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.

TIME animals

Millions of Genetically Modified Mosquitoes Could Be Released in Florida

Jason Garcia
Wilfredo Lee—AP Jason Garcia, a field inspector with the Florida Keys Mosquito Control District, tests a sprayer that could be used in the future to spray pesticides to control mosquitos in Key West, Fla., on Oct. 4, 2012

"This is essentially using a mosquito as a drug to cure disease"

Scientists could release millions of genetically modified mosquitoes in the Florida Keys in an attempt to kill off insects that spread the diseases dengue and chikungunya — if their proposal wins regulatory approval.

The male mosquitoes, created by British biotech firm Oxitec, are engineered to keep their partners from producing offspring when they mate in the wild, the Sun Sentinel reports. The number of mosquitoes capable of spreading the diseases would be reduced if enough wild mosquitoes mate with the genetically modified population.

“This is essentially using a mosquito as a drug to cure disease,” Michael Doyle, executive director of the Florida Keys Mosquito Control District, told the Sun Sentinel.

Despite the benefits of reducing incidences of dengue and chikungunya, two viral diseases that cause a number of uncomfortable conditions, many are wary about releasing genetically modified organisms into the wild. More than 130,000 people have signed a Change.org petition opposing the release of the mosquitoes in the Florida Keys.

[Sun Sentinel]

TIME global health

What the Gates Foundation Has Achieved, 15 Years On

Sunny days: Melinda and Bill Gates in 2014, one year before their self-imposed deadline arrived
Scott Olson; Getty Images Sunny days: Melinda and Bill Gates in 2014, one year before their self-imposed deadline arrived

Jeffrey Kluger is Editor at Large for TIME.

Much has been done over the foundation's first decade and a half — with more still to do

There are a whole lot of things you may or may not get to do in the next 15 years, but a few of them you can take for granted: eating, for one. Having access to a bank, for another. And then there’s the simple business of not dying of a preventable or treatable disease. Good for you—and good for most of us in the developed world. But the developed world isn’t the whole story.

The bad—and familiar—news is that developing nations lag far behind in income, public health, food production, education and more. The much, much better news is that all of that is changing—and fast. The just-released Annual Letter from the Bill and Melinda Gates Foundation makes a good case for hoping there is still more to come.

The 2015 letter represents something of a threshold moment for the Foundation. It was in 2000 that the Gateses began their work and set themselves a very public 15-year deadline: show meaningful progress in narrowing the health, income and resource gap between the world’s privileged and underprivileged people, or be prepared to explain why not. So far, nobody—neither the Gates Foundation nor the numerous other global health groups like the World Health Organization and UNICEF—have much explaining to do.

The number of children under five who die each year worldwide has been nearly cut in half, from a high of nearly 13 million to 6.5 million today. Polio has been chased to the very brink of extinction, and elephantiasis, river blindness and Guinea worm are close behind. Drought-tolerant seeds are dramatically increasing agricultural yields; economies in the once-desperate countries in sub-Saharan Africa are now matching the developed world in rate of annual growth. Up to 70% of people across the developing world now have access to wireless service, making mobile banking possible—a luxury in the West but a necessity in places there is no other banking infrastructure.

The trick of course is that progress isn’t the same as success. The 13 million babies who were dying a year in the years before the Foundation began, for example, factored out to a horrific 35,000 every single day. Slashing that in half leaves you with 17,500—still an intolerable figure. For that reason and others, the Gateses are turning the 15-year chronometer back to zero, setting targets—and framing ways to achieve them—for 2030.

The most pressing concern involves those 17,500 kids. The overwhelming share of the recent reduction in mortality is due to better delivery of vaccines and treatments for diseases that are vastly less common or even nonexistent in much of the developed world—measles, pneumonia, malaria, cholera and other diarrheal ills. Those are still the cause of 60% of the remaining deaths. But the other 40%—or 2.6 million children—involve neonates, babies who die in the first 30 days of life and often on the very first day. The interventions in these cases can be remarkably simple.

“The baby must be kept warm immediately after birth, which too often doesn’t happen,” Melinda Gates told TIME. “This is basic skin-to-skin contact. Breast-feeding exclusively is the next big thing, as is basic cord care. The umbilical cord must be cut cleanly and kept clean to prevent infections.”

HIV may similarly be brought to heel, if not as easily as neonate mortality. A vaccine or a complete cure—one that would simply eliminate the virus from the body the way an antibiotic can eliminate a bacterium—remain the gold standards. But in much of the world, anti-retrovirals (ARVs) have served as what is known as a functional cure, allowing an infected person to live healthily and indefinitely while always carrying a bit of the pathogen. Gates looks forward to making ARVs more widely available, as well as to the development of other treatment protocols that we may not even be considering now.

“We’re already moving toward an HIV tipping point,” she says, “when the number of HIV-positive people in sub-Saharan Africa who are in treatment will exceed the number of people becoming newly infected.”

Food security is another achievable goal. Even as Africa remains heavily agrarian—70% of people in the sub-Saharan region are farmers compared to 2% in the U.S.—yields remain low. An acre of farmland here in America may produce 150 bushels of corn; in Africa it’s just 30. The problem is largely rooted in our increasingly unstable climate, with severe droughts burning out harvests or heavy rainstorms destroying them.

“Millions of people eat rice in Africa,” says Gates, “and rice has to be kept much wetter than other crops. At the equator it’s staying drier longer, but when the rains do come, they hit harder.”

In the case of rice and corn and all other crops, the answer is seeds engineered for the conditions in which they will have to grow, not for the more forgiving farmlands of the West. In Tanzania, site-specific seed corn has been made available and is already changing lives. “That seed,” one farmer told Gates when she visited in 2012, “made the difference between hunger and prosperity.”

Finally comes banking. Across Africa, only 37% of people are part of the formal banking system, but up to 90%, depending on the area, are part of the M-Pesa network—a mobile banking link accessible via cellphone. The Pesa part of the name is Swahili for money and the M is simply for mobile.

“Today too many people put their money in a cow or in jewelry,” Gates says. “But it’s impossible to take just a little of that money out. If someone gets sick or you have another emergency, you simply sell the cow.” Mobile banking changes all of that, making it much easier to save—and in a part of the world where even $1 set aside a day can mean economic security, that’s a very big deal.

Nothing about the past 15 years guarantees that the next 15 will see as much progress. The doctrine of low-hanging fruit means that in almost all enterprises, the early successes come easier. But 15 years is a smart timeframe. It’s far enough away that it creates room for different strategies to be tried and fail before one succeeds, but it’s close enough that you still can’t afford to waste the time you have. Wasting time, clearly, is not something the folks at the Gates Foundation have been doing so far, and they likely won’t in the 15 years to come either.

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 Infectious Disease

Five Workers at Disneyland Have Been Diagnosed With Measles

Disneyland in Anaheim, Calif.
H. Lorren Au Jr.—AP Disneyland in Anaheim, Calif.

Unvaccinated workers who came into contact with them have been asked to take paid leave

Five employees at Disneyland, California have been diagnosed with measles, bringing the total number of cases in the outbreak up to 53.

All workers who have come into contact with the five have been asked to show vaccination records or do a blood test, the Los Angeles Times reports.

Those who have not been vaccinated have been asked to go on paid leave until their health status can be confirmed.

Earlier this month, nine cases of measles were confirmed in two California-based theme parks, and in Utah from people who had visited the resorts between Dec. 17 and 20.

Since then, the disease has spread across three other states and to Mexico.

[LAT]

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