TIME ebola

This Might Be Why Some Survive Ebola

A new mice study may help explain Ebola's varying impacts

Scientists in a biosafety level 4 lab have discovered that genetics are likely involved in how susceptible someone is to Ebola, finds a new mice study published in the journal Science.

Why some people survive Ebola and others do not, even when they’re treated in the same conditions, is a question that’s long intrigued researchers. The current outbreak has also revealed that humans show symptoms of the disease differently; a significant number do not present hemorrhagic fever symptoms like heavy diarrhea, vomiting and bleeding before death.

So far, researchers have primarily used monkeys to study the Ebola virus, but in the new study, the researchers discovered that a genetically diverse population of mice had wide variations in their responses and symptoms to the Ebola virus—similar to how humans have reacted. It’s notable because mice very rarely have similar immune responses to humans, which is why discoveries made in mouse models are evaluated skeptically.

When the researchers infected the mice with Ebola, they found that some of the mice survived with mild disease symptoms, some died, and some died with severe hemorrhagic fever symptoms similar to those observed in humans. Researchers Michael G. Katze and Angela L. Rasmussen of the University of Washington also identified a few potential genetic pathways that might differ in mice who survive the disease versus those who die from it. The hope is that these pathways could help researchers develop drugs for the disease.

“We now have a model that represents the human Ebola disease that we could test vaccines in, we could test novel therapeutics in, and we also could start getting information about the genes that are responsible for the resistance to Ebola and the susceptibility to Ebola,” said Katze in a video about the study. Before the researchers can make the leap to developing drugs for humans, they will have to confirm that the pathways also exist in humans and work in the same way. But the new research is a starting point.

The team started studying the progression of the Ebola virus in mice a few years ago, before the current outbreak of Ebola started in West Africa. Only a handful of of scientists work in the few high-security containment labs in the United States. The training, Katze told TIME, is intense and requires psychological testing. “We’ve been studying Ebola for almost a decade. We’ve always been interested in Ebola because it’s a very interesting virus. It’s like the rockstar of viruses,” Katze told TIME in early October.

Read on for more about the scientists’ emerging Ebola research.

TIME Diet/Nutrition

Here’s Another Reason to Try the Mediterranean Diet

Mediterranean diet
Getty Images

Bring on the nuts and veggies

The Mediterranean diet, high in vegetables, nuts and healthy fats like olive oil, has once again proven itself worthy of our plates.

People who maintained a version of the Mediterranean diet had a 50% lower risk of developing chronic kidney disease and a 42% lower risk of rapid kidney function decline, according to a new study published in the Clinical Journal of the American Society of Nephrology. Over about seven years, researchers scored 900 participants’ diets on a scale based on how closely their eating habits resembled the Mediterranean diet. They found that every one-point increase in Mediterranean diet score was linked to a 17% decrease in their likelihood of developing chronic kidney disease—a disease that afflicts around 20 million Americans.

Though the researchers are not entirely certain why the Mediterranean diet is successful in warding off kidney disease, they believe it might have to do with the diet’s effects on inflammation in the kidney cells and the lining inside the heart and blood vessels. Past research has shown that the Mediterranean diet has positive effects on inflammation and blood pressure, which in turn benefits the kidneys.

The Mediterranean diet has been shown consistently to benefit the body; studies suggest it can keep you healthy in old age, ward off memory loss, fight diabetes, and lower risk of heart attacks, stroke, and childhood asthma. Of course, no diet is a cure-all, especially if it’s not accompanied by other healthy behaviors like exercising, drinking in moderation, and avoiding smoking. Still, the Mediterranean diet is certainly a good place to start.

TIME ebola

California Orders Ebola Quarantine for Some Travelers

The state describes it as a "flexible, case-by-case approach"

California ordered a 21-day quarantine Wednesday for travelers who have had contact with confirmed Ebola patients.

The state said the quarantine order requires local counties to individually assess people at risk for Ebola and assign an “appropriate level of quarantine.” Those who are at a high risk, defined by the state as people who had contact with an Ebola patient, will be put in a 21-day quarantine.

“Although quarantine can involve isolation at home, it may be tailored to allow for greater movement of individuals who are deemed to be at lower risk,” the California Department of Public Health said.

California’s move follows similar quarantine orders from New York, New Jersey and Illinois, measures that have been criticized by health experts—and by President Barack Obama—as putting fear over science and potentially hampering efforts to contain the outbreak that has killed thousands in West Africa by making it harder for aid workers to travel there and back.

The state said local health officials have the authority to order the quarantine of people who may have an infectious disease that’s a public health threat.

“This flexible, case-by-case approach will ensure that local health officers throughout the state prevent spread of the disease,” the department said, “while ensuring that individuals at risk for Ebola are treated fairly and consistently.”

TIME Autism

Major Autism Studies Identify Dozens of Contributing Genes

Researchers collaborate on two large studies identifying the genetic basis of autism

Two new studies exploring the genetic basis of autism tie mutations in hundreds of genes to the disease.

Several teams of researchers collaborated on the studies, both published in the journal Nature, and found that about 60 of the genes are considered “high confidence,” meaning there’s a 90% chance that mutations within those genes contribute to risk for autism. Both studies show through genomic sequencing that many of these mutations are de novo, meaning that parents do not have the gene mutation, but they present spontaneously just before a child is conceived in either the sperm or egg.

It’s long been believed that autism is genetic, but a lack of large studies and advanced genomic sequencing has precluded any sort of consensus about what genes might be at play. But in the last couple years, scientists have been able to look at the genetic mutations in hundreds of people with autism and identify genes that likely factor into a child’s development of the disorder. In the two new studies, scientists were able to expand their work and look at thousands of people.

In one of the studies, several institutions used data from the Simons Simplex Collection (SSC), which is a collection of DNA samples from 3,000 families. In each of the families, one individual had autism. The researchers compared the gene sequences of the individual with autism to their unaffected family members. After analysis, they estimated that de novo mutations contribute to autism in at least 27% of families, where only one member has the disorder.

The other study, by researchers at 37 different institutions as part of the Autism Sequencing Consortium, looked at 14,000 DNA samples of parents with affected children. It found 33 genes the researchers say definitely increase risk for autism, should there be a mutation.

Even though there may be hundreds or even thousands of genes that contribute to a child’s risk of developing autism, the researchers on both studies found that the mutations appear to converge on a much smaller number of biological functions, like nerve-cell communication or proteins known to cause inherited disability. “In my view, the real importance of these studies is not diagnosis, and it’s not figuring out exactly what percentage of people have de novo mutations, it’s about laying the foundation to transform the understanding of the biological mechanisms of autism,” says Dr. Matthew State, chair of the psychiatry department at University of California, San Francisco and a co-leader of the SSC study, as well as a senior participant on the other study.

State doesn’t believe that the findings will mean that families will one day get their genomes sequenced to spot hundreds of possible mutations. Instead, they could lay the groundwork for discovering how autism develops, and what potential treatments, or even drugs, could help fight it.

TIME ebola

U.S. Health System Is Not Ready for Ebola, Report Says

"Many health systems are already overwhelmed"

The United States health care system is vastly unprepared to handle Ebola should the virus spread, according to a new report.

An investigation of emergency preparedness by the Associated Press reveals the country is not ready to handle the disease even on a smaller scale, nor is it equipped to handle the spread of other infectious diseases that are airborne, like a new flu strain or SARS.

“Even though there have been only a couple cases, many health systems are already overwhelmed,” Dr. Kenrad Nelson, a professor at Johns Hopkins Bloomberg School of Public Health, told the AP.

Experts say it’s unlikely that Ebola will spread widely in the U.S.

Read more at the Associated Press

TIME ebola

Scientists Explore 10,000 Compounds for an Ebola Drug

Emory Hospital To Receive American Ebola Patients From Liberia
Dr. Bruce Ribner an epidemiologist and professor in the School of Medicine's Infectious Diseases Division, confirms that Emory University Hospital will be receiving and treating two American patients diagnosed with Ebola virus during a press conference at Emory University Hospital on Aug. 1, 2014 in Atlanta. Jessica McGowan—Getty Images

"Scientists are the only ones who can initiate solving this problem"

Emory University is becoming a one-stop shop for tackling Ebola. The hospital’s infectious disease team has already treated four patients with Ebola, and now a team of biochemists known for their work on HIV wants to take on Ebola.

Scientists at Emory’s Children’s Center for Drug Discovery have extensively studied the development of drugs for HIV that stop the replication of the virus in the body. The center provided breakthroughs for HIV drug development and, more recently, the development of a drug for Hepatitis C. The viruses, though different, have similar replicating mechanisms (viral RNA replication), and now they think they can do it for Ebola.

The team, led by director Baek Kim, is fast-tracking a program to screen a library of over 10,000 chemical compounds that can treat viruses at the molecular level to see if one or more of them may show promise with Ebola. “We need to start screening many, many compounds,” says Kim, anywhere from 500 to 10,000 of them—each of which will be evaluated one by one. Emory chemist Raymond F. Schinazi, who discovered compounds used in multiple very successful anti-HIV drugs, will be working with five to 10 virologists, chemists and biochemists to get the job done.

And if a compound that can treat Ebola is identified and tested on a live virus in a lab, the next step would be to get that compound into a drug of some kind, and then test it in a clinical trial in West Africa.

And while there are ongoing trials in the works for an Ebola vaccine and industry and scientists are racing to find drugs that can treat the virus, Kim’s team and several other research groups nationwide have been eyeing emerging and re-emerging diseases for years. “It’s good to recognize that scientists are the only ones who can initiate solving this problem,” says Kim. “Other pathogens will emerge and re-emerge one day or another, and this is a good exercise in how academics, government and industry can work together toward a single target when we need a fast response.”

TIME ebola

Dallas Nurse Released from Hospital After Beating Ebola

"I am so thankful"

A Dallas nurse who contracted Ebola while caring for the first patient diagnosed with the virus in the U.S. was declared free of the disease Tuesday and released from the hospital.

“As a nurse, and now as someone who knows what its like to be cared for in a life-threatening illness, I am so thankful,” Amber Vinson, 29, told reporters as she was discharged from Emory University Hospital in Atlanta. Vinson had cared for Thomas Eric Duncan, the first U.S. patient, who later died.

“After a rigorous course of treatment and thorough testing we have determined that Ms. Vinson has recovered from her infection with Ebola virus, and she can return to her family community and her life without any concerns,” said Dr. Bruce Ribner, the head medical director of Emory’s Serious Communicable Disease Unit. “We are pleased for Ms. Vinson’s recovery and thankful for the opportunity to apply our training, care, and experience in meeting her medical needs.”

Vinson also thanked missionaries Dr. Kent Brantly and Nancy Writebol, who also survived Ebola, for their donations of blood plasma to herself and other patients with Ebola, an experimental treatment that might have contributed to her recovery.

“Nurses are on the front lines 24 hours a day,” Ribner said. “We must not let fear get in the way of our primary mission which is caring for patients with serious disease such as Ebola virus infection.”

The hospital said last week that the virus was no longer detectible in Vinson’s blood, but that she was being kept in the hospital for continued supportive care. Vinson is the fourth patient treated by Emory, which has a specialized unit for Ebola care that has been hailed as a national model. So far all four patients treated at the hospital have survived, including Brantly and Writebol.

TIME ebola

CDC Issues New Guidelines for Returning Health Workers

Tom Frieden
Dr. Tom Frieden, head of the Centers for Disease Control and Prevention, speaks at a news conference in Atlanta on Oct. 12, 2014 John Amis—AP

Travelers coming to the U.S. from Ebola-affected countries who do not require mandatory quarantines upon arrival will undergo voluntary at-home isolation and could be placed on “do not board” lists, according to new guidelines released by the Centers for Disease Control and Prevention (CDC) on Monday.

The CDC’s new guidelines break down travelers’ risk level into categories: high risk, some risk, low risk and no risk.

People who fall into the high-risk category are those who had direct contact with Ebola patients in West Africa, and who may be at a high risk for infection. For instance, they handled bodily fluids without protection. Those individuals will be asked to isolate themselves in their homes for 21 days. They would be allowed to leave and go out on a jog, for example, but they would not be allowed to take public transportation or go to places with high volumes of people or “congregate gatherings.” They will undergo active monitoring.

People who fall under the “some risk” category would have their temperatures checked twice a day, and their travel and public activities will be assessed on a case-by-case basis. This distinction might apply to a health care worker who did not have direct contact with patients, or who had direct contact but used personal protective equipment fastidiously.

These guidelines are a marked departure from the sweeping quarantine mandate that Florida, Illinois, New Jersey and New York implemented over the last week, stirring up controversy after a recently returned nurse who tested negative for the virus protested her forcible detainment in New Jersey.

When asked why CDC recommendations differ from some states, CDC director Dr. Tom Frieden said, “We find that state health departments generally do follow CDC guidelines.” He added that if states wish to be more stringent, they’re within their rights to do so.

Frieden said fewer than 100 people a day are coming into the U.S. from the Ebola-affected countries. So far there have been 807 people, and of those, 46 are health care workers. The CDC has already instituted daily monitoring for travelers coming in from the Ebola-affected countries. Every traveler is given a kit to take their temperatures and must provide local health care officials with contact information to get in touch with them.

“We base our decisions on science and experience,” said Frieden. “As the science and experience changes, we adapt.” Frieden also acknowledged the active monitoring approach that Doctors Without Borders has urged its physicians to follow. Dr. Craig Spencer is the first Doctors Without Borders worker to be diagnosed with the disease in the U.S., but was immediately quarantined after he reported the first sign of an infection (a lower-grade fever). “This is the kind of approach that they will be effective,” said Frieden.

During the press conference, Frieden cited a 1995 study conducted in what is now the Democratic Republic of the Congo that looked at the Ebola infection risk of 173 people living within a household of someone with Ebola. The study showed that only 28 (16%) of the 173 contacts of 27 primary Ebola cases developed Ebola, and those who did develop Ebola had direct contact with a known patient. None of the 78 family members who did not have direct contact later became infected, stressing that Ebola needs very direct contact to spread.

“We will only get to zero risk by stopping it at the source,” said Frieden.

On Monday, New Jersey Governor Chris Christie said health care worker Kaci Hickox was released after being put in a mandatory quarantine despite not having any symptoms for the disease.

TIME ebola

5-Year-Old Tests Negative for Ebola in NYC

The child is being held at the same hospital as Doctors Without Borders physician Dr. Craig Spencer

A five-year-old boy put in isolation at Bellevue Hospital in New York City Monday has tested negative for Ebola.

The child was taken to the hospital by specialists in personal protective equipment on Sunday evening to undergo monitoring for Ebola, and did not have a fever at that time. On Monday morning, the child developed a fever and the city decided to conduct a test for Ebola. The children had been in one of the three Ebola-affected countries within the last 21 days.

“Out of an abundance of caution, further negative Ebola tests are required on subsequent days to ensure that the patient is cleared,” the New York City health department said in a statement. “The patient will also be tested for common respiratory viruses. The patient will remain in isolation until all test results have returned.”

The child is being held at the same hospital as Doctors Without Borders physician Dr. Craig Spencer.

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