TIME Disease

South Korea Authorizes Prison Time for MERS Patients Who Break Quarantine

Quarantine tent in Seoul, South Korea
Chung Sung-Jun—2015 Getty Images Visitors wearing masks walk in front of a health advisory sign about the MERS virus at a quarantine tent for people who could be infected with the MERS virus at Seoul National University Hospital on June 2 in Seoul, South Korea.

The country is in the midst of the worst outbreak ever seen outside of Saudi Arabia

South Korea tightened quarantine restrictions on patients at risk of being infected with Middle East Respiratory Syndrome virus, declaring that those who defy orders or lie about their potential exposure are now subject to prison terms.

Health officials announced that violators could face up to two years in prison and a fine of 20 million won, or approximately $18,000. Currently, defying quarantine can result in a fine but not a jail sentence.

The new law, which grants greater authority to public health investigators, does not take effect for another six months. The latest tally for the disease reached 181 confirmed cases and 31 confirmed deaths since the outbreak began last month.

[New York Times]

TIME South Korea

South Korea Reports 13th Death From MERS Outbreak

South Korean Health Ministry reported about 3,680 people were still isolated on Friday

(SEOUL, South Korea)—Authorities in South Korea temporarily closed two hospitals amid persistent fears over the MERS virus outbreak, which has killed 13 people through Friday, though health officials said they are seeing fewer new infections.

More than 120 people in South Korea have been diagnosed with Middle East respiratory syndrome since the country reported its first case last month. The outbreak, the largest outside Saudi Arabia, has been occurring only in hospitals, among patients, family members who visited them and medical staff treating them. Still, it has caused widespread fears and rumors, and about 2,900 schools and kindergartens remained closed Friday.

South Korean officials have hoped the disease would begin to ease since the virus’ maximum two-week incubation period for those infected at a Seoul hospital considered as the main source of the outbreak ended Friday. However, several hospitals have treated MERS patients, and the later incubation periods for them is raising worries of possible new sources of infections.

Mediheal Hospital in western Seoul and Changwon SK Hospital in the southern city of Changwon were ordered to temporarily shut down after MERS patients were found to have had contact with hundreds of people there before they were diagnosed, according to officials at Seoul and Changwon.

There are currently no MERS patients at the two hospitals, but dozens of medical staff and existing patients are quarantined at the facilities. Mediheal is to reopen on June 23, and Changwon SK on June 24, city officials said.

Central government officials say there is little chance of the virus spreading from those hospitals because they are quarantining people who had contacts with infected people and monitoring them.

“We see no danger of an additional spread,” Jeong Eun-kyeong, a senior official from the Korea Center for Disease Control and Prevention, told a news conference. She said only a small number of new infections could still be reported from those hospitals.

Some experts have said the outbreak could continue if there are a large number of infected people who evaded government quarantine measures and spread the virus.

The Health Ministry reported just four new cases on Friday, after registering 14 Thursday and 13 on Wednesday. About 3,680 people were still isolated on Friday after possible contacts with infected people, a decline from more than 3,800 on Thursday, according to the ministry.

Senior ministry official Kwon Deok-cheol told the news conference that the public should stop worrying too much about the outbreak as the number of new cases has been falling.

Most of the deaths have been of people suffering from pre-existing medical conditions, such as respiratory problems or cancer.

Three MERS patients in their 70s died on Friday, raising the country’s number of MERS-related deaths to 13. The three had suffered from conditions such as pneumonia, asthma, lung diseases and high-blood pressure before they were confirmed as having MERS, the Health Ministry said.

Experts think MERS can spread in respiratory droplets, such as by coughing. But transmissions have mainly occurred through close contact, such as living with or caring for an infected person.

MERS has a death rate of about 40 percent among reported cases. It belongs to the family of coronaviruses that includes the common cold and SARS, and can cause fever, breathing problems, pneumonia and kidney failure.

TIME health

How the Gates Foundation Aims to Cut Childhood Mortality in Half

Filling bellies: Melinda Gates and the Gates Foundation are going after one of the leading killers of babies
J. Countess; Getty Images Filling bellies: Melinda Gates and the Gates Foundation are going after one of the leading killers of babies

Jeffrey Kluger is Editor at Large for TIME.

A new grant will go straight after a leading killer of kids under five: undernutrition

Correction appended, June 3

There are a lot of ways to think about child mortality—most of them not very pretty. You can think of the 6.3 million children every year who never live to see their fifth birthday. You can think of how that breaks down to the loss of 17,260 babies every day, day after day, for 365 days.

But you can also think that those terrible numbers are exactly half of what they were in 1990, meaning that last year, 6.3 million children who would not have seen age five did. Most of that extraordinary progress has been made by controlling, treating or vaccinating against preventable diseases like cholera, measles, pneumonia and malaria. Now, the Bill and Melinda Gates Foundation proposes to slash the child mortality rate in half once more, announcing a plan to invest $776 million over the next six years to advance one of the most primal and important health interventions of all: giving kids enough to eat.

Death by starvation or undernutrition can be hard to track, because while it’s not always the proximate killer, it’s often the accomplice. Expose a well-nourished child and an undernourished child to, say, the measles virus and it’s no mystery which one of them has a better prognosis.

“Estimates are that in about 50% of all of the remaining under-five deaths, nutrition played at least a significant role,” said Melinda Gates in a conversation with TIME.

The Foundation aims to change that in a lot of ways—little of which will involve the old bags-of-rice-offloaded-at-the-airport model. Emergency supplies can fill gaps in times of natural disasters, but they are, as Gates calls them, downstream strategies—sustainable only as long as the supplies keep flowing from generous benefactors. Upstream strategies involve putting systems in place so that generous benefactors are eventually not needed.

Part of the new strategy will involve providing seeds and the know-how for planting and harvesting such bulked-up crops as golden rice, the super banana and the fortified sweet potato. These and other GMO foods have caused all manner of controversy in the developed world, but people like the Gates focus on the increased vitamin A in such crops, which builds skin, teeth, bones and soft tissue and has anti-oxidant properties.

Instruction will also be given in no-till agriculture and drip-irrigation, which conserve both water and soil. Research stations will be opened in targeted areas to increase public awareness of both the existence of the crops and the best ways to raise them. And a special effort will be made to put this knowledge at the disposal of the family member who is likeliest to make the best use of it: the mother.

“Fifty percent of all farmers in Africa are women,” says Gates. “And research shows that every extra dollar a woman gets is 90% likelier to be put back into the family than a dollar a man gets. We want to put women at the center of this.” Expanding wireless access is another key part of the program, allowing farmers—men or women—to have ready access to commodity prices, so they can sell their crops at the top of the market.

Women are central in other ways too. Good nutrition starts before a baby is born, and most health experts believe it is the first 1,000 days—from conception through age two—that make the greatest difference in long-term physical and intellectual development. That means educating young women and adolescent girls about proper diet before they get pregnant, and encouraging breastfeeding after birth.

The Foundation will also be pressing to get government and religious leaders to climb on board—or at least get out of the way. “We need governments to impose the regulations needed to get the most out of nutrition programs,” says Gates. “We can do that by showing them the evidence. Brazil, for example, has gotten its malnutrition rate down by 80%. So we show that data and say, ‘Now it’s up to you to decide.'”

And while Taliban extremists have tried to block polio vaccination efforts in Pakistan, that kind of deadly obstructionism is hardly true of all parts of the Muslim world. “Nigeria has a high Muslim population and they have said ‘We will help you,'” Gates says,—and not just in matters directly related to food. “The Koran allows for family planning and we can get that message out.”

For now, the Foundation’s funds will be concentrated in five critical spots: India, Ethiopia, Nigeria, Bangladesh and Burkina Faso. That money will be supplemented by even more. The Gateses’ grant frees up $180 million in partial matching funds from the U.K.’s Department for International Development. The European Union, meanwhile, has pledged a whopping €3.5 billion by 2020 to battle child malnutrition.

That’s a big number—but it comes from a bloc of 28 nations. The Gates grant comes from a couple with a foundation and a mission. If that mission includes saving 17,260 babies every 24 hours, well, that’s a pretty fair day’s work.

Correction: The original version of this story misstated the amount of money the Bill and Melinda Gates Foundation is investing. It is $776 million.

Read next: Here’s What’s on Bill Gates’ Summer Reading List

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TIME Infectious Disease

Bill Gates Thinks This Is the Deadliest Threat to Humankind

Bill Gates, co-founder of Microsoft and co-chair of the Bill and Melinda Gates Foundation, speaks at a breakfast meeting with the theme "Dialogue: Technology Innovation for a Sustainable Future" during the Boao Forum For Asia Annual Conference 2015 in Qionghai city, south Chinas Hainan province, 29 March 2015.
Cui hao—Imaginechina/AP Bill Gates, co-founder of Microsoft and co-chair of the Bill and Melinda Gates Foundation, speaks at a breakfast meeting with the theme "Dialogue: Technology Innovation for a Sustainable Future" during the Boao Forum for Asia Annual Conference 2015 in Qionghai city, China's Hainan province, on March 29, 2015

He says it could kill tens of millions

In the next 20 years, is it likely that nuclear war, gigantic earthquakes or asteroids could kill 20 million people? Bill Gates doesn’t think so.

But he did tell Vox that such numbers could be felled by a major outbreak of disease — something the 59-year-old billionaire believes has a “well over 50%” chance of happening in his lifetime.

“The Ebola epidemic showed me that we’re not ready for a serious epidemic, an epidemic that would be more infectious and would spread faster than Ebola did. This is the greatest risk of a huge tragedy,” Gates said, claiming that a serious epidemic could kill more than 10 million people a year.

Read more at Vox

TIME global health

Man Dies of Rare Lassa Fever in New Jersey

He had recently returned from traveling in Liberia

A man died of a rare African virus in New Jersey Monday after recently returning from Liberia, officials confirmed.

The man died of Lassa fever, a virus that causes hemorrhagic symptoms but is very different from Ebola, the Centers for Disease Control and Prevention said. Lassa fever is only fatal for 1% of those who are infected, while Ebola can be fatal for 70% of those infected without treatment. Lassa fever is also much harder to spread from person to person (it’s usually picked up from rodent droppings). About 100,000 to 300,000 Lassa fever cases are reported in West Africa every year, resulting in about 5,000 deaths.

The man with Lassa fever had arrived at JFK airport from Liberia on May 17, and went to a hospital the following day complaining of fever, sore throat and tiredness, officials said. At that time, he did not say he had been traveling in West Africa, and he was sent home the same day. On May 21 his symptoms worsened and he returned to the hospital, at which point he was transferred to a facility equipped to deal with viral hemorrhagic fevers. The patient was in “appropriate isolation” when he died Monday evening. The CDC is working to compile a list of people who may have encountered the patient while he was sick, and they are monitoring close contacts for 21 days to see if they develop the virus.

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 global health

Swine Flu Outbreak Kills 700 in India

Students wearing masks to prevent getting infected by Swine
Pacific Press—LightRocket/Getty Images Students wearing masks to prevent getting infected by Swine flu in Allahabad, India on Feb. 18 2015.

A total of 11,000 people have been infected

A serious outbreak of H1N1 has struck in India, causing more than 700 deaths in the last eight weeks.

More than 11,000 have been infected with the disease commonly known as swine flu, Boomberg reports. The outbreak is thought to be the worst the country has seen since 2009. Infections have seemed to gain momentum over the last week, with the total number of cases doubling since Feb. 11.

While the government said Thursday that there was plenty of medicine available to treat H1N1, hospitals have reported shortages—potentially due to individuals stockpiling the drug as the outbreak worsens.

[Bloomberg]

TIME Cancer

Lung Cancer Now Kills More Women Than Breast Cancer in Developed Countries

The lingering effects of the tobacco epidemic are partly driving the shift

For years, breast cancer has been the leading cause of cancer death among women in developed countries, but according to a new report on the incidence of cancer worldwide from the American Cancer Society, lung cancer now surpasses it.

A combination of early breast cancer detection efforts and the lingering effects of the tobacco epidemic drove the shift, says lead report author Lindsey Torre, an American Cancer Society researcher. The study, which was published in CA: A Cancer Journal for Clinicians and used data from 2012, reported that lung cancer killed 209,000 women in developed countries in 2012, while 197,000 women died of breast cancer.

“We know now that in a lot of developed countries among women, smoking is on the decline,” says Torre, noting that new lung cancer infections today are the result of habits formed decades ago. “The good news is that we can probably expect to see these lung cancer mortality rates peak and start to decline as times go by.”

Read more: The Cancer Breakthrough With Big Implications

The report emphasized the growing incidence of cancer in the developing world. Lung cancer was the leading killer of men in developing countries and breast cancer the leading cause of death for women.

In part, these growing numbers can be attributed to an aging population, a trend that is affecting the world at large. And as the developing world continues to westernize, people in developing countries are increasingly likely to smoke, be overweight and rarely engage in psychical activity, Torre says.

“We’re seeing the burden of cancer shift to developing countries, so they’re taking on an increasing portion of the global cancer burden,” she says.

Cancer killed 8.2 million people worldwide and 1.6 million in the United States in 2012.

TIME China

9 out of 10 Chinese Cities Fail Pollution Test

China Smog Air Pollution Jilin
ChinaFotoPress/Getty Images Smog arrives at the banks of the Songhua River due to low temperatures in Jilin Province, China on Jan. 22, 2015.

Only eight of 74 cities monitored met national standards

Nearly 90% of Chinese cities failed to meet government pollution standards last year, according to the country’s environment ministry.

Although only eight of 74 cities monitored were found to meet national standards, the country’s Ministry of Environmental Protection said the results were an improvement over previous years, Reuters reports.

The country declared a “war on pollution” last year and has since taken steps to reduce the use of coal and eliminate factories that don’t meet certain standards.

Read more: Watch This Haunting Seven-Minute Film About China’s Insane Air Pollution

The government has said that meeting its own standards could take up to 15 years. The city of Beijing, for instance, had an average atmospheric pollutant reading of 93 micrograms of particulate matter per cubic meter last year — almost three times the state-determined standard of 35 micrograms per cubic meter.

China—the world’s largest polluter— produces a quarter of the world’s carbon dioxide emissions.

[Reuters]

TIME global health

This Species Is Close to Extinction and That’s a Good Thing

Guinea worm
John Bazemore—AP Volunteers Moises Matos and Helen Hand help assemble medical kits to fight Guinea worm disease at a warehouse on July 28, 2004 in Atlanta.

The disappearance would mark the scouring of a disease from the face of the earth

WSF logo small

The Guinea worm is inching ever closer to extinction, but unlike just about every other endangered species, no one is going to try to save it, least of all scientists. On the contrary, the worm’s disappearance would mark the scouring of a disease from the face of the earth—a feat humanity’s only been able to celebrate twice before, with the end of smallpox in 1980 and of the cattle disease rinderpest in 2011. (Polio, despite the fact that a vaccine’s been around for more than half a century, has managed to hang on by its microscopic threads.)

What Is Guinea Worm Disease?

The Guinea worm is a parasite that enters the human body when the unwitting host-to-be drinks water contaminated with tiny water fleas in which Guinea worm larvae lurk. Once ingested, the fleas die and the Guinea worm larvae enter the host’s abdominal cavity and, unbeknownst to the host, begin maturing into a worm or worms that grow up to three feet in length. After about a year a painful blister forms on the host’s skin accompanied by itching and a burning sensation. Within about 10 to 15 days, one or more worms erupt from the person’s skin in a painful and drawn-out process. The emergence can occur from different parts of the body, including the roof of the mouth, the genitals, or the eye sockets, but around 90 percent of the worms emerge from the lower legs, according to the World Health Organization (WHO). (There are plenty of videos of Guinea worm extractions on YouTube, but be warned they’re quite unsettling.)

While the disease rarely kills, it can leave the host debilitated and weakened for a short or long period of time.

“The lesions caused by the worms often develop secondary bacterial infections that migrate all along the tract where the worm was,” says Ernesto Ruiz-Tiben, the director of the Carter Center’s Guinea worm eradication program. “The pain and agony can last for weeks.”

To alleviate the pain, the infected person often dips the part of the body from which the worm has emerged into water, where the female worm that is emerging can lay more larvae, and begin the process anew.

A Disease on the Decline

Thanks in large part to the work of the Carter Center, the incidence of Guinea worm disease (also known as dracunculiasis, which is Latin for “affliction with little dragons”) has plummeted in recent years, falling from an estimated 3.5 million cases worldwide in the mid-1980s to just 148 in 2013 and 126 in 2014, according to the WHO.

How has such success been achieved? It’s taken the concerted effort of all involved—the scientists who have figured out how to contain it, community organizers who have helped spread the word on preventative solutions, and the people in areas where Guinea worm disease has been a big problem who are implementing the necessary changes to keep the parasite at bay.

“Guinea worm eradication is like an orchestra: Every player has to play their own instrument but play from the same page of music,” says Ruiz-Tiben.

WORLD SCIENCE FESTIVAL: The Rise of Preventable Illnesses

There’s No Cure for the Long-Lived Dracunculiasis, but Preventive Measures Are Finding Success

While it could disappear in the near future, dracunculiasis is a disease that has been around for centuries. It is believed to be the “fiery serpents” referenced in the Old Testament, and the calcified remains of a male Guinea worm were found in an Egyptian mummy.

The treatment has been around a long time too. A description found on an Egyptian papyrus from 1,500 BC outlines the treatment that’s followed today: Wind the worm around a stick as it emerges.

But unlike rinderpest and smallpox, Guinea worm disease cannot be vaccinated against. Preventing its infection is a matter of making sure people don’t drink the contaminated water. To that end, education and water filtration are key. Both cloth filters, used to filter large amounts of water in containers, and smaller pipe filters, used like a straw when drinking, can screen out the water fleas that carry the Guinea worm larvae. There are also ways of chemically treating water sources to reduce populations of water fleas, but the microorganisms eventually return.

“There’s no magic bullet against this disease,” Ruiz-Taben says. But “the more barriers we can put out there to interrupt the life cycle of this disease, the greater likelihood there is that we can interrupt transmission.”

Once spread across Africa, the worm is now holding on only in South Sudan, Mali, Chad, and Ethiopia. Stamping out those last few strongholds, says Ruiz-Taben, is just a matter of continuing the cooperative work that’s been going on since the 1990s. As the journalist Julius Cavendish wrote in the Bulletin of the World Health Organization this past December:

“Not only is guinea-worm disease relatively easy to control, in theory, but the benefits of eradication far outweigh the costs. … According to a 1997 World Bank study, the economic rate of return on the investment in Guinea-worm disease eradication will be about 29% per year once the disease is eradicated… removing guinea-worm disease translates into hundreds of thousands of communities better able to work their fields, send their children to school and escape the cycle of poverty and disease.”

WORLD SCIENCE FESTIVAL: How We Bounce Back: The New Science of Human Resilience

If Wiped Out, Could It Recrudesce?

If the number of cases drops to zero, there should be little chance of dracunculiasis coming back. There could be hurdles to its total annhilation, however. While Guinea worms (unlike Ebola) don’t seem to have a widespread tendency to hide out in animals when they’re not infecting humans, there have been a few reports of dogs with the worms reported in Chad; if this turns out to be a more common phenomenon, eradication efforts may have to turn to preventing those canine cases too. And if those countries that host the last areas of Guinea worm infestation were to suffer from war, famine, or other kinds of instability, that could slow the process of eradication. In Mali, for example, just seven cases were reported in 2012—but those numbers increased slightly in 2013 and 2014, when conflict with Islamist rebels hampered eradication efforts.

Still, the ultimate end looks to be within reach. Does Ruiz-Taben think he’ll see Guinea worm disease completely eliminated in his lifetime?

“I am very hopeful—more than hopeful,” he says.

WORLD SCIENCE FESTIVAL: What Will Happen to Your Body in 2015?

This article originally appeared on World Science Festival.

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