Health

Seventy uniformed officers to specifically care for doctors and nurses

Uniformed American officers are due to open and staff a field clinic for Ebola patients outside the Liberian capital of Monrovia this coming weekend, marking the United States’ latest bid to help bring the regional outbreak under control.

President Barack Obama had previously said none of the roughly 4,000 American troops deployed to Liberia would care for patients suffering from Ebola. But, USA Today reports, 70 uniformed government personnel from the U.S. Public Health Service Commissioned Corps, of the Department of Health and Human Services, will be the first to do so and specifically treat health care workers who contract the deadly virus.

“They have to feel secure that there will be a high level of care provided if they do fall ill of Ebola,” Rear Adm. Scott Giberson, acting U.S. deputy surgeon general, said in the report, adding that the volunteers were among some 1,700 members who had expressed a willingness to be deployed.

The World Health Organization said Wednesday that at least 310 health care workers have died in the West Africa outbreak that has killed more than 4,800 people this year. That same day, Obama announced he would ask Congress for $6.2 million to fight Ebola.

[USA Today]

"I don't know what went wrong," Teresa Romero said

The Spanish nurse’s aide believed to be the first person to have contracted Ebola outside Africa was on Wednesday released from a Madrid hospital.

Teresa Romero, 44, thanked God and her caregivers for “giving her back life,” the New York Times reports.

Health officials said it was impossible to discern which of several factors — including the use of an experimental Ebola drug and blood plasma from another survivor — had beaten the often fatal disease

Romero had tested positive for the illness almost a month ago, after treating a missionary who had come down with the disease in West Africa and later died in Madrid.

Her case had stoked fears that Ebola could threaten countries with advanced health care systems — worries that reached new heights when two health care workers in Dallas also contracted the illness — and played into a furious blame game.

“I don’t know what went wrong, I don’t even know if anything went wrong,” Romero said. “I only know that … if my infection can be of some use, so that the disease can be studied better or to help find a vaccine or to cure other people, here I am.”

[NYT]

Happiness rises consistently from the mid-40s onward in the U.S.

Will you get happier as you grow older? That might depend on where you live, according to a new Lancet study.

On average, people in high-income English-speaking countries tend to maintain higher levels of wellbeing, but that experience isn’t consistent over time. As people in these countries age, life satisfaction tends to follow a U-shape. In their young days, people report being happy, but that feeling declines as they face increased responsibilities in their 20s and 30s. Finally, happiness rises consistently from the mid-40s onward.

Reported happiness trends look completely different in former Soviet countries, Sub-Saharan Africa and Latin America. Happiness remained consistently low in Sub-Saharan Africa. Happiness began high in Latin America and declined slightly before leveling off in people’s 40s. In Russia and elsewhere in Eastern Europe, people see a precipitous decline in happiness as they age: it starts high, but dips consistently as they grow old.

“It’s not a great surprise that the elderly in those countries are doing really badly relative to the young people,” says study author Angus Deaton, a Princeton University professor. “The young people do can all sorts of things…whereas the old people have no future, and the system they believed in all their life is gone.”

The study also evaluated differences between regions in other metrics of wellbeing, like emotions and physical conditions. And there’s some good news for everyone: In most regions, people reported fewer emotional issues as they grew older.

“Many people have hypothesized that you just get emotionally more skilled when you get older,” says Deaton. “You make mistakes, and you learn.”

As the world waits for new treatments and a vaccine, doctors in Guinea have found the best way to help patients survive Ebola

With the number of cases topping 13,000 and deaths climbing close to 5,000, the current outbreak of Ebola in West Africa is the virus’s worst yet. But from the tragic illness and mortality emerge some important lessons from the region.

The latest, published in the New England Journal of Medicine, details the cases that first appeared in Guinea’s capital city of Conakry between March and April. Unlike in other parts of the region, where the mortality rate from Ebola averages around 60% to 70%, in Conakry it has remained around 43%.

MORE: Here’s What Scientists Know About Ebola in Sierra Leone

Why? As Dr. Robert Fowler, a clinician in pandemic and epidemic diseases with the World Health Organization (WHO) and physician at the University of Toronto, explains, Guinea’s first Ebola treatment center, established in the capital, took a very aggressive approach to handling patients. Working with the humanitarian aid group Medecins Sans Frontieres (MSF) or Doctors Without Borders, the WHO and the country’s Ministry of Health set up a facility where Ebola patients were immediately hooked up to IV fluids and treated for dehydration—often a complication of infection. They were also monitored regularly for changes in their blood chemicals, including the electrolytes that are a marker for whether the body’s cells are getting enough water and nutrients to function. While routine blood work is standard practice at every hospital in developed nations, such testing wasn’t at Conakry health facilities.

“At the beginning of the outbreak, there was no [Ebola] treatment center,” says Fowler. “It evolved from an old cholera treatment facility and the evolution of care went from having no beds to having IVs, IV fluids, antibiotics and antimalarial [drugs]. We were only able to do hand-held point-of-care testing [of blood samples] but that was quite novel for treatment centers anywhere in the outbreak, even though that’s expected and routine almost everywhere else in the world.”

MORE: This Map Will Show You Every Ebola Outbreak in History

The key to helping Ebola patients survive their infection, Fowler and his colleagues saw, was hydrating them with IV fluids, ensuring that their blood work remained stable and addressing any changes in their metabolites as quickly as possible. In the first month of Ebola cases, 37 patients tested positive for the virus, 28 were treated with IV fluids and 16 died. While the death rate remained high, it was lower than that typically seen in other parts of West Africa.

“Our hypothesis has always been that we wanted to establish a culture of very aggressive supportive care for patients who were coming in dehydrated with electrolyte and metabolic abnormalities and try to correct those very early on, so the complications of very severe depletion don’t compound the effects of Ebola virus infection,” Fowler says.

MORE: Why Cuba Is So Good at Fighting Ebola

Fowler is convinced that the key to improving Ebola survival rates is to think about it differently. Instead of thinking of Ebola as an almost-always fatal disease, see it instead as one that is survivable with the right treatments, he says. If people understood that survival is possible—and at higher rates than previously thought—then more people who might be exposed or infected would seek care sooner rather than later, when it’s too late. “I truly do think we can change the way people think about this illness if we evolve the thinking from needing to have isolation facilities…to saying we need rapidly mobilized treatment facilities that can help care for patients with aggressive supportive care as early as possible,” he says.

Even with the dozens of patients he and his team saw at the treatment facility in Conakry, “we just weren’t keeping up with their fluid needs as much as we needed to,” he says. “Collectively as a team, we were thinking we were failing miserably in terms of our goal of delivering optimal care.”

To succeed takes an enormous amount of resources, labor and personnel. Health workers need to routinely draw and measure patients’ blood to track any slight negative changes in their physical state. Fowler acknowledges the need for drug treatments and an effective vaccine, but for now, as thousands of patients struggle to fight off the virus, “we really, really need more health care workers so we can spend enough time with patients and deliver the kind of supportive care that will improve their outcomes,” he says.

MORE: Nurse Explains Why She Fought Ebola Quarantine

Fowler admits the challenges facing recruitment. For starters, working with Ebola patients requires health care personnel to suit up in personal protective equipment that leaves no skin exposed, making them uncomfortable in the equatorial heat of the region. “We are nowhere near hitting the mark that needs to be hit to improve outcomes,” he says. But as data like his starts to build, best practices and the most effective ways to treat Ebola patients are emerging. And hopefully they will start to make a difference.

U.S. has previously committed $500 million and more than 3,000 troops

President Barack Obama is seeking more than $6 billion in emergency funds from Congress to fight Ebola in West Africa and prevent the virus from again reaching the United States.

If approved, the Associated Press reports, $2 billion would be allocated to the United States Agency for International Development (USAID) and $2.4 billion would be set aside for the Department of Health and Human Services. Another $1.5 billion would go to a contingency fund. With the new funding, the report adds, the U.S. would create dozens more treatment centers and secure additional safety suits.

Health officials have long warned that the U.S. is not safe from Ebola until the outbreak is stopped at the source in West Africa. New figures released by the World Health Organization on Wednesday detail the virus’ wrath in the region, with more than 13,000 reported cases, including some 4,800 deaths, as of Nov. 2.

The U.S. has previously committed $500 million to deploy more than 3,000 troops, some of whom are erecting treatment facilitates. As TIME reported in September, Obama also requested another $88 million from Congress, which included $58 million to speed up the development of experimental drugs.

The international community has been criticized by medical aid groups like Doctors Without Borders and the Red Cross for reacting too late to the outbreak.

[AP]

Everything an expectant mother does can have an impact on her baby’s development—including the air she breathes

Research has long connected what a mom-to-be eats and drinks to the health of her baby, and recent studies have even linked behavioral experiences such as stress, sleep and mood to the growing fetus’s development.

Now, scientists reporting in the journal PLOS ONE have pinpointed one exposure that could contribute to a baby’s higher risk of developing attention deficit hyperactivity disorders (ADHD), which the latest data from the Centers for Disease Control show affects around 11% of children aged four to 17 years.

MORE: Early Exposure to Air Pollution Tied to Higher Risk of Hyperactivity in Children

Frederica Perera, director of the center for environmental health sciences at the Mailman School of Public Health at Columbia University, and her colleagues focused in on how the pollutants in the air that pregnant women breathe can affect their babies’ cognitive development. Perera previously found a correlation between polycyclic aromatic hydrocarbons (PAHs) emitted by burning fossil fuels (such as in car exhaust and some forms of residential heating) to developmental delays by age three, reduced IQ in kindergartners and attentional problems by age six. So the team looked specifically at symptoms associated with concentration and evaluated how these effects connected to PAHs might be contributing to ADHD.

The scientists measured the level of PAHs in both the cord blood retrieved when the mothers gave birth and the mothers’ blood following delivery. They also collected urine samples from the children at age three or five years and analyzed them for PAH levels. The children born to mothers with higher levels of PAH during pregnancy had five-fold increased odds of showing symptoms of ADHD than those who were born to mothers with lower levels. The effect remained strong even after the researchers adjusted for the babies’ exposure to air pollution and smoking after birth.

“This is a new finding, and if the PAHs are identified as a contributor to ADHD, that opens up new avenues for preventing ADHD,” says Perera.

MORE: Study Links Exposure to Pollution with Lower IQ

PAHs, says Perera, circulate in the body for a long time, so even brief exposures could contribute to changes in the body. And each person processes the chemicals differently. Some may be more prone to breaking down the compounds into their potentially toxic elements, while others are less affected by the exposure.

While mothers may not be able to control some exposures, such as those from traffic and heating sources, there are some ways that expectant women can reduce their risk. Pushing local legislators to adopt clean air laws is one way to improve air quality, and on a more personal level, families can make sure that cooking areas have proper ventilation, avoid burning candles and incense and other sources of PAHs, and most importantly, ensure that they aren’t exposed to tobacco smoke. “Air quality is a policy problem, but individuals can be empowered to take steps,” Perera says.

MORE: Mom’s Exposure to Air Pollution Can Increase Kids’ Behavior Problems

Women who are pregnant can also eat more antioxidants from sources like fresh fruits and vegetables, since these can counteract some of the oxidative damage that PAHs wreak on fetal cells.

Perera stresses that limiting exposure to PAHs isn’t the only answer to reducing the increasing rate of ADHD in the country. Genetic and other environmental factors all contribute to the disorder, but identifying as many potential factors as possible could start to reduce the effect that the chemicals have not just on mothers, but on their developing babies as well.