Excess bodyweight is linked to experiencing long-COVID neurologic symptoms, including headaches, vertigo, sleep problems and depression, according to a meta-analysis of studies involving almost 140,000 participants published yesterday in PLOS One.

Overall, the studies included 79,050 people with excess weight compared to 57,926 normal-weight people and 30,694 individuals with obesity compared to 107,612 non-obese individuals.

Excess weight was associated with a higher rate of depression in long COVID (risk ratio [RR], 1.21 (95% confidence interval [CI], 1.03 to 1.42), memory issues (RR 1.43; 95% CI, 1.24 to 1.65), and sleep disturbance (RR, 1.30; 95% CI, 1.16 to 1.48), or increases of 21%, 43%, and 30%, respectively.

Obesity was significantly associated with persistent headache (RR 1.45; 95% CI, 1.37 to 1.53), and numbness (RR 1.61; 95% CI, 1.46 to 1.78). Obesity was also linked to persistent loss of taste and smell. 

Fat tissue may act as virus reservoir 

"These findings suggest that EW [excess weight] might contribute to the development of these symptoms that persist for more than 12 weeks after COVID-19 onset," the authors concluded.  "Moreover, this study is opportune as we transition into the post-pandemic period facing the challenges of managing the co-occurrence of pandemics, including overweight/obesity, mental health issues, and the burden of PCC [post-COVID condition, or long COVID]."

The authors explain that the mechanisms behind the association between neurologic symptoms and excess weight are not clear, but it may be because of metabolic disorders already found in the overweight participants before COVID infection. 

The adipose tissue plays a role in SARS-CoV-2 entry and deposition, and it may serve as a reservoir for virus spread.

Alternatively, the authors wrote, "The role of EW in the progression of COVID-19 is not fully understood, though it may be linked to an exaggerated inflammatory response or pre-existing genetic factors that these conditions share. The adipose tissue plays a role in SARS-CoV-2 entry and deposition, and it may serve as a reservoir for virus spread."

Cholera cases are still on the rise in Africa, with four high-burden countries—especially South Sudan and Angola—accounting for about 90% of cases in the most recent reporting week, a top official from the Africa Centre for Disease Control and Prevention (Africa CDC) said today at a weekly briefing.

"The cholera situation is still of great concern," Ngashi Ngongo, MD, PhD, MPH, who leads Africa CDC's mpox incident management team, told reporters. For the most recent week, 3,781 cases were reported, up just over 9% for the previous week. Also, 103 people died from their infection, an increase of 78% from the week before.

Severe crisis requires regional, coordinated response

South Sudan has the highest incidence, followed by Angola. The Democratic Republic of the Congo (DRC) and Sudan round out the four hardest-hit countries.

In Angola, where nearly 18,000 cases have been reported this year, males make up just over half of cases, and children younger than 15 years old are the most affected age-group, Ngongo said. Cases showed a slight decline last week but remain high, and nearly one third of deaths occurred outside of hospital settings.

The outbreaks in Angola, South Sudan, and the DRC signify a severe crisis, and Ngongo said the cholera situation needs an African regional coordinated response, similar to that for mpox, to curb the spread.

Two papers published this week in the journal Vaccine suggest outer membrane vesical (OMV)-based meningococcal B (MenB) vaccines could reduce gonorrhea incidence.

The two systematic reviews and meta-analyses, one conducted by researchers from Semmelweis University in Hungary and the other by a team from the University of West Attica in Greece, looked at studies that compared the incidence of gonorrhea in those who received OMV-based MenB vaccines and either unvaccinated individuals or recipients of other meningococcal vaccines.

With an estimated 82 million cases annually, gonorrhea is one of the most common sexually transmitted infections. But rising antibiotic resistance in Neisseria gonorrhoeae has limited the antibiotic treatment options, leading to growing interest in a gonorrhea vaccine.

Because of the challenges in developing a vaccine against gonorrhea, researchers have also considered whether vaccines that successfully target Neisseria meningitidis could promote cross-protection. Recent research has suggested that the four-component serogroup B meningococcal vaccine (4CMenB) and other OMV-based MenB vaccines might offer such protection.

Evidence of moderate protection

Both papers found evidence from the published literature that OMV-based MenB vaccines could offer moderate protection against gonorrhea. In a quantitative analysis of seven studies, six of which investigated the 4CMenB vaccine, the Hungarian researchers found a pooled vaccine effectiveness (VE) of 38% against gonorrhea infection. Complete vaccination with the full two-dose series was 24% more effective than partial vaccination. When they looked only at the studies of the 4CMenB vaccine, pooled VE was 41%. 

"4CMenB OMV vaccine should be prioritised for sexually active individuals over non-OMV alternatives, with emphasis on completing the full vaccination series," the Semmelweis University researcher wrote. 

In the other review and meta-analysis, which included nine studies (eight investigating the 4CMenB vaccine), the pooled VE was 30%.

"While randomized clinical trials are necessary, the findings of this systematic review and meta-analysis highlight the potential effectiveness of OMV-based vaccines in terms of gonorrhea prevention," the University of West Attica researchers concluded.

Both groups added that targeting high-risk groups, such as men who has sex with men, should be considered.

An analysis of 200 social media mpox memes finds that 60% promoted awareness of the disease, but 40% spread misinformation or perpetuated stigma, according to a study published yesterday in PLOS Global Public Health.

The team from Uganda examined mpox-related English-language memes shared on social media from the public health emergency declaration in August 2024 through October of that year. 

"Memes have become a popular communication tool, especially during public health crises, offering both opportunities and challenges for messaging," the Makerere University researchers wrote. 

1 in 5 exaggerated mpox severity

About 60% of the mpox memes presented accurate information on symptoms, preventive measures, and testing locations. Roughly 25% of these memes humorously depicted mpox symptoms by using exaggerated imagery or captions to remind viewers of signs and symptoms. 

Public health organizations may benefit from partnering with social media influencers to create accurate, relatable meme content that engages audiences without perpetuating harmful stereotypes.

Informative memes on preventive measures such as vaccination and hygiene made up about 20% of this category, often using jokes to destigmatize discussions about vaccination. Many users shared these memes, tagging friends or family to encourage safe health practices.

In 15% of awareness memes, healthcare providers or health agencies were referenced or humorously incorporated, with many providers leaving comments or sharing them.

But 40% of all memes contained misinformation or perpetuated stigma, especially against LGBTQ+ groups, which the authors said may have decreased public trust in health authorities and discouraged health-seeking behaviors.

About 20% of these memes exaggerated the severity of mpox through sensational language or alarming visuals that suggested the disease was uncontainable or far more lethal than reported. Users shared them widely and expressed heightened concern.

Another 15% included stigmatizing language or imagery targeting specific groups, reinforcing stereotypes, and leading to discussions that featured prejudiced or derogatory remarks. And roughly 5% of memes promulgated conspiracy theories about mpox origins.

"The findings suggest that while memes can positively impact public health communication, their potential to spread misinformation requires strategic monitoring and response," the researchers wrote. "Public health organizations may benefit from partnering with social media influencers to create accurate, relatable meme content that engages audiences without perpetuating harmful stereotypes."