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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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UK Scientists Develop Tool to Measure ‘Heart Age,’ Offering New Insights for Cardiovascular Health

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Researchers in the United Kingdom have developed a new tool that can determine how old a person’s heart is in comparison to their actual age, offering a potential breakthrough in the early detection and prevention of cardiovascular disease.

The study, led by scientists at the University of East Anglia (UEA), examined magnetic resonance imaging (MRI) scans from 557 individuals across the UK, Spain, and Singapore. Of those, 336 participants had known health risk factors such as obesity, high blood pressure, or diabetes.

Using these scans, the researchers measured structural and functional markers of cardiac health — including the size of the heart’s chambers and how effectively it pumps blood. These indicators were then used to create an algorithm that calculates the heart’s “functional age.”

The findings, published in the European Heart Journal, revealed that individuals with cardiovascular risk factors had hearts that were, on average, 4.6 years older than their chronological age. In people with obesity, the gap was even wider, indicating faster cardiac ageing.

People with health issues like diabetes or obesity often have hearts that are ageing faster than they should – sometimes by decades,” said Dr. Pankaj Garg, a cardiologist and lead author of the study. “This tool gives us a way to visualize and quantify that risk.”

While the tool shows promise, researchers noted some limitations. The model does not account for how long patients had lived with their conditions, and the study group primarily included older individuals who had survived with these health issues — raising concerns about survivor bias. The relatively small sample size also means the tool needs broader validation before it can be widely adopted.

Despite these limitations, the research team believes the tool could have valuable clinical applications in the future. Dr. Garg said it may help doctors counsel patients more effectively about their cardiovascular health and recommend lifestyle changes or treatments to slow heart ageing.

By knowing your heart’s true age, patients could get advice or treatments to slow down the ageing process, potentially preventing heart attacks or strokes,” he said. “It’s about giving people a fighting chance against heart disease.”

The team hopes the tool could eventually be integrated into routine care, empowering patients to take early steps toward improving their heart health through diet, exercise, and medical intervention.

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Global Health Inequities Persist as Progress on Life Expectancy and Mortality Slows, Says WHO

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While the world has made significant strides in narrowing health disparities between rich and poor nations over the past two decades, progress is now faltering — and in some cases reversing — according to a new report by the World Health Organization (WHO).

The report, the WHO’s first comprehensive analysis on health equity since 2008, finds that although gaps in life expectancy, child mortality, and maternal health have narrowed globally, none of the agency’s long-term health targets for 2040 are currently on track to be met.

There has been some progress narrowing health gaps between countries, but it is stalling,” said Dr. Sudhvir Singh, who leads the WHO’s equity and health unit, during a press briefing. He called for urgent action to address the underlying social, political, and economic factors driving health inequalities.

The WHO’s 2040 targets include halving the gap in life expectancy between countries, reducing adult mortality by half, slashing child deaths under age five by 90 percent, and cutting maternal mortality by 95 percent. Yet, the latest figures reveal that progress toward these goals has slowed dramatically.

A stark example is life expectancy. While people in high-income countries such as Japan enjoy an average lifespan of 84.5 years, those in countries like Lesotho live on average only 51.5 years — a gap of 33 years. The global average gap still stands at 12.5 years, well short of the WHO’s goal to reduce it to 8.2 years by 2040.

Child mortality has improved significantly, with global rates dropping from 77 deaths per 1,000 live births in 2000 to 37 in 2023. But children in low-income nations remain 13 times more likely to die before age five compared to those in wealthier countries. The WHO’s target of eight deaths per 1,000 by 2040 appears increasingly out of reach.

Maternal mortality has declined by 40 percent since 2000, yet the current global rate remains at 197 deaths per 100,000 live births — more than twelve times higher than the 2040 goal of just 16.

The report also highlights major disparities within countries. Poorer communities, women, ethnic minorities, and other marginalized groups continue to face worse health outcomes due to factors such as income inequality, poor access to public services, systemic discrimination, and environmental threats like climate change.

WHO officials warned that climate change alone could push up to 135 million people into extreme poverty in the next five years — further widening health gaps unless governments act decisively.

There’s a very positive return on investment from addressing these social determinants of health,” said Singh. “And there’s a huge cost of inaction.”

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Measles Surges Across Europe as Health Authorities Sound the Alarm

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Measles, one of the world’s most contagious diseases, is spreading rapidly across Europe, with health officials warning of continued outbreaks in the coming months. According to the European Centre for Disease Prevention and Control (ECDC), over 4,500 cases have been reported across the European Union so far this year, with Romania experiencing the most severe impact.

Romania has recorded 3,203 measles cases through the end of March, making it the epicentre of the EU’s measles crisis. Four people have died, the only reported measles-related fatalities in the bloc this year. Experts attribute the surge in Romania to persistent vaccine hesitancy, misinformation, and a strained healthcare system. The country’s measles vaccination rate stood at just 62% in 2023—well below the 95% threshold needed to achieve herd immunity and prevent outbreaks.

France has reported 345 measles cases this year, with authorities noting a significant number of infections linked to international travel, particularly from Morocco. At least 41 cases were directly tied to imported infections. Although France had a relatively high vaccination rate of 93% in 2023, unvaccinated clusters remain vulnerable to outbreaks.

Italy, with 227 cases so far in 2025, ranks just behind France in the number of infections reported outside Romania. The country’s vaccination coverage—85% in 2023—also falls short of the level needed to prevent the disease from spreading.

In the Netherlands, 204 cases have been recorded in the first quarter of the year, many stemming from travelers arriving from Morocco and Romania. Dutch health authorities reported localized clusters, particularly in primary schools and childcare facilities. Despite no national outbreak being declared, the country’s vaccination rate of 81% remains one of the lowest in the EU.

Spain has reported 202 measles infections in 2025, with several localized outbreaks and a number of imported cases. The country’s 92% vaccination coverage places it near herd immunity, but health officials caution that gaps in immunization still leave room for outbreaks, especially when cases are introduced from abroad.

Health experts across Europe are urging parents to ensure their children are fully vaccinated, emphasizing that the measles vaccine is both safe and effective. The ECDC continues to monitor the situation and warns that without improved vaccination coverage, the risk of further outbreaks remains high.

Last year was the worst for measles in Europe and Central Asia since 1997, with over 120,000 cases. Authorities fear 2025 could follow a similar trajectory if vaccination rates do not improve.

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