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.
…

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.
…

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.
…

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. 
…

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.”
…

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.
…

Scientists in Florida are on the cusp of developing promising methods to control toxic algae blooms like the “red tide” that has been killing marine life along a 150 mile (240 km) stretch of the Gulf Coast, the head of a leading marine lab said Wednesday.

Michael Crosby, president and chief executive of the Mote Marine Laboratory in Sarasota, welcomed a red tide emergency order issued this week by Governor Rick Scott, designating more state money for research, cleanup and wildlife rescues.

Scientists field-testing solutions

Interest in mitigation technologies has been heightened by a 10-month-long toxic algae bloom off Florida’s southwestern coast that has caused mounds of rotting fish to wash up on beaches from Tampa to Naples.

The red tide also has been implicated in at least 266 sea turtle strandings and is suspected or determined to have caused 68 manatee deaths so far this year, according to Florida Fish and Wildlife Conservation Commission figures.

In hopes of combating future outbreaks, scientists are field testing a patented process that would pump red-algae-tainted seawater into an ozone-treatment system and then pump the purified water back into the affected canal, cove or inlet, Crosby said.

Experiments carried out in huge 25,000-gallon tanks succeeded in removing all traces of the algae and its toxins, with the water chemistry reverting to normal within 24 hours, he said.

Scientists also are studying the possible use of naturally produced compounds from seaweed, parasitic algae and filter-feeding organisms that could be introduced to fight red tides.

A ‘bad bloom’

Red tides occur on an almost yearly basis off Florida, starting out in the Gulf of Mexico where swarms of microscopic algae cells called Karenia brevis feed on deep-sea nutrients and are sometimes carried by currents close to shore, usually in the fall.

This year’s Gulf Coast Florida bloom is the worst in more than a decade, originating last October and persisting well into the summer tourist season while spreading across 150 miles of coastline spanning seven counties.

“It’s a bad bloom by any standard,” said Richard Stumpf, an oceanographer who studies red tides for the National Oceanic and Atmospheric Administration (NOAA).

For reasons not well understood, strong northerly winds that normally break up a red tide by December failed to materialize last winter, Stumpf said.

It remains to be seen whether a single year of altered wind patterns will turn out to be an isolated deviation or part of more long-term changes in climate, Stumpf said.

Natural phenomenon

But scientists say red tides in and of themselves are a natural phenomenon observed as far back as the 1600s.

For humans, exposure can cause respiratory difficulties, burning eyes and skin irritation. The toxins are often fatal to marine life.

The latest bloom coincided with the spawning season for snook, an ecologically important and popular game fish in Florida, Crosby said. A portion of emergency funding ordered by the governor is earmarked for assessing impacts on that fish.
…

The dismissal of a lawsuit filed by young people claiming government climate policy falls short will be appealed and marks a minor setback in pursuing legal action on behalf of youth and their rights, experts said.

The legal complaint arguing that the state of Washington must do more to cut carbon emissions was dismissed Tuesday by a judge who said it was a matter for politicians, not courts.

The judge’s ruling marked the first time a court has dismissed a case filed by youth demanding authorities ramp up efforts to curb climate change by arguing their constitutional rights to due process are being violated, experts said.

A half-dozen similar cases have been filed in states including Florida and Alaska, said Our Children’s Trust, a youth advocacy group that provides legal assistance.

Tougher plan sought

The Washington complaint, filed in February, asked that a statewide target to emit 50 percent fewer greenhouse gases by 2050 be invalidated in favor of more ambitious goals, court documents said.

The dismissal will be appealed, lawyer Andrea Rodgers of Our Children’s Trust told the Thomson Reuters Foundation.

Scientific consensus holds that the emission of greenhouse gases from the burning of fossil fuels is the main cause of global warming.

Washington Superior Court Judge Michael Scott wrote in his dismissal that he hoped the activists “will not be discouraged,” but Rodgers said they were “devastated” and wanted to “present their constitutional claims in a court of law.”

Several of the cases by young people base their arguments on their rights to fair treatment and due process under the U.S. Constitution.

The remaining cases could still be effective in forcing authorities to strengthen climate change regulations, said Katherine Trisolini, a professor of environmental law at Loyola Law School in Los Angeles.

“I wouldn’t give up on the courts yet,” she told the Thomson Reuters Foundation.

Climate activists are particularly optimistic about a federal case, Juliana v. United States, brought by 21 young activists who say officials violated their rights by failing to address carbon pollution adequately.

Last month, the U.S. Supreme Court rejected a bid by President Donald Trump’s administration to halt the lawsuit, filed in 2015.
…

U.S. health officials are eliminating special regulations for gene therapy experiments, saying that what was once exotic science is quickly becoming an established form of medical care with no extraordinary risks.

A special National Institutes of Health oversight panel will no longer review all gene therapy applications and will instead take on a broader advisory role, according to changes proposed Wednesday. The Food and Drug Administration will vet gene therapy experiments and products as it does with other treatments and drugs.

It’s an extraordinary milestone for a field that has produced only a few approved treatments so far, and not all experts agree that it doesn’t still need special precautions.

With gene editing and other frontiers looming, “this is not the right time to be making any moves based on the idea that we know what the risks are,” said Stanford bioethicist Mildred Cho.

What is gene therapy?

Gene therapy aims to attack the root cause of a problem by deleting, adding or altering DNA, the chemical code of life, rather than just treating symptoms that result from a genetic flaw.

When it was first proposed, there were so many safety worries and scientific unknowns that the NIH created a panel of independent scientists, called the Recombinant DNA Advisory Committee, or RAC, to assess each experiment and potential risks to patients. The risks were underscored in 1999, when a teen’s death in a gene experiment put a chill on the field.

Since then, much has been learned about safety, and last year the FDA approved the nation’s first gene therapies, for cancer and an inherited form of blindness.

It’s time to let the FDA review gene therapy proposals on its own without duplicating regulatory efforts, the NIH’s director, Dr. Francis Collins, and FDA chief Dr. Scott Gottlieb wrote Wednesday in the New England Journal of Medicine. The proposed changes will go into effect after a public comment period.

More than 700 proposals for gene therapy are pending now, and “it seems reasonable to envision a day when gene therapy will be a mainstay of treatment for many diseases,” they wrote. “The tools we use to address other areas of science are now well suited to gene therapy.”

Several experts agree, but not all

“This is something the FDA has the tools to handle. I don’t think this is somehow a massive deregulation,” said Leigh Turner of the University of Minnesota Center for Bioethics. “We never want to become blase or cavalier about gene therapy clinical trials. Careful scrutiny, whether by one body or two, is as important as ever.”

Jeffrey Kahn, director of the Bioethics Institute at Johns Hopkins University, said the move is consistent with recommendations from the Institute of Medicine several years ago.

“We have mechanisms in place to protect patients,” he said. “It doesn’t need to be treated as a special case of clinical research any longer.”

But Cho, who is a member of the RAC, said gene therapies are biologically complex treatments, and “we really don’t understand how they work,” in many cases. “There are miraculous recoveries and remissions that we haven’t seen before but there also are very spectacular failures.”

Important caveat: The rules in question govern gene therapies that alter DNA to treat diseases after someone is born, not altering embryos, eggs or sperm to make permanent changes that would be passed down through generations. That’s prohibited under current rules.

“We need to strengthen rather than weaken the review apparatus if the FDA were to start to consider proposals” for that, said Marcy Darnovsky, executive director of the Center for Genetics and Society, a group that advocates for oversight and responsible use of biotechnologies.
…