Archive for the ‘Health’ Category

Ebola outbreak reaches city of 1 million residents

December 14th, 2018
Ebola treatment center at the Hospital in Beni, North Kivu Province.

Enlarge / Ebola treatment center at the Hospital in Beni, North Kivu Province. (credit: MONUSCO/Alain Coulibaly)

The Ebola outbreak in the Democratic Republic of the Congo has spread to a city of nearly 1 million residents. There are now 30 confirmed cases and 15 deaths in the city of Butembo reported in the latest update provided by the World Health Organization (WHO). The number of cases in the city center is still low, according to Doctors Without Borders, but that number is rising quickly in more outlying districts and suburbs.

The outbreak, which has been going on since August, has so far resulted in 467 confirmed cases and a further 48 probable cases. More than half of the cases have resulted in death (including those of 17 health workers), while 177 patients have recovered, including a newborn baby.

Limited containment

The rate of transmission is beginning to slow down in Beni, a smaller city approximately 36 miles north of Butembo that has the highest number of reported cases so far. But “the outbreak is intensifying in Butembo and Katwa,” writes the WHO, “and new clusters are emerging elsewhere.”

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The fight against measles has taken a turn for the worse

November 30th, 2018
A baby hospitalized with measles in the Philippines, in an outbreak following 2013's typhoon Haiyan.

Enlarge / A baby hospitalized with measles in the Philippines, in an outbreak following 2013's typhoon Haiyan. (credit: CDC Global)

In 2010, the World Health Organization (WHO) set some ambitious goals for measles worldwide. By 2015, they wanted to reduce the number of deaths caused by measles by 95 percent compared to 2000. They set similarly ambitious targets for vaccination rates and measles infections.

The world has not reached these goals. And between 2016 and 2017, there was an alarming uptick in measles cases worldwide, according to a joint report by the WHO and CDC. “Complacency about the disease and the spread of falsehoods about the vaccine in Europe, a collapsing health system in Venezuela, and pockets of fragility and low immunization coverage in Africa are combining to bring about a global resurgence of measles after years of progress,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance, in a statement about the report.

Overall, between 2000 and 2017, there has been a lot of progress: annual global deaths have decreased 80 percent, from 545,174 to 109,638. Over this time period, measles vaccination has prevented approximately 21 million deaths globally, compared to a hypothetical world with no measles vaccines (in this world, the death rate would have been a lot higher in 2000, too). The number of cases reported annually plummeted from 145 cases per million people to just 25—although the goal was five cases per million. And 85 percent of people globally had received the first dose of the measles vaccine in 2017, compared to 72 percent in 2000.

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US life expectancy continues to move in reverse

November 29th, 2018
Cemetry in Craftsbur in Autumn Season, Common, Vermont, New England

Enlarge / Cemetry in Craftsbur in Autumn Season, Common, Vermont, New England (credit: Enn Li Photography | Getty Images)

In 1900, the average person in the US could expect to live just 47.3 years. Throughout the 20th century, that figure climbed rapidly, topping 70 years for the first time in 1961 and reaching 78.9 years in 2014, suggesting 80 was only a matter of time.

Then in 2015, there was a downturn—a small one, to 78.8 years. A single year might be a blip, but the reasons for the increase in death rate (including obesity and drug overdoses) suggested that might not be the case. Data released today by the CDC’s National Center for Health Statistics points to a continuing downward trend: life expectancy in 2017 was 78.6 years, down from 78.7 years in 2016.

That dip of 0.1 years, every year for the last three years, is not a huge trend when taken on its own. But it suggests that the decrease in 2015 was more than a blip—and it points to unfolding stories about health and death in the United States. Those small-seeming numbers also translate to meaningful real-world figures: there were 69,255 additional deaths in 2017 compared to 2016.

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Plot twist: Mitochondrial DNA can come from both parents

November 28th, 2018
Mitochondria (red) and cell nucleus (blue) of two connective tissue cells prepared from mouse embryo.

Enlarge / Mitochondria (red) and cell nucleus (blue) of two connective tissue cells prepared from mouse embryo. (credit: Institute of Molecular Medicine I, University of Düsseldorf)

The vast majority of our DNA—the chromosomes in the nucleus of each cell—is just what you’d expect: a mix of genetic material from both mother and father. But mitochondria are an exception. They contain a relatively tiny amount of DNA, and in nearly all mammals and even unicellular organisms, that DNA comes strictly from the mother. We've even used that fact to trace the spread of humanity around the globe.

But in 2002, researchers in Copenhagen reported a jaw-dropping finding. In an effort to work out why one of their patients had extreme fatigue during exercise despite seeming healthy in many respects, they started examining his mitochondria—the energy-generating power stations living in each cell. What they found floored them: the man had mitochondrial DNA (mtDNA) that matched both his father's and his mother's.

Since 2002, no other cases of paternally inherited mtDNA have been reported in humans, despite several research groups actively looking. But a paper in this week’s PNAS reports mtDNA inherited from both parents in 17 different people from three families. This kind of inheritance is still extremely rare and seems potentially linked to mitochondrial disease, but the robust confirmation of it in humans is huge news for biology and medicine.

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Posted in Genetics, Health, medicine, science | Comments (0)

Trash your romaine lettuce and don’t eat any in restaurants, says the CDC

November 21st, 2018
Romaine lettuce, looking innocuous.

Enlarge / Romaine lettuce, looking innocuous. (credit: Chimpr / Flickr)

Step away from the salad, advises the CDC. Specifically, you should stay away from romaine lettuce in every possible form: baby romaine, spring mix, whole heads, precut, the works. An outbreak of pathogenic E. coli across 11 states and Canada has been traced to romaine lettuce, an echo of a similar outbreak that happened at the same time last year.

The warning extends to lettuce in restaurants, shops, and your home, and the CDC recommends taking no risks: if you think you bought the lettuce before the current outbreak, trash it anyway. If you’re not sure it’s romaine, trash it anyway. If you had romaine in your fridge, they recommend washing down the entire fridge with warm, soapy water; and, if you're inclined to be extra cautious, a bit of diluted liquid bleach to follow.

Why the high level of alarm? The outbreak is caused by a particularly nasty strain of E. coli that can, in some cases, lead to a type of kidney failure; it’s not to be trifled with. So far, 32 people in the US got sick between October 8 and 31, of whom 13 have been hospitalized. In Canada, six people have been hospitalized out of a reported 18 cases. So far, no deaths have been reported. Because of how long it can take before the CDC gets wind of a case, the agency thinks it won’t yet know about cases happening since the first few weeks of November, so those numbers will probably change.

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New anti-gonorrhea drug called “metal as f–k”

November 15th, 2018
Image of someone opening a condom.

Enlarge / It's still best to avoid needing antibiotics. (credit: Wyoming Dept. of Health)

In the battle against gonorrhea, antibiotics have been forced into a rapid and devastating retreat. In the early 1990s, three different antibiotics were available as treatments recommended by the CDC. Resistance to one of these options was detected in the late ‘90s; since then, one after another, treatment options bit the dust. Now, resistance to all available treatment is growing.

“We are facing the real danger of multidrug-resistant, nearly untreatable gonorrhea,” wrote Susan Blank and Demetre C. Daskalakis in the New England Journal of Medicine last week. On its own, this is a very serious public health concern; taken together with the sharp uptick in the number of reported cases of gonorrhea in the US, it’s alarming.

A second paper published last week offers some hope: in a small trial, a new antibiotic did well against gonorrhea. The drug, called zoliflodacin, has a different way of attacking bacteria, making it a useful new option against antibiotic-resistant gonorrhea. A much larger clinical trial is now in the cards.

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Being a morning person might have some health advantages

November 12th, 2018
If you consider 10:50 a reasonable time to wake up, it may or may not say something about your breast-cancer risk.

Enlarge / If you consider 10:50 a reasonable time to wake up, it may or may not say something about your breast-cancer risk. (credit: Henrique Simplicio / Flickr)

A paper presented at the National Cancer Research Institute this week has made for some flashy headlines, like this confident declaration from India’s Economic Times: “Ladies, check your alarm: Waking up early may cut breast-cancer risk.” But most headlines have been appropriately measured and wordy, like The Independent’s “Women who prefer to wake up early have lower risk of breast cancer than night owls.”

In amidst the largely cautious coverage is a truckload of confusion over the details. Some reports frame the paper’s findings as being about preference (preferring to wake up early or stay up late) while others frame them as being about behavior (actually waking up earlier, regardless of preference). Some hold questions of cause and effect at arm’s length, while others dive right in with claims about sleep habits causing cancer.

And what’s the data that was used by the National Cancer Research Institute? Health News Review, in its critique of media coverage of the research, reports that researchers examined “self-reported responses” about being a morning person, but genetic data came into the mix, too.

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As if heroin weren’t dangerous enough, it now comes with lead poisoning

November 9th, 2018
An opium poppy field in Afghanistan.

Enlarge / An opium poppy field in Afghanistan. (credit: United Nations)

After she admitted swallowing 30 packs of opium, a 51-year-old woman was brought to a hospital emergency room in Tehran, the New England Journal of Medicine reported yesterday. When a CT scan confirmed the presence of several small oval objects in her abdomen, the doctors gave her laxatives. She passed a collection of small, sausage-like opium packs “without complication,” report doctors Nasim Zamani and Hossein Hassanian-Moghaddam.

One of those packs was sent for lab analysis, and results came back confirming opium, and also the presence of lead—a lot of lead. Luckily for this particular patient, she didn’t seem to be showing any symptoms of lead poisoning, but she appears to have got off lightly. Over the past few years, the problem of lead-contaminated opium has become increasingly urgent in Iran, which is used as a major pathway for opium trafficking from Afghanistan.

In early 2016, write Zamani and Hassanian-Moghaddam in a CDC report, another patient case report found blood lead levels 14 times higher than normal. The patient in question didn’t have any obvious exposure to lead, but was known to use oral opium. That prompted tracking of another 800 patients over the next few months, whose blood lead levels ranged from about five times higher than normal, to 1100 times higher. These blood lead levels were substantially higher than earlier reports of lead poisoning in opium users.

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Genetics play less of a role in lifespan than we thought

November 8th, 2018
Historical family trees turn up useful new insights into the genetics of longevity, but represent a world of different health risks.

Enlarge / Historical family trees turn up useful new insights into the genetics of longevity, but represent a world of different health risks. (credit: flickr user: Jon. D. Anderson)

Romantic scenes that never happen: your eyes meet. Your heart flutters. This person is the one—you’re sure of it, because you're convinced they'll live to at least 95 years old. It’s what you’ve always dreamed of.

Lifespan doesn't usually make an appearance on people’s lists of what they’re looking for in a partner. But, according to a paper published this week in the journal Genetics, longevity correlates strongly through marriage relationships, meaning that people are pretty good at picking partners who live similar lifespans. Failing to account for that behavior has meant that estimates of the genetic contribution to longevity have been substantially overinflated.

I knew the second I saw your bloodwork

Nobody is choosing partners based on how long they’ll live. As the authors of the paper sagely note, lifespan “cannot be observed until death, at which point the opportunity to mate has ended.” But as anyone who’s ever dated can tell you, people are likely to marry their match (or close to it) in characteristics like wealth and education, which play an obvious role in longevity.

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Cultural barriers still stand in the way of HPV vaccine uptake

November 4th, 2018
The HPV vaccine is often delivered along with sex education.

Enlarge / The HPV vaccine is often delivered along with sex education. (credit: Pan American Health Organization / Flickr)

Every year, nearly 34,000 cases of cancer in the US can be attributed to HPV, the human papillomavirus . The CDC estimates that vaccination could prevent around 93 percent of those cancers. Yet HPV vaccination rates are abysmal: only half of the teenagers in the US were fully vaccinated in 2017.

Cultural barriers play a role in that low rate. Vaccinating pre-teens against a sexually transmitted infection has had parents concerned that that this would encourage their kids to have sex sooner, with more partners, or without protection or birth control. And vaccine rates vary across different social and cultural groups: for instance, rural teenagers are less likely to be vaccinated than urban ones.

Two recent studies explore different facets of the cultural barriers standing in the way of better HPV vaccine uptake. The first, a paper published last month in the Canadian Medical Association Journal, looks at the data on whether the vaccine encourages riskier sexual behavior and finds no evidence that it does. And the second, an early draft of a paper presented at an American Association for Cancer Research meeting this week, reports the results of a culturally-targeted intervention aiming to increase vaccine uptake among low-income Chinese Americans.

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