Depression’s Mark On The World

Depression is the second leading cause of disability around the world, scientists reported Tuesday in the journal of PLOS Medicine.

The study also estimated the rate of depression in each country. And The Washington Post's Max Fisher plotted the data onto a map. 

The color indicates how much of the population in each country has been diagnosed with clinical depression. Redder countries have higher depression rates. Bluer countries have lower rates.

Learn more about the study at The Washington Post. 

Violence Against Doctors On The Rise In China

A Chinese hospital can be a dangerous place to work.

A couple of weeks back, angry patients stabbed four physicians in two separate incidents.

In a third, unrelated attack, family members of a patient who died beat two doctors, leaving one with kidney damage.

Last week, medical staff at a hospital in South China took the rare step of publicly protesting safety conditions.

Several hundred doctors and nurses jammed the courtyard of the No. 1 People’s Hospital in Wenling, a city with a population of about 1 million in Zhejiang province, a four-hour train ride south of Shanghai.

They wore surgical masks to hide their identities from the government and waved white signs that read, “Zero tolerance for violence.”

"Doctors and nurses must be safe to take care of people’s health!" video shows them chanting.

The medical workers were reacting to a triple stabbing at the hospital three days earlier. Wenling officials responded by deploying dozens of riot police, further angering already traumatized hospital staff.

"Withdraw the special forces," chanted the nurses and doctors, many of whom wore white lab coats.

Continue reading.

In the photographs above, medical staff stand together in the hallways of No. 1 People’s Hospital in Wenling, China, to protect the remains of Dr. Wang Yunjie from cremation without consent from the family. Dr. Wang was stabbed to death by a disgruntled patient on October 25. (Photos from Weibo.com)

Getting Your Microbes Analyzed Raises Big Privacy Issues

After spending months working on a series of stories about the trillions of friendly microbes that live in and on our bodies (see video above), I  decided it might be interesting to explore my own microbiome.

So I pulled out my credit card and paid the $99 needed to sign up for the American Gut Project, one of a couple of “citizen science” or crowd sourced microbiome projects.

Organizers of the American Gut Project are recruiting thousands of people to donate their microbes to science — along with lots of personal information — to help researchers learn more about the trillions of microbes that inhabit the human body.

"The fact that they may play a big role in your susceptibility to disease and health is profound. I mean, it’s astounding," says Jeff Leach, who helped dream up the American Gut Project. “It changes everything. I think it’s a watershed moment for human health.”

A few weeks later, an envelope arrived in the mail with an instruction sheet and a long two-pronged cotton swab. After spending a week carefully logging the details of everything I ate and drank, I used the swab to collect a fecal sample and mailed it off for analysis.

While I was waiting for the results, I spent some time talking to bioethicists about some concerns I had heard about participating in these projects.

"I think sending pieces of your microbiome in to be analyzed and posted along with your health information is not for the faint of heart," said Hank Greely, a bioethicist at Stanford University.

Continue reading.

Video: There are 10 times more cells from microorganisms, like bacteria and fungi in and on our bodies, than there are human cells. The animation gives us a glimpse of the huge impact these microcritters have on our health. (By Benjamin Arthur for NPR) 

Why Abused Kids Are More Likely To Develop Anxiety And Depression?

Maltreatment during childhood can lead to long-term changes in brain circuits that process fear, researchers say. This could help explain why children who suffer abuse are much more likely than others to develop problems like anxiety and depression later on.

Brain scans of teenagers revealed weaker connections between the prefrontal cortex and the hippocampus in both boys and girls who had been maltreated as children, a team from the University of Wisconsin reports in the Proceedings of the National Academy of Sciences. Girls who had been maltreated also had relatively weak connections between the prefrontal cortex the amygdala.

Those weaker connections “actually mediated or led to the development of anxiety and depressive symptoms by late adolescence,” says Ryan Herringa, a psychiatrist at the University of Wisconsin and one of the study’s authors.

Maltreatment can be physical or emotional, and it ranges from mild to severe. So the researchers asked a group of 64 fairly typical 18-year-olds to answer a questionnaire designed to assess childhood trauma. The teens are part of a larger study of more than 500 families that has been tracking children’s social and emotional development since 1994.

The participants were asked how strongly they agreed or disagreed with statements like, “When I was growing up I didn’t have enough to eat,” or “my parents were too drunk or high to take care of the family,” or “somebody in my family hit me so hard that it left me with bruises or marks.”

There were also statements about emotional and sexual abuse. The responses indicated that some had been maltreated in childhood while others hadn’t.

All of the participants had their brains scanned using a special type of MRI to measure the strength of connections among three areas of the brain involved in processing fear.

One area is the prefrontal cortex, which orchestrates our thoughts and actions, Herringa says. Another is the amygdala, which is “the brain’s emotion and fear center,” he says, and triggers the “fight or flight” response when we encounter something scary.The participants were asked how strongly they agreed or disagreed with statements like, “When I was growing up I didn’t have enough to eat,” or “my parents were too drunk or high to take care of the family,” or “somebody in my family hit me so hard that it left me with bruises or marks.”

There were also statements about emotional and sexual abuse. The responses indicated that some had been maltreated in childhood while others hadn’t.

All of the participants had their brains scanned using a special type of MRI to measure the strength of connections among three areas of the brain involved in processing fear.

One area is the prefrontal cortex, which orchestrates our thoughts and actions, Herringa says. Another is the amygdala, which is “the brain’s emotion and fear center,” he says, and triggers the “fight or flight” response when we encounter something scary.

Continue reading.

In the animation, the brain’s fear center — the amygdalae — are colored red.  (Images were generated by Life Science Databases(LSDB) via Wikimedia Commons)

Aiming to curb unhealthy consumption habits, Mexico’s Congress on Thursday approved new taxes on sugary drinks and junk food … one peso per liter, or about 8 cents, on soft drinks … Almost 70 percent of Mexicans are overweight, and about a third are obese …

— Paulina Villegas, The New York Times

U.S. Records Highest Number Of Malaria Cases In 40 Years

In 2011, the U.S. recorded 1,925 malaria cases, the Centers for Disease Control and Prevention, said Friday. This is the highest number of cases reported since 1971 and represents a 48 percent increase from 2008.

All but five of the malaria cases were imported from other countries. Most of them came from Africa, specifically West Africa. One person caught the disease in the laboratory.

Both travel and inadequate prevention measures might have contributed to the rise in malaria, the scientists write in the Morbidity and Mortality Weekly Report. “These increases appear to be similar to those being reported in other parts of the world … Despite progress in reducing the number of malaria cases in regions where malaria is endemic, international travel appears to be growing steadily, and use of appropriate prevention measures by travelers is still inadequate.”

Interestingly, airline crews make up only a very small number of malaria cases in the states. But they might increase, as well, given a bump in the number of direct flights from the U.S. to West Africa, the scientists said. 

Learn more.

Top: Number of malaria cases diagnosed in each state during 2011 (Centers for Disease Control and Prevention)

Bottom: The malaria parasite Plasmodium gallinaceum (purple) are caught in the scanning electron microscope invading a mosquito’s gut (yellow). (NIAID/Flickr.com)

New Type Of AIDS Treatment Shows Promise In Monkeys

Scientists have a fresh idea for beating HIV: Target the virus with guided missiles called monoclonal antibodies.

At least in monkeys infected with an experimental virus similar to the human AIDS virus, the approach produced what researchers call “profound therapeutic efficacy.”

The results appear Thursday in two papers published by Nature — one from a Boston group and a confirmatory report from the National Institute of Allergy and Infectious Diseases.

The virus plummeted to undetectable levels in animals that got potent antibodies of a type recently discovered in some humans with HIV. And the virus remained undetectable for weeks after a single antibody injection.

Most impressive, several monkeys who started out with low levels of HIV in their blood maintained extremely low levels of the virus in their systems months after a single antibody injection.

The researchers think they may have turned these animals into so-called elite controllers — like the 1 percent of HIV patients who are able to suppress the virus even without antiviral drugs.

The scientists say their results justify experiments in humans with HIV. And the potential implications seem to be large, in at least two ways:

• Periodic injections of monoclonal antibodies might be a new kind of treatment for HIV-infected humans, either alone or in combination with conventional antiviral drugs.
• Monoclonal antibodies might be incorporated into strategies, now being eagerly pursued by a number of scientists, to cure HIV infection — that is, to clear the virus from patients’ cells, allowing them to stop taking antiviral drugs.

"The findings of these two papers could revolutionize efforts to cure HIV," two cure-seekers write in a Nature commentary.

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In the cryo-EM image of an HIV particle, the capsid surrounding the RNA-containing core is in red while the virus’s membrane is in blue. The yellow contains electron-dense material, including proteases. Credit: Stephen Fuller, Wellcome Images 

Violence, Chaos Let Polio Creep Back Into Syria And Horn Of Africa

Armed conflict and war are making it tough for the world to wipe out the polio virus — once and for all.

Polio has re-emerged in war-torn Syria after more than a decade, the World Health Organization reported Tuesday. 

Over in the Horn of Africa, an outbreak has ballooned into more than 190 cases. The outbreak’s epicenter is Somalia, where fighting and violence have kept vaccinators from reaching hundreds of thousands of kids in the past few years. 

A recent visit to the Somali-Ethiopian border highlights just how easily the virus can move silently around rural areas — and eventually find kids who aren’t vaccinated.

So far Ethiopia has reported only six cases of polio compared to 174 in Somalia. But the landlocked country shares a thousand-mile border with Somalia. Most of it’s unmarked and uncontrolled. Goat, sheep and camel herders move back and forth across the arid plains between the two countries seeking fresh pastures for their animals.

At the border town of Wajaale, a frayed, knotted rope strung across the road marks the international boundary. The rope is ignored by just about everyone. Young men step over it. Vendors with wheelbarrows full of vegetables scoot under it.

Continue reading

Top photo: Men demonstrate how open the Somali-Ethiopian border is in the town of Wajaale. A simple rope marks the international boundary.

Bottom photo: Ethiopia is trying to immunize 13 million kids with the oral polio vaccine to prevent the virus from spreading into the country from Somalia. But the mass vaccination campaigns are putting a huge burden on an already strained national health system. 

Photos by Jason Beaubien/NPR

As Polio Returns To Syria, Europe Becomes Vulnerable

Polio has returned to Syria after more than a decade, the World Health Organization said Tuesday. Ten cases were confirmed in the laboratory and 12 others are suspected. The last polio case recorded in Syria was back in 1999.

"The cases are probably a result of a steep fall in child immunization rates in Syria owing to the ongoing war," Declan Butler writes in the journal Nature. “Because there tend to be about 200 non-paralytic cases of polio for every paralytic one, the cluster is probably ‘only the tip of the iceberg.’ “

There’s also a major risk that the disease can regain a foothold in the war-torn nation and became endemic there again. 

Given its proximity to Syria — and travel around the region — Europe is vulnerable to importing polio cases. Butler explains more:

The situation is “a wake up call”, says Marc Sprenger, director of the European Centre for Disease Prevention and Control (ECDC) in Stockholm. Given the weaknesses in European polio defences, the extensive levels of travel between Europe and Israel, and the millions of refugees fleeing Syria, the ECDC thinks that there is a real risk of outbreaks in the European Union (EU). Member states are taking the threat of import “extremely seriously”, Sprenger adds.

Read the full story at Nature.

The map shows countries in Europe that are most vulnerable to importing polio because of low vaccination rates and poor surveillance. (Courtesy of Nature)

How The World Backed Polio Into A Corner

The world is close to eliminating polio once and for all.

Just a few decades ago, polio was crippling more than a thousand children each day. Now the paralyzing virus is endemic to only three countries — Afghanistan, Pakistan and Nigeria. And there were just 223 cases globally last year.

There have been setbacks recently, including reports of suspected cases inside Syria and an outbreak in Somalia.

In this timeline, Pulitzer Prize-winning historian David Oshinsky explores how polio went from one of the most feared illnesses in the world to a disease on the ropes.

During the past few decades, governments, foundations and nonprofits have joined forces to train thousands of health workers, immunize millions of kids and develop stronger vaccination systems that are also reaching children with other health services.

Until the transmission of poliovirus is stopped in endemic countries, the threat of outbreaks in other areas of the world remains. Nevertheless, health leaders are aiming to eradicate polio completely by 2018.

Check out the timeline.

Photographs:

Top: In 1916, the U.S. recorded about 27,000 polio cases. Nearly a third of the cases were in New York City alone. Here a mother stands over her polio-stricken child during the epidemic in New York City in 1916. The disease killed 2,400 people in the city that year, most of them children under the age of 5. (Courtesy of the March of Dimes)

Middle: Here a soldier in El Salvador vaccinates a child against polio during the Days of Tranquility, when civil war was suspended for three days so that 250,000 children could receive the polio vaccines. Because of efforts like these, North and South America were officially declared free of polio on August, 20, 1994. (Courtesy of UNICEF/1983/Balaza)

Bottom: On January 13, 2011, India recorded its last polio case — a feat many health leaders thought was impossible just a few decades ago. Here a young girl stands in the doorway of a home in Uttar Pradesh, India. The markings on the door signal that a polio immunization team inoculated children in the home. (Courtesy of Rotary International/Alyce Henson)