Health
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.
Inside the World Mosquito Program lab.
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.
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.
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.
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?
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.
All offspring
carry Wolbachia
All offspring
carry Wolbachia
All offspring
carry Wolbachia
All offspring
carry Wolbachia
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.
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.
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.
Americas
2 U.S. states and
45 countries or territories
Oceania
11 countries
or territories
Americas
2 U.S. states and
45 countries or
territories
Oceania
11 countries
or territories
Americas
2 U.S. states and
45 countries
or territories
Oceania
11 countries
or territories
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.
And Medellín, population three million, is the biggest test to date.
One of the neighborhoods in Medellín, Colombia.
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.
Mosquito pupae in a tray 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?
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.
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.
Marlon Victoria and 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.
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.
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
dengue cases
per 100,000
Mosquito releases
began August 2017
2021 was
expected to be
a peak year
120 monthly dengue cases
per 100,000
Mosquito releases
began August 2017
2021 was
expected to be
a peak year
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.
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.
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.
Racks of mosquito eggs and a tray of chilled mosquitoes.
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.
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.”
Health
Cancer Remission Like Catherine’s Does Not Always Mean the Illness Is Cured
Princess Catherine, wife of Prince William, reported on Tuesday that her cancer was in remission. But what does it mean to be in remission from cancer?
Doctors discovered her cancer unexpectedly last March when she had abdominal surgery. She has not revealed the type of cancer she has, nor how advanced it was when it was discovered.
But she did say she had chemotherapy, which she said had been completed in September. She told the British news agency PA Media that she had a port, a small device that is implanted under the skin and attached to a catheter that goes into a large vein. It allows medicines like chemotherapy drugs to be delivered directly to veins in the chest, avoiding needle sticks.
Catherine told PA Media that chemotherapy was “really tough.”
“It is a relief to now be in remission and I remain focused on recovery,” she wrote on Instagram.
Her announcement “certainly is good news and is reassuring,” said Dr. Kimmie Ng, associate chief of the division of gastrointestinal oncology at the Dana-Farber Cancer Institute in Boston.
But cancer experts like Dr. Ng say that the meaning of remission in a patient can vary.
In general, when doctors and patients talk about remission, they mean there is no evidence of cancer in blood tests or scans.
The problem is that a complete remission does not mean the cancer is gone. Even when a cancer is “cured” — defined as no evidence of cancer for five years — it may not be vanquished.
That makes life emotionally difficult for patients, who have to have frequent visits with oncologists for physical exams, blood tests and imaging.
“It’s really scary,” Dr. Ng said. “The amount of uncertainty is very very hard,” she added.
But that ongoing surveillance is necessary, despite the toll it takes on patients.
“Different cancers have different propensities of returning or not returning,” said Dr. Elena Ratner, a gynecologic oncologist at the Yale Cancer Center.
As many as 75 to 80 percent of ovarian cancers, she noted, can come back in an average of 14 to 16 months after a remission, depending on the stage the cancer had reached when it was found and on the cancer’s biology.
“Once the cancer returns, it becomes a chronic disease,” Dr. Ratner said. She tells her patients: “You will live with this cancer. You will be on and off chemotherapy for the rest of your life.”
Dr. Ratner’s gynecological cancer patients have to come back every three months for CT scans to keep an eye out for evidence that the cancer has returned.
“The women live CT scan to CT scan,” she said. “They say that for two and a half months, they have a wonderful life, but then, in time for the next CT scan, the fear returns.”
“It costs them — it costs them a lot,” she said.
“It’s awful, yet I am amazed every day by their strength,” she said of her patients.
Health
Death Toll in Gaza Likely 40 Percent Higher Than Reported, Researchers Say
Deaths from bombs and other traumatic injuries during the first nine months of the war in Gaza may have been underestimated by more than 40 percent, according to a new analysis published in The Lancet.
The peer-reviewed statistical analysis, led by epidemiologists at the London School of Hygiene and Tropical Medicine, used modeling in an effort to provide an objective third-party estimate of casualties. The United Nations has relied on the figure from the Hamas-led Ministry of Health, which it says has been largely accurate, but which Israel criticizes as inflated.
But the new analysis suggests the Hamas health ministry tally is a significant undercount. The researchers concluded that the death toll from Israel’s aerial bombardment and military ground operation in Gaza between October 2023 and the end of June 2024 was about 64,300, rather than the 37,900 reported by the Palestinian Ministry of Health.
The estimate in the analysis corresponds to 2.9 percent of Gaza’s prewar population having been killed by traumatic injury, or one in 35 inhabitants. The analysis did not account for other war-related casualties such as deaths from malnutrition, water-borne illness or the breakdown of the health system as the conflict progressed.
The study found that 59 percent of the dead were women, children and people over the age of 65. It did not establish what share of the reported dead were combatants.
Mike Spagat, an expert on calculating casualties of war who was not involved in this research, said the new analysis convinced him that Gaza casualties were underestimated.
“This is a good piece of evidence that the real number is higher, probably substantially higher, than the Ministry of Health’s official numbers, higher than I had been thinking over the last few months,” said Dr. Spagat, who is a professor at Royal Holloway College at the University of London.
But the presentation of precise figures, such as a 41 percent underreported mortality, is less useful, he said, since the analysis actually shows the real total could be less than, or substantially more. “Quantitatively, it’s a lot more uncertain than I think comes out in the paper,” Dr. Spagat said.
The researchers said their estimate of 64,260 deaths from traumatic injury has a “confidence interval” between 55,298 and 78,525, which means the actual number of casualties is likely in that range.
If the estimated level of underreporting of deaths through June 2024 is extrapolated out to October 2024, the total Gazan casualty figure in the first year of the war would exceed 70,000.
“There is an importance to war injury deaths, because it speaks to the question of whether the campaign is proportional, whether it is, in fact, the case that sufficient provisions are made to to avoid civilian casualties,” said Francesco Checchi, an epidemiologist with an expertise in conflict and humanitarian crises and a professor at the London School of Hygiene and Tropical Medicine who was an author on the study. “I do think memorializing is important. There is inherent value in just trying to come up with the right number.”
The analysis uses a statistical method called capture-recapture analysis, which has been used to estimate casualties in other conflicts, including civil wars in Colombia and Sudan.
For Gaza, the researchers drew on three lists: The first is a register maintained by the Palestinian Ministry of Health, which mainly comprises the dead in hospital morgues and estimates of the number of unrecovered people buried in rubble. The second is deaths reported by family or community members through an online survey form the ministry established on Jan. 1, 2024, when the prewar death registration system had broken down. It asked Palestinians inside and outside Gaza to provide names, ages, national ID number and location of death for casualties. The third source was obituaries of people who died from injuries that were published on social media, which may not include all of the same biographical details and which the researchers compiled by hand.
The researchers analyzed these sources to look for individuals who appear on multiple lists of those killed. A high level of overlap would have suggested that few deaths were uncounted; the low amount they found suggested the opposite. The researchers used models to calculate the probability of each individual appearing on any of the three lists.
“Models enable us to actually estimate the number of people who have not been listed at all,” Dr. Checchi said. That, combined with the listed number, gave the analysts their total.
Patrick Ball, director of research at the Human Rights Data Analysis Group, and a statistician who has conducted similar estimates of violent deaths in conflicts in other regions, said the study was strong and well reasoned. But he cautioned that the authors may have underestimated the amount of uncertainty caused by the ongoing conflict.
The authors used different variations of mathematical models in their calculations, but Dr. Ball said that rather than presenting a single figure — 64,260 deaths — as the estimate, it may have been more appropriate to present the number of deaths as a range from 47,457 to 88,332 deaths, a span that encompasses all of the estimates produced by modeling the overlap among the three lists.
“It’s really hard to do this kind of thing in the middle of a conflict,” Dr. Ball said. “It takes time, and it takes access. I think you could say the range is larger, and that would be plausible.”
While Gaza had a strong death registration process before the war, it now has only limited function after the destruction of much of the health system. Deaths are uncounted when whole families are killed simultaneously, leaving no one to report, or when an unknown number of people die in the collapse of a large building; Gazans are increasingly buried near their homes without passing through a morgue, Dr. Checchi said.
The authors of the study acknowledged that some of those assumed dead may in fact be missing, most likely taken as prisoners in Israel.
Roni Caryn Rabin and Lauren Leatherby contributed reporting.
Health
Dementia risk for people 55 and older has doubled, new study finds
Dementia cases in the U.S. are expected to double by 2060, with an estimated one million people diagnosed per year, according to a new study led by Johns Hopkins University and other institutions.
Researchers found that Americans’ risk of developing dementia after age 55 is 42%, double the risk that has been identified in prior studies, a press release stated.
For those who reach 75 years of age, the lifetime risk exceeds 50%, the study found.
AGING ‘HOTSPOT’ FOUND IN BRAIN, RESEARCHERS SAY: ‘MAJOR CHANGES’
Women face a 48% average risk and men have a 35% risk, with the discrepancy attributed to women living longer than men.
The study, which was published in the journal Nature Medicine on Jan. 13, analyzed data from the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS), which has tracked the cognitive and vascular health of nearly 16,000 adults since 1987.
DEEP SLEEP CAN KEEP TWO BIG HEALTH PROBLEMS AT BAY, NEW STUDIES SUGGEST
“Our study results forecast a dramatic rise in the burden from dementia in the United States over the coming decades, with one in two Americans expected to experience cognitive difficulties after age 55,” said study senior investigator and epidemiologist Josef Coresh, MD, PhD, who serves as the founding director of the Optimal Aging Institute at NYU Langone, in the release.
Understanding risk factors
“One of the main reasons for the increase is that great medicine and tecnological advances are keeping us alive longer and age is a risk factor for dementia,” Dr. Marc Siegel, clinical professor of medicine at NYU Langone Health and Fox News senior medical analyst, told Fox News Digital.
“Obesity is associated with inflammation, diabetes and high blood pressure, which are all independent risk factors for dementia.”
In addition to aging, other risk factors include genetics, obesity, hypertension, diabetes, unhealthy diets of ultraprocessed foods, sedentary lifestyles and mental health disorders, the release said.
“We have an obesity epidemic with over 45% adults obese in the U.S.,” Siegel noted. “Obesity is associated with inflammation, diabetes and high blood pressure, which are all independent risk factors for dementia.”
“And as an unhealthy population, we also have more heart disease, and atrial fibrillation is a risk factor for cognitive decline,” he added.
Dementia risk was found to be higher among people who have a variant of the APOE4 gene, which has been linked to late-onset Alzheimer’s disease. Black adults also have a higher risk.
Research has shown that the same interventions used to prevent heart disease risk could also prevent or slow down dementia, the study suggested.
“The pending population boom in dementia cases poses significant challenges for health policymakers in particular, who must refocus their efforts on strategies to minimize the severity of dementia cases, as well as plans to provide more health care services for those with dementia,” said Coresh.
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What needs to change?
Professor Adrian Owen, PhD, neuroscientist and chief scientific officer at Creyos, a Canada-based company that specializes in cognitive assessment and brain health, referred to the increase in dementia cases as a “tidal wave.”
“This new study’s anticipated surge in dementia cases underscores the urgent need for early and accurate detection,” he told Fox News Digital.
“By catching issues early, we give people the power to make lifestyle adjustments, seek available treatments and plan their futures with clarity.”
“By identifying cognitive decline at its earliest stages, we have an opportunity to intervene before patients and families bear the full weight of the disease.”
Owen recommends conducting regular cognitive assessments as part of routine check-ups to proactively identify early signs of cognitive decline.
“By catching issues early, we give people the power to make lifestyle adjustments, seek available treatments and plan their futures with clarity,” he said.
Maria C. Carrillo, PhD, chief science officer and medical affairs lead for the Alzheimer’s Association in Chicago, said there is an “urgent need” to address the global crisis of Alzheimer’s disease and dementia.
To help keep the aging brain healthy, the Alzheimer’s Association published its report 10 Healthy Habits for Your Brain. Some of the tips are listed below.
For more Health articles, visit www.foxnews.com/health
– Participate in regular physical activity.
– Learn new things throughout your life and engage your brain.
– Get proper nutrition — prioritize vegetables and leaner meats/proteins, along with foods that are less processed and lower in fat.
– Avoid head injury (protect your head).
– Have a healthy heart and cardiovascular system — control blood pressure, avoid diabetes or treat it if you have it, manage your weight and don’t smoke.
The research was funded by the National Institutes of Health.
Fox News Digital reached out to the researchers for additional comment.
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