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Pandora Report 1.20.2017

We’ve got lots of biodefense goodies for you this week, so grab your PPE and let’s get rolling!

Billion-Dollar Vaccine and Epidemic Preparedness Project 
The Coalition for Epidemic Preparedness Innovations (CEPI) launched this week at the World Economic Forum with an initial $460 million backing from Norway, Germany, Japan, the Welcome Trust, and the Bill & Melinda Gates Foundation. CEPI expects to raise the rest of the needed $1 billion by the end of the year. Their focus is on pre-emptively developing and stockpiling vaccines to better prevent and respond to outbreaks. CEPI marks the largest vaccine development initiative and their plan is to start with vaccines against Nipah virus, MERS-CoV, and Lassa fever. While this is wonderful news, it may just be one step closer to marginalizing the WHO, which has been struggling to stay both relevant and effective. The WHO response to Ebola started drawing more recent attention to the organization’s struggles which were only fueled by slow vaccine procurement/development. These issues culminated with their recommendations to dilute the yellow fever vaccines during last year’s outbreak in Africa due to poor planning. Vaccine development and stockpiling is truly vital to outbreak response. “The CEPI intends to support research at every stage, from basic lab work to vaccine discovery and clinical trials. It also made its first call for research proposals on 18 January, and teams have until 8 March to submit preliminary proposals for grants. ‘For too long, we have separated out the academic work from the next step of taking it into all that is actually required to make a vaccine,’ says Farrar. There is also no market for vaccines against ‘potential’ epidemic threats, he notes, which explains why there is no commercial incentive to take research leads out of the lab and into clinical development’.”

ABSA DURC Roundtable
Don’t miss the Dual Use Research of Concern (DURC) Roundtable Discussion offered by ABSA International on March 15th! This distance learning opportunity will be offered from 12-2pm (CDT), and will aid the user in finding resources and guidance on the U.S. government DURC policies, developing a network of biosafety professionals, and more! “One size does not fit all when it comes to solutions to comply with research policy. The goal of this webinar is to provide best practices, provide insight on how several different institutions are meeting the DURC policy requirements, and help participants troubleshoot issues surrounding DURC that they may have at their institutions. Participants will have the opportunity to submit questions regarding DURC prior to the start of the webinar as well as during the live webinar.”

GMU Trains First Responders Against Infectious Disease  firstrespondertraining3_davefarris
GMU’s Office of Safety, Emergency, and Enterprise Rise Management is now providing local and national first responders with infectious disease training so that they’re better able to protect themselves during outbreaks. The program was made available through a three-year grant from the National Institute of Environmental Health Sciences. “This training is a natural extension of a program Mason’s Biomedical Research Lab biosafety manager Diann Stedman has offered to regional emergency response personnel since the 2010 opening of the lab on the Science and Technology Campus. Stedman is leading the training with Julie Zobel, assistant vice president of safety, emergency and enterprise risk management, and David Farris, executive director of safety and emergency management. Collectively, the three have more than 30 years of experience in the health and safety field, much of it focused on biological safety.”

Completing the Development of Ebola Vaccines 
CIDRAP and Welcome Trust have just released their report – Completing the Development of Ebola Vaccines: Current Status, Remaining Challenges, and Recommendations. “This is the third major report from the Wellcome Trust–CIDRAP Ebola Vaccine Team B. The first report, Recommendations for Accelerating the Development of Ebola Vaccines: Report and Analysis, was released in February 2015, and the second, Plotting the Course of Ebola Vaccines: Challenges and Unanswered Questions, was released in March 2016. In this report, similar to our previous efforts, we have three primary objectives. The first is to track progress toward ensuring that safe, effective, and durable multivalent Ebola vaccines are readily available and can be rapidly deployed when the next outbreak occurs. The second is to identify challenges and barriers where additional efforts are needed, although some of the remaining issues are complex and will require substantial resources to resolve. Our third objective is to provide a set of high-level recommendations that we believe, if implemented, will facilitate the goal of having a robust Ebola virus disease (EVD) prevention program in place that allows prophylactic vaccination of high-risk frontline workers and provides well- maintained vaccine stockpiles to facilitate rapid control of Ebola outbreaks.” The report highlights current clinical evaluations of Ebola vaccine candidates, funding, and regulatory activities. Some of the recommendations include reassessing the leadership structure for Ebola vaccine preparedness, developing strategies for mitigating the financial uncertainties and risks for manufacturers, etc. This report has left many experts pointing to the reality that we’re just not ready for another Ebola outbreak. 

Center for Health Security Joins Johns Hopkins Bloomberg School 
The Center for Health Security has a new home in Johns Hopkins Bloomberg School of Public Health! Previously affiliated with the University of Pittsburgh Medical Center, the CHS will now have significant new opportunities for research and work in national and international public health policy. Originally founded in 1998 by the late D.A. Henderson at Johns Hopkins, the center has been affiliated with UPMC since 2003. “The mission of our center is a perfect fit with the Johns Hopkins Bloomberg School of Public Health because we share a commitment to improving global health and to protecting lives through large-scale change,” says Tom Inglesby, director and CEO of the Center for Health Security. “Moving to the Bloomberg School will expand the reach of the center and help us collaborate with and tap into the universe of great talent at Johns Hopkins. We look forward to joining our expertise on health security and preparedness policy to Johns Hopkins’ internationally recognized community of scientists and public health scholars.” We’re looking forward to seeing all the great work that will be done as the center returns to Johns Hopkins!

Zika Outbreak Updates
As the dust settles, some are looking to the WHO and public health infrastructure failures regarding the Zika outbreak as many are pointing out how the response failed millions. “But the positives were counterbalanced by many negatives, experts said. They harshly criticized the partisan bickering that delayed a Zika-funding bill in Congress for months, and they decried the failure of every city in the hemisphere — other than Miami — to control mosquitoes.” You can also read an opinion piece here, from a pregnant woman living in Miami who tested positive for the Zika. As of January 18th, the CDC has reported 4,900 cases of Zika in the U.S.

Stories You May Have Missed:

  • screen-shot-2017-01-19-at-12-31-34-pmCDC Director’s Departing Words- As CDC director, Dr. Tom Frieden, prepares to leave office after 8 years, he’s offering some words of wisdom. Dr. Frieden has been tested by major health events like Ebola, Zika, MERS, 2009’s H1N1, and a growing domestic overdose issue. “Fundamentally, Americans are healthier and safer because of the work CDC has done over the last eight years. Americans are safer because we have better capacities in place, better infrastructure in place in this country and around the world to find threats early, stop them quickly and prevent them wherever possible. We’ve done that through laboratory work that looks at microbial genomics so we can stop outbreaks sooner. We’ve done that by training the next generation of public health specialists — more than 1,000 of them, fresh out of college and graduate school — deployed out to state and local governments. These people will be protecting Americans for decades to come.”
  • Proposed Presidential Autism-Vaccine Panel Could Help Spread Disease– The potential panel is drawing increasing attention as Robert F. Kennedy Jr. is poised to be the leader. The environmental lawyer has been vocal in his vaccine skepticism, which has led many to worry in terms of federal support for vaccine programs. “Although the autism–vaccine claim has been studied and debunked, the president-elect has also suggested a connection. His team later hedged about the panel, saying that nothing had been decided. (Kennedy’s office declined an interview request.) Nevertheless, public health experts and autism advocates are deeply worried that an effort with presidential backing could undermine public confidence in vaccines and trigger epidemics of all-but-eradicated diseases.”
  • Assad Linked to Syrian Chemical Attacks – The Syrian President has officially been linked to a series of chlorine bomb attacks in 2014/2015. “International investigators have said for the first time that they suspect President Bashar al-Assad and his brother are responsible for the use of chemical weapons in the Syrian conflict, according to a document seen by Reuters. A joint inquiry for the United Nations and global watchdog the Organisation for the Prohibition of Chemical Weapons (OPCW) had previously identified only military units and did not name any commanders or officials.”
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Pandora Report 1.13.2017

Make sure to get the CRISPR a cappella song stuck in your head for not only a catchy tune, but one that educates you on the genome editing tool! In light of the recent sanctions, GMU Biodefense Director, Gregory Koblentz is discussing why holding the Assad regime accountable for its use of chemical weapons is likely a lost cause.

Recommended Policy Guidance for Potential Pandemic Pathogen Care & Oversight
On Monday, the White House Office of Science and Technology Policy (OSTP) released their report “Recommended Policy Guidance for Departmental Development of Review Mechanisms for Potential Pandemic Pathogen Care and Oversight (P3CO).” It would seem that P3CO is the new term for GoF research of concern (or GoFROC). Although, as Megan Palmer of Stanford noted, it’s going to be a challenge not calling it the C3PO policy. Adoption of these recommendations will satisfy the requirements for lifting the current moratorium on certain life sciences research that could enhance a pathogen’s virulence and transmissibility to produce a potential pandemic pathogen (an enhanced PPP). This policy follows the 2016 NSABB Gain of Function (GoF) research oversight recommendations, which emphasizes the importance of domestic and international stakeholder input, tracking of lab incidents, etc. One of the suggestions was to refer to the GoF research (meeting the specific criteria) as GoFROC as to avoid lumping all GoF research within the same category of concern. Per the press release, “First, HHS will ask the NSABB to continue to provide advice on the oversight of the creation, transport, or use of enhanced PPP.  After HHS has reviewed its paused projects and made decisions about whether and how those projects will proceed, NSABB will review the process employed by HHS and provide advice, if necessary. Continued NSABB input will be essential to ensuring robust oversight of these projects. Further, discussing the department-level review process with NSABB will promote transparency and provide valuable forums for continued public dialogue. Second, given that studies involving enhanced PPP are often described as ‘dual use’ research, HHS is currently conducting a review of the implementation of policies for the oversight of dual use research of concern (DURC). HHS has asked NSABB to host a series of regional stakeholder meetings to gather information about the implementation of the DURC policies, and it will also solicit feedback more broadly related to their implementation.” Some of the proposed suggestions include risk mitigation and project oversight comments like “modifying the design or conduct of the project” or “if the risks posed by the project cannot be adequately mitigated with these measures, agencies should determine whether it is appropriate to: request voluntary redaction of publications or communications resulting from the project.” The plan will help U.S. agencies decide if they want to fund projects that will enhance the virulence and transmission capacity of dangerous organisms, which will hopefully end a two-year moratorium on GoF work regarding MERS, SARS, and H5N1.

Thinking About Bioterrorism with Schelling’s ‘Thinking About Nuclear Terrorism” 
GMU Biodefense MS student, Greg Mercer is looking at bioweapons through the lens of Thomas Schelling. Professor Schelling, who passed away in December, was an economist and Nobel laureate famous for his work on nuclear strategy and coercive diplomacy. Mercer uses Schelling’s 1982 article, Thinking About Nuclear Terrorism, to consider how he might have addressed the threat of biological weapons in the hands of terrorists. “As with nuclear weapons, it is immensely difficult to acquire and weaponize pathogens. Using them to coerce might be even harder. There are a very few distinct examples of bioterrorism. The Aum Shinrikyo cult, in addition to their sarin gas attacks on the Tokyo subway, pursued biological weapons. This was never viable, thanks to a number of mistakes, including using the wrong strain of anthrax.”

Whole Genome Sequencing in Developing Countries
The WHO/Pan-American Health Organization are working towards utilizing Whole Genome Sequencing (WGS) as a surveillance tool in developing countries. Experts will be meeting this week in DC to discuss the applications and practical advice needed by the recipient countries of such mechanisms. “WGS has the potential to change the way we detect, assess, investigate, manage, and monitor microbiological hazards and to improve the treatment of people suffering from infectious diseases. It allows for the identification and characterization of microorganisms with a level of specificity not previously possible. The technology provides significant cross-sector potential, enabling uniform typing systems across animal, food and human sectors.” This will be a new roadmap for WGS in developing countries, as its history has been primarily research based. While many agree that there are several roadblocks ahead, the potential for application is promising however, it needs the correct leadership to maintain efficacy.

Pandemics, Bioterrorism, and Global Health Security on LinkedIn
Looking for a LinkedIn group that is dedicated to analyzing the challenges facing the world at the nexus of health, science, and security? We’ve got just the one – Pandemics, Bioterrorism, and Global Health Security. The group’s purpose is to serve as a unique forum for discussions and debate on the critical issues on global health security. Nearing 3,000 members, you’ll find a diverse and engaged group of people who are looking to tackle the challenges that are posed by biological threats, regardless of source. This group is devoted to bridging the gaps between science and policy and between health and security to develop new strategies for reducing the risks posed by transnational threats to global health security. It is hoped that this group can serve as a means of keeping scientists informed about the latest policy developments in the global health security domain as well as to educate practitioners about the policy implications of emerging infectious diseases and advances in the life sciences and biotechnology.

America’s Growing AMR Problem  

Courtesy of Reuters
Courtesy of Reuters

Let’s start with a bit of a good news – for the first time, federal injury reports will include healthcare-associated antibiotic resistance bacteria infections in attempts to set penalties for healthcare facilities. The fourth installment in Reuter’s investigational series regarding antimicrobial resistance is out and it brings the issue full circle. Focusing on the costs of AMR, the lack of new antibiotics, and personal accounts, this series is everything we need to paint the full picture of the antibiotic abyss. The fourth installment, Deadly Silence, is particularly fascinating as it looks at the problem from a healthcare reporting perspective. Coming from this infection preventionist, it isn’t surprising to see the lack of required AMR reporting across the U.S. however, it is shocking to see the general indifference towards changing it. Focusing on long-term care facilities (like nursing homes or rehab centers), it becomes increasingly apparent that they’re uniquely vulnerable to outbreaks and have little incentive or responsibility to report cases or events. “As Reuters reported in September, the Centers for Disease Control and Prevention, the national public health monitor, lacks regulatory power to track superbug deaths. It also lacks the authority to enforce outbreak reporting. Instead, it sometimes assists states with their outbreak investigations, a spokesman said, but each state decides which diseases must be reported.” The reporting issues are especially important because it’s not just that we have a problem with lack of new antibiotics or a growing number of antimicrobial resistance, or even a growing usage of antibiotics among humans and animals, but also that we lack the oversight and enforcement to ensure healthcare facilities monitor the problem and do something about it. This gap means that we have little true understanding for not only the depth of the issue, but also the breadth of it. Simply put, we need a new game plan for combating the growing threat of antibiotic resistance.

PHEMCE Strategy & Implementation Plan
HHS recently released their 2016 Public Health Emergency Medical Countermeasures (PHEMCE) Strategy and Implementation Plan (SIP). The report provides updates and a blueprint regarding their plans to enhance national health security via medical countermeasures (MCM). Within the PHEMCE SIP, you can find a summary of their major accomplishments, activities currently being pursued, recap of the advanced research and development and procurement awards, and more. “In FY 2015, BARDA continued to work closely with NIH and DoD to monitor the progress of programs supported under research and development and transition promising candidates. In FY 2015, BARDA re-issued the three BAAs to support advanced development of CBRN and Influenza MCMs and the BAA for Innovations. They were modified to align with the 2015 PHEMCE SIP and to address remaining gaps in preparedness as well as address new initiatives such as CARB and EID.”

Zika Outbreak Updates
As Angola reports cases, a new Moderna Therapeutics mRNA vaccine enters clinical trials. “A $54.2 million grant in 2016 from BARDA has supported the development of the vaccine through the scale-up for larger phase 2/3 efficacy trials. Based on the vaccine’s performance and availability of more funding, BARDA may provide up to $125.5 million to further advance the development of Moderna’s vaccine.” On January 11th, the CDC reported a total of 4,866 cases of Zika within the U.S. Physicians have released a photo showing symptoms of the first person to experience local Zika transmission in the U.S.

Stories You May Have Missed:

  • FDA Drops Plan to Release GMO Mosquitoes – Initial FDA plans to drop millions of genetically engineered mosquitoes in Key Haven, Florida, were halted after local residents voted against it.  The plan “was designed to help fight the Zika virus with mosquitoes that had been genetically altered. It would have been the first such initiative executed in the United States. However, attorneys for Key Haven and concerned citizens noted that the FDA did not complete adequate testing on the potential impact the release would have on people, the local environment, nor area species concerned threatened and endangered. Local residents were presented with the issue via voting ballot in November 2016, in which voters unanimously shot down the release. The Florida Keys Mosquito Control Division met after the Nov. 8, 2016, public referendum and voted against the trial run in Monroe County in Florida, according to http://www.flkeysnews.com.”
  • The Woes of Camel Vaccination Plans – In efforts to test an experimental vaccine against MERS, researchers are trying to slow the spread via camel vaccination. We often forget the battles that make up public health and vaccine development, but camel vaccination is definitely a new one. “Camels are not a very, let’s say, cooperative kind of animal from this point of view,’’ Segalés told STAT. “To get them out from the truck was not that easy. To get them into the facility was not that easy. And to get them into the box (holding pen) was not that easy. Trying to push them in was quite difficult sometimes. And the worst-case scenario was trying to take them out.”
  • Trump Picks Vaccine-Skeptic to Lead Vaccine Safety Commission– “Robert F. Kennedy Jr., a proponent of a widely discredited theory that vaccines cause autism, said Tuesday that President-elect Donald Trump asked him to chair a new commission on vaccines. Hours later, however, a spokeswoman for Trump’s transition said that while Trump would like to create a commission on autism, no final decision had been made.”
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Pandora Report 1.6.2017

Welcome to 2017 and a whole new year of biodefense news! While you’re heading back to work, make sure to wash your hands and stay safe – the CDC has reported increasing flu activity.

The Best of Bio and Chem Weapons Coverage in 2016
The Bulletin of the Atomic Scientists has put together their “five best articles” for bio-chem weapons in 2016 and we were happy to see two familiar faces – GMU PhD alum Daniel M. Gerstein and GMU Biodefense professor, Sonia Ben Ouagrham-Gormley. Daniel Gerstein’s article, How genetic editing became a national security threat, discusses the threatening components of gene drive, like low cost and growing availability. “Armed with the proper genetic sequences, states or bioterrorists could employ genome editing to create highly virulent pathogens for use in such attacks. They could, for example, change a less dangerous, non-pathogenic strain of anthrax into a highly virulent form by altering the genome, or recreate pathogens such as the deadly smallpox virus, which was eradicated in the wild in 1980.” Sonia Ben Ouagrham-Gormley teamed up with Kathleen Vogel to discuss the good, bad, and the hype of gene drive. They emphasize the importance of understanding gene drive to really discern the benefits and risks of the technological process. Looking at all angles, their article gives a wholistic approach to better appreciate the complexities of gene drive for biodefense. “Without a clear and detailed understanding of the range of social and technical factors that cause scientists to succeed or fail in their gene-drive endeavors, threat estimates can only rely on speculation and fantasy rather than fact.”

GMU Biodefense Students – Win Registration for 2017 ASM Biothreats Conference!
Calling all GMU Biodefense students – the program will be offering free registration to four lucky students to attend this premier biodefense event at the Marriott Wardman Park in Washington, DC on February 6-8th. This year, the meeting incorporates three major tracks, “Research, Response, and Policy” to cover relevant topics in basic and applied research; public health, emergency response and preparedness; and biosecurity, government, and policy responses. The exchange between these multidisciplinary communities will shape the future of this very important field. The keynote session on February 6 will be given by Thomas M. Countryman, Acting Under Secretary for Arms Control and International Security and Assistant Secretary to the Bureau of International Security and Nonproliferation at the Department of State.  Anthony S. Fauci, M.D., Director of NIAID Director at the National Institutes of Health, will be presenting at a special session on February 7. You can find the rest of the agenda here. As an attendant for the 2016 conference, I can tell you that it’s a great experience for not only learning, but also networking. Please check your GMU email for the information Dr. Koblentz sent out. To apply: students are required to submit a 250-word essay about how attending the conference will benefit your education/professional aspirations by 5pm today (Friday, January 6th) to Dr. Koblentz. Winners will be announced the following Monday and those selected will be asked to write up summaries of at least two panels for publication in the Pandora Report.

USGS Disease Maps
screen-shot-2017-01-03-at-6-04-01-amLove maps and diseases? Or do you simply like knowing what kinds of vectored diseases are transmitted around you? Check out the USGS disease maps that also allow you to interact with them. Utilizing data from CDC’s ArboNET, you can look at transmission among humans, mosquitoes, birds, sentinel animals, and veterinary transmission. The observable diseases include West Nile Virus, St. Louis Encephalitis, Eastern Equine Encephalitis, Western Equine Encephalitis,  La Crosse Encephalitis, Powassan Virus, Dengue fever (locally acquired and imported), and Chikungunya (locally acquired and imported). The USGS disease maps allow us to not only have a better understanding of vectored disease transmission, but also landscape epidemiology.

CRISPR Off-Switch
CRISPR is going to be a hot story in 2017 and here are the seven things to look for. The burgeoning concerns regarding CRISPR technology involve the rapid pace of development and lagging DURC policies, not to mention the inability to predict future outcomes. The interest and unease over this new form of genome editing has left many searching for an “off button”, but thankfully, researchers are believed to have found one.  While the new “off switch” isn’t capable of reversing changes that were already made, it can stop the system from making additional edits. “The switch is a series of ‘anti-CRISPR’ proteins that were discovered inside viruses that attack bacteria, where they’re used to disable the gene editing tool and sneak into the bacterial DNA. ‘Just as CRISPR technology was developed from the natural anti-viral defence systems in bacteria, we can also take advantage of the anti-CRISPR proteins that viruses have sculpted to get around those bacterial defences,’ said lead researcher Benjamin Rauch. The team isolated these anti-CRISPR proteins from Listeria bacteria that had been infected by viruses. The team isolated the proteins that appeared to be involved and tested whether any of them could stop CRISPR editing from taking place in human cells. They found that two of these proteins, AcrIIA2 and AcrIIA4, worked together to inhibit the CRISPR systems commonly used by scientists.”

CDC Concludes CDP Ricin Exposure Inspection
The CDC just finished their inspection of the lab that sold the ricin toxin that was used by the Centers for Domestic Preparedness (CDP) training facility. The ongoing debate between the CDP and lab regarding the mishandling or misunderstanding points to bigger, systemic issues in regards to select agents. CDP states that the lab is to blame, noting that they ordered a less toxic version of ricin, while the lab rebutted by pointing out that the ricin was always properly labeled as the toxic version and they, in fact, never offered the less toxic version. The site visit and inspection findings are under review as the CDC determines if the lab is responsible and violated federal regulations. The conclusion of the inspection also comes at a challenging time for the CDC as the agency is taking heat for blacking out many details in reports recently released via the Freedom of Information Act. The released laboratory reports were requested by USA TODAY and only fuel the attention to lab incidents and poor biosafety practices.

NAS DURC Committee Meeting 
This week the National Academies held the Committee on Dual Use Research of Concern (DURC): Option For Future Management. You can get not only the webcast recording (check out 2:42:00 in and you’ll see GMU Biodefense director and professor, Gregory Koblentz, talk about the zero sum game in terms of regulating DURC research – to regulate or not to regulate, that is the question!), but also the full presentations. Since the 2011 H5N1 controversies, “it remains unclear as to whether there are practical mechanisms or approaches for managing such dual use research of concern (DURC) and, specifically, how to deal with situations where there is a pressing need, for public health reasons, to publish research findings while limiting, due to national security concerns, the dissemination of certain details that ordinarily would be published. This is especially true in cases where an initial assessment of proposed research does not anticipate results that would warrant such consideration.”

Zika Outbreak Updates
Scientists are currently unveiling the key proteins in the virus that made it so deadly. The first comprehensive description of the Zika genome has identified seven key proteins that are helping researchers understand the devastation the virus does to the human body. “To test the virus, Dr. Zhao used fission yeast, a species that in recent years has become a relatively common way to test how pathogens affect cells. Fission yeast was originally used to make beer, particularly in Africa, where it originated. (Its species name is Schizosaccharomyces pombe; pombe means beer in Swahili.) Over decades, fission yeast has been used by many scientists to find out mechanisms and behavior of cells. For the experiment, Dr. Zhao and his colleagues separated each of the virus’s 14 proteins and small peptides from the overall virus. He then exposed yeast cells to each of the 14 proteins, to see how the cells responded. Seven of the 14 proteins harmed or damaged the yeast cells in some way, inhibiting their growth, damaging them or killing them.” The Entomological Society of America has noted that socioeconomic factors provide protection against a large scale Zika outbreak in the U.S., but that small outbreaks are an ongoing concern. As of January 4th, the CDC reported 4,618 cases of Zika in the U.S., of which 216 were locally-acquired.

Does the CDC’s New Quarantine Rule Violate Civil Liberties?
With a new vaccine and hopeful approach to emerging infectious diseases, have we buried Ebola? Back in August, the CDC proposed a new rule regarding its powers to respond to potential outbreaks via screening, testing, and quarantining people traveling into or within the U.S. You can read the new rule here, but it focuses on “non-invasive public health prevention measures” and reporting requirements for commercial passenger flights of death or illness to CDC, etc. While this may seem pretty reasonable given health emergencies like Ebola and SARS, many ” epidemiologists, lawyers, and health organizations say that the rule, in its current form poses a serious threat to civil liberties, allowing authorities to detain and examine people with little heed to due process and informed consent.” Attempted in 2005, this rule was initially met with criticism, however the recent Ebola outbreak has changed the way we approach travel during times of infectious disease outbreaks. Public health emergencies are defined as ‘communicable disease events’ that the director believes could be high risk for death or serious illness. “It is already authorized to detain people suspected of carrying diseases like plague, Ebola, and (somewhat improbably) smallpox. But the new rule does away with a formal list. It extends the same powers to any “quarantinable communicable disease,” and uses wider range of symptoms (from a list that federal agents can update as the need arises) for defining ‘ill’ people.” While the CDC can detain travelers prior to decision to quarantine, it notes that this shouldn’t last longer than 72 hours and fails to make provisions for a lawyer if the person can’t afford one. “The rule also gives the CDC ultimate authority to carry out medical tests and treatments, stating that ‘the individual’s consent shall not be considered as a prerequisite to the exercise of any authority’.” What are your thoughts? We’d love to hear from our readership – please email or tweet @PandoraReport to give us your thoughts!

USDA ARS 4th International Biosafety & Biocontainment Symposium Registration Deadline
Don’t miss the January 13th registration deadline for this event in Baltimore, Maryland! From February 6-9, the focus of the symposium will be Global Biorisk Challenges-Agriculture and Beyond. Seven presymposium courses will address topics including unique biocontainment challenges, decontamination and inactivation, and institutional governance. Topics include biorisk management challenges in a One Health World, arthropods, HPAI, risk assessments, and more!

Stories You May Have Missed:

  • 85 People Suspected to Have Contracted Rabies– Like something out of a zombie movie, 85 people are suspected of having contracted wild rabies after being bitten by bats in Peru. “Regional director of Health of Cusco, Julio César Espinosa La Torre said that among the group of victims with a bat bite are the 15 soldiers transferred to Lima, of this group, two cases were confirmed, of which one is deceased. Espinoza la Torre said that to date, more than 912 civilians and 680 soldiers have been vaccinated in Alto and Bajo Urubamba, in the district of Megantoni, who must receive up to four doses, every 7 and 14 days.”
  • Anticipating Epidemics Using Computational Models – the White House recently released a report to strengthen the capacity for outbreak prediction. Spearheaded by the National Science and Technology Council, Toward Epidemic Prediction: Federal Efforts and Opportunities in Outbreak Modeling, looks to predictive modeling and data utilization to better understand the “processes that drive disease emergence and transmission could help to predict and prevent large-scale outbreaks. These programs range from foundational research into disease emergence and spillover, to predictive modeling contests, to the development of decision-support technologies for public health responders.”
  • Pandemic Chats – Struggling to chat to a younger generation about diseases? Check out how the Bill & Melinda Gates Foundation is talking to the next generation about the next pandemic.
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Pandora Report 12.23.2016

microbiallsnowmanHappy Holidays from your friends at the Pandora Report and GMU Biodefense! If you’re starting a New Year’s resolutions list for things to improve, it sounds like you’ve got company – the WHO is rethinking how it responds to outbreaks.

The Grim Forecast of Antimicrobial Resistance 
In the wake of the growing threat of antimicrobial resistance, it seems that the worried voices are getting louder but the barriers are growing higher. The return to colistin use points to a growing desperation as physicians are forced to use antibiotics that were previously avoided due to such harsh side effects. Many hospitals have shared their tales of MDRO outbreaks – some stopping as mysteriously as they began, while others have clear culprits. Some hospitals have even begun initiating isolation for any patient who was hospitalized abroad within the last couple of years. It’s also becoming increasingly common for hospitals to pre-emptively test patients via MDRO screening to more rapidly isolate them. The concern is also that few truly new antibiotics have been developed in recent years. “Thirty-seven antibiotics are currently undergoing clinical trials, according to the Pew Charitable Trusts, which keeps track of the U.S. pipeline. Most, however, are based on existing drugs. While these derivatives are cheaper and easier to develop than new classes of drugs, bacteria have a head start in developing resistance to them.Further, most drugs in the pipeline target so-called Gram-positive bacteria, a group that includes the well-known superbug methicillin-resistant Staphylococcus aureus (MRSA). But recently, the main emerging threats have come from the group known as Gram negatives, which are harder to treat because they are encased in tough membranes that repel many drugs.” Many are pointing to a tipping point in 2017 – antibiotics will be consumed by farm animals more than humans worldwide. The UN General Assembly is calling for countries to start getting smart in terms of antibiotic usage but hasn’t set specific goals. Sadly, it seems that there aren’t many more ways this impending reality can be shared – data, shocking titles, future predictions, etc. Check out this factsheet on the use of antibiotics in agriculture and why it impacts resistance. The report has some great suggestions for future work, like refining antibiotic labels and working to collect and report better data. Here’s a spot of good news in this dismal truth – the FDA has just cleared a new one-hour MRSA test to help rapidly identify the lead bug in healthcare-associated infections.

Homeland Biodefense: Science & Technology Capability Review
Just in time for the holidays, it’s like the National Science and Technology Council just knew what biodefense geeks wanted. This report is the product of a comprehensive review of U.S biodefense capabilities, which aided in the prioritization of S&T issues to better strengthen response. The end result is a product of two phases- stage 1: “The goal of this activity was to identify S&T needs articulated by Federal subject matter experts including both science program managers and agency officials in charge of operational programs, to elicit feedback on where additional S&T investments could address operational needs.” Stage 2: “The goal of this activity was to provide coordinated interagency feedback on which needs represent the highest priority to the interagency working group, and to identify which Department or Agency should recommend or coordinate on actions to respond to each of those priority needs.” Scenarios were limited to a handful of events like aerosolized anthrax, avian influenza outbreak (possibly deliberate), food-borne attacks, etc. Perhaps some of the most notable findings were the need to improve abilities to systematically assess how much risk has been mitigated by biodefense investments, understand the impact of bioattacks on companion animals and wildlife, several deficiencies in regards to technical staff and lab infrastructure, etc.

Greek Food Terrorism Threats 
Member of an eco-anarchy group in Greece, FAI/IRF, are announcing their threats for food terrorism over the holiday. The time frame for attacks is December 22nd – January 5th, 2017 and the group has said that their focus is on causing economic disruption, not poisoning people. FAI/IRF has shown their process for poisoning various food and beverage items as their targets include Coca-Cola, Nestle, Unilever, and Delta. Many of these companies have chosen to withdraw specific products from an area in Greece. The group has shown how they can poison foods/beverages with chlorine and hydrochloric acid while leaving the packaging in place. “The four companies that withdrew products were named in the FAI/IRF statements. The eco-anarchists claim to be opposed to both capitalism and Marxism. They contend in their statement that Coke profits from ‘forced labor’ in China and Nestle is ‘held responsible’ for the death of 1.5 million children in the third world. No substantiation was provided for either claim.”

80140100189470lThe Commandant’s Reading List 
In the latest Army Chemical Review (Professional Bulletin of the Chemical Corps) you can find the Commandant’s Reading Program, compiled by Lieutenant Colonel James P. Harrell, which contains a great assortment of books to add to your reading list (or last minute shopping list!). From Laurie Garrett’s The Coming Plague to Michael Oldstone’s Viruses, Plagues, & History, you can pick up some top CBW books. GMU Biodefense’s very own director and professor, Gregory Koblentz, had his book, Living Weapons: Biological Warfare and International Security, make this list, so make sure not to miss it!

Test Driving Genetically Engineered Mosquitoes
Take a tour through the world of genetically engineered mosquitoes at Imperial College London with genetic engineer, Andrew Hammond. What makes these particular mosquitoes especially unique is the use of gene drive to ensure virtually all offspring acquire the desired effects. “Hammond’s team is genetically engineering the Anopheles gambiae mosquito, which is the primary species that spreads the malaria parasite. Nearly all of the offspring of the modified mosquitoes inherit mutations that knock out the genes females need to make eggs. ‘If we can sterilize the females,’ he says, we ‘can actually eliminate a whole mosquito population without affecting those mosquitoes that don’t have the capability to transmit malaria’.” Hammond gives a great tour of the process for creating gene-drive mosquitoes while discussing the dangers of gene drive and genetic engineering. While there is a wealth of opportunity to do good with tools like CRISPR, there’s also the concern that there could be unintended consequences or events we can’t even imagine. To combat the potential risks, there are also research teams working to keep CRISPR in check.  “A team of scientists that previously identified genes within bacteriophage genomes that code for anti-CRISPR proteins has now discovered phages that harbor an antidote to the Cas9 enzyme that is a key component of the predominant CRISPR system that is today used as a gene-editing tool. The team, led by the University of Toronto’s Alan Davidson, described three bacteriophage-encoded, anti–Cas9 genes and showed that the corresponding proteins are able to block the activity of CRISPR-Cas9—derived from bacterial type II CRISPR-Cas systems—in human cells.”

FEMA’s Ricin Mishap 
Going through the Center for Domestic Preparedness (CDP) training a few years back was a fascinating experience – how many times do you get to train with ricin or anthrax and then move into a pandemic preparedness exercise? For this biodefense student, that’s what I call a good time! Sadly, CDP just announced their entry into the club of biosafety failures. The facility is blaming an outside lab for shipping the wrong form of ricin powder…since 2011. “The training center says it submitted order forms asking for a type of ricin extract that is unlikely to cause serious harm. But officials from Toxin Technology, the Florida company that sent nine shipments to the center since 2011, told USA TODAY that its ricin products were all accurately labeled as ‘RCA60’ – a scientific name for the whole ricin toxin, which can be deadly. It’s unclear why training center staff didn’t recognize for years that they were working with a far more dangerous substance.” The news broke late last week and on Saturday, I received an email from CDP regarding the suspension of those classes and some comments on the incident. Here are some of the highlights:
-In November 2016, while making a purchase of ricin A-chain for training, CDP staff recognized an ongoing discrepancy in the documentation related to the type of ricin being provided. The vendor has now said the more toxic holotoxin version of the materials was provided since 2011. It was previously believed that all remaining ricin on campus had been destroyed. This week, it became known that, while CDP had indeed destroyed all of the ricin in question, additional ricin training material, a solution marked A-chain remains securely stored on the premises. This material was not received from the vendor in question and we are working with the appropriate authorities to safely dispose of the additional ricin material.
-As an example, the protective gear you wore exceeded what would be required for working with ricin slurry.  Students who trained with the agent were in full Level C personal protective equipment at all times when training.  We have no indication that students were exposed directly to the holotoxin or harmed by it.

Zika Outbreak Updates
Not surprisingly, researchers are pointing to the impacts of climate change on infectious diseases. Recently, many have noted the role of climate change and El Niño on laying the groundwork for Zika to spread so quickly and proficiently throughout South America. A new study describes interworking of the virus and the mechanisms it utilizes for damage in pregnant women and developing babies. The CDC has reported 4,756 cases in the U.S. as of December 21st.

Stories You May Have Missed:

  • Public Health Preparedness Assessment for Each State – The Trust For America’s Health assessment was just released for each state based on 10 indicators for preparedness. Sadly, it seems that most states are not prepared for disaster. Twenty-six states and Washington, D.C. scored a six or lower on the indicators for public health preparedness. “The most striking are gaps in the ability of the health care system to care for a mass influx of patients during a major outbreak or attack and lack of a coordinated biosurveillance system. ‘Biosurveillance does remain a major ongoing gap,’ Segal said. Given all the recent technological advances, there is the potential for a ‘near real-time’ surveillance system to detect outbreaks and to track containment effort, yet the dream eludes our government, she said.”
  • How A Pandemic Might Play Out Under Trump – The Atlantic’s Ed Yong is looking at how the incoming administration will handle the growing threat of emerging infectious diseases. Outbreaks can make or break leaders and often are canaries in the coal mine for systemic weaknesses. “They demand diplomacy, decisiveness, leadership, humility, and expertise—and they quickly unearth any lack of the same. ‘As far as I can tell, Trump has zero experience on this,’ says Jack Chow from Carnegie Mellon University, who has worked at both the World Health Organization (WHO) and the State Department under Colin Powell. ‘If I asked him, ‘What is your stance on global health?,’ I don’t know what he’d say. I don’t think anyone really does’.”
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Pandora Report 12.16.2016

Sick to your stomach? Make sure to tweet about it! Seriously – the UK Food Standards Agency is using social media to track stomach bugs like norovirus. Before we venture down the biodefense rabbit hole, have you ever wondered what would happen if college students tried to hack a gene drive?

GMU Biodefense PhD Writes ‘Groundbreaking’ Thesis on Cyber Warfare– GMU Biodefense PhD graduate, Craig Wiener, is talking about his PhD experience and the amazing work he did on his dissertation. Craig’s story is pretty unique – between the commute from his position at the Department of Energy’s National Nuclear Security Administration, to his background in biodefense and research in synthetic biology, he’s a prime example of the diverse and passionate students we see in the GMU biodefense program. “Wiener’s PhD dissertation, ‘Penetrate, Exploit, Disrupt, Destroy: The Rise of Computer Network Operations as a Major Military Innovation,’ is groundbreaking, said Gregory Koblentz, director of Mason’s biodefense graduate program, and it has nothing to do with biodefense. Wiener connected some rather complicated dots in determining the origins of computer network exploitation and computer network attacks in the U.S. intelligence community. ‘I’ve established that computer network operations are a major military innovation, and it was developed by the U.S. intelligence community…. It’s the first time the intelligence community has developed a weapon system,’ said Wiener.” A labor of love, his work will significantly contribute to the history of cyber warfare and is a prime example of what makes GMU such a wonderful university to study.

FDA Review of 2014 Variola NIH Incident

screen-shot-2016-12-14-at-7-57-52-amThe newly released report, “FDA Review of the 2014 Discovery of Vials Labeled ‘Variola’ and Other Vials Discovered in an FDA-Occupied Building on the NIH Campus”, details the findings and corrective actions following the FDA’s internal investigation of the 2014 incident. The compilation includes several interviews, findings from reports and site visits, and a timeline of events leading to the discovery of the 327 vials on July 1, 2014. Some of the findings include: “There was no single individual responsible for the entire contents and operation of the shared cold storage area. FDA did not follow the CDC Select Agent Guidelines for the packaging and transfer of samples to a high containment facility for securing the materials.” There were six findings in the report, which included corrective actions, future actions, and compliance mechanisms. The report also includes the table regarding the disposition of the 327 vials. “It was noted that an internal, inward-looking investigation by the FDA had not formally started at the time of the hearing because both the CDC and FBI were in the midst of their own investigations of the incident.  However, FDA informally started an internal review and audit of the incident to understand the failure points to implement best policies and practices to prevent such incidents from happening in the future.”

Global Virome Project – You may remember reading  this summer about finding the next patient zero via a speaking engagement from USAID Director for Global Health Security and Development Unit, Dr. Dennis Carroll. The truth is that outbreaks like Zika and Ebola have shown us that countermeasures are invariably weak and viruses like to hide out in nature. This formidable reality has led to the development of the Global Virome Project, which looks to catalogue viruses from all over the world as a means of identifying the threats before they can identify us. “The idea has been around for a while and is supported by individual scientists and organizations including the US Agency for International Development, the nonprofit EcoHealth Alliance, HealthMap, ProMED, and the epidemic risk firm Metabiota. Now support for a global push may be picking up momentum, as scientists and health organizations find themselves repeatedly called upon whenever new threats arise.” An extension of the vision that brought about the PREDICT project, the Global Virome Project looks to make the process more efficient and effective by utilizing new methodology. While knowing the existence of a disease does not equate to preparedness, the understanding of how it interacts with humans and where it hides can help us determine risk and vaccine development. “For instance, knowing that the risk of contracting viruses carried in a species of bats is highest when their offspring are young might push ecotourism operators to avoid caves at those times. And Carroll said filling in more of the picture of the viral world will simply help scientists understand its patterns and interactions better. Right now, predictions are based on the behaviors of a few hundred known viruses, he said.”

2017-2022 Health Care Preparedness and Response Capabilities – The Office of the Assistant Secretary for Preparedness and Response has released their report outlining “the high-level objectives that the nation’s health care delivery system, including HCCs [health care coalitions] and individual health care organizations, should undertake to prepare for, respond to, and recover from emergencies.” The report further breaks down the capabilities into four sections that will, when combined and fully followed, enable full readiness. The four sections are Foundation for Health Care and Medical Readiness, Health Care and Medical Response Coordination, Continuity of Health Care Service Delivery, and Medical Surge. The report is extremely detailed and includes a wide variety of methods for identifying and coordinating resource needs during an emergency, setting up a health care EOC, implementing out-of-hospital medical surge response, and much more.

Blue Ribbon Study Panel Report on Biodefense Indicators– I remember the excitement during the Blue Ribbon Study Panel presentation on their recommendations since the Ebola outbreak. The room was packed with so many contributors to biodefense and there was a sense of fervor regarding the possibilities that could come from their 87 recommendations. Sadly, it seems that enthusiasm isn’t enough to get the work completed. It seems that an overwhelming majority haven’t been completed, according to the latest report. In fact, Tom Ridge and Joseph Lieberman have taken to TIME magazine as a means to implore the incoming administration to help protect the U.S. from bioterrorism and infectious disease threats.

Nanotherapeutics Opens Plant Near Progress Park – Nanotherapeutics opened their new $138 million 183,000-square-foot plant near Progress Park in Alachua, which was built to fulfill a DoD grant that could be worth up to $359 million. “The purpose and the capability of this facility is really fundamentally to avoid a surprise and be better prepared,” said Chris Hassell, deputy assistant secretary of defense for chemical and biological defense. “Sixty years after Pearl Harbor we were surprised again with the anthrax mailings and other events of 9/11, so this whole issue of surprise is a common area of discussion, what can we do to avoid surprise, to defend it, to respond to it more effectively and to that end this facility is very important to our capability to do that.” The DoD maintains several contracts for vaccine and treatment manufacturing, however Nanotherapeutics has tackled several of the struggles with efficiency that have plagued several other efforts. Utilizing disposable bags within stainless steel equipment allows for less clean-up and quicker transitions to help make the process more efficient and successful. The new plant follows strict NIH and military guidelines regarding waste and handling of hazardous materials, not to mention a pretty hefty security system.

czqg73pwiaacplk-png-largeUNSC 1540 Resolution – The United Nations Security Council unanimously voted on Resolution 1540 this week, which is especially prudent given the devastation in Syria and use of chemical weapons. The overwhelming adoption of the 1540 review resolution furthered the fight to keep WMD’s out of non-state actor hands. Resolution 1540 was adopted in 2004 and extended periodically through 2012 as a means of imposing binding obligations on all states to adopt legislation to prevent the proliferation of nuclear, chemical, and biological weapons. The open debate, “Preventing Catastrophe: A Global Agenda for Stopping the Proliferation of Weapons of Mass Destruction to Non-State Actors” took place on December 15th, ending the second review of 1540 implementation. “The Council is expected to adopt a resolution endorsing the review and noting the findings and recommendations contained in its report, which was agreed by the 1540 Committee last Friday”. The comprehensive review process has been somewhat challenging lately due to differences in Council member priorities and ambitions. “Russia and China made clear that they did not see the need for radical changes in the functioning or mandate of the Committee, whereas Spain, as the chair of the Committee, and other Council members, such as the UK and the US, were pushing for more substantive measures and new approaches. As a result, the discussions in the 1540 Committee on the report of the review were quite contentious, in particular with regard to its conclusions and recommendations. It took more than two months of intense negotiations after the Committee considered the first draft of the report on 27 September to reach agreement on the final document. The whole review process has taken almost two years.” We’ll make sure to keep you posted as news is released!

Avian Influenza and Global Trade Conditions– A series of avian influenza outbreaks are challenging the positive 2017 outlook for the global poultry industry. These events are especially distressing for the poultry industry as the global pork and beef production is rising. “The return of avian influenza is now shaking up global trade conditions and is especially affecting the outlook for Asia, Europe and Africa,” the report said. “It will also be a test for the U.S. industry after last year’s multiple AI outbreaks. As many European and Asian countries are exporters of meat and breeding stock, this will certainly impact the outlook for the industry and could shake up meat and breeder trade again.” The increasing protectionism and disease-related traded restrictions have caused some slowing within the poultry trade. This report comes at an auspicious time as the WHO warns of a H7N9 pandemic.

Zika Virus Updates- The most recent Florida Department of Health daily updates can be found here, which found six new travel-related cases on 12/14 and no new locally acquired cases. The CDC has issued a travel advisory for Brownsville, TX due to Zika virus. A new study has estimated the prevalence of Zika by the time a microcephaly case is detected. Saad-Roy, et al. (2016) explain, “this model gives us the probability distribution of time until detection of the first microcephaly case. Based on current field observations, our results also indicate that the percentage of infected pregnant women that results in fetal abnormalities is more likely to be on the smaller end of the 1% to 30% spectrum that is currently hypothesized. Our model predicts that for import regions with at least 250,000 people, on average 1,000 to 12,000 will have been infected by the time of the first detection of microcephaly, and on average 200 to 1,500 will be infectious at this time. Larger population sizes do not significantly change our predictions.” The CDC has reported, as of December 14th, 4,617 cases in the U.S.

Stories You May Have Missed: 

  • Biological Security Threats Situation Report – In this report from the Danish Centre for Biosecurity and Biopreparedness, you can find an assessment of current biological threats and risks. The authors note that “the overall likelihood of a major biological terrorist attack must be viewed as relatively low at the moment, but a successful attack could have grave consequences for societies.” Focusing on the capacity to respond to intentional attacks through biosecurity and biopreparedness is vital. The report looks at the risks from state, non-state terrorists, and criminals in its assessment.
  • DHS Backs Development of Livestock Disease Outbreak Readiness Program – America has a soft underbelly and it’s livestock and agriculture. The new funding for the National Agricultural Biosecurity Center (NABC) project to develop the readiness program is just over $330,000 and “will provide a clearinghouse for planning, training and knowledge products to help state, local, tribal and territorial entities prepare for transboundary livestock disease outbreaks.he program also entails extensive collaboration of academia, private industry and state governments. Faculty and staff in the Beef Cattle Institute and the College of Veterinary Medicine will provide subject matter expertise and assistance building the website, and student workers will be employed to assist with the project.”
  • ABSA International  – Don’t miss the USDA and the Agricultural Research Service’s 4th International Biosafety and Biocontainment Symposium- Gobal Biorisk challenges: Agriculture and Beyond. This symposium will take place from February 6-9th at Baltimore Convention Center. Topics will range from biorisk management challenges in one health world, arthropod containment in plant research, and much more!

Week in DC: Events 12.12-12.16.2016

Monday, December 12th, 2016
Getting Ahead Of The Curve: The Evolving Threat Of Violent Extremism– United States Institute of Peace
Time: 9am-noon
Location: US Institute of Peace
2301 Constitution Avenue NW, Washington, D.C. (map)
Movements, leaders, targets, tactics and arenas of operation have all proliferated in ways unimagined in 2001. The growing challenges have spurred new interest in broader strategies – to defuse current crises, stem proliferation of extremist ideologies and avoid future shocks. The obstacles in crafting a viable and sustainable policy are many: Limited resources, poor coordination, competing political interests and complex strategic factors. This forum will highlight the analysis of three separate reports:

  • “The Jihadi Threat: ISIS, Al Qaeda and Beyond,” led by USIP and the Wilson Center.
  • ‘Turning Point,” from the Center for Strategic and International Studies’ Commission on Countering Violent Extremism.
  • “Communities First: A Blueprint for Organizing and Sustaining a Global Movement Against Violent Extremism,” from The Prevention Project.

Tuesday, December 13th, 2016
The 2016 Cato Surveillance Conference– Cato Institute
Time: 9am-5:30pm
Location: Cato Institute
1000 Massachusetts Avenue, N.W., Washington, D.C. 20001 (map)
Eight years ago, Barack Obama arrived in Washington pledging to reverse the dramatic expansion of state surveillance his predecessor had presided over in the name of fighting terrorism. Instead, the Obama administration saw the Bush era’s “collect it all” approach to surveillance become still more firmly entrenched. Meanwhile, the advanced spying technologies once limited to intelligence agencies have been gradually trickling down to local police departments. From the high-profile tussle between Apple and the FBI over smartphone encryption to debates over how to detect “lone wolf” terrorists before they strike, hard questions about modern privacy have figured prominently in the 2016 presidential race. Moreover, as WikiLeaks’ sensational release of hacked Democratic Party e-mails demonstrated, surveillance isn’t just a campaign issue: It’s a campaign tactic too. As the nation braces itself for a new presidential administration, the Cato Institute will gather technologists, legislators, activists, and intelligence officials to survey the privacy landscape, look ahead to the issues Americans will be debating over the next eight years — from government hacking to predictive “big data” to the “Internet of things” — and examine how and whether Americans can still live at least occasionally free from prying eyes. Continue reading “Week in DC: Events 12.12-12.16.2016”

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Pandora Report 12.9.2016

Happy Friday and welcome to your weekly source for all things biodefense! Can you guess the 37 viral species that may have epidemic potential? Like something out of a horror movie, a team of researchers found the oldest  known smallpox virus sample in a naturally mummified child in Lithuania.

Learning From Ebola – Workshop Proceedings from NAS & Laboratory Battles
17649_phil_who_on_site_ebola_outbreak_2014This week was rich with information from the 2014/2015 Ebola outbreak and the lessons we’re still extracting from it. The National Academies of Science released their 136 pages proceedings from a workshop on the Ebola epidemic in West Africa. This is an extremely in-depth review of the situation, the failures, and what we’re doing to prevent it from happening again. If you don’t have time to read the full 136 page (too bad they don’t have it as a book on tape, right?), they’ve broken it down into sections- the outbreak, global preparedness and response, current and future research, etc. The actual body of the paper is about 65 pages but there are some gems in the appendixes – EVD preparedness in Germany, the view from the national institute of allergy and infectious diseases, and more. I found the outbreak section particularly interesting as it discussed the differences with previous outbreaks. This section noted the weakening of the affected countries through ongoing civil unrest and relative inexperience when dealing with ebola. Another great resource this week comes from the African Journal of Laboratory Medicine. They’ve just released a special edition that focuses on global health security during the Ebola outbreak. You can find articles on building laboratory capacity to combat diseases in Africa, the lab health system and its response to the EVD outbreak in Liberia, Sierra Leone’s lab system now and in the future, etc. The article on building lab capacity points to issues with Ebola, but also notes the challenge that several countries have in meeting the GHSA as their national disease programs are fragmented and have not yet joined the national lab networks, surveillance systems, and health research institutes. Interestingly, the focus then turns to antibiotic resistance and emphasizes the critical role of labs in detection and containment of AMR’s, which is a serious deficiency in Africa.

Since we’re already talking about Ebola, the CDC just released an article in their Emerging Infectious Diseases journal, regarding media messages and the perception of risk for ebola in the U.S. I think many of us can appreciate the significance of this article as media representation and messaging of risk during this outbreak was just another in a long list of mis-information and avoidable hysteria. The researchers reviewed U.S.-focused news about Ebola from July1-November 30, 2014 and found an abundance of risk-elevating messages. “Overall, 96% of print and television news stories that covered EVD in the context of the United States included >1 risk-elevating messages, 55% of stories contained >1 risk-minimizing messages, and 53% contained both message types. The most common risk-elevating messages (72%) concerned foreigners or travelers bringing Ebola virus to the United States. The most frequent risk-minimizing messages (32%) described scientific knowledge about EVD (Table).” When it comes to responding to ebola and other emerging infectious diseases, aside from the change in media habits, there’s a lot we still need to learn. Some of the more high-priority recommendations DHHS is trying to focus on include the role of the U.S. in aiding countries with limited surveillance and response capabilities (GHSA!), forming a pot of discretionary funds, capacity to call on the necessary public health experts, and clear guidelines for when the U.S. will send medical personnel to other countries.

antimcrresukreview2Farm Animals Are Now Resistant to Antibiotic of Last Resort
Is this the start of the antibiotic apocalypse? A recent study found the presence of carbapenem-resistant (carbapenems are antibiotics that are last-line drugs for severe bacterial infections) bacteria in agricultural settings. Firstly, it’s important to note that because there is concern over this issue, carbapenems are not supposed to be used in agriculture. The samples that revealed the presence of the resistant microbes were taken during a study of a pig farm over the course of five months, and were collected from the floors, walls, fecal samples etc. The good news – none of the resistant bacteria were found in pigs, however it was found in sows and piglets. Dr. Wittum, chair of veterinary preventive medicine at Ohio State University, noted that “farms do not use carbapenem antibiotics not only because doing so is illegal, but that it’s also very expensive. ‘How the [resistant bacteria] got onto the farm we really don’t know,’ said Wittum in an email exchange with TIME. ‘But probably it was introduced from the outside from movements of wildlife, people, equipment, etc.’ He says it’s possible that other legal antibiotics used on the farm could be contributing to the maintenance and spread of the bacteria, but more research needs to be done.”

CRISPR Mortal Combat 
Before we get into the battle that is the CRISPR patent world, Cold Spring Harbor Laboratory (CSHL) just announced the creation of a new molecular tool to change the genomes of plants that will strengthen harvest yields and expand their geographical range. CSHL researchers established a process to make two kinds of tomato plants flower and produce ripe fruit two weeks faster than what is currently possible. “The impact of this discovery cannot be overstated, as the potential impact could mean more plantings per growing season and thus higher yield. Moreover, it also means that the plant can be grown in latitudes more northerly than currently possible. Attributes that are extremely important as the earth’s climate warms and population continue to burgeon.” On to the battle of CRISPR patents! Things have been getting nasty in these hearings and Tuesday morning saw the first and only oral arguments over a patent. “The nasty dispute pits the University of California against the Broad Institute of Harvard and MIT for rights to key patents on CRISPR genome-editing. Since April 2014, the Broad has received 13 CRISPR patents, based on work led by its bioengineer Feng Zhang, but UC believes it deserves some of the most foundational ones, reflecting earlier work by its biochemist Jennifer Doudna and her collaborator Emmanuelle Charpentier.” STAT highlighted three very crucial questions that are being asked by so many as we sit in the audience of this gladiator-like spectacle- should we even be here, what are we arguing about, and why hasn’t there been a settlement? While there are potentially billions of dollars at stake, this could also change the nature of the exclusive and non-exclusive licenses to CRISPR technology. The patent dispute also comes at an interesting time for patent laws. “On March 16, 2013, the U.S. patent system switched the way patents are awarded: Previously, a patent was granted to the very first party to invent something; now, a patent simply goes to whoever files a patent application for an invention first. As it happened, Berkeley filed its initial patent just one day before the March 16 switchover. So here we are trying to figure out who invented CRISPR first.”

Enhancing BioWatch Capabilities Through Tech & Collaboration
The latest National Academies of Science publication looks to BioWatch and how we can improve it. In response to the 2015 Government Accountability Office (GAO) report Biosurveillance: DHS Should Not Pursue BioWatch Upgrades or Enhancements Until System Capabilities Are Establisheda NAS workshop was requested by DHS to further explore the findings and impact they may have on the future of BioWatch. The report reviews the recommendations from GAO and the DHS response, and then discusses the BioWatch collaborative planning process. One particularly interesting section focused on future opportunities for state and local collaboration. Several participants noted their state and local health departments deemed homeland security as a top issue and were open to participate on special projects but often met barriers when working with security and the Secret Service. The publication is definitely worth the read in terms of the issues encountered with BioWatch and what future goals might be. It’s also a breath of fresh air to hear accounts from local public health sources regarding their experiences.

Spanish Minister of Foreign Affairs Chairs High Level Security Council WMD Debate 
On December 15th, the Spanish Minister for Foreign Affairs, H.E. Mr. Alfonso Dastis, will be chairing a high level open debate of the Security Council on the topic of “Preventing catastrophe: A global agenda for stopping the proliferation of weapons of mass destruction by non-state actors”.  The debate will focus on the process to strengthen a preventative system to avoid humanitarian, political, and economic catastrophe that the use of WMD’s by non-state actors would entail. “The debate will take into account the conclusions of the report of the Comprehensive Review of Resolution 1540 (2004), which will be sent to the Security Council by end November and sets the basis of a global agenda to achieve full implementation of resolution 1540 (2004) by 2021, when the current institutional arrangements adopted by the Security Council in this field will expire. Particularly, the debate aims at reflecting on the practical measures that the Security Council and the UN System, Members States, international organisations and relevant sectors of civil society can adopt to prevent non-State from accessing or using WMD. The debate will have a practical and action-oriented approach that connects the discussion with real life, thus creating momentum for an improvement of the effectiveness of the preventive system in the fight against the proliferation of WMD, perhaps the biggest threat the world faces presently. Participants in the open debate are also encouraged to announce specific commitments for implementing the main recommendations of the Comprehensive Review, including financial support for those with the capacity to do it, to push forward the global non-proliferation agenda and directly contribute to a safer world.” The best part? The debate will be open to the public and broadcast over the internet!

Zika Virus Updates
The CDC has reported 4,575 case in the U.S. as of December 7th. The daily Florida Department of Health counts can be found here, in which you’ll see three new travel-associated cases and five new locally acquired cases reported on December 8th. The CDC has released a new article in their EID journal regarding the characteristics of US travelers to Zika-virus affected countries in the Americas from March 2015-October 2016.  They found that 3/4 of the travelers were men or women of reproductive age. The New York City department of health just announced that a 5th baby has been born with Zika-linked brain developmental issues. This makes five babies since July to be born with neurological development symptoms, like microcephaly, related to maternal infection. Arthur Caplan is talking to Forbes about how the Zika outbreak foretold Trump’s win.

Stories You May Have Missed:

  • Big Data & Analytics for Infectious Disease Research, Operations, and Policy – You can now download this NAS workshop document for free! Get the latest news on how big data is a tipping point for global health and surveillance systems. The book includes information on utilizing big data, combating antimicrobial resistance with it, and some great case studies. It points to the range of opportunities for use, however there are several challenges to really access the full potential – like usage, access, interoperability, analysis, validation, liability, security, etc.
  • Responding To The Next Ebola – Will Your Smartphone Play A Role?– Just when you thought we were done talking about Ebola…one of the greatest strengths technology has given us is speed. Coincidentally, that’s something we desperately need when fighting an infectious disease in an area with constantly moving people. Researchers tested this out by logging the number of calls from individual cell towers and then mapping the movement of people throughout the country. “Already, we’re getting immensely valuable insights about what happens during epidemics, and where we need to target our treatment efforts. For example, mobile mapping has confirmed that, in the wake of an epidemic or natural disaster, people head home to their families. So if you’re planning for worst-case scenarios, you can make a surprisingly good forecast by loading up migration data from national holidays such as Chinese New Year, Christmas or Diwali.”
  • Re-emergence of Syphilis Traced to Pandemic Strain Cluster– the past few decades have seen a growth in syphilis cases globally. Researchers led by the University of Zurich analyzed low levels of DNA to delve into the history of syphilis strains. They found that all strains from modern patients share a common ancestor from the 1700s. In fact, the dominating strains of today originated from a pandemic cluster following the 1950s. The concerning aspect of these strains is their ability to fight off the second-line antibiotic, azithromycin.

 

Week in DC: Events 12.5-9.2016

Monday, December 5th, 2016
Cyber-securing The Nation: A Whole Of Nation Approach- New America Foundation
Time: 9:30am-noon
Location: New America 740 15th St NW #900 Washington, D.C. 20005, Washington, D.C. (map)
On December 1, President Obama’s Commission on Enhancing National Cybersecurity will deliver a report to the president with recommendations on bolstering the nation’s cybersecurity. While many of the likely recommendations will require federal government action, intentionally or not, the report will also underline the fact that enhancing national cybersecurity requires as much, if not more, action at the state and local levels. While the President considers the report, we’ll explore what more our states and cities can and should do to achieve these goals. Follow the conversation online with @NewAmCyber and #WONCyber.

Tuesday, December 6th, 2016
The Search For Cuba’s Food Security- Johns Hopkins School of Advanced International Studies
Time: noon-2:30pm
Location: Johns Hopkins SAIS – Rome Building
1619 Massachusetts Ave., N.W., Washington, D.C. (map)
Room: Rome Auditorium
Pedro Sanchez is Research Professor of Tropical Soils at the University of Florida Soil & Water Sciences Department and core faculty of the Institute for Sustainable Food Systems. At UF, he leads the development of a collaborative programs on food and agriculture in Cuba and incorporate faculty and students in the long-standing food security programs he continues to be involved in tropical Africa. Sanchez was formally Director of the Agriculture and Food Security Center and Senior Research Scholar at Columbia University’s Earth Institute. He served as Director General of the World Agroforestry Center (ICRAF), co-chair of the United Nations Millennium Project Hunger Task Force, and director of the Millennium Villages Project. Sanchez has supervised research programs in over 25 countries of Latin America, Southeast Asia, and Africa. Sanchez has written groundbreaking books on tropical soil science and hunger, and has received honorary Doctor of Science degrees from the Catholic University of Leuven (Belgium), Guelph University (Canada), Ohio State University and North Carolina State University. He is the 2002 World Food Prize laureate, a 2004 MacArthur Fellow, and was elected to the US National Academy of Sciences in 2012. Lunch will be provided. RSVP is required. Continue reading “Week in DC: Events 12.5-9.2016”

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Pandora Report 12.2.2016

Welcome to December! We hope you had a lovely Thanksgiving holiday. If you’re still craving poultry and happen to be in Sweden, you may want to keep in mind that the first H5N8 case was just detected. Want an overview on genome editing? Check out the Parliamentary Office of Science & Technology’s note on it here.

Army Reprimands General Over Anthrax Debacle
Biosafety failures have been an increasing concern over the last few years. Within the last few years, the Pentagon was involved in mistakenly shipping live anthrax to nine U.S. laboratories and an airbase in South Korea after failing to inactive the bacteria. The Army has now reprimanded Brig. Gen. William King, the highest-ranking officer implicated in the events. “A reprimand prevents an officer from receiving another assignment, effectively ending his career, according to a Defense official familiar with King’s case but not authorized to speak publicly about it. ‘Brig. Gen. King was reprimanded for failing to take appropriate action to respond to and mitigate lapses in safety and protocol while serving as commander of Dugway Proving Ground,’ Lt. Col. Jennifer Johnson, an Army spokeswoman, said in a statement.” Nine civilians were also demoted and another soldier was disciplined in this attempt to clean up the biosafety mess that has plagued military labs. Investigators at Dugway found several failures – a biosafety officer who lacked training and education needed for the job, failure to conduct routine environmental tests to ensure there was no breach in containment, and staff who “regularly manipulated data” certifying pathogens were safe to for use without PPE and shipment.

The Failure That Was the 8th RevCon epic-failure-thumbnail1-1
The 8th Review Conference of the BWC has closed and with it, the hope of reaching an agreement on a work plan for the next five years to strengthen the intersessional process. You can read the UN Office at Geneva statement here, in which they note that during the RevCon, a Final Document was adopted (including a Final Declaration on the articles of the Convention), renewal of the mandate of the Implementation Support Unit, and this RevCon had higher attendance than previous BWC meetings. If you’d like detailed overviews of each day’s proceedings, you can find them here – in the last day, you can see the frustrations and disappointment voiced by several countries.. The 8th RevCon did decide that States Parties will hold annual meetings in the process up to the next RevCon (2021), with hopes of reaching consensus regarding the intersessional process. You can also read the statement by U.S. State Department’s spokesperson, John Kirby, here, in which he points to the failures of the group to find consensus on a work plan (a plan that was highly supported by the U.S. and would involve much more intensive expert work to make decisions more frequently than every 5 years) to infuse decision-making and expert work into the intersessional process. Kirby’s statement notes that “While the United States does not support the need to negotiate a supplementary treaty, during the review conference, U.S. negotiators were supportive of creating a space in the post-RevCon work-plan for discussion of the full range of proposals to strengthen the Convention, which would have allowed proponents of a protocol to make their case. Although the United States is disappointed that negotiators did not take this opportunity to strengthen the intersessional process, the lack of consensus on a program of work does not damage the international nonproliferation regime.” While many of the official documents note “disappointment”, the realities of those in attendance were marked with frustration at the utter failure that was the 8th RevCon. Some of the noted frustrations including the halting of summer meeting of experts (MX), failure to increase ISU staff, and again, inability to agree on an intersessional process that would facilitate more real-time decision making with the necessary experts. “In their final declarations many countries, especially from the Non-Aligned Movement (NAM), put the blame squarely on Iran (without naming the country). This country’s obsession with returning to a negotiation format like the Ad Hoc Group to achieve the higher goal of a legally binding instrument—possibly with the sole goal of antagonising the USA—led it to exploit to the fullest to principle of consensus decision-making to torpedo any effort at compromise. Many NAM countries—often developing nations—lost out on concrete opportunities for international cooperation and assistance.” You can read the advanced version of the final report here. While this floundering don’t mean the end of the BWC, the lackluster outcome may indicate a gradual slip in overall confidence.

U.S. Military Preps for Gene Drive Woes genetic_manipulation
The new advances in genome editing and biotech point to a bright horizon for innovation, however the safety components to these advances are in need of response measures. DARPA is now working on a new program to respond to potentially harmful or devastating ecosystem outcomes that may come from engineered genes. Safe Genes will be a means of responding to a situation in which the gene-drive systems produce an outcome throughout generations that may be negatively impacting to the ecosystem. This may make genome editing systems, like CRISPR, sound nefarious, but there are growing hopes that this technology could alter insects or pests that carry diseases like malaria, dengue, etc. The gene-drive systems mean that within 20 generations, the newly altered genes could be passed through an entire population of insects (i.e. within 20 generations, a certain species of mosquito could be unable to carry malaria). The Bill and Melinda Gates Foundation has doubled its spending on gene drive tech and even DARPA has been one of the largest funders of synthetic biology research. While the the rewards may be high, so are the risks. “Kevin Esvelt, head of the Sculpting Evolution lab at MIT Media Lab, which is applying for Safe Genes funding in collaboration with eight other research groups, predicts that eventually, perhaps around 15 years from now, an accident will allow a drive with potential to spread globally to escape laboratory controls. ‘It’s not going to be bioterror,’ he says, ‘it’s going to be ‘bioerror.'” Several research teams, including those at the DARPA program, are looking to remove, replace, or inhibit the unwanted genetic changes that are made in order to best respond to a negative outcome. Getting rid of the engineered genes from a species or habitat is one focus area for DARPA’s new program – the second encourages teams (who received funding from Safe Genes) to create systems for controlling/reversing gene editing tools, and the last focal point is on developing small molecules or antibodies that allow organisms to fight off genome editors at the molecular level. “Evolutionary geneticist Austin Burt, who leads Target Malaria’s research at Imperial College London and has no affiliation with Safe Genes, concurs. The prospect of remediation, he says, ‘shouldn’t give us a cavalier attitude.’ Instead, the goal should be to do the incremental work to anticipate and prevent problems. ‘We have the precedent of biological control,” he says, “where if you have an invasive pest that is destroying your crop, you can release a parasitoid wasp,’ which kills its host. ‘They do a very careful assessment. They don’t have something in their back pocket,’ to delete errors.”

FBI Utilizes Student Bioengineers 
With the growing importance and challenges of biotechnology and genome editing, it’s not surprising the FBI is sponsoring the International Genetically Engineering Machine (iGEM) Competition. iGEM is a way for the FBI to collaborate with the biotech community to better understand the challenges, concerns, and help create a culture of trust and transparency. Stanford senior research scholar, Megan Palmer, highlights this growing relationship and its importance in bioterrorism prevention. Science plays a vital role and to better understand this, why not start with those looking to make a difference in the field? “Bioterror incidents are extremely difficult to predict. In the past governments have built the deadliest biological weapons programs, but one worry is that now small groups may also be able to do serious damage, Palmer says”. The biotech world is constantly evolving and it’s important that law enforcement understand the how’s and why’s of the field so that investigations can be more effective and efficient. In fact, GMU biodefense graduate program director and professor, Gregory Koblentz, is working with Dr. Palmer on a CRISPR project for this very reason. The Departments of Defense and State are even getting in on this approach – create transparency and trust with the biohacker community to better prevent and respond to future threats. Like FBI supervisory special agent, Edward You, Megan is looking to strengthen this relationship prior to “trigger events” (an event in which biologists are suspected to be behind it) to ensure the foundation of communication and trust can combat challenging situations. “But there’s a natural tension between biohackers embedded in fringe communities and government agencies that are traditionally secretive. To Palmer, the key to the collaboration is open communication. So far, it’s going well—Palmer says she has been asking the FBI questions about its involvement, what it sees in the field, and why the agency is spending so much time and effort to be involved, and so far she says they have ‘been willing to have more of those conversations.’”

The Diseases That Worry Public Health Officials 
CDC Director, Thomas Friden, and Susan Desmond-Hellman, Chief Executive of the Bill and Melinda Gates Foundation, sat down to discuss the infectious diseases outbreaks that keep them up at night. Frieden noted that every year we identify a new pathogen and every day the CDC starts a new investigation to find a new pathogen. Frieden admits that his biggest worry is pandemic influenza. “Even the 1957 influenza pandemic, which most people haven’t heard of, cost 3% of the world’s gross domestic product. Even SARS, a relatively small outbreak, cost about $30 billion. We don’t know when the next one will come, where it will come from or what it will be. But we’re certain there will be a next one.” Dr. Desmond-Hellmann noted that, “What we learned from Ebola is that there are a couple things that are underutilized and not ready. One is governance. Who makes the call when things happen? The second thing is having the right tools, which is why global health research-and-development is a big focus of our foundation.” Both emphasized the importance of faster and more effective prevention and the role of country accountability in global health security. Truly, Dr. Frieden notes, there is no way to know if a country is ready to handle a health emergency, which is where the GHSA’s Joint External Evaluation has come in as a means of objective, third party, accountability and readiness assessments.

Advances in Radiation Biodosimetry for Mass Casualty Events Involving Radiation Exposure 
GMU biodefense PhD student, Mary Sproull, is looking at the modeling and development of new medical countermeasures for CBRN events. “To respond to large-scale population exposures from a nuclear event or radiation dispersal device (RDD), new methods for determining received dose using biological modeling became necessary. The field of biodosimetry has advanced significantly beyond this original initiative, with expansion into the fields of genomics, proteomics, metabolomics and transcriptomics.” Cytogenetic assessment methods are also being utilized with ramping up laboratory surge capacity. In this assessment, Sproull looks to the progress being made regarding field-deployment readiness in the event of radiation exposure. She notes that the most promising and immediately useful mechanisms for biodosimetry are pointing towards cytogenetic assessment using surge capacity lab networks, proteomics, and genomics-based technologies. “Greater collaboration within each field of biodosimetry would benefit the development of a standardized panel of biological markers for dosimetry assessment. Assessing the application of radiation biodosimetry in special populations, and development of a rapid assay for assessment of partial-body exposures is needed. Critical organ-specific markers of radiation toxicity also need to be identified and validated.”

Zika News 
Shortly after the WHO declared that Zika is no longer a global health emergency, the first case of locally acquired Zika sprung up in Texas. While investigations are ongoing, the latest news points to the importance of maintaining vigilance towards vector control and continued education. The UK has reportedly found its first case of sexually transmitted Zika. You can find the latest updates from the Florida Department of Health here, which reveal two new travel-related cases and four new locally acquired cases on November 30th. A recent study found microcephaly in older babies who were exposed to Zika in the womb. “A study published in the U.S. journal Morbidity and Mortality Weekly Reportinvolved 13 babies in two Brazilian states born with small heads, but not small enough to be diagnosed with microcephaly. The babies tested positive for Zika. Imaging scans of the babies’ heads soon after birth showed brain abnormalities. Researchers then followed the infants. Around the time of their first birthday, 11 of the 13 babies were diagnosed with microcephaly. Their heads and brains had not developed in proportion to their growth and size.” Some are saying that the WHO’s move of declaring Zika no longer a public health emergency was a mistake. The CDC has reported 4,496 cases of Zika in the U.S. as of November 30th,

Stories You May Have Missed:

  • Trump Picks HHS Lead – President elect Trump, has selected Republican congressman, Dr. Tom Price, as the US Health Secretary to oversee CDC, NIH, etc. This selection has been met with a mixture of concern while many worry about the challenges to public health under the new administration.
  • New Viral Discoveries– a international research team has found the jackpot of viral discoveries – 1,500 new viruses! Looking for infection in invertebrates (think insects and spiders), the expansion of the catalogue of viruses will help us better understand viral diversity. Genetic sequencing helped these researcher delve deep into the world of viruses – the virosphere. “Next generation sequencing allows researchers to quickly determine the sequence of these letters. And if you work out the order of the letters on any chain of RNA, you can determine if it belongs to a virus and whether or not the virus is new. Its potential for virus discovery is huge.”
  • Traces of MDRO’s Found in Polluted City Air- recent research from Sweden’s University of Gothenburg looked at hundreds of environmental samples worldwide. The results revealed that the samples taken from Beijing, had high levels of antibiotic resistant genes. “‘We studied only a small number of air samples, so to generalize, we need to examine the air from more places,’ explains lead researcher Joakim Larsson. ‘But the air samples we did analyze showed a wide mix of different resistance genes.’ The research doesn’t show whether the bacteria in Beijing’s smog is actually alive – which would significantly increase the threat – but Larsson says it’s ‘reasonable to believe that there is a mixture of live and dead bacteria, based on experience from other studies of air’.”

 

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Pandora Report 11.18.2016

 Welcome to World Antibiotic Awareness Week! We all have a part in reducing microbial resistance, including companies like McDonalds, KFC, and large chain restaurants. A recent report from Clinical Microbiology is reanalyzing the threat of bioterrorism. The EU has released their action plan for combatting antimicrobial resistance and you can read the roadmap here. Leishmaniasis infections are on the rise in the U.S. due to ecotourism and military campaigns in Iraq and Afghanistan. CRISPR gene-editing was just tested in a person for the first time. The Chinese research group delivered modified cells into a patient with aggressive lung cancer as part of a clinical trial. The cells were modified to disable a gene that codes for protein PD-1 (this normally would restrict immune response and is frequently manipulated by cancer) and the hope is that without the PD-1, the edited cells will be able to overcome the cancer. Did you know that your birth year can help predict how likely you are to get extremely sick from an outbreak of an animal-origin influenza virus? Don’t miss the Next Generation Global Health Security Network Info Session – today at 11a EST!

ISIS Forces Fired Toxic Chemicals in Iraq
Three chemical attacks were launched by ISIS against the Iraqi town of Qayyarah in September and October. The use of chemical weapons was in retaliation after Iraqi government forces retook the town in late August. “ISIS attacks using toxic chemicals show a brutal disregard for human life and the laws of war,” said Lama Fakih, deputy Middle East director. “As ISIS fighters flee, they have been repeatedly attacking and endangering the civilians they left behind, increasing concerns for residents of Mosul and other contested areas.” Victims of the attacks experienced painful symptoms of blister agents, or “vesicants”. The use of chemical weapons is in direct violation of the 1993 Chemical Weapons Convention. The use of these weapons would be classified, under the Rome Statue, as a war crime.

What Will Be the Next Pandemic?
Researchers at the recent International Meeting on Emerging Diseases and Surveillance discussed what the next SARS or Zika-like disease will be. Kevin Olival of EcoHealth used a predictive formula and pointed to flaviviruses that we normally don’t hear about – Usutu, Ilheus, and Louping. “All three have on rare occasions infected people, but they also infect a number of other animal species, which suggests they may have what it takes to jump species. Virologists sometimes call viruses that can do this ‘promiscuous.’ That means ‘it’s more flexible in its ability to infect across hosts, including mammals,’ Olival said.” While the scarcity of human cases proves difficult for gaining funding, emerging diseases tend to hit us by surprise, pointing to the need to expand the scope of surveillance and preparedness.

PCAST Letter to the President to Protect Against Biological Attacks
In a letter to the President, the President’s Council of Advisors on Science and Technology (PCAST) points to the to the unique challenge of bioterrorism threats in that they could be exacerbated by the rapid pace of biological science and technology developments. PCAST emphasizes the need for a renewed effort since Federal leadership can help state and local infrastructure share data and identify patterns during such an event. “Continuing scientific, technical, and regulatory developments allow the medical community to respond to new outbreaks faster than ever before. Developing medical countermeasures to naturally occurring outbreaks today lays the groundwork for responding to potential engineered biological threats in the future. PCAST supports extending this progress into the foreseeable future, setting the ambitious ten-year goal that, for infectious organisms for which effective approaches to creating vaccines exist, the United States should have the ability to accomplish, within a six-month period, the complete development, manufacture, clinical testing, and licensure of a vaccine. ”

Comic Book Explores a World Without Antibiotics  screen-shot-2016-11-15-at-8-40-41-am
A new, dystopian comic book is transporting us to 2036 London. The world is a bleak place where antibiotics have run out. Surgeon X looks at a time where simple infections and hospitalization means certain death, while the government cracks down to maintain selective control over the few drugs that are available via  a”Productivity Contribution Index”, which determines who gets access to medication. Readers follow a surgeon, Rosa, through her work at a secret clinic and the internal dialogue that comes with a repressive government, Hippocratic oath, and constant threat of infectious disease. Sara Kenney, the author of Surgeon X, notes that her own experiences with two premature children frame much of her comments on microbial resistance. Kenney noted that “it was only when she started building for herself what she calls the ‘story world’ that she realized antibiotic resistance is such a threat to medicine that it needed to be in her narrative as the obstacle the protagonist must overcome. ‘I realized the antibiotics crisis we’re facing is probably one of the most extreme obstacles you could throw at a surgeon,’. She found the complexities of the problem—resistance is believed to kill 700,000 people around the world each year—to be staggering.”

WHO Global Action Plan on Antimicrobial Resistance cxt8sslxgaajprd-jpg-large
The WHO has just released their action plan to fight antimicrobial resistance. Countries have committed to having a national action plan by May of 2017 to better support the radical shift that is needed to combat antibiotic resistance. Antimicrobial resistance (AMR) threatens the foundation of modern medicine and public health capacity. There have been little advancements in the world of antibiotics, however we continue to see a growth of AMR. The WHO global action plan has five objectives: to improve awareness and understanding of antimicrobial resistance through effective communication, education and training; to strengthen the knowledge and evidence base through surveillance and research; to reduce the incidence of infection through effective sanitation, hygiene and infection prevention measures; to optimize the use of antimicrobial medicines in human and animal health; and to develop the economic case for sustainable investment that takes account of the needs of all countries and to increase investment in new medicines, diagnostic tools, vaccines and other interventions.

BWC RevCon 
While the 8th Review Conference is underway, there have been some reports from attendants that civil society/NGO’s were asked to leave the room, which goes against precedent for the last two RevCon’s. Some have noted that Iran was seeking to deny NGO’s access to Committee of Whole by using rules of procedure but there has not been consensus yet. While these comments have been coming in from attendants’ Twitter accounts, as of Tuesday afternoon, it appears that the issue has been resolved – as news continues to trickle in, we’ll keep you posted. You can get daily updates on RevCon here, with the most recent one covering the cross-cutting plenaries that are focusing on implementation, article III, solemn declaration and more. These daily reports are the best way to get detailed play-by-play information as to how RevCon is going.

Zika Updates
A recent study found that women are at greater risk for Zika infections due to suppressed vaginal immune response. “Scientists at the Gladstone Institutes discovered that the vaginal immune system is suppressed in response to RNA viruses, such as Zika. The delayed antiviral immune response allows the virus to remain undetected in the vagina, which can increase the risk of fetal infection during pregnancy.” The Brazilian state of Parana has banned aerial spraying of pesticides in urban areas. Florida’s Department of Healthy has their daily Zika updates here, which shows three new locally acquired cases as of 11/16. The CDC has reported 4,255 cases in the U.S. as of November 16, 2016.

Stories You May Have Missed:

  • How NY Hunts for Early Hints of an Outbreak– the New York City Department of Health and Mental Hygiene has a secret weapon in the war against infectious disease outbreaks – a computer program called SaTScan.  This program utilizes big data to help detect and model infectious diseases. It monitors, maps, and detects disease outbreaks throughout the state by utilizing the data that is reported to the health department daily. “It is just not possible to effectively monitor every communicable disease in real time with human eyes alone,” Sharon Greene said. “To be able to quickly and effectively and precisely detect an outbreak, to kick off an outbreak investigation process — the earlier that you can begin this it helps to limit sickness, it helps to limit death, and it makes it more likely that you will successfully solve the outbreak.”
  • Exposure Patterns in 2014 Ebola Transmission – Researchers are presenting new information regarding the largest Ebola outbreak in history by looking at the drivers of transmission and where control efforts could be strengthened. They reviewed data from over 19,000 cases across Guinea, Liberia, and Sierra Leone. “We found a positive correlation (r = 0.35, p < 0.001) between this proportion in a given district for a given month and the within-district transmission intensity, quantified by the estimated reproduction number (R). We also found a negative correlation (r = −0.37, p < 0.001) between R and the district proportion of hospitalised cases admitted within ≤4 days of symptom onset. These two proportions were not correlated, suggesting that reduced funeral attendance and faster hospitalisation independently influenced local transmission intensity. We were able to identify 14% of potential source contacts as cases in the case line-list. Linking cases to the contacts who potentially infected them provided information on the transmission network. This revealed a high degree of heterogeneity in inferred transmissions, with only 20% of cases accounting for at least 73% of new infections, a phenomenon often called super-spreading.” Future Ebola outbreak response will need to consider super spreaders, safe funeral practices, and rapid hospitalization.
  • Rick Bright Selected as New BARDA Director – DHHS recently announced that Dr. Rick Bright will be the new Deputy Assistant Secretary for Preparedness and Response and Director of BARDA. Dr. Bright has been with BARDA since 2010 and served in their Influenza and Emerging Infectious Diseases division.