World Health Organization (WHO) has said that current outbreak of the Chandipura virus in India is the largest in two decades. According to the global health body, between early June and August 15, the Health Ministry reported 245 cases and 82 deaths from the Acute encephalitis syndrome (AES) across the country. Of these, 64 are confirmed cases of the Chandipura virus (CHPV) infection.

“CHPV is endemic in India, with previous outbreaks occurring regularly. However, the current outbreak is the largest in the past 20 years,” the WHO said in its Disease Outbreak news. As of now, the WHO has not recommended any travel or trade restrictions, However, it suggested an enhancement in surveillance efforts in high risk areas and a focus on population at risk.

The Chandipura virus outbreak, first identified in India in 2003, was a significant public health concern. This virus, belonging to the Vesiculovirus genus within the Rhabdoviridae family is characterized by high fever, seizures, and encephalitis. The viral infection resurged in July this year and has claimed the lives of 28 children under the age of 14 in Gujarat.

In a major breakthrough, the U.S. has approved the world’s first twice-a-year injection to prevent HIV — a long-acting medication that could change how millions protect themselves from the virus. The drug, called lenacapavir, is being hailed by experts as one of the most promising tools yet in the fight to end the HIV epidemic. But challenges around access and affordability may limit its true impact.

A Powerful Alternative to Daily Pills

Lenacapavir, made by Gilead Sciences and sold under the brand name Yeztugo for prevention, has shown remarkable results in clinical trials. Unlike traditional pre-exposure prophylaxis (PrEP) options — such as daily pills or shots every two months — lenacapavir is injected just twice a year, making it the longest-lasting HIV prevention method available.

The shot was tested in two major studies involving high-risk groups: one with young women and teenage girls in South Africa and Uganda, and another with gay men and gender-diverse individuals in several countries. In both cases, the results were striking. The women who received the shot had zero new HIV infections, compared to around 2% in those on daily pills. In the second study, the twice-yearly shot proved just as effective for men and gender non-conforming individuals.

“This really has the possibility of ending HIV transmission,” said Greg Millett of amfAR, The Foundation for AIDS Research.

How It Works?

Yeztugo is administered as two small injections in the abdomen, forming a medication "depot" that slowly releases the drug into the body over six months. However, people must test negative for HIV before receiving it, as it doesn’t treat existing infections or prevent other sexually transmitted diseases.

While the drug is already sold under the name Sunlenca for people living with HIV, this preventive form marks a new chapter in global public health efforts.

Why Is Access A Challenge?

Despite its potential, concerns remain over who will actually benefit from lenacapavir.

In the U.S., only about 400,000 people currently use any form of PrEP — a small fraction of those who could benefit. And structural issues like cuts to public health funding, limited insurance access, and stigma pose significant barriers. Carl Schmid of the HIV+Hepatitis Policy Institute warned that current policies are “pulling the rug out of HIV prevention,” just as this breakthrough arrives.

Gilead says the U.S. list price for Yeztugo is $28,218 per year, comparable to other PrEP options. The company says financial assistance is available, and it expects insurers to cover the shot — though that could change if the U.S. Supreme Court rules against current no-copay requirements.

Globally, the challenge is even greater. While Gilead has struck deals with six generic drug makers to provide low-cost versions of the shot for 120 low-income countries, critics argue that middle-income nations have been left out. UNAIDS Executive Director Winnie Byanyima noted that at current prices, the shot “will change nothing” for many who need it.

Despite the hurdles, experts are hopeful. The twice-a-year schedule could be a game-changer for those who find daily medication inconvenient or face stigma. As Houston-based advocate Ian Haddock put it, “Now I forget that I’m on PrEP because I don’t have to carry around a pill bottle.”

If scaled up equitably, lenacapavir could bring the world a step closer to ending the HIV pandemic. But for that to happen, access — not just approval — must be the priority.

In a move that has sparked widespread concern among public health experts, the newly reshaped vaccine advisory panel under U.S. Health Secretary Robert F. Kennedy Jr. is set to hold its first meeting next week. The agenda, however, signals a dramatic departure from expected priorities. While discussions will touch on COVID-19 vaccines, the panel is not slated to vote on their use. Instead, it will focus on fall flu shots, respiratory syncytial virus (RSV) vaccines, and most notably, a contentious vote on thimerosal, a mercury-based preservative long targeted by anti-vaccine groups.

The omission of HPV and meningococcal vaccine proposals two staples of adolescent immunization backed by decades of medical research has triggered alarm among pediatricians, immunologists, and healthcare policy advocates.

Last week, RFK Jr., a longtime critic of vaccine mandates and a central figure in the anti-vaccine movement before his appointment under the Trump administration, abruptly disbanded the 17-member Advisory Committee on Immunization Practices (ACIP). In their place, he handpicked eight new members—several of whom have public ties to vaccine skepticism or have voiced criticism of pandemic-related health measures.

While the official purpose of ACIP is to offer scientifically grounded recommendations on how to use FDA-approved vaccines, the first meeting’s limited scope has left many wondering whether politics is now outpacing public health.

“It’s deeply troubling to see high-impact vaccines like HPV and meningococcal being pushed aside,” Dr. Susan Kressly, president of the American Academy of Pediatrics told AP. “These aren’t fringe topics. They are central to the health of children and young adults.”

What the Panel Will and Won’t Discuss?

According to the published agenda, the committee will not vote on COVID-19 vaccine guidance, although a discussion will open the session. Instead, voting items will include:

1. Updated recommendations for the fall influenza vaccine
2. RSV vaccine use in pregnant women and young children

A pivotal vote on thimerosal, a preservative found in multi-dose flu shot vials

Conspicuously missing are agenda items related to HPV (human papillomavirus) and meningococcal vaccines, both of which were expected to be up for review this month. These vaccines are crucial tools in preventing cervical cancer, genital warts, and bacterial meningitis—diseases that disproportionately affect teens and young adults.

Historically, the committee’s recommendations are submitted to the CDC director for review and approval, and have been widely adopted by private insurance companies to determine vaccine coverage. However, with the CDC currently lacking a director, final decisions are going directly to Kennedy—raising concerns about potential conflicts of interest and non-evidence-based policymaking.

The 'Flu Vaccine' Thimerosal Debate Resurfaces

Among the most controversial items on the agenda is thimerosal, a compound that has long been a lightning rod in vaccine safety debates. Introduced in the 1930s to prevent bacterial contamination in multi-dose vials, thimerosal contains a form of ethylmercury. Despite studies confirming it is safe at the trace levels used in vaccines, it was heavily scrutinized in the 1990s and 2000s due to fears of a link to autism.

Kennedy has long alleged that thimerosal contributes to developmental disorders—claims that have been widely debunked by peer-reviewed studies and public health authorities. Since 2001, nearly all vaccines recommended for U.S. children under six have been thimerosal-free, with the exception of some multi-dose influenza shots. Single-dose flu shots, which constitute the bulk of U.S. supply today, contain no thimerosal.

The decision to revisit thimerosal has been read by many experts as a symbolic win for vaccine skeptics. We’ve moved on from this debate scientifically, but bringing it back to the table politicizes science that’s already settled.

In response to the panel's formation and its narrow agenda, over 30 medical and public health organizations have voiced concerns. A major point of contention was Kennedy’s recent announcement that COVID-19 vaccines would no longer be routinely recommended for pregnant women, prompting groups to call on insurers to continue coverage regardless of the panel’s recommendations. Among the new panel members are individuals who have:

• Criticized mRNA vaccines despite contributing to their research
• Publicly opposed lockdowns and public health mandates
• Led organizations flagged for spreading vaccine misinformation

The changes have led some within the medical community to question whether professional organizations like the American Academy of Pediatrics (AAP) may begin issuing guidance that diverges from federal recommendations for the first time in decades.

“Public trust hinges on consistency, transparency, and evidence,” said Dr. Kressly. “If that breaks down, we risk confusion, declining vaccination rates, and ultimately, the return of preventable diseases.”

Public Health Implications: What’s at Stake?

The sidelining of HPV and meningitis vaccines may seem procedural, but the ripple effects could be profound. Both vaccines have decades of efficacy data and are cornerstones of adolescent preventive care. The HPV vaccine, in particular, is recognized globally for its role in reducing cervical and other cancers, with the CDC, WHO, and FDA supporting its widespread use.

Meningococcal vaccines are critical in protecting against fast-spreading and potentially deadly bacterial infections in young adults, particularly in school and college settings.

Delaying or weakening guidance on these vaccines could:

• Undermine insurance coverage decisions
• Sow confusion among pediatricians and families
• Contribute to declining vaccination rates in youth

While the outcome of the thimerosal vote may be symbolic, the direction of the new panel under RFK Jr. is anything but. The current agenda marks a departure from a decades-long legacy of data-driven, consensus-based immunization policy in the U.S.

As the world watches, many experts warn that political influence over vaccine science could compromise decades of progress.

This isn’t just about thimerosal or flu shots, it’s about whether America remains a leader in evidence-based public health or veers toward populist pseudoscience.

As COVID-19 continues to mutate not just in India but globally, Maharashtra sees a rise in infections with a dominant COVID XFG variant, a newly dominant Omicron sub-lineage, as revealed by recent genome study. A comprehensive analysis of 184 samples across 10 districts has confirmed that XFG now accounts for the majority of cases in the region, signaling a shift in the viral landscape and highlighting the continued importance of genomic vigilance.

As on 20 June 2025, the COVID-19 active cases has dropped to 5976 from an almost 7000 tally.

While the world adapts to a “living with COVID” strategy, the virus itself shows no signs of standing still. The rise of XFG, along with the emergence of multiple other sub-lineages such as LF.7.9, JN.1, and NB.1.8.1, underscores how the SARS-CoV-2 virus remains a moving target—one that scientists and public health officials must continue to track closely.

Genome Study Flags XFG as Dominant Variant in Maharashtra

The state’s genome sequencing efforts—led by BJ Medical College (BJMC), Pune, and National Institute of Virology (NIV), Pune—have found XFG in 84 out of 184 samples, making it the most dominant variant in the latest sequencing batch. Mumbai alone accounted for nine cases of XFG, while three were identified as LF.7.9, another emerging subvariant.

Dr. Rajesh Karyakarte, genome sequencing coordinator for Maharashtra, told TOI, “After NB.1.8.1 was identified in Hong Kong as a possible surge-driving variant, we intensified our sequencing protocols. Interestingly, while NB.1.8.1 did appear in Pune, the highest frequency was noted for XFG and LF.7.9, indicating localized adaptation.”

The presence of 38 unassigned lineages in the sequencing results also indicates the continual mutation and evolution of SARS-CoV-2 in real time.

What is the XFG Variant?

The XFG variant is what virologists call a “recombinant” subvariant, a strain born from the combination of two previous Omicron derivatives: LF.7 and LP.8.1.2. This recombination process occurs when a person is simultaneously infected with both parent variants, allowing the virus to mix and rearrange genetic material to form a new hybrid.

So far, the Indian SARS-CoV-2 Genomics Consortium (INSACOG) has reported 163 XFG cases across the country, with the majority emerging from Maharashtra, followed by Tamil Nadu, Kerala, Gujarat, Andhra Pradesh, Madhya Pradesh, and West Bengal.

XFG is not currently classified as a Variant of Concern (VOC) or Variant of Interest (VOI) by the World Health Organization (WHO) or India’s Ministry of Health. However, experts are monitoring it closely because of its notable immune evasiveness.

Is XFG a 'Variant of Concern'?

According to early lab data and real-world sequencing observations, XFG carries mutations that allow it to bypass existing immune responses, even among vaccinated or previously infected individuals. This characteristic is known as “immune escape,” and it allows the virus to persist longer within hosts and spread more readily within communities.

However, the receptor binding efficiency of XFG that is, how well it binds to ACE2 receptors in human cells—is believed to be moderate. This may limit its ability to cause severe illness or high transmissibility, at least until further adaptations occur.

Unlike Delta, which was known for increased severity, or Omicron, which brought explosive transmission, XFG currently falls somewhere in the middle. It exhibits mild upper respiratory symptoms in most patients, especially those with pre-existing immunity.

Though less prevalent, NB.1.8.1 is another subvariant drawing scientific attention due to its high ACE2 affinity—a trait that may allow it to latch onto and enter human cells more effectively. The variant was detected in a 29-year-old woman in Pune and has since been associated with potential for future surges.

“NB.1.8.1 possesses both high immune escape and strong receptor binding. It could be a future concern if its circulation increases,” said Dr. Karyakarte.

Meanwhile, LF.7.9, found in 34 cases, is another Omicron sub-lineage showing similar immune escape properties. Its presence across multiple samples in Maharashtra indicates that it could become more widespread if not contained.

While none of these variants have yet been linked to higher hospitalizations or severe outcomes, their ability to evade immune defenses warrants continued public health vigilance.

The booster coverage in India and several other countries remains uneven, especially among vulnerable populations and the elderly. Experts caution that waning immunity may provide fertile ground for variants like XFG to spread.

Though current vaccines are still believed to offer protection against severe disease, ongoing surveillance and potentially updated vaccines may be needed to maintain herd protection.

Furthermore, genomic surveillance—once a behind-the-scenes public health tool—has now become an essential weapon in the fight against pandemic fatigue and viral resurgence.

The virus will evolve for survival, variants like XFG show us that COVID-19 is not done evolving. We must match that with equally strong public health intelligence.

While there is no immediate cause for panic, especially with XFG not linked to a surge in deaths or ICU admissions, its silent spread and immune evasion traits are reasons for strategic concern.