Researchers have discovered why influenza can lead to life-threatening complications during pregnancy.
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In most people, influenza stays in the upper respiratory tract – mainly the nose – and clears without spreading further. But during pregnancy, the virus can extend beyond the lungs into the cardiovascular system, increasing the risk of severe complications for mothers and babies.
Now a new preclinical study using animal models reveals precisely why the virus can spill into the bloodstream during pregnancy, opening the door for targeted treatment. The study is a bilateral partnership between Trinity College Dublin, with collaborators from RMIT University and the University of Adelaide and is published in Science Advances.
Researchers identified a viral sensor in the immune system, known as TLR7, that can become overactive during pregnancy, amplifying inflammation and spreading disease into the bloodstream.
Blocking TLR7 could help prevent the harmful inflammation that makes flu in pregnancy so dangerous. This work can help protect developing babies by stopping the placenta from becoming overly inflamed during flu infection.
Professor John O’Leary, School of Medicine, Trinity, said: “This international research is of high impact in relation to our understanding of viruses and pregnancy and the role of the maternal immune response.”
What is the potential impact of this research?
Earlier studies from RMIT have shown that severe flu in pregnancy can have long‑term impacts on babies’ brain development, by inflaming blood vessels and reducing the flow of oxygen and nutrients from mother to baby.
This new study pinpoints the underlying cause of that damage, reshaping our understanding of flu‑related risk in pregnancy and opening the door to more targeted therapies.
RMIT co-lead author, Prof. Stavros Selemidis, said future treatments could focus on the immune system rather than the virus itself.
“Our study shows that in pregnancy, the problem isn’t just the flu virus – it’s the immune system overreacting. That’s where future treatments could really make a difference,” he explained.
“We’re ready to work with partners to help develop the next generation of therapies and clinical guidelines.”
Next steps for this work: The team is planning further research on how to target TLR7 to reduce the risk of severe influenza and pregnancy complications.
National study found use of the drug rose sharply following major media coverage and later White House promotion, despite limited large-scale evidence for autism treatment
Leucovorin prescriptions for children with autism rose more than 2000% by late 2025. Courtesy of UC San Diego Health Sciences.
Researchers from the University of California San Diego found that prescriptions for leucovorin, a drug sometimes used off-label for autism spectrum disorder (ASD), rose sharply among children after widespread media attention and public statements from White House officials. The study, published May 18, 2026 in JAMA Network Open, analysed national electronic health record data and found prescribing rates increased more than 2000% compared with prior years.
“Families of children with autism are often searching for therapies that might improve communication and quality of life, especially when treatment options are limited,” said Joshua Rothman, MD, clinical assistant professor of pediatrics at the UC San Diego School of Medicine and first author of the study. “What this study shows is how quickly information shared through news coverage, social media and public figures can influence real-world prescribing patterns, even before large clinical trials establish whether a treatment is truly safe and effective for broad use.”
Leucovorin, also known as folinic acid, is a biologically active form of folic acid. Small clinical trials have suggested that some children with autism and folate-related deficiencies may experience improvements in verbal communication after taking the medication. However, researchers note that large-scale studies confirming the drug’s effectiveness and long-term safety for children with ASD have not yet been completed.
To better understand prescribing trends, the researchers analysed records from the Epic Cosmos database, which includes more than 300 million patient records from over 1800 hospitals and 41 500 clinics across all 50 states and Washington, D.C. The study focused on 838 801 children with autism who accounted for more than 11.9 million outpatient encounters between January 2023 and January 2026.
For roughly two years, leucovorin prescribing rates remained relatively stable, averaging about 34 prescriptions per 100 000 outpatient encounters among children with autism. Rates then began climbing steadily in early 2025 before surging later that year. By August 2025, prescribing rates had risen to 335 prescriptions per 100 000 encounters. In November 2025, rates climbed again to more than 835 prescriptions per 100,000 encounters.
The researchers observed that the initial rise in prescribing coincided with a February 2025 national television news segment featuring a family who reported dramatic language improvements in their child after treatment with leucovorin. Interest in the medication expanded further after White House officials publicly promoted leucovorin in September 2025 as part of broader autism-related initiatives.
“Families of children with autism are often searching for therapies that might improve communication and quality of life, especially when treatment options are limited. What this study shows is how quickly information shared through news coverage, social media and public figures can influence real-world prescribing patterns, even before large clinical trials establish whether a treatment is truly safe and effective for broad use.”
— Joshua Rothman, MD, clinical assistant professor of paediatrics at the UC San Diego School of Medicine and first author of the study
“The timing was striking,” Rothman said. “The increases began after a widely viewed media story and accelerated again after federal officials publicly discussed the medication. It highlights how rapidly clinical practice can shift when a treatment captures public attention.”
The study does not determine whether leucovorin improves symptoms of autism, nor does it evaluate patient outcomes after treatment. Researchers also cautioned that prescriptions recorded in the database could not always be linked to a confirmed medical indication.
Still, the authors say the rapid increase in use raises important questions for clinicians, policymakers and families. In March 2026, the US Food and Drug Administration approved leucovorin for cerebral folate transport deficiency, an ultra-rare genetic neurological disease associated with specific genetic changes, but the drug was not approved for autism spectrum disorder.
Researchers say the findings underscore the need for continued monitoring of prescribing trends and for larger randomised clinical trials evaluating whether leucovorin is beneficial for specific groups of children with autism.
“We now have a real-world example of how public attention can accelerate adoption of a therapy before the evidence fully catches up,” Rothman said. “The next step is making sure we generate the rigorous data needed to help families and clinicians make informed decisions.”
Time to restore kindness and compassion in healthcare to improve patient and staff well-being
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Healthcare has lost its human, moral, and relational foundations and must reconnect with its core values to improve both patient and staff well-being, argue experts in The BMJ today.
Despite unprecedented advances in diagnostic precision, therapeutic capability, and computational power, a deep paradox exists, say authors Don Berwick, Maureen Bisognano and Bob Klaber. Patients increasingly feel processed rather than cared for, staff report moral distress and loss of meaning, and the workforce is haemorrhaging people at an unsustainable rate.
The core problem, they write, is that we have accumulated extraordinary technical power while quietly losing the human, moral, and relational foundations of care on which its effectiveness ultimately depends.
Several powerful forces have helped create this imbalance, they explain. For instance, in some countries the pursuit of profit has choked healthcare’s moral purpose, while across the globe modern healthcare has become an industrialised system that processes patients through standardised protocols in ways that risk disregarding the unique texture of individual lives.
This has happened through an imbalanced emphasis on a “rational” lexicon (focused on measurement, targets and efficiency) over a “relational” one (concerned with feelings, kindness and human connection).
Yet re-establishing the relational balance is not a sentimental or “soft” approach; it is vital for quality and safety, they argue.
They point to research on NHS culture and behaviour that found organisations where staff felt supported and valued had consistently lower patient death rates, while the Institute for Healthcare Improvement (IHI) framework shows that the conditions for increasing joy in work – clarity of purpose, psychological safety, and feeling that what matters to you is actually valued – are both achievable and measurable.
Kindness – linked empirically to better staff retention, higher teamworking scores, and improved patient outcomes – should also be repositioned at the business end of delivering high quality care, they add.
The “What matters to you?” movement, inspired by an article in the New England Journal of Medicine, exemplifies this shift, changing the clinical encounter from a diagnostic focus to a partnership based on the patient’s lived reality.
While the forces pulling healthcare away from its human dimension are structural and powerful, they are not irreversible, they say. Every ward round, clinical consultation, and leadership conversation is a small but powerful opportunity for all of us working in healthcare to balance relational practice with rational systems and processes.
The evidence is clear: patients do better and staff thrive when healthcare systems invest in joy, kindness, and compassionate leadership, they write. “We do not need to wait for system reform. We can begin now on our collective leadership challenge to reconnect healthcare with its mission and purpose.”
Opinions ranged widely, with some physicians concerned that preparation for preservation could interfere with best practices for a patient’s care.
AI image of a brain being cryogenically preserved. [Ed: The patient better have some hefty medical aid to pay for a new body in the year 3000…]
Surveyed US physicians believed preservation has a one in four chance of working, though opinions amongst physicians varied. Ariel Zeleznikow-Johnston of Monash University, Australia, and colleagues present their findings in the study, published on May 20, 2026 in the open-access journal PLOS One.
It’s unclear whether there is a consensus amongst doctors regarding preservation – the storing of bodies at extremely low temperatures, or using preservative chemicals, in the hopes of future revival. Preservation is not the only way in which physicians have to balance concerns about unproven treatments with patients’ preferences, but it is one with high stakes as it pertains to the end of someone’s life. The technologies necessary to revive someone have not yet been realised, though current preservation organisations report several hundred patients preserved globally, with thousands more signed up for future preservation.
In this study, Zeleznikow-Johnston and colleagues conducted a survey of over 300 physicians, nearly half of whom were primary care providers, the rest being various kinds of specialists including neurologists, intensive care doctors, anaesthesiologists, and doctors who specialise in palliative care. The survey was designed to address three main themes: the perceived feasibility of preservation procedures, clinical interventions that could improve preservation outcomes, and the ethical and legal standing of preservation as an end-of-life option.
About one in four of the physicians said they believed it was plausible, or even very plausible, that someone could be revived in the future after preservation. Just under half said it was unlikely. Neurosurgeons, on average, rated the possibility of revival highest, though most of the other specialties showed a wide spread of opinions that slanted more towards scepticism.
The way doctors are most likely to interact with preservation in their professional capacity is in the choices a patient may make for end-of-life care. A majority of physicians supported prescribing anti-coagulants to dying patients, which could help with the quality of preservation. However, fewer respondents were comfortable with more extreme procedures, such as patients going through medically assisted death and opting to begin the preservation before cardiac arrest. The doctors who most commonly have conversations about end-of-life care were overall more supportive of this kind of choice. About one in five doctors were concerned that decisions to increase the odds of successful cryopreservation would clash with providing the best standards of care.
Currently, pre-cardiac arrest preservation in humans is, to the best of our knowledge, not legally permitted anywhere in the world, but if the technology develops further, may become an issue healthcare professionals must grapple with. The authors emphasise that clarifying the clinical, legal, and ethical frameworks for use of preservation as an end-of life procedure is important, and note that the speculative nature of the findings should be carefully considered.
Zeleznikow-Johnston adds: “A lot of physician hesitancy may come from simple unfamiliarity with the scientific basis of modern preservation methods. The doctors who have actually thought about this – and who regularly sit with dying patients – tend to be more receptive, not less.”
Angelo Maura, General Manager Africa and Middle East at Align Technology
Photo by Tima Miroshnichenko on Pexels
Orthodontic treatment goes beyond getting a better smile; it can also support important oral functions such as chewing and speaking, as well as help patients maintain good oral health over a lifetime. Angelo Maura, General Manager for Africa and Middle East at Align Technology, discusses World Orthodontic Health Day 2026 (WOHD 2026), what “Beyond Straight Teeth” means, and how digital innovation is reshaping orthodontic care for South African patients and practitioners.
Q1: What does “Beyond Straight Teeth” mean to orthodontics?
“Beyond Straight Teeth” strongly reflects how we have always approached orthodontic care. For nearly 30 years, our focus has been on improving the journey to a healthy, confident smile, but that journey has never been limited to aesthetics.
Orthodontic treatment plays an important role in oral function, including how patients chew and speak. It can also support long-term oral health by helping create tooth positions that are easier to clean and maintain. For general dentists and orthodontists, the theme is a reminder that case assessment and treatment goals extend beyond alignment to include function, hygiene access and long-term stability.
Q2: Oral health is said to have an impact on overall health. What are the health benefits of orthodontics?
Misaligned teeth and bite issues can be associated with uneven wear and may make oral hygiene more difficult, which can contribute to plaque build-up and gingival inflammation. In some people, bite problems may also be linked to jaw discomfort. Depending on the individual case, misalignment can also affect everyday functions such as eating and speaking.
At Align Technology, we design solutions that help clinicians address a wide range of malocclusions through modern, evidence-based orthodontic care. The Invisalign® System is designed to treat a wide range of malocclusions, and starting the conversation early can help patients understand their options and plan the right care with their doctor.
Q3: Orthodontic treatment is often associated with teens and young adults. How does it benefit patients at different life stages?
Our aim at Align Technology is to ensure patients of all ages have access to treatment that fits into their daily lives while supporting overall oral health.
For children, early orthodontic assessment can help identify developing issues such as crowding and spacing. Invisalign First™ aligners are designed for growing patients and are removable, which can support oral hygiene when used as directed and supervised appropriately.
For teens, adherence and day-to-day practicality are important. Removable aligners can help many teens maintain normal activities and oral hygiene routines, while clinicians can use digital planning and monitoring to support progress throughout treatment.
For adults, treatment often needs to fit around work and family commitments, and many patients benefit from an interdisciplinary approach. Clear aligner therapy can be an option that balances aesthetics with planned tooth movement, particularly when coordinated with periodontal maintenance and restorative goals where needed.
To date, approximately 22.8 million patients worldwide have been treated with the Invisalign® System, including more than 6.5 million teens and kids.*
*Data on file at Align Technology, as of December 31, 2025.
Q4: How is Align Technology equipping clinicians to raise the standard of care beyond straightening teeth?
We support clinicians through comprehensive education programmes and tools. There are currently approximately 299,500 Invisalign-trained doctors globally. In South Africa, this includes bringing international specialists to work directly with local clinicians through in-market education sessions and academic engagements, ensuring global best practice is shared in a way that is locally relevant.
Q5: Digital technology and AI are changing healthcare. How is the Align™ Digital Platform reshaping what happens in dentistry?
The Align™ Digital Platform connects diagnosis, treatment planning, manufacturing, and monitoring into a single workflow.
One key development is ClinCheck® Live Plan, which automates the generation of an initial doctor-ready ClinCheck® treatment plan within about 15 minutes after an eligible case is submitted with Flex Rx, so the doctor can review and approve the plan faster.
The Align™ Oral Health Suite offers a comprehensive set of digital tools that assist clinicians in evaluating, monitoring, and managing patients’ oral health. By integrating advanced assessment capabilities and patient education resources, the suite supports effective communication and engagement, helping doctors deliver personalised care and promote long-term oral wellness.
These technologies are designed to support clinical expertise, with the doctors central to every treatment decision.
Q6: WOHD 2026 calls for global unity in prioritising orthodontic health. What does this commitment look like in South Africa?
South Africa is an important market for us. There is strong engagement from clinicians, and patient awareness continues to grow. We are also seeing increased adoption of digital dentistry.
At the same time, practitioners are at different stages of their digital journey. A high-volume practice in Johannesburg will have different needs from a smaller practice beginning with aligner therapy.
Our approach is to support clinicians at every stage and grow with them.
Our focus is on expanding access to innovation, strengthening engagement with the dental community, and ensuring clinicians have the tools and support needed to deliver strong patient outcomes.
Ultimately, a healthy smile contributes to overall health.
New research presented at this year’s European Congress on Obesity (ECO 2026) in Istanbul, Turkey, shows that rapid weight loss (RWL) is much more effective than gradual weight loss (GWL) in both achieving higher weight loss and also sustained weight loss at one year.
There exist long‑standing beliefs suggesting that rapid weight loss (RWL) is unhealthy and that losing weight very quickly increases the likelihood of weight regain. However, these concerns are largely based on observational data, historical assumptions, or small, methodologically limited studies. Overall, the scientific evidence directly supporting these claims is limited and inconsistent, and high‑quality randomised controlled trial evidence is relatively sparse.
A recent large population-based cohort study, (Busetto et al., 2025), concluded that a body-mass index (BMI) of ≤ 27 kg/m² and a waist-to-height ratio (WHtR) of ≤ 0.53 after weight loss may represent clinically meaningful treatment targets for reducing the 10-year risk of obesity-related complications (type 2 diabetes, hypertension, atherosclerotic cardiovascular disease, and hip/knee osteoarthritis).
In this new study, the authors aimed to assess the comparative effectiveness of a rapid weight loss (RWL) program versus a gradual weight loss (GWL) program in achieving these treatment targets.
This 52-week investigator-initiated, randomised clinical trial randomised (1:1) a total of 284 adults with obesity (BMI ≥30) (257, 90% women) to either a 16-week food-based RWL-program (weeks 1–8: < 1000 kcal/day; weeks 9–12: < 1300kcal/day; weeks 13–16: < 1500kcal/day) or a 16-week food-based GWL-program (800–1000kcal/day below estimated total energy expenditure (with a mean self-reported intake in this group of approximately 1400kcal/day). Estimated energy expenditure was calculated by estimating the participants’ resting energy expenditure and adjusted based on if they had low, medium or high physical activity.
Following the initial weight loss phase, participants in both groups entered an identical 36-week weight-regain prevention programme. The interventions included weekly in-person weight-loss group sessions from week 1 to week 16, and thereafter, in-person group meetings every 14 days for the first 3 months followed by monthly meetings or individual contacts via webinars, video or telephone for the remaining 5 months of the study. In these sessions, participants were advised to increase their daily energy intake by 100–300 kcal during the first month, until weight stability was achieved. Thereafter, daily energy intake was adjusted as needed in response to any concomitant weight changes throughout the 8‑month weight‑maintenance phase. Participants were free to decide whether they wished to maintain their weight or pursue further weight loss. The majority opted for additional weight reduction following the initial 16‑week period.
The food composition in both programmes was based on current Norwegian dietary recommendations issued by the Norwegian Directorate of Health (https://www.helsedirektoratet.no/faglige-rad/kostradene-og-naeringsstoffer/kostrad-for-befolkningen). Core recommendations included consumption of healthy foods such as vegetables, fruits, whole grains, low‑fat dairy products, fish, eggs, lean meat, and other protein‑rich foods, while limiting the intake of saturated fats and added sugars.
The primary outcome was 1-year percent total body weight loss (%TBWL), and the proportions of participants achieving a BMI of ≤ 27kg/m² or a WHtR ≤ 0.53 after 1 year, were exploratory outcomes. Half of the participants were randomised to the RWL- and 142 to the GWL-programme. At baseline, in the RWL-group, the mean age was 48.5 years, body weight 102.4kg, height 169cm, BMI 35.8kg/m², waist circumference 112.5cm, and WHtR 0.67. Corresponding values in the GWL-group were 47.7 years, 103.0kg, 168cm, 36.5kg/m², 112.8cm, and 0.67.
During the initial 16 weeks, participants in the RWL-group lost significantly more body weight than those in the GWL-group, with mean %TBWL of -12.9% and -8.1%, respectively, corresponding to a between-group difference of -4.8%. At 1 year, the significant difference was maintained, with mean %TBWL of -14.4%in the RWL-group and-10.5 in the GWL-group, corresponding to a between-group difference of -3.9 percentage points. The proportion of participants achieving a BMI ≤ 27 kg/m² was significantly higher in the RWL-group than in the GWL-group at both 16 weeks (13.8% vs 0.8%) and 1 year (28.3% vs 9.7%). Similarly, a higher proportion achieved WHtR ≤ 0.53 in the RWL group at 16 weeks (24.2% vs 8.9%,) and at 1 year (33.0% vs 18.4%).
The authors conclude: “Among adults with obesity, participation in a structured rapid weight loss program resulted in significantly greater weight loss at 1 year, and higher rates of achieving clinically meaningful BMI- and WHtR targets compared with a gradual weight loss approach. These findings indicate that, when provided within a controlled and professionally supervised setting, rapid weight loss may represent a more effective method than gradual weight loss for reaching key body weight targets associated with reduced obesity-related health risks.”
The study is led by Dr Line Kristin Johnson, Department of Endocrinology, Obesity and Nutrition, Vestfold Hospital Trust, Tønsberg, Norway, and colleagues.
Dr Johnson adds: “Our results clearly challenge the prevailing belief that slow and steady gradual weight loss is necessary to prevent weight regain and reduce obesity-related complications. By contrast, we show that rapid weight loss is not associated with weight regain, and, more importantly, that a larger proportion of participants undergoing rapid weight loss – compared with gradual weight loss – achieved clinically meaningful treatment targets for reducing the 10-year risk of type 2 diabetes, hypertension, atherosclerotic cardiovascular disease, and hip/knee osteoarthritis.
“These findings are particularly relevant given the urgent need for effective weight-loss and weight‑maintenance strategies. As many individuals with obesity cannot access or afford medical or surgical treatments, our results support the potential of effective, commercially available weight‑reduction programs to help reduce the growing burden on public healthcare systems.”
New post-portem study reveals over 80% of infection-related neonatal deaths in South Africa are preventable.
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A groundbreaking study published in The Lancet Infectious Diseases Journal has identified that the vast majority of neonatal (newborn infant in the first 28 days of life) deaths caused by infections in South Africa and other low-and-middle-income countries could be prevented through improved clinical care and targeted medical interventions. The research, conducted by the Child Health and Mortality Prevention Surveillance (CHAMPS) network, utilised innovative post-mortem techniques that enables accurate identification of causes of death in low-resource settings. To provide the most granular look to date at what is killing newborns in these regions, more than 2600 neonatal deaths were analysed using minimally invasive tissue sampling (MITS).
Dominant Hospital Pathogens: In South Africa, Acinetobacter baumannii was the overwhelming driver of hospital-acquired infections, contributing to 74.3% of presumed hospital-acquired neonatal deaths.
Community-Acquired Threats: Group B Streptococcus (GBS) was identified as the leading cause of community-acquired neonatal deaths in South Africa, accounting for 30.6% of such cases, followed by Escherichia coli at 24.7%.
Emerging Fungal Risks: South Africa was the only site to report specific life-threatening fungal infections, including Candidozyma auris and Nakaseomyces glabratus, in the causal pathway to death.
Preventability: The modifiable factors identified to reduce these deaths include improvements in infection prevention and control (50.8%), clinical care (50.7%), and antenatal and obstetric care (42.2%).
The findings reveal that current empirical antibiotic treatments may be insufficient, particularly in high-burden settings where antimicrobial resistance is rising. The study also shows that infections often occur alongside other conditions such as prematurity and birth complications, indicating that neonatal deaths are driven by multiple, interconnected factors.
“These findings indicate an urgent need to review empirical antibiotic treatment for neonatal infections,” said Prof Shabir A. Madhi, Director of the South African Medical Research Council Vaccines and Infectious Diseases Analytics Research (Wits VIDA) Unit and lead author of the study. “The high prevalence of multidrug-resistant pathogens like K. pneumoniae and A. baumannii suggests our current standard protocols may no longer be sufficient. Alarmingly, some of these bacteria are resistant to all classes of antibiotics currently available.”
Nearly half of all deaths in children under five occur in the neonatal period, with the highest burden in Africa and South Asia. Importantly, local data further underscores the urgency of action. Within the Soweto and Thembelihle surveillance population, the neonatal mortality rate is estimated at 16.0 deaths per 1000 live births, significantly higher than both South Africa’s national estimate of 10 per 1000 and the Sustainable Development Goal (SDG) 2030 target of 12 per 1000 live births.
These findings highlight persistent inequalities in maternal and child health outcomes, even within urban settings, and reinforce the need for targeted, evidence-based interventions.
The MITS technique used at Wits VIDA uses needle biopsies rather than full autopsies to collect biological specimens. This method proved far more effective than traditional antemortem diagnostics, which failed to identify a pathogen in up to 73% of suspected sepsis cases in South Africa.
The study provides one of the most comprehensive, pathogen-specific analyses of neonatal deaths to date and ultimately, the study highlights a powerful opportunity. That most infection-related neonatal deaths are preventable.The CHAMPS consortium concludes that prioritising new maternal vaccines and strengthening hospital infection control are essential steps to reducing the high burden of neonatal mortality.
CHAMPS South Africa consistently shares its granular research findings with the National Department of Health (NDoH) through various channels to ensure this detailed evidence assists in developing targeted strategies to prevent neonatal infections. These data, which provide a precise look at the pathogens responsible for mortality, are intended to help the NDoH refine empirical antibiotic protocols and strengthen hospital infection control measures. Beyond policy-level engagement, CHAMPS collaborates with local communities to raise awareness regarding prevention strategies, specifically emphasizing the importance of early antenatal care booking and consistent attendance. By focusing on these modifiable factors, the initiative seeks to improve obstetric care and reduce the number of babies born “too soon or too small,” addressing the preterm birth complications that frequently underlie neonatal deaths.
About CHAMPS: The Child Health and Mortality Prevention Surveillance (CHAMPS) network is a global collaboration funded by The Gates Foundation. It aims to provide accurate data on the causes of childhood death to inform policy and save lives in high-mortality regions.
Disproportionately high number of cases among Gen Z, Millennials, and males
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A chemical widely used in food preservation is implicated in an uptick in recent UK deaths by suicide, with a disproportionately high number of cases among young people and boys/men, finds a comprehensive analysis of available data for the period 2019-24, published in the open access journal BMJ Public Health.
There’s now an urgent public health need to review unrestricted access to this source, to avoid further preventable deaths, say the researchers.
Rates of death by suicide have been falling across the UK since the early 1990s. But there is some evidence of a recent uptick in the numbers, coinciding with increasing reports of suicide associated with sodium nitrite poisoning around the world, they explain.
To find out if this form of poisoning is implicated in deaths by suicide in the UK, the researchers retrospectively analysed the details of cases submitted by coroners, forensic pathologists, and police forces between March 2019 and August 2024 to the primary UK laboratory that assesses nitrite and its oxidised metabolite, nitrate, in postmortem samples.
During this period, the laboratory received 274 samples from 201 cases of suspected deliberate or unintentional poisoning from across the UK, Ireland, and Gibraltar.
Most of these cases came from Greater London, South East England, Ireland, and the Midlands, although these figures may reflect coroner awareness rather than true incidence, caution the researchers.
The number of cases rose substantially after 2019, the first year samples were received for nitrite/nitrate assessment.
The final analysis included only the data for which coroners granted permission for use – 82% (164) of the cases received between 2019 and 2024.
The average age of these cases was 28, but ranged from 14–74 for males and 17–82 for females. Nearly three quarters (71%) of all the cases were among younger generations: Gen Z (33%; born 1981-96); and Millennials (38%; born 1997-2012, but listed up to 2005 to account for a separate category of minors, as 4% of cases were among those under the age of 18).
Overall, there were more men (109) than women (52) among the cases. And more than half of the cases in each generation were men, except for the oldest classified generation (Silent, born 1928-45), where the only case was that of a woman.
Levels of nitrite and nitrate found in the blood samples were 100 times higher than would be expected physiologically in 87% of cases, suggesting that swallowing the chemical was intentional, say the researchers.
The researchers highlight some caveats to their findings, including that because nitrite and nitrate analysis isn’t routinely mandated for all suspected suicides, it’s not clear exactly how many such deaths are caused by this chemical.
“It is therefore likely that the cases included here represent a substantial underestimate of the actual incidence. Secondly, the interval between death and sample receipt varied considerably, introducing the possibility that delays may have affected the accuracy of the biochemical measurements,” they say.
Nevertheless, the observed rise in cases among predominantly young people, who tend to be tech savvy, is concerning, they suggest.
“Intentional poisoning has contributed to these recent increases, and at least in the USA, this rise has been partly attributed to the use (and availability) of sodium nitrite,” they point out.
“This trend has emerged alongside freely accessible online information detailing how sodium nitrite can be obtained and used, disseminated both under the guise of providing mental health support and for more explicitly harmful purposes,” they explain.
Their findings warrant urgent action, they suggest. “Collectively, these findings establish unequivocally that use of sodium nitrite in the UK as a method of suicide is both substantial and concerning,” they write.
“Our data provide strong support for the suggestion that the improved digital literacy of younger people enables access to illicit online material promoting suicide practices and lends further support for calls for tighter legislation to prevent availability of such information in online forums,” they add.
In the meantime, steps to mitigate the effects of this type of poisoning, such as the provision of an antidote (methylthioninium chloride kits) in ambulances would be “a simple and cost effective timely method to prevent the devastating consequences of ingestion,” they point out.
*Lead researcher, Professor Amrita Ahluwalia, comments: “This is an extremely difficult subject to talk about, and we appreciate the impact that this might have on all those affected by suicide.
“What our research shows is deeply upsetting. But it makes clear why urgent steps are needed to regulate access to this chemical and to reduce the spread of harmful information about it online.”
For anyone struggling, in South Africa SADAG’s 24 hour hotline can be contacted on 0800 567 567. In the UK and Ireland, Samaritans can be contacted on tel 116 123. In the US, call or text the National Suicide Prevention Lifeline on 988, chat on 988lifeline.org, or text HOME to 741741 to connect with a crisis counsellor. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at www.befrienders.org
Africa CDC and the WHO are working jointly to strengthen coordination by activating an Incident Management Support Team (IMST), building on the successful model used during the mpox and cholera responses
Ebola on a cell. Credit: NIH/NIAID
The Africa Centres for Disease Control and Prevention (Africa CDC), acting on the recommendations of its Emergency Consultative Group (ECG), has officially declared the ongoing Bundibugyo ebolavirus disease outbreak affecting the Democratic Republic of the Congo (DRC) and Uganda a Public Health Emergency of Continental Security (PHECS).
This declaration, under Article 3, Paragraph F of the Africa CDC Statute, empowers the organisation to lead and coordinate responses to significant public health emergencies across the continent. The statute mandates Africa CDC to “coordinate and support Member States in health emergency responses, particularly those declared a PHECS or Public Health Emergency of International Concern (PHEIC), as well as health promotion and disease prevention through health systems strengthening.”
The declaration follows extensive consultations at political, strategic and technical levels, including consultations with H.E. Mahmoud Ali Youssouf, the African Union Commission chairperson; H.E. Cyril Ramaphosa, President of South Africa and the African Union Champion for Pandemic Preparedness, Prevention and Response (PPPR); and consultations with Member States affected or at risk. This declaration was built on recommendations from the ECG, chaired by Professor Salim Abdool Karim, which reviewed the evolving epidemiological situation, regional risks, response capacities, and the implications of the confirmed Bundibugyo ebolavirus strain.
As of May 18, 2026, about 395 suspected cases and 106 associated deaths have been reported in the DRC (mainly in the Mongwalu, Rwampara, and Bunia Health Zones) and in Kampala, Uganda, where two cases and one death have been reported so far.
Africa CDC is deeply concerned about the high risk of regional spread due to intense cross-border population movement, mining-related mobility, insecurity in affected areas, weak infection prevention and control measures, community deaths occurring outside formal healthcare systems, and the proximity of affected areas to Rwanda and South Sudan.
H.E. Dr Jean Kaseya, Director General of Africa CDC, emphasised the urgency of coordinated continental action: “Today, we declare this PHECS to mobilise our institutions, our collective will, and our resources to act swiftly and decisively. The confirmation of the Bundibugyo ebolavirus in interconnected countries reminds us once again that Africa’s health security is indivisible. We must act early, act together, and act based on science.”
Dr Kaseya highlighted that the declaration would strengthen regional coordination, facilitate rapid mobilisation of financial and technical resources, reinforce surveillance and laboratory systems, support the deployment of emergency responders, and accelerate preparedness activities in neighbouring countries considered at heightened risk of transmission.
He further stressed the importance of an Africa-led and partner-supported response: “This outbreak is occurring in one of the most complex operational environments on the continent, marked by insecurity, population mobility, fragile health systems, and limited medical countermeasures for the Bundibugyo ebolavirus disease. We call upon our Member States and international partners to stand together with Africa CDC, the World Health Organization (WHO), UNICEF and the affected countries to prevent further spread and protect our populations.”
Africa CDC and the WHO are working jointly to strengthen coordination by activating an Incident Management Support Team (IMST), building on the successful model used during the mpox and cholera responses under the “4 Ones” principle: one team, one plan, one budget, and one monitoring framework.
Africa CDC has already deployed multidisciplinary experts, including specialists in epidemiology, infection prevention and control, laboratory systems, risk communication, logistics and emergency coordination, and has internally mobilised US$2 million to support the continental response.
The declaration also comes amid growing concerns about the limited availability of validated vaccines and therapeutics for the Bundibugyo ebolavirus disease. Africa CDC is therefore working closely with various partners to assess available medical countermeasures and accelerate operational research and evidence generation efforts to inform outbreak response strategies.
Professor Karim, chair of the ECG, noted: “The ECG carefully reviewed the epidemiological evidence, regional risk profile, and operational realities surrounding this outbreak. The interconnected nature of transmission between DRC and Uganda, combined with the challenges posed by insecurity and cross-border movement, requires urgent coordinated continental action.”
Ebola is a severe and often fatal illness transmitted through direct contact with bodily fluids of infected persons, contaminated materials, or deceased individuals infected with the virus. Early detection, rapid isolation and care, contact tracing, infection prevention and control, community engagement, and safe and dignified burials remain essential to interrupt transmission.
Africa CDC will continue to provide regular updates as additional epidemiological, laboratory, and sequencing information becomes available.
On May 18, 2026 (yesterday), South Africa’s Constitutional Court unanimously upheld a 2024 ruling from the Pretoria High Court, declaring Sections 36 to 40 of the National Health Act 61 of 2003 (NHA) unconstitutional and invalid.
QuickNews previously reported on the High Court judgement, which you can read about here. The Certificate of Need (CON) was part of 2003’s NHA, which was never implemented. Despite it not being a part of the 2023 NHI Act, the removal of the Sections was seen as undermining a core pillar of NHI – centralised management.
The case was brought by Solidarity Trade Union, the Hospital Association of South Africa (HASA).
It was argued that the CON unfairly constrained the rights of doctors to practise where they chose, and hospitals and other healthcare facilities would not be able to operate without one, nor for new facilities to open or even expansions to be made. The provisions, which aimed to promote equitable distribution of healthcare services, had not yet been implemented.
The Director-General of Health, who issued the CON, would have had exercised a “blunt instrument” to control private healthcare in the country, noted Judge Anthony Millar of the Pretoria High Court in his judgement.
The sections were found to be irrational and an unjustifiable limitation on the constitutional right (Section 22) to freely choose a trade, occupation, or profession. They granted overly broad discretionary powers without adequate safeguards. Finally, the court ruled that severing (removing) these sections entirely from the NHA was appropriate, with no need to refer them back to Parliament for fixing. The Health Minister and Director-General were ordered to pay costs.
Anton van der Bijl, Deputy Chief Executive of Solidarity, said: “The Certificate of Need was far more than merely an administrative instrument. It was an instrument of centralisation and state control.”
