This 32-year-old woman, had no cough, no shortness of breath—only a sudden, inexplicable loss of vision in one eye. At such an young age, with no history of smoking or chronic disease, lung cancer was the farthest thing anyone imagined. But deep within her body, a virulent tumor had already invaded, quietly infesting several organs, including her eyes. This remarkable case defies the normal explanation of cancer symptoms, demonstrating how a disease usually associated with respiratory distress can appear in the most unlikely of ways. Her experience is a sobering reminder that even the smallest health irregularity can be an indicator of something much more sinister.

First, the woman went for medical care following total loss of vision in one eye and, at times, flashes of light in the other eye for around 20 days. A thorough checkup did not show any visible abnormalities on her eyes—no pain, no redness, and no apparent structural defect. The first results baffled physicians, with usual reasons for vision loss such as infections, autoimmune diseases, or vascular conditions being eliminated. But a more in-depth examination revealed a veiled and life-threatening diagnosis.

On further probing, physicians found a large whitish-yellow growth at the posterior of her right eye. The tumor was responsible for fluid accumulation behind the retina, resulting in retinal detachment—a severe condition that may result in lasting loss of vision. An identical, although smaller, lesion was present in her left eye, though her retina was intact.

Without preliminary indications of an apparent cause, the doctors relied on more sophisticated equipment. Blood work eliminated infection from viruses, autoimmune disorders, and blood disease potentially causing such anomalies of the eye. The actual shock was when imaging tests showed a tumor in the bottom of her right lung, which had already metastasized to several organs—including the choroid, the eye structure that provides oxygen and nutrients to the retina.

When Cancer Hides in Plain Sight

Cancer that begins in a single organ and spreads to another is metastatic cancer. When malignancies spread to the eye, they most frequently invade the choroid. Lung cancer infrequently metastasizes to the eyes, appearing in 0.1% to 7% of cases. Sudden loss of vision as the presenting symptom of an unsuspected lung tumor is even less common. To our knowledge, fewer than 60 such cases have been described in the medical literature.

Layering on a second level of rarity to this instance, the woman was a life-long non-smoker, contradicting the common belief that lung cancer targets those with smoking history. Her instance could be one of a specific subset of lung cancer that grows aggressively but doesn't manifest with the characteristic signs of metastasis, such as chronic cough, chest pain, or unexpected weight loss.

What is Ocular Metastasis?

Ocular metastasis, although rare, happens when cancer cells circulate in the blood and get deposited in the vascular tissues of the eye. The choroid is especially prone because it has a high vascularity. The presentation of choroidal metastases may be variable but frequently presents with blurry vision, photopsia, or even total blindness, as in this patient.

Although breast cancer is still the most common source of metastases to the eye, lung cancer comes in second. However, what is so worrying about this instance is that there were no preceding respiratory symptoms that might have triggered an earlier diagnosis.

The case is a sobering reminder that cancer does not always present itself with classical symptoms. Some of the important takeaways for both medical practitioners and the general public are:

Changes in Vision Must Never Be Disregarded: Sudden loss of vision, even without pain or redness, must be thoroughly examined. Most eye problems are harmless, but dangerous underlying illness—like cancer—may cause unusual presentations.

Non-Smokers Are Not Immune to Lung Cancer: Even though smoking continues to be the most significant risk factor for lung cancer, incidences among non-smokers are on the increase. Genetic mutation, environmental hazards, and even viral infections have been found to contribute to lung cancer in persons with no smoking history.

Metastatic Cancer Can Mimic Other Conditions: Metastatic cancer to organs far from the primary tumor may have symptoms unrelated to the site of the primary tumor. Here, the woman did not complain of respiratory issues, and the only symptom noticed was loss of vision. This again emphasizes the importance of a thorough diagnostic strategy when unusual symptoms occur.

Advanced Imaging Saves Lives: Not everything can be seen in a standard eye exam or blood test. In unusual medical cases, whole-body imaging such as CT scans and MRIs can be a lifesaver in identifying latent malignancies.

Following her diagnosis, the woman was sent to an oncologist for further management. Although her current status was not reported in the case report, it highlights the necessity of further studies on such unusual cancer presentations. Recognizing patterns in such cases may result in earlier diagnosis and better survival rates among patients with unusual cancer symptoms.

This case points not only to a unusual medical occurrence but also to a wake-up call for healthcare professionals and the public alike. As medicine improves, so too must our knowledge of how diseases manifest in varied and novel ways. Cancer is a slippery foe, but with caution, early detection, and enhanced screening technologies, more lives can be spared.

Sudden blindness is terrifying, but it is also a chance to identify severe, occult medical illness. This case emphasizes the value of thorough medical assessments and heightened awareness of out-of-the-ordinary presentation of cancers. Whether you are the patient or the physician, the moral is the same: never ignore the subtle alterations in health, as they could be the initial signs of a potentially lethal underlying illness.

The World Health Organization (WHO) has prequalified an additional novel oral polio vaccine type 2 (nOPV2) to strengthen the global supply of the vaccine, stop poliovirus type 2 outbreaks more sustainably and accelerate progress towards polio eradication.

The newly approved vaccine was manufactured by Biological E. Limited (BioE), Hyderabad, India, using in-house bulk vaccine following a technology transfer from PT Bio Farma (Persero), Indonesia.

The prequalification status means that the vaccine meets international standards of quality, safety, and efficacy for global immunization programmes.

It also allows the vaccine to be purchased and supplied through United Nations procurement agencies, including UNICEF, across the world and helps governments prevent and control poliovirus transmission.

With the new WHO recommendation, BioE is expected to produce 600 million doses per year of the nOPV2, increasing India's global leadership in vaccine manufacturing and its contributions to expanding access to affordable life‑saving vaccines across the Global South.

WHO Director-General Dr Tedros Adhanom Ghebreyesus highlighted the impact of vaccination efforts on global polio eradication and said: “Vaccines are also bringing us closer to the eradication of polio, with 41 cases of wild polio reported last year from just 24 districts in Pakistan and Afghanistan, down from 99 cases in 49 districts in 2024."

What Is nOPV2?

Novel oral polio vaccine type 2 (nOPV2) is a genetically modified, more stable vaccine designed to stop circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks. It provides comparable protection to the old type 2 vaccine (mOPV2) but is less likely to cause new vaccine-derived outbreaks.

Studies show nOPV2 is safe, well-tolerated and produces similar immunity to mOPV2, with over 500 million doses administered across 23 countries as of early 2024. The vaccine is typically used in targeted, large-scale vaccination campaigns, often for children under five years of age.

The oral vaccine is supplied in 20-dose and 50-dose vial presentations. It has a shelf-life of 24 months when stored at temperatures not exceeding –20 °C and can also be stored for up to six months at +2 °C to +8 °C, providing important flexibility for immunization programmes in diverse situations.

Mike McGovern, Chair of the International PolioPlus Committee, Rotary International and Chair of the Polio Oversight Board, GPEI, said of the new prequalification: "Expanding nOPV2 manufacturing is essential to ensuring countries can respond quickly to variant poliovirus outbreaks. Biological E’s prequalification status strengthens the global supply and brings us closer to ending these outbreaks for good."

Why Is The New Polio Vaccine Useful?

Once a global scourge paralysing hundreds of thousands of children globally, polio is now close to eradication as wild poliovirus cases have fallen by more than 99 percent since the 1980s.

However, given rising vaccine hesitancy and gaps in immunisation, cVDPV2 can re-emerge in under-immunised communities, triggering outbreaks as seen recently in parts of Africa and Southeast Asia. But nOPV2's genetic stability and increased protection help limit that risk and reduce the chances of a mass outbreak.

While India achieved its polio-free certification in 2014, the risk of importations or vaccine-derived outbreaks increases if coverage drops. With the nOPV2's WHO prequalification, officials can safeguard public health by ensuring access to the most advanced tools available.

As of August 2022, 18 out of 21 countries had successfully stopped cVDPV2 transmission following two rounds of mass vaccination activity and a further two countries did so after a third round.

Data has shown that nOPV2 effectiveness is on par with that of mOPV2, and while evidence of the vaccine’s immunogenicity has already been well established, additional studies continue to be conducted throughout the EUL period to confirm protection against type 2 poliovirus in vaccinated individuals.

Mizoram Health Minister Lalrinpuii has expressed serious concern about rising HIV cases, as data shows that cases in the state are 13 times higher than the national average.

Calling it a "collective disgrace", Lalrinpuii said: “About 70 per cent of HIV transmissions in Mizoram occur through sexual contact. While the national prevalence rate stands at a mere 0.2 per cent, Mizoram’s rate has climbed to 2.74 per cent. This is a matter of shame for Mizo society.”

Speaking at an event organised for International Condom Day in Aizawl on February 13, she noted that a majority of that sexual contact remains the primary route of HIV infections in the state, accounting for 70 per cent of all cases.

The minister noted that the spread is largely driven by infidelity and a lack of preventive measures, which she argued contradicted the moral and religious values of the Mizo society.

She urged the people of the state to remain faithful to their partners. “To protect the future of Mizoram, our youth must remain vigilant,” Lalrinpuii added.

The global challenge of HIV/AIDS remains one of the most pressing public health issues today. According to the latest data from UNAIDS, around 38.4 million people worldwide are living with HIV/AIDS.

As of 2024–2025, India has approximately 2.5 million to 2.56 million people living with HIV (PLHIV), marking the third-largest HIV epidemic globally, underlining the need for not only medical intervention but also comprehensive awareness, education, and social change.

How Does Mizoram Plan To Reduce HIV Cases?

During the event, Laltinpuii said condoms are recognised globally as one of the most effective and accessible tools for preventing HIV as well as other sexually transmitted infections, urging the public to discard misconceptions surrounding use.

While suggesting abstinence before marriage, the minister also advised sexually active individuals not to hesitate to use condoms, as they play a vital role in preventing the spread of the virus, if used correctly.

“While we advocate abstinence before marriage, those who cannot abstain must not hesitate to use condoms. It is a simple, life-saving tool that we must stop stigmatising,” she said.

During the event, Laltinpuii launched the “Love Brigade 2.0” campaign aimed at normalising condom access across the state. Under the initiative, two-wheeler taxi riders have been equipped with “Love Brigade Condom Jackets”, allowing passengers and members of the public to access free condoms discreetly and conveniently.

What Is HIV?

HIV is the virus responsible for attacking the body’s immune system, specifically targeting CD4 cells, which are crucial for the body’s defense against infections. As HIV progresses, it destroys these cells, weakening the immune system over time. If left untreated, this continuous damage can lead to AIDS.

HIV is highly contagious and can be transmitted through the exchange of bodily fluids such as blood, semen, vaginal fluids, and breast milk. It is primarily spread through unprotected sexual contact, sharing needles, from mother to child during childbirth or breastfeeding.

Without treatment, HIV progresses through three stages:

- Acute HIV Infection: This stage occurs shortly after transmission and may include symptoms like fever, fatigue, and swollen lymph nodes.

- Chronic HIV Infection: Often asymptomatic or mildly symptomatic, the virus continues to damage the immune system but at a slower rate.

- AIDS: This is the final stage, marked by severe immune damage and the presence of infections that take advantage of the compromised immune defenses.

The disease is diagnosed through blood tests or oral swabs that detect the presence of the virus or antibodies produced by the immune system in response to the virus. Early detection of HIV is crucial, as it allows for timely intervention and treatment, which can prevent the virus from progressing to AIDS.

For HIV, the primary treatment goal is to suppress the virus to undetectable levels, thus maintaining a strong immune system and preventing further transmission of the virus. People living with HIV can often live long, healthy lives if they adhere to antiretroviral therapy (ART).

Norwegian Cruise Line has notified passengers about two confirmed cases of Legionnaires’ disease linked to a December 2025 sailing aboard its ship, the Norwegian Encore.

In a letter dated February 12 and addressed to recent guests, the cruise operator said it is working with the Centers for Disease Control and Prevention (CDC) to investigate the illnesses. The two passengers were diagnosed after traveling on the vessel late last year.

What Is Legionnaires’ Disease?

Legionnaires’ disease is a serious type of pneumonia caused by Legionella bacteria. According to the cruise line’s letter, people become ill when they inhale tiny water droplets that contain the bacteria.

Unlike many respiratory infections, Legionnaires’ disease does not spread from person to person. Instead, the bacteria can grow in water systems and occasionally spread through mist or vapor from fixtures such as hot tubs, showers, whirlpool bathtubs, decorative fountains and misters.

The CDC notes that symptoms usually appear between two and 14 days after exposure, though in some cases they may take longer. The illness often resembles pneumonia and can include cough, fever, headache, muscle aches and shortness of breath. Some patients may also experience confusion, diarrhea or nausea.

While most people exposed to Legionella bacteria do not become sick, certain groups face a higher risk. Adults over 50, current or former smokers and individuals with underlying health conditions are considered more vulnerable to severe infection.

Investigation Underway, Tests So Far Negative

In its communication to passengers, Norwegian Cruise Line said it has launched onboard testing for Legionella bacteria. The testing includes water systems and fixtures such as hot tubs, showers and faucets.

“So far, all test results have been negative,” the company stated. It added that it remains unclear whether the two passengers were exposed through the ship’s water system or from another source unrelated to the cruise.

The cruise line urged anyone currently sailing or who recently disembarked from the Norwegian Encore to monitor their health. Guests who develop symptoms within 14 days of the end of their cruise have been advised to contact the ship’s medical staff and seek immediate medical attention.

CDC Monitoring the Situation

In a statement issued February 13, a spokesperson for the CDC confirmed to PEOPLE that the agency is aware of the cases associated with the Norwegian Cruise Line vessel and is supporting the investigation.

The development follows a separate CDC report released in October 2024 that examined 12 cases of Legionnaires’ disease identified among travelers on two cruise ships between November 2022 and June 2024. In that earlier investigation, private balcony hot tubs were identified as the likely source of exposure in two outbreaks.

The CDC noted that private hot tubs are often subject to less stringent operating requirements than public ones. The agency also warned that certain features — including outdoor placement, water retention between uses and systems involving recirculation, filtration or heating — can increase the risk of Legionella growth and transmission.

For now, health officials and the cruise line continue to investigate the source of the recent cases, as passengers are reminded to remain alert to symptoms and seek prompt care if they feel unwell.