TIME ebola

Ebola Cases Surge in Guinea, as Liberia and Sierra Leone Show Progress

Members of the Guinean Red Cross move the body of a person who died from the Ebola virus on March 8, 2015 at the Donka hospital in Conakry.
Cellou Binani—AFP/Getty Images Members of the Guinean Red Cross move the body of a person who died from the Ebola virus on March 8, 2015 at the Donka hospital in Conakry.

As long as Ebola remains in one of the West African countries at the center of the epidemic the whole region remains at risk

Even though the latest Ebola epidemic first surfaced in Guinea more than a year ago, the tiny West African nation has been largely spared the catastrophic escalations in case counts experienced by neighbors Liberia and Sierra Leone. At the peak of the crisis, Liberia was reporting 442 new cases a week, with corpses filling hospital morgues and rotting on street corners. Now, nearly two weeks after Liberia’s last known Ebola patient was declared free from the disease, Guinea has reached its own grim milestone, with 95 new cases in the week ending March 15, the highest weekly tally of new cases so far this year according to the World Health Organization [WHO]. Sierra Leone, meanwhile, is seeing some success, reporting 55 new confirmed cases last week in its lowest weekly total since June, when the epidemic first started to spin out of control.

Even though Guinea’s reported caseload was down from that country’s peak of 156 at the end of December, it still represents a near doubling of infections, from 58, in the span of one week. That’s a troubling sign for the region as a whole, particularly as WHO noted with concern that the chain of transmission in Guinea is happening largely out of sight of health workers who can monitor and isolate the contacts of infected people, a process that helps stop the spread. Another cause for concern is that most of the infections in both Guinea and Sierra Leone have occurred along a narrow, well-trafficked corridor along the two countries’ shared border. “The population is highly mobile, with a great deal of movement throughout surrounding districts and countries,” says the weekly situation report. “Limiting the movements of cases and contacts is challenging but essential to prevent the seeding of new outbreaks.”

Thursday marks the 13th day since the last patient tested positive for Ebola in Liberia; but the WHO requires 42 days — twice the maximum incubation period for the highly infectious disease — before it can be declared Ebola-free. Even then Liberia can hardly afford to relax if its neighbors still harbor the disease. Ebola spread in Guinea for four months before it crossed the border to Liberia, launching the epidemic that has so far claimed 10,194 lives.

TIME ebola

This Is How Bill Gates Says We Can Avoid Another Global Health Crisis

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ZACHARIAS ABUBEKER —AFP/Getty Images Bill Gates delivers a speech after receiving an honorary degree at Addis Ababa University in Addis Ababa, Ethiopia, on July 24, 2014.

"We are simply not prepared to deal with a global epidemic"

Now that the Ebola crisis is subsiding, Bill Gates says we need to learn from it. And he has a few suggestions.

In an op-ed in the New York Times, Gates says developing countries need technology to map epidemics, groups need ways to more efficiently mobilize large numbers of volunteers and officials need to develop more sophisticated methods of keeping data on an outbreak.

“If anything good can come from this continuing tragedy, it is that Ebola can awaken the world to a sobering fact: We are simply not prepared to deal with a global epidemic,” he wrote.

Gates also says the world should invest heavily to stop epidemics before they begin through diagnostics, drugs and vaccines.

The Ebola epidemic claimed the lives of more than 10,000 people. “We know the cost of failing to act,” Gates said.

[NYT]

TIME Diet/Nutrition

How Los Angeles Tried—and Failed—to Curb Obesity

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Getty Images

A study finds that an L.A. law to cut back on fast food may not have worked

A Los Angeles law meant to improve obesity rates didn’t work out as planned, a new study shows.

In 2008, South Los Angeles passed an ordinance that restricted the opening or expansion of new stand-alone fast food restaurants, in hopes of making residents healthier. However, new research published in the journal Social Science & Medicine reveals that little happened to the diets and obesity rates of people living in the region.

The researchers looked at both the number of food outlets opening in the city, as well as data on neighborhood eating habits and weight. The number of residents who were overweight or obese increased from 2007 to 2012—including in South Los Angeles. Only sugary drink consumption dropped.

“Environmental change is slow, so we should not expect dramatic immediate effects,” the study authors write. But they acknowledge another explanation, too: that the ordinance didn’t target the outlets it should have. The researchers report that South Los Angeles is characterized by smaller food outlets or convenience stores rather than typical fast-food chains. Food outlets that were added since the ordinance looked similar to the outlets that were already there, the authors say.

“It would seem unlikely that changes in the food environment due to the regulation could have had a meaningful impact on dietary choices in South LA,” says study author Roland Sturm, a senior economist at the non-profit research organization RAND.

But the study authors note that in the long run, the fast-food ban could help effect change in a more symbolic way: by helping to shift the mindset of how residents of the area approach food.

TIME Cancer

Diagnosed With Breast Cancer? Get a Second Opinion

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Ben Edwards—Getty Images

A new study reveals that pathologists don't always see a biopsy the same way

A new study shows that when it comes to diagnosing breast cancer, doctors do not always agree on what the biopsy slides reveal.

Every year, about 1.6 million women in the United States undergo a breast biopsy. In some cases, the biopsy results are obvious; a woman has breast cancer or she doesn’t. But other cases are more uncertain.

According to new research in the journal JAMA, when it comes to less obvious cases, the doctors making the call—pathologists—only agree with outside experts about 75% of the time.

In the study the researchers asked 115 U.S. pathologists to assess 240 breast cancer biopsy slides and make a diagnosis. Their responses were then compared to what a panel of three highly regarded experts determined to be the correct diagnosis.

Fortunately, when it came to diagnosing invasive cancer, there was broad consensus; the pathologists agreed with the panel 96% of the time. When it came to non-cancerous biopsies, the pathologists agreed 87% of the time, but 13% of the time they misdiagnosed.

When it came to more challenging cases—like atypia, where breast cancer cells are abnormal but not cancerous—the pathologists only agreed 48% of the time. In 17% of the cases, the pathologists diagnosed atypia when the expert panel did not, and 35% of the time the pathologists missed the diagnosis.

Another challenging diagnosis is ductal carcinoma in situ (DCIS), which happens when the cancer is inside the milk ducts but considered non-invasive. When it came to DCIS biopsies, pathologists agreed 84% of the time. Three percent of the time they diagnosed DCIS, and 13% of the time they missed it.

Though the study did not examine the clinical impact of incorrect diagnoses, the findings raise concern about cancer over-diagnosis and over-treatment, as well as missed opportunities to catch true cancer early.

“These findings are disconcerting but perhaps not altogether surprising,” write the authors of a corresponding editorial. (The editorial authors were not involved in the study.) In the real world, pathologists do have the opportunity to consult with others, they note. They conclude that the findings underline the value of having a second opinion in more ambiguous cases.

“The agreement on the diagnosis of invasive carcinoma was quite high, and that should be reassuring,” says Dr. Benjamin Calhoun of the anatomic pathology department at the Cleveland Clinic, who was also not involved in the study. He sees the results as an opportunity to improve continuing medical education for pathologists. “Instead of a lecture from an expert with a few carefully chosen representative images, pathologists need a more ‘hands-on’ experience,” he says, “and the opportunity to compare their diagnoses with an expert panel.”

For now, more research is needed to understand how such findings may be affecting patients.

TIME

In the Latest Issue

The Cancer Gap Time Magazine Cover
Photographs by Christopher Morris—VII for TIME From left: Mary Ann Anselmo photographed in New York City on March 13, and Marcia Stiefel photographed in Bismarck, ND on March 15.

The Cancer Gap

No two cancers are alike. But what will it take to give every patient equal care?

Diplomacy of Distrust in Iran

U.S.-Iran nuclear talks will never overcome decades of suspicion. Can both sides deal with that?

Benjamin Netanyahu’s Disgrace in Victory

Israel’s Prime Minister won a tragic election by vilifying Arabs and defacing Israel’s history

The Grandparent Clock

There’s often one forgotten variable in the decision about when to have kids

The New Caliphates

Scott Walker: Playing to Win

He changed the rules of the political game as Governor of Wisconsin. Next up, the nation

Who Let the Bears Out?

The end of easy money means a market correction of significant proportions

The Squeeze on Elite Colleges

Top schools appear more exclusive than ever. But a high-quality education has never been easier to find

The Skinny on Diet Soda

Is it time to kick artificial sugars out of the can?

Review: The Sad Guys of World Gone By

Dennis Lehane’s hero is a melancholy mobster

Affable Aliens in Dreamworks’ Home

Home-spun chemistry unites two comics and a diva

Milestones

What You Said About …

Briefing

Serena Is a Thriller That Squanders a Dynamic Duo

Bradley Cooper and Jennifer Lawrence go to waste in the new movie

Terry Pratchett

Prolific fantasy author

Hillary Clinton’s Search Party

Lingering email questions could be a factor in her campaign

Review: Little Miss Sunshine Girl

A spooky YouTube series migrates to print

The Culture

How Meerkat Became the Star of South by Southwest

Live-streaming took off at the festival

Play Ball—Faster

New rules may finally speed up America’s pastime

10 Questions With James Baker

As PBS airs a new documentary about him, the politician talks about current events and his career

Pop Chart

Michael Graves

Architect

The New Tool for Marketers: Your Face

Businesses are using facial analysis to see if their campaigns are working on you

Bob Iger, Media Mogul

The Disney CEO and Chairman has big projects ahead with Star Wars and Frozen 2

Does Nintendo Have Any Big Ideas Left?

The beloved gamemaker has struggled in an age of smartphones and tablets. But its top leaders say they have plans to even the score

Kendrick Lamar’s Butterfly Effect

A new anthem of black identity

In You Are You, A Place for Happy Campers

Documenting a rural retreat for gender-creative kids

TIME Diet/Nutrition

Should I Eat Potatoes?

A surprising show of spud love

5/5 say yes.

Potatoes are the most consumed vegetable in America but that doesn’t stop throngs of tater haters, who malign them as starchy and fattening. Our panel of experts want to shine up spuds’ reputation.

“It is a pity that potatoes got a bad reputation for being fattening, because potatoes are a very nutritious, satiating and low-calorie food,” says Trudy Voortman, nutrition scientist at Erasmus Medical Center in the Netherlands. And a 2014 study also found that potatoes don’t, in fact cause weight gain. “When prepared in a healthful manner there is no reason to not eat potatoes regularly,” says study author Britt Burton-Freeman, PhD, director of the Center for Nutrition Research at Illinois Institute of Technology.

That’s providing, of course, you don’t turn the potato into a French fry, a chip or a boat for bacon, butter and cream. “Yes to potatoes, but be careful of the company they keep,” says David Katz, MD, director of the Yale University Prevention Research Center.

Bare naked, a medium plain white potato has 36% of your daily vitamin C, 27% of your potassium and 14% of your fiber. “Spare yourself the work of peeling,” Voortman suggests, since the skins are extra nutritious. (No, these potato skins are not the same as the kind you see on a menu.)

Potatoes really are starchy, though, and they land high on the glycemic index—right up there with rice cakes and pretzels. That means they’ll raise your blood sugar and insulin levels quickly. Luckily, some scientists have devised clever potato hacks. Eat them with beans or lentils, which are high in fiber and slow the blood sugar spike, advises Dan Ramdath, PhD, a clinical research scientist at the Guelph Food Research Centre in Canada. He also suggests boiling them and leaving them overnight in the fridge; refrigeration is thought to make the spud’s starch more resistant, which our bodies digest slower.

Remember, there’s also a wide and colorful world of potatoes out there, says Kristin Kirkpatrick, registered dietitian and manager of wellness nutrition services at Cleveland Clinic. If your plate’s looking monochromatic, try some purple potatoes. “They may help in the prevention of certain cancers, and one study found that consumption of them could help in managing blood pressure in obese individuals without weight gain,” Kirkpatrick says.

We’re not promising they’ll make you skinnier, but we’ve got some newfound love for the spud.

Illustration by Lon Tweeten for TIME

Read next: Should I Drink Red Wine?

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TIME Infectious Disease

A New Blood Test Could Stop Doctors From Overprescribing Antibiotics

In this image provided by Duke University, lab research analyst Marshall Nichols does research relating to a new blood test on Tuesday, Sept. 17, 2013, in Durham, N.C.
Shawn Rocco—AP In this image provided by Duke University, lab-research analyst Marshall Nichols does research relating to a new blood test on Sept. 17, 2013, in Durham, N.C.

The procedure distinguishes between viral and bacterial infections

Scientists claim to have established a new blood test that can help doctors quickly distinguish between bacterial and viral infections, giving physicians the ability to prescribe antibiotics more accurately. That’s according to a study published by PLOS One on Wednesday.

Israeli-based company MeMed, along with researchers from other institutes, says that they examined over 1,000 patients and found that their ImmunoXpert blood test could distinguish between immune responses to bacterial or viral infections. The procedure is reportedly fast, taking only hours to complete when alternatives often require days.

“Antibiotic misuse is a pressing public health concern, with devastating healthcare and economic consequences,” stated MeMed CEO Eran Eden in a release to media. “Unlike most traditional diagnostics, this approach builds on an exquisitely informative system crafted by nature — the human immune system.”

While still in the laboratory stage, the test could be important because doctors have long struggled to identify the root causes of infections, meaning that antibiotics, which only attack bacteria, are often prescribed unnecessarily.

TIME ebola

2 More Aid Workers Back in U.S. for Ebola Monitoring

That makes 17 Americans total back for observation since Friday

(NEW YORK) — Health officials say two more American aid workers arrived in the United States on Wednesday night to be monitored for Ebola.

The two bring to 17 the number of Americans flown back from West Africa’s Sierra Leone since Friday for monitoring. None have tested positive.

All are connected to an unidentified American who returned to the U.S. last week after he came down with Ebola. He is in critical condition at a government hospital in Bethesda, Maryland.

The other aid workers are staying near hospitals with special isolation units in Bethesda, Atlanta, and Omaha, Nebraska, in case they get sick.

However, a Centers for Disease Control and Prevention spokeswoman on Wednesday said two are now considered to be at low risk. They will go home for the 21-day monitoring period.

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