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A Repeat of Covid: Data Show Racial Disparities in Monkeypox Response

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A Repeat of Covid: Data Show Racial Disparities in Monkeypox Response

New York Metropolis launched new information on Thursday displaying stark disparities in monkeypox vaccine entry, with Black males receiving the vaccine at a a lot decrease fee than members of different racial teams.

White New Yorkers characterize about 45 p.c of individuals at heightened threat of monkeypox an infection, and obtained 46 p.c of vaccine doses. Black New Yorkers, who make up 31 p.c of the at-risk inhabitants, obtained solely 12 p.c of doses administered to date, in response to information from town’s Well being Division.

Hispanic residents have been overrepresented amongst vaccine recipients. They made up 16 p.c of the at-risk inhabitants, however obtained 23 p.c of photographs. Hispanic males to date characterize the biggest share of monkeypox sufferers.

Racial and ethnic imbalances in vaccine distribution are additionally occurring elsewhere, as a extremely restricted provide of monkeypox vaccine has usually gone first to these with higher entry to the well being care system and extra time to determine when doses might be launched. There are additionally considerations amongst advocates {that a} new technique of administering the vaccines favored by the federal authorities, which makes use of solely a fraction of the present dose, could inadvertently deepen disparities.

New York Metropolis has vaccinated extra folks for monkeypox to date than some other jurisdiction. Some 64,000 of the roughly 130,000 folks whom it deems most in danger have gotten the primary of two doses. New York Metropolis estimates that there are about 134,000 folks — primarily males who’ve intercourse with males — who’re at heightened threat of an infection, primarily based on a 2020 metropolis well being survey.

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The racial disparities have left public well being specialists and activists pissed off that classes from the Covid-19 response stay unlearned. Black and Hispanic New Yorkers have been much more possible than white New Yorkers to be contaminated with Covid, and to be hospitalized and die throughout the lethal first wave within the spring of 2020. They have been additionally much less more likely to obtain vaccinations early on, and fewer more likely to obtain early therapies, reminiscent of monoclonal antibodies.

Public well being specialists and activists have been significantly dismayed that appointments for the monkeypox vaccine had been doled out largely on a first-come, first-serve foundation, simply as they have been in an early section of the Covid vaccine drive. Public well being specialists say that has meant that vaccine recipients have tended to be whiter and wealthier than different eligible New Yorkers as a result of they’re extra more likely to have versatile schedules, enabling them to spend the hours it could actually take to discover a vaccine appointment.

“We went again to vaccine cattle calls — everybody come — although we all know that if we do broad-based, top-down, no-nuance messaging, it isn’t going to succeed in everybody who wants it,” stated Matthew Rose, a Black H.I.V. and social justice activist. “This was a foreseeable downside. We ran the identical play now we have run each different time earlier than.”

In New York Metropolis, the primary batch of vaccines got with little advance discover, noon on a Thursday, at a sexual well being clinic in Chelsea, Manhattan, to a largely white crowd. Later vaccine choices relied on a glitchy internet appointment system.

A clinic was arrange in Harlem, however those that got here gave the impression to be largely white and lived elsewhere. Neighborhood residents weren’t capable of stroll in and get photographs, a call that got here beneath deep criticism from neighborhood members who felt excluded. Some Black males have stated town didn’t do sufficient to warn them concerning the illness or tips on how to defend themselves.

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“I feel the data ought to’ve been promoted much more about monkeypox vaccines amongst not solely the L.G.B.T. neighborhood, however for us Black and brown folks as effectively,” stated Dominic Faison, 35, a Bronx resident who acquired monkeypox in early July earlier than even listening to concerning the vaccine.

In latest weeks, town well being division has shifted techniques, giving precedence to high-risk sufferers and offering batches of doses on to neighborhood well being organizations. However the effort has but to totally right the imbalance. The vaccine is named Jynneos and is run in a two-dose course.

“Black males particularly are underrepresented in our vaccination effort in comparison with their threat,” stated Dr. Ashwin Vasan, town well being commissioner, in a Thursday interview.

“I do suppose that now we have work to do to advance fairness,” Dr. Vasan added. “And there are typically commerce offs when it comes to pace and our potential to go deep, construct relationships, work with trusted companions, and get the parents who want it most entry to immunization.”

There are indicators that the unfold of monkeypox is slowing in New York Metropolis. After rising steeply for 2 months, monkeypox circumstances plateaued at between 60 and 70 new circumstances per day by late July. Extra lately, they’ve declined to a mean of 54 circumstances per day, in response to metropolis information.

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Metropolis well being officers stay involved that many circumstances will not be being reported, significantly these in communities of colour with much less entry to well being care.

As of Wednesday, New York Metropolis had about 2,500 of the nation’s 13,000 monkeypox circumstances, in response to federal information — about 20 p.c of the nation’s circumstances.

Whereas few jurisdictions have launched racial information about recipients, those which have revealed worrying developments.

In North Carolina, for instance, 70 p.c of monkeypox circumstances have been in Black males and 19 p.c in white males, however 24 p.c of vaccines have gone to Black recipients, and 67 p.c to white recipients, in response to an Aug. 10 report from the North Carolina Division of Well being. (As a result of the virus has been predominately spreading by networks of males who’ve intercourse with males, the main focus of vaccination campaigns nationally has been on that demographic.)

Comparable developments are showing nationally in who has entry to the antiviral remedy Tpoxx, which is efficient at treating monkeypox: Black folks accounted for simply 17 p.c of the 233 sufferers who obtained the therapy as of July 22, although they made up 26 p.c of the overall variety of sufferers at that time, in response to the C.D.C.

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Tpoxx is just not significantly scarce — the federal authorities has a stockpile of greater than 1.7 million programs — however there are limitations to accessing it, together with cumbersome paperwork.

Doses of Jynneos, the vaccine, have been scarce because the starting of the outbreak, partly as a result of federal missteps. To stretch the availability additional, the federal authorities lately authorised a brand new approach of administering the vaccine, which permits suppliers to make use of solely one-fifth of the present dosage. The vaccine could now be administered intradermally, or between layers of pores and skin, somewhat than within the fats layer beneath the pores and skin.

The technique permits federal officers to say that they’ve solved the availability downside and now have sufficient vaccine to cowl all 1.6 million those that they consider are most in danger.

However some advocates within the homosexual neighborhood are involved that the brand new dosing technique could compound the fairness downside somewhat than remedy it.

Intradermal vaccines may be secure and efficient. However only one research has examined the security and efficacy of administering the Jynneos vaccine intradermally. The producer didn’t notice vital security considerations or a lower in efficacy, however there was a higher likelihood of negative effects on the website of the injection, reminiscent of redness, swelling and firmness.

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Switching over to fractional doses additionally requires coaching. Most suppliers do not need intensive expertise giving photographs just below the pores and skin. If given too deeply, the fractional dose won’t be as efficient. The necessity for coaching might also restrict what number of small neighborhood clinics that attain marginalized teams are capable of provide it.

Dr. Vasan, town well being commissioner, stated that whereas New York and different localities are feeling strain from the federal authorities to modify over shortly to the brand new technique, town deliberate to implement the change step by step. The strain intensified Thursday, because the White Home introduced that the following section of vaccine distribution of 1.8 million doses — calculated by multiplying 360,000 full doses by 5 — will solely be distributed to jurisdictions adopting the brand new method.

“I feel each jurisdiction is feeling like this can be a quick change,” he stated. “We want the time to do that proper. The very last thing I wish to do is roll one thing out that isn’t effectively accepted by the neighborhood.”

Some homosexual rights advocates have been talking with metropolis and state well being officers a few hybrid plan: All recipients would get a full dose for his or her first vaccine shot, and everybody would get the fractional injection for his or her second dose, to make sure fairness.

Metropolis and state officers, they stated, appeared receptive to the concept, which may additionally permit docs to gather information on negative effects and effectiveness throughout a pilot stage. Dr. Vasan stated that every one choices remained on the desk.

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Joseph Osmundson, a virologist at New York College, stated he was involved that the federal authorities’s method would push jurisdictions to maneuver to the brand new technique quickly even when they’ve considerations. Well being advocates stated it may additionally be arduous to promote Black males particularly on the brand new method, which may feed into skepticism that they’re being handled as less-than.

As town noticed throughout the Covid vaccine marketing campaign, many Black New Yorkers distrust the federal government and medical institution’s assurances due to a protracted historical past of racism in medication, in addition to previous medical experimentation on Black folks.

“So now {that a} important mass of white homosexual males within the largest U.S. cities have been capable of get an entire dose, they simply acquired to do — no matter — to us,” stated Kenyon Farrow, the managing director of advocacy at PrEP4All, an H.I.V. advocacy group, describing the sentiment he has heard from fellow Black homosexual males on social media.

“If that turns into in any approach a large quantity of individuals feeling that approach,” he stated, “then you definitely truly undermine the entire level of getting to shift to this technique to start with.”

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Unleashing a New Weapon on the Mosquito: A Mosquito

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Unleashing a New Weapon on the Mosquito: A Mosquito

In a laboratory in downtown Medellín, Colombia, it is lunchtime: A technician in a white coat carries a loaded tray into a steamy nursery. She walks between rows of white mesh cages, each the size of a mini-fridge, and slides a thin tray of blood into every one. In response, her charges, all 100,000 of them, begin to whir and emit an excited hum.

This is a mosquito factory. Each week it churns out more than 30 million adult Aedes aegypti mosquitoes, with their distinctive white polka dots on their wiry black legs. The brood stock of females is fed on discarded blood blank donations, and horse blood. Eventually, some of their progeny will be released into Medellín, Cali and cities and towns in Colombia’s verdant river valleys. Other insects will be chilled into a stupor for a journey up to Honduras.


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Inside the World Mosquito Program lab.




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Anggy Aldana working at the World Mosquito Program lab in Medellín, Colombia.

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The elaborate effort is part of an experiment that is making encouraging progress in the long fight against mosquito-borne disease.

Aedes aegypti spreads arboviruses, including dengue and yellow fever, which can severely sicken or kill people. But these are special Aedes aegyptis: They carry a type of bacteria that can neutralize those deadly viruses.

Five decades ago, entomologists confronting the many kinds of suffering that mosquitoes inflict on humans began to consider a new idea: What if, instead of killing the mosquitoes (a losing proposition in most places), you could disarm them? Even if you couldn’t keep them from biting people, what if you could block them from passing on disease? What if, in fact, you could use one infectious microbe to stop another?

These scientists began to consider a parasitic bacteria called Wolbachia, which lives quietly in all kinds of insect species. A female mosquito with Wolbachia passes it on in her eggs to all of her offspring, who eventually pass it on to the next generation.

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But Wolbachia isn’t naturally found in the mosquito species that cause humans the most problems — the Aedes aegypti, the virus carrier, and the Anopheles subspecies, which carry malaria. If it were, it might eventually render those species essentially harmless.

So how do you infect a mosquito with Wolbachia?

Researchers found, after painstaking trial and error, that they could insert the bacteria into mosquito eggs using minute needles. The mosquitoes that grew from those eggs were infected.


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How mosquito eggs are injected with Wolbachia

A looping video showing a thin needle injecting fluid into a row of black mosquito eggs. Each egg is oblong and about half a millimeter long.




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Source: World Mosquito Program

Eleanor Lutz

The Aedes aegypti mosquitoes that hatched and lived with Wolbachia did just fine. And as hoped, the Wolbachia mostly blocked the viruses: The mosquito who bit someone with dengue, and picked up the virus, didn’t pass it on to the next person it bit.

That got the researchers thinking: If they could infect all the mosquitoes in a village or city, they might stop the disease. Unlike truckloads of insecticides, sprayed down every street and running off into water systems, this method would not harm the ecosystem.

But how do you get Wolbachia into all the mosquitoes in a city the size of Medellín?

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How Wolbachia spreads among wild mosquitoes

A series of three illustrations showing the outcomes of breeding between wild mosquitoes and mosquitoes infected with Wolbachia. When a Wolbachia-infected male and a wild female mate, no offspring will hatch. When a wild male and a Wolbachia-infected female mate, all offspring will carry Wolbachia. And when two Wolbachia-infected mosquitoes mate, all offspring will also carry Wolbachia.


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All offspring

carry Wolbachia

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All offspring

carry Wolbachia

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All offspring

carry Wolbachia

All offspring

carry Wolbachia

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Source: World Mosquito Program

Eleanor Lutz

Once they were confident they could infect generations of mosquitoes in the lab, the scientists needed to know if their theory would work in the wild. The method was first tested in small towns in northern Australia, where females with Wolbachia released in the field mated with wild males and did, indeed, spread Wolbachia through the mosquito population.

A team led by an Australian entomologist named Scott O’Neill next tried some towns in Vietnam, and then a small city in Indonesia. There, after three years, areas where Wolbachia had been released had 77 percent fewer cases of dengue reported, and 86 percent fewer hospitalizations.

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Those results were stunning — a delight for a population used to miserable dengue seasons, and a huge relief for the public health system. Dengue causes intense suffering in even “mild” cases — it’s commonly called “breakbone fever” — and 5 percent of cases progress to the hemorrhagic form of the disease, with uncontrolled bleeding. Half of the people who develop hemorrhagic dengue die if they do not have access to treatment to control the bleeding. There are no antiviral drugs to kill the dengue virus, and the search for a safe and effective vaccine has been long and fraught.

Dengue already sickens 400 million people around the world each year, and kills 20,000, and it’s spreading fast. In places such as Indonesia, where the virus is endemic, every outbreak season, dengue overwhelms hospitals the way Covid-19 did in different places during the height of the pandemic.

Because of climate change, aegypti is broadening its range, bringing dengue with it: France had its first endemic dengue outbreak last year. The virus is in Florida and Texas. The worst dengue outbreak ever recorded was last year in Brazil — 2.3 million cases and nearly 1,000 deaths.


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The countries and territories reporting dengue as of 2018

A map of the world, showing countries with recent dengue transmission highlighted in orange. About 110 countries or territories are included in this group, including most countries in the Americas and a large portion of African and Southeast Asian countries.




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Americas

2 U.S. states and

45 countries or territories

Oceania

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11 countries

or territories

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Americas

2 U.S. states and

45 countries or

territories

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Oceania

11 countries

or territories

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Americas

2 U.S. states and

45 countries

or territories

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Oceania

11 countries

or territories

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Source: Leta et al., International Journal of Infectious Diseases

Note: Data in the United States is shown at the state level. All other areas are shown at the country level. Countries only reporting travel-related dengue infections are not highlighted.

Eleanor Lutz

Mosquitoes are increasingly resistant to insecticides. But the Wolbachia trial results in Indonesia suggested that if the Wolbachia-carrying mosquitoes supplanted the local population, then the bacteria might be established for good — and no further mosquito control would be needed.

From Indonesia, Dr. O’Neill’s group took their testing to Brazil. Another group, called WolBloc and run by the University of Glasgow entomologist Steven Sinkins and his colleagues, began a trial in a neighborhood of Kuala Lumpur, the capital of Malaysia, using a different strain of Wolbachia.

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And Medellín, population three million, is the biggest test to date.


One of the neighborhoods in Medellín, Colombia.

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For a mosquito showdown in a city this size, you need a lot of mosquitoes. Millions and millions of them.

Dr. O’Neill’s group — now calling themselves the World Mosquito Program — set up the production process. It’s tricky work, creating the conditions to maximize mosquito reproduction.

In the factory, females feast from the blood trays at the top of the cages, then fly down to the bottom where they lay eggs on filter paper placed in little cups of water. Technicians pluck out the paper, speckled with hundreds of tiny eggs. Some of those eggs are placed in large tubs of nutrient-enriched water, and after nine or 10 days they hatch into squirming larvae that resemble tiny worms.

From there they become pupae. Hours before they are due to transition to adulthood, they are poured through a strainer that sorts them by sex (females are bigger) and moved into mesh cages.

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Mosquito pupae in a tray of water.


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Mosquito pupae mill about inside a shallow tray full of water.

Some females are kept to breed — like battery hens — but hundreds of thousands of the adults are boxed up to be sent out into the world. They are released into neighborhoods by program staff members on foot or riding on the backs of motorbikes. In the city of Cali, researchers are using a large blue drone that spits out 150 mosquitoes every 50 meters, skimming over rooftops and between high-rises.

The other group of eggs are packaged into capsules that are only a bit bigger than a vitamin, along with the nutrients they need to mature. These are given out to people in the community, who can drop them in a cup of water and grow dengue-proof mosquitoes on their patios.

The World Mosquito Program released two million Wolbachia-infected mosquitoes over three months in its first target area in Medellín.

Then researchers waited: would they successfully mate with locals? And pass on Wolbachia to their progeny?

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After four weeks of releases, the program began to collect mosquitoes in traps through the neighborhood to check. Back in the lab, they ground the insects up and tested for the presence of Wolbachia RNA. Over the ensuing months, more and more of the samples had it.


A drawing of mosquito’s anatomy on a dry erase board inside the lab.

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Eventually, the program found Wolbachia in about two-thirds of the mosquitoes — enough that it could consider the bacteria established in the trial neighborhood — so staff members fanned out over the entire city, gradually blanketing it in Wolbachia mosquitoes.

A few years ago the project expanded to Cali, where the rates of dengue and chikungunya were surging. In the neighborhood of Siloé, which climbs over a hill above the city, Marlon Victoria, 33, had a case of chikungunya in 2018. He was feverish and aching, unable to get out of bed. “I couldn’t work for two months, and that had a big effect on our family economically,” he said.


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Marlon Victoria and family.




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Marlon Victoria with his family.

So when the researchers came looking for help, Mr. Victoria signed up. He hung boxes of mosquito eggs in the trees, and he reassured skeptics that this would help with the dengue cases that were sending their kids to the hospital. “We explained to people that we were going to be bringing more mosquitoes, but good ones,” he said.

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Did it work? It’s a tricky thing, measuring dengue rates: Outbreaks of the disease typically arrive in cycles of four, five or six years, and the Covid pandemic — during which people stayed away from public transportation, markets and schools, all major transmission sites — also complicates the numbers.

But Colombia’s national dengue monitoring system recorded the lowest dengue rates in Medellín in more than two decades in 2021 — which should have been a peak dengue year.


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Dengue infections in Medellín

A graphic showing recurring peaks in dengue infections, and a missing peak in 2021 after mosquito releases began in 2017.




120 monthly

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dengue cases

per 100,000

Mosquito releases

began August 2017

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2021 was

expected to be

a peak year

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120 monthly dengue cases

per 100,000

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Mosquito releases

began August 2017

2021 was

expected to be

Advertisement

a peak year

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Source: Medellín Health Secretariat and the World Mosquito Program

Eleanor Lutz

Enthusiasts such as Dr. O’Neill say the experience of Colombia, combined with that of Indonesia, should be all the evidence it takes to show that Wolbachia mosquitoes should be released everywhere that has an arbovirus problem. But that is no small proposition.

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It’s not cheap to mass produce mosquitoes, and disperse them all over a city or a country. The Colombian program has a bustling technical operation and a vast staff. It took seven years for the mosquito factory there to be able to produce over a million insects a week. Personnel is the main cost; automatization, like using the drone to manage the releases that Mr. Victoria did by hand, helps streamline the process.


A World Mosquito Program drone taking off from an empty parking lot.

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A World Mosquito Program drone.

The World Mosquito Program estimates it has cost $2 to $3 per person to implement Wolbachia in Medellín. Outside estimates put the cost of a mosquito-control-through-release program at closer to $15 per person. But the program says the project will pay for itself in seven years, in reduced health care costs, in reduced spending on insecticide spraying and other control methods and in regained wages.


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Racks of mosquito eggs and a tray of chilled mosquitoes.




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Mosquito eggs and a tray of chilled mosquitoes at the World Mosquito Program lab.

Will it work everywhere? That’s not clear. The World Mosquito Program mosquitoes didn’t establish themselves in some areas in which they were released in Vietnam; Dr. O’Neill says they don’t know why. It’s also taken longer to establish the insects in different parts of Medellín than in others. The Wolbachia strain being used in Malaysia seems to do better at higher temperatures and could be better suited for some countries.

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Laura Harrington, a professor of entomology at Cornell University who is an expert on mosquito mating (What goes into a successful mosquito hookup?), says her decades of research have found that lab-reared mosquitoes don’t compete as well against wild ones for mates, in any climate zone. “They’re not as sexy,” she says. So while the potential for Wolbachia is exciting, it’s much too soon to put a price tag or a timeline on using it for dengue control, she said, because it’s unclear how many mosquitoes a city program would actually need to release.

Then there is the matter of the evolutionary battle underway inside every infected mosquito: The arboviruses need to spread to survive, so they’re trying to find a way to overcome the ability of Wolbachia to disarm them. Likely, they eventually will, Dr. O’Neill said, but he predicts it won’t be soon.

“It might happen on an evolutionary timescale, maybe decades, maybe more like 10,000 years,” he said. “But I’d be content with a few decades, to allow other technologies to develop, until we have a better tool set.”

If the arboviruses move into other mosquito species, that’s a separate problem. But Wolbachia could move into other species, too: The WolBloc team has had some early success in preventing malaria transmission by mosquitoes infected with Wolbachia. That holds enormous promise for countries such as those in West Africa that have heavy burdens of both arboviruses and malaria.

In Medellin, mosquitoes have shifted from menace to irritant. “You don’t hear people talk much about dengue these days,” Mr. Victoria said. “If people can just forget about it — that would be a tremendous thing.”

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The 12 Best Foundations for Mature Skin That Will Cover + Repair Flaws

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The 12 Best Foundations for Mature Skin That Will Cover + Repair Flaws



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Top 12: Best Foundation for Women Over 50 of 2023 – Woman’s World

































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Ask a doc: ‘What should I know before getting a breast lift?’

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Ask a doc: ‘What should I know before getting a breast lift?’

A growing number of women are opting to reverse gravity by getting a surgical breast-lift procedure.

The prevalence of breast lifts has risen 70% since 2000 — twice the growth of breast implant surgery, according to new statistics from the American Society of Plastic Surgeons.

“A breast lift — or ‘mastopexy’ — is a procedure in which excess skin is removed to tighten the breast envelope,” said New York-based plastic surgeon and breast reconstruction specialist Dr. Constance M. Chen in comments to Fox News Digital. 

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“This also repositions the breast tissue and the nipple-areolar complex higher on the chest wall.”

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Why do women opt for breast lifts?

All women’s breasts change with time and gravity, Chen noted. 

New York-based plastic surgeon and breast reconstruction specialist Dr. Constance M. Chen (shown at left) shares what women should know if they are considering getting a breast lift surgery. (Constance M. Chen/iStock)

“As women get older, it is typical and natural for the skin to lose elasticity and for the breasts to drop,” she said. 

Breastfeeding is the biggest cause of this, she said; but occasionally some women who did not breastfeed may find that their breasts droop over time. 

“Menopause is also a factor, because dense, glandular breast tissue is replaced by fat — and fatty tissue is softer and less firm,” Chen said. 

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”If a woman is unhappy about sagging breasts, the only way to fix it is surgery,” the doctor said. “A well-fitted bra can provide support for a better look in clothes, but exercises to firm the underlying chest muscles won’t impact the breast tissue itself.” 

In most cases, a mastopexy will not change the size of the breasts, even though the result may make the breasts appear fuller and rounder, according to Chen. 

Woman with doctor

The prevalence of breast lifts has risen 70% since 2000 — twice the growth of breast implant surgery, according to new statistics from the American Society of Plastic Surgeons. (iStock)

“In cases where a woman wants larger or smaller breasts, additional procedures such as augmentation or reduction can be done in conjunction with a breast lift,” she said. 

Dr. Brian Reagan of CosmetiCare, who practices in San Diego, California, said many patients come to his practice for lifts after they have children — usually a few months post-breastfeeding.

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“The breasts will change for months after breastfeeding, so we want to wait a minimum of three months,” he told Fox News Digital.

Types of breast lifts

There are several different mastopexy procedures depending on the degree of lift needed, Chen advised.

A “crescent lift” is the least invasive procedure. In this case, a crescent of skin at the top of the nipple-areolar complex is removed to improve the position of the nipple, Chen said. 

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“The crescent lift is called for when the breasts are basically perky, but the woman wants her nipple-areolar complex adjusted upward slightly,” the doctor noted. 

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“In cases where a woman also wants bigger breasts, the crescent lift can be performed in conjunction with breast augmentation.”

Woman in mirror

“As women get older, it is typical and natural for the skin to lose elasticity and for the breasts to drop,” said a New York-based plastic surgeon and breast reconstruction specialist (not pictured).  (iStock)

A “Benelli lift” is also used to provide a small lift for barely drooping breasts. 

“Here, a doughnut-shaped incision is made around the nipple-areolar complex, and the skin is tightened,” Chen said. “While this kind of breast lift is less invasive than a full lift, it can have the side effect of flattening the breast. An implant can be used to improve the projection of the breast.”

A “lollipop lift,” or a short-scar vertical mastopexy, is used when the breast tissue itself needs to be positioned higher on the chest wall, the doctor noted. 

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“The short-scar vertical mastopexy refers to the limited scars around the nipple-areolar complex and then vertically to the fold below the breast, which looks like a lollipop,” Chen said. “In this procedure, more breast skin is removed, and the underlying breast tissue is repositioned to significantly change the breast shape and lift it up.” 

Finally, an “anchor lift” — or the traditional Wise-pattern mastopexy — adds a horizontal scar along the crease below the breast to the same scars of the vertical mastopexy, which allows for reshaping and repositioning of the tissue. 

Woman at doctor's office

Every plastic surgery procedure comes with some degree of risk — and breast lifts are no exception, experts say. (iStock)

“This is an older procedure used by older surgeons not trained in the vertical mastopexy, who are particularly prone to using it when there is significant sagging in large breasts,” Chen noted.

The vertical and the Wise-pattern mastopexies are both full breast lifts that are equally effective in creating a perkier, more youthful result, according to Chen. 

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“The vertical mastopexy is also called the ‘short-scar mastopexy’ because it eliminates the horizontal scar in the inframammary fold,” she said. “It is an improvement on the anchor lift.”

She added, “The full mastopexy is the most commonly performed breast lift, because it is usually the appropriate technique for someone who wants a noticeable change to their breast appearance.”

Risks of breast lifts

Every plastic surgery procedure comes with some degree of risk — and breast lifts are no exception.

Woman with doctor

“The ideal candidate [for a breast lift] is someone who is healthy, has no medical issues and has deflated, droopy breasts,” one expert said.  (iStock)

Reagan said the main risks associated with breast lifts are a decrease in nipple sensation, potential loss of tissue (including the nipple) and poor scarring.

Due to elevated risk, there are certain groups of people who are not good candidates for the procedure, he said.

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He advises against smokers getting a breast lift, for example.

“Actively smoking can cause delayed healing and possible open wounds,” Reagan said. 

He recommends kicking the habit at least six to eight weeks prior to surgery.

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People who have existing medical issues, such as high blood pressure or diabetes, are also not good candidates, the doctor warned.

“The ideal candidate is someone who is healthy, has no medical issues and has deflated, droopy breasts,” he said.

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