The World Health Organization's (WHO) designation of noma as a neglected tropical disease (NTD) on 15 December 2023 marks a crucial advancement in global health efforts. This move sheds light on a condition predominantly affecting undernourished children in isolated regions of sub-Saharan Africa. Recognized as the 21st NTD, noma, or cancrum oris, is a serious condition leading to orofacial gangrene. The disease largely impacts young children and those with compromised immune systems, including individuals with human immunodeficiency virus or leukaemia. Determining the exact prevalence of noma is complex, hindered by rapid disease progression, societal stigma and a lack of reporting, especially in impoverished areas. The WHO's acknowledgment is a significant step, emphasizing the need for more in-depth research and resources to address this overlooked disease. It highlights the critical role of multifaceted prevention strategies, including economic empowerment, improved nutrition and enhanced vaccination efforts. This recognition is pivotal in guiding international health initiatives towards better outcomes for some of the most at-risk populations globally.

The SARS-CoV-2 subvariant BA.2.86 'Pirola', first identified in Denmark in August 2023, has manifested with a significantly mutated spike protein profile, suggesting a heightened ability to evade vaccine-induced and infection-induced antibodies. This article outlines the epidemiological spread, immune response implications, and global responses to BA.2.86. Preliminary observations indicate community transmissions of the subvariant, even among those previously infected or vaccinated. Notably, the BA.2.86 infection has shown a potential to amplify antibody responses. The variant's emergence has evoked memories of the Omicron variant's rise in late 2021, though global immunity levels might modulate the impact of BA.2.86 impact differently. Continuous genomic surveillance, coupled with integrated diagnostic and epidemiological strategies, proves crucial in early detection and management. The emergence of BA.2.86 reaffirms the unpredictable nature of the COVID-19 pandemic, emphasizing the need for ongoing research, adaptability, and global collaboration.

Zero-dose children pose a key challenge in immunization programs due to their association with access to the health system and primary healthcare services. Examining zero-dose aids an in-depth understanding of healthcare disparities among children and caregivers. The disparity in utilization of maternal and child health services raises concerns about the potential consequences of unintended pregnancies on vaccine uptake. The National Family Health Survey 2019-21 (NFHS-5) served as the data source, and the study analyzed information from 43,247 children aged 12-23 months. Sociodemographic variables such as birth order, wealth quintile, gender, social group, religion, residence, mother education, and delivery-related factors were considered. Statistical analysis involved weighted estimates, chi-square tests, and multivariate multinomial logistic regression. The results show that 9.14% of children from unintended pregnancies were zero-dose for the DPT vaccine, compared to only 6.69% of children from intended pregnancies in India, indicating a higher prevalence of zero-dose associated with unintended pregnancies. The regression analysis shows the adjusted odds among children from an unintended birth - 1.21 times higher for the zero-dose DPT vaccine as compared to the intended birth (AOR: 1.21, 95% CI: 1.06,1.38). Zero-dose immunization has become a crucial metric of childhood immunization performance, gaining prominence in national agendas, the IA 2030 framework, and Gavi's 2021-25 strategy. The study findings highlight a significant association between unintended pregnancy and zero-dose DPT vaccination. The results provide compelling evidence that unintended pregnancies could be a potential risk factor for zero-dose DPT vaccination in low- and middle-income countries.

Australia has long been free of the highly pathogenic avian influenza (HPAI)-H5N1, but recent developments have changed this status. The first confirmed human case of HPAI-H5N1, involved a 2.5-year-old girl who contracted the virus in Kolkata India between 12 and 29 February, 2024.1WHOAvian influenza A(H5N1) - Australia.https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON519Date: 2024Date accessed: June 22, 2024Google Scholar,2C Raina MacIntyre HS Bird flu is hitting Australian poultry farms, and the first human case has been reported in Victoria. Here's what we know. The conversation.2024Google Scholar The case was confirmed on 18 May, 2024 and the WHO was notified on 22 May. While in India, the girl visited the doctor due to, loss of appetite, fever, cough and vomiting on 28 February and received paracetamol treatment. Upon returning to Australia on 1 March, the illness was not reported to Australian airport biosecurity.1WHOAvian influenza A(H5N1) - Australia.https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON519Date: 2024Date accessed: June 22, 2024Google Scholar The child sought medical attention and was admitted to the ICU in Melbourne on 4 March, and discharged 2.5 weeks after initial admission. The patient was infected with clade 2.3.2.1a, common in South Asian birds, especially in Bangladesh and India. This clade is different from clade 2.3.2.1c, found in Cambodian and Vietnamese poultry, which occasionally infects humans.3Schnirring L. Australia's imported H5N1 case linked to South Asian clade.https://www.cidrap.umn.edu/avian-influenza-bird-flu/australias-imported-h5n1-case-linked-south-asian-cladeDate: 2024Google Scholar The case marks a significant epidemiological event, emphasising the importance of vigilance against avian influenza. H5N1 is divided into several clades, each with its geographic and clinical significance. The global spread of H5N1, particularly the clade 2.3.4.4b, poses ongoing challenges for public health and poultry industries worldwide.4Mohanty A. Mini M. Zaawari A. Banerjee A. Bage R.N. Jha T. From avian to human: understanding the cross-species transmission and the global spread of highly pathogenic avian influenza.The Evidence. 2024; 2https://doi.org/10.61505/evidence.2024.2.2.76Crossref Google Scholar Clade 2.3.4.4b, spreading since 2020, is the most lethal identified so far, with wide geographical reach and severe impacts on multiple species.2C Raina MacIntyre HS Bird flu is hitting Australian poultry farms, and the first human case has been reported in Victoria. Here's what we know. The conversation.2024Google Scholar Globally, 16 human cases of clade 2.3.4.4b include recent cases in dairy workers, one in Texas two in Michigan, and one in Colorado.5WHOAvian influenza A(H5N1) - United States of America.https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON512Date: 2024Date accessed: May 22, 2024Google Scholar Clade 2.3.2.1 of HPAI-H5N1 has caused significant outbreaks in domestic poultry in several countries. These viruses bind exclusively to avian-type receptors (α2,3-linked sialic acids), limiting their ability to infect humans.6Xing X. Shi J. Cui P. et al.Evolution and biological characterization of H5N1 influenza viruses bearing the clade 2.3.2.1 hemagglutinin gene.Emerg Microbes Infect. 2024; 132284294Crossref Scopus (2) Google Scholar They exhibit varying pathogenicity in mice and have evolved through mutations and reassortments into subclades (2.3.2.1a–2.3.2.1f), with specific mutations affecting virulence and host range. Vaccines targeting this clade require ongoing updates to match circulating strains.6Xing X. Shi J. Cui P. et al.Evolution and biological characterization of H5N1 influenza viruses bearing the clade 2.3.2.1 hemagglutinin gene.Emerg Microbes Infect. 2024; 132284294Crossref Scopus (2) Google Scholar,7Huang P. Sun L. Li J. et al.Potential cross-species transmission of highly pathogenic avian influenza H5 subtype (HPAI H5) viruses to humans calls for the development of H5-specific and universal influenza vaccines.Cell Discov. 2023; 9: 58Crossref PubMed Scopus (17) Google Scholar In contrast, clade 2.3.4.4 of HPAI-H5N1 is globally distributed and infects a wide range of species, including humans, by binding to both avian (α2,3-linked) and human (α2,6-linked) receptors. Mutations like PB2 E627K enhance its virulence in mammals. This clade's ability to bind to human receptors increases the risk of cross-species transmission and human infection.8Hu X. Saxena A. Magstadt D.R. et al.Highly pathogenic avian influenza A (H5N1) clade 2.3.4.4b virus detected in dairy cattle.bioRxiv. 2024; https://doi.org/10.1101/2024.04.16.588916Crossref Scopus (0) Google Scholar Reassortment between H5 and H7 influenza strains, where RNA segments mix in co-infected hosts, can produce novel viruses with unpredictable characteristics, such as high virulence or efficient human transmission. Continuous monitoring of these viruses in birds and humans is vital for early detection and risk mitigation. Historical pandemics, like the 1918 Spanish flu, likely stemmed from such reassortment events.9White M.C. Lowen A.C. Implications of segment mismatch for influenza a virus evolution.J Gen Virol. 2018; 99: 3-16Crossref PubMed Scopus (64) Google Scholar The presence of H5N1 and H7 in wild birds and domestic poultry highlights the need for vigilant surveillance and biosecurity measures to prevent the spread of these potentially dangerous reassorted viruses.2C Raina MacIntyre HS Bird flu is hitting Australian poultry farms, and the first human case has been reported in Victoria. Here's what we know. The conversation.2024Google Scholar Australia's poultry industry is currently facing significant challenges due to multiple avian influenza outbreaks, specifically involving H7N3, H7N9, H7N8 strains. The first detection of H7N3 occurred at an egg farm near Meredith, with a further six properties confirmed (most recent confirmed on 24 June 2024), and, one property near Terang reported an H7N9 outbreak, totalling eight HPAI-H7 cases in Victoria's poultry sector as of 10 July, 2024. On June 19 and June 22, 2024, New South Wales confirmed HPAI-H7N8 at poultry egg farms.1WHOAvian influenza A(H5N1) - Australia.https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON519Date: 2024Date accessed: June 22, 2024Google Scholar,10Victoria A. Avian influenza (bird flu) | Current situation.https://agriculture.vic.gov.au/biosecurity/animal-diseases/poultry-diseases/avian-influenza-bird-fluDate: 2024Date accessed: July 10, 2024Google Scholar Australia's H7 outbreaks date back to Melbourne in the 1970s, with the most recent in Lethbridge, Victoria, in 20203Schnirring L. Australia's imported H5N1 case linked to South Asian clade.https://www.cidrap.umn.edu/avian-influenza-bird-flu/australias-imported-h5n1-case-linked-south-asian-cladeDate: 2024Google Scholar (Fig. 1). In the Australian Capital Territory, HPAI-H7N8 was also confirmed at a poultry farm on 27 June, and on 5 July, a second H7N8 infection was found in backyard poultry. Stringent biosecurity and public health measures are essential to prevent and control avian influenza, protecting both the poultry industry and public health. Poultry farms must maintain hygienic facilities, restrict contact between poultry and wild birds, and conduct ongoing surveillance to prevent virus spread. Travellers to affected areas should avoid poultry farms and live bird markets. Seasonal flu vaccination is recommended for poultry workers and travellers to outbreak regions to reduce pandemic risks.1WHOAvian influenza A(H5N1) - Australia.https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON519Date: 2024Date accessed: June 22, 2024Google Scholar Health professionals should assess avian-flu in patients, perform PCR-tests, and educate patients on risks.1WHOAvian influenza A(H5N1) - Australia.https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON519Date: 2024Date accessed: June 22, 2024Google Scholar H5N1's global presence increases the risk of mutations that could enable human transmission, posing a significant threat.5WHOAvian influenza A(H5N1) - United States of America.https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON512Date: 2024Date accessed: May 22, 2024Google Scholar Continuous monitoring and research, alongside international surveillance and data sharing, are crucial to detect and address potential mutations. Enhanced global preparedness is essential to prevent a human pandemic.2C Raina MacIntyre HS Bird flu is hitting Australian poultry farms, and the first human case has been reported in Victoria. Here's what we know. The conversation.2024Google Scholar Australia's first human HPAI-H5N1 case highlights the ongoing avian influenza threat. Although the transmission risk remains low in Australia, the global spread of H5N1 and other virulent strains necessitates continued vigilance, robust biosecurity, and proactive public health measures. Rigorous surveillance and preparedness are vital for managing these risks and safeguarding public health and the poultry industry. Pawan Kumar–literature search, figure, writing original draft. Ayush Sharma–figure, literature search, writing original draft. Vasso Apostolopoulos–literature search, figure, interpretation, writing review and editing. Abhay Gaidhane–literature search, writing review and editing. Prakasini Satapathy–literature search, writing review and editing. The Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations. Authors Declare No conflict of interest. None. Funding: No funding received. Ethical approval: Not applicable.

Introduction: Measles remains a critical public health concern causing significant morbidity and mortality globally. Despite the success of measles vaccination programs, challenges persist, particularly in India. This study investigates dose -wise measles vaccination coverage and explores gaps in immunization focusing on zero -dose, one -dose, and two -dose coverage among children aged 24 - 35 months. Data sources and methodology: The National Family Health Survey 2019 - 21 (NFHS-5) served as the data source and the study analyzed information from 43,864 children aged 24 - 35 months. Sociodemographic variables such as birth order, wealth quintile, gender, social group, religion, residence, mother education, delivery -related factors, and media exposure were considered. Statistical analysis involved weighted estimates, chi-square tests, and multivariate multinomial logistic regression. Results: The study revealed that challenges persist in achieving optimal measles vaccination coverage. Analysis by sociodemographic factors highlighted disparities in coverage, with variations in zero dose prevalence across states and districts. The percentage of zero -dose children was significantly higher, with 11.5% of children in India remaining to receive any measles vaccination. Factors influencing vaccine coverage include birth order, age, wealth quintile, social group, religion, residence, maternal education, place of delivery, media exposure, and mode of delivery. The findings from the spatial analysis show the clustering of zero -dose children is high in the northeastern states of India. Discussion: Measles zero -dose children pose a significant obstacle to achieving elimination goals. Spatial analysis identifies clusters of unvaccinated populations guiding targeted interventions. The study aligns with global initiatives such as the Immunization Agenda 2030 emphasizing equitable vaccine access and discusses how India can tailor its strategies to achieve the goal. Lessons from polio eradication efforts inform strategies for measles elimination, stressing the importance of high -quality data and surveillance. The study underscores the urgency of addressing last -mile measles vaccination gaps in India. Spatially targeted interventions informed by sociodemographic factors can enhance immunization coverage. Achieving measles elimination requires sustained efforts and leveraging lessons from successful vaccination campaigns. The study findings have the potential to contribute to informed decision -making, supporting India ' s roadmap for the measles and rubella elimination goal.

The SARS-CoV-2 virus has undergone substantial evolution, leading to emergence of new FLiRT variants characterized by specific spike mutations-F to L at position 456 and R to T at position 346-enhancing their transmissibility and immune evasion capabilities. Particularly, KP.2 shows a significant increase in cases in the USA, indicating a potential shift in the pandemic landscape due to its greater ability to evade vaccine-induced immunity and its higher effective reproduction number compared to JN.1. This evolving scenario underscores the need for continuous monitoring and adaptive response strategies to address the challenges posed by these new variants. This abstract examines the emergence of FLiRT variants KP.2 and KP1.1, descendants of the Omicron JN.1 variant, as they draw global attention amidst the ongoing coronavirus disease-2019 pandemic.

Journal Article Corrected proof The rising tide of tick-borne encephalitis across European nations Get access P Satapathy, P Satapathy Conceptualization, Data curation, Formal analysis, Visualization, Writing - original draft, Writing - review & editing Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India Search for other works by this author on: Oxford Academic PubMed Google Scholar P Kumar, P Kumar Conceptualization, Data curation, Formal analysis, Visualization, Writing - original draft, Writing - review & editing Global Center for Evidence Synthesis, Chandigarh 160036, IndiaEvidenceSynthesis Lab, Kolkata 700156, India Search for other works by this author on: Oxford Academic PubMed Google Scholar K Chand, K Chand Conceptualization, Data curation, Formal analysis, Visualization, Writing - original draft, Writing - review & editing Global Center for Evidence Synthesis, Chandigarh 160036, IndiaEvidenceSynthesis Lab, Kolkata 700156, India Search for other works by this author on: Oxford Academic PubMed Google Scholar P Gahtori, P Gahtori Conceptualization, Data curation, Formal analysis, Visualization, Writing - original draft, Writing - review & editing School of Pharmacy, Graphic Era Hill University, Dehradun 24800, India Search for other works by this author on: Oxford Academic PubMed Google Scholar S Rustagi, S Rustagi Conceptualization, Data curation, Formal analysis, Visualization, Writing - original draft, Writing - review & editing School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India Search for other works by this author on: Oxford Academic PubMed Google Scholar R Sah, R Sah Conceptualization, Data curation, Formal analysis, Visualization, Writing - original draft, Writing - review & editing Tribhuvan University Teaching Hospital, Kathmandu 46000, NepalDepartment of Clinical Microbiology, DY Patil Medical College, Hospital and Research Centre, DY Patil Vidyapeeth, Pune, Maharashtra 411000, India https://orcid.org/0000-0002-5158-5550 Search for other works by this author on: Oxford Academic PubMed Google Scholar A Neyazi A Neyazi Conceptualization, Data curation, Formal analysis, Visualization, Writing - original draft, Writing - review & editing Afghanistan Center for Epidemiological Studies, Herat, AfghanistanHerat Regional Hospital, Herat, AfghanistanACES Chapter, Medical Faculty, Ghalib University Address correspondence to Dr A. Neyazi, Afghanistan Center for Epidemiological Studies, Herat 3001, Afghanistan. email: ahmadniazi000@gmail.com https://orcid.org/0000-0002-6181-6164 Search for other works by this author on: Oxford Academic PubMed Google Scholar QJM: An International Journal of Medicine, hcad226, https://doi.org/10.1093/qjmed/hcad226 Published: 04 October 2023 Article history Received: 25 September 2023 Published: 04 October 2023 Corrected and typeset: 10 October 2023

The COVID-19 pandemic posed substantial challenges to healthcare systems globally and severely disrupted essential health services, including routine immunization programs. In India, these disruptions were exacerbated due to the sudden emergence of the pandemic and lockdown measures, leading to mass migrations and a shortage of healthcare workers. Caregivers’ concerns about routine immunization sessions further compounded the problem, resulting in a sharp increase in zero-dose children. This review paper examines India’s strategies for conducting one of the world’s largest COVID-19 vaccination programs while effectively restoring and perpetuating its Universal Immunization Program (UIP). The UIP played a pivotal role in sustaining immunization services during the pandemic, ultimately improving immunization coverage compared to pre-pandemic levels. India’s accomplishments in this regard are highlighted through key performance indicators, the reach of immunization services, a reduction in zero-dose children, and antigen-wise coverage. The paper also discusses the successful integration of COVID-19 vaccination within the UIP framework, underscoring the significance of existing infrastructure, technology, and capacity building. India’s dedication to concurrently managing routine immunization and COVID-19 vaccination showcases the adaptability and resilience of its healthcare system. India’s journey serves as a global example of efficient mass immunization during challenging times, emphasizing the importance of political will, healthcare infrastructure investment, skilled healthcare workforces, and comprehensive vaccination programs. In a world grappling with the dual challenge of COVID-19 and routine immunization, India’s experience provides a roadmap for strengthening healthcare systems and promoting public health as the critical agenda in challenging times.