Doctors have long recommended that people who have had a heart attack or stroke take a daily low-dose aspirin to help prevent further heart problems. Now major research has tested whether aspirin can help prevent first-time heart problems. The results of three separate studies show it cannot.

One study looked at more than 12,000 patients at moderate risk of heart problems because of other health issues, such as high blood pressure, high cholesterol or smoking. The results showed no benefit.

Doctor J. Michael Gaziano of Brigham and Women’s Hospital suggests that is because those people already were taking other medications that lowered their risk.

“Risk that a person has changes over time, and some of that change is due to some of the things that we do, like managing their risk factors and taking care of them when they develop symptoms,” Gaziano said.

Dr. Jane Armitage of the University of Oxford led another study of more than 15,000 adults with diabetes that found the benefits of aspirin were outweighed by a greater risk of serious bleeding.

“We also saw almost a 30 percent increased risk in major bleeding,” Armitage said. “So that was bleeding bad enough to get you into hospital. Mainly from the gut, or bleeding into the eye or the brain and if it was into the eye, it was bad enough to threaten your sight.”

Based on results of the studies, disclosed over the weekend at the European Society of Cardiology, doctors say aspirin best benefits patients who already have heart disease. 
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Marijuana’s main mind-altering ingredient was detected in nursing mothers’ breast milk in a small study that comes amid evidence that more U.S. women are using pot during pregnancy and afterward.

Experts say the ingredient, THC, has chemical properties that could allow it to disrupt brain development and potentially cause harm, although solid evidence of that is lacking.

 

The new study involved 50 nursing mothers who were using pot and provided breast milk samples to researchers at the University of California, San Diego. Lab testing found small amounts of THC, the psychoactive chemical that causes marijuana’s “high,” in 34 of 54 samples up to six days after they were provided. Another form of THC and cannabidiol, a pot chemical touted by some as a health aid, were detected in five samples.

 

The study authors said “it is reasonable to speculate” that exposing infants to THC or cannabidiol “could influence normal brain development,” depending on dose and timing.

 

The results echo findings in case reports from years ago, when pot was less potent than what’s available today, said study co-author Christina Chambers, a pediatrics professor. It’s not known if the amounts detected pose any risk, but she said her research team is studying children whose moms’ were involved to try to answer that question.

 

Two small studies from the 1980s had conflicting results on whether pot use affects breastfed infants. One found no evidence of growth delays; the other found slight developmental delays in breastfed infants, but their mothers had used pot during pregnancy too.

 

Most pediatricians encourage breastfeeding and its health benefits for infants, but “they’re stuck with a dilemma” with infants whose mothers use pot, Chambers said.

 

A new American Academy of Pediatrics report recommending against pot use while pregnant or nursing acknowledges that challenge.

 

“We still support women breastfeeding even if using marijuana but would encourage them to cut down and quit,” said Dr. Seth Ammerman, a report co-author and Stanford University pediatrics professor.

 

“In counseling patients about this, it’s important to be nonjudgmental but to educate patients about the potential risks and benefits,” Ammerman said, to ensure “a healthy outcome for themselves and their baby.”

 

The study and report were published Monday in the journal Pediatrics .

 

The American College of Obstetricians and Gynecologists has similar advice.

 

The academy report says its advice is based on theoretical risks to developing brains, but it acknowledges conflicting evidence and a dearth of research. Some studies have linked pot use during pregnancy with lower birth weights or preterm birth, along with developmental delays and learning difficulties in older children. But additional factors including women’s use of other drugs during pregnancy complicated the results, the report says.

 

Marijuana is legal for recreational use in nine states and Washington, D.C., and for medical use in 31 states, according to the National Conference of State Legislatures.

 

As more states legalize marijuana, its use is increasing along with the “false impression” that it is safe, the academy’s report says. Ammerman said caution makes sense, given the uncertainties.

 

According to U.S. government data, about 1 in 20 women report using marijuana during pregnancy. Estimates for use among breastfeeding mothers vary, but a study in Colorado, where recreational marijuana is legal, put the number at almost 20 percent among women in a government supplemental food program.

 

The report, study and a journal editorial all said more research is needed.

 

Last year, a federal advisory panel said lack of scientific information about marijuana poses a public health risk.

 

Research has been hampered by federal government restrictions based on its view that marijuana is an illegal drug.

 

That has contributed to a stigma and shaded doctors’ views, said Keira Sumimoto, an Irvine, California, mother who used marijuana briefly for medical reasons while pregnant and breastfeeding. She said smoking a joint daily helped her gain weight when she was sick before learning she was pregnant, and eased childbirth-related pain, but that she quit because of backlash from marijuana opponents.

 

She said her daughter, now 8 months old, is healthy and advanced for her age.

 

Sumimoto runs @cannabisandmotherhood , an Instagram account that she says aims to present truthful information about marijuana so women can make their own choices.

 

She said she agrees with advice to be cautious, but that the academy’s stance is “is just a little too much.”

 

“The fear is taking over and the need and want to understand this plant is being ignored by the stigma,” Sumimoto said.

 

 

 

 
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It’s a good idea for people to get an annual physical … and it’s important for animals, too. The London Zoo hosted its annual weigh-in for thousands of its animals recently, enticing the creatures with food to get their measurements. The documentation process is an extensive and time-consuming exercise for the zoo keepers, but a crucial one, say zoo officials. VOA’s Julie Taboh has more.
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Brazil’s health officials say more than 4 million children still need to be vaccinated against measles.

More than 1,380 people have been infected in an outbreak linked to cases imported from Venezuela.

To stop the disease’s spread, Brazil’s Health Ministry launched a campaign this month to vaccinate all children between 1 and 5 — regardless of their vaccination history. It said Friday that 4.1 million children still had not been vaccinated as the campaign enters its final week.

Among the places with the lowest vaccination rates is Roraima, one of two border states with Venezuela where cases are concentrated.

Health services in the neighboring country have collapsed amid economic and political turmoil, which has caused more than 1 million people to flee.

Tens of thousands have migrated to Brazil.
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A doctor has become the first probable Ebola case in one of the eastern Democratic Republic of Congo’s “high insecurity zones” which are dogged by militia violence and hard to access, a scenario “we have all been dreading,” the WHO said on Friday.

Since the outbreak erupted on August 1, 103 confirmed and probable cases of Ebola have been identified in North Kivu and Ituri provinces, including 63 deaths, the health ministry said in an overnight update.

The doctor living in Oicha town in North Kivu has been re-hospitalised with Ebola symptoms after his wife was confirmed as having the disease when she traveled to the nearby city of Beni, said Dr. Peter Salama, the World Health Organization’s head of emergency operations.

Oicha is almost entirely surrounded by ADF Ugandan Islamist militia, there are “extremely serious security concerns,” he said. Aid workers, priests and government officials are held hostage in the area, he said.

The doctor’s initial test for Ebola — which causes vomiting, fever and diarrhea — had been negative, but fresh results are awaited, Salama told Reuters.

So far 97 of the doctor’s contacts who may have been exposed to the virus have been identified, and vaccination has begun in the town, he added.

“So for the first time really we have a confirmed case and contacts in an area of very high insecurity. It really was the problem we were anticipating and the problem at same time that we were dreading,” Salama told a news briefing.

WHO and health experts reached Oicha with armed escort by MONUSCO troops this week, he said, adding: “We know from that incident now in Oicha we are going to have to operate in some very complex environments due to security and access concerns.”

In a further worrying development, angry youth burned down a health center in another village, where vaccinations were under way, after learning of a death from Ebola, Salama said.

More than 2,900 people have been vaccinated against Ebola since the outbreak began, he said.

“We are at quite a pivotal moment in this outbreak in terms of the evolution of the outbreak epidemiologically and in terms of the response,” he said.
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Thirty-six million people currently live with AIDS, a disease that claimed the lives of nearly 1 million people last year. Experts predict that by 2030, 100 million people will have been infected with the HIV virus.

Despite the alarming numbers, there have been great strides in treatment. HIV is no longer a death sentence, and researchers say people receiving treatment for HIV are able to live normal lives and do not pose a risk to others when they are being treated proactively.

But success carries a price: complacency. Funding for AIDS research and treatment has declined, and in some places, so has government interest.

“When we talk to ministers of finance, they always say to me, ‘I thought HIV was over because I don’t see anybody dying,’” said Dr. Deborah Birx, a U.S. Global AIDS coordinator who oversees the President’s Emergency Plan for AIDS Relief (PEPFAR).

J. Stephen Morrison of the Center for Strategic and International Studies, said, “We’re not reaching goals.” He added, “There’s going to be a struggle to hold ground. … There’s a widening deficit of political will and financial capacity that we face some really daunting challenges in prevention.”

Dr. Chris Beyrer, with Johns Hopkins Medicine, predicted that things will get worse if governments and civilians continue their complacency. 

“We are not done with AIDS,” he said. “It is much too early to declare victory, and the risks of a resurgent epidemic are real.”

Birx, Morrison and Beyrer discussed the challenges in ending AIDS at a program in Washington to evaluate the messages from this year’s International AIDS Conference in Amsterdam.

New infections are down from 3.4 million a year, but they’re stuck at 1.8 million per year. And there are 17 million people living with HIV who cannot be reached. They are in high risk groups: young women, particularly young African women; men who have sex with men; IV drug users; those in prisons and other closed settings; sex workers and their clients; and transgender people.

“Those key populations and young women account for over 50 percent of new infections, and they are really hard to reach,” Morrison said.

Though it’s relatively easy to prevent HIV transmission during childbirth, Beyrer said about 30 percent of all infants born with HIV worldwide are born in Nigeria.

​In the U.S., HIV is increasingly an infection in communities with high rates of poverty and in black and Hispanic populations.

The National Institutes of Health announced Aug. 20 that getting these groups into care is critical to ending the HIV epidemic in the U.S. NIH also announced an international program to reduce the stigma around the virus so more people with the disease can seek treatment.

Experts agree it is possible to end the HIV pandemic, even without a vaccine. But to do this, governments and communities need to be involved, funding needs to be continued, and everyone with HIV needs to be treated.
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Since the 1990s, annual numbers of U.S. coal miners with new, confirmed cases of an advanced form of so-called black lung disease known as progressive massive fibrosis have been steadily rising, according to a new study.

The resurgence is particularly strong among central Appalachian miners in Kentucky, Pennsylvania, Virginia and West Virginia, the study authors note.

“It’s an entirely preventable disease, and every case is an important representation of a failure to prevent this disease,” said lead study author Kirsten Almberg of the University of Illinois at Chicago and the National Institute for Occupational Safety and Health (NIOSH) in Morgantown, West Virginia.

Progressive massive fibrosis is the most severe form of pneumoconiosis, which is also known as black lung disease and is caused by overexposure to coal mine dust. The symptoms are debilitating and can lead to respiratory distress.

“Many people think black lung is a relic of the past,” she told Reuters Health in a phone interview. “But it shouldn’t fade from our attention.”

Almberg and colleagues looked at the number of progressive massive fibrosis cases among former U.S. coal miners applying for Federal Black Lung Program benefits between 1970 and 2016.Miners can apply for financial help and medical coverage if facing disabling lung impairment, and claims are accepted when medical tests and imaging verify the presence of disabling pulmonary impairment.

Progressive massive fibrosis is “by definition” considered totally disabling, the authors note in the Annals of the American Thoracic Society.

Among 314,000 miners who applied for benefits during the 46-year period, the research team found 4,679 cases of confirmed progressive massive fibrosis, with 2,474 of these representing claims filed since 1996.

The yearly number of cases fell from 404 in 1978 to 18 in 1988 but then began increasing each year, with 383 confirmed cases in 2014, the study found. At the same time, employment has declined from 250,000 miners in 1979 to 81,000 in 2016, the authors note.

“It’s pretty staggering that more than half of the cases were in the more recent period since 1996,” Almberg said. “These are our first snapshots of how big this problem really is.”

The increase has most dramatically impacted the Appalachian region. About 84 percent of miners with confirmed cases of progressive massive fibrosis last mined in Kentucky, Pennsylvania, Virginia and West Virginia, although only 62 percent of claims originated in these states.

“Put simply, we still do not know exactly why severe disease has increased so much among miners in central Appalachia or when this trend may reverse,” said Emily Sarver, a mining and minerals engineer at Virginia Tech in Blacksburg, who wasn’t involved in the study.

Future research should look at the different factors that may affect this ongoing increase in diagnoses, such as changes in the types of dust in mining environments, said Sarver, who works with mine partners to sample dust in active operations and characterize what’s in it and the size of particles.

“This is a real and very complex problem. Unlike safety issues, which are oftentimes apparent or can be identified and mitigated quickly, the exposure-response time with many health issues is quite long,” she said. “If I am exposed to hazardous dust today, for example, it may not impact my lungs for a decade or more, and I may experience a different outcome than another person exposed to the same dust.”

Similarly, Almberg and study co-author Robert Cohen of NIOSH and National Jewish Health and University of Colorado in Denver are working with mining engineers and pathologists to study coal mine dust in lung tissue samples to understand what causes progressive massive fibrosis to develop.

They’re comparing lung tissue samples from current cases to samples collected from autopsies of former miners, and want to understand whether new mining techniques may create smaller dust particles that drive the disease deeper into the lungs or whether more toxic carbon or coal dust is being expelled from mines.

“Like any person, you should expect to be able to work for a full career and leave the workforce and still have your health and life ahead of you,” Almberg said. “Coal miners aren’t the only ones exposed to hazardous materials on the job, and we should be able to catch this early and prevent it from progressing to the severe stages of the disease.”
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Vice President Mike Pence is in Houston, Texas, to reaffirm the Trump administration’s plans to establish an American Space Force by 2020, return Americans to the moon, and set its sight on Mars and beyond.

During a speech Thursday at NASA’s Johnson Space Center, Pence said that recent Pentagon reports have shown that China is “aggressively weaponizing space” and that Russia is developing weapons to “counter America’s space capabilities.”

Pence said the Department of Defense is moving forward to “strengthen American security in space” and that the administration will work with Congress to secure funding and authorization to establish Space Force as a new and separate branch of the armed forces.

Pence also highlighted efforts to move the Lunar Orbital Platform, formerly known as the Deep Space Gateway, from proposal phase to production. NASA, the main U.S. agency for space exploration, and several of its partners, have been developing plans for this lunar-orbit space station that would be used as a staging point for lunar exploration and would have several gateway-to-space features, including a propulsion system, a habitat for the crew, and docking capability.

In its 2019 budget, NASA has requested $504 million in funding for this project, which has yet to be approved by Congress.

There was little new detail in Pence’s speech other than reiterating the administration’s vision for “American dominance in space.” Space Force has been mentioned by Pence on several occasions, and a theme that President Donald Trump often returns to, including during his rally in Charleston, West Virginia, on Tuesday.

Trump first announced the creation of Space Force at the White House in June. He pledged to reclaim U.S. leadership in space, framing it as a national security issue, and saying he does not want “China and Russia and other countries leading us.”

Trump’s Space Force has triggered debate in military space exploration, as well as legal circles, including whether it may violate international law. The U.S. is a signatory and ratifier of the United Nations Outer Space Treaty of 1967.

The treaty prevents any nation from declaring sovereignty over space or heavenly bodies, and prohibits space-faring countries from blocking other nations from exploring space. There are further restrictions over military presence on heavenly bodies such as the moon, which according to the treaty “shall be used exclusively for peaceful purposes.”

Last December, Trump signed Space Policy Directive 1, a national space policy directing a government-private partnership with the goal of returning Americans to the moon, followed by missions to Mars and beyond.

The policy calls for the NASA administrator to “lead an innovative and sustainable program of exploration with commercial and international partners to enable human expansion across the solar system and to bring back to Earth new knowledge and opportunities.”

Pence has been the leading spokesperson for the U.S. space program, delivering remarks about the country’s space ambitions on behalf of the president.
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Russian scientists have found the carcass of an ancient foal perfectly preserved in the Siberian permafrost.

The fossil discovered in the region of Yakutia has its skin, hair, hooves and tail preserved. Yakutia is also famous having wooly mammoth fossils found in the permafrost.  

Scientists from Russia’s Northeast Federal University who presented the discovery Thursday said the foal is estimated to be 30,000 to 40,000 years old. They believe it was about two months old when it died.

Semyon Grigoryev, head of the Mammoth Museum in the regional capital of Yakutsk, was surprised to see the perfect state of the find. He noted it’s the best-preserved ancient foal found to date.

The foal was discovered in the Batagaika crater, a huge 100-meter (328-foot) deep depression in the East Siberian taiga.
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Israel on Tuesday outlawed the import and sale of e-cigarettes made by Silicon Valley startup Juul Labs, citing public health concerns given their nicotine content.

A statement by Israel’s Health Ministry said the Juul device was banned because it contains nicotine at a concentration higher than 20 milligrams per milliliter and poses “a grave risk to public health.”

Since launching in 2015, the flash drive-sized vaping device has transformed the market in the United States, where it now accounts for nearly 70 percent of tracked e-cigarette sales. The company is valued at $15 billion based on its most recent funding round, according to venture capital database Pitchbook.

In a statement Tuesday, Juul Labs Inc said it was “incredibly disappointed” with what it called a “misguided” decision by the Israeli government. The San Francisco company said it planned to appeal the ban, adding that its devices provide smokers “a true alternative to combustible cigarettes.”

The Israeli move was consistent with similar restrictions in Europe, the ministry’s statement said.

The ban, which goes into effect in 15 days, was signed by Prime Minister Benjamin Netanyahu, who also holds the health portfolio.

Israel’s Haaretz newspaper reported in May that Juul e-cigarettes were already available for purchase at 30 locations around the country.

Juul says it targets adult smokers, but it has faced scrutiny over the popularity of its products with teenagers.

In April, the U.S. Food and Drug Administration launched a crackdown on the sale of e-cigarettes and tobacco products to minors, particularly those developed by Juul Labs.
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Food waste could rise by almost a third by 2030 when more than 2 billion tons will be binned, researchers said on Tuesday, warning of a “staggering” crisis propelled by a booming world population and changing habits in developing nations.

The United Nations has set a target of halving food loss and waste by 2030. But the Boston Consulting Group (BCG) study found that if current trends continued, it would rise to 2.1 billion tons annually — an amount worth $1.5 trillion.

“We are seeing a real crisis at a global level,” one of the study’s authors Esben Hegnsholt told the Thomson Reuters Foundation.

“The amounts of waste and the social, economic and environmental implications are serious if we don’t change the trajectory. When we fight food loss and waste, we also fight hunger, poverty and global warming.”

Around a third of the world’s food is lost or thrown away each year. Currently, we waste 1.6 billion tons of food annually, worth about $1.2 trillion.

Much of the projected increase was down to a swelling world population, with more people resulting in more waste, said Hegnsholt, a partner and managing director at the management consultancy.

Household waste will increase in developing countries as consumers gain more disposable income, said rhe report, which identified five key changes which it said could save nearly $700 billion in lost food.

They included more awareness among consumers, stronger regulations and better supply chain efficiency and collaboration along the food production chain.

Liz Goodwin, director of the food loss and waste program at the World Resources Institute, said the report raised serious issues but oversimplified some of the solutions.

“It’s connected with the way our lives have changed and the fact that food is now so much cheaper,” she said, also citing a growing demand for convenience and a lack of cooking skills among younger generations.

Goodwin said she believed measures to cut wastage were having an effect, and the world would at least be on the way to meeting the 50 percent reduction target by 2030.

Consumers, businesses and regulators would all have to play a role in driving change, she said.

“We need a shift in our attitudes to food waste — I think we need to get to the point where it just isn’t acceptable to throw food in the bin,” she said.
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Smoke from wildfires clogged the sky across the U.S. West, blotting out mountains and city skylines from Oregon to Colorado, delaying flights and forcing authorities to tell even healthy adults in the Seattle area to stay indoors.

 

As large cities dealt with unhealthy air for a second summer in a row, experts warned that it could become more common as the American West faces larger and more destructive wildfires because of heat and drought blamed on climate change. Officials also must prioritize resources during the longer firefighting season, so some blazes may be allowed to burn in unpopulated areas.

 

Seattle’s Space Needle was swathed in haze, and it was impossible to see nearby mountains. Portland, Oregon, residents who were up early saw a blood-red sun shrouded in smoke and huffed their way through another day of polluted air. Portland Public Schools suspended all outdoor sports practices.

 

Thick smoke in Denver blocked the view of some of Colorado’s famous mountains and prompted an air quality health advisory for the northeastern quarter of the state.

The smoky pollution, even in Idaho and Colorado, came from wildfires in British Columbia and the Northwest’s Cascade Mountains, clouding a season that many spend outdoors.

 

Portland resident Zach Simon supervised a group of children in a summer biking camp who paused at a huge water fountain by the Willamette River, where gray, smoky haze obscured a view of Mount Hood.

 

Simon said he won’t let the kids ride as far or take part in as many running games like tag while the air quality is bad.

 

“I went biking yesterday, and I really felt it in my lungs, and I was really headachy and like, lethargic,” Simon said Monday. “Today, biking, you can see the whole city in haze and you can’t see the skyline.”

 

One of Colin Shor’s favorite things about working in the Denver area is the view of the high peaks to the west. But that was all but gone Monday.

 

“Not being able to see the mountains is kind of disappointing, kind of sad,” he said.

 

Forest fires are common, but typical Seattle-area weather pushes it out of the way quickly. The latest round of prolonged smoke happened as hot temperatures and high pressure collided, said Andrew Wineke, a spokesman for the state Ecology Department’s air quality program.

It’s a rare occurrence that also happened last year, raising concerns for many locals that it may become normal during wildfire season. Wineke said climate change is expected to contribute to many more fires.

 

“The trend is clear. You see the number of forest fires increasing, and so there’s going to be wildfires,” Wineke said. “There’s going to be smoke. It’s going to be somewhere.”

 

The Federal Aviation Administration said airplanes bound for the Sea-Tac International Airport, Seattle’s main airport, may be delayed because of low visibility.

In Spokane, air quality slipped into the “hazardous” range. Thick haze hung over Washington’s second-largest city, forcing vehicles to turn on their headlights during the morning commute.

 

The air quality was so bad that everyone, regardless of physical condition or age, will likely be affected, according to the Spokane Regional Clean Air Agency.

 

In California, wind blew smoke from several wildfires into the San Francisco Bay Area, where haze led authorities to issue an air quality advisory through Tuesday. They suggested people avoid driving to limit additional pollutants in the air and advised those with health problems to reduce time outdoors.

 

Health officials say signs of smoke-related health symptoms include coughing, scratchy throat, irritated sinuses, headaches, stinging eyes and runny nose. Those with heart disease may experience chest pain, irregular heartbeats, shortness of breath and fatigue.

 

Patients at Denver’s National Jewish Health, a respiratory hospital, were reporting worsening symptoms, hospital spokesman Adam Dormuth said.

 

In Portland, six tourists from Lincoln, Nebraska, posed for a photo in front of the Willamette River with the usual Mount Hood backdrop shrouded in haze. The group of siblings and friends rented an RV and drove in to visit a sister who recently moved to the area.

 

“We are disappointed that we can’t see the mountains and the whole city, because our relatives live here and tell us how pretty it is, and we’re missing it,” Bev Harris said. “We’re from tornado alley, and we don’t have wildfires. It’s a different experience.”
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Australian Prime Minister Malcolm Turnbull has abandoned plans to enshrine the nation’s targeted limits of greenhouse gas emissions into law in the face of an angry revolt by his party’s staunch conservatives.

Australia set a target to cut carbon emissions by 26 percent below 2005 by the year 2030, as part of the 2015 United Nations Framework Convention on Climate Change, commonly known as the Paris Agreement.

Turnbull sought to include the targets in the government’s National Energy Guarantee, but he conceded Monday that he could not get the legislation through the House of Representatives, where his Liberal Party holds a fragile one-seat majority. The conservative opposition, led by former Prime Minister Tony Abbott, argue that the government should be focused on cutting soaring electricity prices. 

The internal revolt has led to speculation that Home Affairs Minister Peter Dutton will challenge Turnbull for leadership of the Liberal Party, which both men have denied. It also comes amid a new voter survey showing the government trailing the opposition Labor Party 55 percent to 45 percent. The next national elections are scheduled to be held next May. 
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A prosthetic hand might look like a hand and move like a hand. But can it ever feel like a hand? Johns Hopkins University graduate student Luke Osborn says yes. As Faith Lapidus reports, Osborn has developed an “electronic skin” that can help amputees feel pressure and even pain – once more.
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With the Democratic Republic of Congo facing its second major Ebola outbreak this year, emergency responders have worked to contain the spread of the disease. Scientists, meanwhile, are testing the effectiveness of experimental vaccines in the field.

Alongside these efforts, researchers in the DRC are collecting data that will improve how we respond to, and prevent, future outbreaks of Ebola and other infectious diseases.

Their work involves building a comprehensive picture of how diseases like Ebola spread by tracking cases and mapping where people live, work and seek health care.

Over time, a more sophisticated understanding of the environments through which contagious diseases spread will lead to faster, more effective treatment.

Long-term response efforts

Anne Rimoin is an associate professor of epidemiology at the UCLA School of Public Health. She’s also the director of the UCLA-DRC Health Research and Training Program, an effort based in Kinshasa, Congo, that’s been underway for 16 years.

Rimoin returned to the U.S. last month from fieldwork in the DRC. She told VOA that her group is collecting data that will benefit responses to not just Ebola but emerging infectious diseases as well as.

“In an outbreak, you have to understand where people are and what their patterns of travel are. Where they’re going, where they’re working, where their fields are,” Rimoin said. “If you don’t know where things are, it becomes very difficult to define a response.”

Collecting this kind of data is especially important in a country like Congo, where small, unmapped villages checker vast forests, and the infrastructure hasn’t, for the most part, been developed.

“The DRC is a very large country,” Rimoin said. “There haven’t been good, accurate maps of the DRC available to date.”

​High-tech and local knowledge

Rimoin’s group partners with several organizations, including the DRC’s Ministry of Health, the World Health Organization and the Centers for Disease Control and Prevention, part of the U.S. Department of Health and Human Services.

Rimoin said the Health Research and Training Program in Kinshasa uses a mix of high-tech solutions and local knowledge. The group analyzes satellite imagery to understand the terrain and population centers in the DRC. But they also rely on insights from residents to compile a more accurate and complete data set.

These data-collection tools allow Rimoin’s team to figure out not just boundaries but human activities, including traffic flows and health centers.

They plot important landmarks like roads, rivers and health centers. They also track exposure to health care workers and people who have been vaccinated to compare them to other populations, building a more complete understanding of how prevention drugs work.

“It’s important for data to be available so that you can look for trends between outbreaks and try to find commonalities and try to be able to quickly ascertain similarities between outbreaks,” Rimoin said.

Local knowledge

Working with local populations is critical to the project’s success. It’s these experts who know the terrain and the population, and that expertise often proves invaluable, especially when faced with skepticism from residents about the efficacy of vaccines.

By partnering with local organizations and international efforts with a long-term commitment to the country, Rimoin said, the Health Research and Training Program is better positioned to work with communities to understand their needs, concerns and beliefs.

“It’s really important to work with people who are there all the time — not parachuting in,” Rimoin said. 
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The World Health Organization says security issues could hamper efforts to contain an Ebola outbreak in the eastern Democratic Republic of Congo. The outbreak is in conflict-ridden North Kivu province, where some areas are too dangerous for health care workers to go.

As of Wednesday, about two weeks after the Ebola outbreak was declared in North Kivu province, there were 78 confirmed and probable cases of the viral disease, including 44 deaths.

That is nearly double the number of cases reported during a recent and separate Ebola outbreak in Equateur Province.

Health workers have fanned out in North Kivu, tracking down contacts of Ebola victims and giving them an experimental vaccine. But WHO spokesman Tarik Jasarevic says more cases of Ebola are expected to be seen in the coming days and weeks.

“It will get worse before it gets better,” he said. “We do not know if we are having all transmission chains identified. We expect to see more cases as a result of earlier infections and these infections are developing into illness.”

He tells VOA that health workers are able to move around freely in the towns of Mangina and Beni, which are the epicenters of the disease. It is the other parts of the province that have the WHO worried.

“There are areas just next to Mangina that are level four on the UNDSS Security scale, which means that it is an area not to go to … We still do not have a full epidemiological picture, so … the worst-case scenario is that we have these security blind spots where the epidemic could take hold and then we do not know about it,” he said.

The WHO reports it is using the same Ebola vaccine that helped contain the outbreak in Equateur province.

So far, it says nearly 500 people in North Kivu have been vaccinated, including health care workers and people who have come in contact with confirmed cases of the deadly disease.
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U.S. health officials Thursday approved a new generic version of EpiPen, the emergency allergy medication that triggered a public backlash because of its rising price tag.

The new version from Teva Pharmaceuticals is the first that will be interchangeable with the original penlike injector sold by Mylan. The Food and Drug Administration announced the approval in a statement.

EpiPen injections are stocked by schools and parents nationwide to treat children with severe allergies. They are used in emergencies to stop potentially fatal allergic reactions to insect bites and stings and foods like nuts and eggs.

EpiPen maker Mylan has dominated the $1 billion market for the shots for two decades. Several other companies sell competing shots containing the drug epinephrine, but they aren’t heavily marketed or prescribed by doctors.

In 2016, Congress blasted Mylan in letters and hearings for raising EpiPen’s to $600 for a two-pack, a five-fold increase over nearly a decade. The company responded by launching its own lower-cost generic version for $300.

Mylan continues to sell both versions at those prices, according to data from Elsevier’s Gold Standard Drug Database.

Teva’s generic shot will be the first version that pharmacists can substitute even when doctors prescribe the original EpiPen.

A Teva spokeswoman declined to comment on the drug’s price but said it would launch “in the coming months.” Generic drugs can be priced as much as 80 percent lower than the original product. But those price cuts usually appear after several companies have launched competing versions.

Teva’s bid to sell a generic EpiPen faced multiple setbacks at the FDA, which rejected the company’s initial application in 2016. While epinephrine is a decades-old generic drug, Teva and other would-be competitors struggled to replicate the EpiPen’s auto-injector device.
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In 1995, a patient sick with the Ebola virus, in what was then called Zaire and is now the Democratic Republic of the Congo, miraculously recovered from this deadly disease. At that time, when the virus first jumped from animals to man, Ebola meant almost certain death.

Doctors found that this patient had antibodies to fight the virus in his bloodstream even after he recovered. 

Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, invited the patient to the U.S., where researchers cloned the cell that had helped him beat Ebola.

“We brought the person back to the United States to draw his blood and try to clone the B cells that make the antibodies that this person had produced … to then, essentially, clear his virus and, hopefully, protect him against any future exposure,” Fauci told VOA. 

Because the NIH scientists made numerous copies of that cell, it is called a monoclonal antibody — in this case, mAB114. It’s hoped that it can be used to target the Zaire strain of Ebola currently spreading in eastern Congo.

Fauci said mAB114 is still experimental.

“We have done a number of tests in an animal model and have shown that when you infect an animal up to five days after they become infected, and you passively transfer this antibody, you can actually protect the animals from getting sick and they recover,” he said.

Not all treatments that work in animals work in humans, something Fauci knows all too well. One treatment for HIV/AIDS that Fauci found worked well in monkeys had disastrous effects when tested in humans.

Fauci’s staff is conducting a phase one clinical trial in volunteers at the NIH hospital to make sure mAB114 is safe. So far, no one can say whether the treatment works, but because of the dire situation in Congo, and the fear the virus will spread in the armed conflict that is going on in the region, Fauci said the antibody has been given to five people with Ebola.

At a news conference Tuesday, Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, said he had been told they were doing well.

As of now, there’s no approved treatment for the disease, although there is a vaccine that protects people who may have been exposed to the virus but who are not sick. 

Other experimental treatments are also being used to help end the outbreak in Congo. One of them is ZMapp, a combination of three monoclonal antibodies. In 2016, NIH found ZMapp safe and well-tolerated, but without an outbreak, it is impossible to prove effectiveness. 

Fauci said another antiviral drug, remdesivir, is being used in patients with Ebola from West Africa, even though that outbreak is over. Scientists have found the Ebola virus can remain in the semen, so men are being treated to prevent further spread.

Remdesivir, or GS-5734, is produced by Gilead. On its website, Gilead says remdesivir is thought to work by blocking a key enzyme the virus needs to reproduce itself. Tomas Cihlar, Gilead’s vice president for biology, is quoted as saying, “Based on animal studies, we believe that the compound is able to penetrate the organs and tissues throughout the body where Ebola replicates.”

So far, there are no proven treatments for Ebola. Scientists are hopeful that that therapeutic antibodies could be the best way to stop this virus. An international study led by Scripps Research suggests that antibodies may be valuable treatments against new viruses and could help a patient’s immune system fight the Ebola virus after being infected.
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More than 100 cases of measles have been diagnosed this year in 21 U.S. states and the District of Columbia, the U.S. Centers for Disease Control and Prevention reported Thursday.

As of July 14, 107 people had contracted the viral infection in Arkansas, California, Connecticut, Florida, Illinois, Indiana, Kansas, Louisiana, Maryland, Michigan, Missouri, Nevada, New Jersey, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Washington, and the nation’s capital.

Measles is a highly contagious virus that spreads through the air via coughing and sneezing. The illness starts with a fever, runny nose, cough, red eyes and a sore throat. It’s followed by a rash that spreads over the body. While the disease is treatable, the CDC said, one or two out of every 1,000 children who get measles die from complications.

This year’s outbreak is on pace to surpass last year’s, when 118 people from 15 states and the District of Columbia were reported to have measles. In 2016, 86 people from 19 states contracted the illness.

The CDC said the majority of people who contracted measles were unvaccinated. Prevention is key, because the virus can be spread easily.

The measles virus can live for up to two hours in an airspace where the infected person coughed or sneezed, according to the CDC. Measles is so contagious that if one person has it, 90 percent of unimmunized people in close contact with the infected person will also become infected.

In 2015, the United States experienced a large, multistate measles outbreak linked to an amusement park in California. The outbreak most likely started with a traveler who became infected overseas, then visited the park. The source of the infection was never identified.

The CDC recommends children get two doses of the vaccine, starting with the first dose at 12 to 15 months of age, and the second dose at 4 through 6 years of age.

Lifetime effectiveness means adults vaccinated as children don’t need to be revaccinated. 
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The scientific community has long acknowledged that vaccines work and have saved millions of lives. However, a vocal community, particularly in the U.S., believes that vaccines expose children to health risks and can cause harm.

It can be easy to write off these opinions, but psychology researchers have long known of many cognitive biases that can lead people to make poor judgments. Several of these researchers are interested in how people end up receiving and believing fallacious ideas as they relate to vaccines.

Cognitive misers

The human mind isn’t like a computer. Our brains aren’t composed of truth values coded as ones and zeros. Emotion, confidence and memory can all impact how we form beliefs. The problem is we often don’t recognize when we aren’t thinking logically.

Gordon Pennycook, a researcher at Canada’s University of Regina, said he’s interested in “the tendency for people to be lazy in the way that they think.” Essentially, he said, high-level reasoning takes a lot of mental effort, and we humans are cognitive misers. If we don’t have to think that hard, we won’t.

“Part of the problem, though,” Pennycook told VOA, “is that when it comes to more complicated domains, like in the realm of science, our intuitions are often wrong. So we need to spend more time thinking about it.”

In 2015, Pennycook published a paper titled On the reception and detection of pseudo-profound bulls**t that focused on whether people find meaning in statements randomly made up of common buzzwords. One example: “Hidden meaning transforms unparalleled abstract beauty.”

He found that people who ascribed meaning to these nonsensical statements were more likely to believe in complementary and alternative medicine, which Pennycook asserts are the same people who are less likely to get vaccines.

“I don’t want to call it open-minded, but it’s a so-open-minded-that-your-brain-kind-of-falls-out type of situation,” he said.

Cognitive biases

The unwillingness or inability to think critically is somewhat tied to another well-known psychological phenomenon, the Dunning-Kruger effect. First formally identified in 1999 by its namesakes, the cognitive bias refers to a broken link between actual knowledge and perceived competence.

As Pennycook puts it, “The incompetent are too incompetent to recognize their incompetence.”

For example, people with little knowledge of vaccines may feel extra certain about the little information they have, whether it’s correct or not. Pennycook noted this can create the frustrating situation where “the people we want to help the most are the least aware of how much help they need.”

And when people feel confident, they aren’t likely to try to challenge those beliefs or ideas. This phenomenon is referred to as confirmation bias. 

Panayiota Kendeou, an educational psychologist at the University of Minnesota, said the pre-existing belief that vaccines are dangerous “influences how [anti-vaccine parents] evaluate any information that they come across, and they view the information in alignment with their pre-existing beliefs.”

Confirmation bias creates a filter on new information. Information that a person agrees with is strengthened, while evidence to the contrary is ignored. In Kendeou’s opinion, “that’s the major or main bias when it comes to vaccinations.”

Misconceptions and misinformation

Kendeou studies reading comprehension and learning, but is particularly interested in what those messages contain. She is an expert in misinformation and has researched how inaccurate or totally misleading information is assessed by a person reading it.

She decided to test whether she could change the way people engage with written misinformation. Kendeou had participants read messages about vaccination, but some of the participants were told to pay special attention to who made claims and whether those claims made sense.

Kendeou found corrective measures like this did help those participants recognize misleading information. And, she told VOA, “what we find a month later is that we get some maintenance of the effect.”

It wasn’t a large difference, but participants were still better at correctly rejecting bad information about vaccines than they were before the test.

When reflecting on how to reach anti-vaccine people, Kendeou said, “Having good logical arguments, it’s a great first step. But also alerting [people] that they need to pay attention who provides those logical arguments is even more important.”

Fear as double-edged sword

Unfortunately, accepting new correct information can be difficult if a person is feeling fearful.

“What we know from our work is that negative emotions like fear and anxiety narrow your attention,” Kendeou said. “And when you end up in that state of mind, you do end up focusing on certain information and not other [information] because of that narrowness in attention.”

Fear of an immediate threat, even one that’s not real — like getting the flu from the influenza vaccine — restricts a person’s ability to see the whole situation. That metaphorical tunnel vision can limit people’s ability to think critically.

But Derek Powell, a postdoctoral scholar at Stanford University, suggests that fear could also change the minds of people who don’t support vaccines. “At root, that [fear] is kind of the thing that’s driving this, for good or ill,” he said.

Rather than focusing on the oft-disproven idea that the MMR vaccine causes autism, Powell and his colleagues wanted to test if a message about the severity and risk of contracting measles, mumps or rubella convinced parents that vaccines are necessary. In a 2015 experiment, they did just that.

Powell assigned participants to one of three groups. The “fear” group was told about the chances of catching an immunizable disease and the resulting severe symptoms. In a second group, participants heard about studies proving vaccines don’t cause autism. A third group was given no additional information.

Powell said the idea was “even if you thought there was a little bit of risk to a vaccine, if we persuaded you there was a lot of risk to not vaccinating, that might kind of overall tip the scale in favor of vaccination.”

As expected, participants who learned about the risks of contracting preventable diseases were more supportive of vaccines. Interestingly, Powell noted that “emphasizing the safety of vaccines in scientific research showing there was no autism link between MMR vaccine and autism wasn’t really effective.”

Sticky beliefs

It seems that just refuting an existing belief about vaccines isn’t enough. Powell said that some beliefs can be “sticky,” in that they are difficult to dismiss.

Kendeou, the University of Minnesota educational psychologist, agrees, saying while there are ways to combat bad information on vaccines, “there is no magic ‘erase and replace’ strategy.” Misconceptions, she said, never fully go away, but we can lessen their impact by reminding people to think critically and seek good evidence to refute bad arguments.

Researchers and communicators still find it difficult to keep that advice in mind.

“There’s a tendency to want to shake somebody until they start acting sensible, and I totally understand it,” Powell said. “I’ve felt it myself, but I don’t think it’s actually going to work in terms of changing their minds.”

For at least one previously anti-vaccine mom, Powell is correct. 

Carli Leon, a mother of two children and previously self-described “loud voice” against vaccinations, said insulting comments online didn’t change her mind.

“When people would ridicule me and call me a bad mother, it only made me dig my heels in more. What helped me was people asking me questions [that] got me to think. That got me to recognize the hypocrisy of the anti-vaxx community and my own hypocrisy with my own beliefs that I had,” Leon said.

“You never know who is reading these posts online,” she added. “It might just change somebody’s mind.”
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A mobile blood-testing lab. Hand-washing stations on street corners. Motorcycle taxi drivers forbidden from sharing spare helmets. If Ebola is coming, the city of Goma in eastern Congo wants to be ready.

An outbreak suspected of killing 43 people is spreading across the lush farmlands of eastern Congo, where ethnic and military conflicts threaten to hobble containment efforts.

Goma, a lakeside city of 1 million people near the Rwandan border, is more than 350 kilometers (220 miles) south from the epicenter of the outbreak in the town of Mangina in North Kivu province, and no cases have been confirmed there.

But the virus has already spread to neighboring Ituri province, and the number of infected is rising daily. Residents in the busy trading hub are taking no chances.

“It’s not only me who fears the appearance of Ebola. The whole community here is scared,” said shopkeeper Dany Mupenda. “To protect ourselves we stick to the rules of hygiene to avoid being one of the victims of this epidemic.”

UNICEF has set up hand-washing stations around the city. Health workers check residents’ temperatures in public places and at the entrance to the city. The hospital has set up a mobile lab to test suspected cases.

900 lives

It is the kind of preparation that has become routine in Congo, which has experienced 10 Ebola outbreaks since the virus was discovered on the Ebola River in 1976. In all, it has killed 900 people.

Ebola causes diarrhea, vomiting and hemorrhagic fever and can be spread through bodily fluids. An epidemic between 2013 and 2016 killed more than 11,300 people in West Africa.

Congo, a vast, forested country, has become a staging ground for new treatments, including the first use of vaccines that helped contain an outbreak that was declared over in July, just days before the latest flare-up was discovered.

Goma residents know that medical breakthroughs mean little if simple measures are not taken on the ground. After basketball games, teams have been told not to shake hands, said Fiston Kasongo, a young basketball player. “What scares me is the speed with which Ebola spreads and the consequences that follow,” he said.

Patrons of Goma’s popular motorcycle taxis have to risk speeding helmetless across town.

“We are told that it can spread through the sweat of heat, and as our helmets are not worn by one customer only, they allowed customers to ride with no helmet to prevent the spread,” said a taxi driver named Wemba.
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Tropical Storm Lane is pushing westward across the Pacific while Subtropical Storm Ernesto heads across the Atlantic in the general direction of Ireland and the United Kingdom.

The U.S. National Hurricane Center said early Thursday that Lane had winds of 50 mph (85 kph) and is expected to strengthen into a major hurricane by Saturday. It was centered about 1,370 miles (2,235 kilometers) southwest of the southern tip of Mexico’s Baja California Peninsula and heading west at 12 mph (19 kph).

Ernesto had maximum sustained winds near 40 mph (65 kph). It was centered about 605 miles (975 kilometers) southeast of Canada’s Cape Race, Newfoundland, and moving north-northeast at 13 mph (20 kph). Forecasters say it’s likely to merge with a frontal zone near Ireland and the U.K. on Saturday.
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