TIME health

Vaccinations Have Always Been Controversial in America

vaccination
Getty Images

Zocalo Public Square is a not-for-profit Ideas Exchange that blends live events and humanities journalism.

While creating the polio vaccine, Jonas Salk had to deal with critics like Walter Winchell, who warned, "It may be a killer"

In 1952, Americans suffered the worst polio epidemic in our nation’s history. As in prior outbreaks, the disease spread during the summer, mainly attacking children who had been exposed to contaminated water at public pools or contaminated objects in other communal places. The poliovirus entered the body through the mouth and multiplied in the gastrointestinal tract. Symptoms started innocently enough—a sore throat, a runny nose. As the virus moved throughout its victims’ bloodstreams, the pains soon began—electric shocks darting through the neck to legs, muscle spasms. Within a day or two, paralysis set in. If the virus made it to the nervous system in the base of the brain, death came quickly. By the time the outbreak’s end, 58,000 people had been stricken. More than a third were paralyzed, many of whom spent the rest of their lives in a wheelchair or bed.

Most Americans today have no concept of the terror generated by polio throughout the first half of the 20th century. During epidemics, newspapers and magazines displayed adorable children struggling to walk in braces or entombed in iron lungs, but the disease mostly fell off the national radar after it was eliminated from the country in 1979. In the past few years, however, polio has begun creeping back into headlines, for two opposite reasons. On the one hand, thanks to the Global Polio Eradication Initiative, the world is closer than ever to wiping out the virus completely; widespread vaccination efforts reduced the number of cases to 414 in 2014, mostly in Pakistan and Afghanistan. On the other hand, because of recent anti-vaccination trends, it’s not unreasonable to worry that a resurgence of polio might afflict Americans again.

The person responsible for easing our minds over the past half century was Jonas Salk, a physician-scientist who was born in a New York tenement and driven by a passion to aid mankind. During the 1952 outbreak, with funds from the March of Dimes, he rushed to develop the earliest vaccine for polio that used a killed, or “inactivated,” form of the virus. In that, he met resistance from more-senior scientists who believed that only a vaccine made from a live virus could provide lifelong protection.

The public was desperate for a vaccine, yet Salk was afraid these scientists would try to derail his efforts. Objections from one even prompted the famed newscaster Walter Winchell to warn his radio audience not to take the vaccine, because “it may be a killer.” So Salk initially made and tested his vaccine in secret. Thankfully, his promising preliminary results led to the March of Dimes launching the biggest clinical trial in the history of medicine. Beginning on April 26, 1954, with a six-year-old named Randy Kerr from McLean, Virginia, the trial eventually involved 1.5 million children, and had remarkable results: Salk’s vaccine was 80 to 90 percent effective in preventing paralytic polio. It was mass-produced and distributed around the country, and by the end of the decade, it had reduced the incidence of paralytic polio in the United States by 90 percent.

When the success of the vaccine trial was first announced, the public crowned Jonas Salk a national hero. He experienced a celebrity accorded few scientists in the history of medicine. Yet his rebuke by the scientific community had only just begun. As heads of states around the world rushed to honor him, scientists—the one group whose adulation he craved—remained ominously silent. Basil O’Connor, director of the National Foundation for Infantile Paralysis/March of Dimes, said they acted as if Salk had committed a felony. They accused Salk of failing to give proper credit to other researchers whose work had laid the foundation for his own. Salk in fact had tried to give them credit. But the media had made him the icon for polio, ignoring other scientists’ contributions. This set the stage for difficulties throughout Salk’s career wherein politics in and beyond the scientific community seemed to override good science.

In 1961, a public health decision was made to replace Salk’s vaccine with one developed by a virologist who constantly tried to discredit him, Albert Sabin. Sabin’s oral vaccine, made with a live virus, was cheaper and more convenient, but also much riskier; it actually caused polio in some cases. Salk worked throughout the rest of his life trying to reverse the decision—a sole warrior in a fight against what he considered entirely a politically-driven change. (In 1999, four years after his death, the Sabin vaccine was replaced with a new version of Salk’s vaccine, which is still used today.)

Salk also campaigned vigorously for mandatory vaccination, putting the health of the public foremost. He went as far as calling the immunization of all the world’s children a “moral commitment.” Thanks to his efforts—along with those of other researchers—we’re able to enjoy our summers without the fear of a crippling disease.

America now has been polio free for more than 35 years, and children are supposed to be vaccinated when they are babies. We’ve reached the point, however, where it seems many people can’t believe an epidemic could really occur. Some parents refuse vaccination, arguing that a healthy lifestyle is enough to protect their children from potentially lethal infections. But studies have shown that the introduction of sanitation actually enhances the circulation of poliovirus, because babies are no longer exposed to the virus in the very small amounts that used to produce lifelong immunity. Poliovirus can spread relentlessly once it gets a foothold in an unvaccinated community.

Such was the case shortly after Salk’s vaccine was released in 1955. Massachusetts closed its vaccination program because a manufacturing error led to some contaminated shots. Even though the mishap was quickly corrected, the state did not reopen its program. That summer, Massachusetts suffered one of its largest epidemics. Four thousand people contracted polio, and 1,700 were paralyzed—mostly children.

Does the public want to repeat history? I think Jonas Salk would plead with them to learn lessons from our past. Californians did with the recent measles outbreak, which affected more than 130 people, the majority of whom were unvaccinated. This helped spur the state to join Mississippi and West Virginia by mandating childhood vaccination, despite an outcry from several groups. Now if only 47 other states would follow suit.

Charlotte DeCroes Jacobs is a professor emerita at the Stanford University School of Medicine and the author of Jonas Salk: A Life. She wrote this for What It Means to Be American a national conversation hosted by the Smithsonian and Zocalo Public Square.

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 Cancer

Black Men are Twice as Likely to Die of Prostate Cancer as White Men

White man's risk of getting prostate cancer is approximately 1 in 8, whereas for black men the risk was 1 in 4

Black men are twice as likely to be diagnosed with and die from prostate cancer as white men, according to a new study.

The study, published online in BMC Medicine, looked at incidence and mortality data from Public Health England and found that in the U.K., a white man’s lifetime risk of being diagnosed with prostate cancer was approximately 1 in 8, whereas for black men the risk was 1 in 4. Asian men fared the best, with a 1 in 13 risk for diagnosis.

Each group was equally likely to die from the disease once they were diagnosed, so proportionally more black men die from prostate cancer than white or Asian men.

The research does not determine why there are these differences in ethnic groups, but Alison Cooper of Prostate Cancer UK, the lead author of the study, told the Guardian, “The study also provides important absolute-risk figures to help black men better understand their risk of developing prostate cancer. These figures can be used for targeted awareness-raising and to help them make an informed decision about whether or not to have a prostate specific antigen test.”

Prostate cancer is the most common form of cancer in the UK.

TIME medicine

Boy Who Received Double Hand Transplant Says He Can’t Wait to Hold His Little Sister

Zion Harvey had the world's first bilateral hand transplant

Eight-year-old Zion Harvey could hardly be more thankful for the incredible double-hand transplant he recently received.

In an interview with Today, the boy said he is eager to do one thing: hold his little sister.

“My favorite thing [will be to] wait for her to run into my hands as I pick her up and spin her around,” he said.

After losing his hands and feet to a life-threatening bacterial infection as a toddler, Harvey, who is from Baltimore, recently became the first kid in the world to receive a double hand transplant.

Doctors at The Children’s Hospital of Philadelphia disclosed the nearly 11-hour operation this week. Harvey said it is a dream come true.

“I hoped and I hoped for somebody to ask me, ‘do I want a hand transplant?’ and it came true,” he said.

It was a 40-member team led by Dr. L. Scott Levin that helped the boy to realize his dream. Levin told NBC News that in the face of such a risky operation, Harvey never shed a tear.

“I’ve never seen a tear, never an untoward face, never a complaint,” he said. “He’s always positive. And that, in and of itself, is remarkable.”

Harvey’s mother, Pattie Ray, said she was happy and overcome with emotion when she saw her son leaving the operating room.

“When I saw Zion’s hands for the first time after the operation, I just felt like he was being reborn,” she told the Today. “I see my son in the light I haven’t seen him in five years.

“It was like having a newborn. It was a very joyous moment for me.”

Through the years, Harvey adapted to life without his hands, mastering writing, eating and playing video games. He said he hopes to add swinging from monkey bars to the list.

He unveiled his new hands at a hospital press conference on Tuesday where he thanked his family.

“I want to say to you guys thank you for helping me do this,” he said.

The 8-year-old will spend the next several weeks going through hand therapy at an inpatient rehabilitation center at Children’s Hospital.

This article first appeared on People.com

TIME medicine

Meet the Heroes and Villains of Vaccine History

A California legislator who faces a recall campaign for his support of a law mandating vaccinations is just one of the heroes in the history of vaccines. Alas, there are villains too

  • Edward Jenner

    Edward Jenner Vaccines
    Popperfoto/Getty Images Edward Jenner

    No one knows the name of the dairy maid 13-year old Edward Jenner overheard speaking in Sodbury, England in 1762, but everyone knows what she said: “I shall never have smallpox for I have had cowpox. I shall never have an ugly pockmarked face.” Jenner was already a student of medicine at the time, apprenticed to a country surgeon, and the remark stayed with him. But it was not until 34 years later, in 1796, that he first tried to act on the dairy maid’s wisdom, vaccinating an 8-year-old boy with a small sample from another dairy maid’s cowpox lesion, and two months later exposing the same boy to smallpox. The experiment was unethical by almost any standard—except perhaps the standards of its time—but it worked. Jenner became the creator of the world’s first vaccine, and 184 years later, in 1980, smallpox became the first—and so far only—disease to have been vaccinated out of existence.

  • Jonas Salk and Albert Sabin

    Albert Sabin Jonas Salk Vaccines
    Mondadori/Getty Images; PhotoQuest/Getty Images Left: Albert Sabin in his laboratory in 1960; Right: Jonas Salk

    Jonas Salk and Albert Sabin didn’t much care for each other. The older, arid Sabin and the younger, eager Salk would never have been good matches no matter what, but their differences in temperament were nothing compared to a disagreement they had over science. Both researchers were part of the National Foundation for Infantile Paralysis—later dubbed the March of Dimes—and both were trying to develop a polio vaccine. Sabin was convinced that only a live, weakened virus could do the trick; Salk was convinced a newer approach—using the remains of a killed virus—would be better and safer. Both men turned out to be right. Salk’s vaccine was proven successful in 1955; Sabin’s—which was easier to administer, especially in the developing world, but can cause the rare case of vaccine-induced polio due to viral mutations—followed in 1962. Both vaccines have pushed polio to the brink of eradication. It is now endemic in only three countries—Afghanistan, Pakistan and Nigeria—and appears, at last, destined to follow smallpox over the extinction cliff.

  • Dr. Maurice Hilleman

    Dr. Maurice Hilleman Vaccines
    Ed Clark—Time & Life Pictures/Getty Image Dr. Maurice Hilleman (center) talks with his research team as they study the flu virus in a lab at Walter Reed Army Institute of Research, Silver Springs, Md. in 1957.

    Around the world, untold numbers of children owe their health to a single girl who woke up sick with mumps in the early morning hours of March 21, 1963. The girl was Jeryl Lynne Hilleman, who was then only 5; her father was a Merck pharmaceuticals scientist with an enduring interest in vaccines. Dr. Maurice Hilleman did what he could to comfort his daughter, knowing the disease would run its course; but he also bristled at the fact that a virus could have its way with his child. So he collected a saliva sample from the back of her throat, stored it in his office, and used it to begin his work on a mumps vaccine. He succeeded at that—and a whole lot more. Over the course of the next 15 years, Hilleman worked not only on protecting children against mumps, but also on refining existing measles and rubella vaccines and combining them into the three-in-one MMR shot that now routinely immunizes children against a trio of illnesses in one go. In the 21st century alone, the MMR has been administered to 1 billion children worldwide—not a bad outcome from a single case of a sickly girl.

  • Pearl Kendrick and Grace Eldering

    Pearl Kendrick Vaccines
    University of Michigan School of Public Health Pearl Kendrick

    It was not easy to be a woman in the sciences in the 1930s, something that Pearl Kendrick and Grace Eldering knew well. Specialists in public health—one of the only scientific fields open to women at the time—they were employed by the Michigan Department of Health, working on the routine business of sampling milk and water supplies for safety. But in their free time they worried about pertussis—or whooping cough. The disease was, at the time, killing 6,000 children per year and sickening many, many more. The poor were the most susceptible—and in 1932, the third year of the Great Depression, there were plenty of poor people to go around. A pertussis vaccine did exist, but it was not a terribly effective one. Kendrick and Eldering set out to develop a better one, collecting pertussis samples from patients on “cough plates,” and researching how to incorporate the virus into a vaccine that would provide more robust immunity. They tested their vaccine first on mice, then on themselves and finally, in 1934, on 734 children. Of those, only four contracted whooping cough that year. Of the 880 unvaccinated children in a control group, 45 got sick. Within 15 years of the development of Kendrick and Eldering’s vaccine, the pertussis rate in the U.S. dropped by 75%. By 1960 it was 95%—and has continued to fall.

  • Dr. Richard Pan

    Sacramento California News - June 30, 2015
    Madeline Lear—Sacramento Bee/ZUMA Wire June 30, 2015 - Sacramento, California - Senator Richard Pan (right) speaks during a press conference at William Land Park Elementary School in Sacramento on June 30, 2015, where vaccination advocates thanked the legislature and Gov. Brown for passing Senate Bill 277, which eliminates personal and religious belief exemptions for vaccines.

    The work that’s done at the lab bench is not the only thing that makes vaccines possible; the work that’s done by policymakers matters a lot too. That is especially true in the case of California State Senator Richard Pan, a pediatrician by training who represents Sacramento and the surrounding communities. Pan was the lead sponsor of the recently enacted Senate Bill 277, designed to raise California’s falling vaccine rate by eliminating the religious and personal belief exemptions that many parents use to sidestep the responsibility for vaccinating their children. For Pan’s troubles, he now faces a possible recall election, with anti-vaccine activists trying to collect a needed 35,926 signatures by Dec. 31 to put the matter before the district’s voters. Pan is taking the danger of losing his Senate seat with equanimity—and counting on the people who elected him in the first place to keep him on the job. “I ran to be sure we keep our communities safe and healthy,” he told the Sacramento Bee. That is, at once, both a very simple and very ambitious goal, made all the harder by parents who ought to know better.

  • Dr. Andrew Wakefield

    Dr. Andrew Wakefield Vaccines Autism
    Shaun Curry—AFP/Getty Images From right: Dr. Andrew Wakefield and his wife, Carmel arrive at the General Medical Council (GMC) in central London on Jan.28, 2010.

    Not every conspiracy theory has a bad guy. No one knows the name of the founding kooks who got the rumor started that the moon landings were faked or President Obama was born on a distant planet. But when it comes to the know-nothing tales that vaccines are dangerous, there’s one big bad guy—Andrew Wakefield, the U.K. doctor who in 1998 published a fraudulent study in The Lancet alleging that the MMR vaccine causes autism. The reaction from frightened parents was predictable, and vaccination rates began to fall, even as scientific authorities insisted that Wakefield was just plain wrong. In 2010, the Lancet retracted the study and Wakefield was stripped of his privilege to practice medicine in the U.K. But the damage was done and the rumors go on—and Wakefield, alas, remains unapologetic.

  • Jenny McCarthy and Jim Carrey

    Jenny McCarthy Jim Carrey Vaccines Autism
    Brendan Hoffman—Getty Images Jim Carrey (center) carries Evan McCarthy, son of actress Jenny McCarthy (left) during a march calling for healthier vaccines on June 4, 2008 in Washington.

    If you’re looking for solid medical advice, you probably want to avoid getting it from a former Playboy model and talk show host, and a man who, in 1994’s Ace Ventura: Pet Detective, introduced the world to the comic stylings of his talking buttocks. But all the same, Jenny McCarthy and Jim Carrey are best known these days as the anti-vaccine community’s most high-profile scaremongers, doing even the disgraced Andrew Wakefield one better by alleging that vaccines cause a whole range of other ills beyond just autism. None of this is true, all of it is shameful, and unlike Wakefield, who was stripped of his medical privileges, Carry and McCarthy can’t have their megaphones revoked.

  • Rob Schneider

    Rob Schneider Vaccines
    Richard Shotwell—Invision/AP Rob Schneider in 2014.

    What’s that you say? Need one more expert beyond Jenny McCarthy and Jim Carrey to weigh in on vaccines? How about Rob Schneider, the Saturday Night Live alum and star of the Deuce Bigalow, Male Gigolo films? Schneider has claimed that the effectiveness of vaccines has “not been proven,” that “We’re having more and more autism” as a result of vaccinations, and that mandating vaccines for kids attending public schools is “against the Nuremberg laws.” So, um, that’s all wrong. A vocal opponent of the new California law eliminating the religious and personal belief exemptions that allowed parents to opt out of vaccinating their kids, Schneider called the office of state legislator Lorena Gonzalez and left what Gonzalez described as a “disturbing message” with her staff, threatening to raise money against her in the coming election because of her support of the law. Gonzalez called him back and conceded that he was much more polite in person. Still, she wrote on her Facebook page, “that is 20 mins of my life I’ll never get back arguing that vaccines don’t cause autism with Deuce Bigalow, male gigolo.#vaccinateyourkids.”

  • Robert F. Kennedy, Jr.

    Robert Kennedy, Jr. Vaccines
    Rich Pedroncelli—AP Robert F. Kennedy, Jr. speaks against a measure requiring California schoolchildren to get vaccinated during a rally at the Capitol in Sacramento, Calif., on April 8, 2015.

    If you’re looking for proof that smarts can skip a generation, look no further that Robert F. Kennedy, Jr., son of the late Bobby Kennedy. RFK Jr. has made something of a cottage industry out of warning people of the imagined dangers of thimerosal in vaccines. An organomercury compound, thimerosal is used as a preservative, and has been removed from all but the flu vaccine—principally because of the entirely untrue rumors that it causes brain damage. But facts haven’t silenced Kennedy who, as a child of the 1950s and ‘60s, surely got all of the vaccines his family doctor recommended. Children of parents who listen to what he has to say now will not be so fortunate.

TIME medicine

You Asked: Is It Bad to Hold in a Sneeze?

Holding in Sneezes
Illustration by Peter Oumanski for TIME

Pulled muscles and perforated eardrums are a couple of the calamities that could befall a sneeze suppressor.

Spend some time reading medical case studies—a great way to ruin a pleasant morning, by the way—and you’ll be shocked at the unlikely ways people manage to hurt themselves. Focus on sneeze-related accidents, and you’ll notice a trend: Bad things happen when people hold in their sneezes. A fractured larynx, acute cervical pain and facial nerve injuries are just a few of the documented mishaps caused by a stifled achoo.

“I’ve seen patients with a ruptured eardrum or pulled back muscles, and you hear about cracked ribs,” says Dr. Michael Benninger, an otolaryngologist—that’s an ear, nose and throat doctor—and chairman of the Head and Neck Institute at Cleveland Clinic.

While sneezes (and the schnozes that expel them) come in many sizes, a whopper sneeze can blast air out of your nose at 500 miles per hour, Benninger says. If you redirect that force inward, your suppressed sneeze can send waves of force rippling through your head and body.

MORE: Don’t Sneeze In Space: When Astronauts Get Sick

Usually that’s not a big deal. After all, most of us have bottled a sneeze here or there without issue. But Benninger says a preexisting musculoskeletal injury or weakness, odd ear or throat physiology or some other anatomical quirk could lead to an adverse reaction to a held-in sneeze.

While such reactions are unlikely, Benninger says sneezes aren’t meant to be caged. “Sneezing probably cleanses the nose of irritants, viruses and those types of things,” he explains. He uses the word “probably” because there’s research to suggest sneezing might perform other functions, from signaling to people that you’re sick to resetting the homeostatic environment in your nose.

“I’ve read reports that people sneeze differently in different cultures—almost like a learned behavior,” he says. He adds that everything from your lung capacity to the structure of your face and nose can play a role in how forcefully you sneeze, and the potential of your sneeze to cause or exacerbate an injury.

MORE: The 7 Best Food Combinations For Weight Loss

His advice? Don’t hold in a sneeze. “If you feel one coming on and you want to stop it, rubbing your nose can help,” he says. For patients who may feel pain when sneezing—those who’ve recently undergone surgery or broken a bone—Benninger advises opening your mouth wide to minimize a sneeze’s strength. “It’s like forcing water through a pipe,” he says. “If the air can escape through your nose and mouth, that creates less pressure than forcing it through a smaller opening.”

Just make sure that when you sneeze, you’re doing it into the crook of your arm, not your hand. “We know sneezing can project smaller particles 10 to 12 feet, so it’s important to cover your mouth,” Benninger says. “But if you sneeze into your hand, everything you touch is going to be contagious.” Your clothes help absorb particles, and you probably won’t be touching much with the inside of your arm, he adds.

Gesundheit! And safe sneezing, everyone.

TIME Healthcare

Hospitals Have Reduced Deaths, Hospitalizations, and Costs Among Medicare Patients

"It's a jaw-dropping finding"

American hospitals have reduced deaths, hospitalizations, and costs among people over the age of 65 in the past couple of decades, according to a new report released Tuesday.

“We didn’t expect to see such a remarkable improvement over time,” said Harlan Krumholz, a cardiologist at the Yale School of Medicine and lead author of the study, which appeared in the Journal of the American Medical Association (JAMA).

Krumholz and his colleagues looked at over 68 million Medicare beneficiaries between 1999 and 2013. The group was chosen for their “fee-for-service” structure, where doctors and hospitals would be paid per procedure or visit.

They found that hospitalization rates for this group plummeted 24%, saving more than 3 million people unnecessary hospital visits. Their chance of survival and recovery had improved from less than two decades ago: patients were 45% less likely to die during their stay, 24% less likely to die within a month of being admitted, and 22% less likely to die within the year.

Deaths among the group fell 16%, meaning 300,000 lives were saved in the 14-year span, according to the report. Patients who visited the hospital also saw a 15% drop in their bills compared to 1999.

Krumholz said that better training for hospital staff led to many of the improvements.

“There has been tremendous focus on making sure that our hospitals are safer and that treatments are more timely and effective,” Krumholz told USA Today.

People are also living healthier, longer lives—smoking less, breathing cleaner air, and able to take advantage of scientific breakthroughs in medicine.

Despite doing so well, Krumholz doesn’t think it’s time for hospitals to get lax.

“The things we’re trying to do to make things better are working,” Krumholz noted. “Rather than wave the victory flag, we want to see that trend continue. There’s no reason to take our foot off the pedal.”

 

TIME medicine

Watch This Amazing Child Get a Bilateral Hand Transplant

A child has successfully received two new hands

Surgeons have successfully performed the first ever bilateral hand transplant on a child.

In early July, surgeons at the Children’s Hospital of Philadelphia performed the complex surgery to attach two donor hands to Zion Harvey, an eight-year-old boy whose hands and feet were amputated several years ago after he caught a severe and unknown infection.

“I made the decision from a medical standpoint, but ultimately, to have the surgery was Zion’s decision,” says Zion’s mother Pattie Ray in an interview with TIME. “He wanted to do what other children can do without so much trouble.”

Since Zion had already undergone a kidney transplant, he was taking anti-rejection medication which increased his potential as a viable candidate for a pediatric hand transplant. The surgery was performed this month when there was a donor match (the precise date of the surgery is withheld to protect donors). Zion also has prosthetic feet.

As depicted in the video above, the medical team performing the surgery was split into four teams, with two focusing on the donor limbs and two focusing on Zion. The surgeons connected bones with steel plates and screws and then connected the arteries and veins. When the team had successful blood flow, they connected the muscles, tendons and nerves.

The Children’s Hospital of Philadelphia

“I was nervous and anxious during his surgery,” says Ray. “When they told me the surgery was successful I breathed a big sigh of relief. I could breathe again.”

Zion continues to undergo hand therapy multiple times a day, something he became accustomed to after his prior surgeries. “He’s improving every day,” says Ray. “Yesterday he held some pizza and put it in his mouth.”

Doctors say that after his rehabilitation, Zion will be able to throw a football among other daily activities that were previously more difficult.

Ray says that Zion wants to have a party to show off his new hands when he’s released from the hospital. “He hopes to inspire others and open doors,” she says.

 

TIME MERS

There May Have Been a Major Breakthrough in MERS Treatment

487737801
Getty Images

Researchers in Hong Kong have cured infected monkeys of MERS using existing drugs

Two existing and widely available drugs may prove to be effective treatments for Middle East Respiratory Syndrome (MERS), new research published by the University of Hong Kong suggests.

According to the South China Morning Post, the medicines—lopinavir with ritonavir and a type of interferon—were tested on marmosets, small monkeys that a 2014 U.S. study concluded would be the best subject for MERS trials because of the way their reactions to the virus mimics human illness. The drugs, currently used to treat HIV and sclerosis, were found to be effective in curing MERS-infected marmosets.

The research is the first of its kind in the world.

“We would recommend doctors to start using both drugs immediately to treat MERS patients if they are critical,” said Jasper Chan Fuk-woo, one of the researchers, told SCMP. “The evidence in this study is quite strong in proving the effectiveness of these two drugs.”

Currently, there is no known cure for MERS.

Meanwhile, South Korea, which struggled with a MERS outbreak in May and June, has not reported any new MERS cases for 23 days and no deaths for more than two weeks. The country declared a “de-facto end” to its outbreak on July 28, although a spokesman for the World Health Organization told the BBC it would not declare an official end to the country’s outbreak until 28 days had passed with no new infections—twice the disease’s incubation period.

[SCMP]

TIME heart

This New FDA-Approved Cholesterol Drug Is a Game Changer

The FDA approved the first of a new class of drugs for treating high cholesterol. Here’s the story of how researchers went from a DNA mutation to a drug in 10 years

On Friday, the U.S. Food and Drug Administration (FDA) approved the first new class of cholesterol-lowering drugs since the statins flooded the market beginning in the 1980s. Similar to the way statins work, by binding up cholesterol made in the liver so less of it circulates in the blood, this new class, called PCSK-9 inhibitors, takes advantage of genetic mutations that regulate the level of LDL receptors in the liver. Less PCSK9 leads to more LDL receptors that can soak up LDL and therefore leave less cholesterol in the blood.

The FDA approved alirocumab (Praluent), an injectable drug made by Sanofi and Regeneron, in people with familial hypercholesterolemia, a genetic condition in which cholesterol levels are high, or those with a history of heart disease who can’t reduce their LDL levels enough with existing statin drugs. (Another PCSK9 inhibitor, evolocumab (Repatha) developed by Amgen, received approval in Europe but won’t be evaluated by the U.S. FDA until the end of August.)

MORE: The Next Big Drug to Treat Heart Disease

While PCSK9 drugs help to lower cholesterol, the story of how these medications developed began in a French family with the opposite problem. Their members had exceptionally high levels of LDL and greater than average rates of heart disease. But unlike others with similar cholesterol problems, this family did not have the usual mutations in cholesterol-regulating genes. Instead, French researchers studying them in 2003 found they had aberrations in PCSK9, a gene that produces a protein found primarily in the liver, kidneys and intestines.

An ocean and half a continent away, Jonathan Cohen and Dr. Helen Hobbs at the University of Texas, Southwestern Medical Center in Dallas (coincidentally the same institute where scientists discovered LDL, or the heart-disease contributing cholesterol and earned the Nobel Prize for their work), read the description of PSCK9 and wondered whether those with lower levels of PCSK9 would show the opposite effect of the French family and actually enjoy decreases in levels of LDL in the blood.

MORE: New Class of Cholesterol Drugs Shows Promise For Heart Disease

Cohen and Hobbs were involved in a large heart disease study involving nearly 15,000 participants, and decided to look for the PCSK9 mutations among their participants. They homed in on those with the highest and lowest levels of LDL cholesterol, and sequenced their genomes to see if any patterns emerged. Sure enough, they found 33 people whose LDL levels were about 40% lower than average and who shared mutations that effectively silenced PCSK9. Essentially, their LDL amounts were about the same as those who relied on statins to drop their cholesterol.

These PCSK9 mutations associated with the lowest LDL appeared predominantly in African-American participants. Those with one copy of the mutation in this gene showed an 88% lower risk of heart disease. Another mutation in the same PCSK9 gene that appeared more commonly in whites had the same effect, but to a lesser extent, dropping LDL by 15% and the risk of heart events by 47%.

“The results were quite compelling,” says Cohen, who published the findings along with his colleagues in the New England Journal of Medicine (NEJM) in 2006. “They told us that PCSK9 was likely an attractive therapeutic target.” Even more encouraging, in all of the people with the mutations and lower LDL levels, there didn’t seem to be any significant side effects. For all intents and purposes, these participants were healthy and had the added advantage of being at very low risk of heart disease.

To confirm this, Cohen searched for anyone in the study with two copies of the mutation, to see if having double the effect would trigger any adverse events. He found one woman, a 32 year old daughter of one of the participants, who had two different mutations in each of the PCSK9 copies she inherited from her mother and father. The result? An LDL of 14 and no other health problems. “If you measure the amount of PCSK9 in her blood, it’s basically absent, you can’t see any,” says Cohen. That contributed to an unprecedented low level of LDL cholesterol as well.

So far, he says, only one other individual has been described with two mutant copies of PCSK9, a 21 year old woman living in south Africa with an LDL of 20.

Those descriptions piqued the interest of researchers at Regeneron, a biotech company that specializes in turning genetic discoveries like this one into drugs. To confirm and better understand the effects of PCSK9, researchers there studied the effect of human versions of PCSK9 in mice, and then began trials of antibodies they developed that inhibit the function of this gene, much like the mutations do, in several thousand people.

Those results, published in the NEJM last April, showed that PCSK9 inhibitors can lower LDL cholesterol by an additional 60% on average beyond that achieved by statins. Those findings formed the basis of the companies’ application to the FDA for approval of these first-in-class drugs.

For now, the agency says the drugs should only be prescribed to people with familial hypercholesterolemia, or those who have failed to reduce their LDL levels sufficiently using statins. For many, the new drugs will be taken in combination with statins and a heart-healthy diet. But doctors say they anticipate many patients outside of these groups, who have family histories of heart disease or other risk factors, such as hypertension or diabetes, may start asking about the medications. For them, doctors will have to weigh how well they are doing on statins before considering adding a PCSK9 inhibitor.

TIME medicine

The First-Ever Malaria Vaccine Just Got a Big Break

Drugmakers received a thumbs up from European regulators, moving the vaccine closer to human use

After nearly 30 years of development and testing, the world’s first malaria vaccine got a major push forward on Friday morning.

Drug maker GlaxoSmithKline announced that a European Medicines Agency (EMA) committee has given a positive recommendation for the company’s vaccine for malaria called Mosquirix (scientifically known as RTS,S). The drug is intended for children ages six weeks to 17 months living in Sub-Saharan Africa. Because the vaccine is not intended for countries outside of Africa, the European regulatory agency is not “approving” the vaccine, but offering a positive opinion that the World Health Organization (WHO) will use to create its own recommendation for the vaccine’s use. Countries in Africa will then approve the vaccine through their own regulatory agencies.

Mosquirix is the first vaccine to prevent malaria in humans and was first created in 1987.

The data assessed by the EMA was primarily from a phase III clinical trial of the vaccine in about 16,000 kids in multiple African countries. After 18 months, GSK reported that the vaccine had about 46% efficacy against clinical malaria and 36% efficacy against severe malaria in kids ages five to 17 months. In babies ages six to 12 weeks, the drug had a 27% efficacy against clinical malaria and 15% against severe malaria.

The efficacy rates may seem low, but the researchers tell TIME that the vaccine is the only one available thus far and will save a significant number of lives that would be lost to the mosquito-borne disease. The vaccine also shows efficacy for a few years after initial vaccination. “Is there room for improvement? Yes. We can improve a lot,” says Moncef Slaoui, co-inventor of the vaccine and the Chairman of GSK Vaccines, in an interview with TIME. At the end of the study period, the researchers found that more than 6,000 cases of clinical malaria were prevented for every 1,000 children who were vaccinated in areas of high transmission. The efficacy of the vaccine was also assessed in a safe study context in which children slept with bed nets treated with insecticide, a measure not always taken.

According to data provided by GSK, there were 584,000 deaths worldwide from malaria in 2013, and 90% of those deaths took place in Sub-Saharan Africa. More than 80% of the deaths occurred in kids under age five.

Currently, the vaccine Mosquirix requires four doses. The first three happen a month apart from each other, and the fourth happens about 18 months later. Ensuring that parents get their children the full dosage can be challenging, but Slaoui notes that most infant vaccines require multiple doses, and while not ideal, there’s still a significant benefit with just three doses.

Slaoui says GSK also has a second generation version of the vaccine in the works—one that may have even better efficacy rates. “It’s a tweak of the current vaccine,” he says. “We know the next generation is close by.”

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