Health
Post-Pandemic Surge in Infections Linked to ‘Immunity Debt’ Across Europe
Although the COVID-19 pandemic has subsided, European countries are facing a rise in non-COVID infections, including respiratory illnesses. Health experts point to a phenomenon known as “immunity debt” as a major factor behind the increased number of cases.
In Denmark, cases of Mycoplasma pneumoniae, a bacterium that causes respiratory infections, have tripled during the 2023-2024 season compared to pre-pandemic years. Hospitalizations among children and teenagers in Denmark have also risen, up by 2.6 times. Despite this surge, Danish health authorities report that the severity of these infections remains unchanged compared to previous years, indicating that while more children are falling ill, they are not becoming more seriously sick than before.
The situation is not unique to Denmark. Other countries, including England, Germany, and France, have reported unusually high levels of respiratory illnesses such as Respiratory Syncytial Virus (RSV) since the pandemic.
“There has been quite a bounceback in a number of these infections which were not circulating significantly for a good winter or two, and they came back with quite a vengeance,” said Dr. Peter Openshaw, a respiratory specialist from Imperial College London.
What is Immunity Debt?
Immunity debt refers to the reduced exposure to common viruses during the height of the COVID-19 pandemic, when public health measures such as lockdowns, social distancing, and frequent handwashing significantly lowered transmission rates of various non-COVID infections. While these restrictions helped curb the spread of viruses and eased the burden on healthcare systems during the pandemic, they also led to a drop in natural immunity among the population.
Many viruses, like certain flu strains, disappeared almost entirely, while others, like RSV, resurged once restrictions were lifted. As more people began socializing and mixing again, these dormant viruses found a susceptible population to infect, particularly among younger children who had not been exposed to them during the pandemic.
According to Dr. Amesh Adalja, an infectious disease expert from Johns Hopkins University, immunity debt was an “inevitable” consequence of pandemic-era measures, but those restrictions were crucial in saving lives. “Decreasing burdens on hospitals during the height of COVID, it was good to go in debt for that,” he explained.
Why the Term is Controversial
While the term “immunity debt” accurately describes the resurgence of infections post-pandemic, it has become controversial. Some argue that it implies natural infections are better for the immune system than vaccines, or that pandemic restrictions were unnecessary. However, experts, including Dr. Openshaw, reject these notions, emphasizing that public health measures saved thousands, if not millions, of lives.
RSV, for example, is a common virus that typically causes mild symptoms in young children. However, due to pandemic restrictions, many babies who would have been exposed to RSV were not, leading to a larger pool of susceptible individuals once the restrictions were lifted.
Looking Ahead
To address immunity debt, health experts are advocating for stronger vaccination efforts. Since 2023, RSV vaccines have been made available to pregnant women and older adults in the European Union and the UK, in an effort to protect the most vulnerable populations.
Despite these measures, hospitals across Europe are facing significant challenges. Ongoing staffing shortages and limited capacity are making it difficult to handle surges in common childhood infections and pneumonia among adults. As Dr. Openshaw noted, “We’re still seeing a lot of hospital attendances and serious illness with these viruses because they’re circulating at a higher-than-previous level.”
With winter approaching, the strain on healthcare systems is expected to grow, making it crucial for governments to bolster public health measures and vaccination programs to mitigate the effects of immunity debt.
Health
AI Speeds Up Ebola Response in Congo, but Experts Warn of Healthcare Risks
Artificial intelligence is helping health authorities respond more quickly to the Ebola outbreak in the Democratic Republic of Congo (DRC), cutting the time needed to prepare a situation report from a full working day to about an hour. However, experts warn that concerns over transparency, reliability and accountability must be addressed before the technology becomes more widely used in healthcare.
Since May, health workers in the DRC have been responding to an outbreak of the Bundibugyo strain of the Ebola virus. Teams visit communities, provide advice, record deaths and recoveries, and refer people with suspected symptoms to medical facilities.
Information collected by these workers has been digitised and analysed using Anthropic’s Claude artificial intelligence model. The initiative involved the Coalition for Epidemic Preparedness Innovations (CEPI), the World Health Organization’s Regional Office for Africa and the country’s National Institute of Biomedical Research (INRB).
The system helps identify people who may have been exposed to the virus, trace contacts and locate potential outbreak hotspots. This information allows authorities to prepare medical supplies and position resources in areas considered at higher risk.
Marie Roseline Darnycka Belizaire, director for emergency preparedness and response at the WHO Regional Office for Africa, said the technology had reduced the time required to produce situation reports to around one hour.
Speaking at the World Health Summit, she said AI could help health authorities assess the spread of an outbreak more quickly and direct medical assistance where it was needed most.
Supporting overstretched healthcare systems
Thomas Zapata, director of the WHO Academy in Lyon, said AI could help address growing demand for healthcare amid persistent shortages of medical staff and resources.
However, he cautioned against treating the technology as a solution in itself, arguing that it must be integrated into existing health systems and support the work of healthcare professionals.
AI could reduce administrative workloads, improve diagnostic processes and assist clinical decision-making, allowing medical staff to spend more time examining patients, listening to their concerns and arranging appropriate treatment.
Cecilia Mbaka, a senior technical adviser for health and emergencies at aid organisation CARE, said the technology could be particularly useful for repetitive tasks and information processing. She stressed that its value should be measured by whether it improves care and gives medical professionals more time to attend to patients.
In the DRC, however, shortages of equipment and limited public confidence in healthcare facilities remain major challenges. Epidemiologist Maximilian Gertler has estimated that around half of deaths in villages occur outside medical facilities, highlighting difficulties in accessing formal care.
Germany recently increased its assistance to the country by €21 million.
Questions over transparency and reliability
Despite the potential benefits, experts warn that many AI systems cannot clearly explain how they reach particular results.
Thomas Thesen, a professor of medical education and informatics at Dartmouth University’s Geisel School of Medicine, said AI models were highly effective at identifying patterns but often struggled to explain what those patterns meant.
This creates concerns when AI systems offer diagnoses or treatment recommendations. Medical professionals need to assess whether a recommendation is appropriate for an individual patient and understand its limitations. Questions also remain over who should be held responsible when an AI-generated recommendation is wrong.
AI should not replace medical education
Experts also warn that excessive reliance on AI could weaken the training of future healthcare professionals.
Thesen cited research suggesting that students who used AI chatbots to find information developed more superficial knowledge than those who relied on conventional search methods.
He said independent learning and mental effort were essential to retaining information, particularly in medicine, where professionals must make decisions even when technological assistance is unavailable.
The Ebola response demonstrates how AI can help process information quickly during emergencies. Experts say its wider use in healthcare will depend on maintaining human oversight, protecting patients and ensuring that technology strengthens, rather than replaces, professional judgement.
Health
Portuguese Teenagers Report Lower Drug and Alcohol Use, but High-Risk Behaviour Persists
Portuguese teenagers are reporting lower levels of alcohol and drug use and fewer problems linked to addictive behaviours, but risks are becoming increasingly concentrated among young people facing multiple personal and social difficulties, according to a new study.
The findings come from the 2024 Study on Alcohol, Tobacco, Drugs and Other Addictive Behaviours (ECATD-CAD), conducted by the Institute for Addictive Behaviours and Dependencies (ICAD). The research examines addictive behaviours among pupils aged 13 to 18 attending state schools across Portugal.
Compared with the previous study in 2019, the latest results show a consistent decline in reported problems, including violence, accidents, hospitalisations, risky sexual behaviour and other incidents with potentially serious consequences.
Researchers linked the broader improvement to several protective factors. Students reported better academic performance, closer parental supervision and fewer nights out, suggesting that changes in family and school environments may be helping reduce risky behaviour.
However, ICAD warned that the overall decline does not mean the problem has disappeared. The most serious behaviours are increasingly concentrated in a relatively small group of adolescents who face greater individual and social vulnerabilities.
Recent alcohol consumption and, particularly, illicit drug use remain strongly associated with problematic situations. Young people who use psychoactive substances report higher rates of risky sexual behaviour, violence between individuals, accidents and trouble with the police.
The report noted that these problems do not necessarily occur immediately after substance use, but the association remains significant.
Combining alcohol with illicit drugs appears to carry additional risks. Adolescents who reported recent use of both substances experienced higher levels of accidents, police-related problems, cyberbullying and risky sexual behaviour than those who consumed alcohol alone.
Alcohol use also raises concerns about why some teenagers drink. While pleasure, entertainment and socialising remain the main motivations, a significant proportion said they consumed alcohol to forget their problems. ICAD identified this as a warning sign associated with potentially harmful drinking patterns and dependence.
Cannabis use presented a mixed picture. Although most users showed no indicators of dependency risk, the proportion classified as being at high risk increased, alongside growth in the group with no identified risk.
Social media remained the main concern among behaviours not involving substances. A significant number of young people acknowledged spending excessive time on these platforms. Indicators of problematic electronic gaming remained broadly stable, while gambling for money became more prevalent among adolescents, despite a slight decline in some indicators of problematic gambling.
The study also identified differences between boys and girls. Boys were more likely to report problems with the police, risky gaming and gambling. Girls reported higher levels of problematic social media use and were more likely to use alcohol to cope with emotional difficulties.
Family circumstances and wellbeing were also important. Low academic achievement, limited parental supervision, frequent nights out and poorer physical and emotional health were associated with greater risk. Better school performance, stronger parental involvement and improved wellbeing appeared protective.
Regional differences were also evident. Alentejo recorded the highest concentration of unfavourable indicators, followed by the Azores. Lisbon, which showed the greatest vulnerability in the 2019 study, no longer held that position.
ICAD’s findings point to the need for targeted support for vulnerable adolescents, even as overall patterns of substance use and related problems improve.
Health
Plague Fears Return After Russian Death, but Europe Faces Very Low Risk
The death of a scientist in Russia’s Siberian region of Irkutsk has revived concerns about plague, but health authorities say there is currently no evidence of an outbreak or sustained transmission in Europe.
The woman died from pneumonia of unknown origin, prompting speculation that she could have contracted pneumonic plague. Russian authorities have said no plague cases have been confirmed in the region, while tests conducted on people who had contact with the woman were negative.
The World Health Organization has asked Russia for additional information about the incident and offered assistance to local health authorities.
Plague is caused by the bacterium Yersinia pestis, which remains present in wild animal populations in parts of the world. It is commonly associated with rodents and the fleas that live on them. People can become infected through bites from infected fleas, contact with tissues or bodily fluids from infected animals, or respiratory particles from people suffering from pneumonic plague.
For Spain and most of Europe, however, the current risk is considered very low. The European Centre for Disease Prevention and Control says routine transmission has not been recorded in Europe for more than five decades.
That does not mean the bacterium has disappeared. Its continued presence in animal reservoirs means isolated human infections remain possible, particularly in areas where infected wildlife and fleas are found.
Spain has maintained epidemiological surveillance despite the absence of locally acquired cases for decades. In April 2026, its Public Health Commission updated the national plague protocol, including case definitions, epidemiological information and procedures for investigating suspected infections.
European authorities have also been monitoring the Siberian incident. The European Union discussed the case at a Health Security Committee meeting on October 7, while the ECDC said there was no evidence of secondary cases or sustained person-to-person transmission.
The WHO has assessed the risk to the European region as very low.
Plague continues to occur in parts of Africa, Asia and the Americas. According to the WHO, most reported human cases between 2019 and 2025 were concentrated in Madagascar and the Democratic Republic of the Congo. Madagascar records bubonic plague cases during its annual epidemic season, generally from September to April. In the United States, about seven human cases are reported each year, mainly in rural areas of western states.
The disease can occur in bubonic, pneumonic or septicaemic forms. Bubonic plague usually causes fever and painful swollen lymph nodes after an infected flea bite. Pneumonic plague affects the lungs and can spread between people through respiratory particles. Septicaemic plague occurs when the infection enters the bloodstream.
Modern antibiotics can successfully treat plague, but early diagnosis is critical. Health surveillance, rapid identification and treatment remain important in preventing isolated infections from developing into wider outbreaks.
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