Public Health

Social media posts from residents of Bosnia and Herzegovina's capital have shown an abundance of rodents swimming in the Miljacka river which flows through the centre of the city.

Health experts blame a failure to control Sarajevo's rodent population for an alarming rise in the number of cases of rat-borne diseases.

In just one 24 hour period this week, the country's largest hospital reported a dozen cases of leptospirosis. That follows a steady stream of other infections earlier in the month.

One of the disease's nicknames, rat fever, reflects its key vector of infection. It generally spreads to humans through water or soil contaminated with rodent urine or faeces.

Symptoms can range from headaches and muscle pain to bleeding on the lungs. The acute form of the illness, Weil's disease, can cause jaundice and even kidney failure.

The local authorities in Sarajevo have declared an epidemic, allowing the imposition of emergency measures, including a long overdue clean-up.

Colton George felt sick. The 9-year-old Indiana boy told his parents his stomach hurt. He kept running to the bathroom and felt too ill to finish a basketball game.

Professor Mohamed Yakub Janabi was [on 18 May 2025] nominated as the next Regional Director of the World Health Organization (WHO) African Region during a Special Session of the WHO Regional Committee for Africa held in Geneva ahead of the World Health Assembly.

I also came across the CV: https://www.afro.who.int/sites/default/files/RD%20Elections%20-%202024/RD%20Elections%20-%202025/CURRICULUM%20VITAE%20Pr%20Mohamed%20Yakub%20Janabi_E.pdf

1. Postdoctoral Fellowship in Cardiology, 2004, Osaka University Hospital, Japan.
2. PhD in Cardiology, Graduate School of Medicine, 2000, Osaka, Japan.
3. Master of Tropical Health, 1994, Queensland Medical School,Australia.
4. Doctor of Medicine, 1989, Kharkov Medical Institute, Ukraine.

The fruit pouches: https://arstechnica.com/health/2023/11/toxic-toddler-fruit-pouches-extremely-high-lead-levels-sicken-7-in-5-states/

Amid the brutal cuts across the federal government under the Trump administration, perhaps one of the most gutting is the loss of experts at the Centers for Disease Control and Prevention who respond to lead poisoning in children.

On April 1, the staff of the CDC's Childhood Lead Poisoning Prevention Program was terminated as part of the agency's reduction in force, according to NPR. The staff included epidemiologists, statisticians, and advisors who specialized in lead exposures and responses.

The cuts were immediately consequential to health officials in Milwaukee, who are currently dealing with a lead exposure crisis in public schools. Six schools have had to close, displacing 1,800 students. > In April, the city requested help from the CDC's lead experts, but the request was denied—there was no one left to help.

In a Congressional hearing this week, US health secretary and anti-vaccine advocate Robert F. Kennedy Jr. told lawmakers, "We have a team in Milwaukee."

But Milwaukee Health Commissioner Mike Totoraitis told NPR that this is false. "There is no team in Milwaukee," he said. "We had a single [federal] staff person come to Milwaukee for a brief period to help validate a machine, but that was separate from the formal request that we had for a small team to actually come to Milwaukee for our Milwaukee Public Schools investigation and ongoing support there."

Kennedy has also previously told lawmakers that lead experts at the CDC who were terminated would be rehired. But that statement was also false. The health department's own communications team told ABC that the lead experts would not be reinstated.

While Milwaukee continues to struggle, a Stat report Friday hints at losses yet to come. Looking back at the national scandal of lead-contaminated apple-sauce pouches, Stat reported that at least six of the CDC scientists and experts who worked on that nationwide poisoning event are gone.

Moving forward, the FDA will adopt the following Covid-19 vaccination regulatory framework: On the basis of immunogenicity — proof that a vaccine can generate antibody titers in people — the FDA anticipates that it will be able to make favorable benefit–risk findings for adults over the age of 65 years and for all persons above the age of 6 months with one or more risk factors that put them at high risk for severe Covid-19 outcomes, as described by the CDC (Figure 2). For all healthy persons — those with no risk factors for severe Covid-19 — between the ages of 6 months and 64 years, the FDA anticipates the need for randomized, controlled trial data evaluating clinical outcomes before Biologics License Applications can be granted. Insofar as possible, when approving a Covid-19 vaccine for high-risk groups, the FDA will encourage manufacturers to conduct randomized, controlled trials in the population of healthy adults as part of their postmarketing commitment.

Source.

The presence of antibiotics in surface waters poses risks to aquatic ecosystems and human health due to their toxicity and influence on antimicrobial resistance. After human consumption and partial metabolism, antibiotic residues are excreted and undergo complex accumulation and decay processes along their pathway from wastewater to natural river systems. Here, we use a global contaminant fate model to estimate that of the annual human consumption of the 40 most used antibiotics (29,200 tonnes), 8,500 tonnes (29%) are released into the river system and 3,300 tonnes (11%) reach the world's oceans or inland sinks. Even when only domestic sources are considered (i.e. not including veterinary or industrial sources), we estimate that 6 million km of rivers worldwide are subject to total antibiotic concentrations in excess of thresholds that are protective of ecosystems and resistance promotion during low streamflow conditions, with the dominant contributors being amoxicillin, ceftriaxone, and cefixime. Therefore, it is of concern that human consumption alone represents a significant risk for rivers across all continents, with the largest extents found in Southeast Asia. Global antibiotic consumption has grown rapidly over the last 15 years and continues to increase, particularly in low- and middle-income countries, requiring new strategies to safeguard water quality and protect human and ecosystem health.

Question Is a multicomponent vaccine against seasonal influenza and SARS-CoV-2 (mRNA-1083) immunogenic and well-tolerated in adults 50 years and older?

**Findings ** In this phase 3 study, mRNA-1083 elicited noninferior immune responses against standard care immunization: licensed standard-dose or high-dose seasonal influenza vaccine (A/H1N1, A/H3N2, B/Victoria, B/Yamagata) coadministered with licensed SARS-CoV-2 (Omicron XBB.1.5) vaccine. The multicomponent vaccine mRNA-1083 had an acceptable tolerability and safety profile.

Meaning mRNA-1083 was demonstrated to be at least as immunogenic as recommended standard care vaccines against both seasonal influenza and COVID-19 and well-tolerated in adults 50 years and older.

It's hard to believe opioid deaths are dropping when you're walking on Vancouver's Downtown Eastside, where B.C.'s drug crisis is most visible.

Open drug use is still common and on a dry day, you can count on seeing dozens of people unconscious on the sidewalk.

But the numbers don't lie: overdose deaths in 2024 decreased 12 per cent in B.C. and across the country compared to the previous 12 months, according to January data from the province and March data from Health Canada.

The downward trend is even more pronounced in the U.S., where drops in fatalities of up to 45 per cent have been seen in states like North Carolina, according to the Centers for Disease Control and Prevention (CDC), which aggregates state numbers.

However, any progress could be undermined if either country sees a dramatic shift in drug supply or harm reduction measures, warns Nabarun Dasgupta, a senior scientist at the University of North Carolina's Opioid Data Lab, which has been closely monitoring the shift in the U.S.

Dasgupta's team in North Carolina is still trying to nail down the reasons behind the significant decrease in overdose deaths, which have been seen in all U.S. states except Nevada and Alaska.

He has three main theories, which at first appeared like total anomalies.

The first is an apparent shift toward a more varied drug supply that's less based on fentanyl and includes lots of ingredients, like other synthetic opioids or amphetamines. Simply put, the drug supply may be getting saturated with substances that are less dangerous than large amounts of fentanyl.

"People are telling us in our field studies that the dope isn't the same as it used to be," Dasgupta said.

Then there's the drug users themselves. People who regularly crunch the numbers on overdose deaths know there's a certain cohort of people that commonly makes up a majority of fatalities. In Canada in 2024, 73 per cent of overdoses deaths happened to men aged 30 to 39, according to Health Canada.

In the U.S., about 70 per cent of overdose deaths hit men in their late-40s to mid-50s. Dasgupta suspects parts of that cohort may have stopped using drugs or could be dying of other causes.

The last hypothesis for the decline is more hopeful.

Interventions could be having a real impact. Treatment options, including lifesaving opioid reversal drugs like naxolone, which people regularly carry with them, or programs to reduce the stigma of drug use or educate young people on the dangers, might be making a dent.

It adds up, says Sarah Blyth, who says the Overdose Prevention Society saves people every day in different ways.

Still, she remains sceptical of a permanent improvement in the long-running drug crisis, as she personally knows people who have recently died from the supply. Optimism in this rolling crisis is easily broken and people are desperate to see things improve.

"No one wants to see anymore people dying," Blyth said. "I want to see people living the best life that they can."

Downward trend in deaths appears stalled due to lack of urgency among doctors, patients, along with healthcare barriers