Published23 minutes agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy Fergus WalshMedical editor A 10-minute MRI scan could be used to screen men for prostate cancer, according to a new study.The scans proved far more accurate at diagnosing cancer than blood tests, which look for high levels of a protein called PSA.MRI picked up some serious cancers that would have been missed by PSA alone.At present there is no national screening programme because PSA is considered too unreliable, although men over 50 can request a PSA test. What is prostate cancer?Part of the male reproductive system, the prostate gland, about the size of a walnut, is in the pelvis, below the bladderIt surrounds the urethra – the tube that takes urine out of the body through the penisCancer is abnormal and uncontrolled cell growthBut in the prostate, it usually develops slowlyThere may be no signs or symptoms for yearsAnd some never develop any problems from itBut in others, the cancer can be aggressive and deadlyEarly diagnosis and treatment is keyFor the Reimagine study, which is published in BMJ Oncology, men aged 50 to 75 in London were invited for screening MRI and PSA tests, which were carried out at University College Hospital.Of the 303 who had both tests, 48 had a positive MRI that indicated cancer and of these 25 were diagnosed with significant cancer after further tests, including biopsies. More than half the men whose cancer was picked up on MRI had low PSA test scores below 3ng/ml, which is considered normal, and so would have been falsely reassured they were free of disease.Prof Caroline Moore, consultant urologist UCLH and chief investigator of the study at University College London, said: “Our results give an early indication that MRI could offer a more reliable method of detecting potentially serious cancers early, with the added benefit that less than 1% of participants were ‘over-diagnosed’ with low-risk disease.” Image source, UCLHPaul Rothwell, 62, had his prostate cancer diagnosed as a result of being on the trial. It was caught early and he was successfully treated. He feels fortunate because his PSA test was negative and so would have given false reassurance had it not been for his MRI. Paul, from Hertfordshire, told the BBC: “If I’d just had the blood test I would be carrying on life as normal walking around unaware that there was some sort of ticking time bomb inside me of a cancer slowly growing, and by the time I did find out, presumably it would have been much harder to treat and much more dangerous to me.”PSA tests are considered useful but unreliable indicators of prostate cancer. High levels, which can indicate cancer, can also be caused by a recent infection or vigorous exercise and sex. This can lead to overdiagnosis of cancer and, as the trial showed, a low PSA score might miss cancer. The authors of the study suggest that prostate MRI could be used for screening, though they say a larger study would be needed to assess this. For the trial, black men were five times less likely to come forward for screening than white men, even though they have a higher risk of prostate cancer. Saran Green, another study author from King’s College London, said: “One in four black men will get prostate cancer during their lifetime, which is double the number of men from other ethnicities. Given this elevated risk, it will be crucial that any national screening programme includes strategies to reach black men and encourage more of them to come forward for testing.”Errol McKellar, 66, from Essex, was diagnosed with prostate cancer 13 years ago. After successful treatment he returned to work as a car mechanic and began offering customers a discount if they got their, or their partner’s, prostate checked.He now runs a charity, the Errol McKellar Foundation, which aims to raise awareness of prostate cancer and to ensure more men come forward for testing.He told the BBC: “When they brought their car in I’d ask men, ‘When was the last time you had a service and MOT on yourself?’.”There’s a massive mistrust of the medical system among the African-Caribbean community, and that has to be dealt with. But also there’s two elements that we find that come up very often: one is fear, and the other one is ignorance.”When prostate cancer turns up at your front door, it doesn’t care whether you’re black, whether you’re white – if you ignore it, it will kill you. In the end this is about all men, and leaving no-one behind.”Prof Mark Emberton, senior author of the study, said a screening programme could be up and running within the next decade: “The UK prostate cancer mortality rate is twice as high as in countries like the US or Spain because our levels of testing are much lower. Given how treatable prostate cancer is when caught early, I’m confident that a national screening programme will reduce the UK’s prostate cancer mortality rate significantly.”Simon Grieveson, assistant director of research at Prostate Cancer UK, said: “When a man’s prostate cancer is caught early, it’s very treatable. Sadly, more than 10,000 men each year are diagnosed too late, when their cancer has already spread. “MRI scans have revolutionised the way we diagnose prostate cancer, and it’s great to see research into how we might use these scans even more effectively. These results are extremely exciting, and we now want to see much larger, UK-wide studies to understand if using MRI as the first step in getting tested could form the basis of a national screening programme.”What symptoms should people check for?The common ones are:needing to urinate more frequently – particularly at nightdifficulty starting to urinate, weak flow and it taking a long timeblood in urine or semenThese symptoms can be caused by other conditions too – but it is important to have any changes checked by a doctor.More on this storyMen left embarrassed by urinary incontinence tabooPublished1 day agoBBC presenter Nick Owen reveals cancer diagnosisPublished7 AugustYearly prostate tests advisable for some menPublished20 October 2021Prostate screening could be ready in five yearsPublished27 December 2021Turnbull saved lives, says prostate cancer charityPublished2 September 2022Cancer patient urges men to get prostate testedPublished14 JuneRelated Internet LinksBMJ OncologyUniversity College London Hospitals NHS Foundation TrustThe BBC is not responsible for the content of external sites.

Published7 hours agoShareclose panelShare pageCopy linkAbout sharingBy Fergus WalshMedical editor The world’s biggest human imaging project is set to rescan the brains and bodies of 60,000 UK volunteers to find new ways of treating and preventing disease. By looking at how bodies age, the study could help predict those more likely to develop dementia or different cancers. The study has already led to a genetic test for people born with an increased risk of coronary heart disease.I was the first volunteer to be scanned nine years ago, and am back for more.Everything from my brain, to my heart, eyes and bone density will be analysed for a second time.Like me, all the volunteers are part of UK Biobank, and researchers in more than 90 countries are using the database for health-related studies.Having two sets of highly-detailed MRI and bone density images for thousands of people, taken several years apart, could open up huge new possibilities for spotting and preventing illnesses like dementia, cancer and heart disease.Chief scientist Prof Naomi Allen told the BBC: “Researchers will be able to look at changes in our organs as we get older that will help to develop biomarkers of disease, perhaps many years before a clinical diagnosis and symptoms.”There will also be many other potential insights from the research.It could also unearth who will respond best to treatments, and why some people seem to be so much more resilient to certain ailments than others, Prof Paul Matthews, head of UK Dementia Research at Imperial College London and chair of the Imaging Working Group for UK Biobank, told me.What is UK Biobank?First launched in 2006, UK Biobank set out to be the most comprehensive study of the nation’s health. It enrolled half a million adults – including me – to undergo medical checks, answer health and lifestyle questions and donate genetic samples, to be stored and studied for decades.All participants have had their genome – their entire DNA – sequenced. The imaging part of the project was started in 2014, and involves detailed scans of the brain, and the rest of the body. All the data gathered is anonymised and there is usually no feedback to participants. So what is in it for them, and me? Marian Keeling, 67, summed it up like this: “There’s a measure of altruism, and it’s a bit like being a blood donor, you do it for your fellow man.” Fellow volunteer Mary Wilson, 81, made a similar point: “It’s going to help future generations and help the health service. The longer you can stay healthy, the better it is.”Other biomedical databases exist, but they are either smaller, or have not been going as long as UK Biobank. It is already starting to help inform medicine. More than 7,000 peer-reviewed papers have been published, nearly a third of those last year alone, showing how its scientific value is increasing over time. In 2018, researchers devised a genetic test to detect people born with an increased risk of coronary heart disease by analysing genomic data from UK Biobank. “If you combine all your genetic variation across your genome, each variation has a small effect but, taken together, some individuals have quite a large genetic risk of developing heart disease or developing different types of cancers that we simply didn’t know beforehand,” said Prof Allen.Prof Paul Elliott, epidemiologist at the School of Public Health, Imperial College London, said the huge store of volunteers’ scans would improve understanding of how our genes and environment affect our risk of disease.”It builds on the ability of the NHS to follow people up through their health records, with consent, and is a pre-eminent example of the benefits of publicly-funded research,” he said.He said UK Biobank had become the “gold standard” internationally for this type of study. The imaging project is funded by the Medical Research Council, Wellcome Trust, British Heart Foundation and Dementias Platform UK.More on this storyScans aim to reveal Covid health legacyPublished11 March 2021Genetic test to detect heart attack riskPublished8 October 2018Related Internet LinksUK BiobankThe BBC is not responsible for the content of external sites.

Published22 minutes agoShareclose panelShare pageCopy linkAbout sharingBy Fergus WalshMedical editor A blood test which can detect traces of cancer cells could spare thousands of patients unnecessary chemotherapy every year.A major bowel cancer trial is examining whether the test can show if surgery has removed all of the tumour.Doctors say half of patients with stage 3 bowel cancer are cured by surgery alone so by using chemotherapy they are over-treating many people. About 1,600 bowel cancer patients are being recruited to the UK study.Ben Cooke runs a hair salon on the King’s Road in Chelsea, London, and also works as a stylist for fashion shoots. In early March last year, he noticed some dark blood in his poo. He rang NHS 111 and was sent to A&E. He was diagnosed with stage 3 bowel cancer, which was successfully treated with surgery. The gold standard treatment is to then have intravenous chemotherapy to mop up any remaining tumour cells and reduce the risk of the cancer returning. But the chemotherapy used in bowel cancer, oxaliplatin, can cause painful tingling and numbness in the hands and feet, called peripheral neuropathy.This nerve damage can be long-term, and Ben was worried it might affect his ability to do the job he loves. “I would not be able to cope with that,” he says. “I need to work – it’s my therapy.”The 52-year-old enrolled in a study at London’s Royal Marsden Hospital, which is evaluating whether a blood test can show if chemo is really needed. His test showed he was clear of cancer, so he avoided intravenous chemotherapy.Instead, like everyone taking part in the trial, he took an oral chemo tablet twice a day. This had minimal side effects and allowed him to carry on working. “The fact that I didn’t have any tingling in my hands has just been an absolute blessing,” he says.The blood tests work by looking for microscopic traces of cancer in the bloodstream called circulating tumour DNA. The presence of these markers indicates whether the patient has been cured by their surgery or not. Such tiny fragments would be invisible on a scan. Ben’s consultant at the Marsden, Dr Naureen Starling, is the principal investigator on the trial. She says the outcome could affect the way thousands of bowel cancer patients are treated every year.”Half of patients with stage 3 bowel cancer are cured by surgery alone, so we are over-treating a large proportion of patients,” she says.The hope is that this specialised technology could spare many cancer patients unnecessary chemotherapy.”That’s good for the patient, it’s good for the health service, it’s good for cost savings within the NHS. That would be a win-win,” says Dr Starling.The trial, called TRACC, is using a test created by US company Guardant Health. The samples are sent to their labs in California for analysis with the results coming back within around two weeks. Survival outcomesThe trial will examine any difference in survival rates after three years between those patients whose treatment was guided by the blood test compared with the standard-of-care chemotherapy group.Trials are also under way in the UK to monitor patients with lung and breast cancer in the same way.Dr Starling says the potential for this new technology across cancer care is “immense”, not just when it comes to detecting residual disease after surgery, but also for early diagnosis.What is clear already, from multiple studies, is that so-called “liquid biopsy” blood tests can reveal the lingering presence of cancer long before it would be found using traditional methods. A trial in Greece published in Nature in January, found that liquid biopsies could show cancer recurrence at least four years before it would be detectable via a scan. That study followed a small group of breast cancer patients after surgery.At the American Society of Clinical Oncology conference in Chicago last June, a study in 455 bowel cancer patients found that by using the blood tests to guide treatment, the number of patients needing post-surgery chemotherapy was nearly halved without the risk of relapse.But Dr Starling says the far bigger randomised trial in the UK is essential to calibrate exactly how much reliance can be placed on liquid biopsies, especially when it means considering the withdrawal of chemotherapy.The tests have already been available to private patients. Susanne Winter, an artist from Surrey, was diagnosed with stage 3 bowel cancer in March 2022 and had successful surgery to remove the tumour and some cancerous lymph nodes. She initially thought she would need chemotherapy to ensure the cancer was entirely gone, but she had the ctDNA test done privately which showed she was clear of cancer.Susanne, 58, had cancelled all her commitments to prepare for several months of chemotherapy, but the negative test result meant she was free to concentrate on her art. She even had two works accepted for the Royal Academy summer exhibition.She feels incredibly lucky to have avoided chemotherapy. “I knew how toxic it can be. You’re psyching yourself up for it, so to hear that you aren’t going to need it is just unbelievable,” she says.What is considered the holy grail of cancer detection is to be able to spot the disease at the very earliest stage, when it is most easy to cure.Blood tests are also being trialled to see if they can diagnose a whole range of cancers.More than 140,000 volunteers aged 50-77 have been recruited across England to see if the test could pick up more than 50 types of tumours, most of which have no screening programmes. The NHS-Galleri trial is made by Californian company Grail, and some interim results are due early next year.

Published8 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, Shaw familyBy Fergus WalshMedical editor A toddler with a rare inherited condition has become the first child to be treated by the NHS with a new life-saving gene therapy.Teddi Shaw was diagnosed in time because her older sister Nala showed symptoms – but it was too late to treat Nala, who is now terminally ill. Both girls have MLD, which severely damages the brain and nervous system.The one-off treatment costs £2.875m and is the most expensive medicine ever approved for the NHS.The BBC was given exclusive access to follow Teddi’s treatment over several months and spoke to other families affected by MLD.Imagine having two daughters with a devastating genetic condition – but only one can be saved. Three-year-old Nala – and Teddi, who is 19 months old – both have MLD, metachromatic leukodystrophy. Children with this fatal genetic disease are born apparently healthy, but MLD gradually attacks the brain and body. Before Nala became ill, she was a completely normal toddler. “She was always singing, dancing and spinning around everywhere, always laughing – just a cheeky little girl,” says her dad, Jake. This video can not be playedTo play this video you need to enable JavaScript in your browser.But just over a year ago, Nala’s walking gradually became uneven and she started falling over more often. She was also showing signs of a tremor.Her parents Ally, 32, and Jake, 29, became increasingly concerned. Ally was convinced Nala had a brain tumour. Initially, doctors reassured them nothing was wrong. But then, in April last year, Jake and Ally took Nala to A&E where she had an MRI scan. Forty-five minutes later they had a likely diagnosis. “When the doctor said ‘It’s not a brain tumour,’ I was doing cartwheels almost, so excited,” Ally says. But her relief evaporated when the doctor mentioned metachromatic leukodystrophy – which they had never heard of before. When she left the room, Jake Googled the term. “I could tell by his face it wasn’t good news,” says Ally. MLD is caused by a faulty gene which means children affected cannot produce an important enzyme called ARSA – a protein that helps the body’s metabolism work. As a result, fatty chemicals called sulfatides build up. These gradually destroy the protective layer around cells in the brain and nervous system, leading to a devastating deterioration. Children lose the ability to walk, talk or eat – and eventually to see or hear.Because both Ally and Jake are carriers of the faulty gene, they were told Nala’s younger sister Teddi had a one-in-four chance of also having MLD.”I thought to myself, it can’t happen again, we can’t be that unlucky,” says Jake. “When we found out, it was just heart-breaking.”Bittersweet MedicineA cutting-edge treatment turning a terminal diagnosis into hope for a healthy life.Watch now on BBC iPlayer(UK Only)But for 10-month-old Teddi, there was hope. The disease had not yet affected her and so she became the first patient treated on the NHS with a new life-saving gene therapy, called Libmeldy, which must be given before the disease has caused irreparable damage.Nala’s MLD was identified too late for her to be treated. She is already unable to walk or talk, and has to be tube-fed. “When they told us there was treatment available for Teddi it was kind of a bitter pill to swallow because Nala can’t be helped,” says Ally. She says they are sad and “extremely grateful” at the same time. “I’ve always said Nala saved Teddi’s life. And that’s how I wanted to think about it,” says Jake. Libmeldy involves altering a patient’s own cells to correct the faulty gene. In June 2022, Teddi was hooked up to a machine at Royal Manchester Children’s Hospital where blood was removed and filtered, so a single bag of stem cells could be collected. The process looks similar to dialysis.The cells were then sent to Milan, where scientists used a harmless virus to insert a working version of Teddi’s faulty gene – the one which should produce her missing enzyme – back into the stem cells. The gene-corrected stem cells were then sent to Manchester to be infused back into Teddi. Teddi and her mum moved into hospital for the duration of the treatment while Jake, a carpenter, was home in Northumberland looking after Nala. Before she could be given the replacement cells, Teddi had to have chemotherapy to kill off the remaining faulty stem cells in her bone marrow. In August, we were back in Manchester to watch Teddi receive Libmeldy.In her hospital room, Teddi, then 14 months old, had chosen that day to attempt her first tentative steps. Mum Ally said her younger daughter was taking it all in her stride. “She’s doing absolutely fine, considering what she’s been through,” Ally told us. “She’s still just her mischievous normal little self.”The infusion of Libmeldy took less than an hour. Over the following days the gene-altered cells migrated to Teddi’s bone marrow and began producing the enzyme she had been missing since birth.What is remarkable is that this is a one-off treatment, with the hope that it provides a permanent fix for MLD.Libmeldy was developed by a British company, Orchard Therapeutics. Its CEO and co-founder, Bobby Gaspar, spent many years as a consultant at Great Ormond Street Hospital, while carrying out research into potential therapies.”Bringing a new medicine to the world that can potentially cure these devastating diseases is incredibly rewarding,” he says, adding that it was “a very long journey to develop a medicine like this”.Libmeldy took nearly 20 years to develop, with the first human trials taking place in 2010. It got EU approval in December 2020 and is now available through the NHS. Doctors who specialise in treating MLD say Libmeldy is a game-changer. “This truly is a breakthrough,” says Prof Simon Jones, one of the consultants involved in Teddi’s treatment. “We have had almost nothing to offer families with this condition for decades. Instead of many years of terrible neurodegenerative disease, we have the potential for a full life, lived healthily.”Now that there is a treatment, it has become even more important to pick up the disease in time. Teddi’s parents, along with other MLD families and the doctors who treat them, are campaigning to have it screened for at birth. In the UK, babies are given a heel-prick blood test which screens for nine genetic conditions, such as cystic fibrosis – but it does not currently include MLD.”We are letting our children down by not screening for these devastating conditions because they are so preventable if you can identify them at birth,” says Dr Gaspar.Is Libmeldy a cure? It is too early to tell, but the signs are good. Several children from the UK were involved in clinical trials of Libmeldy in Milan, before it became a licensed treatment.Joe Elson, who is 12, had his gene therapy in Italy in 2014. Nine years on, he is completely healthy and doing well at school. Watching Joe fly his kite on a beach in Kent, it is hard to imagine that he was born with a devastating disease. It appears that Libmeldy has provided a permanent fix for his MLD. “It’s given him his life back. He makes the most of every moment,” says his mum, Nicola. Joe’s MLD was only picked up when his older sister Connie was diagnosed. She died last summer. Nicola told us 13-year-old Connie had lost the ability to walk, talk, eat and hold her head up. She had also lost her vision and hearing, and the ability to smile. “It’s the most horrific, wicked condition that steals these children away,” she says. Image source, Elson familyIt’s expected that only about seven or eight children a year in the UK will be eligible for Libmeldy. That is because MLD is rare and usually not diagnosed early enough.The health assessment body NICE says Libmeldy is one of the most clinically effective medicines it has ever appraised. And, although it has a list price of £2.875m, NHS England has negotiated a confidential discount. One reason why the price tag is so high is to cover the costs of developing and producing the drug. The price paid by the NHS for this one-off treatment has to be set against the cost of treating children with MLD as they gradually become completely dependent, tube-fed and lose all their senses. And then, there is the suffering endured by patients and their families. The NHS chief executive Amanda Pritchard describes Libmeldy as a revolutionary treatment offering “a huge moment of hope” for parents and children affected by MLD.”It means that children like Teddi can do the things that all children should be able to, like going to school and playing with friends,” she says.Back home in Northumberland, Teddi is going from strength to strength.But seeing her together with her older sister Nala brings home the harsh reality facing Jake and Ally. It is “an absolute blessing”, says Jake, that Teddi has received Libmeldy, but “absolutely heartbreaking” to watch Nala’s rapid decline.”Her body is basically kind of gradually shutting down and she will lose most of her senses. So it will come to a point where there’s nothing left for her to lose,” Jake says.”You feel like you’re grieving from the very start because your child is disappearing almost in front of your eyes,” says Ally. The Shaws know that if Nala had been diagnosed earlier she might have been treated, rather than facing a terminal illness.Jake, who plays guitar, has recorded a song for his daughter entitled “Lay You Down Easy”, which he hopes will raise awareness of the disease, with any money raised going to the MLD Support Association. Although MLD is not currently screened for at birth in the UK, small pilot studies to screen newborns have begun in five countries – including Germany, where testing has identified the first patient with the condition.Later this year, Genomics England will start a pilot project offering whole genome sequencing to 100,000 newborns. This will screen for about 200 treatable conditions, and may include MLD. Could other rare diseases be treated this way?The simple answer is yes. Royal Manchester Children’s Hospital is trialling two other gene therapies for rare disorders, Sanfilippo and Hunter syndromes. The director of the Paediatric Bone Marrow Transplant Programme, Prof Rob Wynn, says many of his young transplant patients have genetic diseases, and he thinks the approach of correcting the conditions using gene-modified stem cells will be “transformative”.Nala’s parents say it would be a fitting testament to her if newborn screening for MLD became the norm. “I would like to think that if another child was born with MLD, it could be picked up quick enough for them to be saved,” says Ally.Additional reporting by Nicki StiastnyFollow Fergus on TwitterMore on this storyGene ‘revolution’ in sick children diagnosis10 June 2019’Most expensive drug ever’ recommended for NHS use4 February 2022

Published14 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy Fergus WalshMedical editor A new Covid sub-variant is causing some concern in the US, where it is spreading rapidly. Some cases have been recorded in the UK, so what do you need to know about XBB.1.5?What is XBB.1.5?It is yet another offshoot of the globally dominant Omicron Covid variant, which itself followed the earlier alpha, beta, gamma and delta variants. Omicron has outperformed all previous versions of coronavirus since it emerged in late 2021, and has given rise to many sub-variants which are even more contagious than the original. Symptoms of XBB.1.5 are thought to be similar to those of previous Omicron strains, but it’s still too early to confirm this. Most people experience cold-like symptoms. Is XBB.1.5 more infectious or dangerous than earlier variants?XBB.1.5 itself evolved from XBB, which began circulating in the UK in September 2022, but which has not been classified as a so-called “variant of concern” by health authorities. XBB had a mutation that helped it beat the body’s immune defences, but this same quality also reduced its ability to infect human cells. Prof Wendy Barclay from Imperial College London said XBB.1.5 had a mutation known as F486P, which restores this ability to bind to cells while continuing to evade immunity. That makes it spread more easily. She said these evolutionary changes were like “stepping stones”, as the virus evolves to find new ways of bypassing the body’s self-defence mechanisms.Scientists from the World Health Organization (WHO) confirmed on Wednesday that XBB.1.5 has a “growth advantage” above all other sub-variants seen so far.But they said there was no indication it was more serious or harmful than previous Omicron variants. The WHO said it would keep a close watch on lab studies, hospital data and infection rates to find out more about its impact on patients.Who can get a Covid booster this winter? Where is XBB.1.5 spreading?Over 40% of Covid cases in the United States are estimated to be caused by XBB.1.5, making it the dominant strain in the country.At the beginning of December, it accounted for only 4% of cases so it has quickly overtaken other versions of Omicron. Covid hospital admissions have been rising in recent weeks across the US. US brings back free at-home Covid testsThe UK Health Security Agency is due to release a report on variants spreading in the UK next week, and may refer to XBB.1.5. Could the XBB.1.5 variant take off in the UK?Nothing is certain, but it does look likely. The UK had five Omicron waves in 2022, and further spikes in cases are inevitable. Figures for the week to Saturday 17 December from the Sanger Institute in Cambridge suggested that one in 25 Covid cases in the UK were XBB.1.5. But that was based on just nine samples, so we’ll need to wait for a week or two to get a better picture of how it is spreading. Prof Barclay said she expected more hospitalisations in the UK if the variant takes off here, “as we expect it to do”. Prof Paul Hunter from the University of East Anglia, said: “The balance of probabilities is that XBB.1.5 will trigger a wave here later this month, but we can’t be sure.” NHS England has said the fears of a “twindemic” of Covid and flu have been realised, with both viruses putting strain on an already stretched NHS. Covid putting massive pressure on NHS – BarclayImage source, Getty ImagesAre scientists worried about XBB.1.5?Prof Barclay said she was not especially concerned about the general UK population because there was “no indication” that XBB.1.5 would “breakthrough” the protection against severe illness provided by vaccines. But she is worried about its effect on the vulnerable, including the immunocompromised, who get less benefit from Covid jabs. Prof Hunter said he’d seen no evidence that XBB.1.5 was more virulent, meaning it was no more likely to “put you in hospital or kill you” than existing Omicron variants. He added: “It’s ironic that everyone is focussing on possible variants emerging from China, but XBB.1.5 came out of the US.” Prof David Heymann from the London School of Hygiene and Tropical Medicine acknowledged that there was still a fair amount to learn about this latest variant. But he said it was unlikely to cause major problems in countries like the UK which have high levels of vaccination and previous infections. His concern was for countries like China, where there was both low take-up of vaccines and little natural immunity because of prolonged lockdowns. “China needs to share clinical information on people infected in order to see how the variant behaves in a non-immune population,” Prof Heymann said. How is China trying to beat its latest Covid surge?Related Internet LinksTracking SARS-CoV-2 variantsLineages (raw) – COVID-19 Genomic Surveillance – Wellcome Sanger InstituteThe BBC is not responsible for the content of external sites.

Published9 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, AFP via Getty ImagesBy Fergus WalshMedical editorWhen a country of 1.4 billion people suddenly ended its zero-Covid policy after nearly three years, there was little doubt what would happen. Poor immunisation levels and little natural immunity meant an explosion of cases – just as China is about to lift restrictions on its citizens travelling abroad. So now, some countries – wary of an influx of cases – are imposing Covid testing, and possible quarantine, on visitors from China.The Covid wave hitting China is not due to some radical new variant, but Omicron in its different forms. BF.7 and BQ.1 are both sub-lineages of BA.5, which itself is part of the Omicron “family” – more contagious, more infectious than any previous Covid strain. But these Omicron sub-variants have all been widely detected outside China – including in the UK. Omicron has been the dominant global variant for more than a year, but that does not exclude the possibility that a new variant of concern will emerge in future. A key reason that many countries are imposing Covid checks on travellers from China is the lack of surveillance data coming out of the country. The more Covid that is circulating, the more chance there is for the virus to mutate. But new variants can pop up anywhere – the UK, Brazil, South Africa and India have all been the likely origins of previous variants of concern.So will the new Covid test restrictions make any difference?Several countries are asking travellers from China to produce a negative Covid test in order to gain entry. The US said this would “slow the spread” of the virus, while scientists worked to identify any potential variants that may emerge. But no-one is suggesting that this will stop Covid cases coming in. Italy has gone further, and is imposing mandatory post-arrival PCR tests on travellers from China. Those that test positive will need to quarantine for several days. This has the advantage of enabling genomic sequencing of the virus, and so aids the search for new variants. But it will also add to airport congestion. Italy’s Prime Minister Giorgia Meloni said that those travellers from China who have tested positive so far are carriers of “Omicron variants already present in Italy”. Italy wants an EU-wide approach on the issue – but the EU’s disease agency says, for many reasons, that is “unjustified”.In the UK, there is plenty of Covid about. Probably well over a million people a week are getting infected, either at work, home or socialising – in other words anywhere people gather. The latest ONS survey estimated that around 1 in 45 people had the virus earlier this month.But most of the UK population is very well protected from severe illness, via a combination of vaccines and repeated natural infection.That means Covid – while still a potential danger here – is no longer the threat it once was. More on Covid in ChinaThis video can not be playedTo play this video you need to enable JavaScript in your browser.How many Covid cases are there in China?’Everyone I know is getting a fever’ – Covid hits China More on this storyHow many Covid cases are there in China?19 hours agoUS demands Covid tests for visitors from China19 hours ago

Published6 hours agoShareclose panelShare pageCopy linkAbout sharingBy Fergus WalshMedical editor The entire DNA of 100,000 newborns in England is to be sequenced as part of a research project to improve the diagnosis and treatment of rare genetic conditions. It will be the first time that whole genome sequencing (WGS) has been offered to healthy babies in the NHS.The Newborn Genomes Programme will screen for around 200 disorders, all of them treatable. It is thought to be the biggest study of its kind in the world. The project, which will begin next year, will be led by Genomics England, in partnership with the NHS. If successful, it could be rolled out across the country. Currently, a heel prick blood test offered to newborns screens for nine rare conditions, including cystic fibrosis and sickle cell disease.Dr Rich Scott, Chief Medical Officer for Genomics England, said: “Our goal is… to do more for the thousands of children born every year in the UK with a treatable genetic condition. “We want to be able to offer speedy diagnosis, quicker access to treatment, and better outcomes and quality of life.”What is your genome? It is the blueprint for how our bodies function, written in chemical code called DNAThe segments of DNA are called genesEvery person’s genome contains many errors or mutationsMost errors are of no consequence, but some can trigger diseaseSource: NHS EnglandThere are at least 7,000 single gene disorders, most of which develop during early childhood.Every year, several thousand children in the UK are affected by rare genetic diseases, but families often endure years of tests and uncertainty before they receive a diagnosis.Whole genome sequencing could speed up the process.The NHS in England recently announced that it would offer genome sequencing of all seriously ill children suspected of having a genetic disorder.The Newborn Genomes Programme goes much further, as it will offer the test at birth to healthy infants. It can take months, or even years, for children to display symptoms of some conditions, by which time avoidable damage may have been done.Diagnostic odysseyOwen, 9, has an extremely rare genetic condition which affects his growth and development. Called THRA-related congenital hypothyroidism, it is one of the disorders which will be included in the new genetic test.Owen’s parents, Sarah and Rob Everitt, from West Yorkshire, noticed something was wrong around his first birthday, because he was not crawling or sitting up. But their concerns were repeatedly dismissed by doctors, and it took until Owen was four and a half to be given a diagnosis.Rob Everitt told the BBC: “I think of all the hours we spent in hospital waiting rooms, getting referred around different departments, all the tests – some of which were quite invasive – that drew a blank every time. I lost count of how many doctors and consultants we went to see and how many tests they did on him.”This diagnostic odyssey – often lasting years – is typical for many families of children with a rare genetic disorder.Eventually, Owen’s entire genome was sequenced, which pinpointed his condition. He was only the sixth person in the UK, and the 30th in the world, to be diagnosed with the gene disorder – which is not inherited, but due to a spontaneous mutation in his DNA. Sarah Everitt says getting the diagnosis was life-changing: “It was like winning the lottery….because we knew there was a treatment pathway; we knew we could get him support and he could attend a mainstream school.”Sarah says daily medication has ‘revolutionised’ Owen’s life: “He used not to have any energy to walk or talk and would just fall asleep during the middle of day. Now he’s full of energy and I can’t keep up with him!”Sarah says she would strongly encourage parents of newborns to take up the offer of whole genome sequencing once the project gets under way next year: “It’s going to change the face of medicine….being able to treat all these unknown medical conditions, or at least to have them explained.”Genomics England estimate that the project will identify hundreds of children with genetic disorders that would otherwise have been missed by current newborn screening. Rob says if Owen’s genome had been sequenced at birth it would have made a dramatic difference: “It would have done away with a lot of the stress and uncertainty, because for several years the doctors couldn’t tell us what to expect – whether Owen was going to walk or talk, or whether his condition would get worse.”EthicsThe list of genetic conditions which will be included in the new screening programme has yet to be finalised, but each of them will have a treatment which could alleviate the disorder.Whole genome sequencing may also identify conditions that occur only later in life, such as some cancers.Around 1 in every 400 people inherit a faulty BRCA1 or BRCA2 gene which can increase the risk of cancer of the breast, ovary, prostate and pancreas. Although whole genome sequencing would identify such mutations, they will not be the focus of the Newborn Genomes Programme.Instead, the data will be anonymised and stored until participants are adults and they can decide whether they want to stay in the study.Having access to genetic data later in life could improve treatment for some conditions and avoid harmful drug interactions.Analysis: Undeniable benefits, but questions remainIt was in 2000 that an international consortium of scientists announced they had completed the first draft of a sequence of the human genome. It had taken many years and cost several hundred million pounds. Now a whole human genome can be sequenced in a day for a few hundred pounds.In June 2000 I remember reporting the ceremony to mark the decoding of the human genome. At the time, President Bill Clinton said: “Today we are learning the language in which God created life.” Tony Blair, who joined the ceremony via satellite link from Downing Street, said: “Every so often in the history of human endeavour, there comes a breakthrough that takes mankind across the frontier and into a new era.” Mr Clinton even joked that the life expectancy of the prime minister’s recently born son, Leo, had just risen by 25 years. It is remarkable that two decades later whole genome sequencing for newborns is about to become a reality. In terms of newborn screening, it is like going from analogue to digital, from black-and-white to colour. There will be undeniable benefits for many families of children with genetic disorders: these will be diagnosed faster and treated more quickly. It will spare months, or years, of anguish as parents search for answers to their child’s malady, which often only becomes apparent when babies fail to reach developmental milestones.But it does raise questions about how much health information is held about individuals, and who controls it. Genomics England says that all newborn genomes will be anonymised. The children involved will have the chance to decide what happens to their data when they reach adulthood. By then, genome sequencing may have become commonplace.More on this storyBaby’s life saved by ground-breaking blood test12 OctoberGene test spared baby unnecessary chemotherapy30 SeptemberRelated Internet LinksGenomics EnglandThe BBC is not responsible for the content of external sites.

SharecloseShare pageCopy linkAbout sharingNearly 900 patients with type 1 diabetes in England are testing a potentially life-changing artificial pancreas.It can eliminate the need for finger prick tests and prevent life-threatening hypoglycaemic attacks, where blood sugar levels fall too low.The technology uses a sensor under the skin.It continually monitors the levels, and a pump automatically adjusts the amount of insulin required.Six-year-old Charlotte, from Lancashire, is one of more than 200 children using the hybrid closed loop system.Her mother, Ange Abbott, told us it has made a massive impact on the whole family. “Prior to having the loop, everything was manual,” she said. “At night we’d have to set the alarm every two hours to do finger pricks and corrections of insulin in order to deal with the ups and downs of Charlotte’s blood sugars.” About 400,000 people in the UK have type 1 diabetes, a condition where the body can’t produce insulin, the hormone which regulates blood sugar levels. NHS England says it is the first nationwide test of the technology in the world, and it comes 100 years after the first diabetes patient received insulin injections.The hybrid system is not completely automated, because the amount of carbohydrates being eaten at mealtimes needs to be inputted. Charlotte’s consultant Dr May Ng, a paediatric endocrinologist at Ormskirk District General Hospital, thinks the new technology has huge potential. “I think it’s absolutely fantastic. I’ve been practising for 25 years in children’s diabetes and it’s a game-changer,” she said.”To be able to improve the quality of life, to be able to see that most of their blood glucose readings are within that target range, it’s very exciting.”For Ange, the constant monitoring means that Charlotte can go back to being the child she was.”She loves days out with her friends and sleepovers, but we had to stop these as soon as she was diagnosed because other people couldn’t manage her diabetes. “Now we can allow her to go out for these social occasions when we’re not there.”Image source, Yasmin HopkinsYasmin Hopkins, 27, from London, has also received an artificial pancreas as part of the pilot.She was diagnosed with type 1 diabetes 15 years ago and had struggled to maintain her blood sugar levels. Yasmin told us she finds the new technology liberating. “I wake up now and I can do a normal day’s work, or go on a dog walk without being concerned,” she said.”Before, I felt like I’d have been at risk from some of the long-term complications of diabetes, whereas now I don’t see that happening.”If blood sugar levels are not kept under control, diabetes patients risk long-term damage to their heart, kidneys, eyes and nerves. Prof Partha Kar, NHS national speciality adviser for diabetes, said: “Having machines monitor and deliver medication for diabetes patients sounds quite sci-fi like, but technology and machines are part and parcel of how we live our lives every day. “It is not very far away from the holy grail of a fully automated system, where people with type 1 diabetes can get on with their lives without worrying about glucose levels or medication.” Chris Askew, chief executive of Diabetes UK, said: “This technology has the potential to transform the lives of people with type 1 diabetes, improving both their quality of life and clinical outcomes.”To date, 875 patients have joined the pilot, which will enrol up to 1,000 people. The results will be part of an assessment by the National Institute for Health and Care Excellence, which is considering where to roll out the technology more widely.It comes after NICE recommended that everyone in England with type 1 diabetes be offered some form of continuous glucose monitoring via a sensor attached to the skin.More on this storyArtificial pancreas for children hailed a success

SharecloseShare pageCopy linkAbout sharingSickle cell patients have begun receiving the first new treatment for the blood disorder in over 20 years. The inherited condition can cause severe pain and organ failure, often requiring hospital admissions. Crizanlizumab is given as a monthly infusion and is thought to cut visits to A&E by 40%.Loury Mooruth, 62, received the treatment at Birmingham City Hospital, having suffered repeated periods of intense pain for decades.These are called sickle cell crises and are common in people with the condition.”To have a crisis is pain beyond what you could ever experience,” Loury says.”They give you a scale of one to 10 – but it is way beyond that.”Sickle cell disease causes red blood cells to distort and become sticky, blocking vessels and restricting oxygen supply, which triggers excruciating pain.Crizanlizumab, a monoclonal antibody, binds to a protein on blood cells, preventing them from clumping.Sickle cell mostly affects black people.During a crisis, patients often need powerful opioid painkillers but Loury, like many others, has faced suspicion when at A&E. “You know the protocol when you go in, which needles and so on. They think straight away you are a drug addict – they don’t believe you,” she says.She has refused to go to hospital during a crisis for the past two years because of her negative experiences. A report from MPs last year found “serious failings” in sickle cell care with some evidence of discrimination against patients.Dr Shivan Pancham, a consultant haematologist at Birmingham City Hospital, told the BBC: “Our patients often find the experience in emergency departments challenging with a lack of understanding of the severity of pain. “It is hoped with these new therapies if we reduce the likelihood of attending emergency departments, ultimately this will be much better for the patients.”‘Bright, new dawn’Ten specialist treatment centres have been set up across England which doctors hope will improve outcomes for sickle cell patients.Each vial of the drug costs £1,000 but NHS England has negotiated a confidential discount and hopes to treat up to 5,000 patients over the next three years. Loury is optimistic about the future, saying: “This is a bright new dawn.” “Hopefully this will take the crises and put them to one side, and I will see my haematologist a lot less.”Dr Bola Owolabi, NHS director of health inequalities, who also works as a GP in the Midlands, said: “It’s fantastic that our first NHS patients have been given this ground-breaking and historic new treatment for sickle cell disease – the first in over two decades.”This revolutionary treatment will allow patients to have a better quality of life, reduce trips to A&E by almost half and ultimately help to save lives.” Kye Gbagbo, chair of the Sickle Cell Society, said: “We are delighted to see the first sickle cell patients are now getting access to this life-changing new treatment. “We encourage others that are eligible to do similar. Sickle cell crises cause extreme pain and are a huge disruption to daily life. “We hope that this new treatment will bring a new lease of life to many living with sickle cell.”What is sickle cell disease?It is inherited from both parents, who pass on a particular geneIt is possible to carry the gene without having the diseaseNearly 300 babies are born with it each year in the UKA simple blood test will show whether someone has itChildren with sickle cell are at greater risk of strokeOther symptoms can include serious infections, anaemia and tirednessSource: Sickle Cell Society / NHS UKMore on this storyMPs find ‘serious failings’ in sickle cell careFirst new treatment for sickle cell in 20 yearsSickle cell disease – NHSSickle Cell Society – Supporting People Affected by Sickle Cell DisorderThe BBC is not responsible for the content of external sites.

SharecloseShare pageCopy linkAbout sharingThis video can not be playedTo play this video you need to enable JavaScript in your browser.People will be likely to need to have annual Covid vaccinations for many years to come, the head of Pfizer has told the BBCDr Albert Bourla said he thought this would be needed to maintain a “very high level of protection”.The UK has now secured an extra 114 million doses of Pfizer and Moderna vaccines to be delivered over the next two years.A year ago the UK was the first country to approve the Pfizer-BioNTech vaccine.How worrying is the new Covid variant?Will our vaccines still work against Covid variants?Pfizers’s chief executive was speaking to the BBC before the emergence of the Omicron variant, first identified in South Africa and also before the announcement that the UK government had signed contracts to buy the 54 million additional Pfizer-BioNTech and 60 million Moderna doses for 2022 and 2023.These deals include access to modified vaccines if needed to combat Omicron and future variants of concern, the Department of Health has said.Dr Bourla said Pfizer had already made updated vaccines in response to the Beta, also first identified in South Africa, and Delta, first identified in India, variants but that they had not been needed. The company is now working on an updated jab in response to the Omicron variant that could be ready in 100 days.He said vaccines had helped save millions of lives during the pandemic, and without them the “fundamental structure of our society would be threatened”By the end of the year Pfizer expects to have supplied three billion doses of its messenger ribonucleic-acid (mRNA) vaccine with four billion planned for next year. There had been a global race to protect people protected, Dr Bourla said, but in 2022, countries would have “as many doses as they need”.Share priceSeveral global health charities see the money Pfizer, BioNTech and Moderna are making out of the pandemic as immoral.Pfizer will generate at least $35bn of Covid vaccine sales this year and has seen its share price soar.But while most people in the world have now had at least one Covid jab, in parts of Africa it is less than one person in 20. Image source, Getty ImagesDr Bourla was unapologetic about making a profit, saying “the bottom line is millions of lives were saved.” He continued; “We have saved the global economy trillions of dollars. “It is a strong incentive for innovation for the next pandemic. “But people will see that if they step up to the game, to bring something that saves lives and saves money, there is also a financial reward.”He denied profiteering – saying the jab was the “cost of a takeaway meal” for richer countries but sold at no profit to low-income ones – but accepted rich countries such as the UK had placed orders early and availability had initially been limited.Having to be stored at -70C, the Pfizer vaccine has been tricky to deploy in countries with limited health services. But within a month or so, Pfizer says it will roll out a new formulation of the vaccine that can be stored for three months in a fridge, which Dr Bourla said, would make a “huge difference” for sub-Saharan African countries.Pfizer has also developed an antiviral pill, Paxlovid, which in trials cut hospital admissions and deaths by nearly 90%. It should be approved in the US shortly and the UK government has agreed to buy enough for 250,000 patients. ‘Severe symptoms’Pfizer is also conducting Covid-vaccine trials in the under-fives.And in October, the United States Food and Drug Administration approved the Pfizer jab for five to 11-year-olds. Immunising that age group in the UK and Europe would be a very good idea, Dr Bourla said.”Covid in schools is thriving,” he said.”This is disturbing, significantly, the educational system, and there are kids that will have severe symptoms. “So there is no doubt in my mind that the benefits, completely, are in favour of doing it.”The mRNA vaccines, from Pfizer and Moderna have now taken over almost completely from the UK developed Oxford-AstraZeneca jab.’Right thing’And Dr Bourla had a strong message for those who did not want to have vaccines.”For those that are just afraid, the only emotion of human beings stronger than fear is love,” he said.”So I am using always this argument that the decision to get another vaccine is not going to influence only your health, it is going to affect the health of others and particularly the health of the people you love the most, because they are the ones that you will interact with. “So take the courage to overcome your fears and do the right thing.”He has recently been the target of some bizarre fake news stories, alleging the US Federal Bureau of Investigation had arrested him for fraud and his wife had died as a result of side-effects from the Pfizer vaccine – both untrue.”In the first news, that I was arrested by the FBI, of course I laughed,” he said. “On the second news, that my wife died, with a picture of her, I was really [angry]. “I worried about my kids, so I tried to call them and I could not get my son on the phone. “What we had to go through, it is nothing compared to the lives that will be lost because of the rubbish that those people published, because people will really think that my wife died because of the vaccine… and she is fine – she is wonderful.”TREATMENTS: What progress are we making to help people?COVID IN SCHOOL: What are the risks?VACCINE: When will I get the jab?NEW VARIANTS: How worried should we be?COVID IMMUNITY: Can you catch it twice?PfizerThe BBC is not responsible for the content of external sites.