BMJ - British Medical Journal

The US measles outbreak that began in Texas in late January is now spreading more widely, with 505 cases in Texas and 56 in nearby New Mexico, making a national total of more than 600 cases in 21 states.Two school age children died of measles complications in Texas. Both had been previously healthy, and neither one had been vaccinated. A third person probably died of measles in the neighbouring state of New Mexico, although the cause of death has not yet been confirmed. The Texas cases have been concentrated in a Mennonite community in Gaines County where vaccination rates are low.Robert F Kennedy Jr, the recently appointed head of the US Department of Health and Human Services, who has long denied the benefits of vaccines, has now urged people to get vaccinated. “The most effective way to prevent the spread of measles is the MMR vaccine,” he wrote on X...

The Royal College of Surgeons of England (RCS England) is calling for urgent reforms to tackle sexual harassment in the NHS after a High Court judge ruled that a surgeon who harassed junior colleagues over more than a decade should not be struck off the medical register.1Mr Justice Calver decided that erasure from the register would be a “disproportionate” sanction for James Gilbert, a leading transplant surgeon and supervisor of surgical trainees at the Oxford Transplant Centre who touched women “inappropriately” without their consent, including in the operating theatre, and made sexually suggestive comments.2A medical practitioners tribunal decided last August to suspend him from the register for eight months without review, allowing him to return to unrestricted practice at the end of the period. The General Medical Council appealed to the High Court, arguing that he should be struck off. But the judge instead extended his suspension to 12 months,...

Vaccination for shingles could be linked to a reduction in the risk of developing dementia, a study published in Nature has reported.1Researchers at Stanford University in California analysed cases of dementia in Wales, based on the health records of more than 280 000 adults born in 1925 to 1942. Over a seven year follow-up period the results showed that dementia diagnoses were 3.5 percentage points lower in people who received the live attenuated herpes zoster vaccine (Zostavax) than in those who did not receive it.Pascal Geldsetzer, lead author of the study and assistant professor of medicine at Stanford University, said, “For the first time, we have evidence for a cause-and-effect relationship between live attenuated shingles vaccination and dementia. The effect sizes appear to be large and, if truly causal, would have profound implications for population health and dementia research.”The study took advantage of a public health policy in Wales that...

US health secretary Robert F Kennedy Jr said he will order the Centers for Disease Control and Prevention (CDC) to revise its recommendation, which has stood for seven decades, that fluoride be added to drinking water.The public health agency said on 7 April that it would re-examine the scientific evidence on fluoride’s safety and effectiveness after Kennedy said he will ask it to drop the guidance.1The CDC currently suggests that 0.7 mg of fluoride be added per litre of water, the equivalent of three drops of water in a 55 gallon barrel. States generally follow that advice. Kennedy said he will instruct the CDC to drop that advice. He added that he was creating a task force to study fluoride in drinking water.The announcements have caused concern in dental and scientific communities who say there is no evidence that fluoride is harmful but plenty of evidence that it delivers dental...

Babies and children aged three months to 11 years with uncomplicated community acquired pneumonia should be offered a three day rather than five day course of antibiotics, the National Institute for Health and Care Excellence (NICE) has said in a draft guideline.1The recommendation follows evidence that for this group of patients a three day course of antibiotics was as effective as a five day course. It is also in line with shorter antibiotic courses for many common infections, such as urinary tract infections and acute bronchitis.Jonathan Benger, chief medical officer and interim director of the centre for guidelines at NICE, said that shorter courses of treatment also reduce the risk of antimicrobial resistance and save NHS resources.The draft guideline includes children for the first time and combines previous guidance on community acquired pneumonia and hospital acquired pneumonia published in 2019.It recommends using steroids in addition to antibiotics for adults with...

Lobbying by the advertising industry is thwarting plans that aim to protect public health by banning junk food advertisements from bus stops and billboards, The BMJ has found.Advertising companies and their representatives are warning local authorities in financial crisis that the councils’ advertising revenues will plummet if they restrict the promotion of food products high in fat, salt, or sugar (HFSS). These warnings have led some local authorities in England to shelve their plans despite the potential benefits to public health, The BMJ’s investigation discovered.media-1vid1Video 1Deny, dilute, delay—how advertisers are fighting billboard bansbmj.r667-vid1Those councils who push ahead with their plans despite such lobbying are facing delays of up to eight years to enforce the bans, because of their existing contracts with the advertising firms. Even when the bans come into effect they allow adverts for products such as McDonald’s chicken nuggets and KFC burgers to continue to be displayed (box...

In this paper by Gao C and colleagues (BMJ 2025;399:e082945, doi:10.1136/bmj-2024-082945, published), in the pdf, figure 2 had missing data for number censored at days 365, the HTML live figure was unaffected. Additionally, in figure 3, the number in the hierarchical component for death in the Ties box, should have been 929 398.

Last month NHS England issued a press release announcing a “nationwide rollout” of an “artificial intelligence tool that predicts falls and viruses.”1 It said that the tool, developed by the care provider Cera, was being “rolled out across the NHS” and “can predict a patient’s risk of falling with 97% accuracy, preventing as many as 2000 falls and hospital admissions each day.”The press release quoted senior government officials backing the tool as a “perfect example of how the NHS can use the latest tech to keep more patients safe at home and out of hospital.” The announcement was covered across several media outlets, including ITV News, the Independent, and the London Standard.23 The NHS Confederation issued a response, welcoming the rollout of the technology, but warning of the need for robust evaluation of AI in the health service.4How will the NHS roll out the AI?The BMJ approached Cera and NHS...

This week is National Public Health Week in the United States and perhaps the saddest one in the 70 years of this celebration. Last week, President Donald Trump’s administration enacted mass firings of staff, or a “reduction in force,” at agencies that form the scaffolding of public health in the US.1 This action continued the attacks on science and health that have quickly become a signature of the new presidency.2The scope and depth of the cuts to staff are vast, including the Centers for Disease Control and Prevention, the National Institutes of Health, the US Food and Drug Administration (FDA), Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration, Centers for Medicare and Medicaid Services, and many other offices.Collectively, these cuts impair government functions that are vital to society, including (but not limited to) the ability to ensure the safety of new medications, devices, food, and other...

Patients in hospital emergency departments are being put at risk because they are not getting time critical medication (TCM) for chronic conditions such as diabetes and Parkinson’s disease on time, says a report by the Royal College of Emergency Medicine.1Analysis of data from 136 UK emergency departments on patients with diabetes or Parkinson’s disease who take certain TCM such as insulin injections and levodopa found that two thirds did not receive their drugs around the expected time. This could potentially exacerbate symptoms or complications and lead to deterioration and increased mortality.Just over half (7197) of the 13 478 eligible patients were not identified within 30 minutes of their arrival in the emergency department, the analysis showed, and just 32% of 10 850 doses that patients should have had were administered within 30 minutes of their scheduled time. This proportion was 39% for levodopa and 22% for insulinIn light of the...

My name is Biotic. Andi Biotic.The UK Health Security Agency (UKHSA) has a new superhero in the form of a pill shaped cartoon character known as Andi Biotic. He’s heading up a campaign to tackle misconceptions about antibiotics among 18 to 34 year olds, as part of the ongoing “Keep Antibiotics Working” programme.A dose of good messaging?The agency is piloting this new six week digital campaign, which is being promoted across YouTube,1 Instagram, and Facebook, and by GP practices and pharmacies, to test its “potential to capture people’s attention and imagination” in order to “help raise awareness of good antibiotic stewardship.”A hard pill to swallowIndeed. An Ipsos survey of nearly 6000 UK residents aged 16 and older, commissioned by the UKHSA last year, found that over half of respondents incorrectly believed they either could not do anything personally to prevent antibiotics becoming less effective at treating infections (26%, 1535) or...

bmj;389/apr08_4/r697/FAF1faSheila Bhattacharya (née Burns) was born in St Leonards-on-Sea, East Sussex, in 1924. Her father, Robert Burns, a classics scholar, had been a colonial administrator in St Kitts and West Africa, while her mother, a highly independent Glaswegian woman, had served as a nurse in the first world war.Sheila had a passion for literature and had intended to study English at university, but the onset of the second world war while she was finishing school was the great event of her life, changing her outlook. Encouraged by her mother, she decided to study medicine and got a place at Newnham College, Cambridge, in 1942. She then decided instead to volunteer for war work and was sent to an explosives research laboratory at Woolwich Arsenal where she learnt about life beyond her privileged upbringing. It was dangerous work handling unstable chemicals, and more so during the V1 and V2 missile attacks....

The UK government should train and employ more health visitors and school nurses as part of a package of measures to tackle the rise in mental health problems among children and young people, a charity has urged.1The Centre for Mental Health, a charity that aims to tackle mental health inequalities, noted that one in five 8 to 25 year olds are now affected by mental health problems. It urged the government to invest in evidence based preventative strategies to reverse the trend, spanning the perinatal period and early years to schools and colleges, through to adulthood and employment.Cuts to health visitors and school nurses under successive governments have led to more children falling through the gaps of early support and going on to need specialist care, the report said.Increasing health visitor and school nurse numbers will benefit babies, children, and families for decades to come, alongside other interventions such as...

In January 2025, the UK government announced that an independent commission is to be set up on social care in England led by Louise Casey, a crossbench peer. The commission will explore problems facing social care and provide recommendations for creating a “national care service.”1 The announcement has elicited considerable (tending towards negative) response.2 Some query the basis for a commission, calling it a “cop out” in light of the urgent need for funding and reform.3 Others decry the long duration, with the commission expected to finally report by 2028, and point to a field already crowded with many similar exercises.4I view things somewhat differently. I agree that social care cannot afford to wait but suggest that the necessary change must be profound and that the commission can be justified as a way of proceeding. The organisational and funding issues are substantial, but we must recognise that reform in complex...

The US has reported 6600 cases of whooping cough (pertussis) in the first three months of 2025, more than four times the number at the same point last year and 25 times as many as had been reported at the same point in 2023.If the current trend continues, the country will be on course for the highest number of infections since vaccination was introduced in 1948.The state of Louisiana last week reported that two people had died from pertussis in the past six months. Both were infants, who are most at risk of serious complications. Two other US deaths have been reported this year: a school age child in North Dakota and an adult in Idaho.Pertussis remains one of the world’s deadliest infectious diseases. The World Health Organization estimated that in 2014 there were 24.1 million cases and 160 700 deaths in children under 5 worldwide.The number of cases typically...

A consultant surgeon who sexually harassed junior female colleagues has been suspended from the medical register for 12 months after a High Court judge ruled that his original eight months suspension had been too lenient.1James Gilbert was regarded as the “golden boy” of his department at the Oxford Transplant Centre, one of the women who gave evidence against him told the medical practitioners tribunal that suspended him last August. The tribunal found that he had touched female colleagues inappropriately without consent, including squeezing one woman’s thigh between his own thighs under the operating table, and made sexually motivated and racist remarks.2Gilbert had told the tribunal that he was a “different person and a fundamentally changed practitioner from the doctor whose conduct led to complaints being raised.”The tribunal noted that “these incidents did not give rise to concerns about risks to patient safety and that there was evidence that Mr Gilbert...

How are AI tools being evaluated?So far, the UK National Institute for Health and Care Excellence (NICE) has evaluated and published reports on five AI technologies. The sixth evaluation, on the first autonomous AI tool, is due to be published later this year.“Most of the AI tech that we have evaluated has been in the diagnostic space and are imaging based technologies,” said NICE’s HealthTech programme director Anastasia Chalkidou. “It’s still a med tech fundamentally.”Chalkidou told NICE’s annual conference on 27 March that most AI tools are currently being evaluated through its early value assessment (EVA) process.1 To be considered for this pathway, technologies with evidence uncertainties must aim to meet an unmet need. If they are conditionally recommended for “early use in the NHS,” an evidence generation plan must then be followed to produce the “evidence that needs to be gathered while it’s in use.” Once this evidence is...

DC and 23 states sue Trump governmentThe District of Columbia and 23 US states have launched legal action against President Donald Trump’s administration after the cancellation of $11bn (£8.54bn; €10bn) in public health funding left over from the covid pandemic.1 The funding was being used in programmes tracking the spread of disease and vaccine rollouts, as well as addiction and mental health services and others.The lawsuit, which asks the court to immediately block the funding cut, says that the federal government did not provide a “rational basis” or facts to support the cuts. The attorney generals representing these states said that the move would lead to “serious harm to public health” and would put states “at greater risk for future pandemics and the spread of otherwise preventable disease and cutting off vital public health services.”California’s attorney general, Rob Bonta, said that Trump and the health secretary, Robert F Kennedy Jr,...

The inequalities in outcomes for pregnant women and babies from black and Asian backgrounds have been improving, but they still persist in Scotland.1A short life working group on racialised health inequalities in maternity care was established in Scotland in January 2023. It took a co-production approach, underpinned by data and evidence, and identified three key deliverables2: an action plan, a best practice toolkit for working with interpreters in maternity and neonatal services, and scoping of data and evidence.Across Scotland, we are fortunate to have organisations—such as Amma Birth Companions (a Glasgow charity that supports women and birthing people from migrant backgrounds; https://ammabirthcompanions.org) and KWISA, Women of African Descent in Scotland (an African women led organisation based in Edinburgh; https://kwisa.org.uk)—advocating for and amplifying the voices of women and families from racialised and marginalised communities.We must continue to listen carefully to those with living expertise and create and maintain the conditions for...

Concerted global efforts to improve maternal healthcare mean that women are far less likely to die in childbirth than they were two decades ago, a new UN report says. But agencies have warned that the gains are already at risk because of to the recent unprecedented cuts to international aid funding.“In the year 2000 nearly half a million women died from giving birth. The figure now in 2023 is just over a quarter of a million,” said Jenny Cresswell, a researcher at WHO’s Department of Sexual and Reproductive Health and Research and the report’s lead author. “This report presents the first time that no countries were estimated to have extremely high levels of maternal mortality.”The report, published by the UN Maternal Mortality Estimation Inter-Agency Group, is the first to assess the global effect of the covid-19 pandemic on maternal health.The 40% decrease in maternal deaths was largely due to better...