TIME ebola

Mali Minister of Health Confirms First Ebola Case

First case is a 2-year-old

Mali’s Minister of Health said the country has its first case of Ebola in a tweet Thursday.

The patient is reportedly a two-year-old girl who recently came into the country from Guinea, Reuters reported. The country borders Guinea, where the Ebola outbreak started. Mali is one of the first countries to start experimental vaccine trials.

TIME Heart Disease

How Mindfulness Protects Your Heart

Mauro Speziale—Getty Images

Tuning in to your body is good for your health

Self-aware people have better heart health, a new study suggests.

People who are mindful score higher on healthy heart indicators, according to recent findings published in the International Journal of Behavioral Medicine from Brown University researchers. The team looked at whether having something called “dispositional mindfulness”—which means you’re the type of person who’s very aware and attentive to what you’re feeling and thinking at any given moment—was a factor for heart health. They found a pretty significant connection: people with high mindfulness scores had an 83% greater prevalence of good cardiovascular health.

Having dispositional mindfulness doesn’t necessarily mean you’re regularly practicing mindfulness processes, like meditation. For some people, being more present is a natural part of their personality. For the rest of us, some say, it can be learned.

In the study, the researchers asked 382 people to evaluate statements that measure their level of mindfulness. Participants responded to statements like “I find it difficult to stay focused on what’s happening in the present”on a six point scale ranging from “almost always” to “almost never.” The participants who scored highest with the best mindfulness scores also had very healthy scores when it came to the seven American Heart Association indicators for cardiovascular health. Those include avoiding smoking, being physically active, having a healthy body mass index, consuming decent amounts of fruits and vegetables, and maintaining good cholesterol, blood pressure and fasting blood glucose levels.

The associations appeared to be strongest with factors including smoking, BMI, fasting glucose and physical activity. “The society we live in right now is very promoting of cardiovascular disease…cigarettes are still pretty inexpensive, and jobs are sedentary,” says study author Eric Loucks, an assistant professor in epidemiology at Brown University. “People who are more mindful tend to have more awareness of where their mind and bodies are at. By increasing our awareness, we might become more aware of the impact of what we are doing on ourselves.” If a mindful person is less physically active, Loucks suggests, they might notice that they have less energy.

Mindfulness-Based Stress Reduction has been taught in some medical settings for years, and Loucks points out that mindfulness scores tend to go up with the practice. “It does seem like mindfulness can be taught,” he says. “I think it’s good for it to be available for people who are interested in it…we shouldn’t force people to go mindfulness [training] if they don’t want to go. But it has the potential to be a resource.”

The findings are still preliminary, and the reasons for the connection are still inconclusive. But if corroborated, mindfulness interventions may be non-invasive ways to help people adopt healthier behaviors.

TIME ebola

Health Care Worker Rushed to New York City Hospital for Ebola Tests

New York's Bellevue Hospital Prepares For Possible Ebola Cases
Bellevue Hospital is viewed following a news conference on how the facility would receive a suspected Ebola patient on October 8, 2014 in New York City. Spencer Platt—Getty Images

Patient rushed to Bellevue Hospital

A health care worker who recently returned to the United States from one of the three West African countries hardest hit by the Ebola outbreak was rushed to New York City’s Bellevue Hospital Thursday to undergo testing for the virus. Results of that test are expected within 12 hours, the City said Thursday.

The patient, who was experiencing fever and gastrointestinal symptoms, was transported to Bellevue by a specially-trained team wearing personal protective equipment. Given the health care worker’s recent travel history, the Centers for Disease Control and Prevention and the New York City Department of Health concluded that he should undergo Ebola testing, though he’s also being tested for more common illnesses like Malaria.

The patient recently worked with Doctors Without Borders, and contacted the group Thursday morning to report a fever, the organization confirmed. “As per the specific guidelines that Doctors Without Borders provides its staff on their return from Ebola assignments, the individual engaged in regular health monitoring and reported this development immediately,” Doctors Without Borders said in a statement sent to TIME.

Disease detectives from the City’s Health Department have already started actively tracing the patient’s contacts as a precaution. They will notify and isolate anyone at potential risk of contracting Ebola.

New York City previously designated Bellevue Hospital to receive any Ebola patients that should enter the city. Bellevue has also been preparing to accept Ebola patients from other hospitals if need be. New York City hospitals in general have been preparing and drilling for the possibility of a patient with Ebola since August, most recently by holding an an Ebola education session for over 5,000 local health care workers on Tuesday.

This is the second time New York City has seen a potential case of Ebola. In the first case, a patient at Mount Sinai Hospital wound up testing negative for the virus.

 

TIME Infectious Disease

University of Maryland Confirms Meningitis Cases

The University of Maryland has confirmed an unknown number of meningitis cases among its students.

“There are confirmed and suspected cases of viral meningitis and viral syndromes on campus, and they are being tracked carefully by the University Health Center in partnership with the Prince George’s County Health Department,” University Health Center Director Dr. David McBride told CBS News Thursday. “We have reached out to the organizations that are primarily affected with information about the condition and what to do in the event that they are feeling unwell.”

Viral meningitis is less severe than bacterial meningitis, but it can still cause stiff necks, nausea and fever. There’s no specific medication for the illness, but most people recover within seven to 10 days. Hospitalization may be necessary in particularly severe cases.

College students are thought to be at a greater risk for viral meningitis than the general population due to the closeness of college life, like sharing cups, living with roommates and eating in dining halls.

[CBS]

TIME Obesity

The Link Between Weight Loss Surgery and Headaches

Weight loss surgery may be a risk factor for a specific kind of headache, according to a new study published in the journal Neurology.

Researchers looked at 338 patients with a history of spontaneous intracranial hypotension—headaches typically caused by a cerebrospinal fluid leak—and found that 11 of those patients had undergone a form of bariatric surgery. Though 11 people, 3.3% of the sample, is a seemingly small number and certainly not enough to change clinical practice, it was still significant enough for the researchers to warn physicians of the possible relationship.

If someone is experiencing spontaneous intracranial hypotension, they typically feel a headache when they are upright, and the pain goes away when they lie horizontal. That’s due to the leaking spinal fluid, which can cause pain, nausea and neck stiffing. Body weight is thought to play a role in cerebrospinal fluid pressure, and it’s possible, the study authors suggest, that fat tissue loss may increase susceptibility to the headaches.

“It’s important for people who have had bariatric surgery and their doctors to be aware of this possible link, which has not been reported before,” said study author Wouter I. Schievink, MD, of Cedars-Sinai Medical Center in Los Angeles, in a press release. “This could be the cause of sudden, severe headaches that can be treated effectively, but there can be serious consequences if misdiagnosed.”

TIME ebola

Ebola Survivor Speaks Out: ‘Blessed to Be Alive’

American video journalist Ashoka Mukpo at an iron ore mining camp in Bong County, Liberia in Aug. 2013
American video journalist Ashoka Mukpo at an iron ore mining camp in Bong County, Liberia in Aug. 2013 Philip Marcelo—AP

Ebola survivor and NBC freelancer Ashoka Mukpo says “today is a joyful day,” in a statement he released Wednesday about his recovery.

Mukpo, who was infected with Ebola while working in Liberia, was evacuated to Nebraska Medical Center for treatment. “I owe this staff a debt I can’t ever repay,” said Mukpo in a statement.

The fact that Mukpo was able to be treated in America is a circumstance that weighs on him, he writes: “I feel profoundly blessed to be alive, and in the same breath aware of the global inequalities that allowed me to be flown to an American hospital when so many Liberians die alone with minimal care.” He thanked everyone from the United States State Department, to Doctors Without Borders to NBC.

He paid a special thanks to fellow survivor Dr. Kent Brantly, who donated blood to Mukpo. “May his health flourish and his compassion be known to all,” said Mukpo.

Mukpo was declared free of Ebola and released from the hospital on Oct. 21. It’s unclear how exactly he was infected with the disease. Mukpo says he plans to discuss his experience in writing, and will talk to media, but for now he is spending time with his family and asks for privacy.

You can read his full statement here.

TIME ebola

All Travelers Coming to U.S. From Ebola-Hit Countries Will Be Monitored

New York's JFK Airport Begins Screening Passengers For Ebola Virus
People arrive at the international arrivals terminal at New York's John F. Kennedy Airport (JFK ) airport on October 11, 2014 in New York City. Spencer Platt—Getty Images

Travelers will be monitored for 21 days upon arrival in the U.S.

All travelers entering the United States from Liberia, Guinea, and Sierra Leone will now be actively monitored for Ebola-like symptoms by state and local health officials for 21 days upon landing in the U.S., the Centers for Disease Control and Prevention announced on Wednesday. Those three West African countries are the hardest-hit by a recent outbreak of the deadly disease, and about 150 people travel from them to the U.S. every day.

CDC Director Dr. Tom Frieden announced the new program as the U.S. began requiring travelers from those three countries to arrive in the country through one of five airports performing intensive screening procedures. The new monitoring program will start on Monday in New York, Pennsylvania, Maryland, Virginia, New Jersey and Georgia, the six states where most travelers from the three countries end their trips.

When travelers from the three West African countries arrive in the U.S., they will be given an explanatory kit that includes a thermometer and will be asked to provide two email addresses, two telephone numbers, a home address and an address for the next 21 days. They will also need to provide the same information for a family member or friend. Travelers will be asked to report to a public health worker from a state or local health department daily, providing a temperature as well as well reporting any symptoms. They must also inform officials if they plan to travel, and if so, they must coordinate their tracking their symptoms with health officials.

“We have to keep up our guard against Ebola,” said Frieden, adding that it’s the “CDC’s mission is to protect Americans.”

 

TIME ebola

More Than 5,000 Health Care Workers Attend Ebola Training

CDC and Mount Sinai health workers demonstrate how to put on and off Ebola personal protective equipment at an Ebola education session in New York City Alexandra Sifferlin

"We are having a family meeting"

More than 5,000 health care and hospital infection control workers gathered at the Javits Center in New York City for an Ebola education session amid growing concern among hospital workers over Ebola preparedness.

“We are having a family meeting,” Kenneth Raske, president of the Greater New York Hospital Association (GNYHA) told TIME. “The turnout is spectacular. We may not answer every question [today], but we are committed to finding the answers.”

The event, which was streamed live nationwide, featured Centers for Disease Control (CDC) experts offering live trainings on how to safely care for patients with Ebola. It was hosted by the Healthcare Education Project from GNYHA/1199SEIU and Partnership for Quality Care.

New York governor Andrew Cuomo helped kick off the event, touting New Yorkers’ resilience and ability to always “rise to the occasion” from 9/11 to Hurricane Sandy. “We have a new challenge we must meet today,” said Cuomo. New York City Mayor Bill de Blasio also made an appearance, thanking health care workers.

“Regardless of immigration status, we will help them all,” said de Blasio, referring to the possibility of patients with Ebola coming into a New York City emergency room.

The session included a hands-on demonstration of personal protective equipment (PPE) led by Dr. Bryan Christensen of the CDC’s domestic infection control team for the Ebola response. On Oct. 20, the CDC revised its guidelines for Ebola-related care, recommending full-coverage PPE and supervision while taking PPE on and off.

Christensen supervised registered nurse Barbara Smith of Mount Sinai Health System as she demonstrated how to put on and take off all the pieces of PPE: sanitizing her hands, putting on her first set of gloves, sitting in a chair to put on her foot covers, donning her suit—and finally doing a little jig, to audience laughter, once she was completely suited. Afterward, she took off each piece, sanitized her gloves numerous times and checked for any holes. The entire process took 15 to 20 minutes, which the CDC said cannot be rushed.

Over 5,000 health care workers gather in the Javtis Center in New York City to attend an Ebola education session. Alexandra Sifferlin

CDC officials also reviewed Ebola care protocols in detail, from what to wear and how to discard linens (they can’t be washed) to the way hands should be washed and how to use an alcohol rub to clean gloves before removing them, something that is not usually part of standard procedure. For respiratory protection, the CDC recommends either a powered air purifying respirator (PAPR) or a disposable respirator like N95. Emory University Hospital uses the former; the Nebraska Medical Center uses the latter. “When we use equipment we are not used to, it makes it difficult,” said CDC’s Dr. Arjun Srinivasan. “The way we address this is practice, practice, practice.”

Massive education sessions like this have been held before over health threats like anthrax, H1N1 and smallpox. “We had to have this in a convention center to accommodate folks,” George Gresham, president of 1199SEIU United Healthcare Workers East told TIME. “Back in the 80s when the AIDS epidemic first started, I was a health care worker myself, and it was the unknown that was the mystery, and the fear, and I think that’s the same here. “

The massive number of health care workers that crowded into the conference center proves that they crave more education about caring for potential Ebola patients. Even though some states, including New York, are identifying specific hospitals that will take in any Ebola patients for actual care, all health facilities have to be prepared for the possibility that a patient like Thomas Eric Duncan could walk through their doors.

The hope is that the session was helpful and positive. “I think this is another moment we can calm the public and reassure the public of health care workers’ commitment,” Gresham said.

TIME Addiction

The Genetic Reason Why Some Drinkers Can’t Stop

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Chris Clor—Getty Images/Blend Images

A new study in mice looks at the link between genetics, alcohol and the brain

Around 10% of people will develop alcohol disorders, and a new study in mice shows that having a specific genetic strand might be the reason some escalate from moderate to excessive drinkers.

Previously, scientists at the University of California, San Francisco showed that moderate drinking activates a protein in the brain called brain-derived neurotrophic factor (BDNF), which might protect against drinking too much.

In the new study published in the journal Molecular Psychiatry, they study what happens when that threshold into excessive drinking is crossed. When mice consumed generous amounts of alcohol for a long period of time—mimicking the human act of binge drinking—their levels of the protective protein BDNF decreased significantly in a part of their brains where decision-making occurs. One possible reason for this decline, the scientists discovered, was a corresponding increase in genetic material microRNA, including miR-30a-5p.

When the researchers increased miR-30a-5p in the mice brains themselves, BDNF went down and mice wanted to drink more, preferring alcohol to water. When the scientists inhibited the miR-30a-5p, the brains returned to normal, and so did the drinking behaviors of the mice.

Though mice studies can’t translate directly to humans, the researchers think a similar situation may be happening in human brains during alcohol consumption, and that perhaps certain people are genetically susceptible, as other research has also suggested. The researchers hope their findings will provide better data for alcoholism therapies.

TIME ebola

CDC Changes Ebola Guidelines

CDC EBOLA TRAINING
Licensed clinician Hala Fawal practices drawing blood from a patient using a dummy on Monday, Oct. 6, 2014, in Anniston, Ala. Brynn Anderson—AP

Now recommending full-coverage for health care workers

Health care workers treating Ebola patients must now wear full-body coverage suits with no skin showing and must undergo significant training prior to treating patients, U.S. health officials said Monday.

“We may never know exactly how [the Dallas infections happened], but the bottom line is the guidelines didn’t work for that hospital,” Dr. Tom Frieden, director of the Centers for Disease Control and Prevention (CDC), said during a news conference announcing the new guidelines for caring for Ebola patients and wearing personal protective equipment (PPE). Prior to the three Ebola infections in Dallas, including two health care workers, the CDC did not recommend full body coverage for Ebola, but instead recommended at least gloves, a gown, eye protection and a face mask. That has changed, in light of the two health care worker infections at Texas Health Presbyterian Hospital.

The new guidelines have three additions:

1. Prior to working with Ebola patients, health care workers must be repeatedly trained and demonstrate competency in treating a patient with Ebola, especially putting on and taking off PPE. “Facilities need to ensure all healthcare providers practice numerous times to make sure they understand how to appropriately use the equipment,” the CDC said in a statement.

2. When wearing PPE, no skin can be exposed. The CDC is providing two options for the PPEs, since the University of Nebraska Medical Center and Emory University Hospital, which have both successfully treated Ebola patients, use different versions. Googles are no longer recommended. The recommendations for PPE are now the following:

  • Double gloves
  • Boot covers that are waterproof and go to at least mid-calf or leg covers
  • Single use fluid resistant or imperable gown that extends to at least mid-calf or coverall without intergraded hood.
  • Respirators, including either N95 respirators or powered air purifying respirator (PAPR)
  • Single-use, full-face shield that is disposable
  • Surgical hoods to ensure complete coverage of the head and neck
  • Apron that is waterproof and covers the torso to the level of the mid-calf should be used if Ebola patients have vomiting or diarrhea

3. Every step of putting on and taking off PPE must be supervised by a trained observer. There should also be designated areas for where PPE are taken on and off.

“It’s hard to care for Ebola, so every aspect… needs to be overseen,” said Frieden in the press conference, adding that hospitals should limit personnel in health care rooms and should limit procedures to only those that are essential.

The CDC is increasing health care worker training across the country as well as sending out training videos, but Frieden argues that there is no alternative for hands-on training, especially taking on and off PPEs. “We agree with the concern of health care workers,” said Frieden citing anxiety from health care workers nationwide that they felt unprepared for treating patients with Ebola. The new recommendations will be effective immediately, though the CDC does not have the regulatory authority to make hospitals follow the guidelines, Frieden said. The recommendations should be available online later Monday evening.

Earlier on Monday, a Dallas County Judge confirmed that 43 of 48 contacts of Thomas Eric Duncan were considered no longer at risk after the 21-day incubation period passed, and Nigeria was declared Ebola-free.

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