TIME medicine

9 Things to Know Before Buying Another Supplement

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A guide to avoiding sketchy ingredients and choosing the most trusted brands

The supplement aisle at the drugstore is lined with products that promise to prevent illness, improve energy, boost metabolism, even brighten your skin. You probably already know these capsules aren’t necessarily silver bullets to perfect health. (Whatever benefits your multivitamin or omega-3 supplements offer, you still have to exercise and eat right, for example.) But you do expect them to be safe to swallow, at the very least.

Sadly, a new study in the Journal of the American Medical Association suggests otherwise. After analyzing supplements that had been recalled by the FDA for containing banned substances—such as steroids or powerful prescription medications like Viagra and Prozac—researchers found that roughly two-thirds of the tainted products were back on store shelves with the same illicit ingredients at least six months later.

HEALTH.COM: 6 Myths (and Facts) About Weight Loss Supplements

Because supplement makers are subject to little regulatory oversight from the U.S. Food & Drug Administration, they aren’t required to prove a product’s safety (or efficacy) before it goes to market. And as this study shows, some fail at accurately providing the most basic safety information.

That said, the supplement industry is vast; Americans are expected to spend $32.4 billion on vitamins and dietary supplements in 2014, according to a Euromonitor International report. And there are reputable, safe supplement-makers out there.

Our buyer’s guide can help you avoid sketchy ingredients and choose the most established, trusted brands.

Be wary of certain types of pills

Namely exercise, weight-loss, and sexual-enhancement supplements. The products analyzed in the JAMA study fell into these three categories. Several of the weight-loss supplements actually contained an amphetamine-like drug called sibutramine, which is banned in the U.S., Asia, and Europe.

HEALTH.COM: Warning: Do Not Mix These Supplements

Shop selectively

Big-chain drugstores, pharmacies, and supplement stores like GNC or the Vitamin Shoppe may act faster to pull recalled items.

Don’t bargain-hunt

A University of Minnesota analysis found that for six types of herbal products, the more expensive the supplement was, the more likely it was that the recommended dosage would be consistent with established standards.

Steer clear of supplements made in China

Lack of regulation and poor manufacturing practices in China mean their goods may be more likely to be contaminated with substances like lead.

HEALTH.COM: Probiotic Foods and Supplements That Really Work

Check for a USP Verified Mark

It means that the nonprofit US Pharmacopeia has verified that a product contains the ingredients on the label in the amounts specified and doesn’t contain unacceptable levels of contaminants.

Do research at reputable sites

You can read supplement fact sheets from National Institutes of Health Office of Dietary Supplements to get all the info you need on everything from the recommended daily amount (RDA) to the latest on the health benefits of a certain supplement. It’s also a good idea to stay on top of warnings or recall alerts from the FDA. When you’re ready to buy, the USP website has a store directory and list of all the participating supplement companies if you want to check before you head to the store.

HEALTH.COM: Vitamins: What to Take, What to Skip

Consult the experts

Namely, the store pharmacist and your doctor. The former can alert you to any potential adverse events or drug interactions, and your doc can advise you on which supplements are safe and effective.

Skip dubious ingredients

These four have been linked to serious side effects, and aren’t worth the risk.

  1. Kava. It has been reported to cause liver damage.
    2. Bitter orange. It contains the chemical syndephrine, which has been linked to heart attacks and strokes in healthy people when taken alone or combined with caffeine.
    3. Contaminated L-tryptophan. It’s associated with neurotoxic reactions.
    4. Chromium. When overused, it’s been linked to anemia—even kidney failure.

HEALTH.COM: Best Foods For Every Vitamin and Mineral

With additional reporting by Hallie Levine

This article originally appeared on Health.com

TIME health

Pilot Sully Sullenberger on Ebola: Medicine Needs a Higher Authority

Chesley "Sully" Sullenberger in New York City, on Jan. 15, 2014.
Chesley "Sully" Sullenberger in New York City, on Jan. 15, 2014. Andrew Burton—Getty Images

Sully Sullenberger is an expert in the fields of aviation and patient safety.

Quality and safety oversight of the medical field is too fractured, and could benefit from an FAA-like agency

For the last several weeks, I have been watching the haphazard response to the appearance of Ebola in the U.S. through the eyes of a professional pilot. With limited federal control over matters related to public health, elected officials around the country are rushing to enact emergency measures to prevent Ebola’s spread, resulting in major disagreements about how best to do that. We saw the limits of that approach in New Jersey, and then in Maine, when the first person subjected to forced isolation called her treatment “inhumane” and defied quarantine orders, setting off a debate among public health experts, civil liberties groups and even the White House.

I have devoted my entire professional life to the pursuit of the safety of the public. Aviation and medicine are both high-stakes endeavors with little margin for error. All complex systems are different, but they all abide by similar rules and need a coordinated system of protocols and uniformity to bring into play under situations that can be very different. Over many decades, aviation has developed a systems approach to manage the complexity and interrelatedness of an endeavor that involves inherent risk, and an effective culture of safety that can, in substantive ways, be transferred to medicine.

When an accident occurs in aviation – often resulting in mass casualties and widespread media attention – the National Transportation Safety Board (NTSB) immediately conducts a thorough investigation into the accident or incident as the U.S. body responsible for recommending systemic changes and making sure that the right lessons are drawn and disseminated widely to all in the industry. In medicine there are too many entities that have a hand in quality and safety and whose efforts are not effectively coordinated. The Centers for Disease Control and Prevention (CDC) lacks the high degree of regulatory authority of an agency like the Federal Aviation Administration (FAA), so there is no single domestic agency that oversees all of medicine and promotes and mandates agreed upon best practices uniformly. And Ebola aside, in medicine, accidents and incidents tend to occur singly, largely without getting much attention.

Without a systems approach, medicine is fragmented. Without sufficient widespread implementation of best practices and effective training, medical personnel and government leaders are forced to scramble, making critical decisions and developing protocols in real time to respond to an evolving crisis. With states and hospitals left to their own devices, no one consistent policy emerges, causing gaps in execution. The result, as we have seen, can lead to chaos and confusion among medical professionals and a loss of confidence by the public.

In aviation we also face complexity, ambiguity and situations we have never specifically trained for, but airline pilots train for the unknown. It is our job to anticipate potential issues and, when faced with the unexpected, to adapt, and to respond calmly, quickly and effectively. The ability to make split-second decisions becomes infinitely easier when the effective protocols, training, equipment and human team skills are already in place as part of the robust and resilient safety system and culture in which we operate. Every day pilots and flight attendants face new situations for the first time at 35,000 feet, but they perform successfully because they know how to execute after years of preparedness training. They’re not trying to use duct tape to solve the problem.

Medical professionals are as dedicated as any. They grapple with imperfect information, highly complex systems and ambiguities that far outweigh those of a Boeing 747. But that’s all the more reason to create a culture of consistent application of best practices and effective communication. In order to establish and maintain public confidence, officials have to handle uncertainty well, acknowledge the limits of their knowledge and have the courage to level with people. Every time I made an announcement from the cockpit, whether it was about a delay or an in-flight emergency, I told my passengers everything that I knew and that I would keep them updated. That kind of transparency is the only way to maintain the public’s trust.

The aviation industry has made great strides in safety over the past 40 years by teaching critical skills some call “soft” skills, which are really human skills, giving crews the tools they need to take a team of experts and make them an expert team. In an overall systems approach, there are real incentives aligned with the public good, and we’ve found that a long-term approach to safety pays for itself by avoiding accidents and bad outcomes.

In medicine, there is so much uncoordinated individual effort on the part of thousands of entities, it is hard to align public health incentives and take the long-term approach. There were candidate Ebola vaccines ready to go to human trial almost 10 years ago. As we’ve learned in aviation, safety is cost-effective in the long term, and for that reason we have for decades used government-industry partnerships to do the hard work and proactively mitigate risks.

Adopting some of these practices may help avoid the systemic gaps we’ve seen over the last few weeks, resulting in better alternatives for those tasked with the heavy burden of managing the Ebola response – and for the public at large.

Sully Sullenberger is an expert in the fields of aviation and patient safety; he is an author, speaker and consultant, and serves as the CBS News Aviation and Safety Expert. He is also the founder and chief executive officer of Safety Reliability Methods, Inc., a company dedicated to management, safety, performance and reliability consulting.

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 medicine

Scientists Develop Drug to Replace Antibiotics

New medicine effective against superbugs

Scientists have created the first antibiotic-free drug to treat bacterial infections in a major development in combatting drug-resistance, according to The Times.

A small patient trial showed that the new treatment was effective at eradicating the MRSA superbug which is resistant to most antibiotics. The drug is already available as a cream for skin infections and researchers hope to create a pill or an injectable version of it in the next five years.

Antibiotics have been one of the most important drugs since the invention of penicillin almost 90 years ago. But the World Health Organization has repeatedly warned of the threat of antimicrobial resistance, saying “a post-antibiotic era – in which common infections and minor injuries can kill” is a very real possibility in the 21st century.

But scientists say this new technology is less prone to resistance than antibiotics because the treatment attacks infections in a completely different way. The treatment uses enzymes called endolysins — naturally occurring viruses that attack certain bacterial species but leave beneficial microbes alone.

Mark Offerhaus, the Chief Executive of the Dutch biotech firm Micreos which is leading the research, said the development of the new drug marks “a new era in the fight against antibiotic-resistant bacteria”, adding that millions of people stand to benefit from this.

[The Times]

 

TIME Innovation

Five Best Ideas of the Day: November 5

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. Beyond PTSD: Returning soldiers struggle to recover from the ‘moral injury’ of war.

By Jeff Severns Guntzel in On Being

2. On climate and so many other scientific issues, the way we communicate polarizes audiences. We can do better.

By Paul Voosen in the Chronicle of Higher Education

3. Entrepreneurs and educators need to observe students in school if they want to make real change.

By Alex Hernandez in EdSurge

4. Lifesaving ultrasound technology may soon come to a device the size of an iPhone. The applications for medicine in the developing world are massive.

By Antonio Regalado in MIT Technology Review

5. Many Arab governments are fueling the very extremism they purport to fight and are looking for U.S. cover. Washington should play the long game.

By Michele Dunne and Frederic Wehrey at the Carnegie Endowment for International Peace

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

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 Innovation

Five Best Ideas of the Day: November 4

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. Peer-to-peer sharing of experiences could transform health care.

By Susannah Fox in Iodine

2. A technological and analytical arms race is producing the best athletes in history. Can those advances be applied to education?

By James Surowiecki in the New Yorker

3. In South Bronx, startups are ‘onshoring’ technology jobs and trying to spark a revolution.

By Issie Lapowsky in Wired

4. ‘Sister City’ relationships foster cross-border collaboration and spur economic development.

By Nehemiah Rolle in Next City

5. Colleges and universities should focus on student success beyond graduation.

By Karen Gross and Ivan Figueroa at Inside Higher Ed

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

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 Innovation

Five Best Ideas of the Day: November 3

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. “Ultimately, gender equality is a vital part of humanity’s progress. ” Read the 2014 Gender Gap Report.

By the World Economic Forum

2. Shopping for Water: Markets just might save the American West from its water crisis.

By Peter Culp, Robert Glennon, and Gary Libecap at the Hamilton Project

3. With Ebola in the spotlight, Liberia’s nurses take to the streets to care for the sick crowded out of the overwhelmed health care system.

By Jina Moore at BuzzFeed News

4. Humanitarians are preparing for a future with autonomous weapons, which are unlikely to understand mercy, proportionality or the difference between combatants and civilians.

By Malcolm Lucard in Red Cross Red Crescent

5. Markets in everything: Can letting the rich buy into clinical trials produce cures for rare diseases faster?

By Alexander Masters in Mosaic Science

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

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 medicine

Weight Loss Surgery Lowers Risk for Type 2 Diabetes, Study Suggests

Obesity is known to be a major risk factor for the condition

Undergoing bariatric surgery significantly lowers an obese person’s risk of develop Type 2 diabetes, a new study suggests.

Adding to prior research that has indicated weight loss surgery could help get rid of Type 2 diabetes, as obesity is known to be a major risk factor for the condition, the new study published in The Lancet Diabetes & Endocrinology shows surgery can lower an individual’s risk before its onset.

Researchers looked at 2,100 obese adults who did not have diabetes and who had all underwent some form of weight loss surgery. They then matched the participants to the same number of obese adults who did not undergo surgery. After following up with the participants for seven years, they learned that the participants who underwent surgery had an 80% lower risk of developing Type 2 diabetes.

The findings are notable, but in a corresponding editorial, Dr. Jacques M Himpens of St. Pierre University Hospital in Brussels says there are holes in the research: “Unfortunately, despite best matching efforts,” he wrote, the patients and controls that were analyzed “differed widely in terms of medical monitoring.” For one, the participants who did not undergo weight loss surgery also did not go through other treatments for their diabetes. And, as Himpens suggests, it’s likely that weight loss in general—without surgery—could reduce risk for Type 2 diabetes risk.

The new findings add to the growing evidence that weight loss can greatly reduce Type 2 diabetes risk and symptoms, but the best ways to achieve that benefit still need further investigation.

TIME medicine

Who’s Better at Baby Talk, Mom or Dad?

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ULTRA.F—Getty Images

The latest research shows that moms and dads use baby talk in different ways, and that boys and girls respond to them differently too

In the latest research on how babies first pick up language, it turns out that gender makes a difference.

Reporting in the journal Pediatrics, Dr. Betty Vohr and her colleagues decided to look at how both moms and dads talk to their young babies. Much research has focused on how mothers engage infants, even before they can speak, but fewer studies have focused on the male side of the equation.

Taking advantage of a small recording device called LENA, which they attached to the babies on a vest for 16 hours, Vohr’s team analyzed all of the verbal interactions a group of 33 babies had (none of the babies were born premature). The recordings occurred just after they were born, while the infants were still in the hospital, and again at 44 weeks and seven months. The last two sessions were recorded on days when both the babies’ parents were home.

MORE: How to Improve a Baby’s Language Skills Before They Start to Talk

From more than 3, 000 hours of recordings, the scientists got a good snapshot of the babies’ verbal environments. And the results were both expected and surprising. When babies made sounds, moms were more likely to respond to them verbally than fathers were — “Oooo, sweetie pie, you’re talking this morning.” Mothers responded 88% to 94% of the time to the babies vocalizations, while dads responded only 27% to 33% of the time.

Perhaps because of the increased responsiveness, or because of other reasons, both boys and girls were also more likely to respond to their mothers’ or female voices than they were to male voices.

Vohr says it’s possible that mothers may use more mother-ese — the higher pitched, sing song-y conversational tone that women, more than men, tend to adopt with infants. Mothers may also pair their vocal interactions with more eye contact with the baby, encouraging them to respond more when they hear their mothers’ voices.

“It seems to me that adults talking to children is absolutely the most cost effective intervention a family could do to improve children’s language,” says Vohr, professor of pediatrics at Alpert Medical School at Brown University.

She also found other intriguing gender-based differences. When she compared mothers of girls to mothers of boys, she found that mothers of girls responded more frequently to their babies’ sounds than mothers of boys did to theirs. The same trend occurred for dads; those who had boys tended to respond more frequently to their infants than those who had girls.

“We’re not certain why that is, but the important thing here is knowing that of critical importance in early language development is the need to encourage both parents,” says Vohr. “The more we learn about it, the more we can inform parents of the power they have in just talking and interacting with their infants to improve the long term outcomes for their child and their school readiness.”

Previous studies have documented that the amount of verbal interaction, or “conversations” babies are exposed to even before they can speak, can predict their later language skills and even academic performance in school.

TIME Research

12 Key Health Items to Carry Every Day

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Toting these essential items in your purse or wallet could save you when a sudden health issue strikes

What’s in your purse, backpack, or pockets? Aside from your keys, wallet, and mobile phone, chances are you’ve got some old receipts and a few dollars worth of loose change—and nothing that would help you if you landed in a health jam. Health emergencies can pop up at any time, so make sure you have these 12 small—but essential—items stowed away in your bag or your desk drawers at work.

Insurance card

This card can be used for more than simply filling out health forms. It’s also an easy way for medics to identify your name and call your insurance company for more information in an emergency. “Your insurance card is the next best thing to your social security card,” says Melisa Lai Becker, MD, site chief of emergency medicine at Cambridge Health Alliance, near Boston. If you can’t find space in your wallet, snap a picture of the front and back and keep them on your smartphone, Dr. Lai Becker suggests. Two others to add: your business card and your doctor’s. The first is another easy way to identify you, while the second hints at what conditions you might have. “If the card is for a cardiologist, then you know the person is seeing someone for a heart issue,” Dr. Lai Becker says.

HEALTH.COM: How to Stock a Smart First Aid Kit

Emergency contacts

In an emergency, medics will want to know who to contact. “Medical personnel are accustomed to looking for ICE under a phone’s contact list,” Dr. Lai Becker says. That stands for “In Case of Emergency” and is usually entered with the phone number of a family member. You can list your medications, allergies, health conditions, and doctor’s name in the note section of the contact too. Keeping a written list isn’t a bad idea since most phones these days are password protected, though the new Health app from Apple will allow you to make an emergency card accessible from the lock screen.

Water

A 2011 study published in The Journal of Nutrition found that women with even mild dehydration experienced headaches, poor concentration, fatigue, and worse moods. So it’s a good idea to have some H2O on you no matter the temperature. “We breathe out water all the time,” Dr. Lai Becker says. “It’s important to keep up lubrication.” Though eight cups a day is the traditional recommendation, there’s an easy way to tell if you’re dehydrated: check your pee. “If you’re turning the water yellow then the urine is too concentrated,” Dr. Lai Becker says. “Your goal is to have a light yellow urine.”

HEALTH.COM: 14 Surprising Reasons You’re Dehydrated

Pain reliever

Headaches pop up at the most inconvenient times. “So many people deal with the pain and don’t do anything,” says Robin Miller, MD, a board-certified internist and co-author of The Smart Woman’s Guide to Midlife and Beyond. At the end of the day, taking an over-the-counter pain reliever like ibuprofen or acetaminophen can help you focus more on work projects or errands. Ibuprofen is also an anti-inflammatory drug, so it’s good for treating backaches, muscle soreness, and menstrual cramps. Acetaminophen is thought to be better for headaches and arthritis. The best time to pop a pill would be as soon as you start to feel pain, Dr. Miller says. Just make sure you’re taking the medication as prescribed, so read the label.

Antacid

Chest pain after a meal is no fun, especially when you’re dining out. If you’re going to a restaurant where the food may flare up your heartburn, it’s safe to have a chewable antacid on you in case. “Take just one when you start to feel something,” Dr. Miller says. Otherwise, you can save it for another day. Tums has the added benefit of giving you extra calcium, Dr. Miller says. The medication’s main ingredient is calcium carbonate, also used as a dietary supplement for people low on the nutrient, according to the National Institutes of Health. Be wary of how much you take though. Too many may lead to a case of diarrhea, Dr. Miller says.

HEALTH.COM: 14 Foods That Fight Heartburn

Bandages

Having a couple bandages on you is useful because there’s always someone looking for one, Dr. Lai Becker says. You never knew when you will get a paper cut or scrape. Not covering your wound up leaves it vulnerable to bacteria you come across throughout the day. If you don’t have access to any antibiotic ointment, that’s fine. With any minor cut, the most important thing is to wash it out with plain tap water, Dr. Lai Becker says. Add soap if there’s oil or grease in your wound and apply pressure for any bleeding.

Tummy reliever

Diarrhea is an all-too-common ailment you need to be ready to handle. The CDC reports that travelers’ diarrhea affects 30% to 50% of vacationers. Luckily, Pepto-Bismol contains an agent shown to reduce the incidence of travelers’ diarrhea by 50%, according to the CDC. Like antacid, it comes in a compact chewable form. “If you’re going to a questionable place to eat, take one before you eat,” Dr. Miller says. Don’t freak out, though, if you get a black tongue or stool. That happens in some people and is normal, Dr. Miller says.

HEALTH.COM: 27 Mistakes Healthy People Make

Tissues

If you do yourself one favor this cold and flu season, carry a set of tissues. “You don’t want to be blowing on your sleeve,” Dr. Miller says. That’s a surefire way to spread germs to your clothing and even infect others. According to the National Institutes of Health, you can catch a cold if your nose, eyes, or mouth touch anything contaminated by the virus. In addition to stocking up on tissues, you should practice proper hand washing too. In a Michigan State University study of college students, researchers found 23% didn’t use soap when washing their hands and—big yikes—10% didn’t wash their hands at all.

Sunscreen

Just because you slather on sunscreen in the morning doesn’t guarantee it will stick all day. Most formulas wear off as you sweat—more so after a workout. “Even rubbing your nose or face can wipe it off,” says Debra Jaliman, MD, a New York City-based dermatologist and author of Skin Rules. You should be reapplying the lotion daily every two hours—yes, even on cloudy days—to protect from cumulative sun damage. That also means little spots like the tops of feet or your ears, Dr. Jaliman says. If you’re not a fan of messy lotion, you can opt for a powder formula or spray sunscreen.

Floss

If you’re already flossing once a day, good job—you’re doing better than 10% of Americans who don’t floss at all, according to the American Dental Association. If you’re going out for a round of wings, though, it doesn’t hurt to have some floss with you. Bits of stray food can sit in your teeth for a while, says Gigi Meinecke, a dentist in Potomac, Maryland, and spokesperson for the Academy of General Dentistry. That can be uncomfortable and lead to more serious problems like an abscess, a tooth infection that can spread to your gums. Don’t want to carry a whole pack? Cut off the corner of a regular mailing envelope and place a little floss inside, Dr. Meinecke suggests. “You can’t carry your brush easily,” she says. “But you can carry floss anywhere.”

HEALTH.COM: 20 Things That Can Ruin Your Smile

Aspirin

A travel pack of aspirin is great to have around if you or someone you know has heart troubles. “It’s one of the first line agents medics will give to someone who calls an ambulance with chest pain,” Dr. Lai Becker says. During a heart attack, your blood vessels can’t supply enough oxygen to the muscle because of a clot that forms and blocks an artery, according to the American Heart Association. “Aspirin works to inhibit the function of the platelets that help people form clots,” Dr. Lai Becker says. As long as you’re not allergic, medics will usually give four baby aspirin to the patient to chew, Dr. Lai Becker says.

Benadryl

Just four melt-away tablets of children’s Benadryl could temper a severe allergic reaction, Dr. Lai Becker says. When someone goes into potentially life-threatening anaphylaxis, the chemical histamine is released in your body. When a large amount of histamines is released, your lips, tongue, face, and airway can swell and you can have trouble breathing, Dr. Lai Becker says. It’s a medical emergency so call 9-1-1, but Benadryl is a powerful antihistamine that can help block the chemical. Giving someone about 50 milligrams of Benadryl could be the start to saving a life, Dr. Lai Becker says. (Chewables are 12. 5 milligrams; liquids are 12.5 milligrams per teaspoon, and capsules may be 25 or 50 milligrams.)

This article originally appeared on Health.com.

TIME health

This Is Where Ebola First Struck in 1976 and What Happened

Ebola Virus
An electron micrograph photo of the Ebola Virus. May 11, 1995. AP Photo

Investigators identified a cotton factory as the source of the infection

History News Network

This post is in partnership with the History News Network, the website that puts the news into historical perspective. The article below was originally published at HNN.

It began in Nzara, a town inhabited by 20,000 people living in thatch-roofed houses within the dense woods in southern Sudan. Roughly five percent of the population worked in a large cotton factory that was owned by an even larger agricultural company. The factory kept detailed records of its employees’ work hours, perhaps to keep close tabs on absenteeism. Fortunately, it also helped investigators track the pattern of a deadly virus transmission.

On June 27, 1976, one employee would not make it to his work as a storekeeper in the factory. The person, later designated by the initials YG, became very ill, experiencing severe fever, headaches, and chest pains. His brother initially nursed him at home, located 10 kilometers from the factory in a remote and rural area south of Nzara. Three days later, with his condition worsening, he was brought to the Nzara hospital – a small and ill-equipped facility that typically did not admit a lot of patients. By the fifth day he was bleeding from the mouth and nose. He began to suffer from bloody diarrhea. Nine days after his illness began, YG died. His brother became ill a week later but survived.

One of YG’s co-workers, BZ, who was also a storekeeper, was admitted to the same hospital on July 12, six days after YG died. This second storekeeper died on July 14. On July 19, the second storekeeper’s wife also died from the same illness. A third factory employee, PG, worked in the cloth room next to the store.

In contrast to YG and BZ, who usually stayed close to home and had few friends, PG was an outgoing bachelor who lived at the center of town and was quite well known in the area. PG and his two brothers, Samir and Sallah, lived with a merchant, MA. The brothers were active in their community and organized social events such as dances. When PG fell ill in late July, many of his friends naturally came to visit. Two women in particular, HW and CB, were kind enough to nurse him during the first days of his illness. His condition apparently deteriorated rapidly as he succumbed to infection three days later. Samir became ill a day before PG died, and together with Sallah, they travelled 128 kilometers east to Maridi where Samir was admitted to the Maridi hospital. Sallah assisted in caring for his brother who died on August 17. A day later, Samir himself became sick and died not too long after. By this time, the two women who cared for PG, as well as another factory worker and a nurse in Nzara hospital had died from the same disease. Investigators later determined that 48 cases and 27 deaths could be traced to exposure to PG – the ebullient, outgoing bachelor of Nzara.

During this first Ebola outbreak in southern Sudan that started in June 1976, 248 cases were identified. Fifty-three percent of the victims died. Investigators identified the cotton factory in Nzara as the source of the infection. Most of the victims, however, were actually infected in Maridi, which ironically had a more active and larger hospital where transmission of the virus was amplified. By the end of the year, the epidemic also hit the Democratic Republic of Congo (DRC), infecting more than 300 people and killing almost 90% of the victims.

In late October of 2014, the World Health Organization reported nearly 10,000 Ebola Virus Disease cases from the 2014 outbreak. Nearly all the cases were in Liberia, Sierra Leone, and Guinea. The fatality rate was nearly 50%. Thirty-five years after the initial Ebola outbreak, it is chilling to see the similar pattern of risk of transmission, particularly to the individuals who care for the Ebola victims, being mirrored even within 21st century hospitals.

Rod Tanchanco is a physician specializing in Internal Medicine. He writes about events and people in the history of Medicine. His personal blog is at talesinmedicine.com.

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