Pandora Report: 1.18.2019

Welcome to your weekly dose of all things biodefense – we’ve got a lot of health security goodies for you this week!

OPCW Agrees to Ban Novichok
The Organization for the Prohibition of Chemical Weapons (OPCW) Executive Council approved adding two families of chemical compounds (Novichok) to the list of Schedule 1 chemicals that are subject to verification. “The 41 members of the decision-making body within the Organisation for the Prohibition of Chemical Weapons (OPCW) adopted a joint proposal by the United States, the Netherlands and Canada, member states said. They agreed ‘to add two families of highly toxic chemicals (incl. the agent used in Salisbury),’ Canada’s ambassador to the agency, Sabine Nolke, said on Twitter. ‘Russia dissociated itself from consensus but did not break,’ she wrote. Western allies ordered the biggest expulsion of Russian diplomats since the height of the Cold War in response to the attack on former Russian secret service agent Sergei Skripal and his daughter Yulia in Salisbury in March.” You can read the OPCW decision release on January 14th here. The Novichok family of chemical warfare agents were developed by the Soviet Union in the 1970s. In 2018, a Novichok CW agent was used in the attempted assassination of Sergei Skripal in Salisbury and led to the contamination of him, his daughter, a police officer, and two private citizens in the nearby town of Amebury, one of who died.

GMU Biodefense Alum Spotlight – Tam Dang
We love to show off the amazing alumni of GMU Biodefense and we’re excited to tell you about Tam Dang – epidemiologist and communicable disease all-star at the Dallas County Department of Health and Human Services. Tam works as an epi for the acute communicable disease division, helping to lead epidemiological investigations for outbreaks or potential bioterrorism events, monitors local/regional/state data sources related to infectious diseases, helps develop outbreak/bioterrorism plans to help support public health preparedness, and analyzes data collected as part of a vector control/bioterrorism surveillance team. Whether it be West Nile, enteric diseases or tuberculosis, Tam’s working to help improve communicable disease preparedness and response. Tam started in the biology world but her Schar Biodefense MS degree “introduced me to the public health field, and offered a unique perspective from a biosecurity and bioterrorism standpoint. It helped me stand out from the pile of applications my supervisor received. In addition, my biology background and prior employment experiences also played a large part in rounding out my graduate education and narrowing my professional field of interest. Overall, past experience and the added education and skills I obtained from the Biodefense Program were a critical factor in helping me pursue my career goals.” Her work is at the intersection of public health and health security. When asked what she felt was the biggest health security threat we’re facing in 2019, Tam noted that “I think some significant health security threats we are facing in the US in 2019 are related to the potential for importations or outbreaks of high-consequence emerging infectious diseases (HCID) such as Ebola and avian influenza. In a metropolitan area like Dallas/Fort Worth, our Public Health Emergency Preparedness (PHEP) division is keenly aware that our proximity to the Dallas/Fort Worth (DFW) International Airport confers particular risk for international importations of infectious diseases. The DFW airport is the twelfth busiest airport internationally, and received the highest number of travelers from countries affected by Ebola outbreaks in 2014-2015, of any airport within Texas. The local health security impact of such global interconnectivity was highlighted in Dallas during the 2014 Ebola outbreak, when a patient from Liberia was diagnosed with Ebola, and two nurses involved in his medical care were subsequently infected with Ebola. Because of this past experience, the current Ebola outbreak affecting the Democratic Republic of Congo has been watched closely by our PHEP epidemiologists over the past year, and this team has been busy participating in drills with area hospitals, and facilitating planning meetings with area hospitals and other community agencies to ensure appropriate measures are in place to rapidly identify, isolate, and evaluate possible cases.”

Revisiting the 2001 Anthrax Attacks and Investigation
The impact of the 2001 anthrax attacks may be slowly fading from memory but the truth is that it had profound implications for American perception of biological threats and fueled a booming biodefense initiative. GMU Biodefense PhD alum Glenn Cross discusses the new book from Scott Decker on the attacks and the evolution of forensics in the FBI. “Scott Decker’s book on Amerithrax is the first and, so far, only insider account of the science involved in the investigation. Decker served as an FBI special agent, one of very few in the bureau with a PhD in the life sciences. His strong academic background and experience in the FBI’s then-fledgling bioforensics effort ensured his rise to a prominent role in the Amerithrax investigation. In time, Decker became the supervisory special agent overseeing Amerithrax’s Squad 2, which was responsible for the scientific and forensics work of the task force. Thus, Decker is perhaps one of only a handful of people capable of providing comprehensive insight into the inner workings of Amerithrax’s bioforensics effort. His book likely will be the only one to offer such a detailed and unique perspective into the U.S. government’s response to the first deadly bioterrorism attack on American soil in peacetime”.

Bill Gates Warns About Gene Editing
Bill Gates recently spoke about gene editing technologies and that we simply are not having enough public debate regarding the ethical implications. “It also raises ‘enormous’ ethical questions, Bill Gates recently warned, and ‘could make inequity worse, especially if it is available only for wealthy people.’ ‘I am surprised that these issues haven’t generated more attention from the general public,’ he said in a December blog post, adding that ‘this might be the most important public debate we haven’t been having widely enough’.”

Going Viral- The Transformation of Biological Risks
The World Economic Forum has released a new report on biological risks. In this report, they discuss the growing threat of infectious diseases- regardless of origin. “The frequency of disease outbreaks has been rising steadily. Between 1980 and 2013 there were 12,012 recorded outbreaks, comprising 44 million individual cases and affecting every country in the world. Each month the World Health Organization (WHO) tracks 7,000 new signals of potential outbreaks, generating 300 follow-ups, 30 investigations, and 10 full risk assessments. In June 2018 there were—for the first time ever—outbreaks of six of the eight categories of disease in the WHO’s ‘priority diseases’ list. If any had spread widely, it would have had the potential to kill thousands and create major global disruption. Five main trends have been driving this increase in the frequency of outbreaks. First, surging levels of travel, trade and connectivity mean an outbreak can move from a remote village to cities around the world in less than 36 hours. Second, high-density living, often in unhygienic conditions, makes it easier for infectious disease to spread in cities—and 55% of the world’s population today lives in urban areas, a proportion expected to reach 68% by 2050. Third, increasing deforestation is problematic: tree-cover loss has been rising steadily over the past two decades, and is linked to 31% of outbreaks such as Ebola, Zika and Nipah virus. Fourth, the WHO has pointed to the potential of climate change to alter and accelerate the transmission patterns of infectious diseases such as Zika, malaria and dengue fever.  Finally, human displacement is a critical factor in this regard. Whether due to poverty, conflict, persecution or emergencies, the movement of large groups to new locations— often under poor conditions— increases displaced populations’ vulnerability to biological threats. Among refugees, measles, malaria, diarrheal diseases and acute respiratory infections together account for between 60 and 80% of deaths for which a cause is reported.” The report also points to fewer deaths but higher costs of these outbreaks, like that of MERS in South Korea in 2015 – while it only infected 200 people, it is estimated to have cost $8.5 billion. Furthermore, the new biotechnologies becoming available – like CRISPR – pose unique challenges for a world with already too many biopreparedness gaps.

Global Health Security and Universal Coverage
A new article addresses this marriage that once started from convenience and is now a strategic partnership. “A consequence of ignoring their individual characteristics is to distort global and local health priorities in an effort to streamline policymaking and funding activities. This paper examines the areas of convergence and divergence between global health security and universal health coverage, both conceptually and empirically. We consider analytical concepts of risk and human rights as fundamental to both goals, but also identify differences in priorities between the two ideals. We support the argument that the process of health system strengthening provides the most promising mechanism of benefiting both goals.”

Are We Normalizing Ebola?
Laurie Garrett discusses the challenges of this current outbreak regardless of the arsenal of tools at hand. Despite the capacity to vaccinate, rapidly detect, and an impressive body of knowledge, this Ebola outbreak is not slowing and the painful truth is that it’s due to human behavior. “But day after day, cases are popping up all over North Kivu that don’t connect to any known chains of transmission—it’s as if they popped out of thin air. The problem: North Kivu is one of the most violent places on Earth, rife with distrust, rumors, conflicts, and multigenerational hatreds. Investigators can’t find the links in the disease chains because the people there do not trust anything, even the very idea that a virus called Ebola exists, and refuse to comply with investigations.” The outbreak continues to pop up and challenge response efforts not because it has become some super strain, “but because of humans and their behaviors in a quarter-century-old war zone.”

National Rights and A Debate Across Science
Helen Branswell of STAT discusses the Nagoya Protocol and that while it aims to protect a country’s control over biological resources, it could pose challenging for scientific collaboration. “More than 100 countries have ratified the protocol. The United States, which is not a party to the Convention on Biodiversity, has not. Some involved in the debate argue genetic sequences aren’t covered by Nagoya, and that the free sharing of digital genetic information is so entrenched in scientific practice — scientific journals require it of their authors — that there’s no going back. Plus, some argue, to subject genetic sequence data to further bureaucracy would be counterproductive to science and dangerous to public health. But a large number of developing countries insist that the protocol gives them as much sovereignty over the genetic sequence data of viruses, bacteria, fungi, and other pathogens found within their borders as it does over plants that are crucial to drug production. In an age of synthetic biology, when a virus can be made from scratch by following a genetic sequencing recipe plucked from a public database, to have the genetic information is to have the bug itself, these countries argue.” You can read about the Nagoya Protocol here, via the Convention on Biological Diversity.

Militaries and Global Health
The role of militaries in global health efforts is not a novel concept but has evolved over time -consider the Ebola outbreak in the DRC as an example of security challenges during an outbreak. A new paper evaluates and summarizes these dynamics and the roles militaries have taken throughout global health efforts over time. “Militaries have many capabilities applicable to global health, ranging from research, surveillance, and medical expertise to rapidly deployable, large-scale assets for logistics, transportation, and security. Despite this large range of capabilities, militaries also have limitations when engaging in global health activities. Militaries focus on strategic, operational, and tactical objectives that support their security and defence missions, which can conflict with humanitarian and global health equity objectives. Guidelines—both within and outside militaries—for military engagement in global health are often lacking, as are structured opportunities for military and civilian organisations to engage one another. We summarise policies that can help close the gap between military and civilian actors to catalyse the contributions of all participants to enhance global health.”

The Threat of North Korea’s Bioweapons
Sure, we worry about nuclear weapons from North Korea, but what about biological weapons? This may not be an entirely new concern, but many experts warn of a growing bioweapons program and that the general lack of attention to it from the Trump administration is worrisome. “Still, Anthony H. Cordesman, a former Pentagon intelligence official now at the Center for Strategic and International Studies, said the North ‘has made major strides’ in all technical areas needed for the production of a major germ arsenal. In unclassified reports, the Trump administration has alluded to the North’s bioweapons program in vague terms. President Trump did not broach the subject of biological weapons during his meeting with Mr. Kim in Singapore, according to American officials. The lack of detail and urgency is all the more surprising given that John R. Bolton, Mr. Trump’s national security adviser, has long described it as a regional and even a global threat.” There have been debates though, about the progress made by North Korea. As GMU Biodefense professor Sonia Ben Ouagrham-Gormley noted, there are several the factors that go into a successful program and “One might ask why, if North Korea has been able to produce a nuclear weapon in the same adverse conditions, it shouldn’t also be successful in the bioweapons field. The answer lies in the decidedly different nature of bio-agents and nuclear weapons. Unlike nuclear material, living microorganisms are fragile and unpredictable. They are more sensitive than nuclear material to changes in work conditions, equipment, laboratory materials, and other disruptions. A country that cannot ensure a stable and continuous work environment is unlikely to operate a successful bioweapons program.”

 Battling Fake News On Top of Ebola
Working against an Ebola outbreak is hard enough, but throw in a conflict zone…and now you’ve really got challenges. Let’s add disinformation and fake news on top of it – making this a chimeric beast of an outbreak. The DRC’s recent election in the middle of the Ebola outbreak has amplified challenges to sharing public health information and guidance to the public for protecting themselves against the disease. “In West Africa, fear kept people away from clinics, meaning Ebola cases, as well as diseases such as measles and malaria, went untreated. Mistrust of governments and aid workers ran high and rumors were rife. That’s even more true in the DRC now. In September 2018, an opposition politician, Crispin Mbindule Mitono, claimed on local radio that a government lab had manufactured the Ebola virus ‘to exterminate the population of Beni,’ a city that was one of the earliest foci of the outbreak. Another rumor has it that the Merck vaccine renders its recipients sterile. On 26 December 2018, the national electoral commission decided to exclude Beni and Butembo from the polls because of the epidemic; the following day, an Ebola evaluation center was attacked during protests. Although opposition organizations condemned the commission’s decision, they called for the Ebola response to be protected—which health workers saw as a small but significant victory. ‘We’ve managed to get communities to separate in their minds Ebola control from the broader political agenda,’ says Michael Ryan, who directs the World Health Organization’s role in the campaign in Geneva, Switzerland. ‘That’s been really helpful.’ Ryan hands much of the credit to social scientists working for the various agencies involved in the response. Along with community engagement workers, they make up one-third of the workforce.” Experts are working to combat the epidemic of rumors by supplying accurate information via WhatsApp or local radio. Responders are hopeful, but this new challenge gives insight into the need for stronger tools against disinformation during an outbreak. Regarding the outbreak – there were 9 new cases identified including one new area. This brings the total case count to 658, with 402 deaths.

Code of the Wild
Interested in joining a public and international conversation on gene-editing? Check out Code of the Wild, which is a communication campaign and upcoming documentary about the social, medical, and ethical issues on genetic engineering. Through the webpage, people can join the conversation by entering a video response to questions raised by the research team. The goal of Code of the Wild is to form a narrative on gene-editing across several industries, sectors, and countries, to help better understand the social and ethical concerns that may or may not exist. You can also find them on Facebook, Twitter, and Instagram.

Stories You May Have Missed:

  • Dermatologists Are Cutting Antibiotic Usage – “Dermatologists have been identified as the most frequent prescribers of oral antibiotics in medicine, handing out more antibiotics per clinician than any other specialty. But a study today in JAMA Dermatology shows that antibiotic prescribing by the specialists has substantially decreased over the past decade. The study, by researchers with the University of Pennsylvania Perelman School of Medicine and the US Centers for Disease Control and Prevention, found that oral antibiotic prescribing by dermatologists fell by 37% from 2008 through 2016. Much of the decrease, they report, has occurred in the extended courses of antibiotics that are typically prescribed for patients with acne and rosacea to lessen inflammation. The researchers estimate that the decrease translates to nearly 480,000 fewer antibiotic courses being prescribed in 2016 than in 2008.”

Pandora Report: 1.11.2019

Happy Friday! If you’re feeling the post-holiday lull about getting back into work, here’s a great podcast on the biology of zombies.

New Bat-borne Virus Discovered by Singapore Researchers
Researchers have identified a new genus of filovirus found in fruit bats. This virus is similar to Ebola and has the potential to cause infection in humans. “The researchers discovered the new virus while analysing the diversity of filoviruses in Rousettus bats. They named it the Mengla virus because it was discovered in Megla County, Yunnan Province, China. They detected the virus from a bat sample and conducted sequencing and functional characterization studies. The results showed that the Menga virus represents a new genus named Dianlovirus within the filovirus group. The Mengla virus is genetically distinct, sharing just 32 percent to 54 percent of its genetic sequence with other known filoviruses. It is found in different geographic locations compared to other filoviruses. This new genus, which could include more than one species, sits in between Ebola virus and Marburg virus on the evolutionary tree.”

House Passes Pandemic Response and All-Hazards Preparedness and Advancing Innovations Act 
The House also passed the Pandemic and All-Hazards Preparedness and Advancing Innovation Act 401-17, which organizes programs to react to terrorism, disease outbreaks, and natural disasters. House Energy and Commerce Chairman Frank Pallone, D-N.J., and top-ranking Republican Rep. Greg Walden of Oregon said in a statement that the bill would ‘strengthen our nation’s emergency preparedness and response efforts and modernize the nation’s regulatory framework for over-the-counter drugs. Thanks to this legislation our communities will be safer and better prepared for emergencies, and FDA’s regulatory standards for OTC drugs will be modernized to better ensure consumer safety’.” “U.S. Rep. Anna Eshoo (D-CA) sponsored H.R. 269. U.S. Reps. Susan W. Brooks (R-IN), Bob Latta (R-OH), U.S. House Energy and Commerce Committee Chairman Frank Pallone Jr. (D-NJ) and Ranking Member Greg Walden (R-OR) are among the bill’s seven original cosponsors. Many of the same lawmakers also played key roles in the original law’s 2006 enactment and subsequent first reauthorization in 2013.”

WHO’s Draft Code of Conduct for Open/Timely Sharing of Pathogen Genetic Sequence Data During Outbreaks
WHO has just released their code of conduct to help enable the sharing of pathogen genetic sequence data during infectious disease outbreaks. “Pathogen genetic sequence data (GSD) is an increasingly valuable source of information in understanding and controlling outbreaks of infectious disease. With the advent of next generation sequencing, the depth/extent of available information will expand further. A key concern in recent outbreaks has been variable timelines between the start of an outbreak and the public availability of the first and subsequent genetic sequences. WHO strongly supports public access to sequence data to inform public health and research decision-making during outbreaks, the equitable sharing of benefits derived from the use of such data, and the legitimate interests of data providers. WHO has consulted with many stakeholders and institutions working in the pathogen sequencing arena, including those who have been involved in applications to recent outbreaks. Based on these consultations, and on lessons learned from recent outbreaks as part of the data sharing workstream of the WHO R&D Blueprint, WHO is proposing elements of a code of conduct for GSD sharing in infectious disease outbreaks.” You can access the full draft here.

EU Human Brain Project Opinion on Responsible Dual Use
The Ethics and Society Group of the Human Brain Project has just released their opinion on responsible dual use, which includes recommendations for dealing with concerns in relation to misuse of brain research. “As a consequence, The Human Brain Project has established a project-wide dual use working group to evaluate the research carried out within the project, and to disseminate the recommendations from the opinion, as well as experience accumulated through the work of the group itself. Target audiences include national governments, the European Commission, national and international research associations.” Not only does the report include political, security, intelligence, and military research of concern, but it also includes recommendations for the HBP, the EU, and other social actors. For example, “We recommend that the European Commission addresses the tension between the policy of ‘Open Innovation, Open Science, Open to the World’ and the need to regulate and restrict dual use research of concern.”

Second International Summit on Human Genome Editing: Continuing the Global Discussion
The National Academies have released their proceedings from the second summit held from November 27-29 in Hong Kong. The summit involved over 500 researchers, ethicists, policymakers, etc., to discuss the potential benefits and risks of human genome editing and ethical cultural perspectives. “The second international summit follows the First International Summit on Human Gene Editing, which was held in Washington, DC, on December 1-3, 2015.3 In a statement released at the end of the 2015 summit, the organizing committee of the 2015 summit observed that intensive basic and preclinical research on genome editing was clearly needed and that such research should be subject to appropriate legal and ethical rules and oversight. The statement said that genome editing of somatic cells—that is, cells whose genomes are not transmitted to the next generation— could be “appropriately and rigorously evaluated within existing and evolving regulatory frameworks for gene therapy, and [that] regulators […could] weigh risks and potential benefits in approving clinical trials and therapies.” However, the 2015 organizing committee stated that genome editing of germline cells, which can be passed on to subsequent generations as part of the human gene pool, would be “irresponsible” until safety issues were resolved and until there was broad consensus that the proposed use of genome editing was appropriate.” This summit is especially relevant as it came right after He’s announcement of using CRISPR in human embryos.

Government Shutdown Impacts FDA Food Inspections
It seems almost daily we’re learning more and more about how the government shutdown is impacting just about everything. The wave goes beyond travel and national parks, but now includes the routine food safety inspections of seafood, fruits, vegetables, and other high-risk foods. “F.D.A. inspectors normally examine operations at about 160 domestic manufacturing and food processing plants each week. Nearly one-third of them are considered to be at high risk of causing food-borne illnesses. Food-borne diseases in the United States send about 128,000 people to the hospital each year, and kill 3,000, according to the Centers for Disease Control and Prevention. Domestic meat and poultry are still being inspected by staff at the Agriculture Department, but they are going without pay. The F.D.A. oversees about 80 percent of the nation’s food supply, as well as most overseas imports.” FDA Commissioner Dr. Scott Gottlieb tweeted this week on how the shutdown has impacted several FDA operations.

One Health -Social Sciences Webinar Series
Don’t miss this webinar next Tuesday 1.15 at 11am EST on Addressing Gender Issues in One Health and Infectious Disease Preparedness. Hosted by One Health Commission and presented by Dr. Brigitte Bagnol and Dr. Janetrix Amuguni, you won’t want to miss it!

Ebola Outbreak Update
Two additional cases were reported in the DRC, bringing the total case count to 627, of which 579 were confirmed. 98 cases are still being investigated. “Five more deaths were reported: three in Butembo and one each in Beni and Katwa. The fatality from Katwa involves someone who died in the community, a factor known to increase the risk of Ebola transmission. The number of people who received the VSV-EBOV vaccine continues to rise. Since Aug 8, 58,866 people have been vaccinated. The World Health Organization (WHO) African regional office said today in a weekly outbreak and health emergency report that Butembo, Katwa, and Oicha are the current main hot spots in the outbreak, which is now entering its sixth month. It said resumption in response activities in the wake of recent election protest disruptions is encouraging, but more interruptions could pose serious problems for timely containment of the outbreak.”

Ebola Readiness- A False Sense of Security
GMU biodefense doctoral student and infection preventionist Saskia Popescu discusses a recent report on hospital preparedness and how surveyed administrators might have a false sense of security. “For many of us who worked in health care during the 2014-2016 Ebola outbreak, memories of those months are filled with frantic efforts to bring ourselves and staff up to par on personal protective equipment (PPE) guidelines, confirm there were patient movement algorithms, and ensure that if someone with Ebola walked through our doors, we would rapidly identify and isolate them. To say that it was a stressful time would be an understatement. The question is: are we better off than we were in 2014?  The answer? Somewhat. Investigators on a new report by the Office of the Inspector General evaluated hospital preparedness across the United States for emerging infectious diseases (EIDs) after the Ebola outbreak. Administrators from 368 hospitals around the United States were surveyed, of which 10 were Special Pathogens Centers. When surveyed in 2017, 14% of administrators felt their facilities were unprepared for a patient with Ebola or an EID. Conversely, 71% of hospital administrators reported that their facilities were unprepared to receive an Ebola patient in 2014. The financial cost of maintaining competencies, PPE, and other specialized equipment was a challenge for many and ultimately, 79% of hospital administrators reported that other types of emergencies were more likely to occur than EID threats. The challenges of training necessary and often critical staff, obtaining full participation from clinicians, and even combating frequent turnover in staffing, all stressed the capacity for hospitals to maintain readiness.”

Quantum Computing, Biotech, And Other Threats to the U.S.
In the middle of a government shutdown and at the beginning of a new year, there is a lot to worry about. Some concerns are short-term, while others are long-term issues. Elisabeth Eaves discusses the list from the GAO regarding long-range emerging threats. “New and evolving diseases from the natural environment—exacerbated by changes in climate, the movement of people into cities, and global trade and travel—may become a pandemic. –It’s a question of when, not if. As Tom Inglesby, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, told The Bulletin last year, ‘What we don’t know about flu is exactly when the next flu pandemic will occur, but I think all flu virologists and public health experts believe that it’s a matter of time’.”

Estrogen Receptor Modulators Could Tackle Infectious Diseases
The pursuit of infectious disease treatment options is challenging as they’re not often seen as strong sources of revenue for pharmaceutical companies. “Investigators on a new study have thrown their hat into the ring in this effort to repurpose already approved medications by exploring how estrogen receptor antagonists could be utilized for infectious disease treatments. They evaluated the triphenylethylene class of estrogen receptor modulators related to tamoxifen (ie, tamoxifen, clomiphene/clomifene, and raloxifene) as a potential agent against bacteria, fungi, parasites, and viruses. Tamoxifen has shown analogs effective against HIV, Ebola, hepatitis C, Candida spp, Mycobacterium tuberculosisStaphylococcus aureus, and more. The antifungal activity of tamoxifen has been documented since the 1980s, while studies exploring its antiviral activities have gone back to the 1990s. Investigators reviewed these studies to assess just how much power tamoxifen could offer against infectious diseases. They found that antimalaria activity of tamoxifen and clomiphene was investigated in vitro and study results showed that parasitic growth was inhibited by 80%.”

Rift Valley Fever Endangers Pregnant Women
While many have focused on Zika virus as a danger to pregnant women, new research is showing that Rift Valley fever may cause severe injury to human fetuses if contracted during pregnancy. “In a study published last month in the journal Science Advances, researchers used infected rats and human fetal tissue to discover how the virus targets the placenta. Results showed that the virus may be even more damaging to fetuses than the Zika virus, which set off a global crisis in 2015 and left thousands of babies in Central America and South America with severe birth defects.” While it is primarily in livestock in sub-Saharan Africa, hundreds of human cases occur each year. “Two cases of infected fetuses have been documented. One infant was born with an enlarged liver and spleen, among other symptoms; the other died within a week. Because the disease can be asymptomatic in pregnant women, many more cases of abnormalities and stillbirths may have been misidentified. Among rats used in the study, 65 percent of the pups born to infected mothers died, compared to 25 percent of pups born from uninfected controls. Each infected mother lost at least one pup, and all of the infected mothers’ offspring contracted the virus.”

Stories You May Have Missed:

  • U.S. Flu Season – Looking for the latest trends this flu season? The CDC’s latest report can be found here. The majority of the cases have been Influenza A(H1N1N)pdm09  but H3 have been seen more in the southeastern U.S. “The proportion of outpatient visits for influenza-like illness (ILI) increased to 4.1%, which is above the national baseline of 2.2%. All 10 regions reported ILI at or above their region-specific baseline level. The increase in the percentage of patient visits for ILI may be influenced in part by a reduction in routine healthcare visits during the winter holidays, as has occurred during previous seasons.”
  • New York Measles Outbreak – Despite measles being declared from the US in 2000, New York has seen a surge of cases. “Since September 2018, New York state health officials have seen approximately 170 measles cases to include 55 confirmed cases in the Orthodox Jewish community in Brooklyn, 105 cases in Rockland County, 7 in Orange County and one in Monroe County in western NY. According to the New York State Department of Health, the current outbreak is the largest in New York State since the 1990’s, prior to elimination of measles in the United States.”

 

Pandora Report 1.4.2019

Happy New Year! We’re excited to start the new year with a dose of biodefense news. Here’s a good list of what to expect in science this year – hint: you might see some gene-editing and biosafety in there…

 US Healthcare Worker Brought to Nebraska for Ebola Observation
Over the weekend, it was reported that a US healthcare worker was flown from the DRC to  Nebraska Medical Center for close observation following a suspected exposure. “The health worker has no symptoms, the medical center said. If symptoms begin, the patient will be housed in the Nebraska Biocontainment Unit at the center, which was established to treat people who have serious, high-risk diseases. ‘This person may have been exposed to the virus but is not ill and is not contagious,’ said Ted Cieslak MD, infectious diseases specialist with Nebraska Medicine and associate professor of epidemiology in the University of Nebraska Medical Center College of Public Health. The healthcare worker was transported by automobile and private plane to Nebraska. Monitoring could last 2 weeks, but Nebraska Medical Center said it would not provide updates ‘unless the need arises’ or if the person is transferred to the biocontainment unit.” Very little information has been provided about the healthcare worker beyond that they are a 39-year-old physician. The DRC Ebola outbreak continues to stress resources and pose a risk for responders. WHO’s Dr. Tedros tweeted earlier that responders were attacked at Komanda. 10 new cases were reported on Tuesday, bringing the total to 600 cases in this outbreak.

GMU Master’s Open House 
Come learn about how you can earn your MS in biodefense in person or online! We’ll be hosting a Master’s Open House on Thursday, February 21st, at 6:30pm at the Arlington campus. This is a great chance to talk to faculty, learn about the admissions process, and the variety of classes we offer in global health security.

Extensively Drug-Resistant Typhoid Outbreak in Pakistan
The WHO has reported over 5,200 cases of XDR typhoid in an outbreak that began in 2016. “The circulating strain of XDR Salmonella entericaserovar Typhi, which is resistant to five classes of antibiotics, was first reported in the Hyderabad district of Sindh province in 2016 and has been spreading throughout the province since then. After health officials formally agreed to case definitions for non-resistant, multidrug-resistant (MDR), and XDR typhoid, a review of typhoid cases reported from Nov 1, 2016 through Dec 9, 2018 identified 5,274 XDR cases in Sindh province.” Outbreaks of resistant Salmonella Typhi strains have been increasing in frequency in the last few decades, which leaves many without treatment options in resource-stressed areas.

CRISPR and DIY Biohacking – An Infectious Disease Threat to Be Aware of in 2019
Everyone is making lists about which disease or biothreats to look for in 2019, but GMU biodefense doctoral student Saskia Popescu is pushing us not to forget CRISPR and other gene editing technologies. “CRISPR has great potential to improve the human condition through research, medicine, agriculture, etc. With great power though, comes great responsibility; there is a real concern that the technology is moving too fast for its own good and too fast for governance, regulation, and oversight to keep up. Biosecurity experts have been raising the red flag about the disruptive nature of genome editing, pointing out that the manipulation of biological systems and processes can have untold consequences. A recent study published by investigators from George Mason and Stanford universities notes that the technology must be taken seriously and the broader and ever-evolving landscape of biosecurity must be considered. For instance, it is possible that genome editing could one day be used to create biological weapons—think of a totally resistant tuberculosis or an influenza with increased virulence.”

Lisa Monaco Joints Blue Ribbon Study Panel on Biodefense
“The Blue Ribbon Study Panel on Biodefense welcomed former White House Homeland Security Advisor, Lisa Monaco, as a Panel Member. Monaco served as Assistant to the President for Homeland Security and Counterterrorism between 2013 and 2017. She replaces outgoing Panel Member, former Secretary of Health and Human Services Donna Shalala, recently elected to serve as a U.S. Representative for the 27th District in Florida. ‘I am delighted to welcome Lisa Monaco to the Panel. She brings a tremendous wealth of knowledge to our bipartisan team,’ said former Senator Joe Lieberman, Panel Co-Chair. ‘As Homeland Security and Counterterrorism Advisor, Lisa was responsible for advising President Obama on all aspects of counterterrorism policy and strategy, and issues ranging from terrorist attacks at home and abroad to cybersecurity, pandemics, and natural disasters. We have an ambitious agenda for 2019, so Lisa arrives at an ideal time.’ Former Secretary of Health and Human Services Donna Shalala was one of the founding members when the Panel was formed in 2014. She leaves the Panel having played a key role in advancing recommendations for better biodefense preparedness, response, and recovery – particularly at the state, local, tribal, and territorial levels.”

2018 Year in Review – CDC Looks At The Most Pressing Health Threats
The CDC is looking back to name the top health threats of 2018 – from opioid overdoses to Ebola and foodborne illness. One of the listed threats was global health security – “The most effective way to protect Americans from health threats that begin overseas is to prevent, detect, and contain diseases at their source. This year, to advance global health security and protect Americans and U.S. interests, CDC continued to support more than 60 countries in building core capacities in disease surveillance, laboratory systems, public health workforce, and emergency management and operations.” The CDC also discussed the decreasing life expectancy in the United States and challenges of responding to disease outbreaks. Not only is the goal to stop outbreaks, but ultimately prevent them. The ongoing cases of AFM and foodborne outbreaks that halted consumption of romaine lettuce, are all issues the CDC works to understand and prevent in the future.

The Universal Flu Shot Moves Within Reach
This has been almost the holy grail of biodefense – a universal flu shot to potentially halt a pandemic. “How is it possible to protect against a virus that doesn’t yet exist? By looking for the parts that don’t change, says García-Sastre, Professor of Microbiology and Medicine (Infectious Diseases) and Director of the Global Health and Emerging Pathogens Institute at the Icahn School of Medicine. ‘The current vaccine is actually very good at inducing response to the variable regions of the virus,’ says García-Sastre. ‘But there are other parts of the structure of the virus that remain unchanged, or conserved. Our idea for the universal vaccine is to induce antibodies against the conserved areas’.” Genome sequencing advances have allowed the research team to more accurately assess the surface proteins of influenza viruses. “How close is the universal flu vaccine to becoming reality? ‘Our initial findings are promising, but we still need to conduct phase II and phase III trials,’ says García-Sastre. ‘Hopefully, the vaccine could be ready in five years’.”

NIH Hospital Battles Resistant Germ in Sinks
Rare and resistant organisms has been wreaking havoc at the NIH Clinical Center for over a decade. “Researchers tracked the superbugs to sinks in patient rooms amid a freaky outbreak in 2016. Searching through genetic sequences of clinical samples collected as far back as 2006—a year after a new inpatient hospital building opened—researchers identified eight other cases for a total of 12 instances where the sink-dwelling germs had splashed into patients. The aquatic germ in these cases was Sphingomonas koreensis. Such sphingomonas species are ubiquitous in the environment but rarely cause infections. In the NIH patients, however, they were found to cause a variety of problems, including pneumonia, blood infections, a surgical site infection, and a potential urinary tract colonization. Some isolates were resistant to 10 antibiotics tested, spanning three classes of drugs. Three of the 12 affected patients died following their infection. However, they were all also suffering from severe, unrelated infections prior to exposure to the sink-based germs, the NIH researchers note.” Researchers found the germ surviving in sink faucets and fixtures, which is unusual. Replacing faucets, aerators, and mixing valves seemed to do the trick, but researchers found the areas re-colonized. Sink deposal was the next step, as well as upping chlorine concentration and hot water temperatures. “In all, the researchers suspect that ‘a single S. koreensis strain entered the water system soon after construction of the new NIH Clinical Center hospital building in 2004′ and colonized pipes before the hospital opened, while water in the plumbing was stagnant. Then, the germ ‘disseminated throughout the hospital and diversified at multiple distinct locations,’ causing a sporadic, decade-long clonal outbreak.”

Stories You May Have Missed:

  • Higher Risk of Meningitis in College Students– just another reason you want to get vaccinated before starting the campus life! “College freshmen have previously been found to have a higher risk of meningococcal disease in general than other adults their age, and several college MenB disease outbreaks have been reported recently, note the authors, a team from the US Centers for Disease Control and Prevention. The investigators used data from the National Notifiable Diseases Surveillance System and enhanced meningococcal disease surveillance to examine the incidence and relative risk of the disease among college students and non-students aged 18 to 24 years between 2014 and 2016. They also used lab methods to characterize meningococcal isolates.”
  • Measles Cases Grow in Europe – Anti-vaccination movements are growing and Europe is feeling the effects of a severe measles outbreak. “A fresh Guardian analysis of WHO data shows that measles cases in Europe will top 60,000 this year – more than double that of 2017 and the highest this century. There have been 72 deaths, twice as many as in 2017. Health experts warn that vaccine sceptics are driving down immunisation rates for measles, HPV against cervical cancer, flu and other diseases – and that their opinions are increasingly being amplified by social media and by rightwing populists equally sceptical of medical authorities.”

 

Pandora Report: 12.28.2018

It’s our last Pandora Report newsletter of 2018 and what a year it has been! From horsepox synthesis to CRISPR babies and an Ebola outbreak, 2018 hasn’t been a boring one. As 2019 rolls in, we’d like to thank our readers for a great year of biodefense news (and nerdom) – we truly appreciate you!

Don’t Let Russia Undermine Trust in Science
Genetic editing has been a hot conversation topic lately and while there are arguments all along the spectrum, Jesse Kirkpatrick and Michael Flynn are drawing attention to a growing threat in the debate – disinformation. “Russia, or another U.S. adversary, could use the megaphone of social media to stoke worries about genome editing in the U.S. in a campaign timed with the next high-level meeting on gene drives. In fact, Russia has recently engaged in a disinformation campaign claiming—falsely—that the U.S. is developing biological weapons in neighboring countries, and it has also used state-funded news outlets to cast doubt in the U.S. about the safety of GMOs. These campaigns are concerning—they can impact national security, international relationships, and trade—yet haven’t received nearly the same level of exposure as discussion about misinformation campaigns designed to achieve political objectives. As a report prepared for the U.S. Senate shows, Russia used every major social media platform, including Snapchat, Pinterest, and Tumblr, to target specific demographic groups in an effort to influence the 2016 presidential election. Similar information warfare tactics could be used to exploit Americans’ lack of knowledge and opposition to particular forms of genome editing.” In fact, this concern is so significant that it was discussed in the recent report on biosecurity in the age of genome editing, which you can read here. There are legitimate concerns that disinformation regarding weaponized gene drive technology would be picked up by major news outlets and fuel false stories. A healthy dose of skepticism and making sure your news sources for science and tech are legitimate is important.

Piloting Online Simulation Training for Ebola Response
Maintaining competencies and training efforts can be cumbersome in preparedness efforts, but even more challenging during an outbreak in a resource-challenged area. A new article pilots a trial of internet-distributable online software to train healthcare workers in highly infectious diseases, like Ebola. “This study describes a pilot trial of the software package using a course designed to provide education in Ebola response to prepare healthcare workers to safely function as a measurable, high-reliability team in an Ebola simulated environment. Eighteen adult volunteer healthcare workers, including 9 novices and 9 experienced participants, completed an online curriculum with pre- and posttest, 13 programmed simulation training scenarios with a companion assessment tool, and a confidence survey. Both groups increased their knowledge test scores after completing the online curriculum. Simulation scenario outcomes were similar between groups. The confidence survey revealed participants had a high degree of confidence after the course, with a median confidence level of 4.5 out of 5.0 (IQR = 0.5). This study demonstrated the feasibility of using the online software package for the creation and application of an Ebola response course. Future studies could advance knowledge gained from this pilot trial by assessing timely distribution and multi-site effectiveness with standard education.”

CRISPR and DIY Biohacking – An Infectious Disease Threat to Consider in 2019
When you compile a list of the infectious disease concerns you might have for 2019, does CRISPR make the cut? “CRISPR has great potential to improve the human condition through research, medicine, agriculture, etc. With great power though, comes great responsibility; there is a real concern that the technology is moving too fast for its own good and too fast for governance, regulation, and oversight to keep up. Biosecurity experts have been raising the red flag about the disruptive nature of genome editing, pointing out that the manipulation of biological systems and processes can have untold consequences. A recent study published by investigators from George Mason and Stanford universities notes that the technology must be taken seriously and the broader and ever-evolving landscape of biosecurity must be considered. For instance, it is possible that genome editing could one day be used to create biological weapons—think of a totally resistant tuberculosis or an influenza with increased virulence. The growing popularity of genome editing also means that these technologies are no longer restricted to laboratories where there is some degree of oversight and regulatory processes; they now extend to the everyman’s garage. That’s right—there are people performing genome editing right in their own homes. DIY (Do It Yourself) biohacking allows people to play around with gene editing technologies at home, with zero supervision or guidance. It’s not difficult to think about what the repercussions could be if the wrong person experiments with the genomic modification of viral or bacterial DNA. ”

A Highly Hackable US Biodefense System
The efficacy of BioWatch as a biodefense tool has been questioned since it was first developed but new issues are arising surrounding the security of the data. “Operating in more than 30 cities, BioWatch gathers air samples, sends them to labs, and analyses them for DNA that would indicate a toxin or pathogen. But the program, which has cost more than $1 billion so far, turned up false positives and can take upwards of a day to report results. Earlier this fall, a Department of Homeland Security official said BioWatch would be replaced within the next couple of years. Until then, it’s a first line of defense against bioterrorism. But as Defense Onereports, the website that BioWatch uses to coordinate between health workers and government officials (called biowatchportal.org) is insecure, according to both the Department of Homeland Security inspector general and a former department employee. With access to the website, an adversary could find the sensor locations where air samples are gathered, target the professionals using it, or presumably simply take it offline.”

Ebola Outbreak Update
Over the holiday weekend, 22 more cases were reported, bringing the outbreak to 585 cases (537 confirmed). “Also, officials reported 13 more deaths, raising the overall outbreak fatality count to 356. Six of the latest deaths occurred in community settings, a factor that raises the risk of spread, given that the sick people weren’t isolated in Ebola treatment units and that viral levels are at their highest when patients are severely ill. As of today, health officials are still investigating 74 suspected Ebola cases. The World Health Organization (WHO) African regional office said yesterday in its weekly outbreak and health emergencies report that Katwa, Komanda, Beni, Butembo, and Mabalako are the main hot spots.”

Swine Fever Virus Found in Wontons and A New Outbreak in China’s Guangdong Province
Taiwan reports “The minced pork meat on wonton wrappers brought by a traveler into Taiwan has been found to contain the highly contagious African swine fever (ASF) virus, the Bureau of Animal and Plant Health Inspection and Quarantine (BAPHIQ) said Friday.” This is on the heels of a new outbreak of the African swine fever reported in China via their agriculture  ministry as 11 pigs were killed on a farm of 90. “China has already reported more than 90 cases of the incurable disease since it was first detected in the country in early August.” China has been hard hit with ASF and a new video shows 10,000 pigs killed by the disease in the province closest to Taiwan. The Chinese government has also been under fire for underreporting the outbreak in their state-run media.

Stories You May Have Missed:

 

Pandora Report: 12.21.2018

The holidays may be fast approaching but you can count on us to provide you with the latest news on all things biodefense in the coming weeks. Do you miss the Oregon Trail game? The CDC has got something even better- the 1918 Pandemic Trail Game, in which you try to survive one day in the fall of 1918 and avoid infection.

 ASM Biothreats – GMU Student Coverage
ASM Biothreats is next month (January 28-31, 2019) and like recent years, we’ll be providing detailed accounts of the conference. Current GMU biodefense students – check your email for an opportunity to attend and report out on the event! For those unable to attend, make sure you check back in early February for a recap of the event (see our coverage in 2017 and 2018).

GMU Biodefense Spotlight – Leaders in Graduate Education
Foreign Policy is highlighting the GMU Schar School biodefense program and school of policy and government as a leader in graduate education. “With a focus on global health security, the Schar School’s Biodefense programs train students to prevent, prepare for, and respond to the full range of biological threats, from naturally occurring pandemics to deliberate threats from biological weapons and other types of weapons of mass destruction (WMD). The Biodefense graduate programs include the Master’s in Biodefense, PhD in Biodefense, and Graduate Certificate in Biodefense. “’We aim to produce graduates who can bridge the gap between science and policy,’ says Koblentz, who also serves as an associate faculty member of the Schar School’s Center for Security Policy Studies and as a member of the Scientist Working Group on Biological and Chemical Security at the Center for Arms Control and Non-Proliferation in Washington, D.C.”

GAO Report: Long-Range Emerging Threats Facing the United States As Identified by Federal Agencies
The U.S. Government Accountability Office (GAO) has just released a national security report that identified 26 long-term threats across 4 categories: Adversaries’ Political and Military Advancements, Dual-use Technologies, Weapons, and Events and Demographic Changes. “DOD, State, DHS, and ODNI independently identified various threats to the United States or its national security interests. In analyzing more than 210 individual threats identified by organizations across DOD, State, DHS, and ODNI, as well as its review of national security strategies and related documents, and interviews with key agency officials, GAO developed four broad categories for 26 long-range emerging threats that officials identified.” Within the Dual-Use Technologies, biotechnologies are listed – “Actors—which may include state or non-state entities such as violent extremist organizations and transnational criminal organizations—could alter genes or create DNA to modify plants, animals, and humans. Such biotechnologies could be used to enhance the performance of military personnel. The proliferation of synthetic biology—used to create genetic code that does not exist in nature—may increase the number of actors that can create chemical and biological weapons.” Under Events and Demographic Changes, you can find Infectious Diseases – “New and evolving diseases from the natural environment—exacerbated by changes in climate, the movement of people into cities, and global trade and travel—may become a pandemic. Drug-resistant forms of diseases previously considered treatable could become widespread again.” You can find the full report here.

Agricultural Improvement Act of 2018 Includes Blue Ribbon Panel Biodefense Recommendations
“President Trump today signed into law H.R. 2, the Agricultural Improvement Act of 2018. Also known as the Farm Bill, the act includes several recommendations proposed by the bipartisan Blue Ribbon Study Panel on Biodefense to better protect the nation’s food and agriculture sector from biological attacks and naturally occurring outbreaks. Key provisions include: Establish a National Animal Disease Preparedness and Response Program, as recommended in the Study Panel’s 2017 Defense of Animal Agriculture report; Create a National Animal Vaccine and Veterinary Counter-Measures Bank, with increased funding for the stockpiling of animal medical countermeasures – also in the Defense of Animal Agriculture report; and Authorize increased funding levels for the National Animal Health Laboratory Network – addressed in Recommendation 14b from the Panel’s 2015 National Blueprint for Biodefense.”

 Congrats GMU Biodefense Graduates!
It’s our favorite time of year – graduation! We’d like to congratulate several students on their hard work and graduation from the Schar School Biodefense program. Steven Messersmith and Morasa Shaker are both graduating with their MS in Biodefense while Julie Duckett (dissertation title: Global Health Governance in the Caribbean: States, Institutions, and Networks) and Jennifer Osetek (The Last Mile: Removing Nonmedical Obstacles in the Pursuit of Global Health Security) are graduating with their doctorates. Congrats!!

New Book: Understanding Cyber Warfare: Politics, Policy, and Strategy
Just in time for a holiday gift – Christopher Whyte and GMU Biodefense alum Brian Mazanec have released their new book, Understanding Cyber Warfare: Politics, Policy, and Strategy. “The international relations, policy, doctrine, strategy, and operational issues associated with computer network attack, computer network exploitation, and computer network defense are collectively referred to as cyber warfare. This new textbook provides students with a comprehensive perspective on the technical, strategic, and policy issues associated with cyber conflict as well as an introduction to key state and non-state actors. Specifically, the book provides a comprehensive overview of these key issue areas: the historical emergence and evolution of cyber warfare, including the basic characteristics and methods of computer network attack, exploitation, and defense; a theoretical set of perspectives on conflict in the digital age from the point of view of international relations (IR) and the security studies field; the current national perspectives, policies, doctrines, and strategies relevant to cyber warfare; and an examination of key challenges in international law, norm development, and the potential impact of cyber warfare on future international conflicts.”

GMU Biodefense Student Receives Wilson Center Earth Challenge 2020 Special Project Internship
We’re proud to announce that Anthony Falzarano is the new Special Project Intern in the office of Science and Technology Innovation Policy at the Wilson Center, led by Dr. Anne Bowser. The Earth Challenge 2020 project is a joint initiative with Earth Day Network, Wilson Center, US Dept of State, and other partners to engage millions of people worldwide with the mission of collecting 1 billion data points from areas such as water quality, air pollution, and human health. The goal is to utilize citizen science to help inform research and empower the public to engage decision makers and drive meaningful policies at all levels. Anthony will be providing scoping and implementation support of this project as well as conducting research, writing, and stakeholder outreach.

AFM Is Testing Us For the Next Global Epidemic
Acute flaccid myelitis (AFM) is the disease we’ve been warned against and told to prepare for, but are we taking it for the learning lesson it is? The expectation of Disease X is that it would come in some massive pandemic wave like the 1918//1919 influenza, pushing public health and healthcare to the brink. Maryn McKenna writes about how AFM is actually doing this and giving us a heads up that we’re struggling against an unknown and uncommon illness. “The challenge of tracking an uncommon illness is giving us a glimpse of how our surveillance systems will struggle to counter the world-spanning epidemic that Disease X may turn out to be.” “AFM has not yet been made what the CDC calls a “nationally notifiable” disease, that is, something a physician is required to tell the state health department and thus the CDC about. But when or if it is, communicating the occurrence of a case will still require time-consuming composing of an email or filling out a web form, and equally time-consuming assessment and investigation on the other side. AFM appears to be an illness that moves slowly through the population; the CDC believes this year’s outbreak is over. When Disease X arrives, whatever it turns out to be, it is likely to move much faster. That makes our experience of investigating and communicating AFM something like a practice round—one that medical researchers should use wisely. We probably cannot avoid new diseases surprising us. But it is up to us to decide whether we’ll be able to catch up.”

 Antimicrobial Resistance: Addressing the Funding Dilemma
Read the latest report on this growing biological threat from the Dag Hammarskjöld Foundation and ReAct (Action on Antibiotic Resistance). “Effective antibiotics are critically important cornerstones of all health systems, but bacteria becoming resistant threatens the continued lifesaving value of antibiotics. A return to a pre-antibiotic era would have devastating impacts on global public health as well as the global economy. In December, the Dag Hammarskjöld Foundation and ReAct (Action on Antibiotic Resistance) organised a joint workshop in Uppsala, Sweden, inviting 20 international experts in the field of antimicrobial resistance (AMR) and global health. The participants were invited to search together for financing options for this growing issue. Together they examined options for the mobilisation of capital and proposed new and existing funding streams to invest in addressing AMR. The outcomes of the workshop will feed into the ongoing discussions on future global governance for AMR”

Ebola Outbreak Update
Seven new cases and seven new deaths have been reported in the DRC due to Ebola. Three of the new cases were healthcare workers, which brings the total of HCW infections to 53, with 18 deaths. “Officials have now reported 549 total Ebola cases and 326 deaths. Eighty-two suspected cases are under investigation. Three of the new cases occurred in Katwa, two in Komanda, and two in Mabalako. Four of the seven new deaths were community deaths (two each in Katwa and Komanda), which raises the risk of transmission.” Nearly 50,000 people in the DRC have been vaccinated against Ebola in efforts to control the outbreak.

Tibetan Refugee Children Suffer High Rates of Tuberculosis
“Although tuberculosis is preventable and curable, it remains one of the top 10 causes of death worldwide. Furthermore, despite widespread eradication and treatment efforts, incidence of the disease has only fallen about 2% per year, which is well below the necessary reduction to meet the 2020 World Health Organization milestone. In 2017, 1.6 million people died from tuberculosis, including 230,000 children. Now, investigators on a new study have found that in Tibet, 1 in 5 children has the disease. The investigators, from Johns Hopkins Medicine and the University of Wisconsin, found these troubling results among Tibetan refugee schoolchildren during their screening and treatment initiatives in northern India. The initiative, Zero TB Kids, found a dangerous high prevalence of tuberculosis, both active and latent, in children in Himachal Pradesh, India.”

“Outbreak Culture” Can Derail Effective Response
Despite the numerous opportunities we’ve had, humanity just doesn’t have a good response to infectious disease events. Addressing a problem rampant throughout this history, Lara Salahi and Pardis Sabeti discuss the societal and cultural dynamics that impact disease response. Starting with Ebola in 2015, they note that “Nearly all of those surveyed mentioned that political and interpersonal challenges at times slowed their responses. Many said they feared the politics more than the virus. More than a quarter reported either witnessing, hearing about, or falling victim to illegal or unethical tactics while responding to the outbreak. Among the tactics they reported: money and other forms of aid disappearing before it reached its intended recipients; knowingly defective personal protective equipment sent to health workers treating Ebola patients; harmful competitive practices among research groups, like intimidation and data hoarding, to prevent others from conducting field research.”

Stories You May Have Missed:

  • Romaine Lettuce E coli Investigation – “Federal health officials today said Adam Brothers Family Farms, based in Santa Barbara County, Calif., may be a source of romaine lettuce contaminated with Escherichia coli O157:H7, based on testing that matched the bacteria in irrigation water sediment to the outbreak strain that sickened patients. In a media telebriefing today, however, Stephen Ostroff, MD, senior advisor to the Food and Drug Administration (FDA) commissioner, said the newly identified link doesn’t explain all of the outbreak cases and that traceback investigations are still under way”

 

 

Biodefense Events

UPCOMING EVENTS

July 2019 – Summer Workshop on Bioterrorism, Pandemics, and Global Health Security.

Dates: TBD

PAST EVENTS

Schar School of Policy and Government – Preventing Pandemics and Bioterrorism: Past, Present, and Future

Tuesday, December 4th, 2018, 6-7pm EST

Schar School of Policy and Government, Founders Hall, Auditorium, 3351 Fairfax Drive, Arlington, VA, 22201

Join the Schar School Biodefense Program, Schar Alumni Chapter, and Dean Mark Rozell for an evening of connecting with alumni, academics, practitioners, and students!  Preventing Pandemics and Bioterrorism: Past, Present, and Future featuring Robert Kadlec, M.D., Assistant Secretary for Preparedness and Response (ASPR) Health & Human Services, Office of the Secretary. We are excited to announce this special event in celebration of the 15th anniversary of the George Mason University Biodefense Program at the Schar School of Policy and Government. We invite you to attend this exciting opportunity to hear from Dr. Kadlec about lessons learned for pandemic preparedness since the 1918-1919 influenza pandemic, plans for implementing the new National Biodefense Strategy, and the importance of education for the future of biodefense. Continue reading “Biodefense Events”

Pandora Report 12.14.2018

Happy Friday fellow fans of biodefense! We’re grateful to share some of the latest health security news with you this week – McDonald’s has set a timeline to cut antibiotics in their meat supply as a measure to combat antimicrobial resistance.

Preventing Pandemics & Bioterrorism: Past, Present, & Future – Video
We’re excited to announce that you can now access the recording of our event featuring ASPR’s Dr. Robert Kadlec. If you missed this event, here’s your chance to learn about the history of biodefense programs in the United States, lessons learned from the 1918/1919 pandemic, and future implementation of the National Biodefense Strategy.

India Works to Tackle AMR
A new research study found that “strains of hypervirulent, carbapenem-resistant Klebsiella pneumoniae associated with extremely high mortality rates” were found at an Indian hospital through the efforts of researchers at Christian Medical College in Tamil Nadu. “Of the 86 isolates tested, 27 (31.3%) had a positive string test, which indicates hypervirulence. But PCR tests found that only 3 of the string-test-positive isolates contained the rmpA2 hypervirulence gene, and none contained the rmpA or magA hypervirulence genes. The authors say the absence of these genes could indicate that other genes were responsible for the hypervirulence. The most common carbapenem-resistance gene found in the isolates wasblaNDM.” On the heels of this news, the Indian government is reportedly banning the use of colistin in livestock. “The UK-based Bureau of Investigative Journalism and Livemint, an Indian business news website, report that India’s National Antimicrobial Resistance Action Plan committee, the country’s top drug advisory body, and government agencies that oversee agriculture and food safety have all recommended that the Indian government ban the use of the last-resort antibiotic in livestock in an effort to preserve the drug’s efficacy in humans. An advisor to the committee told the Bureau of Investigative Journalism that the Indian government is in the processing of crafting a rule on colistin use.” While it will take considerable more work to stop the spread of antimicrobial resistance, such findings and efforts are critical.

NTI – Preparing for Biological Threats: Are We Ready to Prevent a Global Catastrophe
NTI has released an extremely informative and helpful page with details regarding the cost of bio threats, quotes from reports, consequences of such events, etc. The best though, is a navigation tool that explores how every and any country is vulnerable. Make sure to check out this helpful website!

Blue Ribbon Study Panel – Fighting the Next War: Defense Against Biological Weapons
The Blue Ribbon Study Panel on Biodefense will be hosting this meeting on February 5th, 2019, from 10am to 3:30pm at the Council on Foreign Relations. They are holding the “meeting to get a better understanding of the responsibilities and requirements for federal biodefense efforts that are unique to the U.S. Department of Defense. We want to know more about the role of the Department in implementing the National Biodefense Strategy. Participants will share their experiences regarding the current threat environment, research and development programs, and the Department’s biodefense policies.”

Ebola
The Ebola outbreak in the DRC continues to stress response efforts with the unique security situation that is an active war zone. “It was like a horror film,” Anoko said of the Nov. 16 attack in the city of Beni, the epicenter of the outbreak. “Attacks by armed groups happen on a daily basis across Congo’s North Kivu province, where the Ebola virus has been spreading since August, infecting almost 500 people and killing more than 270. It is now the second-biggest outbreak ever, after the vast epidemic that swept through Guinea, Sierra Leone and Liberia between 2014 and 2016.” The WHO has had to address growing concerns regarding the number of women and children that have been disproportionately infected during this outbreak as females account for 62% of cases and within that patient subgroup, 18 were pregnant and 7 were breastfeeding. As of December 12th, the DRC’s health ministry reported 5 new cases and 9 new deaths, with 100 people being investigated as potential cases. “Outbreak totals now stand at 505 cases, including 298 deaths. The new cases include two in Katwa and one each in Komanda, Musienene, and Mabalako. At least one of the newly recorded deaths occurred in the community, in Katwa, an event that heightens the risk of virus spread, the DRC said. Officials also issued two health alerts about possible disease spread in Goma, the capital and largest city in North Kivu province. For weeks, officials have warned that Ebola could spread in the city.”

One Health-Social Sciences Webinar Series
The One Health Social Sciences (OH-SS) Initiative is hosting a free webinar series to feature inspirational speakers addressing the role of the social sciences in advancing animal, human, and environmental health systems. Don’t miss the Tuesday, January 15th webinar from 11am-noon EST “Addressing Gender issues in One Health andInfectious Disease preparedness” presented by Dr. Bridgitte Bagnol and Dr. Janetrix Hellen Amuguni. Attendance is free but you must register here.

CEPI Partnership to Create Vaccines Against Emerging Infectious Diseases
The Coalition for Epidemic Preparedness Innovations (CEPI) and Imperial College London just announced a new partnership “to develop a self-amplifying RNA (saRNA) vaccine platform that enables tailored—just-in-time—vaccine production against multiple viral pathogens. The idea behind this saRNA approach is to harness the body’s own cell machinery to make an antigen (ie, a foreign substance that induces an immune response) rather than injecting the antigen directly. Currently, vaccines can take 10 years or more to develop. They must go through many phases of development—including research, discovery, pre-clinical testing, clinical testing, and regulatory approval. However, epidemics, by their nature, are sporadic, unpredictable and fast-moving. Through this partnership, CEPI aims to develop vaccines against new and unknown pathogens (also referred to as Disease X) within 16 weeks from identification of antigen to product release for clinical trials.” The partnership is worth up to $8.4 million and has the potential to change global preparedness efforts against emerging and unknown pathogens.

Release – National Strategy for Countering WMD Terrorism
The White House has just released the latest WMD national strategy which you can read here. “The National Strategy for Countering WMD Terrorism describes the United States Government’s approach to countering non-state WMD threats, emphasizing the need for continuous pressure against WMD-capable terrorist groups, enhanced security for dangerous materials throughout the world, and increased burden sharing among our foreign partners. The United States will draw on the full range of our nation’s and partner nations’ capabilities to place WMD and associated materials and expertise beyond the reach of terrorists. We will also strengthen our defenses at home to ensure the peace and security to which every American is entitled. Although not every class of weapon that falls under the rubric of ‘WMD’ is capable of producing truly large-scale casualties, chemical, bio- logical, radiological, and nuclear weapons each have characteristics that set them apart from conventional arms. Rudimentary chemical weapons, for instance, may be difficult to disseminate widely and may thus be inefficient killing agents, yet their gruesome effects make the psychological impact of these weapons especially potent.” Some of the objectives include: states and individuals are deterred from providing support to would-be WMD terrorists, the U.S. is able to identify and respond to technological trends that may enable terrorist development, acquisition, or use of WMD, etc.

Meat Allergy? You May Have Been Bitten By A Tick
Maryn McKenna lifts back the curtain on a spike in meat allergies and how a pesky vector is increasingly found to be the cause. “McGraw is allergic to the meat of mammals and everything else that comes from them: dairy products, wool and fibre, gelatine from their hooves, char from their bones. This syndrome affects some thousands of people in the USA and an uncertain but likely larger number worldwide, and after a decade of research, scientists have begun to understand what causes it. It is created by the bite of a tick, picked up on a hike or brushed against in a garden, or hitchhiking on the fur of a pet that was roaming outside. The illness, which generally goes by the name ‘alpha-gal allergy’ after the component of meat that triggers it, is a trial that McGraw and her family are still learning to cope with. In much the same way, medicine is grappling with it too.”

Pandemic Influenza Vaccine – Investing in Preparedness
Creating a vaccine that can combat pandemic flu is sort of the holy grail in bio preparedness. It’s something we desperately want but haven’t been able to develop…yet. ASPR and BARDA have been working hard to fix this gap in preparedness. “BARDA began pre-pandemic influenza vaccine procurement in 2005 for vaccines that would provide protection against emerging avian influenza H5N1 viruses posing a significant pandemic threat.  But a decade later we were compelled to ask how long would those stored vaccine components continue to be safe and effective at providing protection and when would they need to be replaced? The results of the ‘BARDA Ready In Times of Emergency’ (BRITE) study have just been finalized. The study is the first of its kind in the world and provided the data needed to answer that important preparedness question. H5N1 influenza vaccine stored for more than a decade in the National Pre-Pandemic Influenza Vaccine Stockpile (NPIVS) is still safe and immunogenic.”

One Health Video Competition Winner Announced
“ISOHA and NextGen Global Health Security Agenda are excited to announce Makerere University, Uganda, with the winning submission for our One Health Video Competition. They did a spectacular job of representing the diversity of One Health and defining what One Health means to them.”

Stories You May Have Missed:

  • Mobile HIV Diagnostic Tool Could Revolutionize Detection in Developing Countries – “HIV diagnostics have gone mobile thanks to a new cellphone app and 3D-printed attachment that use optical sensing and micromotor motion to detect the presence of the RNA nucleic acids of HIV-1 in a single drop of blood. Investigators from Brigham and Women’s Hospital in Boston, a teaching affiliate of Harvard Medical School, detailed this innovation in a recent paper published in Nature Communications.”

  • Organization of oversight for integrated control of neglected tropical diseases within Ministries of Health – “Neglected tropical diseases (NTDs) are communicable diseases that impact billions of people but receive disproportionately little attention from researchers and funders. Many of these diseases have similarities in their epidemiology and control measures, rendering the integration of control programs a practical option to improve accountability, efficiency, and cost-effectiveness. Efforts to integrate NTD control programs have begun across many of the countries with the highest overall burden of NTDs, although no standardized approach for integration exists. Our research sought to examine the landscape of approaches for NTD integration, across the 25 countries with the highest burden of NTDs, to identify models that could be used for countries seeking to integrate their NTD programs. Integration often first targets diseases that can be treated with preventative chemotherapy, though multiple administrative pathways and models exist, including integrating NTD control programs with other NTDs, other communicable diseases, or other health initiatives. Still, no country has yet fully integrated all of their NTD control efforts into a single program. This may be due to internal and external factors that impede the integration of NTD control. Future NTD integration efforts must account for these factors to maximize the potential success of integrated programs.”

Pandora Report: 12.7.2018

Review – Preventing Pandemics & Bioterrorism Event 
If you weren’t able to make this event on Tuesday evening, you’re in luck. We’ve got everything from the program to a detailed recap. You can also see the slides from our featured speaker, Dr. Robert Kadlec of ASPR. We highly suggest watching the recording of the event (to be released shortly) as you’ll not only learn about pandemic preparedness from Dr. Kadlec, but also the evolution of biodefense strategies through several administrations. “’Biology makes our world a better, safer place, but it could also end the world,’ he said. ‘The key is understanding the opportunities, risks, and considerations for what we need to do in security.’ For students in the field, ‘the bio-economy is an extraordinary opportunity,’ he said. ‘What Greg Koblentz [director of the Schar School biodefense program] has done is an incredible effort. I understand he has 300 graduates, 60-plus students this year—that’s a testimony not only to Greg and his counterparts on the faculty but also to the interest and recognition of how important a topic this is’.”

Biosecurity in the Age of Genome Editing
Last week was a busy biodefense events week! If you weren’t able to attend the launch of New America’s latest report on biosecurity in the age of genome editing, we’ve got a full summary from GMU Biodefense graduate student Justin Hurt. Justin noted that “the discussion centered around the findings of the recently released study, Editing Biosecurity, Needs and Strategies for Governing Genome Editing, and included authors Jesse Kirkpatrick of Arizona State University, Greg Koblentz and Edward Perello, both from George Mason University, and Megan Palmer and David Relman, both from Stanford University. Each author spoke about specific portions of the study, a two-year project designed to ascertain the inherent risks and security challenges regarding the rapidly developing field of genome editing, which includes such technologies as the highly promising but potentially risky CRISPR gene editing technique.” We also have created a page with everything from the video recording of the event to the full report available in one place to make it easier.

15 Worrying Things About the CRISPR Baby Situation
Speaking of CRISPR concerns….as more information comes out regarding Chinese researcher He Jiankui and his claims of making the first CRISPR-edited babies, here’s a good recap of 15 concerning details. One of the worrisome aspects of the experiment is the lack of clarity surrounding the function of the new mutations- “At least two of the three mutations that He introduced into Nana and Lulu’s genomes are substantial changes that could alter how CCR5 works. Typically, scientists would introduce the same mutations into mice or other lab animals to see what would happen. If they felt reassured enough to move into human patients, they could recruit patients with HIV, take out some immune cells, introduce the new CCR5 mutations, transplant the cells back, and monitor the volunteers to see if they’re healthy. ‘That could take months or years, but to do anything less would be cutting corners,’ Ryder says.” Bioethicist Kelly Hills of Rogue Bioethics noted the key differences though regarding innovative treatment and clinical research. “In the USA, there is no way any government authority would demand that a woman pregnant with a genetically modified fetus abort the pregnancy, so in the end, we have to ask: will a $100,000 fine and maybe a year in jail, as the most severe theoretical punishments, actually discourage people, especially given the very long history of both the FDA allowing innovative treatment AND not intervening when companies are clearly breaking much more clearly established laws around clinical research and human subjects Finally, and one of the other reasons I tie this to CellTex, the FDA often seems to expend its energy on enforcement of issues where they will have strong public support. In the case of stem cell injection, though, public support for prosecution was not there—and likewise, the American public overwhelmingly supports germline gene editing of serious medical issues. It is simply not clear the political will would be there to pursue someone doing He’s project in America, even if it were determined to be ‘distributing a new drug.’ (And again, I think it’s much more likely that it would be argued and treated as innovative treatment rather than a new drug—ESPECIALLY if it’s true that the new pregnancy is a PCSK9 modification, rather than CCR5.)”

Biological Weapons Convention – Meeting of States Parties (MSP)
The MSP began this week and not surprisingly, the topic of financing the BWC has been the elephant in the room – overlooked by many countries but not those in the audience. The BWC is in a dire situation due to many countries failing to meet their financial obligations. You can find daily reports from Richard Guthrie here, which provides a detailed account of the meetings and events. Guthrie reported that “Many statements noted that the root cause of the financial difficulties was the late payment of assessed contributions. Numerous calls were made for those states parties behind with payments to clear their arrears and, in future, to pay in full and pay on time. There were a number of expressions of support for some method to smooth cashflows such as a working capital fund. It was noted such a fund could be established through voluntary contributions, by placing any credits from future budgetary underspends into it or by putting arrears payments from past financial years into it. China noted that it had already paid its assessed contribution for 2019 to ease cashflow.” The Joint NGO Statement was also given – emphasizing the important role the NGO community plays in the BWC. One of the main issues discussed was that “over recent months, unsupported allegations of ‘secret laboratories developing biological weapons’ have intensified. These claims risk diminishing the taboo against biological weapons. They create uncertainty around the prohibition and undermine the BWC, and they may give the impression that biological weapons are worth pursuing, possibly even encouraging other nations to do so. If a state party has genuine concerns about a biological weapons threat, there are existing mechanisms and precedent under Article V of the BWC to raise the issue. In the meantime, the international community must push back on unsupported allegations, and step up its efforts to actively devalue biological weapons as a military option.”

Federal Select Agent Program Strategic Plan FY18-FY21
The latest Select Agent Program strategic plan is out! Within this document, there are several goals, such as ensuring the recruitment, development, and retention a knowledgable and professional FSAP workforce, harmonize FSAP organizational processes and inspections, engaging and increasing transparency and highlighting program benefits, etc. “We are pleased to share this FSAP Strategic Plan, which will guide our efforts for the remainder of fiscal year (FY) 2018 through FY2021. Our joint strategic planning effort serves as a clear reminder of the many successes we have achieved together over nearly two decades as FSAP, as well as the myriad challenges against which we must continue to focus in order to sustain and enhance biosafety and security of BSAT in the United States.”

Governance of Dual Use Research in the Life Sciences – NASEM Workshop
“Continuing rapid developments in the life sciences offer the promise of providing tools to meet global challenges in health, agriculture, the environment, and economic development; some of the benefits are already being realized. However, such advances also bring with them new social, ethical, legal, and security challenges. Governance questions form an increasingly important part of the discussions about these advances—whether the particular issue under debate is the development of ethical principles for human genome editing, how to establish regulatory systems for the safe conduct of field trials of gene drive-modified organisms, or many others. However there are continuing concerns that the knowledge, tools, and techniques resulting from life sciences research could also enable the development of bioweapons or facilitate bioterrorism.” The findings of this June 2018 workshop involved the efforts of more than 70 participants from 30 countries and 5 international organizations.

Ebola in the DRC – Updates
As of Wednesday, the additional cases of Ebola in the DRC have raised the total to 458 cases, of which 410 are confirmed, and 263 deaths. “In a weekly report from the WHO African regional office that covered 28 cases reported between Nov 23 and Dec 1, the group said the number of illnesses declined from 46 reported the week before. Weekly deaths dropped from 22 reported 2 weeks ago to 19 last week. Three more infections were reported in healthcare workers, raising the total to 43 illnesses in health workers, 12 of them fatal. Based on locations of cases reported over the past 3 week weeks, Beni, Katwa, and Kalunguta are still the hot spots.” There are 75 suspect cases still being investigated.

Infection Prevention Training Through the Center for Domestic Preparedness: An Infection Preventionist’s Experience
“For many of us, it has been a while since we’ve donned Ebola personal protective equipment (PPE). In 2014, there was a mad dash to obtain the PPE the US Centers for Disease Control and Prevention (CDC) were recommending for working with patients with Ebola virus disease. We rapidly learned the art that was donning and doffing this enhanced PPE while working to ensure we did not cross contaminate each other, let alone the observer/aid that was helping us. This was a relatively novel moment for many of us in infection prevention and health care. Who would have thought we would be preparing for Ebola in the United States? Last week, I attended the Barrier Precautions and Controls for Highly Infectious Diseases (“HID”) training hosted by the Center for Domestic Preparedness (CDP). CDP is a training center used for military purposes (think chemical and biological incidents, etc). In 2007, the Noble Training Facility was integrated into the CDP and the former Noble Army Hospital was used as a new site to strengthen public health, health care, and medical personnel during disasters and incidents. The CDP is part of the Federal Emergency Management Agency (FEMA) after it was transferred from the Department of Homeland Security in 2007. The whole purpose of CDP is to strengthen critical infrastructure through training and education to state, local, tribal, and territory emergency responders.”

Book Review- Stalin’s Secret Weapon
Searching for a good winter book to read? Look no further – Stalin’s Secret Weapon discusses Stalin’s obsession with biological weapons. “Joseph Stalin’s obsession with weapons of mass destruction included the promotion of biological weapons (BW), but the background to his regime’s development of this type of warfare, with its triumphs and failures, makes for eye-opening and sometimes grim reading. Anthony Rimmington’s book pulls together his 30 years of research and specialist articles, showing first how Russia’s interest can be traced back to the late 19th century when a St Petersburg guards officer was bitten by a rabid horse. The officer’s treatment led to the establishment of groups of physicians and veterinary surgeons studying ways to combat the likes of brucellosis, glanders and rabbit fever, as well as diseases that affected humans, such as smallpox and pneumonic plague. During the First World War the focus shifted to military uses of this knowledge: horses and mules deliberately infected with dangerous bacteria could disrupt entire campaigns, and many of these animal diseases could transfer to enemy troops.”

Stories You May Have Missed:

  • Cracking A Pandemic Flu Secret – “Rolland, a pathologist, had written a report in 1917, the year before the start of the Spanish flu. It described cases of British soldiers in France who had contracted an unusually fatal respiratory illness. Worobey, an evolutionary biology professor with a particular interest in the 1918 pandemic, wanted to know whether any of Rolland’s samples might still be lying about a century later. Within a few hours, he had found a possible contact and fired off an email. Across the Atlantic, 5,000 miles away, a retired family physician in England’s picturesque Lake District received it. He replied immediately.”

Event Review: Editing Biosecurity, Needs and Strategies for Governing Genome Editing

By Justin Hurt, GMU Biodefense

On December 3rd, 2018, the New America policy study organization hosted an event entitled “Biosecurity in the Age of Genome Editing,” a panel discussion moderated by Daniel Rothenberg of Arizona State University. The discussion centered around the findings of the recently released study, Editing Biosecurity, Needs and Strategies for Governing Genome Editing, and included authors Jesse Kirkpatrick of Arizona State University, Greg Koblentz and Edward Perello, both from George Mason University, and Megan Palmer and David Relman, both from Stanford University. Each author spoke about specific portions of the study, a two-year project designed to ascertain the inherent risks and security challenges regarding the rapidly developing field of genome editing, which includes such technologies as the highly promising but potentially risky CRISPR gene editing technique. Continue reading “Event Review: Editing Biosecurity, Needs and Strategies for Governing Genome Editing”

Pandora Report 11.30.2018

Next week is your chance to attend two amazing biodefense events – one hosted by GMU Biodefense featuring Dr. Kadlec of ASPR and the second on biosecurity in the age of genome editing. You can find all the details below!

Preventing Pandemics and Bioterrorism: Past, Present, and Future
Are you attending our event on the evening of Tuesday, December 4th? Special guest Dr. Robert Kadlec, Assistant Secretary for Preparedness and Response (ASPR) of the Department of Health and Human Services, will be discussing lessons learned for pandemic preparedness since the 1918-1919 influenza pandemic, plans for implementing the new National Biodefense Strategy, and the importance of education for the future of biodefense. Following his speech and Q&A session, you are invited to an informal reception for academic and professional members of the biodefense community to socialize and network. Hors d’oeurves and drinks will be provided. Seats are limited, so make sure you save your spot and RSVP.

Biosecurity in the Age of Genome Editing
Claims of CRISPR use in babies brought forth a flurry of discussion surrounding the ethics and uses of genome editing. This technology promises major beneficial contributions, yet it has the potential to radically alter the security landscape. Next week, on Monday, December 3rd, New America will be hosting an event on the biosecurity implications of genome editing. “In a new report Editing Biosecurity: Needs and Strategies for Governing Genome Editing based on two years of study by researchers from George Mason University, Stanford University, and New America examines the issue and provides concrete and actionable options for policy makers.” This is a great opportunity to learn from and chat with experts in the field on the potential for genome editing technologies to be misused for nefarious purposes and the implications for biosecurity.

Reflections on the 5th Ministerial Meeting of the Global Health Security Agenda
We’re excited to provide you with a full recap of the 5th Ministerial Meeting of the GHSA. Within this summary, you’ll find reflections from NextGen Health Security Network’s Coordinator Jamechia Hoyle, GMU Global Health Security Ambassadors Annette Prieto and Saskia Popescu, and several other attendees. This is a great review of the international meeting in Bali, Indonesia, and the topics that were just as diverse as the biological threats we seek to prevent. From antimicrobial resistance to financing preparedness at the national level, and even strengthening hospital response, we hope you find the review of this exciting meeting as captivating as it was for us to attend!

DRC Ebola Outbreak Updates
Ebola continues to spread within the DRC. On November 26th, 33 more cases were reported, and then on Thursday, it was reported that the total cases have reached 426, 379 of which are confirmed, and a total of 245 deaths. This outbreak is now the second largest ever. Health centers have been a source for transmission, as nosocomial transmission tends to be a theme in Ebola outbreaks. Additional efforts have been directed to infection prevention and control measures, as well as training and disinfection products. Unfortunately, cases have also been seen in babies – on November 20th, 7 newborn babies and 6 children 2-17 years of age were identified as cases. Approval was given to test experimental treatment as well. “The health ministry said in a Nov 24 announcement that an ethics committee at the University of Kinshasa has approved a protocol for testing four experimental Ebola treatments, which are currently being used on an emergency basis in Ebola treatment centers. They are mAb114, Zmapp, remdesivir, and Regeneron’s REGN-EB3 antibody. The authorization for emergency or compassionate use, however, doesn’t provide for the standardized collection of data on the efficacy and safety of each treatment the health ministry said. The ministry statement indicates that the clinical trial started last week on three of the four treatments (Zmapp, mAb114, and remdesivir) at Beni’s Ebola treatment center. Future trials could be extended to other sites and include REGN-EB3. However, for now, the other Ebola treatment centers will continue to administer the drugs on a compassionate basis.”

The Red Box- A New Healthcare Approach to Infection Control?
GMU Biodefense doctoral student and infection preventionist Saskia Popescu discusses a new approach to improving patient interactions without decreasing isolation precautions during hospitalization of infectious patients. “Although these methods are pivotal to patient and staff safety, donning and doffing PPE is time-consuming, and therefore, often a barrier for health care workers to make frequent visits to a patient’s room. This can often leave patients feeling isolated and create a negative association with isolation precautions for both the staff and patients during their hospitalization. It can also negatively impact medical care. To circumvent these issues, investigators on a new study tested a strategy for supporting isolation precautions while encouraging more health care worker-patient interaction through the use of a ‘red box’. Just like a red line in the operating room and peri-op areas, the red box was a visual reminder. It was a designated area on the floor of a patient’s room created using red duct tape that extended 3 feet beyond the door of the room, but stopped more than 6 feet from the patient. The use of PPE was required outside of the red box; however, while inside, the health care workers could communicate with the patient without the use of PPE, while still maintaining a safe distance from the patient and contact with the environment.”

Unseen Interactions Play An Important Role in Disease Transmission
Sometimes, all it takes is a small moment in time for a disease to spread. A recent study looked to these tiny, often ignored moments in bat populations to see how disease may be transmitted by unseen interactions. “A new study by investigators at the University of California–Santa Cruz set out to find out more about this moment by evaluating disease transmission in bats frequently impacted by the fungal infection, white-nose syndrome. This infection can devastate bat populations and the investigators were hoping to understand the under-the-radar (pun intended) connections between bats that might facilitate the spread of the disease. For the study, the investigators dusted bats with a fluorescent powder that glowed under ultraviolet light to track ‘cryptic connections.’ They evaluated 8 bat hibernation sites in the upper Midwest (fun fact: abandoned mine tunnels are prime bat spots!) in which they found up to 4 different bat species. Prior to ‘dusting’ the bats with the powder, the team observed the bats’ social networks and measured direct physical contacts between bats that were hibernating together in groups, as well as contact between those bats that moved between groups.”

Foundation of Evidence Base for Health Security Implementation – Special Supplement of Healthy Security
In the latest supplement of Health Security, joint efforts with CDC and partners are described. “The foundation of this work is detailed in a series of articles and commentaries in a special supplement to Health Security, “Building the Evidence Base for Global Health Security Implementation,” published Nov. 27 and produced in collaboration with the Johns Hopkins Center for Health Security. In the articles, CDC and global health security partners describe outcomes and lessons learned from multiple countries throughout Africa, Asia, and Latin America that are implementing activities to enhance public health capacities in disease prevention, detection, and response. CDC and partners have gathered and are sharing these lessons on specific approaches and interventions that are most effective in enhancing a country’s capacity for health security. The world has, in recent years, seen a series of alarming public health emergencies that have resulted in thousands of lives lost and billions of dollars in economic losses.”

Stories You May Have Missed:

  • AFM Task Force Created – “The Centers for Disease Control and Prevention (CDC) announced yesterday the creation of the Acute Flaccid Myelitis (AFM) Task Force, which will search for the cause of the mysterious polio-like condition. ‘I want to reaffirm to parents, patients, and our Nation CDC’s commitment to this serious medical condition,’ said CDC Director Robert Redfield, MD, in a press release. ‘This Task Force will ensure that the full capacity of the scientific community is engaged and working together to provide important answers and solutions to actively detect, more effectively treat, and ultimately prevent AFM and its consequences’.”
  • GMU Biodefense PhD Student Spotlight – Curious about our array of biodefense doctoral students? Check out this spotlight on Saskia Popescu. “It was her strong interest in both the medical side of the field and the policy side that drew her to Mason’s Biodefense Program. ‘The program brings it all together to understand the complexities of health security,’ she says. ‘We have experts from both fields coming to the classroom who can speak to all aspects, which is huge’.”