TIME Mental Health/Psychology

Most People With Depression Aren’t Getting Treatment, Survey Finds

The latest depression report shows that the majority are suffering in silence

The latest statistics on depression in the U.S. don’t paint a picture of progress, though the condition is common. Nearly 8% of Americans over age 12 have recently been depressed, finds the new report from the National Center for Health Statistics (NCHS) at the Centers for Disease Control and Prevention, but the vast majority aren’t actively getting treatment.

Of those surveyed between 2009 and 2012, about 3% with depression reported having severe symptoms, and nearly all of these people (90%) said their depression made it difficult to work, go to school or participate in their normal activities at home and in other social settings.

Women are more likely than men to be depressed at any age, and women between 40 and 59 years old had the highest rates of depression among the adults studied. While the survey did not delve into the possible reasons for depression, other studies suggest that for many women in this age group, the pressures of balancing work and family responsibilities, including children as well as aging parents, may lead to added mental health burdens.

Poverty seems to be a factor in depression as well. Those living below the federal poverty level were more than twice as likely to be depressed than those living above the line; this trend applied regardless of race or ethnicity.

But what was most concerning to study co-author Laura Pratt, an epidemiologist at the NCHS, was that 65% of people with severe symptoms of depression were not getting help from a mental health professional. “The fact that people aren’t getting treatment is disturbing,” she says. “People with severe depression should be getting therapy from a mental health professional, and they should also in a lot of cases be on a more complicated medication regimen that requires a psychiatrist to treat them. The fact that only 35% have seen a mental health professional in the last year was pretty alarming.”

The data should raise awareness about the prevalence of depression, she says, and hopefully stress the importance of encouraging those with depression to seek help. “It’s serious, it really affects your life and we need to figure out a way to get people treated appropriately,” she says.

TIME Diet/Nutrition

This Diet Has Been Linked to a Longer Life—Again

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Mediterranean include fresh fruits and vegetables, beans, olive oil and moderate amounts of wine Image Source—Getty Images/Image Source

Fruits, vegetables, beans, grains, fish and olive oil help cells stay biologically young

It’s no coincidence that some of the world’s populations with the longest lifespans live along the Mediterranean coast. The climate there ensures that foods like fruits, vegetables, olives, beans and fish are abundant, which are all rich in the antioxidants that can combat aging triggered by pollution and stress. They’re also powerful fighters against the inflammation driving so many chronic diseases, from heart disease to cancer.

Now, a new study published in the BMJ gives more meat to the biological connection between longevity and the Mediterranean diet. Researchers studied 4,676 women enrolled in the Nurses’ Health Study, an ongoing trial tracking the health and habits of more than 120,000 registered nurses in the U.S. since 1976. The team, led by Immaculata De Vivo, associate professor of medicine at Harvard Medical School and Brigham and Women’s Hospital, found that women who ate a Mediterranean diet had cells that were different from those who ate diets that were heavier in red meats and dairy products. The Mediterranean fans had longer telomeres, bits of DNA located at the tips of chromosomes, in their cells. Telomeres shorten every time a cell divides; they shrink by half from infancy to adulthood, and again by half among the elderly. Previous studies have linked longer telomeres to longer life and shorter telomeres to shorter lifespans.

MORE: Eat Better and Stress Less: It’ll Make Your Cells (and Maybe You) Live Longer

Even after De Vivo and her colleagues adjusted for other factors that could affect telomere length, including age, smoking status and physical activity, the link between the Mediterranean diet and longer telomeres remained strong,

“Our contribution is that we provide a link at the molecular level, at the DNA level, of the association between the Mediterranean diet and longevity and beneficial health effects,” says De Vivo.

And it wasn’t any one element of the Mediterranean diet that was primarily responsible for effect. “We didn’t find that any single component was driving the association,” she says. “It was the entire package, the pattern of eating itself.”

MORE: How to Live 100 Years

That makes sense, since each of the hallmarks of the diet—from fish to olive oil to moderate amounts of alcohol—are strong antioxidants that can fight the oxidative damage connected with aging. Together, it’s possible that the synergistic effect is beneficial for longevity.

It’s also a lesson that diet alone won’t help you live to old age. “I think nothing by itself will do anything. But a good healthy diet that’s good for you and that tastes good, physical activity, and not smoking—I think the whole composite is beneficial,” says De Vivo.

TIME

Here’s How to Remove Ebola Waste From a Hospital

Officials at the University of Nebraska, which treated Ebola patients, issues a case study in how to get rid of Ebola waste

When treating Ebola patients, hospitals have more than their patients and workers to protect. It’s their responsibility to properly dispose of anything involved in caring for the patients that might be contaminated—and that includes liquid waste, protective equipment, anything used in the lab, linens, towels, pillows, mattresses and even the curtains used in the patient’s room.

In the latest issue of the American Journal of Infection Control, John Lowe, associate director of research from the Nebraska Biocontainment Unit at the Nebraska Medical Center, describes how the team there disposed of waste generated while two patients recovered from their infections there. Some of the procedures in place, Lowe says, go beyond the guidelines set by the Centers for Disease Control and Prevention (CDC). The report will undoubtedly be studied by the 35 hospitals that the CDC designated on Dec. 2 as Ebola treatment centers across the nation.

“A number of things came up that surprised us and that we felt really needed to be shared with our colleagues,” he says.

The first of those was the sheer volume of waste generated by each Ebola patient. The group calculated that each patient treated at the Nebraska facility created about 1,010 pounds of solid waste, most of it in the form of personal protective equipment (PPE) — the hoods, face shields, suits and foot covers that doctors and nurses wear. That equipment, as well as towels and linens used for bedding, created around four to eight large bags of waste a day.

Lowe says that the group decided to treat liquid waste generated by the patients even more stringently than required by the CDC. “The lion’s share of calls we took from groups both within our facility and from outside the facility were concerns about exactly what we were doing with all that liquid waste,” he says.

CDC guidelines say that normal waste treatment chemicals in toilets are sufficient to kill Ebola. But the unit’s director Philip Smith and Lowe had two concerns. In the event that the toilets backed up, potentially infectious material could flood into the patient rooms and possibly into other pipes in the hospital as well. Public health groups also wanted assurances that the waste would not be contaminating facilities outside of the hospital. So Smith decided to take extra measures by treating the toilets in the patient’s room with hospital-grade disinfectant. Normally it takes four minutes to sterilize the waste, but to be safe, all Ebola patients’ waste was held in this sterilizing solution for 2.5 times the recommended time before it was flushed.

Flushing, says Smith, is preferable to storing the waste in a separate container and then autoclaving the contents. “You could end up having containers full of liquid that are difficult and hazardous to work with,” he says.

The bags of solid waste, meanwhile, were tied and taped closed, then doused with bleach and handled in very strict ways by workers in full PPE. The Nebraska biocontainment unit is intentionally designed to have its own decontaminating autoclave inside the unit, so soiled waste does not have to be removed from the premises. While Ebola-related waste requires special sterilization and decontamination procedures, it can be turned into normal medical waste that can be disposed of in the hopsital’s normal ways.

MORE: 12 Answers to Ebola’s Hard Questions

To do that, health care workers send the bags into a sterilizing room. Each bag is handled at arm’s length so the workers don’t get contaminated by virus that may be on the bag and so that workers who may have virus on their PPE don’t contaminate the bags further. The bags are then treated with high temperatures and sterilizing chemicals. Once decontaminated, the bags are placed into another bag and into a watertight container and marked as biohazardous material. In this state, the waste can be disposed of as any other hospital waste in the proper medical waste removal sites.

So far, those strategies are working. Two Ebola patients, Ashoka Mukpo and Dr. Richard Sacra, were treated there and recovered, and no health care workers were infected with the virus.

TIME ebola

Here Are The 35 U.S. Hospitals Approved To Treat Ebola

Emory University Hospital in Atlanta, seen in august 2014.
Emory University Hospital in Atlanta, seen in August 2014. Jessica McGowan—Getty Images

These treatment centers are specially equipped to care for Ebola patients

The Centers for Disease Control (CDC) has designated 35 hospitals across the U.S. as Ebola treatment centers: facilities that will take in Ebola patients from wherever they first present and provide the more intensive care in isolation wards that the cases require.

The hospitals were evaluated by the CDC’s Rapid Ebola Preparedness team, and staff were trained in infection control, use of personal protective equipment and removal of waste from patient rooms. The CDC reviewed 50 hospitals in 15 states.

About 80% of people entering the U.S. from the affected West African countries live within 200 miles of one of the centers, according to the agency. Every person returning from these regions is required to take their temperature daily for 21 days, the incubation period for the virus. More than 3,000 travelers have been monitored by the CDC and state health departments since the program was implemented in November.

More Ebola treatment centers may be added in coming weeks, but for now, here is a list of the approved facilities:

  • Kaiser Oakland Medical Center; Oakland, California
  • Kaiser South Sacramento Medical Center; Sacramento, California
  • University of California Davis Medical Center; Sacramento, California
  • University of California San Francisco Medical Center; San Francisco, California
  • Emory University Hospital; Atlanta, Georgia
  • Ann & Robert H. Lurie Children’s Hospital of Chicago; Chicago, Illinois
  • Northwestern Memorial Hospital; Chicago, Illinois
  • Rush University Medical Center; Chicago, Illinois
  • University of Chicago Medical Center; Chicago, Illinois
  • Johns Hopkins Hospital; Baltimore, Maryland
  • University of Maryland Medical Center; Baltimore, Maryland
  • National Institutes of Health Clinical Center; Bethesda, Maryland
  • Allina Health’s Unity Hospital; Fridley, Minnesota
  • Children’s Hospitals and Clinics of Minnesota; St. Paul, Minnesota
  • Mayo Clinic Hospital; Minneapolis, Minnesota
  • University of Minnesota Medical Center, West Bank Campus, Minneapolis;Rochester, Minnesota
  • Nebraska Medicine; Omaha, Nebraska
  • North Shore System LIJ/Glen Cove Hospital; Glen Cove, New York
  • Montefiore Health System; New York City, New York
  • New York-Presbyterian/Allen Hospital; New York City, New York
  • NYC Health and Hospitals Corporation/HHC Bellevue Hospital Center; New York City, New York
  • Robert Wood Johnson University Hospital; New Brunswick, New Jersey
  • The Mount Sinai Hospital; New York City, New York
  • Children’s Hospital of Philadelphia; Philadelphia, Pennsylvania
  • Hospital of the University of Pennsylvania; Philadelphia, Pennsylvania
  • University of Texas Medical Branch at Galveston; Galveston, Texas
  • Methodist Hospital System in collaboration with Parkland Hospital System and the University of Texas Southwestern Medical Center; Richardson, Texas
  • University of Virginia Medical Center; Charlottesville, Virginia
  • Virginia Commonwealth University Medical Center; Richmond, Virginia
  • Children’s Hospital of Wisconsin, Milwaukee; Milwaukee, Wisconsin
  • Froedtert & the Medical College of Wisconsin—Froedtert Hospital, Milwaukee; Milwaukee, Wisconsin
  • UW Health—University of Wisconsin Hospital, Madison, and the American Family Children’s Hospital, Madison; Madison, Wisconsin
  • MedStar Washington Hospital Center; Washington, DC
  • Children’s National Medical Center; Washington DC
  • George Washington University Hospital; Washington DC
TIME

Ebola Vaccine Is Safe and Effective, According to First Study

Trials of a vaccine against Ebola show that it is safe and able to trigger an immune response against the virus

In the first results from tests on an experimental Ebola vaccine, researchers at the National Institute of Allergy and Infectious Diseases (NIAID) report for the first time Wednesday that the shot is safe and that it leads to an immune response among healthy volunteers. The vaccine, developed by the National Institutes of Health and GlaxoSmithKline, was tested in 20 participants in the US at the NIH Clinical Center in Bethesda.

“This tells us that this is kind of a positive signal about moving to the next stage,” says Dr. Anthony Fauci, director of NIAID.

MORE: We’re Getting Closer to Vaccines and Drugs for Ebola

The vaccine is meant to protect uninfected people from Ebola, and, if effective, would be tested next in populations in high-risk areas such as west Africa, where the outbreak is ongoing, to immunize them against the virus. It does not contain live Ebola virus, but does contain snippets of its protein coat, just enough to alert the immune system to produce antibodies and immune cells that can recognize and destroy any live viruses that people might eventually encounter. The pieces of Ebola protein are introduced to the body via another virus, one related to the common cold that infects chimps.

The shot was tested in two doses among 10 people each; it triggered antibodies and immune cells that in primate studies were enough to protect them against a challenge of Ebola up to 10 months later. Whether that’s also the case among people won’t be known until the vaccine is tested among thousands more in west Africa, including health care workers and family members of ill patients, who are most vulnerable to getting exposed to the virus.

Only two people reported brief fevers after getting vaccinated.

MORE: Here’s How the Ebola Vaccine Trial Is Doing

The vaccine is one of two that scientists are preparing to test in the outbreak zone beginning in early 2015. Another candidate uses an entirely different approach involving a live Ebola virus that has been crippled so it can’t reproduce once it infects a person. The advantage to that system is that it might launch a stronger and more robust immune response than the NIAID and GSK shot, which may require a boost after several months to maintain strong immune protection against Ebola. “At the end of the day, you don’t know which is the most effective until you test them, and that’s the point,” says Fauci.

TIME

When the Heart Stops Beating, Advanced Care Might Not Be Better

Heart with coronary vessels
Getty Images

To restart a heart, a high-tech response doesn't mean better results

When emergency medical responders receive a call that someone’s heart has stopped, standard practice is to send the best help available: a truck equipped with a team trained in provide everything needed for advanced life support, from administering an IV drip to inserting a breathing tube down a person’s airway to get air into their lungs.

But in a study published in JAMA Internal Medicine, researchers led by Prachi Sanghavi, a PhD candidate in health policy at Harvard University, found that the more advanced teams and trucks didn’t always lead to better outcomes for patients. In fact, when people whose hearts had stopped received care from basic life support—oxygen via masks and life-support interventions like chest compressions with automatic defibrillators—they survived more often after getting to the hospital than those receiving advanced life support. Sanghavi and her colleagues, who included physicians at Massachusetts General Hospital, found that those receiving basic life support were 43% more likely to survive and be discharged from the hospital than those getting more advanced care by emergency teams. That pattern held even after 90 days.

MORE: Cardiac Arrest Patients Need CPR, Not Hospitals, Doctor Says

People who got basic life support also showed fewer effects on brain function compared to those who received the more sophisticated care. Only 21% of those admitted after getting basic life support showed poor brain functioning on tests of brain injury, compared to nearly 45% among those getting the higher tech services.

Why does the more advanced care lead to worse outcomes? Sanghavi says that the study, which looked at Medicare claim data for people having out-of-hospital cardiac arrest, did not collect data on the experience levels of the emergency medical responders, but they did account for potential influences such as the patients’ previous heart health history. She notes that the data involved only patients whose hearts had stopped, and not those who had a heart attack, in which blocked vessels may cause the heart to beat irregularly but continue to function.

MORE: New CPR Rules: Pump First, and Save the Breaths for Later

Researchers found that basic life support teams might be able to bring patients to the hospital more quickly because they aren’t equipped to do much in the way of treating patients in the field. “One argument is that the time it takes to provide interventions in the field isn’t worth it when the hospital is not far away,” says Sanghavi. The study looked only at urban or suburban areas where hospitals are relatively close by.

Data also shows that hospital staff may be more experienced at performing advanced life support techniques like inserting breathing tubes and setting IVs, so fewer complications may arise. Some previous studies found that emergency responders only perform about one intubation a year, a procedure that may require more practice to be performed well. “It’s the kind of thing you want to keep up with, and do all the time to be good at,” says Sanghavi.

MORE: New CPR Guidelines: Hands Only

Advanced life support teams are able to provide more potentially lifesaving drugs to patients, including those that may open up blockages or restart the heart. But using such drugs properly requires knowing exactly what caused the heart to stop, something that’s not always obvious to those working in an emergency situation in the field. “There are treatments that would get at the underlying cause of cardiac arrest that we would never provide in the field,” Sanghavi says.

Based on their data, Sanghavi’s team believes that the priority for patients whose hearts have stopped should be to transport them as quickly as possible to a hospital. For that, an advanced life support team—which is more expensive and may even end up doing more harm than good—may not be necessary. “We believe the priority should be to provide basic life support principles of rapid transport, because it doesn’t seem like advanced life support is doing any better,” she says.

TIME Aging

Why Complex Jobs Protect Aging Brains Better

The more engaging your job, the sharper your thinking skills

Studies show that there are a lot of things you can do to preserve your intellect—stay social and interact with as many friends and family as you can, learn new things (especially languages), go to new places and stay physically active. If there’s any time left over, consider getting a more engaging career. There’s now evidence that what you do to make a living can also help to preserve your brain power.

Reporting in the journal Neurology, scientists at the University of Edinburgh found that the more complex a person’s job is, the more likely they are to score higher on memory tests and general cognitive skills when they reach age 70.

MORE: Cocoa May Help With Memory Loss, a New Study Finds

The team recruited about 1,000 69-year-olds who were part of the Lothian Birth Cohort, a database that included people born in the Scottish town in 1936. At age 11, the participants had taken IQ tests so the researchers could compare those scores to cognitive tests given to them at age 70.

In the study, researchers assessed their occupations by their complexity, based on how much interaction with people, data or things the job required. Complex “people” jobs, for example, include lawyer, social worker, surgeon or probation officer, compared to less socially complex jobs like factory worker, or painter. Complex “data” occupations include architect, graphic designer and musician, while less complex data jobs include construction worker, cafeteria worker or telephone operator. Finally, people working in more intricate ways with “things” would include machine workers and those who make instruments, while bank managers and surveyors might rank as having simpler interactions with things.

When the scientists compared occupations with cognitive tests at age 70, they found that people with more complex people and data jobs scored higher on memory, speed and general thinking skills than those with less involved jobs in these areas. People with more complex data-related jobs also scored much better on processing and speed skills.

MORE: 5 Secrets to Improve Learning and Memory

But when the researchers factored in the effect of the participants’ IQ at age 11—in other words, their starting intellect—they found that the influence of the jobs remained, though it shrunk a bit. “People who have higher cognitive ability to begin with are those more likely to have more complex jobs,” says Alan Gow, assistant professor of psychology at University of Edinburgh and Heriot-Watt University and one of the study’s co-authors. “Once we account for that, the association between more complex jobs and better cognitive outcomes is reduced, but there remains a small additional benefit for our cognitive abilities from being in more complex jobs.”

In fact, he says, the strongest predictor of cognitive abilities at age 70 is intellect earlier in life. So the IQ of the participants at age 11 accounted for about 50% of the variance in test scores when they reached 70. Jobs can add to that effect. The stronger the cognitive starting point, the more brain reserve people might have as the normal processes of aging start erode some nerve connections involved in higher order thinking. Having a complex job that requires constant activation of these neural networks, and formation of new connections, can also contribute to building this reserve capacity.

Gow admits, however, that the study did not take into account how long people stuck with the jobs, so there may yet be a stronger effect of occupation on later life intellect the longer people stay with a complex job. Given the results, he and his team are eagerly following the 70-year olds to see if occupation and other factors can influence their cognitive functions. Now, they’re studying brain images of the volunteers to find changes in volume in certain thinking areas of the brain, as well as connections in the nerve network that’s responsible for higher order skills like processing, memory and reasoning.

TIME Sex/Relationships

Science Proves It: Men Really Do Find High Heels Sexier

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Women: wear these and you're more likely to get help from men J.B.C.—Getty Images/Flickr RF

They’re bad for the feet and bad for the back, but high heels do wonders for sex appeal

Cue a collective sigh from women everywhere: a new study in the journal Archives of Sexual Behavior proves that men really do find women in high heels significantly sexier.

Study author Nicholas Gueguen in the department of social behavior at the University of Bretagne conducted three experiments using French women identically dressed in black suits with straight skirts and white shirts. Most were also all brunettes: because previous studies showed that men were more likely to approach blonde women over brunettes and ask them out on dates. The only differences between the women were their shoes.

In the series of experiments, Gueguen dangled the women as science bait in front of unsuspecting men.

First, the women—wearing either black flats with no heel, black shoes with a 2 inch heel or black pumps with a 3.5 inch heel—approached several people and asked them for assistance. The woman switched shoes after soliciting every 10 people.

MORE: ‘Stiletto Whisperer’ Teaches Women To Walk In High Heels

When a 19-year-old woman approached men between ages 25 and 50, asking for their help with a survey on gender equality, she garnered the most responses when she wore the highest heels—83% of the men she approached agreed to spend three to four minutes answering her questions, compared to nearly half as many, 47%, when she wore flat shoes. Not terribly surprising.

But would women react the same way to fellow sisters in high heels? To find out, four women asked both men and women to participate in a food survey about what they ate. Again, men were more likely to respond when the women wore higher heels—82% agreed to do the survey when the women wore 3.5 inch heels, compared to 42% who did when they wore flats. But ladies didn’t fall for it. Only about 33% of women on average said yes to the survey request, regardless of the heel height.

Why were men more receptive to the women in high heels? To test the obvious attraction hypothesis, Gueguen told the women to find “marks” and walk ahead of them, then drop a glove. A whopping 93% of men chased after the women when they wore high heels to return the glove, compared to 62% of those who did when she wore flat shoes. And while women were also more likely to track down the high-heeled women than those wearing flats, the rates were much lower—52% for the heel wearers and 43% for the flats wearers.

MORE: Skinny Jeans and High Heels: What Health Dangers Lurk in Your Closet?

For the grand finale, researchers wanted to see if high heels could actually make men more likely to pursue the wearers as mates. They strategically placed women wearing different heel heights in three bars, seating them at tables near the bar where their shoes were visible to those standing at the counter and perusing the field. On average, it took men only 7.49 minutes to approach women wearing the high heels. For those wearing flat shoes, it took nearly twice as long—13.54 minutes.

All of this confirms that men tend to use physical attributes as a way to gauge women’s attractiveness and to find potential mates. It’s not exactly a revelation; Gueguen found in a previous study that female hitchhikers with bigger breasts get picked up more often by male drivers. But now, science gives some credibility to the seemingly illogical (and unhealthy) choice to endure pinched toes and vertiginous heights. “As a man I can see that I prefer to see my wife when she wears high heels and many men in France have the same evaluation,” Gueguen writes in an email response.

MORE: Can High Heels Trigger Migraines?

What exactly is so sexy about high heels? Gueguen blames (or credits) the media for its strong imagery association between stilettos and sexiness. And yes, higher heels can change the way a woman walks, making her hips sway a bit more as she negotiates walking at a more precarious height, but in the study, even women who were seated and wearing heels were approached by more men. And Gueguen’s follow-up studies, in which he showed men photos of women wearing heels or flats, confirmed that there was more to the attraction than a woman’s gait. “The results showed that high heels were associated with greater sexiness, overall physical attractiveness, breast attractiveness, beauty, attractiveness to other men, and willingness for a date,” he writes. Now, whether you want to be approached or left blissfully alone, there’s a shoe height for that.

TIME medicine

‘Bubble Boy’ Disease Cured With Stem Cells

Alysia Padilla-Vacarro and daughter Evangelina on the day of her gene therapy treatment. Evangelina, now two years old, has had her immune system restored and lives a healthy and normal life.
Alysia Padilla-Vacarro and daughter Evangelina on the day of her gene therapy treatment. Evangelina, now two years old, has had her immune system restored and lives a healthy and normal life. Courtesy of UCLA

Researchers have treated more than two dozen patients with a treatment made from their own bone marrow cells

Alysia Padilla-Vaccaro and Christian Vaccaro owe their daughter’s life to stem cells. Evangelina, now two, is alive today because she saved herself with her own bone marrow cells.

Evangelina, a twin, was born with a severe immune disorder caused by a genetic aberration that makes her vulnerable to any and all bacteria and viruses; even a simple cold could be fatal. But doctors at University of California Los Angeles (UCLA) Broad Stem Cell Research Center gave her a new treatment, using her own stem cells, that has essentially cured her disease. She’s one of 18 children who have been treated with the cutting-edge therapy, and the study’s leader, Dr. Donald Kohn, says that the strategy could also be used to treat other gene-based disorders such as sickle cell anemia.

Known to doctors as adenosine deaminase (ADA)-deficient severe combined immunodeficiency (SCID), it’s better known as “bubble boy” disease, since children born with the genetic disorder have immune systems so weak that they need to stay in relatively clean and germ-free environments. Until Evangelina and her sister Annabella were 11 months old, “We were gowned and masked and did not go outside,” says their mother Alysia Padilla-Vaccaro. “Our children did not physically see our mouths until then because we were masked all the time. We couldn’t take them outside to take a breath of fresh air, because there is fungus in the air, and that could kill her.”

Both parents wore masks at work to lower the chances they would be exposed to germs that they might bring back home. And they took showers and changed clothes as soon as they entered the house.

MORE: Gene-Therapy Trial Shows Promise Fighting ‘Bubble Boy’ Syndrome

SCID is caused by a genetic mutation in the ADA gene, which normally produces the white blood cells that are the front lines of the body’s defense against bacteria and viruses. The Vaccaros decided to treat Annabella in the same way that they cared for Evangelina; “They were crawling and playing with each other, and every toy they sucked on, they stuck in each other’s hands and each other’s mouth, so we couldn’t take one outside to have a grand old time and potentially bring something back that could harm her sister,” says Padilla-Vaccaro.

Christian and Alysia Padilla-Vaccaro and their healthy twins Annabella (left) and Evangelina. Now with a newly-restored immune system, Evangelina lives a normal and healthy life. Courtesy of UCLA

The only treatments for SCID are bone marrow transplants from healthy people, ideally a matched sibling; the unaffected cells can then repopulate the immune system of the baby with SCID. But despite being her twin, Annabella wasn’t a blood match for her sister, nor were her parents. Padilla-Vaccaro and her husband, Christian, were considering unrelated donors but were concerned about the risk of rejection. “We would be trying to fix one problem and getting another,” she says.

MORE: Stem Cells Allow Nearly Blind Patients to See

That’s when the doctors at the Children’s Hospital at Orange County, where Evangelina was diagnosed, told her parents about a stem cell trial for SCID babies at UCLA, led by Dr. Donald Kohn. “As soon as they said trial, I thought, ‘my kid is dead,” says Padilla-Vaccaro of the last resort option. But a dozen children born with other forms of SCID—in which different mutations caused the same weak immune systems—who were successfully treated by Kohn convinced the couple that the therapy was worth trying. Kohn had one spot left in the trial and was willing to hold it for Evangelina until she matured more. Born premature, she was diagnosed at six weeks old and needed more time for what was left of her immune system to catch up to weather the procedure.

When she was two months old, Evangelina was admitted to UCLA and had bone marrow drawn from her tiny hip. It contained the stem cells that go on to develop into all of the cells in the blood and immune systems. Kohn treated them with gene therapy, co-opting a modified virus to carry the healthy ADA gene so it could infect the stem cells from Evangelina’s bone marrow. The idea was that by transplanting these healthy ADA-containing cells back into Evangelina, she would soon be making her own healthy immune cells. And because they were made from her own cells, her body wouldn’t reject them.

MORE: Woman Receives First Stem Cell Therapy Using Her Own Skin Cells

“After the transplant of this miraculous tube of stem cells, which literally took five minutes, we had to just wait and see for a good six weeks,” says Padilla-Vaccaro. “The week after Christmas [in 2012], Dr. Kohn came in and told me, ‘It worked.’ It worked. Those words…besides the birth of my children, that day will always be the best day in my life.”

The success was a long time coming for Kohn as well. His group has been researching the best way to treat SCID with gene therapy for more than two decades. In the first trial, in 1993, they used cord blood, treating it with the healthy ADA gene and hoping enough of them would “take” to rebuild an immune system. It didn’t work.

In 2001, they tried a different way of delivering the precious gene in four patients. That failed as well.

MORE: Type 1 Diabetes Treatment Gets Boost from Stem Cells

Then, in 2009, he and his team began the trial that Evangelina eventually joined. After reading about a group in Italy that completely obliterated the patients’ existing immune systems with chemotherapy first, before introducing the new bone marrow cells to repopulate the system, Kohn tried that strategy on 10 babies. “Of all the patients we treated, all have had good immune reconstitution,” he says. “Within a month or two, we start seeing cells appear in the blood that are making the missing gene. When they are six months old or so, their immune systems are good enough for them to go out and not be protected, and by age two, they are pretty stable—their immune systems are reset.”

That’s where Evangelina is now, able to finally enjoy the world outside her home and the hospital. She got her first kisses from her parents when she was 18 months old. “My worry was that I couldn’t raise my daughter without her sister,” says Padilla-Vaccaro. “Now I don’t have to.”

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