TIME Research

Your Supplements Might Contain Recalled Ingredients

colored pill capsules
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Two thirds of recalled supplements still contain the substance banned by the FDA

Dietary supplements with recalled ingredients often remain on the shelves despite a health warning from the Food and Drug Administration (FDA), according to a new study in the Journal of the American Medical Association.

Looking at 27 supplements recalled between 2009 and 2012, researchers found that two thirds of those supplements what were still being sold contained the substance banned by the FDA. The other supplements either remained on the shelf with the recalled ingredient removed or were pulled completely.

The study also found that some types of supplements were more likely to contain recalled ingredients than others. Sports supplements stayed on the shelf despite containing recalled ingredients 85% of the time, higher than any other type of supplement. Only 20% of sexual enhancement supplements that had faced a recall continued to be sold with the recalled element still included, the study found.

Supplement manufacturers make varying levels of effort to ensure that their recalled product is taken off the shelves, says Pieter Cohen, a Harvard researcher who helped conduct the study.

“These companies…were so unabashedly willing to continue to sell exactly the same product that they had recalled with banned drugs in them,” he says. “It shows that the FDA is not … double checking.”

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

Dog Belonging to Nurse With Ebola Tests Negative for the Virus

Nina Pham's dog will be tested again at the end of a 21-day quarantine

Bentley, a dog belonging to Dallas nurse and Ebola patient Nina Pham, has tested negative for the virus, the City of Dallas said Wednesday.

The dog was tested amid fears that he might have contracted Ebola from his owner, who was infected at the Dallas hospital where she cared for Thomas Eric Duncan, the only person to die of Ebola in the United States. Duncan died Oct. 8 at Dallas’ Texas Health Presbyterian Hospital.

Bentley’s samples were sent to a lab on Monday and the results show that he tested negative for the virus. The dog is being isolated and more specimens will be conducted again at the end of a 21-quarantine period.

Pham is in the care of the National Institutes of Health in Maryland.

[Jason Whitely]

 

TIME ebola

Why Ebola Hasn’t Really Spread Across West Africa

A burial team in protective gear carry the body of woman suspected to have died from the Ebola virus in Monrovia, Liberia, Oct. 18, 2014.
A burial team in protective gear carry the body of woman suspected to have died from the Ebola virus in Monrovia, Liberia, Oct. 18, 2014. Abbas Dulleh—AP

Experts point to strong national health systems and proper contact tracing

Though a few cases of Ebola in the U.S. and Europe have sparked panic that the deadly virus is spreading far and wide, a closer look at the outbreak in West Africa tells a slightly different story. The epidemic, which the World Health Organization reports has claimed at least 4,877 lives, largely in West Africa, has so far been mainly confined to three countries: Guinea, Sierra Leone and Liberia. But why have others like Guinea-Bissau, Mali and Côte d’Ivoire — which all share at least one border with a badly afflicted country — so far managed to avoid any cases of the virus?

“Part of it is still luck of the draw, due to movement of people and the relatively porous nature of borders,” says Aboubacry Tall, West Africa Regional Director for Oxfam. And the threat seemingly posed by open borders has led to the affected countries gradually sealing themselves off to prevent Ebola from being passed on to neighbors. When the first cases were confirmed in March by Guinea’s Ministry of Health, Senegal decided to close its southern border with the country. As the outbreak spread to Sierra Leone and Liberia, more border closures followed: Sierra Leone shut its borders on June 11 and Liberia did the same on July 27, with the exception of a few major entry points (such as the main airport) where screening centers would be set up.

Greg Rose, a health advisor at the British Red Cross, says that while border controls may have had “a small effect” on the situation in West Africa, a key difference “was that that other countries had been forewarned,” which allowed them to “set up systems to prevent further infections.” Moreover, Tall says that “in neighboring countries like Côte d’Ivoire, Senegal and Mali, the health systems were in a slightly better shape.” In comparison, the three most-affected countries already had overburdened health care infrastructure before the Ebola outbreak. Sierra Leone and Liberia had not yet fully recovered from the damaging effects of long civil wars — Sierra Leone had two doctors per 100,000 people and Liberia had only one, whereas Mali had eight and Côte d’Ivoire had 14. (The U.S. has 242.) With a lack of staff and resources, Tall says, “Ebola came in and rapidly overwhelmed the health systems” in the three countries, which have now collectively seen more than 9,900 cases of the virus.

Tall adds that two key elements in containing the spread in neighboring countries are community mobilization and the preparedness of the public health system. He highlights the importance of “raising public awareness on Ebola” and of putting the medical system “on high alert all the way to border areas, so that anything that looks like a suspect case has a higher chance of being picked up.” The difference made by a rapid response can be seen in Senegal’s success with its one Ebola case. Despite closing its border, Senegal reported its first case on Aug. 29, after a a Guinean university student traveled by road to Dakar, the capital. He was treated and recovered, and his contacts were traced and monitored. On Oct. 17, WHO declared the outbreak in Senegal officially over, saying the “most important lesson for the world at large is this: an immediate, broad-based, and well-coordinated response can stop the Ebola virus dead in its tracks.”


Though not a bordering country, Nigeria suffered an outbreak of 20 cases — including eight deaths — after a Liberian-American man died of Ebola after arriving at the main airport in Lagos. However, the government of Africa’s most populous nation was able to successfully trace those in contact with him and has since been declared Ebola-free. Nigeria has kept its borders open to travelers from the most affected countries, but increased surveillance. Dr. Faisal Shuaib, of the country’s Ebola Emergency Operation Center, recently told TIME that “closing borders tends to reinforce panic and the notion of helplessness. When you close the legal points of entry, then you potentially drive people to use illegal passages, thus compounding the problem.”

Shuaib pointed out that closing borders has another unwelcome effect: it stifles commercial activities in countries whose economies are already struggling because of the Ebola crisis. “Access to food has become a pressing concern for many people in the three affected countries and their neighbors,” Bukar Tijani, a U.N. Food and Agriculture Organization representative, said in September. In Liberia, for example, the collapse of cross-border trade meant that the price of cassava — a food staple — jumped 150% in early August. Another immediate consequence of travel restrictions, says Tall, is that “most airlines have stopped flying to these countries, which makes it more difficult for humanitarian personnel to get in and out.”

The most effective way to contain the spread of Ebola is in “proper tracing of the epidemic, containment within communities and caring for those infected,” says Rose, the Red Cross advisor, who believes “this problem is not going to be solved by closing borders.” And though Ebola has not spread quickly beyond Guinea, Liberia and Sierra Leone, it’s clear that neighboring countries in West Africa need to remain vigilant. As Tall says, “we’re not out of the woods yet.”

Read next: Nigeria Is Ebola-Free: Here’s What They Did Right

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 medicine

10 Biggest Myths About the Flu

Flu shots here
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Don't get us wrong, we're all for washing your hands with soap and water. But it's not enough to stop the flu

Every flu season—which starts in October and peaks in January and February in the U.S.—as many as 20% of Americans get sick with a virus that can cause serious, even lethal complications (not to mention the general awfulness of a fever, chills, congestion, and body aches). So how come there are still so many myths and rumors about the flu? While officials aren’t predicting whether this year’s influenza will be better or worse than in years past, it’s smart to make sure you know the truth about this dreaded virus and what you can do to reduce your risk of catching it.

HEALTH.COM: 10 Ways to Soothe a Sore Throat

You can catch the flu from the flu shot

No, you can’t. Really. This longstanding rumor just won’t die no matter how often experts debunk it. “The flu vaccine is made with dead viral particles, and since the virus is not living, it can’t infect you,” explains Holly Phillips, M.D., a New York City internist and WCBS News medical contributor. The nasal-spray version of the vaccine, called the FluMist, (which is FDA-approved for kids and adults between ages two and 49 who are healthy and not pregnant) does contain a crippled version of live flu virus. However, it still can’t make you sick, says Dr. Phillips. This misconception may stem from the fact that it takes 2 weeks for your body to form antibodies to the vaccine and fully protect you. So if you pick up a cold or the flu before or just after rolling up your sleeve, don’t blame your runny nose and sore throat on the shot.

Young, healthy people don’t need to worry about the flu

“While it’s true that influenza is most threatening to the very young, the elderly, and people with underlying illnesses, it can still cause severe symptoms in otherwise healthy people,” says Dr. Phillips. That’s why the CDC recommends that everyone get the shot, preferably early in flu season. Even if you’re not in a high-risk group, getting the shot can stop you from transmitting the virus to more vulnerable people. “The more people who get the shot, the more we cut down on the amount of influenza circulating in the population, which can protect your grandmother or child,” says Dr. Phillips. Even if you don’t regularly interact with kids or seniors, take a few minutes and get the shot—at your doctor’s office, local pharmacy, or community health center. You can’t pass on a virus you never got in the first place.

HEALTH.COM: 10 Ways You Put Yourself at Risk for the Flu (Without Realizing It)

The flu includes gastrointestinal symptoms

As miserable as symptoms of the flu are, digestive distress is rarely one of them. What’s politely called the “stomach flu” is a colloquial term that refers to a group of viruses that primarily cause vomiting and diarrhea, says Dr. Phillips. “These viruses are not influenza,” she says. That’s not to say that the flu doesn’t occasionally lead to some gastrointestinal issues; some sufferers do experience nausea and even vomiting. But if you develop these symptoms without any of the classic flu tip-offs, you’re probably dealing with an entirely different germ.

Pregnant women can’t get a flu shot

On the contrary, all pregnant women should get the jab as soon as possible. “The flu shot is very safe for pregnant women, and getting it can even protect the baby for the first few months of life, when he or she is not old enough to get the flu shot yet but is very vulnerable to illness,” says Dr. Phillips. (Babies at least six months old are eligible for the vaccine.) Antibodies that form in response to the shot will not only protect you from the flu, they will protect your baby after birth and be delivered via breast milk, according to the CDC. Pregnancy causes immune, heart, and lung changes that can increase your risk for a bad case of flu, which can affect your pregnancy. “High fevers and severe infections can lead to serious pregnancy complications and even premature labor,” says Dr. Phillips.

HEALTH.COM: 10 Diet Changes All Pregnant Women Must Make

You can stop the flu by washing your hands a lot

Don’t get us wrong, we’re all for washing your hands with soap and water. But it’s not enough to stop the flu. Influenza is spread through the air via droplets of saliva from a person who is contagious (which starts a day before symptoms show and up to seven days after). The droplets can land on you and get into your nose, mouth, and eyes. You can also pick up the flu by touching contaminated surfaces (the flu can live up to eight hours on surfaces, according to the CDC), then touching your hand to your face. So wash your hands with soap and water and avoid touching your eyes, nose, or mouth. This slashes your risk somewhat, Dr. Leavey says. It’s also important to stand at least six feet from anyone with the flu; the airborne droplets can’t travel farther than that. Disinfect common areas in your home or workplace if someone with the flu spent time there. And above all, get vaccinated.

If you get the flu, the shot didn’t work

The flu vaccine isn’t like vaccines that protect you against measles or polio, which offer 100% protection. Usually, the flu shot is only about 60 to 90% effective. That’s because multiple strains circulate every year, and it’s difficult for scientists to predict perfectly which strains will be dominant. “If you do get the flu after going for the shot, it just means that you contracted a different strain that wasn’t included in the vaccine,” says Dr. Phillips. If this happens, there is an upside: your symptoms will likely be less severe, since the shot will probably be at least somewhat effective against the strain you have, she adds. And keep in mind that to the CDC, a flu shot is a success if it prevents hospitalizations and deaths, not if you sail through the season without a sniffle.

Antibiotics can fight the flu

There’s no point in bugging your doctor—antibiotics don’t work on viruses. That said, there are Rx antiviral meds that might help. Tamiflu is the best known; this drug has been shown to cut the course of the disease by 1-2 days, if you take it within 48 hours of the first sign of flu symptoms. These are generally recommended only for those at high risk of complications. “The effects are relatively modest,” says Dr. Phillips. “Once you have the flu, you’re going to be miserable regardless. Prevention with the flu shot is a better approach.” Other meds that can offer some relief include over-the-counter fever reducers such as ibuprofen and acetaminophen, as well as congestion fighters. Best bet? Stay home, get some rest, drink lots of fluids, and wait it out (but be on your guard for serious complications).

Bell’s palsy is a side effect of the flu shot

Bell’s palsy is a condition that causes weakness or paralysis on one side of the face. It’s usually temporary, clearing up after several weeks, and it’s typically thought to be triggered by a viral infection, such as herpes simplex (the virus responsible for cold sores) or Epstein-Barr, which leads to mononucleosis. How did the flu get into the mix? Decades ago, a few isolated cases of people developing Bell’s palsy after getting a flu vaccine were reported. Yet no link was ever established showing that one caused the other, says Dr. Phillips. The overwhelming consensus is that the two have nothing to do with each other, adds Dr. Leavey.

HEALTH.COM: Unexpected Ways to Prevent the Flu

Flu shots can cause Alzheimer’s

The flu shot doesn’t cause any illness or condition, and that includes Alzheimer’s disease, says Dr. Leavey. Alzheimer’s is a type of dementia that leads to memory loss and other cognitive changes. Why some people develop Alzheimer’s is not fully understood, and that opens the door to lots of speculation—which seems to be how the rumor linking the flu jab to Alzheimer’s got its start. “The connection also has to do with the fact that senior citizens are strongly advised to get a flu shot every year, so people associate old age with flu shots, the way they associate old age with Alzheimer’s,” he says. “Or an elderly person who had a flu shot begins showing signs of memory loss months later. The two are unrelated, yet people conclude that the vaccine had something to do with it.”

This article originally appeared on Health.com.

TIME ebola

Drugmakers Working Together to Mass Produce Ebola Vaccine

Britons Test New Ebola Vaccine
Ruth Atkins has her blood taken before receiving her injection of the ebola vaccine called Chimp Adenovirus type 3 (ChAd3), she is the first healthy UK volunteer to receive an ebola vaccine, at the Oxford Vaccine Group Centre for Clinical Vaccinology and Tropical Medicine (CCVTM) on September 17, 2014 in Oxford, England. WPA Pool—Getty Images

Johnson & Johnson and GlaxoSmithKline, two of the world's largest drugmakers, are already working together to make vaccine doses

The world’s leading drugmakers are collaborating to develop millions of doses of an Ebola vaccine for use next year, aiming to prevent West Africans and frontline healthcare workers from contracting the deadly virus.

Johnson & Johnson said Wednesday that its goal is to produce 1 million doses of a two-step vaccine next year, and is already collaborating with Britain’s GlaxoSmithKline, Reuters reports.

The two companies could combine their vaccines and support each other’s work, while other companies are volunteering to provide production capacity. “I have spoken with (GlaxoSmithKline chief executive) Andrew Witty over the past few days several times as colleagues on how we are going to solve this,” Johnson & Johnson U.S. research chief Stoffels told reporters. “It might even be that we have to combine their vaccine with ours.”

The World Health Organization wants tens of thousands of people in West Africa, including frontline healthcare workers, to start receiving Ebola vaccines in January as part of clinical trials.

[Reuters]

TIME Research

You Asked: Is Cracking Your Knuckles Bad?

Illustration by Peter Oumanski for TIME

And just what is that cracking sound, anyway?

From fingers and toes to necks and knees, everyone knows a “cracker.” And most habitual joint poppers have heard rumors their habit may cause arthritis. But are those rumors true?

First, a quick anatomy lesson: Many of your joints—including those that allow your fingers to beckon or point—feature small pockets or gaps that are filled with synovial fluid. Like axle grease, this fluid allows the bones that commingle in your joints to glide close to one another without grating, explains Dr. Pedro Beredjiklian, chief of hand and wrist surgery at Philadelphia’s Rothman Institute.

When you pull, twist or otherwise “crack” a joint, you’re expanding the volume of space between your bones, Beredjiklian says. That volume expansion creates negative pressure, which sucks the synovial fluid into the newly created space. This sudden inflow of fluid is the popping you feel and hear when you crack a knuckle, he adds.

The more you crack your joint, the more you stretch and loosen both its capsule and the surrounding ligaments. And the looser those components become, the more easily your joint will pop, Beredjiklian says.

So is this bad for your joints? Almost certainly not, he assures. Multiple studies have looked into the prevalence of “crackers” among large groups of osteoarthritis patients. They found no evidence that finger pullers and poppers are more likely to suffer from arthritis than those who don’t crack their knuckles. One devoted researcher—a man who habitually cracked the joints on his left hand—actually studied himself. After roughly six decades of lopsided joint popping, this case study of one showed no increased presence of arthritis in his left hand as opposed to his right.

“Finger cracking is so common you would expect to see a lot of causal reports if it was harmful,” Beredjiklian says. “But you don’t. So I think it’s unlikely cracking joints in hands leads to arthritis.”

While one 1990 study linked long-term joint popping to hand swelling and lower grip strength, there isn’t any more research to back up that finding. On the other hand (pun intended), at least one study concluded that knuckle cracking offers those who do it a sense of almost therapeutic “release.”

Poppers, you can ignore your fusty aunt or cranky coworker when they try to scare you with talk of debilitating cracking-related ailments.

Just one note of caution: Tendons catching on irregular bone or joint formations can also explain some clicking or popping sounds, especially in places like your neck, Beredjiklian says. Whether this can cause harm will depend on the person and his or her anatomy. But if a weird sound emanates from your shoulder or knee when you flex it a certain way, you may want to avoid angering that area with deliberate cracking.

Read next: You Asked: Is Coffee Bad For You?

TIME Drugs

Go Inside the Harvest of Colorado’s Most Controversial Marijuana Strain

Take a look at how Charlotte's Web transforms from plant to medicine.

The Stanley brothers of Colorado grow a strain of cannabis called Charlotte’s Web on a farm near Wray, Colo. An oil made from the plant is being used to treat children with epilepsy in Colorado and California and is in high demand throughout the country. Until this year, the Stanleys cultivated and sold Charlotte’s Web as medical marijuana. But because the plant meets the legal definition of hemp, containing less than 0.3 percent THC, the Stanleys are hoping they will be legally allowed to ship Charlotte’s Web oil across state lines.

TIME Infectious Disease

There Are Half a Million More Tuberculosis Cases Than Once Believed

INDIA-HEALTH-TB-TREATMENT-MSF FRANCE
An Indian tuberculosis patient rests at the Rajan Babu Tuberculosis Hospital in New Delhi on March 24, 2014. AFP—AFP/Getty Images

The disease killed 1.5 million people last year

Nearly half a million more people have tuberculosis than was previously estimated, the World Health Organization said Wednesday, adding to the 9 million people who developed the disease in 2013.

The epidemic killed 1.5 million people in 2013, including 360,000 people who were HIV positive, according to the WHO. The disease has been declining, however, by a rate of 1.5% per year, while its mortality rates have dropped 45% since 1990.

“Following a concerted effort by countries, by WHO and by multiple partners, investment in national surveys and routine surveillance efforts has substantially increased,” said Dr. Mario Raviglione, director of the WHO’s Global Tuberculosis Program. “This is providing us with much more and better data, bringing us closer and closer to understanding the true burden of tuberculosis.”

The WHO said $8 billion is needed each year to combat the epidemic, but there’s currently a $2 billion annual shortfall.

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