Research pinpoints key to the cold sore virus’s ability to evade treatment, offering broader clues on antiviral drug resistance
A 3D representation of a herpes simplex virus enzyme involved in viral replication.
« What Enables Herpes Simplex Virus To Become Impervious to Drugs?
Credit: Jonathan Abraham Lab/HMS
Newswise — All organisms — from fungi to mammals — have the capacity to evolve and adapt to their environments. But viruses are master shapeshifters with an ability to mutate greater than any other organism. As a result, they can evade treatments or acquire resistance to once-effective antiviral medications.
Is the Herpes Simplex Virus Becoming Impervious to Drugs?
Working with herpes simplex virus (HSV), a new study led by Harvard Medical School researchers sheds light on one of the ways in which the virus becomes resistant to treatment, a problem that could be particularly challenging among people with compromised immune function, including those receiving immune-suppressive treatment and those born with immune deficiencies.
Using a sophisticated imaging technique called cryogenic electron microscopy (cryo-EM), the researchers found that how parts of a protein responsible for viral replication move into different positions can alter the virus’s susceptibility to medicines.
The findings, published Aug. 27 in Cell, answer long-standing questions about why certain viruses, but not others, are susceptible to antiviral medications and how viruses become impervious to drugs. The results could inform new approaches that impede viruses’ capacity to outpace effective therapies.
Counterintuitive results
Researchers have long known changes that occur on the parts of a virus where antiviral drugs bind to it can render it resistant to therapy. However, the HMS researchers found that, much to their surprise, this was often not the case with HSV.
Instead, the investigators discovered that protein mutations linked to drug resistance often arise far from the drug’s target location. These mutations involve alterations that change the movements of a viral protein, or enzyme, that allows the virus to replicate itself. This raises the possibility that using drugs to block or freeze the conformational changes of these viral proteins could be a successful strategy for overcoming drug resistance.
“Our findings show that we have to think beyond targeting the typical drug-binding sites,” said the study’s senior author, Jonathan Abraham, associate professor of microbiology in the Blavatnik Institute at HMS and infectious disease specialist at Brigham and Women’s Hospital. “This really helps us see drug resistance in a new light.”
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The new findings propel the understanding of how alterations in the conformation of a viral protein — or changes in how the different parts within that protein move when it carries out its function — fuel drug resistance and may be relevant for understanding drug effectiveness and drug resistance in other viruses, the researchers noted.
HSV, estimated to affect billions of people worldwide, is most commonly known as the cause of cold sores and fever blisters, but it can also lead to serious eye infections, brain inflammation, and liver damage in people with compromised immunity. Additionally, HSV can be transmitted from mother to baby via the birth canal during delivery and cause life-threatening neonatal infections.
Clues on resistance rooted in structure and movement
A virus can’t replicate on its own. To do so, viruses must enter a host cell, where they unleash their replication tools — proteins called polymerases — to make copies of themselves.
The current study focused on one such protein — a viral DNA polymerase — crucial for HSV’s ability to reproduce and propagate itself. The ability to carry out its function is rooted in the DNA polymerase’s structure, often likened to a hand with three parts: the palm, the thumb, and the fingers, each carrying out critical functions.
Given their role in enabling replication, these polymerases are critical targets of antiviral drugs, which aim to stop the virus from reproducing itself and halt the spread of infection. The HSV polymerase is the target of acyclovir, the leading antiviral drug for treating HSV infection, and of foscarnet, a second-line drug used for drug-resistant infections. Both drugs work by targeting the viral polymerase but do so in different ways.
Scientists have long struggled to fully understand how alterations in the polymerase render the virus impervious to normal doses of antiviral drugs and, more broadly, why acyclovir and foscarnet are not always effective against the altered forms of the HSV polymerase.
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“Over the years, the structures of many polymerases from various organisms have been determined, but we still don’t fully understand what makes some polymerases, but not others, susceptible to certain drugs,” Abraham said. “Our study reveals that how the different parts of the polymerases move, known as their conformational dynamics, is a critical component of their relative susceptibility to drugs.”
Proteins, including polymerases, are not rigid, motionless objects. Instead, they are flexible and dynamic.Composed of amino acids, they initially fold into a steady, three‐dimensional shape known as the native conformation — their baseline structure. But as a result of various bonding and dispersing forces, the different parts of proteins can move when they come into contact with other cellular components as well as through external influences, such as changes in pH or temperature. For example, the fingers of a polymerase protein can open and close, as would the fingers of a hand.
Conformational dynamics — the ability of different parts of a protein to move — allow them to efficiently administer many essential functions with a limited number of ingredients. A better understanding of polymerase conformational dynamics is the missing link between structures and functions, including whether a protein responds to a drug and whether it could become resistant to it down the road.
Unraveling the mystery
Many structural studies have captured DNA polymerases in various distinct conformations. However, a detailed understanding of the impact of polymerase conformational dynamics on drug resistance is lacking. To solve the puzzle, the researchers carried out a series of experiments, focusing on two common polymerase conformations — an open one and a closed one — to determine how each affects drug susceptibility.
First, using cryo-EM, they conducted structural analysis to get high-resolution visualizations of the atomic structures of HSV polymerase in multiple conformations, as well as when bound to the antiviral drugs acyclovir and foscarnet. The drug-bound structures revealed how the two drugs selectively bind polymerases that more readily adopt one conformation versus another. One of the drugs, foscarnet, works by trapping the fingers of the DNA polymerase so that they are stuck in a so-called closed configuration.
Further, structural analysis paired with computational simulations suggested that several mutations that are distant from the sites of drug binding confer antiviral resistance by altering the position of the polymerase fingers responsible for closing onto the drug to halt DNA replication.
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The finding was an unexpected twist. Up until now, scientists have believed that polymerases closed partially only when they attached to DNA and closed fully only when they added a DNA building block, a deoxynucleotide. It turns out, however, that HSV polymerase can fully close just by being near DNA. This makes it easier for acyclovir and foscarnet to latch on and stop the polymerase from working, thus halting viral replication.
“I’ve worked on HSV polymerase and acyclovir resistance for 45 years. Back then I thought that resistance mutations would help us understand how the polymerase recognizes features of the natural molecules that the drugs mimic,” said study co-author Donald Coen, professor of biological chemistry and molecular pharmacology at HMS. “I’m delighted that this work shows that I was wrong and finally gives us at least one clear reason why HSV polymerase is selectively inhibited by the drug.”
Authorship, funding, disclosures
Additional authors included Sundaresh Shankar, Junhua Pan, Pan Yang, Yuemin Bian, Gábor Oroszlán, Zishuo Yu, Purba Mukherjee, David J. Filman, James M. Hogle, Mrinal Shekhar.
This work was supported by the National Institutes of Health (awards R21 AI141940 and R01 AI19838), with additional funding from a Centers for Integrated Solutions in Infectious Diseases grant.
What Enables Herpes Simplex Virus To Become Impervious to Drugs?
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There is currently no bird flu vaccine for people.
Digicomphoto/ Science Photo Library via Getty ImagesHanna D. Paton, University of Iowa
The flu sickens millions of people in the U.S. every year, and the past year has been particularly tough. Although infections are trending downward, the Centers for Disease Control and Prevention has called the winter of 2024-2025 a “high severity” season with the highest hospitalization rate in 15 years.
Since early 2024, a different kind of flu called bird flu, formally known as avian influenza, has been spreading in birds as well as in cattle. The current bird flu outbreak has infected 70 Americans and caused two deaths as of April 8, 2025. Public health and infectious disease experts say the risk to people is currently low, but they have expressed concern that this strain of the bird flu virus may mutate to spread between people.
As a doctoral candidate in immunology, I study how pathogens that make us sick interact with our immune system. The viruses that cause seasonal flu and bird flu are distinct but still closely related. Understanding their similarities and differences can help people protect themselves and their loved ones.
What is influenza?
The flu has long been a threat to public health. The first recorded influenza pandemic occurred in 1518, but references to illnesses possibly caused by influenza stretch back as as early as 412 B.C., to a treatise called Of the Epidemics by the Greek physician Hippocrates.
Today, the World Health Organization estimates that the flu infects 1 billion people every year. Of these, 3 million to 5 million infections cause severe illness, and hundreds of thousands are fatal.
Influenza is part of a large family of viruses called orthomyxoviruses. This family contains several subtypes of influenza, referred to as A, B, C and D, which differ in their genetic makeup and in the types of infections they cause. Influenza A and B pose the largest threat to humans and can cause severe disease. Influenza C causes mild disease, and influenza D is not known to infect people. Since the turn of the 20th century, influenza A has caused four pandemics. Influenza B has never caused a pandemic.
A notice from Oct. 18, 1918, during the Spanish flu pandemic, about protecting yourself from infection.Illustrated Current News/National Library of Medicine, CC BY
An influenza A strain called H1N1 caused the famous 1918 Spanish flu pandemic, which killed about 50 million people worldwide. A related H1N1 virus was responsible for the most recent influenza A pandemic in 2009, commonly referred to as the swine flu pandemic. In that case, scientists believe multiple different types of influenza A virus mixed their genetic information to produce a new and especially virulent strain of the virus that infected more than 60 million people in the U.S. from April 12, 2009, to April 10, 2010, and caused huge losses to the agriculture and travel industries.
Both swine and avian influenza are strains of influenza A. Just as swine flu strains tend to infect pigs, avian flu strains tend to infect birds. But the potential for influenza A viruses that typically infect animals to cause pandemics in humans like the swine flu pandemic is why experts are concerned about the current avian influenza outbreak.
Seasonal flu versus bird flu
Different strains of influenza A and influenza B emerge each year from about October to May as seasonal flu. The CDC collects and analyzes data from public health and clinical labs to determine which strains are circulating through the population and in what proportions. For example, recent data shows that H1N1 and H3N2, both influenza A viruses, were responsible for the vast majority of cases this season. Standard tests for influenza generally determine whether illness is caused by an A or B strain, but not which strain specifically.
Officials at the Food and Drug Administration use this information to make strain recommendations for the following season’s influenza vaccine. Although the meeting at which FDA advisers were to decide the makeup of the 2026 flu vaccine was unexpectedly canceled in late February, the FDA still released its strain recommendations to manufacturers.
The recommendations do not include H5N1, the influenza A strain that causes avian flu. The number of strains that can be added into seasonal influenza vaccines is limited. Because cases of people infected with H5N1 are minimal, population-level vaccination is not currently necessary. As such, seasonal flu vaccines are not designed to protect against avian influenza. No commercially available human vaccines currently exist for avian influenza viruses.
How do people get bird flu?
Although H5N1 mainly infects birds, it occasionally infects people, too. Human cases, first reported in 1997 in Hong Kong, have primarily occurred in poultry farm workers or others who have interacted closely with infected birds.
Initially identified in China in 1996, the first major outbreak of H5 family avian flu occurred in North America in 2014-2015. This 2014 outbreak was caused by the H5N8 strain, a close relative of H5N1. The first H5N1 outbreak in North America began in 2021 when infected birds carried the virus across the ocean. It then ripped through poultry farms across the continent.
The H5N1 strain of influenza A generally infects birds but has infected people, too.NIAID and CDC/flickr, CC BY
In March 2024, epidemiologists identified H5N1 infections in cows on dairy farms. This is the first time that bird flu was reported to infect cows. Then, on April 1, 2024, health officials in Texas reported the first case of a person catching bird flu from infected cattle. This was the first time transmission of bird flu between mammals was documented.
As of March 21, 2025, there have been 988 human cases of H5N1 worldwide since 1997, about half of which resulted in death. The current outbreak in the U.S. accounts for 70 of those infections and one death. Importantly, there have been no reports of H5N1 spreading directly from one person to another.
Since avian flu is an influenza A strain, it would show up as positive on a standard rapid flu test. However, there is no evidence so far that avian flu is significantly contributing to current influenza cases. Specific testing is required to confirm that a person has avian flu. This testing is not done unless there is reason to believe the person was exposed to sick birds or other sources of infection.
How might avian flu become more dangerous?
As viruses replicate within the cells of their host, their genetic information can get copied incorrectly. Some of these genetic mutations cause no immediate differences, while others alter some key viral characteristics.
Influenza viruses mutate in a special way called reassortment, which occurs when multiple strains infect the same cell and trade pieces of their genome with one another, potentially creating new, unique strains. This process prolongs the time the virus can inhabit a host before an infection is cleared. Even a slight change in a strain of influenza can result in the immune system’s inability to recognize the virus. As a result, this process forces our immune systems to build new defenses instead of using immunity from previous infections.
Reassortment can also change how harmful strains are to their host and can even enable a strain to infect a different species of host. For example, strains that typically infect pigs or birds may acquire the ability to infect people. Influenza A can infect many different types of animals, including cattle, birds, pigs and horses. This means there are many strains that can intermingle to create novel strains that people’s immune systems have not encountered before – and are therefore not primed to fight.
It is possible for this type of transformation to also occur in H5N1. The CDC monitors which strains of flu are circulating in order prepare for that possibility. Additionally, the U.S. Department of Agriculture has a surveillance system for monitoring potential threats for spillover from birds and other animals, although this capacity may be at risk due to staff cuts in the department.
These systems are critical to ensure that public health officials have the most up-to-date information on the threat that H5N1 poses to public health and can take action as early as possible when a threat is evident.Hanna D. Paton, PhD Candidate in Immunology, University of Iowa
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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(Family Features) Throughout history, humans’ ability to rely on one another has been crucial to survival. Despite modern developments that help individuals live with minimal human engagement, the human need to connect remains.
However, in many parts of America, a trend toward isolation is emerging. Over the past two decades, people are spending more time alone and less time engaging with others in person, according to data from the Office of the U.S. Surgeon General. One segment of Americans at particular risk of social isolation, loneliness and their negative impacts are select populations who live in rural areas.
“There is an urgent need to take action and improve mental health in rural America,” said Jeff Winton, dairy farmer and founder and chairman of Rural Minds, a nonprofit mental health advocacy organization that partnered with Pfizer to raise awareness about the physical and mental risks of social isolation. “Challenges to mental health can be inherent in a rural lifestyle, including a belief in self-reliance as a virtue, fear of judgment and difficulty getting an appointment with a limited number of mental health professionals, among others.”
Many Americans are increasingly spending more time alone according to the American Time Use Survey. They are increasingly more likely to take meetings, shop, eat and enjoy entertainment at home, making it easier for them to stay within their own four walls and avoid social interactions.
Authentic human connection is a basic but often unacknowledged necessity for health, “as essential to survival as food, water and shelter,” according to the U.S. Surgeon General’s Advisory on the Health Effects of Social Connection and Community.
Understanding Social Isolation
According to the Centers for Disease Control and Prevention (CDC), about one-third of U.S. adults reported feeling lonely and about one-fourth said they don’t have social and emotional support (the basis of social isolation).
The concepts of social isolation and loneliness can go hand-in-hand, but the two are actually quite different.
Social isolation is defined by an absence of relationships or contact with others. Someone experiencing loneliness may or may not have social connections, but lacks feelings of closeness, support or belonging. Despite the distinction, both can have a negative impact on a person’s mental and even physical health.
Several factors can influence a person’s risk for social isolation and loneliness.
“Social connection is a dynamic that changes over time,” said Nikki Shaffer, senior director, occupational health and wellness, Pfizer. “Transient feelings of loneliness or solitude may be beneficial because they can serve as motivation to reconnect. However, chronic loneliness (even if someone is not isolated) and isolation (even if someone is not lonely) can represent significant health concerns.”
Isolation in Rural America
Compared to people who live in urban areas, many rural Americans experience higher rates of depression and suicide but are less likely to access mental health care services, according to the “Health Disparities in Rural America: Current Challenges and Future Solutions” study published in “Clinical Advisor.” What’s more, CDC data shows suicide rates among people living in rural areas can be 64-68% higher than those in large urban areas.
Rural areas have 20% fewer primary care providers compared to urban areas, according to a report in JAMA, and the Health Resources and Services Administration reports more than 25 million rural Americans, more than half of rural residents, live in mental health professional shortage areas.
Among rural counties, 65% lack a psychiatrist. Nearly 30% of rural Americans don’t have internet access in their homes, which complicates the option for telehealth. These figures from Rural Minds exemplify the challenges facing rural America.
“Some people in rural communities still don’t understand or accept that mental illness is a disease,” said Winton, who grew up on a rural farm. “Rather, a mental illness can often be viewed as a personal weakness or character flaw. A lot of the stigma around mental illness results in unwarranted shame, which adds to the burden for someone already suffering from mental illness.”
Health Impacts of Social Isolation
Loneliness is far more than just a bad feeling; it harms both individual and societal health. In fact, loneliness and social isolation can increase the risk for premature death by 26% and 29%, respectively.
Lacking social connection can increase the risk for premature death as much as smoking up to 15 cigarettes a day or drinking six alcoholic drinks daily.
In addition, poor or insufficient social connection is associated with increased risk of disease, including a 29% increased risk of heart disease and a 32% increased risk of stroke.
Social isolation is also associated with increased risk for anxiety, depression and dementia. Additionally, a lack of social connection may increase susceptibility to viruses and respiratory illness.
Learn more about the impact of social isolation, especially on residents of rural areas, and the steps you can take to reduce isolation and loneliness by visiting ruralminds.org.
Boost Your Social Connections
Take a proactive approach to combatting social isolation and loneliness with these everyday actions that can promote stronger social ties.
Invest time in nurturing your relationships through consistent, frequent and high-quality engagement with others. Take time each day to reach out to a friend or family member.
Minimize distractions during conversation to increase the quality of the time you spend with others. For instance, don’t check your phone during meals with friends, important conversations and family time.
Seek out opportunities to serve and support others, either by helping your family, co-workers, friends or people in your community or by participating in community service.
Be responsive, supportive and practice gratitude. As you practice these behaviors, others are more likely to reciprocate, strengthening social bonds, improving relationship satisfaction and building social capital.
Participate in social and community groups such as religious, hobby, fitness, professional and community service organizations to help foster a sense of belonging, meaning and purpose.
Seek help during times of struggle with loneliness or isolation by reaching out to a family member, friend, counselor, health care provider or the 988 crisis line.
(Family Features) Many people don’t think much about whether their blood is clotting properly. However, when you have a bleeding disorder, a condition that affects the way your body controls clots, it’s no small matter.
According to the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, abnormal clotting can lead to a host of problems, including excessive bleeding after an injury or during surgery.
About 3 million people in the U.S. have bleeding disorders. Some types, such as hemophilia, are inherited, meaning a person who has it is born with it. Inherited bleeding disorders are caused by certain genes passed down from parents to children. These genes contain instructions for how to make proteins in the blood called clotting factors, which help blood clot. If there is a problem with one of these genes, such as a mutation – a change in the gene’s instructions – the body may make a clotting factor incorrectly or not make it at all.
You can also have what’s called an acquired bleeding disorder, meaning you develop it during your lifetime. Acquired bleeding disorders can be caused by medical conditions, medicines or something unknown. Your risk of developing a bleeding disorder depends on your age, family history, genes, sex, or other medical conditions. If bleeding disorders run in your family, you may have a higher risk of developing or inheriting one.
Symptoms of a bleeding disorder may appear soon after birth or develop later in life and can include:
Excessive bleeding or bruising, such as frequent or long nose bleeds (longer than 15 minutes) or frequent or long menstrual periods
Petechiae, which are tiny purple, red, or brown spots caused by bleeding under the skin
Redness, swelling, stiffness, or pain from bleeding into muscles or joints
Blood in urine or stool
Excessive umbilical stump bleeding
Excessive bleeding during surgery or after trauma
If you believe you, or someone you care for, may have a bleeding disorder, talk to a health care provider. Your provider may make a diagnosis based on symptoms, risk factors, family history, a physical exam, and diagnostic tests. Health care providers typically screen for bleeding disorders only if you have known risk factors or before certain surgeries.
How your bleeding disorder is treated depends on its type. If your disorder causes few or no symptoms, you may not need treatment. If you have symptoms, you may need daily treatment to prevent bleeding episodes, or you may need it only on certain occasions, such as when you have an accident or before a planned surgery.
If you have been diagnosed with a bleeding disorder, it’s important to be proactive about your health and follow your treatment plan. To lower your risk of complications:
A Story of Bravery, Balance, and a Bleeding Disorder
There are lots of things that make Mikey White Jr. special. He’s a dedicated athlete. He’s determined, disciplined, and optimistic. He’s also living with hemophilia, a type of bleeding disorder.
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White was diagnosed with hemophilia at age 3 after experiencing several severe bleeding episodes. He had to give up baseball and basketball, his passions, because of the high risk of injuries, but he found competitive swimming – and he’s been breaking records ever since.
“Competitive swimming is a noncontact sport, so it complements my hemophilia while still being an intense and rigorous sport,” White said.
Being an athlete with hemophilia requires support, White admits. He works with his healthcare team and coaching staff to make sure he safely manages his condition and balances it with his training. He hopes his story encourages others living with bleeding disorders to accept and appreciate their bodies the way they are.
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Hanna D. Paton, PhD Candidate in Immunology, University of Iowa
This article is republished from The Conversation under a Creative Commons license. Read the original article.
(Family Features) Throughout history, humans’ ability to rely on one another has been crucial to survival. Despite modern developments that help individuals live with minimal human engagement, the human need to connect remains.
However, in many parts of America, a trend toward isolation is emerging. Over the past two decades, people are spending more time alone and less time engaging with others in person, according to data from the Office of the U.S. Surgeon General. One segment of Americans at particular risk of social isolation, loneliness and their negative impacts are select populations who live in rural areas.
“There is an urgent need to take action and improve mental health in rural America,” said Jeff Winton, dairy farmer and founder and chairman of Rural Minds, a nonprofit mental health advocacy organization that partnered with Pfizer to raise awareness about the physical and mental risks of social isolation. “Challenges to mental health can be inherent in a rural lifestyle, including a belief in self-reliance as a virtue, fear of judgment and difficulty getting an appointment with a limited number of mental health professionals, among others.”
Many Americans are increasingly spending more time alone according to the American Time Use Survey. They are increasingly more likely to take meetings, shop, eat and enjoy entertainment at home, making it easier for them to stay within their own four walls and avoid social interactions.
Authentic human connection is a basic but often unacknowledged necessity for health, “as essential to survival as food, water and shelter,” according to the U.S. Surgeon General’s Advisory on the Health Effects of Social Connection and Community.
Understanding Social Isolation
According to the Centers for Disease Control and Prevention (CDC), about one-third of U.S. adults reported feeling lonely and about one-fourth said they don’t have social and emotional support (the basis of social isolation).
The concepts of social isolation and loneliness can go hand-in-hand, but the two are actually quite different.
Social isolation is defined by an absence of relationships or contact with others. Someone experiencing loneliness may or may not have social connections, but lacks feelings of closeness, support or belonging. Despite the distinction, both can have a negative impact on a person’s mental and even physical health.
Several factors can influence a person’s risk for social isolation and loneliness.
“Social connection is a dynamic that changes over time,” said Nikki Shaffer, senior director, occupational health and wellness, Pfizer. “Transient feelings of loneliness or solitude may be beneficial because they can serve as motivation to reconnect. However, chronic loneliness (even if someone is not isolated) and isolation (even if someone is not lonely) can represent significant health concerns.”
Isolation in Rural America
Compared to people who live in urban areas, many rural Americans experience higher rates of depression and suicide but are less likely to access mental health care services, according to the “Health Disparities in Rural America: Current Challenges and Future Solutions” study published in “Clinical Advisor.” What’s more, CDC data shows suicide rates among people living in rural areas can be 64-68% higher than those in large urban areas.
Rural areas have 20% fewer primary care providers compared to urban areas, according to a report in JAMA, and the Health Resources and Services Administration reports more than 25 million rural Americans, more than half of rural residents, live in mental health professional shortage areas.
Among rural counties, 65% lack a psychiatrist. Nearly 30% of rural Americans don’t have internet access in their homes, which complicates the option for telehealth. These figures from Rural Minds exemplify the challenges facing rural America.
“Some people in rural communities still don’t understand or accept that mental illness is a disease,” said Winton, who grew up on a rural farm. “Rather, a mental illness can often be viewed as a personal weakness or character flaw. A lot of the stigma around mental illness results in unwarranted shame, which adds to the burden for someone already suffering from mental illness.”
Health Impacts of Social Isolation
Loneliness is far more than just a bad feeling; it harms both individual and societal health. In fact, loneliness and social isolation can increase the risk for premature death by 26% and 29%, respectively.
Lacking social connection can increase the risk for premature death as much as smoking up to 15 cigarettes a day or drinking six alcoholic drinks daily.
In addition, poor or insufficient social connection is associated with increased risk of disease, including a 29% increased risk of heart disease and a 32% increased risk of stroke.
Social isolation is also associated with increased risk for anxiety, depression and dementia. Additionally, a lack of social connection may increase susceptibility to viruses and respiratory illness.
Learn more about the impact of social isolation, especially on residents of rural areas, and the steps you can take to reduce isolation and loneliness by visiting 
