Combining malaria vaccination with chemoprevention: a promising new approach to malaria control

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Emerging And Reemerging Neglected Tropical Diseases: Epidemiology, Transmission, Mitigation, And Vaccines And Chemotherapy Advancements

Zoonotic and other infectious diseases are emerging and reemerging rapidly in recent times owing to altered climatic conditions, changing lifestyles, and unhealthy living conditions. The WHO listed 20 infectious conditions as neglected tropical diseases (NTDs), contributing to about 11% of the disease burden globally, affecting over 1 billion people (especially in the tropics and subtropics.) All these NTDs shared two common characteristics. The first is their prevalence in rural and/or displaced communities and urban slums in tropical areas with warmer weather conditions. These are the most susceptible groups. Secondly, the disease-countering therapeutic interventions are low owing to deficient funding.

NTDs involve intricate transmission cycles between humans and the vertebrate and invertebrate carriers (from dogs, snakes, and livestock to mosquitoes, flies, and snails), and the environmental dynamics (like fluctuating temperature, rainfall, humidity and the occurrence of extreme weather conditions) influence the infection pattern. The earlier-characterized temperate regions are experiencing a temperature rise and altered precipitation patterns, which has led to the development of more suitable habitat for the transmission of dengue, chikungunya, leishmaniasis, and schistosomiasis that otherwise prevailed in the tropics (to parts of central Europe and the US). Furthermore, Noma was identified and added as the 21st disease to this WHO list of NTDs as late as November 2023 and has been identified as a potential epidemic.

Recognizing the lack of funding for research of NTDs and an urgent need to fill the financial gap, the international community pledged in September 2000 to reduce abject poverty by 2015 spearheaded by the UN under the Millennium Development Goals commitments. The main focuses of the Development Goals are to reduce the child death rate globally, improve maternal health, and handle the 'big three' targets: malaria, tuberculosis, and HIV/AIDS.

The efforts, however, have remained inadequate even a decade after the target year (2015). It is attributed to becoming increasingly defocused and thus inadequately addressing the other major factors in the impoverished community contributing to NTD-led mortality and morbidity.Thankfully, there has been a recent shift in this after the Department for Control of Neglected Tropical Disease was set up in 2005 by the WHO especially to tackle NTDs. With an aim to leverage awareness and mobilize NTD control efforts, the Global Network for Neglected Tropical Diseases Control (www.GNNTDC.Org) alliance has been newly set up. The 74th World Health Assembly held in 2021 proposed a nine-year plan to eradicate NTDs between 2021 and 2030.

Reemerging NTDs call for increased attention. These include communicable and vector-borne fungal, bacterial, viral, and parasitic diseases. Although the majority of the diseases remain endemic to specific regions, some were reported elsewhere exhibiting a potentially epidemic tendency, thereby compelling public health agencies worldwide to activate necessary precautions to control the spread. COVID-19 significantly impacted global socioeconomic and healthcare infrastructure over the past three years. Coordinated efforts among high-income and low/middle-income countries are recommended now more than ever to address the threats posed by the NTDs worldwide. It could be initiated in line with the very promising (although funding-intensive) 'One Health' model, wherein experts from various line departments could collaborate to forge solutions.There is currently a lack of knowledge on how such diseases are transmitted and the suitable mitigation strategies to control the spread. One of the strategies could be better availability of diagnostic tests, vaccines, and drugs in the affected countries after due tests and trials- which calls for enough funding for focused research and development.

In this Research Topic, we wish to address the best-case scenario to tackle the emerging and reemerging NTDs. We welcome a range of NTD-targeted articles (like opinion, commentary, systematic reviews, and original research) on epidemiology, transmission, mitigation strategies, and recent advances in vaccines and chemotherapy. The themes include, but are not limited to, studies on:

• Identifying the reservoirs/carriers and vector control strategies• Rapid testing modalities for diagnosis, screening, and surveillance• Healthcare strategies (with drinking water safety, and improved sanitation and hygiene)• Recent advances in the discovery and delivery of vaccines and drugs

Keywords: NTDs, WHO, Tropical diseases, neglected tropical diseases, zoonotic

Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

Keywords: NTDs, WHO, Tropical diseases, neglected tropical diseases, zoonotic

From The Bubonic Plague To Cholera – The 4 Killer Diseases Making A Comeback In 2024

JUST two months into 2024 and we've already seen outbreaks of several killer diseases - some of which we had already consigned to the history books.

Measles is staging a comeback around the world, with whooping cough not far behind - a retro bug many thought had been vaccinated out of existence a century ago.

Infectious that were once common within society have come back with force

There is also a global shortage of the cholera jab and even a case of bubonic plague for one unlucky cat owner in the US.

"In the West we tend think of these diseases as having disappeared," Professor Tom Solomon, director of The Pandemic Institute, tells The Sun.

"However, they have not gone at all, they are just being controlled by good public health measures," he adds - life-saving measures that experts warn are waning.

Here, we look at each bug making a re-emergence, where cases are rising, and we ask infectious disease scientists if these outbreaks could become a bigger issue...

1. Measles

Symptoms:

A high temperature

A runny or blocked nose

Sneezing

A cough

Red, sore, watery eyes

Small greyish-white spots on the inside of the cheeks

A red-brown blotchy rash

Cases of measles, one of the world's most infectious diseases, have increased by over 3,000 per cent in Europe in the last year.

More than 30,000 infections were reported between January and October 2023, up significantly from the 941 in all of 2022, according to the World Health Organisation (WHO).

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The surge is being blamed on falling vaccination coverage in all 53 of the European member states since 2020. This includes the UK.

Powerful new video urges all parents to protect their children from surge of deadly Victorian disease as millions 'at risk'

At least 650 people in England and Wales have already caught measles since October and more than three million are still not fully vaccinated with the MMR jab.

The UK Health Security Agency (UKHSA) has started running an ad campaign on TV and social media in a bid to get more kids jabbed.

"Measles is so infectious that if vaccine uptake is lowered even by a few per cent, then larger outbreaks are likely," Dr Michael Head, senior research fellow in global health, University of Southampton, warns.

"The target for measles vaccination is 95 per cent but many parts of the UK have an uptake of around 75 per cent, so there are many people who remain unprotected."

Prof Tom previously told the Sun that as many as 1,500 children in the UK could die of a brain swelling measles complication encephalitis if the current outbreak is not taken more seriously.

Encephalitis is a rare complication of measles that happens when the virus enters the brain.

"Inevitably, there will be children who develop measles encephalitis and are at risk of death or brain damage," Prof Tom said.

"This disease is completely preventable by vaccination.

"We must do everything we can to get people vaccinated."

2. Whooping cough

Symptoms:

Coughing, violently and rapidly, until all the air has left the lungs and a person is forced to inhale, causing a "whooping" sound

Sneezing

Nasal discharge

Fever

Sore, watery eyes

Lips, tongue, and nailbeds may turn blue during coughing spells

Earlier this month, cases of the dreaded whooping cough, also called as the '100-day-cough', reached a 10-year-high in England and Wales.

A total of 412 Brits fell ill with the bacterial infection medically known as pertussis in the week leading up to February 4.

Altogether, that adds up to 1,416 suspected cases of whooping cough in the first five weeks of 2024. Cases are also risking in Europe and Asia.

"There are often larger outbreaks of whooping cough every few years," Dr Michael says, which is usually down to a fall in vaccine upatake.

Much like with the measles jab, vaccine rates for pertussis are falling in the UK.

"Whooping cough is a very nasty infection, particularly in babies," Dr Michael explains.

"Any outbreaks among vulnerable populations can lead to preventable hospitalisations and deaths. Thus, protection from the vaccine is the best approach."

3. Cholera

Symptoms:

Profuse watery diarrhoea, sometimes described as "rice-water stools"

Vomiting

Thirst

Leg cramps

Restlessness or irritability

Since the start of the year, cases of the tropical disease cholera have started popping in some holiday hotposts.

Almost 41,000 cases of the deadly bacterial infection that causes relentless diarrhoea have so far been reported in 2024, according to the WHO.

The widespread outbreak has so far killed 775 across 17 countries in the Americas, South East Asia, the eastern Mediterranean and Africa.

Efforts to curb the spread of cholera have been hampered by a critical shortage of oral cholera vaccines, officials warned.

The health watchdog last year branded the global resurgence of cholera as a grade three emergency, its highest classification.

"Increases in unpredictable and severe weather events, such as flooding, can result in increased waterborne diseases, and that includes cholera," Dr Michael said.

"If we combine that with vaccine shortages and outbreaks in hard-to-reach areas, then cases of cholera can easily spread," he added

The countries grappling with the biggest surge in cases this year are Zambia and Zimbabwe, which recorded 8,300 and 6,600 cases respectively throughout January.

But popular holiday destinations like South Africa and India have also seen cases of the deadly bacterial infection, which spreads through drinking unclean water and eating infected food.

Although no cases have been spotted in the UK, Dr Michael warned we could start seeing infections closer to home.

"Our future over the coming decades is likely to involve some of the tropical infections we're not used to seeing here," the expert added.

4. The bubonic plague

Symptoms:

Fever

Headache

Chills

Weakness and one or more swollen, painful lymph nodes (called buboes)

A case of the bubonic plague - the horrifying disease that killed tens of millions of people in medieval Europe - was reported in Oregon, in the US, last month.

The disease is believed to have been passed on to the unlucky individual from a pet cat.

And at the time, health officials said there was "little risk" to other people in the community.

"Plague has always been with us, and nowadays, it rarely causes big outbreaks," Prof Paul Hunter, professor in medicine, University of East Anglia (UEA), told the Sun.

"But when it does, it is usually because the infection spread from animals living with humans."

This appears to be true for many recent cases in the US, for which the majority have been reported in people who get too close to prairie dogs.

"We could see more cases in the future if we live closer to animals and if climate change continues to get worse," the Prof warned.

The disease is easily treatable with modern medicine - but left untreated, most infected will die within a week.

Some other countries suffer regular outbreaks of the bubonic plague due to animals carrying the bacteria.

The plague has been reported in Peru, China, Bolivia, Uganda, Tanzania, and Russia.

My Son Has A Rare Disease; We Can Band Together To Support Research On Treatments

The author, Scott D. Reich, with his son Eli. Credit: Ilissa Reich

By Scott D. ReichGuest essayMarch 17, 2024 9:00 am

Until a few years ago, I knew very little about rare diseases. That changed in 2019 when my five-month-old son, Eli, was diagnosed with FOXG1 syndrome, an ultrarare disease that makes him unable to walk, talk, or do anything independently.

Along this torturous journey, I've been surprised to learn how "common" rare diseases are in aggregate — and how much opportunity exists to address them.

There are more than 10,000 rare diseases, which the National Institutes of Health defines as a disease afflicting fewer than 200,000 people in the U.S. Some 30 to 40 million Americans suffer from rare diseases, 95% of which have no treatment options.

It doesn't have to be this way.

Recent advances in science and technology have enabled us to literally and figuratively leap into the future, converting sci-fi dreams to reality. Greater access to improved genetic tests has enabled earlier diagnoses. Innovative machine-learning platforms facilitate more effective aggregation of patient data. And new tools like CRISPR have revolutionized our ability to edit genes.

But we're not quite "there" yet.

We're still struggling with how to safely deliver these novel treatments. The cost of making new therapeutics remains high, so rare diseases are unattractive for biopharma to pursue, leaving the burden of drug development on impacted families.

But opportunities do exist to improve lives and narrow the gaps we must address as a society.

NIH should shorten review periods to assess novel research proposals and accelerate its decision-making process to award funding. Lengthy processes deter innovation.

To propel more collaboration among scientists working on the same disease, we should link NIH funding those scientists receive to the collaborations we seek. In academia, funding is often tied to peer-reviewed publications of one's work. This deepens research silos instead of fostering partnership. Stand Up To Cancer's model of crushing preexisting research silos — by prioritizing the funding of collaborative, cross-institutional research teams — is a model.

We similarly need to reward scientists and patient organizations for sharing information about unsuccessful experiments to increase efficiency. Most experiments don't achieve the desired aims. Because research is performed in silos, scientists in the same field replicate fruitless work without knowing it, wasting time and money. NIH can centralize access to information and reward scientists who participate.

We must create more financial incentives to attract more investment in the rare disease space. The Food and Drug Administration Safety and Innovation Act of 2012 created a novel voucher program to reward companies for pursuing rare disease research. It's due to sunset partly in September and fully in 2026. It must be renewed.

We need to help impacted families more quickly organize scientific efforts and accelerate new research in centralized hubs. There is no main place to "go" when one gets a life-changing diagnosis. We need a respected nonprofit destination for rare disease families upon diagnosis. There is power in numbers.

We must build a rare-disease community and direct our efforts toward the common good. No one who gets a rare disease diagnosis is asked who they voted for in the last election, where they pray, whom they love, or any other dividing factor. This is a field that ought to unite us in our shared sense of humanity, to help innocent kids who deserve a shot at life. Let's get going.

This guest essay reflects the views of Scott D. Reich, a Port Washington father who cofounded the nonprofit Believe in a Cure, which works to develop a treatment for the rare disease that afflicts his son.

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