Twice a week we publish problems that will feature in a forthcoming Dear Jeremy advice column in the Saturday Guardian so that readers can offer their own advice and suggestions. We then print the best of your comments alongside Jeremy’s own insights.
I’m about to start a new job, my first with any prospect of security after several years of juggling part-time, short-term contracts, and I’m keen to make a good impression.
However, my previous work pattern and some of the stresses involved have taken their toll and I’ve been struggling with depression for a while. I have just been offered a few months of therapy on the NHS, starting in the next couple of weeks.
The catch is, to take this up I would need to take some time out of my working day. As a certain amount of my work is fairly independent of my colleagues’ input, making up the hours won’t be a problem. I’ve already worked out a few strategies to do this, depending on what would best fit with my new employer’s work pattern.
My worry is that I don’t know how to broach the subject – starting a new job by declaring any health issues is difficult enough, but I fear they may see those involving mental health as a stigma and this makes this worse.
How can I best approach this? I don’t feel I can let the opportunity for treatment go. I’ve done the sums and there’s just no way I can afford to get this privately, now or in the foreseeable future, but I also need this job.
Do you need advice on a work issue? For Jeremy’s and readers’ help, send a brief email to dear.jeremy@theguardian.com. Please note that he is unable to answer questions of a legal nature or to reply personally.
The sooner a disease is diagnosed, the more likely it is to be well managed or cured. The challenge to finding a disease early is that most of us don’t seek treatment until we have symptoms, which means the disease has already progressed.
But breakthroughs in nanobiotechnology techniques mean that in five years we will be able to examine and filter bodily fluids for tiny bioparticles that reveal signs of disease like cancer before we have any symptoms, letting us know immediately if we should consult a doctor.
Information about the state of our health can be extracted from tiny bioparticles in bodily fluids such as saliva, tears, blood, urine and sweat called exosomes. These particles were first discovered in the 1980s as vesicles secreted by immature red blood cells, but later they were found to be secreted in all cell types. Scientists discovered that exosomes carry information from the cell they originated from, including proteins, RNA (ribonucleic acid) and DNA. Because the state of the originating cell can be inferred from these exosomes, they have been considered as potential biomarkers of disease for more than a decade. Besides cancer, exosomes are being considered as insightful for central nervous system diseases (Alzheimer’s, multiple sclerosis and stroke), renal fibrosis and cardiovascular disease.
At the moment it’s difficult to capture and analyse these bioparticles as they are thousands of times smaller than the diameter of a strand of human hair. But at IBM Research we are developing lab-on-a-chip nanotechnology that can separate and isolate bioparticles down to 20 nanometres in diameter, a scale that gives access to DNA, viruses and exosomes. These particles could be analysed to potentially reveal signs of disease even before we have symptoms.
This technique is known as liquid biopsy, designed to be more accessible, comfortable and convenient than the traditional tissue biopsy or cancer screening techniques many of us are familiar with. The goal is to shrink down to a single silicon chip all of the processes necessary to analyse a disease that would normally be carried out in a full-scale biochemistry lab.
In the future, the lab-on-a-chip technology could be packaged in a convenient handheld device to allow people to measure the presence of biomarkers found in small amounts of bodily fluids, streaming this information into the cloud from the convenience of their home. There it could be combined with health data from other IoT-enabled devices, like sleep monitors and smartwatches, and analysed by artificial intelligence systems for insights. When taken together, this dataset will give us an in-depth view of our health and alert us to the first signs of trouble, helping to stop disease before it progresses.
Treating a disease like cancer is expensive. According to Cancer Research UK, there was a 10% annual increase in cancer drugs prices from 1995-2013. Photograph: KatarzynaBialasiewicz/Getty Images/iStockphoto
The next five years will see significant advances in the application and development of this technology. Practically speaking, it’s difficult to say confidently that it will be in widespread use in our homes by 2022, but based on current developments and advances in research, this innovation will likely be used by physicians in some capacity by that time.
The vision for this technology is that it could be used anywhere in the world, from remote rural locations to developed urban areas. To reach the people who need it most, the technology must be affordable. Putting these capabilities on a regular silicon chip means they can be manufactured inexpensively. The challenge will be to do so at a scale that can reach people worldwide while also educating users and physicians on its benefits.
As we all know, treating a disease like cancer is expensive, and rising. According to Cancer Research UK, there was a 10% annual increase in cancer drugs prices from 1995-2013 and many new immunotherapies have price tags of over £100,000 per patient per year. When your doctor can diagnose cancer in its early stages, your odds of financial hardship – and death – decrease significantly. By making it nearly as easy to detect early stage cancer as taking a home pregnancy test, you could argue that we will change the economics of cancer. If all goes well, we may greatly diminish the physical and emotional toll of this terrible disease for future generations.
Gustavo Stolovitzky is program director of Translational Systems Biology and Nanobiotechnology at IBM Research
A wearable patch that safely and gradually exposes the body to small amounts of peanut allergen appears effective in easing the allergy, an early new study shows.
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By Steven Reinberg HealthDay Reporter SUNDAY, Feb. 22, 2014 (HealthDay News) — A wearable patch that safely and gradually exposes the body to small amounts of peanut allergen appears effective in easing the allergy, an early new study shows. The Viaskin peanut patch, worn for a year by peanut-allergic children and adults, appears to “educate cells to turn off the allergic reaction,” said lead researcher Dr. Hugh Sampson, director of the Jaffe Food Allergy Institute at Kravis Children’s Hospital at Mount Sinai in New York City. His team was scheduled to present the study results Sunday in Houston at the annual meeting of the American Academy of Allergy, Asthma and Immunology. The study was funded by DBV technologies, which is developing the patch. Peanut allergy is one of the most common food allergies, and can cause a severe and potentially fatal allergic reaction known as anaphylaxis if the person comes into contact with peanut. In recent years, immunotherapy — where the allergic person is safely exposed to small but increasing amounts of peanut under a doctor’s supervision — has shown promise in easing the allergy. As it’s done now, immunotherapy involves having people eat increasing amounts of the food they are allergic to. “That has been effective,” Sampson said, “but there has been a high rate of adverse reaction, such as itchy mouth, swollen mouth and stomach.” He said the new skin patch may be a way to avoid these reactions. According to Sampson, the new Viaskin patch works by exposing users to a controlled amount of peanut allergen in hopes of increasing their tolerance. The new study involved 221 people, ages 6 to 55, with peanut allergy. The researchers tried varying patch doses to see which was most effective. In addition, some participants were given a placebo. Half of the participants wore the Viaskin patch for a year, and by the end of that time they were able to tolerate at least 1 gram of peanut protein — about four peanuts. That’s about 10 times the dose they could tolerate at the start of the study, Sampson noted. “This is a new way to do immunotherapy,” he said. As people wear the patch for several years, their tolerance to peanuts should improve, Sampson said. “It is likely that we will see a better response as it goes longer,” he said. The patch appears safe: more than 95 percent of study participants used the patch as directed, and less than 1 percent dropped out due to adverse effects, the researchers said. Even the levels of peanut tolerance attained in a year “would protect you from small contaminations like at a restaurant or at a party,” Sampson said. “And you wouldn’t have to worry about labels that say, ‘May contain peanut.’ “ “We can really change the quality of life for those allergic to peanuts,” he said. The patch was most effective in children, meaning that larger doses may be needed for adults, Sampson said. He added that it will take several years — and larger trials — before the patch may be approved for use. Dr. Vivian Hernandez-Trujillo is director of allergy and immunology at Miami Children’s Hospital. She said that “this is a very exciting time for patients with peanut allergy. I am speaking not only as an allergist, but as a mom of a child with peanut allergy.” The patch appears to be a “groundbreaking treatment option,” she added, since there appeared to be no adverse reactions to the patch. The fear of having a severe allergic reaction is “the scariest thing anyone with an allergy to peanut lives with,” Hernandez-Trujillo said. “As a parent of a child with peanut allergy, the biggest concern is that you are living with the possibility of having to deal with a reaction on an everyday basis. The hope is that if children can tolerate the patch, they will not have a severe life-threatening reaction.” Peanut allergy has been increasing around the world, but it isn’t clear why, Hernandez-Trujillo said. “We really don’t have a good explanation for it.” Experts note that findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.More information Find out more about peanut allergy at Food Allergy Research & Education.
First, the myths. There are no “super rats”. Apart from a specific subtropical breed, they do not get much bigger than 20 inches long, including the tail. They are not blind, nor are they afraid of cats. They do not carry rabies. They do not, as was reported in 1969 regarding an island in Indonesia, fall from the sky. Their communities are not led by elusive, giant “king rats”. Rat skeletons cannot liquefy and reconstitute at will. (For some otherwise rational people, this is a genuine concern.) They are not indestructible, and there are not as many of them as we think. The one-rat-per-human in New York City estimate is pure fiction. Consider this the good news.
In most other respects, “the rat problem”, as it has come to be known, is a perfect nightmare. Wherever humans go, rats follow, forming shadow cities under our metropolises and hollows beneath our farmlands. They thrive in our squalor, making homes of our sewers, abandoned alleys, and neglected parks. They poison food, bite babies, undermine buildings, spread disease, decimate crop yields, and very occasionally eat people alive.A male and female left to their own devices for one year – the average lifespan of a city rat – can beget 15,000 descendants.
There may be no “king rat”, but there are “rat kings”, groups of up to 30 rats whose tails have knotted together to form one giant, swirling mass. Rats may be unable to liquefy their bones to slide under doors, but they don’t need to: their skeletons are so flexible that they can squeeze their way through any hole or crack wider than half an inch. They are cannibals, and they sometimes laugh (sort of) – especially when tickled. They can appear en masse, as if from nowhere, moving as fast as seven feet per second. They do not carry rabies, but a 2014 study from Columbia University found that the average New York City subway rat carried 18 viruses previously unknown to science, along with dozens of familiar, dangerous strains, such as C difficile and hepatitis C. As recently as 1994 there was a major recurrence of bubonic plague in India, an unpleasant flashback to the 13th century, when that rat-borne illness killed 25 million people in five years. Collectively, rats are responsible for more human death than any other mammal on earth.
Humans have a peculiar talent for exterminating other species. In the case of rats, we have been pursuing their total demise for centuries. We have invented elaborate, gruesome traps. We have trained dogs, ferrets, and cats to kill them. We have invented ultrasonic machines to drive them away with high-pitched noise. (Those machines, still popular, do not work.) We have poisoned them in their millions. In 1930, faced with a rat infestation on Rikers Island, New York City officials flushed the area with mustard gas. In the late 1940s, scientists developed anticoagulants to treat thrombosis in humans, and some years later supertoxic versions of the drugs were developed in order to kill rats by making them bleed to death from the inside after a single dose. Cityscapes and farmlands were drenched with thousands of tons of these chemicals. During the 1970s, we used DDT, the active ingredient in Agent Orange. These days, the poison is not just sown in the earth by the truckload, it is rained from helicopters that track the rats with radar – in 2011 80 metric tonnes of it were dumped on to Henderson Island, home to one of the last untouched coral reefs in the South Pacific. In 2010, Chicago officials went “natural”: figuring a natural predator might track and kill rats, they released 60 coyotes wearing radio collars on to the city streets.
How is it that we can send robots to Mars and yet remain unable to keep rats from threatening our food supplies?
Still, here they are. According to Bobby Corrigan, the world’s leading expert on rodent control, many of the world’s great cities remain totally overcome. “In New York – we’re losing that war in a big way,” he told me. Combat metaphors have become a central feature of rat conversation among pest control professionals. In Robert Sullivan’s 2014 book Rats, he described humanity’s relationship with the species as an “unending and brutish war”, a battle we seem always, always to lose.
Why? How is it that we can send robots to Mars, build the internet, keep alive infants born so early that their skin isn’t even fully made – and yet remain unable to keep rats from threatening our food supplies, biting our babies, and appearing in our toilet bowls?
“Frankly, rodents are the most successful species,” Loretta Mayer told me recently. “After the next holocaust, rats and Twinkies will be the only things left.” Mayer is a biologist, and she contends that the rat problem is actually a human problem, a result of our foolish choices and failures of imagination. In 2007, she co-founded SenesTech, a biotech startup that offers the promise of an armistice in a conflict that has lasted thousands of years. The concept is simple: rat birth control
The rat’s primary survival skill, as a species, is its unnerving rate of reproduction. Female rats ovulate every four days, copulate dozens of times a day and remain fertile until they die. (Like humans, they have sex for pleasure as well as for procreation.) This is how you go from two to 15,000 in a single year. When poison or traps thin out a population, they mate faster until their numbers regenerate. Conversely, if you can keep them from mating, colonies collapse in weeks and do not rebound.
Solving the rat problem by putting them on the pill sounds ridiculous. Until recently no pharmaceutical product existed that could make rats infertile, and even if it had, there was still the question of how it could be administered. But if such a thing were to work, the impact could be historic. Rats would die off without the need for poison, radar or coyotes.
SenesTech, which is based in Flagstaff, Arizona, claims to have created a liquid that will do exactly that. In tests conducted in Indonesian rice fields, South Carolina pig farms, the suburbs of Boston and the New York City subway, the product, called ContraPest, caused a drop in rat populations of roughly 40% in 12 weeks. This autumn, for the first time, the company is making ContraPest available to commercial markets in the US and Europe. The team at SenesTech believes it could be the first meaningful advance in the fight against rats in a hundred years, and the first viable alternative to poison. Mayer was blunt about the implications: “This will change the world.”
Mayer is a tall, vigorous woman in her mid-60s with bright eyes, spiky grey hair and a toothy grin. Her ideologies of choice are Buddhism and the Girl Scouts. “It’s kind of my core,” she said of the latter, “to do for others.” In conversation, her manner is so upbeat that she seems to be holding forth radiantly before an audience or on the verge of bursting into song. When asked how she is doing, she frequently responds in a near-rapture: “If I was any better, I’d be a twin!” – she also appears to enjoy watching people wonder whether this is an expression they should know.
When I took a seat in her office earlier this year, she clapped her hands triumphantly and said “Ooh! You’re sitting in history and strength!” There was a pause. “I had a feng shui person come and do my office,” she explained.
Loretta Mayer, CEO of SensTech, holds up a test cup of the company’s rat contraceptive formula. Photograph: Taylor Mahoney/SenesTech
Mayer came to science later than usual, in her mid-40s, after a career in real estate development and a stint as the international vice president of Soroptimist, a global volunteer organisation dedicated to improving the lives of women. The career change was unexpected, even to her. After a close friend died suddenly of a heart attack, Mayer called up a biologist she knew and asked how something like this could have happened. The biologist had no satisfying answer; she explained that while heart disease in men had been thoroughly studied, little attention had been devoted to post-menopausal heart disease in women. “Well you’ve got to change it,” Mayer replied, outraged. The biologist was otherwise occupied, so Mayer decided to do it herself. At 46, she entered a PhD programme in biology at Northern Arizona University.
After graduate school, her initial research as a professor of biology at Northern Arizona focused on artificially inducing menopause in lab mice so that she could study changes in the postmenopausal heart. Three years into her efforts, Mayer was contacted by Patricia Hoyer, a colleague in Phoenix, who said that she had stumbled across a chemical that seemed to make mice infertile, without having any other effects. Together, Mayer and Hoyer synthesised a new compound, which they called Mouseopause.
Shortly after Mayer and Hoyer published their work on Mouseopause in 2005, Mayer received a telephone call from a veterinarian in Gallup, New Mexico, who had read about her research. The Navajo reservation where he worked was overrun by wild dogs. There were too many to spay and neuter, so he was euthanising almost 500 a month. “If you could do for a dog what you can do for a mouse, I could stop killing dogs out here,” he told her.
Mayer describes herself as “extremely connected to animals, dogs in particular”. When she arrived in Gallup and saw the piled corpses, she agreed to test Mouseopause on an initial group of 18 reservation dogs. “I held up that first puppy, who I called Patient Zero,” she told me, “and I said, ‘I don’t know what this is gonna do to you, but you will live on a satin pillow the rest of your days.” The injection made the dogs infertile, but left them otherwise happy and healthy. (Mayer brought home all 18 dogs and built a kennel in her yard to house them until she could find homes for them with families she knew personally. Patient Zero, renamed Cheetah, lived with her until she died of old age – though the pillow was fleece.)
The next call came from Australia in 2006. Biologists there wanted an adaptation of Mouseopause for rats. Rats, they told her, were eating 30% of the rice crop in Australia and Indonesia. If she could reduce the rat population by even half, they claimed, the crops that would be saved could feed millions of people.
Mayer was moved by the idea of finding a solution to rat overpopulation that was neither lethal nor toxic. Since its invention, rat poison has been our primary method of curbing rat populations, but it is dangerous. Ingested in high doses, it’s fatal to humans, and it poses a particular to children because it is sweet and brightly coloured. In the US alone, more than 12,000 children per year, most of whom live below the poverty line, are accidentally poisoned by pesticide meant for rats.
The collateral damage inflicted by rat poison also extends to the environment, leaching into the soil and poisoning house pets, farm animals, and wildlife that feed on rats. Worst of all, rat poison is not very effective at eliminating large infestations. As long as there is still a food source, colonies bounce back, and, especially in Europe, rats have grown resistant to the toxins. As Mayer often says, “Doing the same thing over and over and expecting different results: isn’t that the definition of insanity?”
Persuaded by the research, and by her wife, fellow biologist Cheryl Dyer, Mayer decided to devote her career to developing a new, smarter way to control the rat population. In 2007, they founded SenesTech. “People say never to invest with a husband and wife team,” Mayer joked to me. “I say, ‘Oh absolutely not! Then you have dominance.’ But wife and wife? Works great!”
For Dyer and Mayer, the immediate problem was obvious: while the lab mice and feral dogs had received injections in controlled studies, wild rats would have to eat the formula of their own volition. Rats are neophobic – they avoid what they don’t know. What’s more, city rats are already well fed. In New York City, for example, they have fresh bagels, pizza, melted ice cream and fried chicken in unending supply. To succeed, Dyer and Mayer had to make the compound not just edible but delicious.
After a series of tests, they quickly settled on a liquid, rather than solid, formulation. Rats have to drink 10% of their body weight every day to survive, and so are always looking out for something potable. “We compared the [two] and they peed on the solid and drank the liquid,” Dyer told me. “Rats are pretty straightforward.”
Where Mayer is tall and voluble, Dyer is short and broad-shouldered, quiet and succinct. She seems most comfortable behind the scenes, if only because it is easier to get away with wearing Hawaiian-print shirts and no shoes. At SenesTech’s headquarters, Dyer’s windowless office is right next to Mayer’s, and if Mayer’s office evokes Zen, Dyer’s evokes an island paradise. Scenes from Hawaii cover her walls, hula (and rat) figurines line the shelves, and on her desk sits a small wooden sign, which says, “WELCOME TO THE TIKI BAR.” There is also a widescreen TV, on which Dyer likes to watch old movies on mute all day.
It was Dyer’s job to make Mouseopause palatable for rats – a tricky proposition because its active ingredient, 4-vinylcyclohexene diepoxide (VCD), is bitter and caustic. Rats have the same taste preferences as humans – they love fat and sugar – though Dyer’s experiments with various flavour profiles indicated that their appetite for both exceeds ours.
She was also tasked with the greater challenge of adapting Mouseopause to work on rats, which are much hardier than mice. While VCD caused the eggs in mouse ovaries to degenerate rapidly, female rats were far less susceptible. Hoping for a compound effect, Dyer added a second active ingredient: triptolide, which stunted any growing eggs. The results were better, but still not good enough. “They just had smaller litters, goddammit,” she said.
Eventually, out of a mix of curiosity and desperation, she fed it to both males and females. The result was dramatic. It turns out that the triptolide destroyed sperm – the males became sterile almost immediately after ingesting the formula. This was a total surprise: no one had ever tested triptolide on male rats before. It was “stunning”, Dyer told me. “Totally unpredictable.” Test after test: no pups. She sighed. “Man, you should have seen the No Pup party.” After three years of research and development, they had a product that worked and did not harm other animals. (The active ingredients are metabolised by the rat’s body in 10 minutes, which means that any predator that eats it is not affected, and the compound quickly breaks down into inactive ingredients when it hits soil or water.)
ContraPest, the finished product, is viscous and sweet. Electric pink and opaque, it tastes like nine packets of saccharine blended into two tablespoons of kitchen oil. “Rats love it,” Dyer said. “Love it.” Mayer, who taste-tested every version during the development process, could not say the same for herself.
In 2013, New York’s Metropolitan Transit Authority (MTA) reached out to Mayer after hearing about SenesTech’s early trials to ask whether the company would test ContraPest in New York’s subways as part of a citywide effort to find new, more successful alternatives to poison. Many cities devote manpower and money to keeping the rats under control, but New York, which is more or less the rat capital of the western world, is the epicentre of anti-rat efforts. Every incoming mayor of New York declares his intentions for a vast rodenticide – Giuliani even appointed a “rat czar” to oversee the carnage – only to leave the next guy even more to deal with.
Brown rat (Rattus norvegicus) rearing up. Guardian Design Photograph: Frank Greenaway/Getty Images/Dorling Kindersley
When the MTA officials contacted Mayer, she recalled, they were worried that the formula would not work on New York rats, which have the reputation of being bigger, tougher, and smarter than any other city rat in the world. (Norway rats, the species infesting New York, are not in fact the largest rat type.) They asked Mayer whether they should send a few New York rats on a plane to Arizona so that SenesTech could experiment with them before coming to New York. “No, I don’t think so,” replied Mayer, amused. “I never met a rat I couldn’t sterilise.”
Mayer dispatched two of SenesTech’s youngest scientists, women in their 20s, to New York in order to test whether the formula was appealing enough. Would New York rats prefer ContraPest to water or pizza? Wearing their best approximation of hazmat suits to protect themselves from the filth, the scientists patrolled the subway’s trash storage rooms under Grand Central Station. They planted bait boxes filled with feed stations of ContraPest and then stood nearby, counting the rats that came in and out with clickers in order to track how many rats were taking the bait. For six months, they baited and counted, washing their suits at the end of each day in bleach.
The two young women went home to Arizona with good news: not only did the New York rats drink ContraPest, the drink actually worked on them. The test confirmed the highest hopes of the company – there was an alternative to poison that would work, even in New York City, and they had found it.
When humans and animals come together, there are choices. Mayer believes that if you understand the ecology of the animal and you understand your own ecology, then you and the animal will be able to coexist peacefully. After centuries of misperception and squeamishness, we finally have a good grasp of rat ecology. Now the problem may be our reluctance to look too carefully at ourselves.
In his 1983 book More Cunning than Man, writer Robert Hendrickson lists “the obvious ways in which rats so well resemble humans: ferocity, omnivorousness, adaptability to all climes, migration from east to west in the life journey of their species, irresponsible fecundity in all seasons, with a seeming need to make genocidal war on their own kind.” He describes rats and men alike as “utterly destructive, both taking all other living things for their purposes.”
Humanity’s long struggle with rats mostly signals the worst traits we share with them: our inability to live responsibly within our environment; our tendencies toward hedonism and greed; and our failures to look after the weakest among us. Getting rid of them means correcting ourselves first.
SenesTech is not alone in its attempts to devise a more sustainable, responsible method of ending the rat problem. Its work is heir to an existing method: integrated pest management, or IPM, which holds that if humans – particularly city-dwellers – took more care with their environment, rats wouldn’t thrive.
IPM’s most vocal advocate is Bobby Corrigan, who has brought its principles to farmlands and cities all over the world, most notably New York, which recently revised its rat control programme on his advice. Twice a year, he teaches the New York health department’s “Rat Academy”, a three-day training for industry professionals. This April, there were maybe 100 attendees wedged into wooden theatre seats in a downtown auditorium, holding weak coffee and spongy muffins.
Corrigan is a thinnish, pale man, bald except for a low, wispy crown framing his ears. He spends his nights on the streets or in basement corners studying rats. Once, he lay in an alley with peanut butter spread around him all night so he could get good photographs. (“No, it wasn’t safe. Yes, they were urinating on me. In grad school, you do crazy things.”) He regards his work with utmost seriousness.
“Here’s what health professionals do,” he said to his audience by way of introduction. He pointed at a slide behind him and read aloud.
We protect the roof over people’s heads. We protect the food they eat. We protect their health, comfort and safety.
“I’m not saying this to pat us on the back. This is real. This is our job. [Rats] get on airplanes. They gnaw on wires. They cause diseases. To me, this is the shot heard round the world.” Then he spent 20 minutes explaining how to divine information from rat droppings based on their moisture.
As the day wore on, Corrigan’s core message for his audience emerged: fighting rats means committing to holistic efforts, not looking for a quick, flashy fix. “We love to spritz problems away,” Corrigan told me later. “A chemical or a trap, it’s a Band Aid, and they’re Band Aids that come off very quickly.” Instead, Corrigan argues that you first need to remove the rat’s food, then remove the rat’s shelter, and only then take lethal measures if you have to.
In theory, this solution is simple. It does not involve radar or guns. Instead, it demands lids for the trash can, and caulking for the cracks in foundations, or “keeping our own little nests clean”, as Corrigan says. It is the obvious answer, the one that has been sitting under our noses for centuries: stop feeding them, stop housing them, and they will go away on their own.
The problem is that people, as a rule, prefer the quick fix. Setting out poison is easier; the ultrasonic machine looks cool. The sensible, labour-intensive option meets with resistance. Often, when Corrigan is called out to consult with a property owner, the owner rejects his advice, simply because following it would require too much thought, effort or expense.
Your rats are my rats. If the city blows it off, the sewer rats become everybody’s rats. Rats are everybody’s issue
And sometimes, even those who are willing to try his methods do not have the resources. Ricky Simeone, the director of pest control for New York’s health department, explained to me that the neighbourhoods that struggle with the worst rat infestations are not the ones who file the most reports to his office. The poorest neighbourhoods are too overwhelmed with other social or economic problems to file complaints – or, worse, they accept rat infestation as one of the conditions of living in poverty.
Corrigan confirmed that rats, especially in cities, affect the poor more than the rich, because effective pest control services are expensive. But he pointed out that no one totally escapes the rat problem, no matter how rich. Cities such as New York make evident a universal truth. “We’re all holding hands whether we know it or like it. Your rats are my rats. If the city blows it off, the sewer rats become everybody’s rats. Rats are everybody’s issue.
“Everyone thinks, ‘It’s not my job, it’s someone else’s job,’” Corrigan continued. “They think, ‘Oh I live in New York, no one can get rid of the rats in New York!’” He gave a short sigh. “We don’t think we can do it alone, so we don’t do anything as a group.” As with all conditions that threaten everyone but torment the disadvantaged above all, the situation is not better because we are not better.
“Homo sapiens,” Corrigan said to his audience at the Rat Academy. “Does anyone know what this means?”
He smiled a grim little smile. “Wise man.”
Improving society is a collective project, but as Corrigan attests, it happens because individual people make it their business to incite change. Mayer and Dyer, too, see this as their mission. “We have to be better stewards than this,” Dyer told me fiercely. “We’re better than this.” If SenesTech looks quirky in the attempt, its founders do not seem to mind.
‘Rats are so longstanding a threat to humanity that contemplating an end to the rat problem seems like a fantasy.’ Photograph: AFP/Getty Images
On a Tuesday night in August, Mayer and Dyer held a celebration in their backyard for staff and investors. The company had just received US Environmental Protection Agency registration, a process that usually takes years and often costs more than companies of SenesTech’s size can afford. (The EPA is making an active effort to get rat poison off the markets in the US, and received news of SenesTech’s science with enthusiasm.) Now, with the EPA’s blessing, the company could take ContraPest to commercial markets. Immediately, more than 100 calls and 200 emails came in with order requests.
Mayer and Dyer live in a one-level wood cabin a few miles north of downtown Flagstaff, in a wooded area near a field of wildflowers. For the occasion, they had cleared the back patio, where Mayer does her morning meditation and yoga, and filled it with deck furniture and folding tables. The sun was coming down the San Francisco Peaks.
It was not a typical investors dinner, but then, SenesTech’s nearly 700 stakeholders are mostly firemen. While most biotech startups are funded by investment bankers and venture capitalists, Mayer chose to pursue funding from grant-giving bodies and a horde of private donors, all of whom made small investments, and each of whom Mayer knows by name. It was a pure accident of networking that so many of them turned out to be firemen, but she is thrilled with the situation. “Firefighters really believe in doing good,” Mayer explained to me. “And they’re like teenage girls. Once one of them invested, they all wanted in.”
There were perhaps 25 people – investors, board members and SenesTech staff – gathered on the back patio, eating tacos and drinking from Mayer and Dyer’s impressive liquor collection, but they made noise for 50. They were boisterous and loving, hugging each other, teasing each other, shouting old stories to roars of laughter, and clinking glasses. About half the room seemed to be wearing Hawaiian patterned shirts.
When the time came for Mayer to give a speech, she demurred for a moment before standing. Her toast turned briefly into an anecdote about flattening mouse skeletons in lasagna tins. “But seriously,” she said, returning to her theme, “We knew [this day] would come. It’s great to be riding this wave with you. It’s just so sweet.” Glasses heaved into the air.
There was considerable work left to do: now that SenesTech had its national registration, it would have to file for registration in every state. (Since then, the company has registered in 11 US states, and begun registration in the EU.) The manufacturing team was hurrying to make enough ContraPest to accommodate the requests coming in.Dyer was working hard on adaptations that would make the formula work in a variety of different environments, and planning variations for different species. Mayer was preparing for a torrent of meetings. While ContraPest has been effective in every test SenesTech has run so far, there is a lot still to learn about how rats in different parts of the world will respond to it in the wild.
It sounds crazy: a band of animal loversand firemen in the mountains of Arizona, led by a Buddhist girl scout, making a pink milkshake for rats that may eventually improve the lives of millions of people. They are unruffled by scepticism: In the middle of one interview, Mayer forgot a detail and yelled towards the door, “Cheryl, who said to you, ‘That’s just not how we do it?’” Dyer hollered back from the other room. “Which time?” In response, they point to hard science, solicitations from governments and companies around the world, and an endorsement from Stephen Hawking, who featured them on his documentary mini-series Brave New World.
Rats are so longstanding a threat to humanity that contemplating an end to the rat problem – and one that does not require us to kill them – seems like a fantasy. They are, as Mayer herself put it, a more successful species than us. Long after we’re gone, they will still be here. But the possibility of a truce seems closer than ever before. “The answer in the future may lie completely within biotechnology,” said Corrigan when I asked for his impressions. (He and Mayer consider themselves allies in the campaign to create sustainable solutions to the rat problem. Mayer fondly recalls a nighttime “rat safari” she once took with Corrigan in New York.) “The SenesTech product is a breakthrough, but it is still at the very infancy stages of biotechnology for this species,” Corrigan said. “This is going to be maybe years of refinements and changing and experiments. We’re not walking yet. And we’re certainly not running.”
Mayer, Dyer and their team seem cheerful at the prospect, and confident that they are doing the work of the future. “Do you see this?” asked Ali Applin, a senior member of SenesTech’s staff. We were sitting in Mayer’s office, and Applin pointed to a little sign on the coffee table that read “Make it so.”
“This is what she tells us,” Applin said.
Mayer nodded, smiling. “That’s what you need to do. I mean, why squabble over something and say, ‘I can’t do that’. Make it so. Find a way. There’s always a way.”
After a moment, she had another thought. “You’re really gonna have to do that, Ali, when you take this to Argentina soon. If we thought Laos was hard – I mean, my God.” She grinned mischievously and folded her hands together and pressed them to her forehead and said a mantra. “I wish you ease on the path to peace. I wish you an end to your suffering.”
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GPs are increasing the anguish of cancer patients by depriving them of pain relief, research has suggested.
A study found that terminal patients in the UK were often not prescribed powerful opioids such as morphine until nine weeks before their death.
Many would have been suffering pain for much longer, said the authors. Doctors were waiting too long before allowing patients with advanced cancer to have the drugs, they claimed.
Lead researcher Dr Lucy Ziegler, from the University of Leeds, said: “We have identified for the first time the relatively late onset and short duration of strong opioid treatment in cancer patients prior to death.
“This pattern of prescribing does not match population data which points to earlier onset of pain. Nine weeks before death is considered late in the course of the cancer trajectory.”
The scientists used cancer registry data and medical records to investigate the fate of 6,080 patients who died between 2005 and 2012. They found that 48% were issued prescriptions for morphine and other opioids during the last year of their lives.
Typically, the time interval between the first prescription and death was only nine weeks. Late diagnosis could not explain the delay. On average, patients were diagnosed with the disease long before receiving opioids.
Ziegler said: “Although the prevalence of pain is higher in patients with advanced cancer and towards the end of life, for many patients pain is experienced at many stages throughout the illness.
“In fact, pain is the most common presenting symptom at diagnosis. Our research highlights the need to prioritise earlier access to effective pain management for patients with advanced cancer.”
The study found that over-60s were more likely to be prescribed painkillers late. Cancer patients who died in a hospice, rather than in hospital, at home or in a care home, were more likely to have been offered the drugs earlier.
One explanation for the findings, published in the journal Pain, could be concern over the so-called opioid epidemic – the overuse of potentially addictive opioids, said the researchers.
NHS data showed that in 2000-10 opioid prescriptions soared by 466%. However, it increased by only 16% for cancer patients. Previous studies have found up to 86% of patients with advanced cancer will experience pain.
“Within the advanced cancer population there is a need to develop mechanisms to improve pain assessment and initiate a more proactive approach to prescribing, particularly for older patients,” said Ziegler.
“Effective pain control is fundamental to good quality of life. For patients who are approaching the end of their lives, it is crucially important we strive to get this right and that we help them achieve the best quality of life possible.”
Labour has warned that the NHS could be forced to spend hundreds of thousands on competitors attorneys soon after the UK’s biggest private healthcare provider demanded an fast investigation into a decision to award an elective care contract to a regional health trust.
Care Uk has been branded a undesirable loser following lodging a complaint with the NHS watchdog Keep track of more than the management of a contract by commissioners in north London.
Check has now begun an investigation into the determination by 4 GP-led clinical commissioning groups (CCGs) to award a contract to the Barking, Havering and Redbridge University Hospitals NHS Believe in. The believe in mentioned it was very disappointed by the investigation and warned that it would delay the opening of a care centre.
Andrew Gwynne, the shadow overall health minister, explained the new competition guidelines could force the NHS to waste hundreds of thousands on competition lawyers.
“This is a worrying sign of what lies ahead for the NHS under the Tories,” Gwynne said. “David Cameron promised to put medical doctors in control, but his competitors principles allow massive private wellness organizations to challenge the awarding of contracts to the NHS,” he extra. “It’s a ridiculous state of affairs that ministers need to have to urgently tackle.”
Care Uk, the UK’s biggest personal provider of wellness and social care, explained that the GP-led commissioning groups had applied the wrong criteria in awarding the contract, with as well considerably emphasis on price and too minor fat on top quality.
The contract covers a assortment of providers, which includes basic surgical treatment, orthopaedics and ophthalmology, for 965,000 men and women.
Care Uk, which has supplied elective care providers in the area for many many years, explained the CCGs’ decision to take away the contract was discriminatory.
Campaign groups warned that the NHS could face higher legal costs if private businesses began often interesting CCG selections.
Professor Sue Richards, the co-chair of Hold Our NHS Public, stated large private sector firms like Care Uk have been full of the virtues of competitors in concept, but claimed that when in practice NHS hospitals had been proven to be capable to do a greater occupation at a reduce cost, they called in the attorneys.
Richards stated that investigations into contracts could increase legal expenses for the NHS. “The last chief executive of the NHS, Sir David Nicholson, warned that the NHS had turn out to be a competitors lawyers’ paradise. How considerably will all of this cost and what could it have attained if invested on patient care?” she explained. “Don’t be a undesirable loser, Care Uk.”
Richard Vautrey, the deputy chair of the BMA’s Basic Practitioners Committee, stated that GPs had issues about challenging tendering processes, which could favour commercial companies.
“We remain concerned that worthwhile resources that would be much better invested on patient care are currently being diverted into an expensive tendering procedure and, possibly, into legal difficulties about the outcome of contract awards,” he mentioned.
Care United kingdom had revenues of virtually £730m in 2014, with underlying earnings of around £53m. The care supplier, whose nationwide portfolio includes hospitals, GP surgeries and psychological wellness centres, is owned by the private equity company Bridgepoint Capital.
Monitor explained that the investigation would target on whether or not the CCGs’ assessment of the bids was “consistent with their obligations to act in a transparent and proportionate way and to deal with suppliers equally”.
The NHS trust insisted that its productive bid had shown the greatest worth for cash, which was why it was selected by the CCGs. “Putting the elective care centre into NHS hands implies that sufferers will have greater continuity of care, and waiting instances will be diminished,” it said.
Care United kingdom explained it welcomed the investigation, adding that the existing circumstance could potentially trigger reduction of patient choice and increase troubles about cost competitors.
“Care Uk is committed to continuing to operate the service to the highest possible standards and continuing to assistance the neighborhood NHS in addressing its functionality issues for the duration of the period of Monitor’s investigation,” it mentioned.
A spokesman for the CCGs stated: “Barking and Dagenham, Redbridge, Havering, and Waltham Forest Clinical Commissioning Groups are disappointed that this investigation has been launched. We will of course cooperate completely with Check to help them acquire the info they demand.
“The CCGs continue to be confident that our arrangements to decide on a supplier of these services have been in the very best interests of sufferers, in accordance with the NHS principles on procurement, option and competitors.”
The FDA has ultimately accepted the tiny pink pill to assist females enhance their sex drive.
Flibanserin, to be offered as Addyi, finally received a green light from the US Foods and Drug Administration on Tuesday. This was the third time the agency has regarded approval for the drug, which is intended for ladies diagnosed with hypoactive sexual wish disorder, HSDD.
The drug, while usually referred to as “female Viagra”, is more akin to an antidepressant as it changes brain chemistry related to the way that dopamine and serotonin do. Viagra relaxes muscle tissue and increases blood movement to specific regions of the male body, assisting deal with erectile disfunction. Although the blue pill for men should be taken ahead of engaging in sexual action, girls are to consider the pink pill day-to-day.
“Today’s approval provides women distressed by their lower sexual desire with an authorized therapy choice,” stated Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research (CDER). “The FDA strives to protect and advance the health of females, and we are committed to supporting the development of safe and effective treatment options for female sexual dysfunction.”
But the FDA cautioned that care should be taken for prospective adverse reactions to the pill, like reduced blood strain and loss of consciousness.
“Because of a probably critical interaction with alcohol, treatment method with Addyi will only be offered by means of certified overall health care professionals and licensed pharmacies,” Woodcock mentioned. “Patients and prescribers should entirely understand the dangers connected with the use of Addyi before taking into consideration remedy.”
Connected: ‘Female viagra’: FDA panel backs Flibanserin with security restriction
In June of this 12 months, the pill took the 1st step to making it into US pharmacies. An FDA panel voted 18-6 in favor of approving Flibanserin on the problem that Sprout develops a strategy to restrict safety dangers. The panel had previously rejected the pill twice before.
When the FDA rejected Boehringer Ingelheim’s application for Flibanserin in June of 2010, it ruled that the drug worked no better than a placebo.
“I certainly hope Boehringer does not give up,” Sheryl A Kingsberg, a psychologist and Case Western Reserve University healthcare professor, informed the New York Times at that time. “Flibanserin showed an terrible good deal of guarantee. I’m going to have some quite, really disappointed patients if there’s practically nothing for them.”
However by October of that year, Boehringer did just that, announcing that it was discontinuing advancement of Flibanserin. Months later on, in 2011, the drug was acquired by Sprout. The pharmaceutical company attempted its luck ahead of the FDA in June of 2013, only to be thwarted when the company ruled that the dangers of sleepiness, dizziness, fatigue and nausea outweighed the rewards.
It was at about that time that the conversation about Flibanserin became heated, with opponents lobbying against the drug due to its side results and supporters accusing the FDA of gender bias.
In October of last year, Sprout, along with number of organizations supporting the approval of Flibanserin, launched a campaign referred to as “Even the Score”.
“There are 26 FDA accredited drugs to treat a variety of sexual dysfunctions for males (41 if you count generics!), but nonetheless not a single one for women’s most frequent sexual complaint,” the campaign argues on its site. “Why do we rapidly track the approval of medication like Viagra (1998) for men?”
According to the campaign, intercourse is “a standard human right” and now is the “time to even the score when it comes to treatment of women’s sexual dysfunction”.
But a coalition of organizations led by the National Women’s Overall health Network wrote in a letter to the FDA: “The problem with Flibanserin is not gender bias at the FDA but the drug itself.” The group expressed help of the FDA’s “evidence-primarily based evaluation and decision-making”.
Some healthcare authorities, like Dr Adriane Fugh-Berman, a professor at Georgetown University, fret about how such campaigns might influence the FDA in the potential now that Flibanserin has been approved.
“This may possibly set a precedent of risky medication getting accepted based on public relations campaigns rather than science,” she informed Marketplace.
Relevant: We shouldn’t push dubious ‘pink Viagra’ capsules on girls and contact it emancipation | Barbara Mintzes and Leonore Tiefer
“I believe whether or not or not this is eventually the proper decision for ladies is a story that will be advised in the marketplace,” Cindy Whitehead, the chief executive of Sprout, informed Quickly Business. Whitehead stated that building the drug and receiving it accepted grew to become “a cause” for her.
Ladies struggling from HSDD also argue that it’s up to them to decide if the benefits outweigh the risks. Testifying prior to the FDA in June, a number of them urged the company to approve the drug.
Amanda Parrish was a single of the more than eleven,000 women who have participated in Flibanserin’s trial. Prior to joining the trial, she would attempt to avoid her husband, Ben, come bedtime. Soon after she started taking Flibanserin, she stated she did not come to feel any distinct throughout the day but her evenings turned around.
“What it did do was at the finish of a prolonged day, no matter how tired I was, I desired to initiate and it was not operate to do that,” she told NBC Nightly Information.
“She was flirty once more. She was leaving me notes on my bathroom mirror in the morning,” explained Ben Parrish. “We know that it performs. We experienced it.”
The Scottish well being authorities have contacted about 4,000 British scouts who took part in a jamboree in Japan following 3 from the north of Scotland required therapy for meningitis.
The precautionary letter from Overall health Protection Scotland mentioned whilst the danger of an additional case was very slight, it was sensible to be aware of the signs and symptoms, which incorporate vomiting, serious headache, stiff neck and seizures.
The HPS letter, dated 14 August, mentioned the 3 Scottish scouts were recovering nicely after currently being treated with antibiotics.
Jim McMenamin, a advisor epidemiologist, wrote: “I value this news may possibly lead to some anxiety but please be reassured that as a result far no other cases have been reported from scouts from other elements of the Uk or from other international nations attending the jamboree. The occurrence of this sickness is unusual and the danger of one more case amongst individuals attending the jamboree is quite small.”
Even so, the Associated Press reported that Sweden’s public well being company explained on Monday that one particular Swedish participant was most likely to have contracted the condition at the jamboree, and that two other cases had been below investigation.
An estimated thirty,000 scouts from around the world attended the 12-day event that ended on 8 August in Kirarahama in western Japan, like 4,000 from Britain. The jamboree incorporated a go to to the Hiroshima Peace Memorial Museum as portion of the 70th anniversary of a nuclear bomb being dropped on the city.
In his letter, McMenamin stated not all of indicators and symptoms of meningitis might demonstrate at once, but somebody with the sickness could grow to be really ill. The sickness might progress in excess of one or two days, but can develop really quickly, occasionally in a matter of hrs.
Meningitis, an infection of the meninges (protective membranes that surround the brain and spinal cord), can be caused by bacteria or a virus. It leads to the meninges turning into swollen, which can harm the nerves and brain. The early signs can be like poor flu, but diagnosis in the early phases can be difficult.
McMenamin mentioned laboratory and other data indicated that the chance of infection appeared confined to the little group of scouts in the north of Scotland who attended the jamboree and individuals in households of the 3 confirmed instances.
She had fought the illness for more than 4 many years, Manchester Coroner’s Court was advised.
Her death came despite undergoing stem cell transplant, and her family members think she would have survived if she had chemotherapy.
But they explained she would not have been in a position to turn into a mom, which she longed for.
At the inquest, Dr Jim Cavet, consultant haematologist at Christie Hospital, Manchester, stated Mrs Cockx deferred remedy in 2010 and in 2011, when she grew to become pregnant.
Dr Cavet met his patient to discuss her remedy program all through her pregnancy right up until she gave birth to Harriet by means of a C-area.
Tests showed that following the birth of her daughter, the cancer had returned, but much more aggressively than before.
Dr Cavet informed how the new mom place her daughter’s well being first during, in spite of being in “a rather undesirable way” right after the birth.
“Nicola was really concerned for Harriet and her health and was reluctant to have any chemotherapy even then,” mentioned Dr Cavet.
“She did accept steroids and they dealt with the higher ranges of calcium but not the underlying myeloma.”
Mrs Cockx first realised she had a issue in June 2008 when she began limping.
3 months later she went on a company trip in Germany with her father, John Flowers.
Although there she decided to see an orthapaedic professional about her leg, but tripped and fell on the way to the medical doctor, breaking her femur.
It was only then she was diagnosed with bone marrow cancer.
Her husband Rudy Cockx informed the inquest that when the diagnosis came, it was “extremely stressful”.
The IT consultant, 39, mentioned she was initially taken care of with radiotherapy “but despite this she sought substitute medication and therapy”.
Dr Cavet explained Mrs Cockx needed to delay ‘toxic’ remedy so she could have a child initial.
She only makes use of steroids in the course of her pregnancy simply because “chemotherapy was not a excellent idea”, he told the inquest.
Dr Cavet explained it was only since of her youth and fitness the she was capable “to get to the stage of delivering the baby”.
By the time she gave birth: “She had had a lump in her chest that had presently broken her ribs and lumps in her skull that have been developing in various instructions.”
Following the birth, Mrs Cockx had further chemotherapy and a stem cell transplant which initially seemed to operate.
Even so, she later on experienced tremors and fevers – typical side-results soon after a transplant – and referred to Salford Hospital, Greater Manchester.
Sooner or later she was discharged from the hospital and died inside of a number of days – eight months soon after turning into a mother.
Pathologist Dr Leena Joseph informed the coroner’s court that Mrs Cockx died from sepsis and hypersensitivity myocarditis, a drug-relevant irritation of the heart
She told the inquest that the mom died from a complication brought on by one of the healthcare therapies she was on.
Recording a narrative verdict, assistant coroner Sara Lewis, stated: “Nicola’s primary concern was her fertility and the she must have a youngster and of course she did in 2012.
“Obviously it is very tragic that the stem cell transplant could not give a longer remission for her.”
The loved ones are now raising cash for a lot more investigation into the illness on a JustGiving page.
Their campaign inspired an extraordinary response with the world’s most expensive footballer, Gareth Bale lending his help.
He was joined by other well-known names which includes comedian Russell Howard, Wales rugby captain Sam Warburton, Tv presenter Gethin Jones and EastEnders actor Richard Elis.
The appeal led to a two,580 per cent increase in the variety of folks in Wales joining the Anthony Nolan register in contrast to the very same period final 12 months.
Right after waiting a gruelling 3 months, Hollie discovered out last week that a donor had been located.
Sharing the information on Hollie’s campaign Facebook webpage, Mrs Clark wrote: “We want to thank everyone who has acquired off their BOTT and aided us.
“There are virtually also several to identify, suffice to say, you know who you are and what you did Its difficult to make clear how we really feel so we will not try out, it would be messy.
“We get massive power and comfort from you all. We could not have began this journey without having the response to this campaign. You all genuinely did Assist Hollie. You really did #putyourpantsonyourhead.”
She urged individuals to carry on registering to help others like Hollie in require of a donor.
“Although we are full of happiness we still have a lengthy way to go,” she wrote.
“We know there are many Mums and Dads looking out of a window right now. Hunting and asking yourself if that special man or woman will join a bone marrow register to save their child’s lifestyle.
“Trust us, it’s not a nice feeling. Trust us when we say, it truly is not a place you EVER want to be in. It is despair, fear and terror.
“Try & envision just for a minute. Try out and imagine seeking for that one particular special person in the globe who could conserve your child’s life. It does not have to be like this. It could be distinct. It is simple, here is the remedy, right here is the secret. Register as a bone marrow donor and tell your close friends to do the exact same.”
Mrs Clark added: “In a brief time Anthony Nolan have turn into part of us. They were there for us and we Positive AS HELL will be there for them. We cannot and will not walk away from them.
“We will get Hollie fixed & be back to aid soon. We will be returning the favour.
“Parents in a similar place, preserve constructive & stay powerful.
“We will be there for you, that is a promise.”
Hollie, of Roath Park, Cardiff, was diagnosed with Myelodysplastic syndrome (MDS), a blood disorder which triggers a drop in the quantity of healthier blood cells in the body, three months in the past.
Mrs Clark, a GP, mentioned: “It was an absolute shock, it is practically the worst factor as a parent you could be informed.
“It was difficult to believe because she’d been so active at the time, she loves swimming and cycling and taking part in with her pals, and she’d been doing all these things with no us even knowing that her haemoglobin levels have been dangerously reduced.”
Right after discovering her younger brother Sam was not a match, her mothers and fathers made the decision to take action to locate one as quickly as achievable which led to the campaign.
In Cardiff, there was a 2,600 per cent enhance in individuals joining the register and, in the United kingdom as a total, the figure was 170 per cent compared to the exact same time last 12 months.
Karen Archer, regional register development manager at Anthony Nolan stated: “We are absolutely delighted that a match has been located for Hollie and we want her and all of her household the greatest of luck for the potential.”
To indicator up to the register visit www.anthonynolan.org/helphollie.
The lady treated in Mississippi appeared to be living evidence that it was achievable to outwit HIV. Photograph: Eliseo Fernandez/Reuters/Corbis
The brave hopes of HIV scientists that they were on the path in the direction of a remedy for Aids have received a substantial blow with the news from the US that, soon after appearing to have been completely cleared from the entire body of one particular small woman, the virus has been detected once more.
The Mississippi infant was the poster little one of the “hunt for a remedy”, which is the mantra scientists and campaigners have adopted given that more widely accessible medicines stemmed the rise in the Aids pandemic and lowered the sense of emergency. We have in no way known her title, but the little one treated in the Jackson Memorial Hospital in Mississippi appeared to be residing proof that it was possible to outwit the virus. Research have been planned to test the treatment method she acquired in other infants. Now there will have to be a rethink. During the HIV local community, there will be genuine dismay.
Pregnant ladies with HIV are put on antiretroviral medication to suppress the virus in their blood, for their own overall health and to protect their child. In North America and Europe, the vast bulk of babies with HIV-optimistic mothers are born free of charge of the virus as a outcome. The Mississippi baby’s mom, however, had never ever attended an antenatal clinic. Dr Hannah Gay, a paediatric HIV consultant at the hospital, took the choice to place the child on a specifically strong course of antiretroviral drugs inside of thirty hrs of the birth, just before she even had any HIV test outcomes. This was an unusual procedure, but confident sufficient, when the test outcomes came back, they confirmed HIV in the baby.
The youngster continued to be offered antiretroviral drugs for 18 months, when doctors lost contact with her. Ten months later, mom and daughter reappeared. When tests have been done, there was no indicator of the virus anywhere in the girl’s body. A buzz of amazement and excitement went all around the planet. But now, at nearly 4 many years old, the typical tests to which the child has been subjected have shown traces of the virus after once more. She is no longer in remission and has been place back on remedy.
HIV has proved a formidable opponent for scientists striving to develop vaccines as well as drugs simply because of its ability to hide in the body. Medicines can suppress the virus till it is almost undetectable, but after they are stopped, the virus rebounds.
The events in Mississippi might nevertheless educate scientists a great deal. It does appear that treatment method hit the virus harder in this child’s situation than any person has managed to do prior to. Other medical doctors have been keen to consider the method. In March it was exposed that a second infant, in Los Angeles, had been treated with a equivalent sturdy cocktail of drugs inside just 4 hrs of her birth. Tests could not find the virus afterwards, but that child is even now on treatment method and now probably to continue to be so.
There have been strategies in the US to carry out a federally funded review of early aggressive treatment in newborn infants with HIV. If there was no signal of HIV after two years, medical professionals would end the medication. No matter whether such a examine can now be ethically done will be in question.
“We’re going to get a good tough appear at the review and see if it requirements any modifications,” mentioned Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Conditions. At a minimal, consent types to join the research would have to be revised, he stated. He added that scientists remained committed to obtaining a cure for HIV.
Jeffrey Safrit, analysis chief at the Elizabeth Glaser Pediatric AIDS Foundation, was one of these to supply an upbeat view. “What we have learned from this situation is really very wonderful,” he said. “They were able to suppress the virus for a extremely lengthy time with no treatment. We need to have to take the good aspects of this case and find out from them to move forward [with the federal examine]“.
Hopes have been raised before. Like the Mississippi little one, the “Berlin patient” appeared to offer a blueprint for a cure when his story emerged in 2008. The patient was an American, Timothy Ray Brown, who obtained a bone marrow stem cell transplant in Germany to deal with his cancer, acute myeloid leukaemia. His doctors managed to get the donation from a man who is a single of the tiny minority who have organic immunity to HIV. Brown’s HIV has not recurred. Stem cell transplants from donors have considering that been provided to other individuals with HIV, but the virus has constantly produced a comeback.
At the International Aids Conference, which opens in Melbourne at the finish of next week, the promise of babies freed from HIV was anticipated to be a single of the greatest and most hopeful themes. Now there will be a lot of stoical talk from HIV specialists about what can be discovered from the setback. They have been right here ahead of and will be right here yet again ahead of HIV is, hopefully, last but not least conquered.
