TIME ebola

WHO Has Acknowledged the Failings of Its Ebola Crisis Response

Health workers walk inside a new graveyard for Ebola victims, on the outskirts of Monrovia, Liberia on March 11, 2015.
Abbas Dulleh—AP Health workers walk inside a new graveyard for Ebola victims, on the outskirts of Monrovia, Liberia on March 11, 2015.

“Our current systems ... simply have not coped”

Top leaders at the World Health Organization (WHO) have admitted to being “ill prepared” to handle the Ebola outbreak and released a comprehensive list of agency failings as well as suggested reforms they and global policymakers must realize moving forward.

“We can mount a highly effective response to small and medium-sized outbreaks, but when faced with an emergency of this scale, our current systems — national and international — simply have not coped,” said WHO Director-General Margaret Chan, Deputy Director-General Anarfi Asamoa-Baah and the organization’s regional directors in a joint statement dated April 16.

The statement listed eight lessons WHO learned from the crisis, including “communicating more clearly what is needed.”

The statement also articulated nine remedies WHO must undergo to better handle large outbreaks in the future — such as intensifying “our advocacy with national authorities to keep outbreak prevention and management at the top of national and global agendas,” as well as establishing a “Global Health Emergency Workforce” and a contingency fund.

In a separate “situation report” dated April 15, WHO said there were 25,791 suspected Ebola cases in Guinea, Liberia and Sierra Leone with 10,689 deaths.

TIME

Shorter People More at Risk From Heart Disease Says Study

72964838
Roy Hsu—Getty Images/Uppercut Short business man standing next to tall man

"If you're 6ft 1in, you still need to stop smoking"

A study of nearly 200,000 men and women found that shorter people have a higher risk of heart disease than their taller counterparts.

Every 2.5 inches up reduce the risk of heart disease by 13.5 percent, according to the study published in the New England Journal of Medicine on Wednesday.

Scientists have long considered there to be a link between height and heart health, but the latest research found that genes controlling height were directly linked to heart disease risks.

To be sure, height is only one of many factors that affect the level of risk.

“In the context of major risk factors this is small – smoking increases the risk by 200-300% – but it is not trivial,” Nilesh Samani, a professor of cardiology at the University of Leicester and lead author of the study, told the BBC News website. “If you’re 6ft 1in, you still need to stop smoking.”

TIME Infectious Disease

Mysterious Morgellons Disease Explained

Singer Joni Mitchell was rushed to the hospital on Tuesday. While what caused her to be found unconscious is still unknown to the public, the New York Times points out that Mitchell has said in the past she has a disease known as Morgellons. But what is it?

Morgellons is a syndrome where people feel like something is right under their skin, or trying to come out of it. People who have the disorder will describe pulling “fibers” and other tiny objects like “specks, granules, dots, worms, sand, eggs, fuzz balls and larvae” through their skin. This can leave lesions and scars on their body.

Morgellons is not very well understood and is controversial within the medical community. It’s clear people who say they have Moregellons are suffering from something, but many doctors think it’s a psychological rather than physical condition. Research trying to determine what the disorder is has been very inconclusive.

“I have this weird, incurable disease that seems like it’s from outer space, but my health’s the best it’s been in a while,” Mitchell told the Los Angles Times in 2010. “Fibers in a variety of colors protrude out of my skin like mushrooms after a rainstorm: they cannot be forensically identified as animal, vegetable or mineral. Morgellons is a slow, unpredictable killer — a terrorist disease: it will blow up one of your organs, leaving you in bed for a year.”

Mitchell said at the time that she planned to get out of the music business and help raise awareness—and gain credibility—for the disease.

In 2012, the CDC published a study that tried to determine what is going on. It was part of a $600,000 project launched in 2008 in response to massive interest in the syndrome. The researchers studied skin biopsies and urine and blood samples to see if they could determine a common cause. They basically concluded that they didn’t buy it: “No common underlying medical condition or infectious source was identified, similar to more commonly recognized conditions such as delusional infestation.”

The condition is rare, with the CDC determining that about 4 out of every 100,000 people in the 3.2 million person population they studied had it. Only 115 people were identified in that study with symptoms similar to the disorder.

It’s obvious that people with Morgellons are experiencing something that’s truly taking a toll on their quality of life. Not having answers and lacking credibility is a large part of the problem, and something Mitchell hoped to combat.

TIME Disease

Thousands of Geese ‘Fell Out of the Sky’ in Idaho

Disease kills birds in as little as six hours

At least 2,000 snow geese were found dead in Idaho over the weekend, many plummeting to the ground mid-flight, according to local officials.

The birds, which were migrating from Mexico to Alaska, “just fell out of the sky,” a spokesman for the Idaho Department of Fish and Game told Reuters.

The Fish and Game Department believes the birds died of avian cholera, a bacterial disease that can kill wildlife in as little as six hours.

Officials are burning the dead carcasses in hopes that other birds won’t pick up the disease. However, a group of 20 bald eagles has already been spotted near the carcasses and officials say it will be difficult to track the birds to see if they develop the disease.

While avian cholera can be fatal to birds, it poses little threat to humans, officials said.

[Washington Post]

 

TIME ebola

Why West Africa Might Soon Have 100,000 More Measles Cases

Now more than ever: Measles vaccinations have dramatically cut disease rates in Africa
Spencer Platt; Getty Images Now more than ever: Measles vaccinations have dramatically cut disease rates in Africa

One lethal epidemic could give rise to another

Correction appended, March 12

There’s not a war college in the world that couldn’t learn a thing or two from the way viruses operate. They’re stealthy, they’re territorial, they seek and destroy and know just where to hit. And, just when you think you’ve got them beat, they forge an alliance with another of your enemies. That, according to a new paper published Thursday in Science, is what’s poised to happen with Ebola and measles—and it’s the babies and children of Africa who will overwhelmingly pay the price.

The Ebola epidemic is by no means over, but it is being contained and controlled. With nearly 24,000 cases and more than 9,800 fatalities so far—mostly in Guinea, Sierra Leone and Liberia—the epidemic is still claiming new victims, though more slowly. The crisis, however, has disrupted health-care delivery across the entire affected region, preventing children from receiving badly needed measles vaccines. That, the new study reports, could result in an additional 100,000 measles cases over the next 18 months, leading to an additional 2,000 to 16,000 deaths. Rates of vaccination against other diseases—particularly polio and tuberculosis—have fallen too. But measles’ ease of transmission makes it especially worrisome.

“When there’s a disruption of medical services, measles is always one of the first ones in the door,” says Justin Lessler, of the Johns Hopkins Bloomberg School of Public Health, a co-author of the paper. “The Ebola epidemic significantly increases the likelihood of a major measles outbreak occurring.”

Lessler and his co-authors arrived at their numbers painstakingly. First, they used health data to map and estimate the share of vaccinated and unvaccinated children in 5 km by 5 km (3.1 mi. by 3.1 mi.) squares across the three affected countries. They then estimated a 75% reduction in vaccination rates during the epidemic and projected forward by 6, 12 and 18 months. They factored in the transmissability of the virus within each region and estimated the likely number of deaths using what’s known as a Case Fatality Ratio—a mathematical tool that, as its name suggests, estimates lethality for any particular disease under any particular set of circumstances.

The final numbers—especially the potential 16,000 deaths—rightly alarmed the researchers, though lessler does admit that they are by no means a certainty. “The 75% decrease in vaccinations is a little too pessimistic,” he concedes. But the critical word in that admission is “little,” and the investigators did consider 25%, 50% and 100% rates too, before settling on 75% as at least the most plausible. No matter what, the odds are still high of a five figure death rate and a five to six figure additional case rate—and the Ebola epidemic, which led to the problem in the first place, has not even fully abated.

Lessler and his colleagues are not waiting until it does to sound the alarm, urging global health groups to mobilize a vaccination campaign now so it can be ready to launch in the affected areas the moment the Ebola all-clear sounds. The new push would first target children who were born during the Ebola epidemic since they would have likely received almost no medical attention at all up until that point, and then expand to all children in the most measles-susceptible age group—about 6 months to 5 years.

“The best time to start the campaign would be as soon as it’s logistically feasible,” says Lessler. “For every month no campaign begins, the risk of an outbreak occurring and the impact of such an outbreak worsens.”

The happy news, Lessler believes, is that done right, the campaign could not only prevent the measles epidemic from beginning, but could actually put West Africa in a better position than it was before Ebola, with vaccine coverage for measles and other diseases exceeding the pre-outbreak rates. “Previous campaigns have reached coverage in excess of 90%,” he says.

Victory in the battle against Ebola—to say nothing of the battle against measles—is by no means yet assured. But, again as the war colleges would teach, with the right cooperation and the right deployment, the good guys can win.

Correction: An earlier version of this story misidentified an assistant professor at the Johns Hopkins Bloomberg School of Public Health. He is Justin Lessler.

TIME Liberia

Schools in Liberia Reopen After a Six-Month Closure Due to Ebola

Liberia Ebola West Africa
Abbas Dulleh—AP Liberian school children wash their hands before entering their classrooms as part of the Ebola prevention measures at Cathedral High School as students arrive in the morning to attend class in Monrovia, Liberia, Feb. 16, 2015.

Cases of the deadly virus have been in decline over the past few weeks

After a six-month closure due to the Ebola epidemic, many schools in Liberia reopened their classroom doors on Monday.

Before lessons began, pupils lined up to wash their hands in chlorinated water while teachers took their temperatures as part of new safety measures, reports the BBC.

Though students were excited to get back to school, some were worried that the virus had not been completely eradicated.

Liberia was one of the worst affected countries by Ebola with at least 3,800 people killed. However, there has been a general decline of the deadly disease in recent weeks.

According to the World Health Organization, only three new confirmed cases were reported in Liberia in the week leading to Feb. 8.

The reopening of schools comes a day after leaders of the three worst affected West African states — Liberia, Guinea and Sierra Leone — vowed to achieve “zero Ebola infections within 60 days,” during a meeting in the latter on Sunday.

[BBC]

TIME Infectious Disease

California Lawmakers Move to End Exemptions for Measles Vaccine

Carmen Lopez, Charles Goodman
Damian Dovarganes—AP Pediatrician Dr. Charles Goodman talks with Carmen Lopez, who is holding her 18-month-old son Daniel after being vaccinated with the measles-mumps-rubella (MMR) vaccine, at his practice in Northridge, Calif., on Jan. 29, 2015

More than a hundred people have been infected in a recent measles outbreak.

Lawmakers in California have moved to end parents’ right to exempt their children from school vaccinations based on personal beliefs.

The state senators said Thursday that they planned to introduce the legislation to make California the 33rd state to bar the exemption, Reuters reports.

More than 100 people have been infected with the measles in a recent outbreak partially linked to Disney California Adventure Park in Anaheim, Calif. Most of those infected were unvaccinated.

“The high number of unvaccinated students is jeopardizing public health not only in schools but in the broader community,” state Senator Ben Allen said in a written statement. He is co-sponsoring the legislation along with fellow Democrat Richard Pan. “We need to take steps to keep our schools safe and our students healthy.”

[Reuters]

TIME public health

What You Should Know About Chronic Lyme Disease

Yolanda Foster on 'Watch What Happens Live'
Bravo—NBCU Photo Bank via Getty Images Yolanda Foster on Watch What Happens Live on Dec. 23, 2014.

Lyme disease affects about 300,000 people in the U.S. each year

Real Housewives of Beverly Hills star Yolanda Foster is making waves with her recent blog post about her struggle with chronic Lyme disease. Foster, who was diagnosed with Lyme in 2012, according to People.com, says she’s had severe mental impairment from her condition, writing, “I have lost the ability to read, write, or even watch TV, because I can’t process information or any stimulation for that matter.”

But don’t antibiotics cure Lyme disease and, if so, what exactly is chronic Lyme? Health has the scoop:

What is Lyme disease and how is it treated?

Lyme disease is a bacterial infection, caused by the bacteria Borrelia burgdorferi and transmitted by ticks. It hits more of us than we realize—the Centers for Disease Control and Prevention estimates that about 300,000 people are diagnosed with the disorder each year, about 10 times higher than the number actually reported to the CDC. Left untreated, it can cause symptoms such as headaches and neck stiffness, pain and swelling in joints, even neurological symptoms such as memory problems.

Lyme is diagnosed based on symptoms (including the distinctive “bull’s-eye rash“) and blood tests. Most people recover with a 21-day course of antibiotics, though if the disease has spread to your central nervous system, you may need a longer course (2-4 weeks) of intravenous antibiotics.

HEALTH.COM: 15 Diseases Doctors Often Get Wrong

Is there such a thing as chronic Lyme?

While in rare cases an infection can still persist, “when patients talk about chronic Lyme, they’re usually referring to what doctors term ‘post-treatment Lyme disease syndrome,’ where you still have a cluster of symptoms such as fatigue, trouble concentrating, and muscle and joint aches after treatment,” explains Brian Fallon, MD, MPH, director of the Lyme and Tick-Borne Diseases Research Center at Columbia University Medical Center. The CDC says approximately 10 to 20% of Lyme disease patients will have lingering symptoms like these. While it’s not clear what causes it, “it could be damage done to the body by the bacteria itself, or it could even be neurotransmitter changes in the brain induced by the prior Lyme disease,” Dr. Fallon says.

How is post-Lyme syndrome treated?

The treatment is itself controversial, mainly because it’s virtually impossible to tell if symptoms remain due to a recurrent infection or if they’re due to residual damage from Lyme. “The current diagnostic tests just reveal whether someone has antibodies due to previous exposure to Lyme disease, so while they indicate if you’ve ever been infected, they don’t show whether or not you’re infected now,” explains Dr. Fallon.

HEALTH.COM: The Best and Worst Foods for Pain

A small subgroup of doctors argue that the condition is caused by residual bacterial infection and should be treated with long-term antibiotic therapy for months or even years. (Indeed, animal studies do suggest that Lyme infection may persist in some cases, Dr. Fallon says.) However, groups such as the Infectious Diseases Society of America frown on this approach. “There’s no research to show that this type of treatment works—several studies have shown that people taking long-term antibiotic for Lyme disease to treat lingering symptoms fare the same as those who take placebo,” states Chris Ohl, MD, an infectious disease expert at Wake Forest Baptist Medical Center.

Dr. Fallon allows for another possibility: Lyme bacteria are “very slow growing, so if you go off antibiotics but find your symptoms return within two to three weeks, it’s highly unlikely that Lyme is the culprit,” he explains. “But if they return within a few months, or even a year, you may have a recurrent infection” and thus may need another (short) course of antibiotics.

If it’s not really Lyme, what causes those symptoms?

It could be another condition entirely—such as another tick-borne infection. “It may very well be that [a patient has] developed an autoimmune disease such as rheumatoid arthritis, which was triggered by the Lyme disease,” adds Dr. Fallon.

HEALTH.COM: 15 Surprising Facts About Rheumatoid Arthritis

“Most of the cases I’ve seen, we’ve done a thorough workup and eventually come up with an underlying condition like anemia, a thyroid condition, a viral infection like Epstein-Barr virus, or even hepatitis C,” says Michael Parry, MD, Thomas J. Bradsell Chair of Infectious Diseases at Stamford Hospital in Stamford, Connecticut.

If extensive testing reveals nothing, then most doctors recommend cautious monitoring and addressing the symptoms (for example, treating joint or muscle pain with either over-the-counter or prescription anti-inflammatory drugs). It’s also important to utilize therapies also used with conditions like chronic fatigue syndrome, including good sleep and exercise habits and, if needed, treatment for depression.

HEALTH.COM: 19 Signs Your Thyroid Isn’t Working Right

This article originally appeared on Health.com.

TIME ebola

The Ebola Virus Is Mutating, Say Scientists

Guinea West Africa Ebola
Youssouf Bah—AP A health care worker, right, takes the temperatures of school children for signs of the Ebola virus before they enter their school in the city of Conakry, Guinea, Monday, Jan. 19, 2015

The outbreak has so far claimed 8,795 lives across the affected West African region

Scientists at a French research institute say the Ebola virus has mutated and they are studying whether it may have become more contagious.

Researchers at the Institut Pasteur are analyzing hundreds of blood samples from Guinean Ebola patients in an effort to determine if the new variation poses a higher risk of transmission, according to the BBC.

“We’ve now seen several cases that don’t have any symptoms at all, asymptomatic cases,” said human geneticist Dr. Anavaj Sakuntabhai. “These people may be the people who can spread the virus better, but we still don’t know that yet. A virus can change itself to less deadly, but more contagious and that’s something we are afraid of.”

Although virus mutations are common, researchers are concerned that Ebola could eventually morph into an airborne disease if given enough time.

However, there is no evidence to suggest this has happened yet, and the virus is still spread only via direct contact with an infected person.

Institut Pasteur, which first pinpointed the current Ebola outbreak last March, is hoping that two vaccines they are developing will reach human trials by the end of the year.

Current figures indicate 8,795 of some 22,000 cases across Liberia, Guinea and Sierra Leone — around 40% — have been fatal.

[BBC]

TIME public health

Medical Pot May Have a Place for Very Ill Kids, Says Pediatric Group

Medical Marijuana
Colin Brynn—Getty Images

'The Academy recognizes some exceptions should be made for compassionate use'

In an update to its 2004 policy statement on marijuana legalization, the American Academy of Pediatrics (AAP) now says that in some cases, children with certain debilitating illnesses should be allowed derivatives of marijuana to ease their suffering.

The group of pediatricians announced the change in position today in a statement reaffirming its opposition to the legalization of marijuana. It now includes several exceptions for “compassionate use” in children dealing with debilitating or life-limiting conditions. Compounds found in pot, known as cannabinoids, have become a method of stopping seizures for children suffering from epilepsy.

“Given that some children who may benefit from cannabinoids cannot wait for a meticulous and lengthy research process, the Academy recognizes some exceptions should be made for compassionate use in children,” the organization said in a press release.

Read More: Pot Kids: Inside the Quasi-Legal, Science-Free World of Medical Marijuana for Children

The organization stopped short of explicitly endorsing the practice and called for further research into its effectiveness.

“While cannabinoids may have potential as a therapy for a number of medical conditions, dispensing marijuana raises concerns regarding purity, dosing and formulation, all of which are of heightened importance in children,” said policy statement co-author William P. Adelman in the press release.

The organization maintained its steadfast opposition to recreational marijuana use, arguing that allowing its use for adults is more likely to lead to increased use among teenagers.

“Just the campaigns to legalize marijuana can have the effect of persuading adolescents that marijuana is not dangerous, which can have a devastating impact on their lifelong health and development,” said Seth D. Ammerman, another author of the statement, in the release.

Your browser is out of date. Please update your browser at http://update.microsoft.com