A Narcolepsy Breakthrough, Europe's Heat Toll Reaches 20,000, and Ebola at 1,800 Cases
Takeda's orexin-based narcolepsy drug nears FDA approval as Europe's 2026 heatwave death toll climbs to an estimated 20,000.
By Dr. Asher Knippel
This weekend brings a narcolepsy therapy that targets the root cause of the disease for the first time, troubling new arithmetic on European heat mortality, a viral haemorrhagic fever outbreak that has crossed 1,800 cases in the DRC, and the most detailed study yet of what each successive pregnancy does to the brain.
Oveporexton Phase 3: Near-Normal Wakefulness Restored; FDA Decision Expected This Quarter
Takeda Pharmaceuticals has published complete results from the FirstLight and RadiantLight phase 3 trials of oveporexton (TAK-861) for narcolepsy type 1, delivering the most comprehensive efficacy dataset to date for a mechanism-targeted narcolepsy treatment. At 12 weeks, both the 1 mg and 2 mg twice-daily doses produced statistically significant improvements in mean sleep latency — the speed at which the brain falls asleep under standardised conditions demanding wakefulness — compared with placebo. Gains approached values seen in healthy adults. Cataplexy frequency fell substantially across both doses.
Narcolepsy type 1 is caused by the near-total loss of hypothalamic neurons that produce orexin, a neuropeptide that anchors wakefulness. The condition is permanent and affects an estimated 200,000 people in the United States and millions more globally; diagnosis is frequently delayed by a decade or more. Current treatments — sodium oxybate, pitolisant, modafinil — relieve symptoms without replacing the missing signal. Oveporexton is an orexin receptor 2 (OX2R) agonist that directly substitutes for the absent neuropeptide, addressing the neurochemical deficit rather than masking its consequences. The FDA accepted Takeda's new drug application and granted Priority Review in February 2026, with a PDUFA action date in the third quarter of 2026. A positive decision would make oveporexton the first cause-targeted therapy available for narcolepsy type 1 — a significant shift for patients who have managed a permanent neurological condition with symptomatic tools alone.
Follow-Up — Europe's Heatwave: Country-Level Data Show an Estimated 20,000 Excess Deaths, with More Deadly Weeks Ahead
When this column last covered Europe's summer heat emergency on 8 July, preliminary estimates attributed roughly 1,300 excess deaths to the late-June heatwaves. New country-level data and modelling published in early July sharpen that picture dramatically. Researchers at Indiana University estimated 20,390 excess deaths attributable to the 2026 heatwaves across Europe (95% CI: 17,201–25,141). Belgium's health surveillance authority reported 1,747 excess deaths between 18 June and 1 July — the deadliest Belgian heatwave in 30 years. Spain's Carlos III Health Institute confirmed at least 1,028 heat-related deaths in June alone. Across Europe, approximately 60% of emergency hospital admissions during the current heatwave involve adults aged 75 or older, and WHO has noted that many of those admissions are preventable.
On 7 July, WHO Regional Director Hans Kluge issued a statement warning that "more deadly weeks may still lie ahead" as a fresh heat dome reloaded over the Mediterranean basin. Daytime peaks across southern Italy and the Balkans are running 10–15°C above normal, with some areas expected to reach 38–41°C through mid-July. Barcelona recorded 40.5°C on 8 July — its highest temperature since records began. WHO has called on member states without national Heat-Health Action Plans — fewer than half the European Region currently has one — to adopt them urgently. Cyprus and the eastern Mediterranean are among the most geographically exposed sub-regions: the Eastern Mediterranean is warming at nearly double the global average rate, and average July temperatures in Nicosia are already 4–5°C above the 1990 baseline.
Continuing Outbreak: Ebola in DRC Passes 1,800 Cases; Uganda Spillover Appears Contained
As of 9 July, the Bundibugyo-strain Ebola outbreak in the Democratic Republic of the Congo has reached 1,792 confirmed cases and 625 deaths, according to ECDC External Update #3 published 10 July. Ituri province accounts for over 90% of DRC cases, with active transmission confirmed in 25 of its 36 health zones. On the Uganda side of the outbreak, there is cautious news: Uganda had reported 20 confirmed cases and 2 deaths after a cross-border spillover from DRC, but the last confirmed Ugandan case was recorded on 21 June — 18 days before the most recent data cut — and no new cases have been detected since. Sixteen of Uganda's confirmed patients have recovered.
There is no licensed vaccine or specific antiviral for Bundibugyo ebolavirus. The clinical trial evaluating MBP134 (a monoclonal antibody) and remdesivir — the first therapeutic trial ever conducted against this Ebola species — opened enrolment on 2 July. CEPI has fast-tracked three vaccine candidates into early development; none are expected to reach phase 3 readiness within the current outbreak window. Active armed conflict across the most affected provinces in eastern DRC continues to limit case-finding, contact tracing, and community engagement.
Saturday, 11 July: Each Pregnancy Rewires the Brain in Its Own Distinct Way
A study published in Nature Communications by researchers at Amsterdam UMC is the largest multimodal neuroimaging study of pregnancy-related brain changes conducted to date. The team followed 127 women through five MRI sessions: one before conception, two during pregnancy, and again at one and six months postpartum. The design allowed direct comparison between women experiencing their first and second pregnancies.
First pregnancies drove grey-matter changes concentrated in the default mode and frontoparietal networks — regions involved in social cognition and mentalising — consistent with the idea that the brain is reorganising to focus attention on an infant. Second pregnancies showed a recognisably similar but distinct signature: less pronounced changes in those social networks, with relatively greater alterations in regions governing attention and sensory processing. The clinical implications of these differences have not yet been established; this is structural neuroimaging, not a mental health trial. The authors suggest, however, that peripartum depression screening tools developed on first-time-mother populations may not fully capture vulnerability signals in women on a second pregnancy. Peripartum depression affects approximately 10–15% of women and remains underdiagnosed across all parities — data on whether risk profile or presentation differs by parity is limited.
E. coli O145:H28 Traced to GreenWise Frozen Organic Blueberries; FDA and CDC Investigating
The US FDA and CDC are investigating an active outbreak of E. coli O145:H28 linked to GreenWise-brand frozen organic blueberries sold at Publix supermarkets in Florida and Georgia. Twelve illnesses have been confirmed so far, including four hospitalisations; no deaths have been reported. Consumers who purchased these products are advised to discard them or return them to the store for a full refund. Retailers have been asked to remove remaining stock from shelves.
E. coli O145:H28 is a non-O157 Shiga toxin-producing E. coli (STEC) strain. Like other STEC strains, it can cause haemolytic uraemic syndrome (HUS) — a potentially life-threatening complication involving acute kidney injury, particularly in young children and older adults. The source investigation is ongoing.
Isolated Marburg Virus Case in Uganda — No Secondary Spread Detected
Uganda's Ministry of Health confirmed a single case of Marburg virus disease in a 1½-year-old child in Kyegegwa district in western Uganda in late June, identified through enhanced surveillance activities running in parallel with the Ebola response. The child died. Africa CDC has confirmed that none of the child's contacts developed symptoms and there is currently no active Marburg case in Uganda. Uganda has experienced four previous Marburg outbreaks (2007, 2012, 2014, 2017), all self-limiting, and has robust community-based filovirus surveillance structures.
There is no licensed Marburg vaccine, although candidates including mRNA-platform approaches are in early clinical development. This item is currently a watch-level item, not an active public health alert; no travel or contact precautions beyond routine hand hygiene and surveillance awareness are in effect for the general public.
The content of this article is journalistic in nature and does not constitute medical advice. Readers should consult a qualified healthcare clinician before making any changes to their treatment, vaccination schedule, or health management plan.