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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.

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.

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Scientists Warn of Health Risks from Fine Microplastics in Drinking Water

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A new study has highlighted the presence of fine microplastics in drinking water, urging the European Union (EU) to revise its detection standards to include smaller particles that may pose a greater risk to human health.

Researchers in Toulouse, France, found that most microplastics in bottled and tap water samples measured less than 20 microns (μm), a size small enough to potentially pass from the human intestine into the bloodstream and organs. Current EU guidelines only require monitoring of particles between 20 μm and 5 mm, leaving these finer plastics largely undetected.

Majority of Microplastics Found Are Under 20 Microns

The study, published in PLOS Water, tested 10 bottled water brands and one tap water source using a new method capable of detecting microplastics smaller than 20 μm. Results showed that 98% of the microplastics detected were below this threshold, with 94% measuring less than 10 μm in diameter.

“The idea was to prove it’s possible to analyze very fine plastics and to show the European Union that setting the detection limit at 20 microns makes little sense,” said Oskar Hagelskjaer, CEO of Microplastic Solution and the study’s lead author.

The researchers found microplastic concentrations ranging from 19 to 1,154 particles per liter, with the tap water sample from Toulouse containing 413 particles per liter—higher than most bottled water samples.

Advanced Detection Methodology

The study employed enhanced instrumentation and rigorous quality control to prevent sample contamination, offering a more accurate assessment of microplastic prevalence.

Bethanie Carney Almroth, a professor of ecotoxicology at the University of Gothenburg, Sweden, called the methodology “quite strong,” noting the researchers’ careful consideration of potential contamination and measurement accuracy.

Microplastics in Bottled vs. Tap Water

While bottled water was packaged in polyethylene terephthalate (PET) bottles, PET was not the most prevalent plastic found in the samples. Researchers speculate that factors such as tap water filtration processes or river contamination may contribute more significantly to microplastic presence.

Groundwater-sourced drinking water, which undergoes natural soil filtration, showed significantly lower microplastic concentrations compared to treated surface water, the study found.

Health Concerns and Global Impact

The health implications of microplastic exposure remain uncertain, though their ubiquity raises concerns. “They’re finding them everywhere they look. We know we have them in our bodies,” Almroth said, adding that emerging evidence suggests potential health impacts.

Researchers described microplastic contamination as a “pervasive problem,” noting that no region on the planet remains unaffected. The findings call for immediate action to address the risks associated with microplastics in drinking water and the broader environment.

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Obesity Linked to Poorer Outcomes in Childhood Cancer Patients, Study Finds

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Children with obesity diagnosed with cancer face significantly worse health outcomes, including a heightened risk of relapse and death, according to a new Canadian study.

The research, published in the journal Cancer, analyzed data from over 11,000 cancer patients aged 2 to 19, of whom 10.5% were obese at diagnosis. The study examined various cancers, including leukemia, lymphoma, and other tumors, and found that obesity negatively impacted outcomes across the entire cohort.

Increased Risk of Relapse and Mortality

The findings revealed that obese children had a 16% higher risk of cancer relapse and a 29% increased risk of death within five years of diagnosis, even after accounting for factors such as age, sex, and ethnicity.

“Our study highlights the negative impact of obesity among all types of childhood cancers,” said Dr. Thai Hoa Tran, a pediatric hematologist and oncologist at the University Hospital Centre Sainte-Justine in Montreal, Canada, and one of the study’s authors.

Dr. Tran emphasized the need for strategies to address obesity’s impact on cancer outcomes in future clinical trials and highlighted the importance of combating the childhood obesity epidemic to prevent severe health consequences.

Acute Lymphoblastic Leukemia and Brain Tumors Most Affected

The study found the impact of obesity was particularly pronounced in children with acute lymphoblastic leukemia (ALL)—a cancer of the blood and bone marrow—and brain tumors. Researchers suggested that fat tissue may play an active role in tumor progression, metastasis, and resistance to treatment.

Previous research has indicated that adipose (fat) tissue cells can promote tumor development and hinder the effectiveness of therapies. Additionally, the study noted concerns about potential undertreatment and inappropriate dosing of chemotherapy in obese patients, which could further compromise outcomes.

Limitations and Calls for Improved Measures

The researchers acknowledged limitations in their study, including reliance on body mass index (BMI) to define obesity. They pointed out that BMI is an imprecise measure that does not fully capture body composition or nutritional status.

“BMI remains a crude and imperfect measure,” the authors wrote, echoing recent calls from experts to adopt more accurate diagnostic tools for obesity. Critics argue that BMI may lead to overdiagnosis or fail to reflect the nuanced impact of weight on health outcomes.

Implications and Urgency

The findings underscore the urgent need for interventions targeting childhood obesity and call for more precise research to better understand the interplay between obesity and cancer treatment. As childhood obesity rates continue to rise globally, addressing this epidemic could have far-reaching implications for improving survival rates and health outcomes for young cancer patients.

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Tanzania Reports Deadly Marburg Virus Outbreak, Eight Fatalities Confirmed

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Tanzania is grappling with an outbreak of the highly lethal Marburg virus, with eight fatalities confirmed so far, global health authorities reported.

The World Health Organization (WHO) identified the outbreak in the Biharamulo and Muleba districts of the Kagera region, an Eastern African transit hub. As of January 11, nine suspected cases have been reported, including healthcare workers. The Marburg virus, which is related to Ebola, has a case fatality rate of up to 89%, according to WHO officials.

Symptoms and Transmission

WHO said the suspected patients displayed classic symptoms of Marburg, such as high fever, headache, back pain, diarrhea, vomiting with blood, and severe physical weakness. In later stages, external hemorrhaging may occur.

The virus is transmitted through contact with bodily fluids of infected individuals or contaminated surfaces, putting healthcare workers and close contacts at heightened risk.

“There is an expectation of further cases as disease surveillance improves,” WHO Director-General Tedros Adhanom Ghebreyesus said in a social media update.

Containment Efforts Underway

Rapid response teams have been deployed to the affected areas to investigate and contain the outbreak. Authorities are tracing contacts of infected individuals, setting up treatment centers, and enhancing public awareness to prevent further spread.

However, officials caution that detection and isolation of cases have been delayed due to the Kagera region’s role as a transit hub, which may have facilitated the virus’s spread.

Neighbouring countries, including Rwanda, Uganda, Burundi, and the Democratic Republic of the Congo, have been urged to remain vigilant. “We recommend neighbouring countries be on alert and prepared to manage potential cases,” Tedros said.

No Approved Vaccine or Treatment

Marburg virus outbreaks are rare but severe, with fatality rates ranging from 24% to 88%. There is currently no authorized vaccine or treatment, although experimental options are being tested.

In 2023, a similar outbreak occurred in Tanzania’s Kagera region, resulting in nine cases and six deaths. Another outbreak in Rwanda last year sickened 66 people and caused 15 deaths before being declared over in December.

Zoonotic reservoirs, such as fruit bats, are believed to play a role in the virus’s transmission and remain endemic to the region, WHO noted.

Global Risk Assessment

While the risk of global spread is low, WHO considers the threat high for Tanzania and its regional neighbors. Health authorities are focusing on containing the outbreak swiftly to prevent a broader crisis.

“Marburg virus outbreaks underscore the need for robust surveillance systems and rapid response measures to protect public health,” the agency said in a statement.

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