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Post-Pandemic Surge in Infections Linked to ‘Immunity Debt’ Across Europe

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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.

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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.”

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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.

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Global Mental Health Cases Near 1.2 Billion as Anxiety and Depression Drive Sharp Worldwide Rise

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A major global analysis has found that mental health conditions have surged to an estimated 1.2 billion people worldwide, driven largely by steep increases in anxiety and depression over the past three decades.

The findings, published in The Lancet as part of the Global Burden of Disease Study 2023, show that the number of people living with mental disorders has almost doubled since 1990, marking a 95% rise. Researchers say major depressive disorder and anxiety disorders have seen even sharper growth, increasing by 131% and 158% respectively, making them the most prevalent mental health conditions globally.

The report describes mental illnesses as widespread conditions that create long-term disability and significant human suffering. It also highlights broader consequences for economies and public services, including reduced productivity, lower workforce participation and increasing pressure on health and welfare systems.

Researchers estimate that in 2023 alone, around 620 million females and 552 million males were affected by mental health conditions. While the overall burden is rising across both sexes, the study points to notable differences in the types and prevalence of disorders.

Among women, depression and anxiety were the most commonly reported conditions, alongside higher rates of eating disorders such as anorexia nervosa and bulimia nervosa. The report links this disparity to a mix of biological, social and structural factors, including exposure to domestic violence, sexual abuse, gender inequality and reproductive health-related changes.

In contrast, neurodevelopmental and behavioural disorders, including attention deficit hyperactivity disorder (ADHD), conduct disorder and autism spectrum conditions, were more frequently diagnosed in men.

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Teenagers aged 15 to 19 were identified as the group experiencing the highest mental health burden globally, raising concerns about early onset of conditions and insufficient preventive care for young people.

The study identifies several key risk factors associated with mental illness, including childhood sexual violence, bullying and intimate partner violence. These factors are strongly linked to conditions such as depression, schizophrenia, bipolar disorder and anxiety disorders. However, researchers note that such exposures have remained relatively stable over time and account for only a portion of the overall rise.

According to the authors, broader drivers are likely contributing to the increasing prevalence of mental disorders. These include genetic and biological influences, poverty, inequality, and the growing impact of global crises such as armed conflict, pandemics, natural disasters and climate-related stress.

While mental health conditions have long been a leading cause of disability worldwide, the report warns that the situation is worsening. At the same time, health systems have not expanded services at a pace matching demand.

The authors caution that the gap between rising need and limited access to care is becoming more pronounced, leaving millions without adequate treatment or support.

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Europe Records Sharp Rise in Sexually Transmitted Infections, ECDC Warns

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Cases of bacterial sexually transmitted infections across Europe have climbed to record levels after rising steadily for a decade, according to new figures released by the European Centre for Disease Prevention and Control.

The agency said infections such as gonorrhoea and syphilis reached their highest levels since European surveillance began, raising concerns among health officials about the growing impact on reproductive and long-term health.

“Sexually transmitted infections have been on the rise for 10 years and reached record high levels in 2024,” said Bruno Ciancio, head of the ECDC unit for directly transmitted and vaccine-preventable diseases.

The report found that gonorrhoea cases rose to 106,331 in 2024, marking a 303 percent increase since 2015. Syphilis infections more than doubled over the same period, reaching 45,577 cases. Chlamydia remained the most commonly reported infection, with 213,443 recorded cases.

Health officials warned that untreated infections can lead to serious complications, including infertility, chronic pain and neurological or cardiovascular problems linked to advanced syphilis.

The steepest increase was recorded in gonorrhoea cases. The ECDC said the 2024 notification rate was the highest since monitoring began in 2009.

Gonorrhoea, caused by the bacterium Neisseria gonorrhoeae, often shows no symptoms, particularly among women, making diagnosis and treatment more difficult and allowing transmission to continue unnoticed.

Between 2023 and 2024, gonorrhoea rates rose by 7.9 percent among men, with the highest levels seen in those aged 25 to 34. More than half of reported cases involved men who have sex with men.

Among women, reported gonorrhoea cases fell by 8.6 percent overall, although the highest rates remained among women aged between 20 and 24.

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The ECDC said high infection rates among women of reproductive age remained concerning because of the risk of complications affecting fertility and reproductive health.

Ireland, Malta, Iceland, Luxembourg, Denmark and Spain recorded the highest gonorrhoea rates in 2024.

The report also highlighted a sharp increase in congenital syphilis, a condition in which the infection passes from a pregnant woman to her unborn child. Cases nearly doubled from 2023 levels and reached the highest point recorded since 2009.

Between 2015 and 2024, Bulgaria reported the highest number of congenital syphilis cases, followed by Portugal and Hungary.

The ECDC said congenital syphilis is preventable and noted that the World Health Organization European region has set a target of reducing cases to fewer than one per 100,000 live births by 2030.

Experts pointed to changing sexual behaviour as a major factor behind the increase in infections. Josep Mallolas, head of the HIV/AIDS unit at Hospital Clínic Barcelona, said condom use had declined while the number of sexual partners had increased, particularly among younger age groups.

The ECDC added that expanded screening programmes, improved testing access and better reporting systems may also partly explain the rise in detected cases. Officials called for broader prevention campaigns, increased testing and stronger monitoring efforts across Europe.

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White House Rejects Report It Blocked Return of Ebola-Infected US Doctor

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The White House has denied reports that the United States blocked the return of an American missionary doctor infected with Ebola while working in the Democratic Republic of Congo, after a newspaper report claimed his evacuation to the US had been delayed over political and public health concerns.

The report, published by The Washington Post and citing unnamed sources familiar with the matter, alleged that US officials initially refused to allow Dr. Peter Stafford to return home after he contracted Ebola in eastern Congo. According to the report, Stafford was eventually flown to Germany for treatment after delays linked to internal discussions within the administration.

White House spokesman Kush Desai strongly rejected the claims, calling the report “absolutely false.”

“The Trump administration’s overriding and sole priority is the health and safety of the American people,” Desai said in a statement. He added that Berlin’s Charité hospital is internationally recognised for treating highly infectious diseases and offers care comparable to top American medical centres.

Dr. Stafford had been working in Bunia, in eastern Congo, when he treated a patient suffering from severe abdominal pain. The illness was initially suspected to be linked to gallbladder complications, but the patient later died and was believed to have been infected with Ebola. A test confirming the disease was reportedly not conducted before burial.

Several days later, Stafford developed symptoms including fever, severe fatigue, pain and chills. He was eventually transported to Germany for specialist treatment at the Charité hospital in Berlin, which has extensive experience handling dangerous viral outbreaks.

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The doctor’s wife and four children have also been admitted to the hospital’s isolation unit after US authorities requested assistance from Germany, according to the German Federal Health Ministry.

The controversy has revived memories of the 2014 Ebola outbreak in West Africa, when two infected American aid workers were flown back to the United States for treatment. At the time, Donald Trump publicly criticised the decision in social media posts, warning against bringing Ebola patients into the country.

The latest outbreak in Congo has been identified as the Bundibugyo strain of Ebola, which carries a fatality rate estimated between 25 and 50 percent. Health officials say there are currently no approved vaccines or targeted treatments specifically for this strain.

Authorities in Congo have reported nearly 600 suspected cases and 139 deaths so far, although officials believe the real number of infections may be higher because of limited testing and surveillance capacity in affected regions.

Meanwhile, heightened concerns over Ebola have also affected international travel. A recent Air France flight from Paris to Detroit was diverted to Canada after US authorities reportedly denied the aircraft entry into American airspace because a passenger had recently travelled to Congo.

Despite the concerns surrounding his evacuation, reports from Berlin indicate Stafford’s condition has begun to improve and that he is now able to eat again.

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