Pandora Report 4.21.2017

If you missed the Infectious Disease Mapping Challenge webinar last week, you can catch the recording here! Ongoing reports are highlighting that the Trump administration is unprepared for a global pandemic.

How Prepared Is The U.S. For Disease Threats?
Scientific American sat down with former CDC director Tom Frieden to discuss his experiences and what he worries may be on the horizon for public health threats. When asked about immediate health issues facing the current administration, Frieden highlights the ongoing Zika outbreak, antibiotic resistance, emerging infections, and the ever-present risk of influenza. In terms of CDC preparedness, Frieden says that, “It’s a big problem that when there is an emerging threat, we are not able to surge or work as rapidly as we should, as a result of a lack of additional funding and legislative authority. When there is an earthquake, the Federal Emergency Management Agency doesn’t have to go to Congress and say, ‘Will you give us money for this?’ But the CDC does. We have made a really good start working with 70 countries to strengthen lab systems, rapid-response and field-monitoring systems, but it is going to take a while before countries around the world are adequately prepared. A blind spot anywhere puts any of us at risk.”

Bill Gates Warns of Increased Bioterrorism Threat
The entrepreneur and philanthropist has been drawing increasing attention to the threat of infectious diseases, especially in regards to bioterrorism. Speaking at the Royal United Services Institute in London (RUSI), Gates stated that, “bioterrorism is a much larger risk than a pandemic.” “All these advances in biology have made it far easier for a terrorist to recreate smallpox, which is a highly fatal pathogen, where there is essentially no immunity remaining at this point.” He goes further to point out the unique aspects of infectious disease threats that make them more deadly than nuclear bombs. “When you are thinking about things that could cause in excess of 10 million deaths, even something tragic like a nuclear weapons incident wouldn’t get to that level. So the greatest risk is from a natural epidemic or an intentionally caused infection bioterrorism events. Whether the next epidemic is unleashed by a quirk of nature or the hand of terrorist, scientists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year. So the world does need to think about this.” Gates pointed to the insufficient public health response in countries that are likely to experience emerging infections and the importance of foreign aid. Moreover, he highlights two major advancements since the 1918 pandemic – globalization and genetic editing. The DIY biohacker and potential for a single infectious person to travel around the globe in a day are all making the threat of a pandemic that much more real. Lastly, Gates emphasizes that the stability of a country and that of its health systems are vital in that an outbreak is more likely to become an epidemic in a country where both qualities are poor.

Biopreparedness – Developing Vaccines For An Eradicated Disease
Speaking of smallpox and the risk of bioterrorism…Filippa Lentzos is pointing to the smallpox vial discovery at the NIH and that despite the eradication of the disease, a biotech company, Bavarian Nordic, is still working to develop a vaccine. She notes that “possible avenues for the re-emergence of smallpox, including the impact of developments in synthetic biology, and it gives an inside view on the biodefence industry and its unusual business model.” Lentzos is an expert in the field of biodefense and focuses her work on the governance of emerging technologies like synthetic biology.

A Scope, A Resistant Germ, and Missing Data Walk into a Bar
GMU Biodefense PhD student Saskia Popescu is looking into the rise of the resistant bug and how medical equipment can pose increased risks for such infections. In 2015 several outbreaks occurred in patients following a procedure with a type of duodenoscopes made by Olympus. These scopes are “flexible medical devices that look like thin tubes and are inserted through the mouth, throat, and stomach into the small intestine—are reusable $40,000 medical devices that contain many working parts, including a camera, and are used for more than half a million procedures a year. The successful dynamics of the device also make it challenging to clean and disinfect. Just over two years ago, cases of drug-resistant infections started popping up in patients who had recently had the procedure that commonly uses duodenoscopes (endoscopic retrograde cholangiopancreatography or ERCP).” Following an outbreak of the highly resistant carbapenem-resistant Enterobacteriaceae (CRE) at UCLA Medical Center, the scopes were recalled and interim cleaning guidance was provided by the CDC. Unfortunately, there is growing concern that the issues with the scope weren’t fully remedied. “In fact, Sen. Murray highlighted a recent outbreak in Europe (location not disclosed within the US Food and Drug Administration report) tied to the modified scopes. Although, modifications made by Olympus were done in response to the previous outbreaks and meant to reduce the risk of bacteria getting into the device’s channels and preventing proper cleaning and disinfection, Sen. Murray is now questioning Olympus regarding the devices and the role they played in this most recent outbreak. The senator is specifically asking for data proving that the repaired scopes could be properly disinfected between patient use.” As the threat of antibiotic resistance rises, the role of medical devices and manufacturer accountability will become increasingly relevant.

CRISPR Breakthrough Gives Hope for Disease Diagnostics 
CRISPR technology news often comes with a bit of controversy, but research recently published in Science is pointing to exciting new diagnostic capabilities. Feng Zhang and eighteen colleagues “turned this system into an inexpensive, reliable diagnostic tool for detecting nucleic acids — molecules present in an organism’s genetic code — from disease-causing pathogens. The new tool could be widely applied to detect not only viral and bacterial diseases but also potentially for finding cancer-causing mutations.” If you’re a fan of 221b Baker Street, you’ll be pleased to hear that the new tool is named SHERLOCK – Specific High Sensitivity Enzymatic Reporter UnLOCKing. The SHERLOCK tool utilizes the viral-recognition within CRISPR to detect genetic pathogen markers in some one’s urine, blood, saliva, or other body fluids. “They report that their technique is highly portable and could cost as little as 61 cents per test in the field. Such a process would be extremely useful in remote places without reliable electricity or easy access to a modern diagnostic laboratory.” This new finding has amazing potential for public health and rapid disease detection in rural areas to improve time to treatment, isolation, and prevention efforts.

National Science Advisory Board for Biosecurity May 2017 Meeting
Don’t miss this May 11th meeting (2-4:30pm EST)! Items include presentations and discussions regarding: (1) the Blue Ribbon Panel draft report on the 2014 variola virus incident on the NIH Bethesda campus; (2) stakeholder engagement on implementation of the U.S. Government Policy for Institutional Oversight of Life Sciences Dual Use Research of Concern (DURC); and (3) other business of the Board.  A detailed agenda and other meeting material will be posted on this website as they become available. This meeting will be a conference call only; there will be no in-person meeting. To join the call as a member of the public, please use the dial-in information below. The toll-free teleconference line will be open to the public at1:30 P.M. to allow time for operator-assisted check-in.  Members of the public planning to participate in the teleconference may also pre-register online via the link provided below or by calling Palladian Partners, Inc. (Contact: Carly Sullivan at 301-318-0841).  Pre-registration will close at 12:00 p.m. Eastern on May 8, 2017. Make sure to check the website for the public conference line and passcode.

Synthetic Bioterrorism – US Developing Medical Response 
Preparedness efforts against biological threats are now expanding to include synthetic biological threats. “Dr. Arthur T. Hopkins, acting assistant secretary for Nuclear, Chemical, and Biological Defense Programs at the U.S. Department of Defense (DOD), testified that…’emerging infectious diseases, synthetic biology and engineered diseases…[is] an area where we are focusing and we have to continue to focus.’ To counter such current and emerging threats, DOD’s Chemical and Biological Defense Program is developing new strategies to more rapidly respond, especially in the area of medical countermeasures, Hopkins said.” He noted that the DoD has commissioned the National Academy of Science to lead a study on the potential for such an event and its impact on national security.

Chemical Reaction: North Korea’s Chemical Weapons Are A Big Threat- And China Needs to Help Deal With Them
GMU Biodefense PhD alum Daniel M. Gerstein is looking at the “role that China could play with respect to North Korea, in particular dissuading the use of chemical weapons. While tensions are high, the use of chemical weapons could be the “spark that could bring the region to war.” Gerstein notes that while the focus in Syria is internal, if Kim Jong Un used chemical weapons it would most likely be external- against South Korea or Japan (or even the U.S.). It is vital that there be a clear-cut response to the use of chemical weapons and action from China may just be the clear message that’s needed. “To prevent the unthinkable from occurring, the North Koreans must be dissuaded from using chemical weapons. They must be convinced that the use of chemical weapons is a red line that cannot be crossed. China should consider being the messenger for this message. China also should consider taking an active, forward-looking approach to prevent the use of chemical weapons by North Korea. When Syria deployed chemical weapons, there was speculation that Russia may have been complicit or at least aware of plans to conduct the attack.” Or perhaps some friendly games of volleyball are in order?

Wildlife Disease Biologists – An Unstoppable Force 
Neither rain nor sleet could keep APHIS wildlife disease biologists out of the field collecting samples. Animal diseases are a major source for infections coming down the pipeline for humans (i.e. spillover events) and these researchers are on the front lines trying to make sure we have a heads up. APHIS’ Wildlife Services (WS) program includes 36 wildlife disease biologists who work diligently to collect samples from wild birds for avian influenza testing (among other things). “‘By monitoring the avian influenza strains circulating in wild birds, WS and its partners are able to provide an early warning system to America’s poultry producers,’ states Dr. Tom DeLiberto, Assistant Director of WS’ National Wildlife Research Center. ‘Our experts focus their sampling on waterfowl species and locations where we are most likely to detect avian influenza. This ensures our efforts are as efficient and informative as possible’.” I think we can all appreciate the brave few who venture into frigid waters to help trap and test wild birds to help detect the spread of infectious diseases.

Stories You May Have Missed: 

  • Trends in Apocalyptic and Post-Apocalyptic Fiction – Writers frequently use an apocalyptic or post-apocalyptic backdrop for fictional stories. The Doomsday Clock is a visual representation of the general mood and often represents the fear and unease in the environment. Whether it be an environmental event or a killer virus, the end of humanity has been a frequent topic for many writers. “Often it is a fear of a naturally-evolving virus, as in Max Brooks’s World War Z: An Oral History of the Zombie War (2006) or Emily St. John Mandel’s Station Eleven (2014). Yet, with the advent of new biotechnologies, authors also considered the impact a malignant engineered virus would have on humanity, as seen in Margaret Atwood’s Maddadam trilogy (2003 onwards) and Justin Cronin’s The Passage trilogy (2010 onwards).”
  • Ebola Theme Issue – The Royal Society – Philosophical Transactions of the Royal Society B is focusing their latest biological sciences journal on the 2013-2016 Ebola outbreak in West Africa. In this edition, you can find opinion pieces discussing the contribution of engineering and social sciences, old lessons on new epidemics, and a wealth of information on outbreak evaluation and notes from the field.

Pandora Report 4.14.2017

Greetings from your favorite source for all things biodefense! Have you ever thought about debugging the details on biological warfare?

Infectious Disease Mapping Challenge Calling all undergraduate and graduate students who have an affinity for infectious diseases, maps, and global health security! The Infectious Disease (ID) Mapping Challenge, piloted in 2015 and 2016 on college campuses by interns with the U.S. Department of State’s Virtual Student Foreign Service program, has evolved into a project to promote the use of geospatial mapping to address the objectives of the Global Health Security Agenda, a global effort to create a world safe and secure of the threat of infectious disease. The challenge is jointly sponsored by the Next Generation Global Health Security Network and DigitalGlobe Foundation. There will be a webinar at 11am ET today about this great challenge and GMU partnership. 

Syria’s Chemical Weapons Kill Chain    GMU Biodefense professor and graduate program director, Dr. Gregory Koblentz, is looking at Syria’s chemical weapons chain of command and who decides when to pull the nerve gas trigger. “The Syrian chain of command for chemical weapons is composed of four tiers: the senior leadership, which is responsible for authorizing the use of these weapons and providing strategic guidance on their employment; the chemists, who produce, transport, and prepare the chemical weapons for use; the coordinators, who provide intelligence on targets and integrate chemical weapons with conventional military operations; and the triggermen, who deliver the weapons to their targets. Together, these individuals and organizations form a chemical weapons kill chain that has so far claimed roughly 1,500 lives and caused more than 14,000 injuries.” Assad is the end-all in terms of deciding if and when to use chemical weapons. Intelligence reports note that he and a handful of close advisors are ultimately the only people able to order such attacks. After reviewing those decision makers, Koblentz turns to the chemists and head of the Syrian chemical weapons program, the SSRC. Interestingly led by Amor Najib Armanazi, a computer scientist, the program has its headquarters in Barzeh and utilizes several entities that have already been sanctioned as front companies. After the development of such weapons, the Syrian military institutions play a vital role in coordinating between the SSRC and the units conducting the attacks. “At the end of the Syrian chemical weapons kill chain are two military organizations in charge of delivering the weapons: the Syrian Artillery and Missile Directorate and the Syrian Arab Air Force. The Syrian Artillery and Missile Directorate was responsible for conducting the 2013 chemical strike on Ghouta. That attack involved approximately eight to 12 Syrian-made 330 mm Volcano rockets, each carrying approximately 50 liters of sarin nerve agent, and at least two Soviet-era M-14 140 mm artillery rockets filled with sarin.” Where is justice in terms of this chain of terror? We know there are intelligence gaps in the chain of command and the identities of several commanders are unknown, which makes bringing them to justice that much more challenging. “Attribution is the first step to accountability, which forms the basis for deterrence. But attribution without consequences will only embolden the perpetrators, demonstrate to other dictators that the use of chemical weapons is tolerable, and badly damage the global norm against the use of these barbaric weapons.” Ultimately, Koblentz notes that long-term efforts to dissuade the use of chemical weapons have to incorporate legal and economic steps that make accountability unavoidable.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
From Anthrax to Zika, we’ve got the place to be in July for all things biodefense. This three-day workshop will provide you with not only seminars from experts in the field, but also discussions with others interested in biodefense. You can check out the flyer and register for the event here. Don’t miss out on the early-bird registration discount of 10% if you register before May 1st. A returning participant, GMU student/alumni, or have a group of three or more? You’re eligible for an additional discount! Check out the website to get the scoop on all our expert instructors and the range of topics the workshop will be covering.

Salad With A Side of Bat This sounds like a menu item from the Little Shop of Horrors, doesn’t it? The CDC and FDA are currently assisting the Florida Department of Health to investigate the finding of a decomposing bat in a packaged salad. Two people who bought the salad came across the bat body after they had already been consuming the lettuce. “According to a CDC statement, the two people who bought the salad have been prophylactically treated for rabies, a potentially deadly disease. The CDC said the bat’s remains were too deteriorated to test for rabies, so the agency could not rule out the disease. ‘It’s extremely rare for rabies to be transmitted through mucosal membrane contact with a dead animal,’ CDC spokesman Tom Skinner told CIDRAP News. ‘The likelihood of transmission is a theoretical risk, but we’re taking every precaution’.” The producer of the salad mix, Fresh Express, has recalled the salads that were sold exclusively in Walmart stores.

Sarin and sentimentality: Trump and Assad’s emotional chemistry GMU Schar School professor, Dr. Charles Blair, and biodefense MS student, Brooke Higgins, are looking into the complicated reversal of Trump’s “no intervention” stance on Syria and why chemical weapons are such a game changer. The belief that Syria had destroyed its chemical weapons stash is all but nonexistent after this latest attack. “The virtually global taboo against using chemical weapons developed relatively recently. The United States, for example, largely accepted chemical weapons ‘as an unavoidable fact of war‘ throughout most of the 20th century.” “In the modern era, a new objection has emerged—that poisons (used on a wide scale) do not discriminate between combatants and civilians. Of course, the same can be said of nuclear weapons, but nuclear weapons’ advanced technology largely grants them a perceived status as ‘modern’ tools in the arsenals of ‘sophisticated’ states.” The ongoing use of chemical weapons is also placing strain on the viability of the Chemical Weapons Convention (CWC) and the lack of international community response. Blair and Higgins note that while Trump’s actions uphold the CWC and were rationalized via a humanitarian lens, the unpredictable nature of Trump means this is most likely an isolated case and highlights the emotional nature behind chemical weapons. Speaking of chemical weapons and history…on Tuesday, White House press secretary Sean Spicer claimed that Adolf Hitler failed to ever use chemical weapons.

Growing Bird Flu Worries This past season saw more H7N9 deaths related to bird flu than in any season since the strain was identified in humans. H7N9 is responsible for killing 162 people since September of 2016 and is worrying many scientists. Researchers, like Hong Kong University’s Guan Yi, have noticed the increasing lethality of H7N9 in chickens over the years. In the beginning, the strain barely affected chickens however, now it has become more lethal and can kill them within 24 hours. “Guan says this is very bad news for a global poultry industry that’s worth hundreds of billions of dollars, and he says China’s government is already looking into vaccinating chickens. What worries Guan more, though, is that H7N9 has proved an ability to mutate quickly. There’s no evidence that the virus has become more deadly in people. But already, in the rare cases when humans catch it from birds, more than a third of them die.” While disease transmission has been limited between humans, there is concern that a mutation could change this. Between the growing H7N9 bird mortality and poor global public health response, it’s not much of a stretch to think that bird flu could be the next pandemic.

Battelle and Nanotherapeutics Form Alliance to Accelerate Medical Countermeasures Development 
In the fight against Chemical, Biological, Radiological, and Nuclear (CBRN) threats, two giants have joined together to strengthen research, development, test and evaluation (RDT&E) for medical countermeasures. The Department of Defense (DoD) relies on such efforts to protect troops against these threats, which has only been reinforced with the recent chemical attacks in Syria. “Battelle has provided RDT&E facilities and expertise to support DoD CBRN medical countermeasure programs for decades. Nanotherapeutics operates a U.S.-based state of the art BSL-3 capable facility offering extensive capabilities, including a pilot facility for performing optimization of upstream, downstream and formulation functions, bulk cGMP manufacturing, and analytical development for proteins, antibodies, viral vaccines and gene therapy drug products.” The plan is that such a partnership between these heavyweights will not only speed up processes, but also facilitate more effective testing and development.

Stories You May Have Missed:

  • 7 Reasons We’re More At Risk for A Pandemic – If you missed last week’s Unseen Enemy film, here are some of the reasons we’re at an increased risk for a pandemic now more than ever…growing populations and urbanization, encroaching into new environments, climate change, global travel, civil conflict, fewer doctors and nurses in outbreak regions, and faster information.
  • British Special Forces in Syria Now Have Chemical Warfare Suits– Amid fears they could be exposed to sarin nerve gas based off President Bashar al-Assad’s recent use of the chemical weapon, British special forces are now equipped with the suits. “New equipment including man-portable chemical agent detector systems, known as MCAD, have already been flown forward to SAS troops operating with a US-led Joint Special Operation Task Force.A source said: ‘The threat is live, therefore we have deployed new equipment to ensure they are protected. It includes everything from detectors to new suits’.”

 

Pandora Report 4.7.2017

Don’t forget to tune in to CNN’s Unseen Enemy tonight at 7pm ET/PT to hear about the next potential pandemic from some of the world’s top disease experts!

Chemical Attack in Syria
On Tuesday, a chemical weapons attack killed dozens in northern Syria. While the Organization for the Prohibition of Chemical Weapons is working to collect data to determine the perpetrator, most are pointing to the Assad regime as the attacks appear to be consistent with a military-grade nerve agent. On Thursday it was announced that the autopsies performed on victims show they were subject to chemical weapons that were likely sarin nerve gas. Later last night, President Trump ordered a targeted missile strike on the Syrian Al Shayrat airfield via 59 Tomahawk cruise missiles. Some are saying the death toll from the chemical attack is between 70 and 100 and the volume of injured reported to be high. Russia is denying involvement in the latest attack that is said to have killed many children. Dr. Greg Koblentz notes that this has the implications of a sarin nerve attack, and if proven to be done by the Syrian regime, it’s one of the largest attacks. He emphasized that the U.S. will need to work to put pressure on Syria and on the Russian and Iranian allies who shouldn’t be immune to suffering the consequences from backing a regime who performs such attacks. Dr. Koblentz also recently spoke to the BBC regarding resolutions and international response towards the chemical attack, highlighting the importance of helping the victims and bringing the perpetrators to justice.

Can Bill Gates Rescue the Bioweapons Convention?
Who can save the Biological Weapons Convention? GMU biodefense graduate program director and professor Dr. Gregory Koblentz highlights the growing monetary deficits within the BWC. Dependent upon international cooperation and funding, many treaty members have been inconsistent at paying their budgetary share, which puts the implementation services unit and future meetings in jeopardy. Pointing to the challenges of acquiring funds, Koblentz draws attention to an individual who is both extremely wealthy, philanthropic, and interested in public health – Bill Gates. “Gates, ever the businessman, pointed out that this dire outcome could be avoided by spending an estimated $3.4 billion a year on pandemic preparedness. To his great credit, Gates and his foundation have already contributed vast sums to global health. Most recently, the Bill and Melinda Gates Foundation provided $100 million to help launch a public-private initiative called the Coalition for Epidemic Preparedness Innovations, with the goal of accelerating the development of new vaccines.” His recent comments at the Munich Security Conference regarding the realities of biological threats shine a harsh light the devastation a biological weapon could cause. Koblentz looks outside the box in this article, highlighting that dire times may call for unusual actions to save the BWC. “The global health community has achieved great gains over the decades, but a single bioweapon attack could reverse all that. Now more than ever, an ounce of prevention is worth a pound of cure.”

Safeguarding the Bioeconomy – Securing Life Sciences Data
Check out the latest meeting recap from the NAS workshop, which worked to assist the FBI WMD Directorate “in understanding the applications and potential security implications of emerging technologies at the interface of the life sciences and information sciences.” This workshop brought together experts from a wide range of fields to help solve the challenges of encouraging a strong bioeconomy, while preventing nefarious use and considering the implications of such data. “Advances in the life sciences are increasingly integrated with fields such as materials science, information technology, and nanotechnology to impact the global economy. Although not traditionally viewed as part of bio-technology, information technology and data science have become major components of the biological sciences as researchers move toward –omics experimental approaches.” “There is currently no government agency charged with holistically assessing the security of the bioeconomy, and the emerging importance of data (and data security) within it. These concerns will continue to grow as the world becomes more digitized and interconnected. There are a number of different types of data that can be aggregated and analyzed as part of the bioeconomy, and the collection, sharing and use of these different types of data may pose different potential concerns.” Within the workshop summary, you’ll see the division of bioconomy economy into clinical and nonclinical data, the biosecurity perspective from academia, technological advances that will further data access, data sovereignty issues, and much more.

Novel Antimicrobials – The Quest For The Grail?
The new CARB-X partnership is trying to combat the growing threat of antimicrobial resistance through innovation and supporting new research. “The CARB-X board thoroughly vetted 168 proposals and selected 11 projects that represent truly exciting early stage research. Three of them could become the first in new classes of antibiotics, and four are innovative non-traditional products. Some of the projects also take new approaches, known as mechanisms of action, to target and kill bacteria. All of the potential new medicines target Gram-negative bacteria prioritized by the U.S. Centers for Disease Control and Prevention and the World Health Organization.” BARDA is also in the race for halting the rise of the resistance bug – they’ve got a clinical-stage antibacterial program which has 13 products that are looking promising. The threat of antimicrobial resistance means that partnerships in even the most unlikely places are unfolding to help develop anything from new drugs to diagnostic tests that can determine if a lung infection is bacterial or viral. The truth is that the looming antibiotic apocalypse truly requires all hands on deck, so what’s the hold-up? At least we may have a potential cure in maple syrup

Pandemics, Personnel, and Politics: How the Trump Administration is Leaving Us Vulnerable to the Next Outbreak
GMU Biodefense graduate program director and professor, Dr. Gregory Koblentz, and MS student Nathaniel M. Morra are looking at the increase in infectious disease outbreaks in recent years (Ebola, Zika, SARS, MERS-CoV) and how the new administration is prioritizing public health. “Despite this heightened risk of a global pandemic, the Trump Administration has dragged its feet in appointing senior officials to key Federal agencies responsible for preparing and responding to a pandemic or bioterrorist attack. These agencies are also subject to steep budget cuts under Trump’s budget for Fiscal Year 2018. The delays in installing senior leaders at these agencies and pending budget cuts puts U.S. and global health security at risk.” Interim directors, a lack of Assistant Secretary for Preparedness and Response within HHS, and a planned cut in funds are already creating vulnerabilities within U.S. health security. “If a major influenza pandemic were to occur, no wall would be high enough to stop the virus from entering the United States. The best defense against pandemics and other disease threats are Federal, state, and local health agencies and international partners with strong leadership and the necessary resources to fund vital surveillance, preparedness, response, and research activities. Mother Nature doesn’t play politics; Trump shouldn’t play politics with global health security.”

Pandemics, Bioterrorism, and Global Health Security LinkedIn Group
If you’re not already already a member, make sure to check out this LinkedIn group “dedicated to the analysis of the challenges facing the world at the nexus of health, science, and security. The group’s purpose is to serve as a unique forum for discussion and debate on critical issues in global health security.” We’re happy to announce that the group just reached 3,000 members thanks to Arthur Seward-El and Veena R. Kumar! If you’re looking for a LinkedIn group dedicated to global health security and includes members from all over the world, don’t miss out!

Center for Health Security Emerging Leaders Take on The Eight Ball
I’m a biodefense nerd – always have been and always will be, so you can imagine my excitement when part of the ELBI class of 2017 fellowship workshop involved getting to visit the Eight Ball near USAMRIID. The Eight Ball is from the days of America’s active bioweapons program and despite its history, is now a rather interesting sight stuck between two buildings and surrounded by trash dumpsters. Dr. Koblentz has provided some great trivia regarding the Eight Ball – it cost $715,468 (in 1950 dollars), is four stories high and weights 131 tons, was used to test animals ranging from mice to horses, and held its first human tests in 1955 as part of Operation Whitecoat. “This one million liter metal sphere is currently tucked away behind a service building, but at one point it was the epicenter of Operation Whitecoat, the US Cold War biodefense program. From the 1950s through the ‘70s, researchers developing treatments for biological agents released small amounts of these selected agents into the eight ball, allowed them to disperse, and then exposed volunteers to this contaminated air via specially rigged gas masks. By treating the volunteers (who signed consent forms) with their newly developed vaccines and therapies, scientists were able to develop effective methods to respond to biological warfare. Whitecoat volunteers were exposed to agents that cause diseases such as rabbit fever (tularemia), Q fever, yellow fever, and plague.”

Digital Surveillance of Emerging Infectious Disease and Outbreaks: A One Health Approach 
Don’t miss out on this Next Generation Global Health Security Network Webinar on April 7th, at 1pm EST. You can check out the webinar here to learn from Maja Carrion, Assistant Director of ProMED, about digital health surveillance in human and animal sectors.

Investing In Public Health Keeps America Great
Simply put, a nation cannot be great if it lacks health. The proposed budgetary measure that drastically cut funding for HHS point to what public health has been battling for decades – a necessary force that receives too little funding amid too many expectations. Investing in public health is the most obvious thing one could do to make a country strong and capable of growth. Whether it be extending life, eradicating disease, or even a thriving workforce, public health is a force that simply can’t be ignored. “Instead of making deep investments in public health, and thus public safety, we allocate pennies. Americans spend more per capita on health care than any other country in the world, but less than 3 percent of all health spending goes to public health. The CDC’s budget has declined slightly over the past decade, and funding cuts at the state and local levels have been ‘drastic,’ says Trust for America’s Health.” At the end of the day, we have to ask ourselves – at what price do we value our own health and that of those around us?

Dynamic Challenges & Opportunities for Global Health Security Talk
All GMU biodefense students and alum are welcome to attend Dr. Gene Olinger’s talk during Professor Nuzzo’s BIOD 710 class on Tuesday, April 11th, from 6:15-7:10pm! Dr. Olinger serves as principal science advisor for MRIGlobal Biosurveillance and Global Health Division and will be talking about global health security as a subject matter expert for multiple federal panels related to biodefense and emerging viral pathogens.

Stories You May Have Missed:

  • Two Very Different Views of Terrorism and What To Do About Them – GMU biodefense PhD alum Daniel M. Gerstein is looking at the reaction to two major events – the aviation electronics ban and the London terrorist attack. He emphasizes that risk perception and personal inconvenience plays a big role in the limitations people are willing to accept in the name of safety. “Risk perception will undoubtedly continue to be an important determinant in the types of security policies and measures that will be acceptable to governments and the public. Clear and precise communications on the various threats faced, the vulnerability to particular attacks and the potential consequences of such attacks, could help reduce inflated perceptions of risk while at the same time making people more accepting of security enhancing initiatives.”
  • Measles Takes Hold in Eastern Europe– Europe is seeing a large outbreak of measles currently as over 500 cases were reported just in January 2017. 474 cases were reported in endemic countries (France, Germany, Italy, Poland, Romania, Switzerland, and Ukraine). “The largest current measles outbreaks in Europe are taking place in Romania and Italy. Romania has reported over 3400 cases and 17 deaths since January 2016 (as of 10 March 2017). The majority of cases are concentrated in areas where immunization coverage is especially low. According to reported data, the 3 measles genotypes circulating in Romania since January 2016 were not spreading in the country before, but were reported in several other European countries and elsewhere in 2015. Comprehensive laboratory and epidemiological data are needed before the origin of infection and routes of transmission can be concluded.”
  • 10 Saudi MERS Hospital-Associated Cases– Infection prevention goes well beyond the normal hand hygiene and healthcare-associated infections. MERS-CoV is a prime example of a disease that takes advantage of poor infection prevention efforts in healthcare. “A MERS-CoV outbreak linked to a dialysis unit at a hospital in Wadi Aldwaser has sickened 10 people, 2 of them with asymptomatic infections, the World Health Organization (WHO) said yesterday in an update covering 18 recent cases in Saudi Arabia.” Two of those infected are healthcare workers.

Pandora Report 3.31.2017

Welcome to your weekly dose of all things biodefense! If you take heartburn medication, you may want to check out the latest research that ties it to a higher risk of recurrent Clostridium difficile infections.

Inferno
Dr. Steve Hatch is taking readers through the harrowing journey of Ebola via the eyes of an ETU physician. He traces the origins of the outbreak, the complexities of the disease, and what it was like working as a physician during this deadly outbreak in Liberia. “There, he served as a physician (and at times a nurse’s aide, a surrogate parent and even a masseur) to the droves of patients arriving in makeshift ambulances. Inferno is Hatch’s exploration of Ebola’s origins and spread throughout Africa and beyond, coupled with his personal experience caring for those infected.”

The Real Threat to National Security: Deadly Disease
As more attention is focused on Trump’s proposed budget and the impact to public health (i.e. massive drops to NIH and CDC funding, a 28% drop in the United States Agency for International Development, etc.), the glaring reality of disease vulnerability is following suit. “Those cuts will not protect American citizens. They will diminish research and vaccine development and our ability to respond to the growing threats of antibiotic resistance and new infectious diseases. Those agencies are already falling short, as we saw last year, when they couldn’t effectively respond to the Zika threat. What will they do when we face a real pandemic? With 7.4 billion people, 20 billion chickens and 400 million pigs now sharing the earth, we have created the ideal scenario for creating and spreading dangerous microbes.” Disease is a mixed bag of tricks – antibiotic resistance, vector diseases like yellow-fever, emerging infectious diseases, zoonotic bugs like Nipah, and those that we can’t even begin to imagine. That’s just touching on the natural kind, lest we forget the threat of bioweapons or potential for biosecurity/biosafety failures in labs performing dangerous or dual-use research. The truth is that public health efforts are already strained as it is. Despite the untold benefits of prevention, it’s never been as flashy to invest in public health as in military. Unfortunately, in this day and age of globalization and interconnectedness, the poor investment we make in public health is coming back to bite us. Ebola preparedness cost U.S. hospitals $360 million…mostly because they weren’t prepared to handle these kinds of things from the beginning. Imagine if we had the funds to train healthcare workers how to handle more challenging diseases from the beginning. Regrettably, these kinds of things can’t happen if we continue to cut funds to necessary public health agencies and decide that prevention isn’t worth the investment. The stark realities of global health security aren’t things that will go away, but rather will continue to grow if we ignore prevention efforts and decide that public health isn’t worth the expenditure. Ex-CDC director, Tom Frieden, recently wrote an article for TIME magazine about the historical dangers of underfunded health programs.  If you still aren’t convinced, check out the Center for Health Security’s Infectious Disease Cost Calculator here or this article on the economic disruption of infectious disease.

Antibiotic Resistance Crisis
The American Society for Microbiology (ASM) established a new initiative to support existing efforts against antimicrobial resistance (AMR) and research developments. “This new ASM initiative is a multi-stakeholder mechanism that shares information on the current state of AMR, and identifies relevant opportunities to address AMR challenges across the microbial sciences. The initiative’s subject matter experts have identified potential approaches to maximize the impact on public, animal, and environmental health, expand surveillance, promote rapid diagnostics, and implement stewardship across settings. ‘The Steering Committee is well positioned to advise the Society on interdisciplinary One Health approaches and opportunities to address critical data gaps and human resource needs to confront this multifaceted, urgent domestic and global challenge,’ said Steering Committee co-chair James Tiedje, University Distinguished Professor and director of the NSF Center for Microbial Ecology at Michigan State University.” ASM is not new to the AMR game and has been organizing and participating in working groups since the 1990’s. The hopes for this new initiative is to really hone in on the clinical and environmental issues that facilitate AMR growth. They are also looking at surveillance and how to expand these efforts to ensure we’re getting the full scope of the issue and can truly address it with the most accurate information.

Safety First with Gene Editing
The technology and developments are quickly outpacing regulatory and oversight efforts in the world of genome editing, so the question is now becoming “should we restrict their use in the face of uncertain threats, or embrace the potential they offer and hope that appropriate responses can be rallied if experiments bring serious risks to the fore?” Many would have hoped that safety mechanisms would’ve been built into the editing systems or that we weren’t racing to catch up in terms of safety. DARPA’s Safe Genes program is one such effort that anticipates starting this summer. “Safe Genes aims to accelerate the collection of data currently missing from the debate on how to apply genome editors. The initiative also aims to strengthen the scientific foundation upon which formal safety standards for genome editing applications may someday be developed and adopted.” DARPA’s new program focuses on genome editing for many reasons – the real national security implications, the rapid pace of development and DIY potential, the dramatically declining costs for genome editing toolkits, etc. Aside from the dangers of mishandled or nefarious usage, it’s important to remember there is the potential of using genome editing for a host of beneficial things like fighting diseases, etc.

Lassa Fever Outbreak in West Africa 
Lassa fever has now seared through five West African countries in the latest outbreak. Nigeria and Sierra Leone were the first countries to see cases in December 2016. Nigeria has a total of 283 cases and 56 deaths while Sierra Leone has seen 24 cases. Of the twenty-four cases in Sierra Leone, only four were laboratory confirmed, all of whom died. While the disease is endemic in West Africa and yearly peaks occur between December and February, public health officials are working to slow the spread of the disease. Benin, Togo, and Burkina Faso are also affected by the outbreak.

GHSA Roundtable With FAO Chief Veterinary Officer Dr. Juan Lubroth
Don’t miss this event on April 4th, from 10:30-11:30am (EDT)! The FAO Liaison Office for North America cordially invites members of the Global Health Security Agenda Consortium, Private Sector Roundtable, and Next Generation Network to an informal roundtable discussion with FAO Chief Veterinary Officer, Dr. Juan Lubroth on Tuesday, April 4, from 10:30 – 11:30 a.m. Dr. Lubroth has played an important role in shaping FAO’s involvement in the Global Health Security Agenda (GHSA) since its inception in February 2014 and remains a forceful and effective advocate for the GHSA’s multisectoral and One Health approach to global capacity-building to prevent, detect, and respond to infectious disease threats. Dr. Lubroth looks forward to sharing his thoughts on the GHSA from an international organization perspective and learning more about the role of non-governmental stakeholders in this important initiative. Please confirm your attendance to Mr. Gabriel Laizer, at FAOLOW-RSVP@fao.org

Meeting On The Trump Administration, Congress, and The Future of Global Health
Don’t miss this roundtable discussion on April 6th, from 5-6:30pm, hosted by the Center for Strategic & International Studies (CSIS) Global Health Policy Center. This discussion will feature Jennifer Yates (Vice President and Director of Global Health & HIV Policy Kaiser Family Foundation), Liz Schrayer (President & CEO U.S. Global Leadership Coalition), and Chris Beyrer (Director of Center for Public Health and Human Rights John Hopkins, Bloomberg School of Public Health).

Fostering an International Culture of Biosafety, Biosecurity, and Responsible Conduct in the Life Sciences
Second-year, GMU biodefense PhD candidate, and intern for the Department of Health and Human Services, Assistant Secretary for Preparedness and Response within the Office of Policy and Planning, Elise Rowe, is taking on the international role of biosafety! As part of the student internship program, all interns are required to work on an independent project and present to ASPR staff upon its completion. Elise will be presenting her project, titled “Fostering an International Culture of Biosafety, Biosecurity, and Responsible Conduct in the Life Sciences,” on Wednesday, April 5th at the Thomas P. O’Neil Jr. Federal Building from 2-3:30 pm. You can read the abstract here.

Stories You May Have Missed:

  • Beth Cameron Joins NTI To Lead Global Biological Policy and Programs– Dr. Beth Cameron is now the senior director for global biological policy and programs at the Nuclear Threat Initiative (NTI). “Among other duties, Dr. Cameron will oversee the development of a Global Health Security Index, as well as work related to national security risks associated with emerging biotechnologies. This initiative was announced by NTI earlier this month in partnership with the Open Philanthropy Project, the Robertson Foundation and the Johns Hopkins Center for Health Security. Dr. Cameron most recently served as the Senior Director for Global Health Security and Biodefense on the White House National Security Council staff, where she was instrumental in developing, launching, and implementing the Global Health Security Agenda.”
  • Georgia Reports Low-Pathogenic H7 in Commercial Breeding Flock – Agriculture officials in Georgia (GDA) reported the low-path H7 presence in a breeding operation in Chattooga Country, Georgia. “The GDA said as a precaution, the affected flock has been depopulated and officials are testing and monitoring other flocks within the surveillance area. So far no poultry at other facilities have tested positive and none has shown any clinical symptoms. Gary Black, Georgia’s agriculture commissioner, said in the statement that poultry is the top sector in agriculture, the state’s number one industry, and officials are committed to protecting the livelihoods of farm families. ‘In order to successfully do that, it is imperative that we continue our efforts of extensive biosecurity’.”
  • Hazardous Materials Research Center Live-Agent Test – Battelle will be hosting this workshop on April 17-21st for manufacturers and developers of PPE against CBRNE threats to test their PPE against live chemical agents. “Permeation test data will help accelerate research and development to enable developers to meet critical government test and evaluation requirements or be prepared for certification, ensuring materials can provide chemical agent protection against mission specific scenarios.” Have some PPE you want tested against a chemical threat? Check it out!

Fostering an International Culture of Biosafety, Biosecurity, and Responsible Conduct in the Life Sciences

Second-year, GMU biodefense PhD candidate, and intern for the Department of Health and Human Services, Assistant Secretary for Preparedness and Response within the Office of Policy and Planning, Elise Rowe, is taking on the international role of biosafety! As part of the student internship program, all interns are required to work on an independent project and present to ASPR staff upon its completion. Elise will be presenting her project, titled “Fostering an International Culture of Biosafety, Biosecurity, and Responsible Conduct in the Life Sciences,” on Wednesday, April 5th at the Thomas P. O’Neil Jr. Federal Building from 2-3:30 pm.

The abstract for her project is below: Continue reading “Fostering an International Culture of Biosafety, Biosecurity, and Responsible Conduct in the Life Sciences”

Pandora Report 3.24.2017

Welcome to the start of the weekend and World TB Day! The WHO estimates that just in 2015, 1/3 of people with TB missed out on quality care and 480,000 people developed multidrug-resistant TB.

Public Health Concerns in Trump’s New Budget
President Trump’s newly released proposed budget blueprint makes drastic cuts to many programs, of which, one of the hardest hit is HHS. On top of the cuts to science and public health, there is something buried within the budget that is concerning ex-CDC director, Dr. Tom Frieden. Frieden worries about the proposal to award block grants to states, which would allow them to decide how to respond to public health issues (think Ebola, Zika, etc.). “That proposal is ‘a really bad idea,’ according to Dr. Tom Frieden, who until this past January was director of the U.S. Centers for Disease Control and Prevention. Currently, the CDC experts work with state and local governments to devise evidence-based plans to respond to public health issues, such as foodborne and infectious disease outbreaks. With a block grant, states can use the federal money to replace their own spending in certain areas or spend the money unwisely, ‘and never have to report what they have done or be held accountable for it,’ Frieden said.” A withdrawal of one fifth of NIH’s budget would mean a deep slash to biomedical and science research funding.  These cuts will also impact foreign aid, which has many worried about the role of public health interventions in foreign countries. Bill Gates recently talked to TIME magazine regarding the safety implications of cutting foreign aid. “I understand why some Americans watch their tax dollars going overseas and wonder why we’re not spending them at home. Here’s my answer: These projects keep Americans safe. And by promoting health, security and economic opportunity, they stabilize vulnerable parts of the world.” Gates points to the role of overseas public health work like polio eradication, Ebola outbreak response, and America’s global HIV/AIDS effort (PEPFAR), which points to the stabilizing role that strengthening public health can have in a country.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
From Anthrax to Zika, we’ve got the place to be in July for all things biodefense. This three-day workshop will provide you with not only seminars from experts in the field, but also discussions with others interested in biodefense. You can check out the flyer and register for the event here. The best part is that we’re doing an early-bird registration discount of 10% if you sign up before May 1st. A returning participant, GMU student/alumni, or have a group of three or more? You’re eligible for an additional discount! Check out the website to get the scoop on all our expert instructors and the range of topics the workshop will be covering.

Unseen Enemy Documentary 
Mark your calendars for this upcoming infectious documentary on the lurking pandemics that worry experts. Airing on April 7th, Unseen Enemy will follow researchers looking for the early warning signs of diseases that could cause the next pandemic. The National Academy of Medicine will be hosting a special D.C. premiere of the film on April 2nd, that you can even attend.

Expert Views on Biological Threat Characterization for the U.S. Government: A Delphi Study 
Biological threat characterization (BTC) is mixed bag of risk and reward. The laboratory research involving deadly pathogens as a means for biodefense can translate to better risk assessments but also the potential for biosafety failures. To better address this issue, researchers performed a Delphi study to gather opinions from experts around the country. “Delphi participants were asked to give their opinions about the need for BTC research by the U.S. government (USG); risks of conducting this research; rules or guidelines that should be in place to ensure that the work is safe and accurate; components of an effective review and prioritization process; rules for when characterization of a pathogen can be discontinued; and recommendations about who in the USG should be responsible for BTC prioritization decisions.” Following their assessment, the researchers found that experts agree that BTC research is necessary, but there is also a need for continued oversight and review of the research to reduce as much risk as possible. “It also demonstrates the need for further discussion of what would constitute a ‘red line’ for biothreat characterization research—research that should not be performed for safety, ethical, or practical reasons—and guidelines for when there is sufficient research in a given topic area so that the research can be considered completed.”

GMU Schar School PhD Info Session
If you love global health security and have been wanting to further your education, come check out our PhD info session next Wednesday, March 29th at 7pm in Arlington. You can come learn about our biodefense PhD program from the director, Dr. Koblentz, and hear from several students about their experiences. The info session is a great way to find out what a GMU Schar PhD entails, the application process, and what current students think!

What Biosecurity and Cybersecurity Research Have In Common
Kendall Hoyt is looking at the similarities between these two research fields and how work into the unknown can often expose and create vulnerabilities. Did I mention Kendall is one of the instructors at our biodefense Summer Workshop? Hoyt provides two examples to really hone in on this point – to defend against a dangerous pathogen, we have to isolate and grow it to try and develop treatment or a vaccine and to defend against a cyberattack, we need to know how to break into the computer system. That whole dual-use dilemma creates a lot of risk-versus-reward scenarios for biosecurity and cybersecurity researchers. While the research is highly relevant and necessary, government efforts to control or maintain oversight have been challenging. Do we pull back the reigns on innovation or run the risk of a security breach or a big “whoops” moment? “Intellectual property and cybersecurity legislation—namely the Digital Millennium Copyright Act and the Computer Fraud and Abuse Act—has similarly stifled legitimate scientific and commercial activities and delayed defensive applications. In one well-known example, fear of prosecution under DMCA deterred a Princeton graduate student from reporting a problem that he discovered: Unbeknownst to users, Sony BMG music CDs were installing spyware on their laptops.” Hoyt also points out the biosecurity efforts that have begun looking not just at the pathogens and publications, but the laboratory techniques that are used for such research. Certain experiments (like gain of function work) have the capacity to increase transmissibility or host range. “For all of their similarities, key differences between biosecurity and cybersecurity risks and timelines will dictate varied regulatory strategies. For example, zero-day exploits—that is, holes in a system unknown to the software creator—can be patched in a matter of months, whereas new drugs and vaccines can take decades to develop. Digital vulnerabilities have a shorter half-life than biological threats. Measures to promote disclosures and crowd-sourced problem-solving will therefore have a larger immediate impact on cybersecurity. Still, both fields face the same basic problem: There are no true ‘choke points’ in either field. The U.S. government is not the only source of research funds and, thanks in large part to the internet itself, it is increasingly difficult to restrict sensitive information.” In the end, Hoyt notes that both fields and their regulations will need to relax the governance process and be a bit more flexible and mobile with how they control items. Both fields are constantly evolving, which means regulators need to be just as fluid.

How To Prepare For A Pandemic
NPR decided to create a “Pandemic Preparedness Kit” based off the continuous questions related to the ongoing news of increasing infectious disease threats but little info in terms of practical things people can do. While these aren’t things you can go out and buy for your home, the list hits close to home in terms of things we should be focusing our efforts and funding on. Firstly, vaccines. This is a no brainer and yet, we’ve become the habitual users of the theme “create it when we’re struggling to contain an outbreak”. Secondly, virus knowledge. “One of your best weapons during a disease outbreak is knowledge, says Dr. Jonathan Temte of the University of Wisconsin. ‘Keep up with the news and try to understand what threats might be out there,’ he says. For example, new types of influenza are one of the biggest threats right now — in terms of pandemic potential, Temte says. But if you know how to protect yourself from one type of influenza, you can protect yourself from all of them.” Lastly, and my personal favorite, is very clean hands. While every disease is different, one of the most basic and fundamental truths for infection prevention and control is hand hygiene. These three are solid ways to better prepare for future outbreaks, pandemics, emerging infectious diseases, and just about anything infectious that makes you a bit worried.

CARB-X MissionWhen I first read the name of this group, I thought it was some kind of fitness fuel, but I was pleasantly surprised to see this initiative is working to fight antibiotic resistance. CARB-X is a collaboration between NIAID and BARDA to help accelerate the development of antibacterials over the next 25 years. The goal is to help combat antimicrobial resistance through a diverse portfolio and partnership. Make sure not to miss their March 30th meeting from 11am-noon on antibiotic resistance. “CARB-X (Combating Antibiotic Resistant Bacteria Accelerator) was launched in August 2016 to accelerate pre-clinical product development in the area of antibiotic-resistant infections, one of the world’s greatest health threats. CARB-X was established by BARDA and NIAID of the U.S. Department of Health and Human Services along with Wellcome Trust, a global charitable foundation dedicated to improving health. This partnership has committed $450 million in new funds over the next five years to increase the number of antibacterial products in the drug-development pipeline.” While CARB-X may not be the latest workout supplement, it’s definitely a boost to performance in the fight against antimicrobial resistance.

New Roles and Missions Commission on DHS Is Urgently Needed
GMU biodefense PhD alum, Daniel Gerstein, is looking at DHS and pointing to the need for a Roles and Missions Commission. It’s been almost 15 years since DHS was created under rapid and urgent circumstances, which means that it’s time to look introspectively. “More generally, a roles and missions review could also examine whether the department is properly resourced for all its missions. For example, a joint requirement council was recently established for the department composed of less than 10 government civilians. Is this adequate for supporting requirements development activities for a department of over 240,000 personnel?” Gerstein looks at some of the big issues that require a comprehensive review, like centralization versus decentralization, management of R&D and engineering, and critical infrastructure issues related to national security and safety. Another component needing review is the human factors issue that impacts homeland security. How are the relationships between departments, with state and local authorities, or with the public? “The effort should not necessarily be viewed as a requirement for change, but rather an opportunity to reexamine DHS and its relations with the rest of government, the nation and its citizens, and even with our international partners across the globe. Finally, a homeland security roles and mission commission would be an ideal lead-in to a much needed update to the original 2002 authorizing legislation.”

Deadliest Enemy: Our War Against Killer Germs
Don’t miss this event on Thursday, March 30th, hosted by New America with speakers Michael T. Osterholm and Mark Olshaker. “In today’s world, it is easier than ever for people and material to move around the planet, but at the same time it is easier than ever for diseases to move as well. Outbreaks of Ebola, MERS, yellow fever, and Zika have laid bare the world’s unpreparedness to deal with the threat from infectious diseases. In Deadliest Enemy: Our War Against Killer Germs Dr. Michael Osterholm and Mark Olshaker marshal the latest medical science, case studies, and policy research to examine this critical challenge.”

Stories You May Have Missed:

  • The Feds Are Spending Millions to Help You Survive Nuclear War – North Korea’s recent firing of four ballistic missiles from Pyongyang into the ocean off Japan’s coast has brought back worries of nuclear attacks. While the days of stocking a bomb shelter are in the past, the U.S. government isn’t slowing down efforts to protect Americans. “Over the last ten years the US has poured millions of dollars into technologies and treatments it hopes to never have to use, but could, in the event of a nuclear catastrophe. From assays that measure radiation exposure to cell therapies that restore dwindling blood cells to liquid spray skin grafts, government officials are now far better equipped to deal with diagnosing and treating people if the unthinkable were to happen. And the next generation of treatments are being funded right now.” DHHS projects like BARDA and Project BioShield are just some of the sources for ongoing research to strengthen protection, whether it be a nuclear blast or reactor melt-down.
  • Disinfection and the Rise of the Superbug – GMU biodefense PhD student Saskia Popescu is addressing the growing disinfection needs as we teeter on the edge of the antibiotic abyss. Disinfection is already a challenge in healthcare however, the rise of more resistant germs means that efforts often need to be ramped up. The recent influx of Candida auris infections that we talked about last week really brings this issue to point in that this emerging infection is difficult to get rid of via traditional disinfection routes. “As new organisms are identified and existing ones become resistant to antimicrobials, the availability of strong disinfecting products has become even more pivotal.”
  • China and EU Cut Brazilian Meat Imports Amid Scandal– If you’re a fan of importing Brazilian meat, you may have to hold off for a while. A recent police anti-corruption probe is accusing inspectors of taking bribes to allow the sale of rotten and salmonella-contaminated meats from the largest exporter of beef and poultry. As the news unfolds, the Brazilian government is criticizing gate police as alarmist. “As the scandal deepened, Brazil’s Agriculture Minister Blairo Maggi said the government had suspended exports from 21 meat processing units.”
  • Study on Interferon for Treatment of Ebola Infection – The common hepatitis treatment is now being tested out on Ebola patients to help alleviate their symptoms. The pilot study was performed from March-June of 2015 and  had some interesting results. “When compared to patients who received supportive treatment only, 67 per cent of the interferon-treated patients were still alive at 21 days in contrast to 19 per cent of the former patients. Additionally, the viral blood clearance was faster in those patients treated with Interferon ß-1a. Many clinical symptoms such as abdominal pain, vomiting, nausea and diarrhea were also relieved earlier in the interferon-treated patients. A further 17 patients in other Guinean treatment centres who matched the interferon-treated patients based on age and the amount of Ebola virus in their blood were included in the analysis. These added patients, who did not receive interferon, more than doubled their risk of dying as a result of not being treated with the drug.”

Pandora Report 3.17.2017

Happy Friday! In honor of  John Snow‘s birthday (the father of epidemiology), our featured image is the Broad Street pump map he used to combat cholera in the 19th century. Don’t miss out on the early registration discount for our biodefense summer workshop!

NAS Calls for Increased Federal Regulatory Agency Preparation for Growing Biotechnology Products 
The National Academies of Science (NAS) recent press release is emphasizing the need for federal regulatory agencies to prepare for greater quantities and ranges of biotechnology products. As the biotech world constantly evolves, regulatory agencies have struggled to keep up and this latest report states that in the next five to ten years, the pace will outmatch the U.S. regulatory system. According to the report, biotechnology, like CRISPR, has a rapidly growing scale and scope, which already stresses existing staff, expertise, and resources available at agencies like the EPA, FDA, and USDA. “To respond to the expected increase and diversity of products, the agencies should develop risk-analysis approaches tailored to the familiarity of products and the complexity of their uses, the report says. For biotechnology products that are similar to products already in use, established risk-analysis methods can be applied or modified, and a more expedited process could be used. For products that have less-familiar characteristics or more complex risk pathways, new risk-analysis methods may need to be developed.  Regulatory agencies should build their capacity to rapidly determine the type of risk-analysis approaches most appropriate for new products entering the regulatory system.” Within the report, NAS notes that the federal government needs to develop a strategy to combat the current issues and strengthen their ability to scan for future biotechnology products to better prioritize.

GMU Schar School Master’s Open House 
Have you ever wanted to study topics like CRISPR, bioterrorism, global health security, and pathogens of biological weapons? Good news – we’ve got just the program for you! Come check out GMU’s biodefense MS program at our Open House on Wednesday, March 22nd at our Arlington Campus, Founders Hall (Room 126) at 6:30pm. You can talk to some of our biodefense faculty and learn about our program. Whether you’re looking to take classes in person or earn a degree online, the biodefense MS is the best for the intersection of science and policy.

DARPA Works Towards “Soldier Cell” To Fight Bioweapons 
A bio-control system to fight off invading pathogens? Sounds like something out of a science fiction movie! Well, researchers at Johns Hopkins University just received funding from DARPA to develop the capacity to “deploy single-cell fighters” that would target and eliminate the lethality of certain pathogens. “‘Once you set up this bio-control system inside a cell, it has to do its job autonomously, sort of like a self-driving car,’ said Pablo A. Iglesias, principal investigator on the project. Iglesias, a professor of electrical and computer engineering in the Whiting School, shifted his research focus from man-made to biological control systems about 15 years ago. ‘Think about how the cruise control in your car senses your speed and accelerates or slows down to stay at the pace you’ve requested,’ Iglesias said. ‘In a similar way, the bio-control systems we’re developing must be able to sense where the pathogens are, move their cells toward the bacterial targets, and then engulf them to prevent infections among people who might otherwise be exposed to the harmful microbes’.” This angle, which is being focused on bacteria outside of the body, is just one potential tool in the biodefense arsenal.

Yellow Fever Outbreak in Brazil 
Since December of 2016, Brazilian health officials have reported an ongoing outbreak of yellow fever. The CDC has moved the alert to a  Level 2 – Practice Enhanced Precautions. A report recently published in the New England Journal of Medicine looks at the outbreak and the potential for cases in U.S. territories. In Brazil, there were 234 cases and 80 deaths reported between December and February. “Although it is highly unlikely that we will see yellow fever outbreaks in the continental United States, where mosquito density is low and risk of exposure is limited, it is possible that travel-related cases of yellow fever could occur, with brief periods of local transmission in warmer regions such as the Gulf Coast states, where A. aegypti mosquitoes are prevalent.”

GMU Biodefense Represented At Biothreats Conference
If you missed out on our coverage of ASM’s 2017 Biothreats conference, here’s a spotlight on GMU biodefense students attending this captivating three-day event. GMU’s biodefense program sent four graduate students to experience and report on the conference, which addressed biothreat research, policy, and response. “The program was exciting, according to the George Mason students in attendance. Mercer and Goble recall that the conference engaged topics of specific interest to them, their degree, and their futures. ‘I attended a panel that was very closely related to disease forecasting, my graduate thesis topic,’ Mercer said. ‘I was able to hear some of the cutting-edge research in that field, which was really helpful’. ‘I didn’t really have a part I didn’t like,’ Goble said. ‘I enjoyed the niche topics that were presented in both panel discussions and poster  sessions, from emergency operations to the FDA. All of these specific topics were extremely interesting to hear about and to know they are being researched’.”

Just How Well Did the 2009 Pandemic Flu Vaccine Strategy Work?
Researchers from the University of Nottingham recently looked at the success of vaccines in terms of preventing pandemic flu and reducing hospitalizations. Their work looked at the 2009 WHO-declared pandemic of the novel A(H1N1) virus, which infected around 61 million people around the world. Vaccines against the virus were rolled out globally between September and December of 2009, with the majority being inactivated A(H1N1)pdm09 influenza virus. Their work involved reviewing 38 studies between June 2011 and April 2016 regarding the effectiveness of the inactivated vaccine, which covered around 7.6 million people. “We found that the vaccines produced against the swine flu pandemic in 2009 were very effective in both preventing influenza infection and reducing the chances of hospital admission due to flu. This is all very encouraging in case we encounter a future pandemic, perhaps one that is more severe,” noted Professor Van Tam said. “Of course, we recognize that it took five to six months for pandemic vaccines to be ready in large quantities; this was a separate problem. However, if we can speed up vaccine production times, we would have a very effective strategy to reduce the impact of a future flu pandemic.” The 2009 pandemic A(H1N1) vaccine was 73% effective against laboratory confirmed cases and 61% against preventing hospitalizations. Interestingly, when looking at the vaccines’ effectiveness in different age groups, “they were shown to be less effective in adults over 18 years than in children, and effectiveness was lowest in adults over 50 years of age. Adjuvanted vaccines were found to be particularly more effective in children than in adults against laboratory confirmed illness (88 per cent in children versus 40 per cent in adults) and hospitalization (86 per cent in children versus 48 per cent in adults).”

Deadly Fungal Infection Arrives in U.S. 
While many are asking if surveillance methods for tracking the deadly CRE bacteria are adequate, a new issue is emerging in U.S. hospitals. Despite WHO’s recent plea for increased R&D surrounding certain resistant pathogens, it seems that more and more organisms of concern are springing up in U.S. hospitals. Since last summer, roughly three dozen people have been diagnosed with a highly resistant Candida auris infection. The fungal infection has caused worry ever since it was identified in 2009 due to its capacity as an emerging and resistant organism. Candida yeast infections are pretty common and known to cause urinary tract infections however, this strain is especially concerning because it easily causes bloodstream infections, has a stronger capacity for transmission between people, and is much more hardy in terms of living on skin and environmental surfaces. “Of the first seven cases that were reported to the CDC last fall, four patients had bloodstream infections and died during the weeks to months after the pathogen was identified. Officials said they couldn’t be sure whether the deaths were caused by the infection because all the individuals had other serious medical conditions. Five patients had the fungus initially isolated from blood, one from urine, and one from the ear.”

CDC Director Warns Loss of DHHS Funds Could Weaken Infectious Disease Prevention
Acting CDC director, Anne Schuchat, recently testified before Congress to make the case for for increased funding for several programs (one being the DHHS’s Prevention and Public Health Fund). Among other things, the Prevention and Public Health Fund is responsible for 12% of the CDC’s budget. Dr. Schucat’s testimony emphasized the previous usage of these funds in terms of vaccine delivery, disease surveillance, monitoring of water supplies, and tracking hospital-acquired infections. The growth of antibiotic resistance made her testimony and plea to Congress that much more relevant and urgent. “The CDC and other government agencies have in recent years cited the numerous public health threats posed by infectious diseases in general, and have lobbied officials for increased funding for research and development of novel vaccines and treatments as well as programs to effectively distribute interventions as needed. In 2016, for example, the CDC, DHHS, and National Institutes of Health requested federal funding to combat Zika, a request that was not approved until late in the year.”

Stories You May Have Missed:

  • Science on Screen – Don’t miss this great event hosted by Lawrence Livermore National Laboratory! On March 18th, you can watch the second installment of the Science on Screen series, featuring “Lawrence Livermore scientists Monica Borucki and Jonathan Allen, who will present ‘Reconstructing a Rabies Epidemic: Byte by Byte.’ This informative and entertaining lecture will explain how biologists and computer scientists used cutting-edge, ultra-deep sequencing technology to study the dynamics of a 2009 rabies outbreak. This case study, based on a dramatic increase (more than 350 percent) in the gray fox population infected with a rabies variant for which striped skunks serve as the reservoir hosts, will be used to help illustrate the changes in the viral genome during cross-species viral transmission. This lecture is appropriately paired with the feature-length film, “Contagion” (PG-13).”
  • Clorox Gets Spot on EPA A-Team – Clorox just earned its varsity spot on the team against hospitality-acquired infections. The EPA approved two of the company’s products in killing clostridium difficile spores. C-diff is a constant battle in healthcare facilities, so having the new tool in the infection prevention and environmental disinfection toolkit, is a huge advantage for many. “In addition, the cleaners and wipes recently become EPA-registered to disinfect against other bacterial infections, such as those caused by Staphylococcus epidermidis, Candida glabrata, and Enterococcus hirae. Moreover, the products are also effective against several viral pathogens, such as Middle East Respiratory Syndrome (MERS), and Severe Acute Respiratory Syndrome (SARS), measles, and Influenza A and B, among others.”

 

Pandora Report 3.10.2017

Looking for a great podcast on CRISPR? Check out RadioLab – they also have a captivating one on patient zeroes throughout history!

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security: From Anthrax to Zika 
If you’re looking to learn more about global health security, synethic biology, biosecurity, and what exactly “biodefense” entails, you’ll want to mark your calendar for the GMU Biodefense three-day, non-credit summer workshop on July 17-19, 2017! Participants will look at the challenges facing the world at the intersection of national security, public health, and the life sciences. Instructors for the workshop range from FBI special agents to biodefense professors and USAMRIID commanders. The workshop will look at the spectrum of biological threats – including naturally occurring disease outbreaks such as SARS, Zika, and Ebola, lapses in biosafety, dual-use research of concern, and the threat of bioterrorism. From now until May 1st, you can take advantage of the early bird registration discount!

Glaring Gaps: America Needs A Biodefense Upgrade
GMU biodefense PhD alum Daniel M. Gerstein is emphasizing the need to strengthen American biodefense capabilities. “Recent legislation has called for a comprehensive biodefense strategy. If carried out in a thorough and systematic way, and properly funded, this will be a great improvement for the country and the world.” Gerstein notes that while the National Defense Authorization Act for Fiscal Year 2017 called for a joint biodefense effort, there is still a desperate need for a structured and systematic approach. Perhaps one of the biggest issues Gerstein found is the current view of biodefense as a series of programs. Approaching global health security threat requires us to view biodefense as a complex system, not a series of programs. To fix the glaring gaps in U.S. biodefense efforts, he notes that any remedy will have to accept the complexity of the problem and that there is no single panacea. Internal coordination, improvement of diagnostics and treatment, and technology management are all things that must be addressed to strengthen American biodefense. “Export controls in the United States, for example, actually hinder international collaboration. Exchanging pathogen strains used in the development of medical countermeasures, diagnostics, and bio-surveillance remains difficult – even, at times, for close international partners. In one case, the United States was attempting to share a strain of the Ebola-Reston pathogen with the government of Australia, but export laws prevented this sharing, so the strain was instead acquired from the Philippines, where the strain originated.” While we’ve made great strides since the Amerithrax attacks, there is much to be done to create a systematic and resilient biodefense strategy.

Chemical Weapons Reportedly Used in Mosul
The WHO has recently activated an emergency response plan with several partners to help treat twelve people for potential exposure to chemical weapons in Iraq. “Lise Grande, the UN humanitarian coordinator in Iraq, called for an investigation. ‘This is horrible. If the alleged use of chemical weapons is confirmed, this is a serious violation of international humanitarian law and a war crime, regardless of who the targets or the victims of the attacks are,’ she said in a statement.” Many are pointing to ISIL as the likely culprit since they hold the majority of west Mosul and have a history of rudimentary use of chemical weapons.

China’s Growing Bird Flu Worries  
Despite a recent surge in human A(H7N9) cases, the WHO has stated that the risk of an epidemic remains low. Even with this release, the development of two distinct strains in a disease that has a mortality rate hovering around 30%, has many worried. “That will probably force development of a second small stockpile of emergency vaccine to be rolled out if the virus becomes more transmissible and threatens to turn into a pandemic, a scientist at the Centers for Disease Control and Prevention said. Flu specialists from around the world gathered in Geneva this week to assess the global influenza situation and discuss with vaccine companies which viral strains should be in next winter’s flu shots. China has had 460 lab-confirmed human cases of H7N9 bird flu this winter, said Dr. Wenqing Zhang, head of the W.H.O.’s global influenza program. That is the most in any flu season since the first human case was found in 2013.” Interestingly, around 7% of the new H7N9 cases were resistant to drugs like Tamiflu, which has many researchers working to make a H7N9 seed vaccine, including a secondary one due to the split strains. Coming on the heels of this outbreak, US officials have announced that highly pathogenic avian influenza (HPAI) was found in a commercial poultry farm in Tennessee. 700 birds died from infection and almost 73,000 were destroyed. The farm is a contracted supplier of chicken meat for the U.S.’s biggest supplier, Tyson, which released an announcement on March 5th regarding testing of local birds, etc.

Global Health Security Index Development
Johns Hopkins Center for Health Security recently received a grant from the Open Philanthropy Project and the Robertson Foundation to coordinate with the Nuclear Threat Initiative (NTI) and the Economist Intelligence Unit (EIU) to develop a Global Health Security Index. “The mission of the index is to encourage progress towards a world that is capable of preventing epidemics of international impact (either natural, accidental or deliberate) from arising, or, should, prevention fail, respond quickly to contain them.” The first phase of the project will aim at developing framework that can measure a country’s level of health security. While the GHSA and JEE are processes to increase transparency, preparedness, and country capabilities, the goal of this index is to fill the gaps in motivation and also the factors that are not in the hands of the health sector.

Antimicrobial Resistance in Pets: Are We Ignoring A Looming Threat? 
GMU biodefense PhD student Saskia Popescu is looking at the threat of antibiotic resistance, but from a somewhat forgotten patient population – our pets. The recent WHO list of worrisome antimicrobial resistant bugs has drawn a lot of attention to the growing threat of an antibiotic apocalypse however, sometimes it takes a personal experience to look outside the box. Pulling from experiences of dealing with drug resistance in her dog to the loss of SeaWorld’s controversial orca, Tilikum, Popescu notes the rising threat of AMR brewing in domesticated animals. Sadly, it seems that many veterinarians and infectious diseases researchers have been drawing attention to the role of household animals in antimicrobial resistance and yet, just like the human issue, it’s not getting the attention it deserves. In her article, Popescu points to the need to start addressing the full circle of microbial resistance, starting with our furry friends.

Stories You May Have Missed:

  • Constraining Norms for Cyber Warfare Are Unlikely – GMU Biodefense PhD alum, Brian M. Mazanec, is talking to the Georgetown Journal of International Affairs about the realities of norms for cyber warfare. The question of whether constraining international norms for cyber warfare will emerge and thrive is of paramount importance to the unfolding age of cyber conflict. Some scholars think that great powers will inevitably cooperate and establish rules, norms, and standards for cyberspace. While it is true that increased competition may create incentives for cooperation on constraining norms, Mazanec argues that norm evolution theory for emerging-technology weapons leads one to conclude that constraining norms for cyber warfare will face many challenges and may never successfully emerge.
  • ABSA International Webinar- Behaving Safely in the Laboratory: Understanding Complexities of Building and Sustaining a Culture of Safety–  ABSA is hosting a 2-hour webinar session for three days. “The webinar will be offered Monday, April 3; Wednesday, April 5 and Friday, April 7, 2017.  Millions of dollars on engineering.  Thousands of dollars on PPE.  Hundreds of hours spent writing SOPs – and in one instant all of these controls can be negated with one inappropriate behavior.  Behavior is the bridge between written plans and desired outcomes.  But what does it take to behave safely?  Day 1 will focus on what it takes for an individual to behave safely – as behavior requires five critical items – and without these items – sustained behavior cannot occur. Day 2 will focus on motivating behavior – the differences between leadership and management – and the motivating factors which are extrinsic, systemic, and intrinsic. Day 3 will focus on building and sustaining a ONE SAFE culture – blending the efforts of the workforce, leadership, and safety officials.”
  • High Flu Activity Throughout the U.S. – The CDC has warned that the U.S. is still experiencing high flu activity in all regions. This flu season has seen elevated pediatric mortality, with six reported last week, bringing the total to forty pediatric deaths. “The CDC said there have been more hospitalizations and clinical visits for influenza-like illness (ILI) at this point in the flu season than in 2012-13, another season when H3N2 strain predominated. The CDC said the cumulative overall rate is 39.4 hospitalizations per 100,000 people. During the 2012-13 flu season, the rate was (38.2 per 100,000).”

 

Pandora Report 3.3.2017

Welcome to March! On Tuesday, Russia cast its seventh veto and China cast its sixth veto to aid in protecting the Syrian government from UNSC actions and sanctions regarding chemical weapons attacks.

DIY Gene Editing Gets Faster, Cheaper, and More Worrisome
CRISPR/Cas-9 lab projects may not have been a possibility when I was in high school, but today’s students are getting a taste for genome editing. The technology has allowed relative amateurs to easily and cheaply learn gene editing tactics. “The question is, can we rely on individuals to conduct their experiments in an ethical and appropriately safe way?” says Maxwell Mehlman, a professor of law and bioethics at Case Western Reserve University, who is working with do-it-yourself scientists to develop DIY Crispr ethical guidelines. “The jury is out,” he says. “Crispr is too new. We have to wait and see.” GMU’s Dr. Koblentz has noted dual-use research is a wicked problem, and it seems that CRISPR/Cas-9 is one as well. Do-it-yourself (DIY) CRISPR kits can be purchased online for $150 and you can even get a handful of tutoring sessions for $400. While these products and experiments utilize harmless organisms, it’s not hard to see why so many are worried about the potential for misuse. Harvard University’s Dana Bateman visits high school classrooms for a lesson on CRISPR and during her time, she poses several ethical questions to the students. Dr. Bateman “asked a group of seventh-grade students whether Crispr should be deployed to bring extinct animals back to life. After a spirited discussion, one student asked, ‘How can we decide if we aren’t sure what will happen?’ Ms. Bateman replied that such questions will increasingly be part of public debate, and that everyone, including 12-year-olds, can benefit from learning about Crispr.” Learning the ins and outs of CRISPR isn’t so easy that it’s comparable to switching batteries in a remote, but probably closer to a complex set of IKEA instructions (ok, that’s a bit of an over simplification, but you catch my drift). Simply put, CRISPR does make DIY gene editing easier and cheaper, but foundational knowledge or instruction is still necessary. In this moment, we’re racing to catch up with the pace of innovation and understanding the risks versus rewards is proving more difficult. What are your thoughts on this hot topic?

China’s New BSL-4 Lab Plans 10729_lores
The Chinese mainland is hoping to see the construction of at least five BSL-4 labs by 2025. A laboratory in Wuhan is currently in the accreditation and clearance phase to work with the most deadly pathogens we face. While many celebrate the building  of this new lab, others are concerned about the biosafety and biosecurity risks. The increase in biodefense labs and programs has created several trade-offs for work with such high-risk pathogens.  Each new lab presents a new risk – for both biosafety failures and biosecurity failures. Biosafety failures are already plaguing U.S. labs – will this be the case with China’s labs? “The Wuhan lab cost 300 million yuan (US$44 million), and to allay safety concerns it was built far above the flood plain and with the capacity to withstand a magnitude-7 earthquake, although the area has no history of strong earthquakes. It will focus on the control of emerging diseases, store purified viruses and act as a World Health Organization ‘reference laboratory’ linked to similar labs around the world.” Skeptics have pointed to several escapes of SARS from a high-level containment facility in Beijing. Several biosafety and biosecurity experts are highlighting the need for transparency and an open and responsible culture. Addressing issues with staff at all levels and opening the floor for an honest and frank discussion regarding concerns from those working in the environment is vital to addressing the issues that may not be seen at a higher level.

WHO’s List of Superbug Super Offenders  screen-shot-2017-02-28-at-10-19-28-am
If there was an A-list for multi-drug resistant organisms, this would be it. This first-of-its-kind list, highlights the “priority pathogens” that comprise of twelve families of bacteria “that pose the greatest threat to human health”. “The list was developed in collaboration with the Division of Infectious Diseases at the University of Tübingen, Germany, using a multi-criteria decision analysis technique vetted by a group of international experts. The criteria for selecting pathogens on the list were: how deadly the infections they cause are; whether their treatment requires long hospital stays; how frequently they are resistant to existing antibiotics when people in communities catch them; how easily they spread between animals, from animals to humans, and from person to person; whether they can be prevented (e.g. through good hygiene and vaccination); how many treatment options remain; and whether new antibiotics to treat them are already in the R&D pipeline.” Not only is the publishing of this list an indicator as to the seriousness of the issue, but it signals a desperate plea for the pharmaceutical industry to develop new antibiotics. The three most critical bacteria on the list are carbapenem-resistant Acinetobacter baumannii, carbapenem-resistant Pseudomonas aeruginosa, and Enterobacteriaceae that are both carbapenem-resistant and ESBL-producing.

Kim Jong Un and the Case of the of VX Nerve Agent 
Last week saw the shocking revelation by Malaysian police that Kim Jon-nam, half-brother to North Korea’s Kim Jong-un, had been assassinated with the nerve agent, VX. The use of VX has left many wondering gif Kim Jong-un decided to use this overt form of assignation to signal his possession and willingness to use it or was this a botched assassination that was supposed to look like a natural death? Since this event has taken us into uncharted territory, many chemical and biological weapons experts are weighing in on what this means. GMU biodefense professor and graduate program director, Gregory Koblentz, pointed out that “it’s very hard to make an accurate intelligence assessment”. The dual-use nature of bio-chem weapon production facilities and materials makes intelligence gathering that much more difficult. “While Kim Jong-un is unpredictable, seasoned Korea watchers see method in what may sometimes seem like madness. And that leads them to doubt that he actually intends to use nuclear weapons — which make more sense as a bargaining chip in dealing with the US and other powers. Pyongyang’s chemical arsenal is a different prospect, however. ‘If there’s a conflict on the Korean peninsula, North Korea would probably use chemical weapons early on,’ Koblentz said.”

PHEMCE Review: Accomplishments and Future Areas of Opportunity 
GMU Biodefense PhD student and VP of Marketing at Emergent BioSolutions, Rebecca Fish, is looking at the Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) and their recent strategic implementation plan. Highlighting their four goals and sample accomplishments, Rebecca looks at their work on emerging infectious diseases (EIDs) like Ebola response and Zika. While PHEMCE has made great progress, there is still room for engagement and opportunity. Rebecca points to their plans to incentivize innovation, “while biotechnology is increasing at an exponential rate, and the opportunity for misuse (bioterrorism) is increasing, the number of companies interested in making significant investment in medical countermeasures development is decreasing. There are important MCM innovation gaps that need to be addressed.” She notes that PHEMCE activity encompasses a great deal of federal agencies, which can make work that much more challenging. “However, the PHEMCE effort still requires strong, centralized leadership and a comprehensive strategic plan with measurable outcomes against which progress can be reported. It’s impressive that so many groups are working on these challenges, but who is determining the overall strategic plan? How does it come together? Which single individual has responsibility for the entire biodefense strategic effort? Who is managing the enterprise U.S. biodefense budget? No one. No one has clear accountability for the U.S. biodefense strategy, and this puts our country at risk.”

Johns Hopkins Center for Health Security Announces 2017 Emerging Leaders in Biosecurity
The Center for Health Security at Johns Hopkins University has announced the new class of emerging leaders in biosecurity. GMU is happy to announced that one of our Biodefense PhD students, Saskia Popescu, was named among the 2017 emerging leaders. “The program’s goal is to build a multidisciplinary network of biosecurity practitioners and scholars. ELBI is supported by a grant from the Open Philanthropy Project. As part of its commitment to grow and support the field of biosecurity, the Center has selected 28 Fellows from the US, the UK, and Canada. As in previous years, this year’s Fellows have backgrounds in government, the biological sciences, medicine, national security, law enforcement, public health preparedness, and the private sector.” Congrats to the new class of emerging leaders!

Multivariate Analysis of Radiation Responsive Proteins to Predict Radiation Exposure in Total-Body Irradiation and Partial-Body Irradiation Models
GMU Biodefense PhD student, Mary Sproull, is working to strengthen medical countermeasures in the event of a radiological or nuclear attack. Advanced screening and medical management of those exposed are vital during such an event. “In such a scenario, minimally invasive biomarkers that can accurately quantify radiation exposure would be useful for triage management by first responders. In this murine study, we evaluated the efficacy of a novel combination of radiation responsive proteins, Flt3 ligand (FL), serum amyloid A (SAA), matrix metalloproteinase 9 (MMP9), fibrinogen beta (FGB) and pentraxin 3 (PTX3) to predict the received dose after whole- or partial-body irradiation.” Researchers found that the novel combination of radiation responsive biomarker proteins are an efficient and accurate tactic for predicting radiation exposure. You can read the paper here.

Stories You May Have Missed:

  • OPCW Call for Nominations For A Workshop on Policy & Diplomacy for Scientists – The OPCW Technical Secretariat is organizing a workshop, “Introduction to Responsible Research Practices in Chemical and Biochemical Sciences”, from September 12-15, 2017. “The objective of the workshop is to raise awareness among young scientists on the policy and diplomacy aspects that are related to the use of chemicals in various scientific disciplines, including chemistry, biochemistry, biotechnology, and other related fields.” Check out their link for more info on applying for admission and/or a scholarship.
  • Epidemic Tracking Tool Wins Open Science Grand Prize – A new prototype, Nextstrain, has won the new Open Science Prize. This tool analyzes and tracks genetic mutations during the Ebola and Zika outbreaks and they’re hoping to use it for other viruses. “Everyone is doing sequencing, but most people aren’t able to analyze their sequences as well or as quickly as they might want to,” Bedford said. “We’re trying to fill in this gap so that the World Health Organization or the U.S. Centers for Disease Control and Prevention — or whoever — can have better analysis tools to do what they do. We’re hoping that will get our software in the hands of a lot of people.”

Pandora Report 2.24.2017

Happy Friday and welcome to your weekly dose of all things biodefense! A preliminary report from the Malaysian police has found that VX nerve agent was most likely used to murder Kim Jong-nam.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security: From Anthrax to Zika 
Want to dabble in the world of global health security? Don’t miss out on the GMU Biodefense three-day, non-credit summer workshop on July 17-19, 2017! Participants will look at the challenges facing the world at the intersection of national security, public health, and the life sciences. Instructors for the workshop range from FBI special agents to biodefense professors and USAMRIID commanders. The workshop will look at the spectrum of biological threats – including naturally occurring disease outbreaks such as SARS, Zika, and Ebola, lapses in biosafety, dual-use research of concern, and the threat of bioterrorism. From now until May 1st, you can take advantage of the early bird registration discount!

Progress Report on BARDA & Project Bioshield 
A 10-year report card was recently published for these two efforts to defend the U.S. against biological threats. The report found 80 candidate countermeasures, 21 stockpiled countermeasures, and 6 FDA approvals supported by BARDA and Project Bioshield. “Over a decade has passed since the anthrax attacks of 2001; preparedness has increased substantially since that time, and defense against CBRN threats has become melded into national security. Both BARDA and Project Bioshield are essential elements of national security, and, especially in light of a change in presidential administration, it is important to emphasize the critical role these agencies have had in fortifying the nation against intentional CBRN threats. Larsen and Disbrow note, however, that despite the reauthorization of Project Bioshield in 2013 with annual funding at $2.8 billion (from 2014-2018), that funding is subject to annual congressional appropriations; as such, only a fraction of that funding has been appropriated.”

BWC Newsletter 
If you’re looking to keep tabs on the Biological Weapons Convention, we’ve got just the place for you. The BWC Implementation Support Unit has prepared a newsletter to better support communication among States Parties and encourage involvement in BWC-related issues and events. The first issue discusses the recent Eighth Review Conference and news like the launch of EU projects to support BWC universalization and a Confidence-Building Measures reminder letter (deadline for submission is April 15th!).

screen-shot-2017-02-21-at-2-11-26-pmCDC Lab Closure Due to Safety Concerns
The CDC has temporarily closed down its Biosafety Level-4 laboratories following the finding that their air supply hoses to researchers in protective suits were not approved for use. “‘We have no evidence that anybody has suffered ill health effects from breathing air that came through these hoses,’ Stephan Monroe, associate director for laboratory science and safety at the CDC, told Reuters. Monroe said he was confident scientists were not exposed to pathogens because the air they breathed passed through HEPA filters. The suits they wear also use positive air pressure to prevent pathogens from entering the suit.” Safety tests are currently being performed while employees are being notified and monitored. Interestingly, Monroe’s position is a newly minted one, having been established in 2015 to combat the continuous findings of major lab safety failures involving anthrax, avian influenza, and Ebola in CDC labs.

Why Bill Gates Worries About Biological Threats
Bill Gates recently spoke to Business Insider following his speech for the Munich Security Conference, in which he highlighted his real concerns for global health security. He noted that conflict areas and regions that are struggling to find stability are perhaps the most challenging in terms of outbreak containment. Gates emphasized the vulnerability for genome editing of a virus to make it more contagious, and also the advances in biotechnology that may help prevent the spread of an epidemic. “The point is, we ignore the link between health security and international security at our peril. Whether it occurs by a quirk of nature or at the hand of a terrorist, epidemiologists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year. And they say there is a reasonable probability the world will experience such an outbreak in the next 10-15 years.” Perhaps the most important thing on our “to-do” list is to invest in vaccines, drugs, and diagnostics. We have a tendency to put these priorities lower on the totem pole until a major public health crises occurs however, Gates highlights their relevance. The launch of the new Coalition for Epidemic Preparedness Innovations (CEPI) is one step closer to bridging this gap. “The really big breakthrough potential is in emerging technology platforms that leverage recent advances in genomics to dramatically reduce the time needed to develop vaccines. Basically, they create a delivery vehicle for synthetic genetic material that instructs your cells to make a vaccine inside your own body.” Gates also emphasized the importance of strengthening basic public health systems, especially in vulnerable countries – adding to that age old saying, “an outbreak anywhere is an outbreak everywhere”.

screen-shot-2017-02-23-at-7-48-50-amFinancing Pandemic Preparedness At the National Level = First Line of Defense
Pandemic preparedness funding is one of those common sense investments…right? Unfortunately, many don’t always make it a priority. Ebola alone cost billions, including a $2.27 billion allocation for response by the U.S. government. Dozens of after-action reports and papers on lessons learned have been published since the outbreak. Peter Sands noted that “all these reviews – including the one I chaired  for the US National Academy of Medicine – agreed on three key priorities: strengthening preparedness at a national level; improving coordination and capabilities at a regional and global level; and accelerating R&D in this arena.  Over the last twelve months progress has been made in implementing many of these recommendations, but big gaps and weaknesses remain. As a recent paper in the British Medical Journal put it, there has been ‘ample analysis, inadequate action’.” The highest priority though is preparedness at a national level. The International Working Group on Financing Pandemic Preparedness was created in 2016 as a means to propose ways in which national governments and partners can work to establish sustainable financing to strengthen their pandemic preparedness. Their focus “includes domestic resource mobilization, development assistance and private sector engagement. For many countries, financing preparedness through the domestic public sector budget is the best way to ensure sustained funding and seamless integration with the rest of the health system. This requires ensuring sufficient priority is attached to investing in pandemic preparedness in budget allocations. In some countries, there may also be scope to increase the fiscal envelope through improvements in tax design and collection or even hypothecated taxes.”

Insider Threats 
Get ready to add this new book to your reading list. Matthew Bunn and Scott D Sagan are looking at insider threats like nuclear material theft and Edward Snowden. “Insider Threats offers detailed case studies of insider disasters across a range of different types of institutions, from biological research laboratories, to nuclear power plants, to  the U.S. Army.” Don’t miss the chapter from Jessica Stern and Ronald Schouten, “Lessons Learned from the Anthrax Letters”. Stern and Schouten look at the investigation of the Amerithrax attacks and provide a portrait of Ivins and his troubling behavior. They also address “the combination of regulatory changes, red flags missed by Ivins’s colleagues, and the organizational and cognitive biases that contributed to the failure to identify Ivins as a potential insider”, and the current environment and new regulations.

Stories You May Have Missed:

  • Former Secretary of Defense Outlines the Future of Warfare – “Two years ago, Barack Obama appointed a new Secretary of Defense, Ashton Carter—a technocrat physicist, an arms control veteran, and a professor at Stanford—to help close this divide.” Carter recently sat down with WIRED magazine and discussed the challenges facing the White House. When asked about the impact of autonomy on warfare, Carter notes that it will change it in a fundamental way, but also points biotechnology. “I think if there is going to be something ever that rivals nuclear weapons in terms of the pure fearsomeness of their destructiveness it’s more likely to come from biotechnology than any other technology. Looking back decades from now, I do think the biological revelation could rival the atomic revolution for the fearsomeness of the potential. I think that’s one reason we need to invest in it. And although biotechnology has not been a traditional area for Defense, the new bridges that they build shold not only be to the IT tech community but also to the biotech communities in the Valley.”
  • Did Salmonella Take Down the Aztecs?– History and infectious disease? That’s surely the best way to start a weekend! Researchers recently looked at the DNA of a 500-year-old bacteria to study one of the worst epidemics in history. “In one study, researchers say they have recovered DNA of the stomach bacterium from burials in Mexico linked to a 1540s epidemic that killed up to 80% of the country’s native inhabitants. The team reports its findings in a preprint posted on the bioRxiv server on 8 February. In 1519, when forces led by Spanish conquistador Hernando Cortés arrived in Mexico, the native population was estimated at about 25 million. A century later, after a Spanish victory and a series of epidemics, numbers had plunged to around 1 million.” After extracting and sequencing the DNA from the teeth of 29 buried people buried in the highlands of southern Mexico, all but five were found to be linked to cocoliztli. “Further sequencing of short, damaged DNA fragments from the remains allowed the team to reconstruct two genomes of a Salmonella enterica strain known as Paratyphi C. Today, this bacterium causes enteric fever, a typhus-like illness, that occurs mostly in developing countries. If left untreated, it kills 10–15% of infected people.”