Public Health

The United States has, for 70 years, been fighting a continuous aerial war against the New World screwworm, a parasite that eats animals alive: cow, pig, deer, dog, even human. (Its scientific name, C. hominivorax, translates to “man-eater.”) Larvae of the parasitic fly chew through flesh, transforming small nicks into big, gruesome wounds. But in the 1950s, the U.S. Department of Agriculture laid the groundwork for a continent-wide assault. Workers raised screwworms in factories, blasted them with radiation until they were sterile, and dropped the sterile adult screwworms by the millions—even hundreds of millions—weekly over the U.S., then farther south in Mexico, and eventually in the rest of North America.

The sterile flies proceeded to, well, screw the continent’s wild populations into oblivion, and in 2006, an invisible barrier was established at the Darién Gap, the jungle that straddles the Panama-Colombia border, to cordon the screwworm-free north off from the south. The barrier, as I observed when I reported from Panama several years ago, consisted of planes releasing millions of sterile screwworms to rain down over the Darién Gap every week. This never-ending battle kept the threat of screwworms far from America.

But in 2022, the barrier was breached. Cases in Panama—mostly in cattle—skyrocketed from dozens a year to 1,000, despite ongoing drops of sterile flies. The parasite then began moving northward, at first slowly and then rapidly by 2024, which is when I began getting alarmed emails from those following the situation in Central America. As of this month, the parasite has advanced 1,600 miles through eight countries to reach Oaxaca and Veracruz in Mexico, with 700 miles left to go until the Texas border. The U.S. subsequently suspended live-cattle imports from Mexico.

Central America is shaped like a funnel with a long, bumpy tail that reaches its skinniest point in Panama. Back in the day, the USDA helped pay for screwworm eradication down to Panama out of not pure altruism but economic pragmatism: Establishing a 100-mile screwworm barrier there is cheaper than creating one at the 2,000-mile U.S.-Mexico border. Even after screwworms began creeping up the tail of the funnel recently, the anti-screwworm campaign had one last good chance of stopping them at a narrow isthmus in southern Mexico—after which the funnel grows dramatically wider. It failed. The latest screwworm detections in Oaxaca and Veracruz are just beyond the isthmus.

Tracking measles through wastewater is giving health officials a new window into where the virus is spreading.

I've copied it below:

Your Excellency, Dr Khaled Abdel Ghaffar, Minister of Health and Population of Egypt,

Distinguished officials,

Representatives of the Egyptian Vaccine Manufacturers Alliance,

Colleagues and Partners,

On behalf of the World Health Organization, I extend my warmest congratulations to Egypt for becoming the first country in the Eastern Mediterranean Region to achieve the regional target for hepatitis B control, as set by the Regional Committee Resolution EM/RC56/R.5 (2009).

This recognition follows a rigorous review led by the independent Regional Validation Committee (RVC).

Based on robust and verifiable data, the RVC concluded that Egypt has indeed met the regional target, supported by the following key indicators:

• Hepatitis B surface antigen (HBsAg) prevalence among children aged 5 years and older is below 1 per cent;
• Third-dose hepatitis B vaccine coverage maintained at 90 per cent or higher for over a decade;
• And birth dose coverage has exceeded 90 per cent for at least five years.

These achievements are a testament to your leadership, sustained investment, and steadfast commitment to public health.

I commend Your Excellency, the Ministry of Health and Population, and the dedicated teams driving Egypt’s national immunization and hepatitis control programmes.

Egypt’s success represents not only a national achievement, but a regional milestone—a powerful example of what is possible when science, policy, and public trust align.

Through your strong Expanded Programme on Immunization, you have significantly reduced vaccine-preventable diseases, improved child survival, and strengthened health systems—culminating in the elimination of measles and rubella.

WHO stands ready to support you in introducing additional life-saving vaccines to protect against rotavirus, human papillomavirus, pneumococcus bacteria, and other deadly pathogens.

Moreover, the establishment of the Egyptian Vaccine Manufacturers Alliance (EVMA) signifies a bold step toward self-reliance, vaccine innovation, and equitable access. This is crucial for sustaining high coverage and ensuring timely, affordable vaccines for all.

But this success is not the end—it is a beginning. With continued commitment, Egypt is well-positioned to move from control to elimination of hepatitis B as a public health threat.

I urge other countries in the Eastern Mediterranean Region to draw inspiration from Egypt’s journey. With determined leadership, evidence-based strategies, and inclusive partnerships, we can achieve similar milestones.

Once again, congratulations Egypt.

Online Angus Reid survey comes as measles cases continue to climb across Canada

Health nonprofits and medical interpreters warn that federal cuts have eliminated dozens of positions in California for community workers who help non-English speakers sign up for insurance coverage and navigate the health care system.

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.