• Several studies presented at the Union World Conference on Lung Health in Paris highlight positive developments in the treatment of drug-resistant strains of tuberculosis (DR-TB).

• The Leveraging Innovation for Faster Treatment of Tuberculosis (LIFT TB) trial revealed a nearly 95% cure rate with the World Health Organization-recommended regimen.

• The regimen includes a 6-month all-oral BPaL.

• The EndTB trial identified four alternative shorter regimens with higher cure rates than the standard 18- to 24-month regimens.

• The regimens included different combinations of bedaquiline, delaminid, clofazimine, linezolid, moxifloxacin or levofloxacin, and pyrazinamide.

• Additionally, studies in South Africa and Vietnam suggest that an oral antibiotic could reduce the risk of developing DR-TB in both adults and children.

• Lastly, preventive treatment trials using levofloxacin demonstrate a 56% reduction in the risk of developing MDR-TB in children under 5.

• The goal is to encourage more countries with a high DR-TB burden to adopt updated treatment guidelines and provide access to shorter, more effective treatments.

• The findings are expected to inform upcoming WHO guidelines on MDR-TB preventive treatment.

Infectious Disease, AMR Resistance, Tuberculosis

• With almost 5 million deaths annually attributed to bacterial infections and inadequate investment in new antimicrobials, the WHO identifies AMR as a top global health threat.

• World AMR Awareness Week, scheduled for November 18–24, emphasizes the crucial actions required to combat antimicrobial resistance (AMR), with the theme of “preventing antimicrobial resistance together.”

• AMR arises when microorganisms no longer respond to medicines designed to treat them, leading to increased disease spread and mortality risks.

• Misuse and overuse of antimicrobials in human health and food production drive AMR.

• Despite 93% of countries having AMR national action plans (NAPs), only 27% have budgeted plans, revealing a need for enhanced governance, leadership, and financial support.

• The WHO's Access, Watch, Reserve (AWaRe) antibiotic book (published in December 2022) aims to optimize global antimicrobial use.

• The World AMR Awareness Week advocates collaborative efforts to protect antimicrobials and public health.

• Additionally, the UN General Assembly High-Level Meeting in September 2024 will urge countries to make bold commitments to address AMR.

Antimicrobial Resistance, WHO

• The Eurasian H5N1 clade was first detected in US poultry and commercial stock in early 2022.

• Since October 2022, cases have spiked, and outbreaks have been reported in backyard flocks, poultry families, and commercial bird producers.

• The USDA and Animal and Plant Health Inspection Service report that this wave of rise in cases crossed the record 60 million mark in November 2023.

• The first commercial farm outbreak was reported from a gamebird producer in Alabama, which houses 296,500 birds.

One health, Public health, Zoonotic disease, Outbreak

• WHO has four new policy briefs to support nations in implementing laws for the betterment of urban health.

• The four policy briefs are related to the following:

• Governance and financing

• Generating and working with evidence

• Participation and Partnership

• Innovation

• Two of the four were released on October 31st to mark World Cities Day 2023.

• The Partnership for Healthy Cities, a global network of cities dedicated to reducing urban mortality by preventing noncommunicable diseases (NCDs) and injuries, will also find value in these new policy papers.

• The WHO Eastern Mediterranean Region in Doha, Qatar, held a meeting to commemorate World Cities Day in 2023.

• The region's growing Healthy Cities network enables towns to overcome challenges and realize their full potential in enhancing regional public health outcomes.

Global health, Healthy cities network, WHO, Policy briefs, Public health days

• Given the alarmingly high rates of stray animal bites and related fatalities, the high courts of some of the states have decided on the provision of compensation for the victims.

• The states involved in this decision are:

• Punjab

• Haryana

• Union Territory of Chandigarh

• This was in response to 193 pleas outlining the lack of any regulatory measures to control such incidences by the states.

• The justice ordered the formation of a committee by the state to decide the compensation to be paid to the victims who claim it.

• Any bite of stray cattle or animals, wild or pet animals, qualifies for compensation.

• The compensations in case of a dog bite are as follows:

• ₹10,000 for a teeth mark

• ₹20,000 for a 0.2 cm wound depth of flesh removed

One Health, Public Health Laws, Dog-bite

• In line with the six-point action plan to clean the Yamuna River by 2025, the Delhi government will soon commission two year-long studies.

• One study will focus on the levels of microplastics in river water compared to underground water.

• Bioaccumulation of microplastics has been postulated to cause genetic and organ dysfunction.

• The other will study foaming in river water.

• Foaming results from alarmingly high phosphate levels from toxic pollutants, leading to eutrophication and rendering the water devoid of dissolved oxygen.

• The studies aim to develop policy decisions for short and long-term solutions.

Environmental Health, Water pollution

• A monumental achievement for Bangladesh: WHO validates sustained kala-azar reduction, with reported cases below 1 per 10,000 in all subdistricts for three consecutive years.

• Kala-Azar is caused by Leishmania spp. And is transmitted by phlebotomine sandflies.

• It threatens the rural areas with poverty, poor housing, and malnutrition.

• If left untreated, it can be fatal in over 95% of cases.

• In 2005, Bangladesh, India, and Nepal initiated the Regional Kala-Azar Elimination Initiative, which was further updated in 2012 for continued elimination efforts.

• Tools that were crucial in the early detection and treatment of kala-azar in remote places included:

• rK39 test

• Liposomal amphotericin B

• Miltefosine

• In 2022, there were only 47 kala-azar cases in Bangladesh and 1069 in the Southeast Asia Region, the historic lowest number till now.

• Further, Bangladesh eliminated lymphatic filariasis in May 2023, making it the first country to eliminate two tropical diseases in one year.

Kala Azar, Neglected Tropical Diseases

• The US FDA approved Ixchiq as the first vaccine against the Chikungunya virus for the 18-year-old and above age group.

• Chikungunya is endemic in tropical and subtropical regions of Africa, Southeast Asia, and America.

• Its threat is not only restricted to the acute symptoms but also to the chronic debilitating complications and fatal infection in newborns following mother-to-child transmission.

• The FDA approved the vaccine using the Accelerated Approval pathway based on Phase III clinical trial data.

• Six months after vaccination, the live-attenuated, single-dose vaccine demonstrated 96.3% seropositivity.

• The trial reported severe adverse reactions in some participants.

• It awaits a postmarketing trial to determine the seriousness of the reactions.

Vaccination, Chikungunya, Clinical Trial, Vector-borne diseases

• The US Food and Drug Administration released a corporate announcement by Kilitch Healthcare India Limited on November 15, 2023.

• The announcement states that the company is voluntarily recalling adverse events reported by patients who have used any of its 26 different eye drops nationwide.

• The company has notified its distributors, wholesalers, and retailers to report any adverse events following the use of the eye drops, which have an expiration date of November 2023 to September 2025.

• As per the report, there has been an issue regarding sterilization during the manufacture of the products.

• Due to inadequate and ineffective sterilization, they carry the risk of spreading potential infections.

Drug safety, FDA

• "FluTrackers" is an infectious disease news message board.

• The board has been delivering reports of continuous CCHF hospitalizations since August, reporting 15 deaths until mid-October.

• On November 5, Flutrackers reported that the government of Balochistan had announced a red alert in the aftermath of 16 CCHF deaths in the region, including a doctor.

• Officials at the outbreak hospital have taken the following steps:

• Isolated the infected ward,

• Taken special precautions to disinfect all cattle markets in the province

• They have banned private animal slaughter in public areas for two weeks.

• Also, France reported the first CCHF finding in Hyalomma ticks in October in cattle.

• CCHF is a viral hemorrhagic fever spread by Hyalomma ticks that is endemic in Africa, the Balkans, the Middle East, and Asia.

• The disease currently has no vaccination or specific treatments and is highly fatal.

Epidemic, Viral outbreak, Viral hemorrhagic fever

• Researchers from the University of Warwick led a team that found that after being immersed in a river for a week, both new and old plastics carried opportunistic "microbial hitchhikers" and different sets of antibiotic resistance genes (ARGs).

• Examples of these hitchhikers were organisms such as Pseudomonas aeruginosa and Acinetobacter baumannii.

• Plastics operate as a reservoir for pathogenic bacteria, or ARGs, often exacerbated by their persistence in the environment due to their recalcitrance and buoyancy.

• The findings raise worries that the "riverine plastisphere" could act as an antibiotic resistance reservoir.

• However, the researchers note that it's too early to tell whether plastics can transmit infection-causing, antibiotic-resistant bacteria.

Microbial resistance, Water Pollution, AMR

• Impact Wellbeing is a new campaign launched by the Center for Disease Control and Prevention's (CDC) National Institute for Occupational Safety and Health (NIOSH).

• This campaign provides hospital leaders with evidence-based resources to improve workplace policies and practices.

• These will help:

• Reduce burnout

• Normalize help-seeking

• Strengthen professional well-being.

• Impact Wellbeing assists hospital executives and their healthcare workforce by providing concrete measures to:

• Fine-tune quality improvements

• Build new workflows

• Make employees feel safe seeking help

• Furthermore, hospital administrators can eliminate one of the most significant system impediments to healthcare worker well-being: intrusive mental health questions on hospital credentialing forms.

• For more than 50 years, NIOSH has provided methods and resources to workers and employers, including hospital management, in order to promote sustainable, safe workplaces.

Occupational health, well being