensive outcomes of real-world evidence for over 800 patients with epilepsy treated with VNS Therapy globally. Researchers noted that the participants included in this analysis had a median of 10 years between epilepsy diagnosis and VNS Therapy implantation. In the interim analysis, approximately half of those who experienced GTC seizures were under 18 years of age, and nearly all (94%) had no prior history of epilepsy surgery.

Following 12 months of VNS, the number of participants who reported the postictal severity of their most debilitating seizure as “severe” or “very severe” decreased from 52.8% to 25.3% (21/83). Additionally, the percentage of participants that reported these levels of postictal severity was 26.3% (20/76) after 24 months of VNS. The company noted that participants’ drug load did not significantly change during the follow-up and adverse events were consistent with those previously documented in patients with DRE using VNS.

“I am struck by the significant seizure burden carried by the people, many of whom are so young, in this real-world dataset. Participants in this study failed a median number of six anti-seizure medications—some even as high as 20—and had a median of four tonic-clonic seizures per month at baseline,” Stephanie Bolton, LivaNova President, Global Epilepsy, said in a statement.¹ “Our focus remains on contributing to the science of the treatment of epilepsy, working in partnership with physicians, and transparently communicating the latest scientific information available.”

REFERNECES
1. LivaNova Announces CORE-VNS 24-Month Data Show Adjunctive VNS Therapy is Associated with Substantial Reductions in Generalized Tonic-Clonic Seizures in People with Drug-Resistant Epilepsy. News Release. Published June 5, 2025. Accessed July 8, 2025. https://investor.livanova.com/news-releases/news-release-details/livanova-announces-core-vns-24-month-data-show-adjunctive-vns
2. Suller Marti A, Verner R, Keezer M, et al. Reduction of generalized tonic-clonic seizures following vagus nerve stimulation therapy: CORE-VNS Study 24-month follow-up. Epilepsia. Published online April 1, 2025. doi:10.1111/epi.18371

Please chooseI’m not a medical professional.Allergy and ImmunologyAnatomyAnesthesiologyBiostatisticsCardiac/Thoracic/Vascular SurgeryCardiologyCritical CareDentistryDermatologyDiabetes and EndocrinologyEmergency MedicineEpidemiology and Public HealthFamily MedicineForensic MedicineGastroenterologyGeneral PracticeGeneticsGeriatricsHealth PolicyHematologyHIV/AIDSHospital-based MedicineI’m not a medical professional.Infectious DiseaseIntegrative/Complementary MedicineInternal MedicineInternal Medicine-PediatricsMedical Education and SimulationMedical PhysicsMedical StudentNephrologyNeurological SurgeryNeurologyNuclear MedicineNutritionObstetrics and GynecologyOccupational HealthOncologyOphthalmologyOptometryOral MedicineOrthopaedicsOsteopathic MedicineOtolaryngologyPain ManagementPalliative CarePathologyPediatricsPediatric SurgeryPharmacologyPhysical Medicine and RehabilitationPlastic SurgeryPodiatryPreventive MedicinePsychiatryPsychologyPulmonologyRadiation OncologyRadiologyRheumatologySubstance Use and AddictionSurgeryTherapeuticsTraumaUrologyMiscellaneous

In a recent study, the first of its kind to explore the impact of antibiotics on adolescent depression, investigators evaluated the risk that antibiotic exposure may pose to adolescents in developing depression.¹ With a growing prevalence of depression in adolescents, the authors examined the link between gut microbiome and depression, finding that antibiotics may impact gut microbiome.

Jin et al, in their study “The association between urinary antibiotic levels and the risk of adolescent depression,” identified 4 common antibiotics (azithromycin, sulfadimidine, ofloxacin, and ampicillin) to measure through urinary analysis. They compared single day, morning urinary samples from a group of 30 adolescents diagnosed with depression per the International Classification of Diseases (ICD-10) and a healthy control group of 32 adolescents. Urinary analysis was performed via liquid chromatography. Within the group of patients with depression, individuals were divided into low-moderate and severe groups based on their HAM-A and HAM-D scores. The control group was 75% female and 25% male, while the patient group was 76.7% female and 23.3% male. Between the control group and group with depression, there was no significant difference in BMI, age, or gender.

Participants with depression had significantly higher levels of each antibiotic, and higher levels were positively correlated with higher scores on elements of the Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D). The authors further noted that a combination of measuring of all 4 antibiotics showed the best performance as a predictor of adolescent depression. The study indicated that urinary antibiotic measurements are a potential screening tool for adolescent depression risk and noted that antibiotic exposure for this age group is a modifiable risk.

For each of the 4 antibiotic types evaluated in this study, all 4 were positively correlated with HAM-A and HAM-D scores. For HAM-A scores: azithromycin (r = 0.402, P = 0.0012), sulfadimidine (r = 0.384, P = 0.002), ofloxacin (r = 0.390, P = 0.002), and ampicillin (r = 0.461, P = 0.0002). For HAM-D scores: azithromycin (r = 0.383, P = 0.0021), sulfadimidine (r = 0.362, P = 0.0004), ofloxacin (r = 0.350, P = 0.005), and ampicillin(r = 0.429, P = 0.0005). From the HAM-A test, each antibiotic was correlated with scores on anxiety and autonomic nervous symptom items; from the HAM-D, each antibiotic was correlated with scores on anxiety, weight, cognitive disturbance, sleep disturbance, hopelessness, and other items. Although, there was no significant difference between the low-moderate and severe subgroups. There was still a significant difference between the control and depression groups.

A multitude of previous studies have acknowledged the effect of antibiotics on gut microbiome homeostasis, and the interactions of the microbiome-gut-brain axis are widely recognized.^2,3 The gut microbiome also has a known influence on brain function and behavior in adolescents.⁴ Similarly, previous studies were also conducted with groups of elderly individuals in China which showed evidence of antibiotic induced depression. With these prior findings, the investigators delved further into the effects of antibiotics on the gut microbiome, and therefore brain function and risk of depression in adolescents. The study authors also noted that there are no consistent, replicable finding on what specific types or levels of microbiome elements are associated with major depressive disorder (MDD). There is also potential that different gut microbiota can lead to depression through a variety of metabolic pathways.

The authors also explored performance of screening techniques based on urinary antibiotic analysis. With the finding that a combinatory measurement of antibiotic types was the most accurate screening for adolescent depression risk using urinary analysis, investigators proposed that evaluating urine may enhance screening for high risk populations. Elevated urinary antibiotic levels may also serve as more objective measurements for critical risk factors in adolescent depression, compared with subjective self reported patient surveys. Especially as use of antibiotics to treat infections in adolescents is associated with increased risk of mental disorders, the authors noted that controlling use of antibiotics in adolescents may be a key step to prevent depression in this population. New measurements of urinary antibiotic levels can bolster existing strategies to enhance early risk assessment and targeted intervention for MDD in adolescents, they added. “Our study highlights urinary antibiotic levels as modifiable risk factors strongly associated with adolescent depression. The integration of these non-invasive biomarkers demonstrates robust performance in screening for depression risk, offering a novel approach to complement existing diagnostic strategies and prioritize early risk identification in vulnerable populations,” the authors concluded.

References

1. Jin Y, Jin X, Ge Z, et al. The association between urinary antibiotics levels and the risk of adolescent depression. Sci Rep. 2025;15(1):24093.

2. Kelly JR, Borre Y, O’ Brien C, et al. Transferring the blues: depression-associated gut microbiota induces neurobehavioural changes in the rat. J Psychiatr Res. 2016;82:109-118.

3. Chung YE, Chen HC, Chou HL, et al. Exploration of microbiota targets for major depressive disorder and mood related traits. J Psychiatr Res. 2019;111:74-82.

4. Diaz Heijtz R, Wang S, Anuar F, et al. Normal gut microbiota modulates brain development and behavior. Proc Natl Acad Sci U S A. 2011;108(7):3047-3052.

Measles have surged to a record high, with more cases reported this year than any year since the disease was declared eliminated in the United States in 2000.

This disappointing record comes amid falling childhood vaccination rates: Coverage against measles, mumps, rubella, chickenpox, polio and pertussis is declining in more than 30 states, according to data from the US Centers for Disease Control and Prevention.

Some people may believe that if they’re personally vaccinated, they have nothing to worry about. But is individual protection enough when contagious illnesses start multiplying? How will falling vaccination rates result in the return of previously eliminated diseases? Will only children be affected, or could adults see an impact as well? Who would be at highest risk if there is lower population-wide immunity? And what can be done to prevent this possibility?

To get some answers, I spoke with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and clinical associate professor at George Washington University. She previously was Baltimore’s health commissioner.

CNN: Can falling vaccination rates result in the return of diseases that have been eliminated?

Dr. Leana Wen: Yes. There are numerous examples around the world. Countries that were once polio-free have had polio outbreaks due to interruptions in childhood immunization programs caused by war and conflict. Measles outbreaks have occurred in countries where measles had been eliminated, due to falling vaccine coverage.

This, in fact, is what we are seeing now in the US. In Texas, 753 measles cases have been confirmed since January. According to the Texas Department of State Health Services, 98 of these patients have been hospitalized, and two people, both children, have died. This outbreak is believed to have originated in communities with low vaccination rates.

What could happen if childhood vaccination rates declined further? A recent study published in JAMA predicted that a 10% decline in measles-mumps-rubella (MMR) vaccine coverage could result in more than 11 million measles infections over 25 years. A 50% decline in routine childhood vaccinations could result in 51 million measles cases, 9.9 million rubella cases and 4.3 million polio cases.

The projections also included the number of people affected by severe consequences of these diseases: As many as 10.3 million people in the US could be hospitalized, 159,200 could die, 5,400 could experience paralysis from polio, and 51,200 could have neurological consequences from measles.

CNN: Is that only unvaccinated people? If someone is vaccinated, do they need to worry if others are unvaccinated?

Wen: They should still worry for three main reasons.

First, while many vaccinations provide excellent protection against disease, there is still a chance of breakthrough infections — meaning that the vaccine doesn’t provide 100% protection. Two doses of the MMR vaccine are 97% protective against measles infection, which is an outstanding level of protection. But it’s not 100%, so if someone is exposed to measles, there is still a chance they could become infected. However, vaccination substantially reduces the likelihood of infection and also of having severe disease if they were to become infected. The more disease there is in the community, the higher the likelihood of exposure and infection.

Second, there may be some waning of vaccine effectiveness over time. For instance, according to the CDC, immunity to pertussis — also known as whooping cough — starts to wane after a few years following vaccination. Older adults who received childhood vaccinations many years ago may become susceptible if previously controlled childhood diseases make a comeback.

Third, there are people who are unable to receive the benefit of vaccination directly themselves. Some people are unable to receive certain vaccines because of specific medical conditions. For instance, someone who has a weakened immune system may not be able to get the MMR vaccine because it contains a live, weakened form of the virus.

Also, some people may have medical conditions that render vaccines less effective at protecting them. These individuals depend on the rest of society — those who can receive the vaccine — to do so and try to prevent these diseases from spreading.

CNN: What about pregnant people? Are there also some vaccines they cannot get?

Wen: This is another good point. Take rubella, or German measles. Pregnant individuals cannot receive the MMR vaccine because it contains live virus. But rubella can be especially dangerous during pregnancy.

In addition to increasing the risk of miscarriage and stillbirth, rubella can lead to a condition called congenital rubella syndrome that can cause numerous birth defects including heart problems, brain damage, deafness, and lung, liver, eye and thyroid ailments. According to the World Health Organization, before the introduction of the vaccine, as many as 4 babies in every 1,000 live births were born with this condition. Rubella remains the leading cause of vaccine-preventable birth defects.

Pregnant patients should not receive other live-attenuated vaccines either. Varicella, the vaccine against chickenpox, is another one of these vaccines. People should receive the vaccines before they are pregnant, ideally as part of their routine childhood immunizations. And other people can help to reduce disease in the community by getting vaccinated themselves.

CNN: Who would be at highest risk if there is lower population-wide immunity?

Wen: There are three groups I would be the most worried about. First are newborns who are too young to be vaccinated. They are also among the most medically fragile; something that is a mild cold for an older child or healthy adult could send them to the hospital.

Second are immunocompromised people. This is a large group and includes patients receiving cancer treatments, transplant patients and individuals taking immunosuppressant medications. These individuals are more likely to become severely ill if exposed to disease. Vaccines may also not protect them as well, or they may be ineligible to receive certain vaccines as we discussed earlier.

Third are the elderly. As we discussed many times in reference to Covid-19, these are individuals whose age and underlying medical conditions make them more susceptible to severe illness. That, in combination with possible waning immunity from certain vaccines, could put them at higher risk if there is more disease in the community because of lower vaccine coverage.

CNN: What can be done to prevent this possibility?

Wen: Everyone should speak with their primary care provider to verify that they are up to date on recommended vaccines. Parents with young children should do this with their family’s pediatrician, and adults should also be sure to speak with their family physician or internist as well.

The reason to do this is primarily to ensure that you are well-protected. If you are eligible for additional booster doses, you may consider getting them, or, if you are more susceptible to certain illnesses because you are not eligible for some vaccines, you should also know this and take precautions accordingly.

There’s another reason: The entire concept of population immunity depends on all of us doing our part to keep diseases at bay. That protects us — and others around us, including those who are especially vulnerable to severe illness and death.

Infant birth weight is not significantly increased by the use of trimethoprim–sulfamethoxazole prophylaxis during pregnancy, according to a recent study published in The New England Journal of Medicine.¹

Risks of preterm birth and maternal infections

Preterm birth, small for gestational age, or low birth weight is reported in 1 in 4 newborns worldwide, increasing the risk of neonatal mortality.² Maternal infections and inflammation during pregnancy, especially human immunodeficiency virus (HIV), further increase the risks of these outcomes.¹

“Antibiotics received during pregnancy may therefore plausibly improve birth outcomes, although evidence to date is heterogeneous,” wrote investigators.

Data collection and treatment regimen

The double-blind, randomized trial was conducted to assess the impact of trimethoprim–sulfamethoxazole, a broad-spectrum antimicrobial agent, on birth outcomes in patients with HIV. Patients attending 1 of 3 antenatal clinics in Shurugwi with a positive urine pregnancy test, known HIV status, not receiving trimethoprim–sulfamethoxazole, and no contraindications were included.

The authors obtained demographic, obstetrical, and clinical data at baseline, with trained midwives performing ultrasonography to measure gestation duration. Participants were randomized 1:1 to receive either trimethoprim–sulfamethoxazole or placebo.

The trimethoprim–sulfamethoxazole regimen included 2, 480-mg tablets per day, with a single tablet containing 400 mg of sulfamethoxazole and 80 mg of trimethoprim. Placebo tablets were taken at the same rate and were indistinguishable from the study drug in appearance and taste.

Follow-up and safety assessments

Participants attended follow-up appointments at 20-, 26-, 30-, 34-, 36-, 38-, and 40-weeks’ gestation. A safety visit also occurred 1 week following initiation of the study regimen, Data about adherence, side effects, dietary intake, illness recall, obstetrical complications, and HIV was obtained during these visits, alongside blood pressure measurements.

Ultrasonography was performed at 26- and 34-weeks’ gestation to assess fetal growth. Safety measurements included liver function, kidney function, and complete blood count. Delivery was tracked by weekly telephone calls starting 36-weeks’ gestation.

Birth weight was reported as the primary outcome, while secondary outcomes included low birth weight, gestation duration, preterm birth, small for gestational age, fetal loss, maternal hospitalization or death, and neonatal hospitalization or death. Investigators also obtained z-scores for weight for age, length for age, and head circumference.

Birth outcome results

There were 993 women included in the final analysis, 495 of whom were given trimethoprim–sulfamethoxazole and 498 placebo. A median age of 24.5 years was reported in the overall study population, and a median gestation duration of 20.4 weeks at enrollment. HIV was identified in 13.2% of participants.

Most participants began the regimen at a median 21.7-weeks’ gestation. Seventeen miscarriages, 19 stillbirths, and 928 live births were reported, with 14 sets of twins. No significant differences in birth weight were reported between groups, with a mean of 3040±460 g in the trimethoprim–sulfamethoxazole group vs 3019±526 g in the placebo group.

The mean difference in birth weight of 20 g was not statistically significant. Additionally, similar results were reported for most secondary outcomes. This included low birth weight with a rate of 10% in the trimethoprim–sulfamethoxazole group and 11.6% in the placebo group.

Secondary outcomes and implications

Additional rates included small for gestational age at 20.3% and 17.3%, respectively, and fetal loss at 4.2% and 3.3%, respectively. Mean gestation durations at birth were 39.3 weeks and 38.9 weeks, respectively. Adverse events were also similar between groups.

“In this trial we found that a universal, pragmatic strategy of antenatal trimethoprim–sulfamethoxazole in a district in Zimbabwe with a high prevalence of HIV did not lead to a significant improvement in birth weight,” concluded investigators.

References

1. Chasekwa B, Munhanzi F, Madhuyu L, et al. A trial of trimethoprim–sulfamethoxazole in pregnancy to improve birth outcomes. N Engl J Med. 2025;392(21):2125-2134. doi:10.1056/NEJMoa2408114
2. Blencowe H, Cousens S, Oestergaard MZ, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012;379(9832):2162-72. doi:10.1016/S0140-6736(12)60820-4

Sara Embry was newly pregnant and contracted C difficile in a most unusual way. She picked up fecal spores at a local restaurant. She had not taken any antibiotics.

As many people who get the infection, she initially struggled to find answers to her condition. She also lacked information from medical providers. She eventually found support through the C difficile organization, the Peggy Lillis Foundation (PLF), and became a peer volunteer helping others who are suffering from the condition and seeking answers and comfort.

Embry sat down with Contagion to discuss her experience and her involvement with PLF.

Contagion: Can you share what it was like to be diagnosed with C diff while pregnant, and how you managed both the infection and your pregnancy at the same time?

Embry: It was absolutely terrifying, because all the doctors and nurses that I came into contact with didn’t really have much experience with it. They misdiagnosed me. At first, I was extremely sick for a few weeks.

I thought that I was going to lose my baby.

For one, there was no information that I could find related to pregnancy and C diff online. I kept asking doctors about it, and no one could give me any information. They just told me that vancomycin was safe for my baby, and that was the extent of it. However, whenI was experiencing C diff, I was losing weight rapidly. I couldn’t get out of bed, I couldn’t keep any food down. And for anyone that has been pregnant, they know that nutrients are very important. Morning sickness is already hard, but then adding C diff on top of it—where you’re rapidly losing the nutrients that you desperately need for your growing baby. The level of weakness that I experienced was something that I’ve never had before. My husband and I are modern day homesteaders, so I’m used to being up and working, doing all the things that I need to do, and I just wasn’t able to. And, it kept progressing.

Contagion: What were some of the most challenging aspects of your recovery from C diff, both physically and emotionally?

Embry: Well, physically, I am already a rather small person, and keeping weight on has always been hard for me, but especially in the first part of pregnancy. This was my third pregnancy. At the time, I already struggled with morning sickness and losing weight and trying to maintain that, but I lost 17 pounds in a matter of just a few weeks. I was extremely weak. I could not get out of bed. My arms didn’t even look like they belonged to me. They look like child’s arms, and I was losing my muscles.

Walking across the house was expending all the energy that I had. That’s something that I was absolutely not used to. And I had 2 other young children that I needed to care for, and I wasn’t able to, It was hard on everybody in the family. My husband had to take off work, and not being able to care for myself was something I was not used to experiencing.

Emotionally, there’s an isolation that comes along with C diff that no one really talks about, because you can’t invite people over. At first, they’ll start offering to bring you meals or help with the kids, but they couldn’t be over to the house. It was so contagious, and I was terrified of passing it along to anyone. I couldn’t let my children sit around me. They couldn’t come and talk to me and play with me. It was horrible. It was hard on them. I had an active infection for over a month, and I was completely alone. I couldn’t let anyone come around me. And that’s something it really messes with your head whenever you are that isolated.

And when I finally got over the active infection the fear of reoccurrence is something that it’s almost like PTSD, because everything that I eat, I was worried, am I going to be feeding the infection? Am I giving it? What am I doing to make it worse? What am I doing to make it better? Is every thought that I had. What can I do today that will help me tomorrow and not make it worse, but the fear of reoccurrence. I mean, I still struggle with that. One of the things that I do, I’m very, very strict about what I eat, even still, over a year later, I don’t compromise on my diet. I stick to what I know is safe, and that that’s something that I’m not sure if I’m ever going to be able to look past, because the impact that C diff has on your body is something that you can’t even describe to someone unless you’ve they’ve seen it themselves, or they’ve had it themselves. Even thinking about it just makes my stomach churn, because there’s just nothing like it.

It’s like PTSD, and itlingers and stays with you, even after the experience.

Contagion: In talking about this traumatic experience that you had with C diff, how did it inspire you to get involved with the Peggy Liillis foundation?

Embry: Yes, well, as I said earlier, finding information on C diff was extremely hard outside of a Wikipedia article. And eventually I did come across the Peggy Lillis Foundation, and they had a handbook for how to deal with the active infection, and it had recipes for foods that were safe. And what to do, like warning signs, all the things that you need to know, and that was the most in depth.

Whenever I reached out to them, I couldn’t believe that they actually wanted to talk to me. They had people who were checking in on me, and not only did they provide me with the information that I needed to get through the infection, but just that level of isolation that I talked about. The Peggy Lillis Foundation really helped me with that, because they understood—Christian [PLF cofounder] losing his mom to see death like he really understands and speaking to them, it just it made me feel like I wasn’t alone, which I had felt alone throughout the whole process up until that point, and so with them. As soon. I believe that they’re doing good work, and I’m just so incredibly thankful that I want to be able to do that for other people.

Contagion: In terms of looking at a potential message, what do you hope to convey to the public, as well as policy makers through your advocacy work with the foundation?

Embry: Yes, well, I stand behind Peggy Lillis Foundation’s vision of where we believe in a world where C diff is rare, treatable and survivable. We believe in spreading awareness and knowing for people are going through it, that they’re not alone, and that you can get through it on the other side. And with me being pregnant, for all those women out there who may have it and and can’t find any information like I did, my baby is happy and healthy and strong, and they can get through it, too.

Contagion: What are the biggest misconceptions about C diff, and how can we build better awareness to improve prevention and treatment?

Embry: Sure, I think that the biggest misconception is that it won’t happen to me. We are people that eat the food that we grow; I’m very health conscious, and it happened to me. It can happen to anybody. The mindset that it won’t happen to me. It’s for elderly people, or people with compromised immune systems, or people who abuse antibiotics. I didn’t take any antibiotics. I picked it up by going to a birthday dinner with someone at a restaurant. It can happen to anyone, and it can pull the rug out from underneath of you faster than you believe.

I think that another misconception is that it’s rare. It’s estimated to cause half a million infections each year. It’s something that everyone that I’ve encountered, they have never heard of it before, and it’s happening to so many people.

It’s not as rare as we think. I think that everyone just needs to be aware that it is a possibility that could happen to you if you’re taking antibiotics, and doctors should warn you. You know this could be a side effect of taking an antibiotic, and do you really need the antibiotic? If the answer is yes, then absolutely take it, but the answer is no, and let, let’s explore some other options, because see if it’s way worse than just trying to describe it to people is hard to do, but it’s definitely something that would outweigh me considering taking the antibiotic again, and also that it only comes from antibiotic abuse. It comes from use of antibiotic, not just abuse. You take antibiotics once, and you can get C diff, and also that the spores are everywhere they it’s not just spread by or it’s not just acquired by taking antibiotics.

it could be on the grocery cart at the store. You don’t know, and you need to wash your hands properly. And even then, don’t touch your face, and all the things that they’ve been drilling into our head the last few years of COVID.

I think that awareness is key. I had never heard of it before. Maybe if I had, I wouldn’t have felt so helpless in the beginning. The doctors and nurses that I encountered were ignorant as well. They just diagnosed me and sent me on my way. They didn’t send me any information about it. I had to learn from myself how sick I was, and that was pretty terrifying on its own. Awareness is a big one, because for something that no one’s ever heard of, it’s affecting a lot of people.

Contagion: Can you talk about what you’re doing with PLF?

Embry: I attended the summit, and we went to Capitol Hill. We advocated for being able to make your own decisions As far as prescriptions, having some freedom with your doctor and insurance companies, not dictating what we are allowed to have and what we’re not. There’s a lot of options when it comes to C diff, well, not too many options, but there are a few options, and being able to to advocate for yourself what you need is very important,

And since the summit, I have been working as a peer support volunteer. Anyone who’s going through an active treatment or active infection can contact me. PLF will assign them to me, and I can call them, email them, whatever they are in the need of what they what they feel like. Some people don’t actually feel like talking on the phone whenever they’re in the middle of a an infection, but they can email me and I’ll email them back, or they can text me and I just offer I’m just that friend that has been through it, because we talked about the isolation of it when you don’t know anyone who’s going through what you’ve gone through, and you can talk to someone who went through it and ask them questions about, you know, I can’t give medical advice. Obviously, I’m not a doctor, but if you have questions about what to know, or just how I got through some stuff. I’ll share my story with them and walk them through it. Whenever someone is having a bad day, maybe a woman who is really struggling with the depression side of it, and just being able to talk to someone who had been through it really helped her, and that that’s what helped me; just being able to speak to someone who knows really makes a difference. And that’s what I want to try to do for other people.

When several countries endorsed the notion of some high-risk people taking the antibiotic doxycycline after unprotected sex to lower their chances of contracting a sexually transmitted disease, as the U.S. did last year, there was a theoretical concern the shift could drive antibiotic resistance in some bacterial infections.

That risk no longer appears to be theoretical.

In a newly published letter in the New England Journal of Medicine, researchers reported a steep rise in resistance to tetracycline — the antibiotic class to which doxycycline belongs — in gonorrhea isolates collected from across the country since results of the studies investigating the use of so-called doxy PEP were made public. PEP is short for post-exposure prophylaxis. 

An earlier report out of the University of Washington showed a similar trend in the Pacific Northwest, as well as a rise in tetracycline resistance in other bacteria carried by people who took doxy PEP, specifically Staphylococcus aureus and group A Streptococcus. 

Yonatan Grad, senior author of the latest report, said there is a clear benefit in advising some people at high risk of contracting an STI to take a dose of doxycycline within 72 hours of having unprotected sex. The Centers for Disease Control and Prevention recommends health care providers discuss the pros and cons of using doxy PEP with all gay, bisexual, and other men who have sex with men, and transgender women who have had a bacterial sexually transmitted infection in the last year.

But Grad said the benefit is mainly for controlling chlamydia and syphilis, and for driving down rates of congenital syphilis, which can trigger stillbirths, miscarriages, and can result in devastating birth defects for babies born with the infection. 

Evidence is growing, however, that the benefits of doxy PEP come with a cost: increasing resistance in other bacterial pathogens, said Grad, a professor of immunology and infectious diseases at the Harvard T.H. Chan School of Public Health.

“It’s less a theoretical concern now and more [that] we have evidence to indicate that it’s happening,” said Grad, whose co-authors are from Harvard and the College of Veterinary Medicine at the University of Georgia, in Athens.

Several studies found that using a single dose of doxycycline within 72 hours of unprotected sex to fend off STIs had a dramatic effect on lowering rates of infections. Chlamydia and syphilis cases declined by nearly 80%, and gonorrhea infections dropped by about 50%. The benefit for gonorrhea will likely decline as resistant strains of the bacterium continue to spread, Grad said.

The United States, Germany, and Australia have adopted the use of doxy PEP. Other countries are either still studying the issue or actively discourage the approach. It is not recommended in the United Kingdom or in the Netherlands, for example. 

Among the concerns has been that using antibiotics in this way flies in the face of the principles of antibiotic stewardship — limiting use of these key drugs to try to preserve their effectiveness.

Grad and his colleagues studied more than 14,000 genetic sequences of the bacterium Neisseria gonorrhoeae, the cause of gonorrhea, that were collected from patients from across the country from 2018 through 2024. The sequence data were generated by the CDC’s gonorrhea surveillance system. They were looking for a gene, called tetM, that is known to confer high-level resistance to tetracycline. 

Prior to 2020, tetM was found on fewer than 10% of genetic sequences nationwide. By the first quarter of 2024, it was found in more than 30% of sequences, Grad and his coauthors reported. The sharpest increase was in the Pacific Northwest, where the earlier paper by the University of Washington researchers showed that among 2,312 men who have sex with men who were diagnosed with gonorrhea, high-level resistance to tetracycline rose from 2% of cases in the first quarter of 2021 to 65% in the second quarter of 2024.

During the time when resistance in gonorrhea rose, several factors could have contributed to the increase. But it seems clear that doxy PEP is playing a role.

“The idea being that, of course, taking antibiotics drives resistance. And you’ll see it not only in the thing you’re targeting, but also anything else that happens to be on you and in you,” Grad said.

Gonorrhea has an uncanny ability to develop resistance to antibiotics; over the course of decades, it has steamrollered its way through every one of the drugs that has been used to treat it. In fact, the only currently licensed drug that is still reliably effective against it is an antibiotic called ceftriaxone, which is not a member of the tetracycline class. Ceftriaxone, not doxycycline, is the recommended first-line treatment for gonorrhea, and resistance to the latter does not erode the effectiveness of the former. But already there are strains of the bacterium, mostly circulating in Asia, that are resistant to the drug.

Two new antibiotics that appear promising for the treatment of gonorrhea are in the development pipeline. But given gonorrhea’s history, the concern remains that they, too, could fail eventually.

Experts who were not involved in this new study said they were not surprised to see what Grad and his group found. The findings also underscore the importance of closely watching the evolving resistance patterns in gonorrhea, said Barbara Van Der Pol, a professor of medicine and public health in the Heersink School of Medicine at the University of Alabama at Birmingham.

“Monitoring of Neisseria gonorrhoeae is an important public health need,” Van Der Pol said via email.

Jeanne Marrazzo, an STI expert who was director of the National Institute of Allergy and Infectious Diseases until she was fired by the Trump administration, pointed out that the very laboratory at the CDC that does this type of surveillance and testing was inexplicably closed in April — a decision that was later reversed. “We won’t have the ability to do this type of analysis if we lose the resources that CDC has available for it,” noted Marrazzo, who before joining NIAID was the director of the division of infectious diseases at the University of Alabama at Birmingham.

Marrazzo said she does not believe the findings suggest it is time to reconsider the use of doxy PEP — but there should be an understanding that its benefits may be transient.

“As I’ve been saying for ages and others are too, it really needs to be seen as a bridge to an effective vaccine for [gonorrhea],” she said.

In any case, Grad suggested any effort to stop the use of doxy PEP would likely not be easy. At-risk populations have adopted the practice even without a formal endorsement from public health authorities. A study last week in the journal Eurosurveillance reported on an online survey of doxy PEP use in the Netherlands, where it is not recommended.

Of 1,633 men who have sex with men, transgender, and gender-diverse people in the Netherlands, 22% had used doxy PEP or PrEP (before unprotected sex) informally, 15% reported having recently used it, and 65% had a high intention to use it. 

“I think it’s a hard genie to put back in the bottle,” Grad said. “I don’t think we’re going to stop doxy PEP, and I think doxy PEP has good clinical indications. You want to try to reduce the rates of syphilis and chlamydia.”

A new variant of the continually mutating COVID-19 virus has health officials on alert as it spreads rapidly worldwide.

Despite the uptick in illness, the WHO considers the overall public health risk from XFG to be low, and current data does not suggest that this variant leads to more severe illness or deaths than other variants in circulation.

“In most parts of the United States, we are in a pretty good place regarding respiratory illness, and most people should be enjoying their summer activities without too much worry,” says Mark Rupp, MD, a professor in the division of infectious diseases at the University of Nebraska Medical Center in Omaha.

July 9 (UPI) — A common virus once thought harmless to humans might be linked to Parkinson’s disease, a new study says.

The germ, Human Pegivirus (HPgV), was found in half the autopsied brains of patients with Parkinson’s, but not in any brains from healthy people, researchers reported Tuesday in the journal JCI Insight.

“HPgV is a common, symptomless infection previously not known to frequently infect the brain,” lead researcher Dr. Igor Koralnik, chief of neuroinfectious diseases and global neurology at Northwestern Medicine in Chicago, said in a news release.

“We were surprised to find it in the brains of Parkinson’s patients at such high frequency and not in the controls.”

The virus also appeared to prompt different responses from people’s immune systems, depending on their genetics, Koralnik said.

“This suggests it could be an environmental factor that interacts with the body in ways we didn’t realize before,” Koralnik said. “For a virus that was thought to be harmless, these findings suggest it may have important effects, in the context of Parkinson’s disease. It may influence how Parkinson’s develops, especially in people with certain genetic backgrounds.”

Parkinson’s disease occurs when brain cells that produce an important hormone called dopamine begin to die off or become impaired.

As dopamine levels decrease, people develop movement symptoms like shaking or stiffness, as well as problems maintaining balance and coordination.

More than 1 million people in the U.S. live with Parkinson’s disease, including actors Michael J. Fox and Alan Alda, singer Neil Diamond and football great Brett Favre. About 90,000 new cases are diagnosed every year, researchers said.

Most cases of Parkinson’s are not linked to a person’s genetics, raising the question of what might trigger the death of dopamine-producing nerve cells, researchers said in background notes.

For the new study, researchers autopsied the brains of 10 Parkinson’s patients and 14 people not suffering from the disorder.

The team found HPgV in 5 out of 10 brains from people with Parkinson’s, but none of the 14 healthy brains. The virus also was present in the spinal fluid of Parkinson’s patients, but not in the control group.

Further, more brain damage was found in patients with HPgV, researchers said.

Next, researchers tested blood samples from more than 1,000 participants in the Parkinson’s Progression Markers Initiative, a biosample library available for Parkinson’s research. HPgV is a blood-borne virus in the same family as hepatitis C.

Only about 1% of Parkinson’s patients had HPgV in their blood samples, researchers found.

But people who had the virus showed different signals from their immune system, particularly those with a Parkinson’s-related gene mutation called LRRK2, researchers said.

“We plan to look more closely at how genes like LRRK2 affect the body’s response to other viral infections to figure out if this is a special effect of HPgV or a broader response to viruses,” Koralnik said.

Researchers plan to continue tracking how common the virus is among Parkinson’s patients, and how it might trigger the brain disorder.

“One big question we still need to answer is how often the virus gets into the brains of people with or without Parkinson’s,” Koralnik said. “We also aim to understand how viruses and genes interact; insights that could reveal how Parkinson’s begins and could help guide future therapies.”

More information

The National Institute on Aging has more about Parkinson’s disease.

Copyright © 2025 HealthDay. All rights reserved.