TIME medicine

FDA Approves Combined Hepatitis Drug

Harvoni
Harvoni, the first single medication to treat hepatitis C, was recently approved by the FDA. Gilead Sciences

Harvoni is the third hepatitis C drug approved in the past year

The Food and Drug Administration approved the first single medication to treat hepatitis C on Friday, green-lighting one pill in the place of multiple treatments. The new drug, Harvoni, is the third hepatitis C drug approved in the past year.

“With the development and approval of new treatments for hepatitis C virus, we are changing the treatment paradigm for Americans living with the disease,” said FDA official Edward Cox.

Harvoni, developed by Gilead Sciences, will be the first hepatitis drug to require a pill only once daily. A full 12-week treatment will cost $94,500, less than existing treatments, Reuters reports.

TIME ebola

Why One Airline Flies To West Africa Despite Ebola

"It is our humanitarian duty to operate there"

Several major airlines including British Airways and Emirates have suspended service to Ebola-stricken regions of West Africa in response to a rapidly worsening Ebola outbreak, and Americans seem to agree with the service halts: 58% of people polled in a recent survey from NBC News want to ban all incoming flights from West African countries with Ebola.

But two airlines—Brussels and Royal Air Maroc, Morocco’s largest airline—have continued serving Sierra Leone, Liberia and Guinea.

Brussels Airlines says it has no plans to stop flying into Guinea, Sierra Leone or Liberia in the immediate future. “It is our humanitarian duty to operate there,” said Geert Sciot, a vice president at Brussels Airlines. “Without our fights it would become almost impossible for medical staff to reach the country.”

In recent days, health and governmental officials have warned that a shortage of flights limits the ability to get aid to the region and ultimately could worsen the global Ebola crisis.

Sciot, who said that the airline has made flights to Africa a focus of their service for decades, said that the World Health Organization and other health groups had directly asked senior airline leadership to continue service to West Africa. Health groups also partnered with Brussels Airlines to implement measures to ensure safety for the passengers and crew.

All passengers leaving the region have their temperatures taken and are screened with a questionnaire; patients with Ebola symptoms are not allowed to fly. Airline crew are not permitted to spend the night in at-risk locations, so they travel on a Brussels flight to Senegal when they need to stay overnight in West Africa.

“It’s absolutely safe for us as an airline, for our passengers and for our crew, to operate these flights,” said Sciot.

Despite conducting what he described as a public service, Sciot acknowledged the potential fallout from people who are concerned that flying to West Africa may help spread Ebola.

Part of that attention undoubtedly surrounded the death of Thomas Eric Duncan, the only person to die of Ebola on American soil. Duncan flew on Brussels Airlines from Liberia en route the United States before exhibiting symptoms of the disease.

Sciot said that compared to last year, about the same number of people fly on the route and revenue is comparable, though there is a wait list for cargo space.

“For our image, I don’t think we benefit from this at all,” he said. “We get a lot media requests linked to a disease.”

TIME Research

How Pre-Schoolers Can Predict Disease Outbreaks

Sick Child with tissue
Getty Images

Pre-schoolers might be the key to identifying the next big disease outbreak, finds a new study soon to be presented at the American Academy of Pediatrics national conference.

The idea is simple—the researchers created an online disease surveillance system that allows child care staff to log symptoms, like fever or stomach flu, that they see in the young kids they care for. Nearby public health departments have access to the real-time data, which helps them quickly spot emerging trends. Health officials can then loop back to the child care staffers about a spreading illness, along with instructions on how to handle it, so that the caretakers can prepare for it and alert parents.

A zeroed-in system like this can help catch outbreaks early, since diseases like the flu often strike kids first. Children, who lack the robust immune systems and hygiene habits of adults, are among the most vulnerable populations. According to study co-author Dr. Andrew N. Hashikawa, an assistant professor in the Department of Emergency Medicine and Pediatrics at University of Michigan, when children get infected, they tend to pass disease onto the next most at-risk group—their grandparents or the elderly. It then tends to strike parents and adults, followed by school-aged children.

“Illnesses identified in child care can be an indicator of what’s going on in a community,” says Hashikawa. And the surveillance system works, according to the four early-learning centers in Michigan that tested it.

Every day, staff would report ill kids with symptoms like fever, flu, pink eye, stomach illness, cold or respiratory issues, ear infections and rash. The data showed that between Dec. 2013 to March 2014, pre-schoolers got sick the most, followed by toddlers and infants. Stomach flu was the most common illness, and it was so well-documented that they were able to correlate a rise in stomach flu with a nationwide spike in schools three weeks later.

“People tend to focus on absenteeism in schools as a disease indicator, but no one looks at child care,” says Hashikawa. “By the time public health departments get this kind of data, it’s about three weeks later before reports are out, and at that point it’s late.”

MORE: What You Should Know About Enterovirus D68

A system like this might even help identify an outbreak like enterovirus D68, the respiratory virus dominating flu season this year and striking children the most.

The virus appeared to emerge in grade school age kids first, Hashikawa says, but he saw a rise of another viral illness in the same family—hand, foot and mouth disease—a couple months earlier. Hand, foot and mouth is more common among infants and young kids, so an online symptom-tracking system might help spot a wider outbreak even before it starts.

Read next: Here’s How to Protect Yourself From Enterovirus

TIME ebola

Ebola Death Toll Tops 4,000

Liberia Races To Expand Ebola Treatment Facilities, As U.S. Troops Arrive
An Ebola burial team carries the body of a woman through the New Kru Town suburb on Oct. 10, 2014 of Monrovia, Liberia. John Moore—Getty Images

More than 8,300 total cases have been confirmed

At least 4,033 people have died of Ebola in seven countries, the World Health Organization (WHO) said Friday. More than 8,300 total cases have been confirmed.

The new statistics, which include deaths in five West African countries as well as the United States and Spain, come just days after the death of the first patient to be diagnosed in the U.S. The current Ebola outbreak is the worst in history.

Numbers released last month warned that under worst-case-scenario circumstances, as many as 1.4 million people may be infected with Ebola by the end of January. And U.S. Centers for Disease Control and Prevention Director Tom Frieden warned Thursday that action was need to prevent Ebola from becoming “the world’s next AIDs.”

TIME Aging

Quiz: How Long Will You Live?

baby
Getty Images

8 questions that help determine your life span

Americans can now expect to live longer than ever, a new government report finds. That’s largely because death rates are declining for the leading causes of death, like heart disease, cancer and stroke.

How long will you live? These eight basic questions, calculated by two researchers from the University of Pennsylvania, are some of the most predictive of American life expectancy. “Those are the most important risk factors that we have solid evidence for,” Lyle Ungar, professor of computer and information science at the University of Pennsylvania, tells TIME.

The one missing factor? “If you’re in a happy marriage, you will tend to live longer,” he says. “That’s perhaps as important as not smoking, which is to say: huge.” So feel free to give yourself a little bump if you’ve got a happy relationship.

Find out yours in the quiz below (and if you’re on your phone, turn your device sideways):

via Life Expectancy Calculator from Lyle Ungar and Dean Foster

Read next: Eat More Mediterranean Foods Now: Your Later Self Will Thank You

TIME health

America Must Prepare for Ebola Refugees

Ebola virus
Getty Images

Duncan's success in reaching America and getting advanced health care may spur others to flee if economies and living conditions collapse further.

The tragic journey of Ebola victim Thomas Eric Duncan from Liberia to Texas, where he died at the hospital that initially sent him home undiagnosed, revealed gaps in the screening and preparedness system aimed at detecting Ebola cases. However, no one foresaw how that system could be porous enough to allow a disease carrier to pass undetected from the West Africa Ebola zone to the suburbs of Dallas. Nor did anyone foresee how his missed diagnosis worsened matters by allowing his infection to intensify further.

Ironically, by escaping Liberia’s overwhelmed hospitals and in reaching Dallas, Duncan found himself in a land where his illness could be fought using modern intensive care, including access to an experimental drug. His sickness resulted in quarantines for those who came in contact with him, stoked fears within the community in which he lived ever so briefly, and forced a realization that Ebola could pop up anywhere within a country.

Even more cases like his could be forthcoming.

As the epidemic accelerates, a new onrush may emerge of West African “Ebola refugees” fleeing their homelands’ increasingly hellish conditions. Duncan’s success in reaching America and getting advanced health care may spur others to flee if economies and living conditions collapse further. Others who interacted with active Ebola victims and those who believe themselves infected might evade travel restrictions en masse in order to reach foreign lands with better health care.

With more people falling ill and infecting others, the number of symptom-free carriers there will escalate rapidly. Because Ebola can incubate symptom-free for up to 2-3 weeks, present control measures may not be able to detect those harboring the virus as they board planes or arrive at customs halls. Such controls are keyed to active symptoms, such as fever or bleeding, and will miss those who are symptom-free.

A further vulnerability is the reliance on travelers’ self-reporting of past contacts with Ebola victims. But unknowing or desperate people may misstate their past contact status, and if they are not exhibiting active symptoms even upon questioning, then chances are that they would be allowed to progress to their destinations.

If more asymptomatic Ebola carriers reach industrialized countries, those nations’ medical preparedness will be tested if and when they become sick. In spite of proclamations of readiness, it is uncertain if all health care sites are ready to detect and treat them. Finding Ebola cases relies upon frontline health workers to recognize key signs, to zero in on travel history, and to act quickly.

But health workers already complain of lack of training and protective equipment, and the myriads of health facilities nationwide with wide variations of staffing, equipment, and physical layout complicate planning. Our sophisticated, high volume hospitals have an unintended liability: Risks are raised that patients presenting with the true signs of Ebola, which can mimic other illnesses, can slip past the attention of harried or undertrained health workers.

To date, no strict travel bans are expected to be imposed on those leaving West Africa as a result of the Texas case. Officials believe that doing so may inadvertently worsen conditions, and even provoke panic if people try to leave all at once ahead of a complete ban.

Still, the Texas case has stoked rising public and political pressures to bolster travel screening. If new measures are weighed, they should be directed towards the key points of vulnerability in the travel system: departure, en route, arrival, and in the homeland. Airports in the Ebola zone could impose wider screening measures such as temperature checks and individual interviews by a health official to elicit any traveler’s past Ebola exposure.

Passenger manifests could be scrutinized ahead of departures or even while planes are en route. On flights deemed high risk, on-board health marshals could immediately assess any passenger with suspect symptoms, apply protective measures, and inform ground authorities to institute isolating procedures upon landing.

Arriving passengers could receive stickers on the back of their passports with a toll free number to call should they suspect onset of Ebola consistent symptoms along with a short list of such symptoms. Calls to that number would alert authorities to potential cases and give them an opportunity to direct the sick to the closest, well-equipped hospital for evaluation. Isolation beds kept in reserve at the hospitals close to airports would give screeners ability to quickly send patients for evaluation.

Domestically, we can begin special stress testing of hospital responsiveness. Simulated patients can be deployed who, with the prior knowledge and approval of authorities, present themselves into emergency rooms and imitate symptoms of Ebola. Different test patients could be inserted into clinics who present in a variety of ways -—from overt, classical signs to more subtle and challenging presentations. Staff reactions to these “mystery patients” can be gauged and evaluated, and weaknesses identified and overcome.

Another tactic is to conduct preplanned Ebola exercises, similar to disaster response drills, that activate the entire hospital staff and are coordinated with public health authorities. Publicity of these exercises raises community awareness and boosts citizens’ confidence that local authorities are taking the threat of Ebola seriously. Lessons learned would enhance readiness by flagging shortcomings so they could be overcome.

If the epidemic intensifies, we should prepare for the possibility of an influx of Ebola refugees who, upon gaining entry, could become ill in any locale, putting many more at risk. Thus we need to re-think the Ebola defense zone to go beyond hard hit West Africa to include the world’s transport links and major destinations in the American homeland. With fears rising, readiness should go beyond pronouncements of readiness to involve both a rapid upgrade of screening measures along travel corridors and the initiation of stress testing of hospitals and clinics.

Jack C. Chow, M.D. is a former U.S. ambassador on HIV/AIDS and global health (2001-2003) and a former assistant director-general of the World Health Organization on HIV/AIDS, tuberculosis, and malaria (2003-2005). He is currently a professor of global health at Carnegie Mellon University’s Heinz College of Public Policy, and based in Washington D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME ebola

Ebola and Enterovirus: A Graphic Rundown

On Oct. 1, Texas health officials issued orders of quarantine to four people who’d had contact with Thomas Eric Duncan after he was diagnosed with Ebola. When Duncan died the morning of Oct. 8., those four remained quarantined. For many Americans, this raised the question of who has the legal authority to monitor their movement and human contact, restricting the liberty of presumably innocent people.

Under Section 361 of the Public Health Service Act, the Secretary of Health and Human Services is authorized to take measures to prevent the spread of communicable diseases between states and from outside the country. The CDC is responsible for carrying out these functions.

Isolation and quarantine can also be imposed by states under their police-power functions, but in the event that states’ powers aren’t sufficient to stem the spread of a disease, the federal government can step in.

Isolating the ill—or the potentially ill—under hospital authority is another way to contain bugs. On Wednesday, a hospital in Dallas isolated a patient with some Ebola symptoms until the test results come back showing whether or not he has the deadly virus. In September, an Indiana hospital placed a girl with Enterovirus, possibly the strain known as EV-D68, in isolation. This flu-like illness has infected 664 people in 45 states since mid-August, which is why doctors recommend the sick stay home from school and work – a form of self-isolation.

By definition, isolation separates contagious patients from the healthy whereas quarantine restricts healthy people who may have been exposed to a communicable disease. Both measures have been used throughout history, though the first formal system dates back some 700 years ago, when the city of Venice mandated a 40-day quarantine for incoming ships. The idea was to detain cargoes and individuals to ensure no one was carrying the plague onto its shores.

Here’s a closer look at the history of germ containment and how the two viruses – Ebola and EV-D68 – compare. (When viewing graphic: To zoom in, hover your mouse over the graphic. To scroll down, move your mouse over to the right, near the scroll bar in your browser. On a mobile device, turn sideways and keep to the right when swiping down.)

Graphic by Heather Jones for TIME
TIME gender

I’m Beautiful, But Hire Me Anyway

Physical attractive ought not work against you—but in HR offices it might
Physical attractive ought not work against you—but in HR offices it might Johnny Greig; Getty Images

Employers often discriminate against attractive women. Here's why—and what the women themselves can do about it

It has ranked among the top ten irritating TV ads of all time. “Don’t hate me because I’m beautiful,” pouted actress and model Kelly LeBrock back in 1980, tossing her hair coquettishly as she shilled for Pantene shampoo. What few people realized at the time was that the tag line came close to describing a real type of discrimination. It wasn’t in the form of jealousy from other women, as the commercial implied; that trope has never really held up to much scrutiny. But beautiful women do face other challenges; a study published just the year before the Pantene ad ran showed that attractive women often encounter discrimination when applying for managerial jobs—with beauty somehow being equated with reduced authority or even competence. The authors called it the “beauty is beastly” effect.

What the study didn’t address, says Stefanie Johnson, assistant professor of management and entrepreneurship at the University of Colorado, Boulder, is what women are supposed to do about it. Neither did a study she herself conducted in 2010 which showed that the effect applied to a wide range of jobs normally thought of as masculine.

But a new study Johnson and two colleagues just published in the journal Organizational Behavior and Human Decision Processes does tackle the question more directly. The improbable-sounding conclusion: if you’re beautiful and female, acknowledge it. Simple as that.

Well, not quite that simple. The research doesn’t suggest attractive women say straight out, “Yes I know, I’m gorgeous.” It is, says Johnson, “a little more subtle than that.” What she and her colleagues did was to recruit 355 students, male and female, and ask them to evaluate four fictitious candidates for jobs in construction—three male and one female. The applications included photos, and the female applicant was either unusually attractive or unusually unattractive—qualities evaluated by an independent crowdsourcing group.

In some cases, the attractive woman made no reference to either her appearance or her gender in the written application. In others, she referenced her appearance, but subtly, writing something like “I know I don’t look like a typical construction worker, but if you look at my resume, you’ll see that I’ve been successful in this field.” In still others, the attractive woman referred to her gender in a similar way (“I know there aren’t many women in this industry”), but not her beauty.

The unattractive female applicants did the same (although the “I known I don’t look…” part was may have been seen as a mere reference to her gender). In general, the “employers” tended to hire attractive women more often if they alluded either to their gender and to their beauty. With the unattractive woman, referencing gender directly made no difference—but referencing appearance made them less likely than average to be hired.

The study does have holes—rather gaping ones, actually. For one thing, the construction industry is not remotely typical of the field in which gender bias usually plays out. Like it or not, there is a real reason most construction workers are men—and that’s because they are, on average, physically larger than women and have greater upper body strength as a result. It’s the reason we have women’s tennis and men’s tennis, a WNBA and an NBA and on and on. As with the less attractive candidates in the study, the attractive ones’ reference to their appearance might well have been interpreted to mean simply that the typical applicant appears—and is—male. Johnson’s findings would carry a lot more weight if her hypothetical candidates were applying for the kinds of positions in which the gender wars really do play out—vice president of marketing in a large corporation, say.

Still, as a starting point, her research has value, and she does appear to be onto something. “What we think may be going on,” Johnson says, “is that the person doing the [hiring] has an unconscious bias.” But when that bias is brought to the conscious level, triggered by the woman’s addressing it head-on (sort of, anyway), it loses force. “Once you acknowledge it,” says Johnson, “it goes away.”

The takeaway message, she argues, is not that you should feel sorry for good-looking women, since attractive people, both male and female, have all sorts of advantages overall. “It’s more that we’re exposing a more subtle form of sexism,” she says. “People are still stereotyping women.” That, all by itself, is a form of discrimination, even if in this case it’s a form few people think about.

TIME Aging

Men’s Bone Health Is Largely Ignored

skeleton xray bones
Getty Images

Why men need to start saving their skeletons

A third of all hip fractures happen in men, and in the year after a fracture, men are twice as likely to die as women. That’s due, in part, to the fact that men don’t get treated as often as women do for osteoporosis, a new report from the International Osteoporosis Foundation says.

In fact, men’s bone health is largely ignored, and one study showed that men are half as likely as women to get treatment. About 20% of men over 50 have osteoporosis fractures, a number set to rise with the aging population, the report says. From 2010-2030, the number of hip fractures in American men is set to rise 52%, while the number among women is expected to drop by nearly 4% (likely because women are routinely screened for bone loss and are treated preventively).

The lifetime risk of a bone fracture for men is now higher than the risk for getting prostate cancer, and those who smoke, drink heavily, or have vitamin D, testosterone or calcium deficiencies are especially at risk. “People should not have to live with the pain and suffering caused by osteoporosis as we can help prevent and control the disease,” says Professor John A. Kanis, president of the International Osteoporosis Foundation, in a statement.

One of the best lifestyles switches men can make for their bones is to exercise more. Men lose muscle as they age, which makes bones much more vulnerable. Weight-bearing exercise protects against bone loss and falls, and these 6 best anti-aging exercises for men are proven to make aging men stronger.

TIME ebola

Brazil Announces First Suspected Ebola Case

Electron micrograph of Ebola virus
A scanning electron micrograph of Ebola virus buds from the surface of a Vero cell of an African green monkey kidney epithelial cell line. NIAID/EPA

But the case isn't confirmed yet

Brazil is treating its first suspected case of the Ebola virus, the country’s Health Ministry announced Thursday night.

A 47-year-old man arrived in Brazil on Sept. 19 from Guinea and reported he had a fever on Oct. 8, within the 21-day Ebola incubation limit. He has no other symptoms, like bleeding or vomiting, but has been put in isolation and flown to the National Institute for Infectious Diseases in Rio de Janeiro per the country’s security protocol.

Guinea, Liberia and Sierra Leone are the three West African countries hardest hit by the virus.

Brazil’s Health Ministry will hold a news conference on the case at 10 am on Friday.

 

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