TIME Infectious Disease

Polio’s Two Vaccines Are More Effective When They’re Combined

For decades, there’s been a tug-of-war between the oral and inactivated polio vaccines over which is more effective at preventing the paralyzing disease. Researchers have now resolved the dispute and say that pairing them are better than either alone

When it comes to fighting a virus, having as many weapons as possible, especially in the form of vaccines that can prevent infection, is certainly welcome. And that’s always been the case with polio, which has not one but two effective immunizations that can stop the virus from causing debilitating paralysis. Which is more effective in preventing illness and which is better at stopping transmission of the virus? Scientists report in the journal Science that neither is ideal, but that together, the vaccines are powerful enough to achieve both results. The results “revolutionize our thinking about how to use polio vaccines optimally,” says Hamid Jafari, director of polio operations and research at the WHO, who led the research.

Recent efforts to erradicate polio has pitched the two vaccines against each other. Developed in the 1950s and 1960s, one was made by Jonas Salk using killed polio virus, and the other, developed by Albert Sabin, uses a weakened but still live virus that could replicate in the human gut to deliver immunity. Jafari and his colleagues, report that children vaccinated with the oral polio vaccine who then received a boost of the Salk vaccine showed the lowest amount of virus in their feces—one of the primary ways that the virus spreads from person to person—and excreted these viruses for a shorter period of time than children who had been immunized with the oral vaccine and received a boost with an additional dose of the same oral vaccine.

MORE: WHO Declares Health Emergency on Polio

The WHO’s global effort to eradicate polio has relied heavily on the oral vaccine, because it’s a liquid that can be eaily given to children orally, and it’s cheaper. Plus, the oral vaccine, because it contains a weakened virus that can reproduce in the human gut, helped to reduce the volume of virus excreted in the feces, and thus lower the chances that others coming in contact with the feces could get infected.

But in places where polio infections were rampant, such as northern India, the oral vaccines didn’t seem to be doing much good at reducing the burden of disease. Even when children were getting the recommended three doses, rates of infections remained high. “The transmission pressure was extremely high in these areas that were densely populated, had a high birth rate, poor sanitation and high rates of diarrhea,” says Jafari. In those regions, it took an additional 10 to 12 vaccination campaigns—about one a month to provide children with additional doses on top of the recommended three doses—to finally control the disease and limit spread of the virus. It turns out that the immunity provided by the oral vaccine wanes over time.

In order to eradicate the disease, public health officials knew they had to do better. So they tested whether adding in the inactivated vaccine would help. And among 954 infants and children aged five years to 10 years who had already received several doses of oral vaccine, adding a shot of the inactivated vaccine did help them to shed less virus compared to those who received another dose of the oral vaccine.

PHOTOS: Endgame for an Enduring Disease? Pakistan’s Fight Against Polio

With polio currently endemic in Pakistan, Cameroon, Equatorial Guinea, and the Syrian Arab Republic, the WHO declared the spread of polio a public health emergency of international concern, and issued temporary recommendations for all residents and long-term visitors to those countries to receive a dose of either the oral or inactivated vaccine before traveling out of the country. In other countries where polio has been found, such as in some sewage samples and fecal samples from residents in Israel, health officials have also advised residents living in those regions to receive a dose of inactivated polio vaccine in order to limit spread of the virus.

“The inactivated polio virus vaccine is becoming an important tool in preventing international spread of polio,” says Jafari. Whenever outbreaks of the disease occur, health officials are now recommending that even vaccinated individuals who could be infected but not get sick, receive an additional shot of the inactivated vaccine in order to limit the amount of virus they shed and spread to others.

TIME Diet/Nutrition

Consumer Reports Says Pregnant Women Should ‘Avoid All Tuna’

Standards For "Dolphin-Safe" Tuna Label Upheld In Federal Court
Cans of tuna are seen on a shelf August 12, 2004 in a grocery store in Des Plaines, Illinois. Tim Boyle—Getty Images

A new report analyzes the mercury levels in fish

In a new analysis of government data on mercury levels in fish, Consumer Reports suggests that pregnant women should “avoid all tuna” — particularly if it comes in a can.

Earlier this summer, the Environmental Protection Agency and Food and Drug Administration suggested that women who are pregnant, want to get pregnant, or are breast feeding should eat up to 12 ounces of fish a week. While fish can be a good source of protein and provider of nutrients, Consumer Reports released an article Thursday warning vigilance given the high mercury level in many fish, including tuna.

“We’re particularly concerned about canned tuna, which is second only to shrimp as the most commonly eaten seafood in the United States,” said Jean Halloran, director of food policy initiatives for Consumers Union, the advocacy arm of Consumer Reports, in a statement. “We encourage pregnant women to avoid all tuna.”

While Consumer Reports identified 20 seafoods that can be eaten safely several times a week, the report reads:

“Consumer Reports disagrees with the recommendations from the FDA and EPA on how much tuna women and children may eat. (We don’t think pregnant women should eat any.) We also believe the agencies do not do enough to guide consumers to the best low-mercury seafood choices. To make decisions easier for consumers, our chart below gives advice about good low-mercury choices.”

The federal agencies and Consumer Reports agree that childbearing women and small children should avoid swordfish, shark, king mackerel, and tilefish due to mercury levels.

[Consumer Reports]

TIME Infectious Disease

Americans With Ebola Discharged From Atlanta Hospital

Dr. Kent Brantly seen working at an Ebola isolation ward at a mission hospital outside of Monrovia, Liberia.
Dr. Kent Brantly seen working at an Ebola isolation ward at a mission hospital outside of Monrovia, Liberia. Getty Images

Both patients are virus-free

Updated 12:10 p.m.

Two Americans who contracted Ebola while on an aid trip in West Africa have been discharged from Atlanta’s Emory University Hospital, officials said Thursday. Dr. Kent Brantly was released Thursday, while Nancy Writebol was released Tuesday, though her discharge wasn’t publicly known until now.

Dr. Bruce Ribner, an infectious disease specialist at Emory who was leading the patients’ care, said his team determined in conjunction with the U.S. Centers for Disease Control and Prevention (CDC) and Atlanta’s Health Department that the patients are virus-free and can return home with no public health concerns. Ribner also defended the choice to bring the two Ebola-stricken Americans to Emory for treatment.

“It was the right decision to bring these patients back to Emory to treat them,” Ribner said in a press conference Thursday. “What we learn from them will help advance the world’s understanding of how to treat Ebola virus infection, and help to improve survival in parts of the world where patients with Ebola are treated.”

Brantly, the more public of the two American Ebola patients, gave a public statement thanking both his organization Samaritan’s Purse and the medical team at Emory. The smiling doctor looked well, and thanked God multiple times for his recovery.

“Today is a miraculous day. I am thrilled to be alive, to be well, and to be reunited with my family,” he said. “[In Liberia] I prayed that in my life or in my death, that [God] would be glorified. I did not know then, but have learned since that there were thousands, maybe millions of people around the world praying for me that week . . . I cannot thank you enough for your prayers and your support . . . I serve a faithful God who answers prayers. God saved my life.”

Writebol, the other American Ebola patient, asked for privacy and requested the hospital not give details about her recovery, which is why her discharge remained private. She did, however, ask Dr. Brantly to extend her thanks. “As she walked out of her isolation room, all she could say was, to God be the glory,” said Brantly. Both Writebol and Brantly said they will be spending time alone with their families for some time.

 

The pair were brought to Emory as the hospital has an infectious disease unit specially equipped for treating serious communicable diseases. There is no vaccine or cure for Ebola, though the patients did receive a drug still in early stages of development. Dr. Ribner added that since the patients were the first humans to ever receive the drug, it is still unclear how it played a role in their recovery.

The team of doctors treating the patients previously told TIME that they hope what they learn from treating the patients can shed insight into the disease that can be shared with other physicians fighting Ebola, the latest global outbreak of which has claimed at least 1,350 lives, according to the latest World Health Organization numbers.

“We are mindful of all of those in West Africa that are still fighting for their lives against this threat, and those who are carrying for them, putting their own lives in danger,” said Dr. Ribner. The Emory medical team will be releasing guidelines for physicians in West Africa to provide insight into what worked during the Americans’ treatment.

TIME psychology

Quiz: Are You A Narcissist?

Take the Narcissistic Personality Inventory, developed by Robert Raskin and Howard Terry.

Check the answer in each pair that comes closest to describing you. Don’t leave any pairs blank; try to complete the survey in just a few minutes. The highest possible score is 40, the lowest is 0.

Penguin Group

Excerpted from The Narcissist Next Door: Understanding the Monster in Your Family, in Your Office, in Your Bed—in Your World

Read More: The Evolution of a Narcissist

TIME Infectious Disease

American Doctor Who Had Ebola Has Recovered

Dr. Kent Brantly seen working at an Ebola isolation ward at a mission hospital outside of Monrovia, Liberia.
Dr. Kent Brantly seen working at an Ebola isolation ward at a mission hospital outside of Monrovia, Liberia. Getty Images

Set to be discharged on Thursday

(ATLANTA) — At least one of the two American aid workers who were infected with the Ebola virus was to be discharged Thursday from an Atlanta hospital, a spokeswoman for the aid group he was working for said.

Meanwhile, Emory University Hospital planned to hold a news conference Thursday morning to discuss both patients’ discharge.

Alison Geist, a spokeswoman for Samaritan’s Purse, told The Associated Press she did not know the exact time Dr. Kent Brantly would be released but confirmed it would happen Thursday.

Meanwhile, Franklin Graham, president of Samaritan’s Purse, said in a statement that Brantly has recovered.

“Today I join all of our Samaritan’s Purse team around the world in giving thanks to God as we celebrate Dr. Kent Brantly’s recovery from Ebola and release from the hospital,” Graham’s statement said.

Brantly and Nancy Writebol were flown out of the west African nation of Liberia earlier this month and have been getting treatment for the deadly disease in an isolation unit at the hospital. The two were infected while working at a missionary clinic outside Liberia’s capital.

The Ebola outbreak has killed 1,350 people and counting across West Africa.

Ebola is only spread through direct contact with the bodily fluids of sick people experiencing symptoms.

TIME Research

Blood Transfusions Could Reduce Strokes in Kids With Sickle-Cell Anemia

Sickle Cell Anemia SEM
Under a high magnification of 8000X, this scanning electron micrograph reveals red blood cells in a 6-year-old male patient with sickle cell anemia. Media for Medical—UIG/Getty Images

The risk of a stroke can be cut by more than half

A new trial involving nearly 200 children with sickle-cell anemia found that monthly blood transfusions could reduce the chance of strokes by more than half in children who have the condition, according to U.S. News.

Sickle-cell anemia — a disorder in which red blood cells adopt a rigid, sickle shape that blocks flow, causing strokes and other complications — is most common in children of African and Central or South American descent. According to the U.S. National Heart, Lung and Blood Institute, 1 out of 500 African-American children in the U.S. is born with sickle-cell anemia. “Silent strokes” — which lack discernible symptoms but have also been known to reduce a child’s IQ — affect 30% of those with the condition.

Researchers involved in the study, published in the New England Journal of Medicine, used an MRI scan to identify 196 children ages 5 to 15 with a history of silent strokes, and gave about half of them monthly blood transfusions over three years. Out of the group that had monthly blood transfusions, only six had another stroke during the study, in comparison with 14 children in the control group who had another stroke.

Allison King, a co-author of the study, explained in a statement released by Washington University School of Medicine that the blood transfusions helped to increase the number of healthy red blood cells and “lower the percentage of sickle-shaped cells in the patient’s bloodstream.”

The team stressed that all children with sickle-cell anemia — which was previously thought to be untreatable — should be regularly screened for signs of silent stroke. “Now that we have identified a viable treatment option, early detection of silent cerebral strokes should become a major focus for clinicians and families of children with sickle-cell disease,” Michael Noetzel, a chairman of the study’s neurology committee, said in a statement.

Researchers added that additional long-term studies were needed to determine whether regular blood transfusions could also prevent reduced IQ, which was not a focus of the study.

[U.S. News]

TIME health

3 Reasons Why Your Relationship With Food is Crazy

mom's cookies
Getty Images

1) You ignore the importance of context

You ate more because you were hungry? Maybe, but you’re probably not giving nearly enough credit to how context affects you. I’ve posted many times about how context is far more influential than you think.
From Paul Bloom’s How Pleasure Works:

  1. Protein bars taste worse if they are described as “soy protein”
  2. Orange juice tastes better if it is bright orange.
  3. Yogurt and ice cream are more flavorful if described as “full fat” or “high fat.”
  4. Children think milk and apples taste better if they’re taken out from McDonald’s bags.
  5. Coke is rated higher when drunk from a cup with a brand logo.

How much you eat is strongly affected by how much those around you eat, but you rarely realize it. Dining with friends? You’ll probably eat twice as much.

Via The Social Animal: The Hidden Sources of Love, Character, and Achievement:

At restaurants, people eat more depending on how many people they are dining with. People eating alone eat least. People eating with one other person eat 35 percent more than they do at home. People dining in a party of four eat 75 percent more, and people dining with seven or more eat 96 percent more.

Eating with overweight friends? You’ll eat more. Is your waitress overweight? You’ll eat more. Are you a woman eating with a man? You’ll eat less. Wide variety of food? You’ll eat more.

Smaller serving sizes make you eat less overall. The order of items on a menuaffects what you eat. The color of plates can affect how sweet dessert tastes.

Brian Wansink, author of Mindless Eating: Why We Eat More Than We Think, instructs us to tell the guests that wine is from California, not North Dakota:

It was all the same $2 cabernet. And we found that if people thought it was from California, they rated the wine as better, they rated the food as better, they stayed at the restaurant about 10 minutes longer, and many of them made reservations to come back.

When we served them the North Dakota wine, it poisoned the entire meal. They didn’t rate the food as good, they left 10 minutes earlier, and they didn’t make reservations to come back.

When you serve dessert, put it on some fancy china, not a napkin:

If they ate it on the napkin, they’d say, “Wow, this is really good.” On a paper plate, they said, “This is really, really good.” If they ate it off of Wedgwood china, they would say, “This is the greatest brownie I’ve eaten in my entire life.” And the amount they were willing to pay for it tripled.

And give them silverware, not plasticware:

Consumers’ quality and liking judgments concerning identical yoghurt samples differed significantly when tasted either with a metallic plastic spoon or else with a stainless steel spoon, the latter resulting in significantly higher scores.

Don’t feel guilty – even dieticians are inaccurate about how much they eat. (And only 7% of shoppers obey the “10 items or less” rule at the supermarket.)

2) You forget that so much of what makes food good or bad is in your head

Comfort food really does comfort you. Grandmom’s cookies do taste better than other cookies. You can’t tell pate from dog food. Coffee junkie? When you haven’t had your joe anything with caffeine tastes better. Dieting actually makes food look bigger.

Eating organic food might turn you into a jerk. Anything that affirms your feelings about your own morality (“I eat organic, therefore I’m a good person.”) your brain may subconsciously use to justify doing something immoral. (“I’m generally a very good person so it’s okay if every now and then I…”)

Why do people order a cheeseburger, fries, dessert and a *Diet* Coke?

It’s called a “health halo effect.” As long as we have the feeling we’re doing something healthy, we extend it to everything during that meal. Due to this, most people surveyed estimated that a cheeseburger with a salad had fewer calories than the cheeseburger alone.

Via The Willpower Instinct:

We feel so good about ordering something healthy, our next indulgence doesn’t feel sinful at all. We also see virtuous choices as negating indulgences— literally, in some cases. Researchers have found that if you pair a cheeseburger with a green salad, diners estimate that the meal has fewer calories than the same cheeseburger served by itself. This makes no sense, unless you believe that putting lettuce on a plate can magically make calories disappear.

(And, no, those fortune cookies aren’t very Chinese.)

3) Food and hunger affect your judgment whether you realize it or not

Hungry judges give harsher sentences. Lemonade can reduce racism. Eating something disgusting can make you feel morally disgusted. Hungry men prefer heavier women and Playboy playmates are thicker during economic recessions.

Kids who skip breakfast misbehave more than kids who eat their Wheaties. After given a snack, all the children are little angels again.

Via Willpower: Resdiscovering the Greatest Human Strength

All the children in a class were told to skip breakfast one morning, and then, by random assignment, half of the children were given a good breakfast at school. The others got nothing. During the first part of the morning, the children who got breakfast learned more and misbehaved less (as judged by monitors who didn’t know which children had eaten). Then, after all the students were given a healthy snack in the middle of the morning, the differences disappeared as if by magic.

People who have low blood sugar are far more prone to criminal and violent behavior:

…hypoglycemics were more likely than the average person to have trouble concentrating and controlling their negative emotions when provoked. Overall, they tended to be more anxious and less happy than average. Hypoglycemia was also reported to be unusually prevalent among criminals and other violent persons, and some creative defense attorneys brought the low-blood-sugar research into court.

Across the board, yeah, food puts you in a better mood. To be more exact, research has shown that 2 cheeseburgers = one orgasm. Smiling gives the brain as much pleasure as 2000 bars of chocolate.

Via Smile: The Astonishing Powers of a Simple Act (TED Books):

They discovered that smiling stimulates our brain’s reward mechanisms in very powerful and surprising ways. How did the power of a smile stack up against other “well-regarded” pleasure-inducing sensations? Depending on whose smile you see, the researchers found that one smile can be as pleasurable and stimulating as up to 2,000 bars of chocolate!

(Health-wise, a little starvation can be good for you, actually.)

So what can you do?

Use this info to help you:

  1. If you need to concentrate or something is going to require good judgment, make sure to eat something.
  2. Use your knowledge of the way certain foods make you feel to control and improve your mood.
  3. Use context to control your eating.

You probably utilize the first two points from time to time but maybe not often enough. The third is very powerful but you probably don’t put it into action.

From Mindless Eating author Brian Wansink:

The good news is that for every external cue that messes people up in our studies, you can solve the problem by doing the opposite. If going from a 10-inch to a 12-inch plate causes you to eat 22 percent more, use a 10-inch or 91/2-inch plate.

Use smaller bowls. Don’t rely on your willpower or the power of education. Don’t say, “Now I know that I’m three times more likely to eat the first thing I see in my cupboard than the fifth thing I see in my cupboard … but I won’t let that influence me.” It absolutely will!

The solution is to make sure that the first thing you see–the thing that’s front and center–is healthier than that chocolate-covered foie gras.

People eat food that’s on the table much more frequently than food that’s off the table, so just put the salad and vegetables on the table. Leave everything else on the counter or stove.

 

Related posts:

5 things you need to know about alcohol

5 things you need to know about that wonder-beverage, coffee

Will eating healthier make you sexier?

Join 25K+ readers. Get a free weekly update via email here.

This piece originally appeared on Barking Up the Wrong Tree.

TIME Diet/Nutrition

How Instant Noodles Can Hurt Your Heart

Getty Images

In the proverbial pantry of cheap, convenient eats, nothing beats ramen. You no longer even have to be a college student to indulge: the processed noodle has graduated from dorm room to restaurant, popping up on U.S. menus 18% more from 2013 to 2014, according to the food industry research firm Technomic.

But while the rise of ramen is good for noodle shops, a study published in The Journal of Nutrition found that it’s not great for your heart, particularly if you’re a woman.

The study looked at the reported diets of 10,711 adults using data from a two-year survey of South Koreans, who reportedly eat more ramen than anyone else in the world. Two diet tracks emerged: a “traditional diet,” which was full of rice, grains, fish, and produce, and a so-called “meat-and-fast-food pattern,” which replaced some of those staples with meat, soda, fast food, and instant noodles.

Neither of those diets on the whole were associated with an uptick in cardio-metabolic syndrome—which is a collection of risk factors for heart disease, type-2 diabetes and stroke including high blood pressure, blood sugar, and cholesterol. But the instant noodles were. Eating instant noodles at least twice a week was associated with 68% more cardiometabolic syndrome for women, regardless of what else their diet was made up of.

This effect was only seen in women. Study author Dr. Hyun Joon Shin, a clinical cardiology fellow at Baylor University Medical Center and a nutrition epidemiology doctoral student at Harvard School of Public Health, says that one likely reason is that women have different sex hormones and metabolism than men. Other culprits could include instant noodle packaging, which is often lined with the endocrine disruptor BPA and can mess with estrogen signaling, which may, in turn, lead to some of the risk factors for cardiometabolic syndrome.

Regardless, those noodle packs are hardly a healthy choice for anyone. Highly processed instant noodles differ from regular noodles because they’re often prepped in palm oil for fast cooking and loaded with salt, artificial flavors, and preservatives. “The noodle is very artificially made to make it more delicious, and it can be cooked very easily, within 5 minutes,” Shin told TIME. But cooking “slow” noodles—you know, the kind you dump in boiling water for just a few minutes longer than the instant ones—is well worth the wait for your heart.

TIME Mental Health/Psychology

Therapy and Antidepressants Work Better Together Than Just Pills Alone

A combination of antidepressants and therapy work to help severely depressed patients recover

Depression is a tricky, often very individual disease, which can have both physical and psychological symptoms. New research out on Wednesday shows that patients with the most common kind of depression—meaning episodes of being low as opposed to chronic depression, which can last years—recovered better if they were treated with both cognitive therapy and antidepressants, compared to people who only received drugs.

“We think antidepressants work from the bottom up on the brain, smoothing hyperactivity in the area near the brain stem where emotions are generated. And cognitive therapy may work from the top down in the frontal cortex. You learn you’re more controlled than you thought you were,” says study author Steven Hollon, a professor of psychiatry at Vanderbilt University.

In the study, which was published in JAMA Psychiatry, the researchers studied 452 depressed adults at three medical centers in the U.S. who were randomly assigned to either treatment with antidepressants, or antidepressants with cognitive therapy. While many clinical trials of depressed patients are for a fixed period of time, in this study, the end point was recovery—meaning the patients experiences 6 full months without symptoms of depression. The group who had therapy and drugs fared better.

The researchers say the impetus for the study is a growing consensus that patients with depression need more than just their symptoms treated. In a corresponding editorial, Dr. Michael Thase, a professor of psychiatry at the University of Pennsylvania, said finding treatment options for people who do not respond to conventional methods is a top research priority. “There is no debate about whether cognitive therapy should be thought of as a first-line option, but what should a psychotherapist do when it doesn’t work?” he asks.

Beyond cognitive therapy and antidepressants, Thase, among others, wants more research into the efficacy of methods like mindfulness, interpersonal psychotherapy, and dialectical behavior therapy.

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