TIME Infectious Disease

Most Countries Are Unprepared for Superbugs, Report Says

Only 34 countries have a comprehensive plan

Only 34 countries have plans in place to tackle antibiotic resistance and prevent superbug infections, according to a report.

The report, released on Wednesday by the World Health Organization (WHO), surveyed 133 countries about their level of preparedness for the growing global issue of antibiotic resistance. Only a quarter of countries that responded to the study said they have comprehensive plans.

“Scientists, medical practitioners and other authorities including WHO have been sounding the warning of the potentially catastrophic impact of ignoring antibiotic resistance,” said Dr. Keiji Fukuda, WHO’s assistant director-general for health security in a statement. “Today, we welcome what has been achieved so far, but much more needs to be done to avoid losing the ability to practice medicine and treat both common and serious illnesses.”

The overuse of antibiotics can contribute to the development of disease strains that are resistant to the very drugs used to treat them. Many countries do not have the necessary infrastructure to do proper surveillance of drug resistant diseases, according to the report. The issue of antibiotic sales without a prescription is also widespread and can contribute to overuse.

In 2013, there were an estimated 480,000 new cases of multidrug-resistant tuberculosis (TB). Another strain of drug resistant TB has been discovered in 100 countries, the WHO said. Other drug-resistant diseases have been identified around the world, including infections like gonorrhea and pneumonia.

The agency will be ask countries to declare their commitment to attempting to control the problem, and implement necessary steps to keep superbugs at bay.

TIME Infectious Disease

Americas Region Becomes World’s First to Eliminate Rubella

The last major endemic cases in the region were in 2009

The Americas region has become the first to successfully eliminate rubella, a contagious viral infection with similar symptoms to measles, health officials announced on Wednesday.

Medical experts are calling the milestone against the endemic transmission of the infection a “historic achievement.” Rubella and congenital rubella syndrome (CRS) are now the third and fourth vaccine-preventable diseases to be eliminated in the Americas, following small pox in 1971 and polio in 1994, and experts say it also speaks to the success of a 15-year initiative to provide widespread vaccination against mumps and rubella (MMR) in the area.

“It shows how important it is to make vaccines available even to the remotest corners of our hemisphere,” Carissa F. Etienne, Pan American Health Organization/World Health Organization (PAHO/WHO) director, said during a news conference.

Before mass vaccination was available, medical experts say an estimated 16,000 to 20,000 children were born with CRS in Latin America and the Caribbean. The last major endemic cases in the region were in 2009. The virus is usually mild, but it can cause birth defects and miscarriages when women are infected during pregnancy.

Rubella is less contagious and typically less severe than the measles, but health officials say measles is the next target and that many countries have set a goal to eliminate the disease in their borders as well. The U.S. has experienced new clusters of measles outbreaks in the last year, with low vaccination rates blamed among some communities.

Though rubella has been eliminated in the Americas, it’s still prevalent in other regions in the world. Dr. Susan E. Reef, the team leader for rubella in the Global Immunization Division at the U.S. Centers for Disease Control and Prevention (CDC), told reporters on Wednesday that the Americas region and the European region are the only two regions that have an official elimination goal for the disease.

“Now that we have achieved this goal,” Reef said, “the next step is to continue to maintain it.”

TIME toxins

Jeni’s Ice Cream Recalls All Products Because of Listeria Contamination

A pint of a Jeni's ice cream tested positive for Listeria

Jeni’s Splendid Ice Creams is recalling all its ice cream, frozen yogurt and sorbet after a sample tested positive for the deadly bacteria Listeria.

Once the contamination was discovered in a randomly selected pint of Jeni’s ice cream, the company “made the swift decision to cease all ice cream production and sales” until “all products are ensured to be 100% safe,” the company announced on its website Thursday.

“We have called in experts to help us find the root cause. We will be working with our suppliers to determine if the bacteria was introduced by one of the ingredients we use. We will not reopen the kitchen until we can ensure the safety of our customers,” a statement from Jeni’s CEO John Lowe reads.

The company is not aware of anyone getting sick from the contamination, but the recall announcement comes in the wake of an expanded recall of Blue Bell Ice Cream products, which have been linked to three Listeria-related deaths and several illnesses. The Centers for Disease Control and Prevention said the Blue Bell Listeria case dates back to 2010.

Listeria causes nausea, headaches, abdominal pain and diarrhea in healthy people. Listeria can be fatal to the very young, very old, and those with weak immune systems. It can also cause pregnant women to miscarry.

Read next: How Ice Cream Gets Contaminated—and Sometimes Kills

Listen to the most important stories of the day.

TIME Infectious Disease

An Experimental Ebola Drug Shows More Promise

TKM Ebola, which at least a few US and European health care workers may have received to treat their Ebola infection, is upgraded and proves effective in animal studies

When the Ebola outbreak hit last spring, there were a handful of potential treatments at the experimental stage in labs around the world. Some of them—like the drug TKM Ebola—that had shown promise in primates were given to U.S. and European health care workers who had been infected. Assessing how effective these drugs were in humans, however, posed some unique challenges.

That’s because many of the patients who got experimental treatments were also given a number of other therapies—making it impossible to know what was responsible for their recovery. But in a new paper published Wednesday, several of the scientists responsible for developing TKM Ebola, led by Thomas Geisbert of the University of Texas Medical Branch, report that the drug worked on all the monkeys it used it on, even after the monkeys were given a lethal dose of Ebola.

The animals exposed to Ebola that didn’t get the drugs all died at day eight or nine.

The study used an updated version of the drug that is made up of snippets of the Ebola virus’ genome encapsulated in fatty particles. The fragments bind to their matching counterparts on the circulating virus and become a genetic monkey wrench that prevents Ebola from copying itself and infecting more cells.

MORE: WHO Outlines Timeline for Experimental Ebola Drugs

It turns out that the virus responsible for the current outbreak in west Africa differs from the 1976 strain at three points in the Ebola genome, so Geisbert and his team adjusted the drug accordingly. That’s one of advantages of the TKM Ebola approach, he says, compared to therapies such as vaccines or other drugs that rely on antibodies to the virus. These regimens are designed to attack the broadest range of virus strains possible, but in doing so, they may give up some of their virus-fighting potency. With gene sequencing technology becoming more refined and accessible, however, having drugs that are specifically targeted against a particular strain of a virus is actually a realistic goal. “It’s especially important when you look at how big this outbreak is, and it’s continuing for over a year,” says Geisbert of such matched therapies. “With this technology, we could theoretically turn around a new treatment in something like weeks. This outbreak taught us a lot about how to prepare for the future.”

MORE: The Ebola Fighters

These results will still have to be repeated in human patients, to ensure TKM Ebola is both safe and effective, but they strongly hint that the drug could be a critical part of future anti-Ebola strategies. The company that is developing TKM, Tekmira Pharmaceuticals, is now testing this latest form of the drug in Ebola patients in Sierra Leone, west Africa.

TIME Infectious Disease

HPV Vaccine May Work For People Who Already Had the Virus

TIME.com stock photos Health Syringe Needle
Elizabeth Renstrom for TIME

A new study underlines the effectiveness of the HPV vaccine, showing the vaccine is protective against the virus on multiple sites on the body, even for women who have been infected in the past.

In a randomized controlled trial—considered the gold standard of scientific research—scientists wanted to know if the HPV vaccine protected against cervical, anal and oral HPV. Daniel C. Beachler, a postdoctoral fellow in the Infections and Immunoepidemiology Branch of the National Cancer Institute (NCI), and his colleagues followed 4,186 women between the ages of 18 to 25 who were either vaccinated with a HPV16/18 vaccine or a control vaccine (a hepatitis A vaccine). Cervical samples from the women were collected at their annual visits and oral and anal samples were collected at a four-year follow-up visit.

“We were interested in the question of whether the vaccination may protect non-infected sites against HPV infection or re-infection in women who were previously exposed to HPV prior to vaccination,” says Beachler. The study was presented at the American Association for Cancer Research annual meeting.

The results showed that the efficacy for the vaccine in all three sites was 83% among the women with no evidence of prior HPV exposure and infection, 58% among women with prior HPV exposure, and a 25% among women with active cervical HPV16/18 infection (the percentage was considered nonsignificant). In total, the researchers report that the overall vaccine efficacy was 65% for all sites and 91% for protection in at least two sites.

Among the women in the trial, some had no evidence of HPV, some had an active HPV infection, and some of the women did not have an active infection but had antibodies for HPV, suggesting that they had been exposed to the virus previously. That’s not uncommon, considering the U.S. Centers for Disease Control and Prevention (CDC) estimates that nearly all sexually active men and women get HPV at some point in their lives.

The CDC says teen boys and girls who did not start or finish the HPV vaccine series when they were younger should get it, and young women can get the vaccine through age 26 and young men through age 21.

The CDC says that girls who are already sexually active can still benefit from the vaccine, but it may be less effective since it’s possible they have already been exposed to one or more HPV strains. Still, the CDC says that since young women are not necessarily infected with all types of HPV, they can still benefit from the vaccine. This new study underscores that guidance.

“[This study] is supportive that there could be some benefit at these older ages,” says Beachler. “Close to 90% of individuals are able to clear an HPV infection on their own. This is not a therapeutic vaccine but it could still help protect from acquisition of new infections.”

Dr. Miriam Lango, a head and neck cancer surgeon at Fox Chase Cancer Center, says that the new study is some of the “best kind of evidence we have,” in support of vaccinating against HPV in women of that age. “My understanding was always that you get the vaccination before you get the infection and that after you’ve been infected there’s no benefit to having the vaccination,” she says. “That’s really not what the data tells us.” Lango was not involved in the study.

Beachler noted that at the end of the study, the women in the control arm of the trial were able to get vaccinated against HPV.

TIME ebola

Ebola Fighters Say Now Is Not the Time to Let Up

Barack Obama, Ellen Johnson Sirleaf, Alpha Condé
Manuel Balce Ceneta—AP President Barack Obama, flanked by Liberian President Ellen Johnson Sirleaf, left, and Guinean President Alpha Condé, speaks in the Cabinet Room of the White House in Washington, Wednesday, April 15, 2015, to discuss the progress made in the international Ebola response.

Cases may be nearing zero in certain areas, but the threat of the disease lingers

There were only 37 confirmed cases of Ebola last week, just a year after the deadly virus was spreading quickly across Western Africa. But key stakeholders in the effort to reduce the number of cases to zero said Thursday that success is not guaranteed.

“We are dealing now with the most difficult areas,” said Bruce Aylward, the assistant director-general of polio and emergencies at the World Health Organization. “We’re dealing with issues of fear, of trust with communities that have been marginalized. That have not been fully engaged.”

Alyward added, “These are issues that take time to resolve.” What’s more, the most affected areas are nearing their annual rainy season in April and May, which could exacerbate the disease’s spread. And, Alyward says, the eradication effort is running out of money.

“The only thing that’s falling faster than this graphic right here,” he said, holding up a chart that showed new confirmed cases, “is the one that shows you new financial contributions.”

The message on Thursday was clear: in the fight against Ebola, there’s no room for complacency. That’s not to say there hasn’t been progress. There has been a decline in new cases over the past several weeks and Liberia is inching closer to zero cases. In Sierra Leone, there were nine cases this past week and the week before. In Guinea, the situation is more mixed—there were 28 cases this week, up from 21 the week before. In an effort to keep numbers low, the government instituted a four-day stay-at-home policy in the most infected area so that teams can go to homes and share information.

Alyward, who joined WHO Director General Margaret Chan and others for a roundtable briefing at the United Nations Foundation on Thursday, said it’s important to keep up the fight, because if a single case or contact is missed, the community will suffer the consequences.

That message was similar to one that President Obama reiterated before meeting with leaders from Sierra Leone, Liberia and Guinea at the White House on Wednesday. “We can’t be complacent. This virus is unpredictable,” Obama said. “We have to be vigilant, and the international community has to remain fully engaged in a partnership with these three countries until there are no cases of Ebola in these countries.”

Presidents from the three countries will also appear Friday with World Bank Group President Jim Yong Kim to discuss the continued effort to get to zero. The meetings and appearances on the Ebola effort come in the wake of a scathing New York Times report that said the U.S.’s response to the crisis was too much, too late. Few of the treatment centers the U.S. military spent resources and manpower to complete have been put to use, the report found.

David Nabarro, who has organized the UN’s response to Ebola, said Thursday the American response should be commended. “This immediate and rapid response by the U.S. to use military to build treatment centers was amazing,” he said. “Instead of feeling abandoned by the world, they felt there was a group who believed they were worth supporting.”

TIME Infectious Disease

African CDC to Open in 2015

The goal for the agency is to support the continent with active disease surveillance and response

Secretary of State John Kerry signed an agreement Monday to help establish a Centers for Disease Control and Prevention (CDC) in Africa.

The memorandum of cooperation, signed by Kerry and African Union Commission (AUC) Chairperson Nkosanzana Dlamini Zuma, makes formal the relationship between the United States CDC and AUC, and mandates the establishment of an African CDC. The new institute, set to launch in 2015, will work to prevent and respond to future outbreaks in the continent, like the Ebola epidemic.

“The West African Ebola epidemic reaffirmed the need for a public health institute to support African ministries of health and other health agencies in their efforts to prevent, detect, and respond to any disease outbreak,” said CDC director Dr. Tom Frieden, in a statement. “This memorandum solidifies the commitment by the United States to advance public health across Africa and global health security.”

The formation of an African CDC has been under development for a few years, and the physical launch of the health institute will happen later this year. An African Surveillance and Response Unit will be established with an emergency operations center. Five regional centers will also be identified with a coordinating center in Ethiopia’s capital, Addis Ababa. Like the U.S. CDC, there will be epidemiologists at the various locations who will perform disease surveillance, investigation and tracking of infection trends. The new unit will also provide response expertise during large outbreaks.

“With the African CDC in place, these volunteers and others can be organized to form a deployable force ready to serve Member States during future health emergency responses on the continent,” said a CDC statement.

TIME Infectious Disease

A Virus Spread by Ticks Could Be More Dangerous Than Lyme Disease

Virus could cause permanent neurological damage, and has no cure

Don’t just worry about Lyme disease this summer—Powassan virus is also spread by ticks, and doctors say it could be much more dangerous.

Ticks in the Northeast and around the Great Lakes are carrying the Powassan virus, which can cause encephalitis and meningitis, leaving about half of survivors with permanent neurological symptoms. According to the Centers for Disease Control and Prevention, about 10% of Powassan virus cases are fatal.

Doctors told CBS2 that symptoms of Powassan are similar to Lyme disease, but much more severe, and that the patients can start exhibiting symptoms—including vomiting, fever, confusion and weakness—just minutes after infection. There is no known treatment or cure.

Powassan is still much less common than Lyme disease. There were only 12 reported cases in 2013, the highest number since 2004 (there were also 12 cases in 2011), according to the CDC.

[h/T CBS2]

TIME Infectious Disease

Travelers Are Bringing a Superbug into the United States

CDC

The bug is resistant to the antibiotics used to treat it

Some international travelers are bringing back and spreading a bacteria that’s resistant to the drugs used to treat it, the U.S. Centers for Disease Control and Prevention (CDC) reported on Thursday in an investigation published in the CDC’s Morbidity and Mortality Weekly Report.

The bug, called shigella sonnei, causes an estimated 500,000 cases of diarrhea in the U.S. each year, and the CDC reports that between May 2014 and February 2015, a drug-resistant strain infected 243 people in 32 states and Puerto Rico. When investigating clusters of shigellosis—the infection caused by shigella—in Massachusetts, California and Pennsylvania, the CDC discovered that 90% of the cases were resistant to an antibiotic called ciprofloxacin (Cipro), which is the drug of choice when treating shigellosis.

Most shigella strains are already resistant to other drugs used to treat it, and public health experts have noted that a Cipro-resistant strain is spreading worldwide. The bacteria can spread very quickly and are commonly discovered in places like childcare centers and nursing homes, according to the report.

“Drug-resistant infections are harder to treat and because Shigella spreads so easily between people, the potential for more—and larger—outbreaks is a real concern,” said CDC director Dr. Tom Frieden in a statement. Frieden added that the recent outbreaks reveal a “troubling trend” of infections in the U.S.

The CDC was first alerted to a new strain of shigella in December 2014 and discovered in the lab that it was resistant to Cipro. The CDC then investigated several large clusters of shigella infections across the United States. Nearly 100 cases were from an outbreak among homeless people in San Francisco, and others were related to international travel. Infection can be common among people who travel to developing countries.

The CDC says international travelers should wash their hands “meticulously” and be cautious about food and water consumption. Travelers can download the CDC’s app, “Can I Eat This?” as a guide for what’s safe to eat while traveling.

Antibiotic resistance is becoming a growing global problem; in September 2014, President Obama signed an executive order to create a task force to tackle the issue of antibiotic-resistant bacteria.

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.

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