Pandora Report 12.14.2018

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

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

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

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

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

Pandora Report: 12.7.2018

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

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

By Justin Hurt, GMU Biodefense

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

Pandora Report 11.30.2018

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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



Reflections on the 5th Ministerial Meeting of the Global Health Security Agenda

On October 6-8, 2018, the 5h Global Health Security Agenda (GHSA) Ministerial Meeting was held in Bali, Indonesia. This summit aimed “to review the work done to date by GHSA, successes and challenges encountered, and to chart the way forward. Under the theme ‘Advancing Global Partnerships’, the meeting will further elaborate on the existing and possible partnerships at the global and regional levels, as well as a broader engagement of the non-governmental stakeholders in the whole process of our work.” The GHSA is growing with partnership including 64 nations, international organizations, and non-governmental stakeholders.

In partnership with Next Generation Global Health Security Network, GMU’s Schar School Biodefense graduate program sponsored two student fellowships to attend through the George Mason Global Health Security Student Ambassador program. These two students, Annette Prieto and Saskia Popescu, represented GMU Biodefense and have provided a report on their experiences in conjunction with NextGen’s coordinator, Jamechia D. Hoyle, and other NextGen representatives. This is the second year for the George Mason Global Health Security Student Ambassador program and you can read the recap of last year’s summit in Uganda here.

We’re pleased to provide you with reflections from these three days focused on the past, present, and future of the GHSA. Below you’ll find brief sections of and links to the reflections from Dr. Hoyle, and our student ambassadors. You can also access the entire page here (also available in the Word doc here), which includes all reflections from Dr. Hoyle, the student ambassadors, and members of the Next Generation Global Health Security Network.

Next Generation Global Health Security Network Coordinator, Jamechia D. Hoyle
“The 3-day event included a variety of high-level updates and more intimate discussions in side events on next steps under the newly-launched GHSA 2024. Under the GHSA 2024 Framework, the initiative will move toward a more structured approach with “clear governance, collaboration structures and processes, increased engagement of the broader GHSA community, tracking and measurement of progress and enhanced accountability for delivery on commitments”. With over 100 countries expected to complete an external evaluation of health security capacity under this new framework, GHSA members and relevant partners remain committed to undergo planning and resource mobilization to address gaps. However, as repeatedly discussed during the Ministerial Meeting, a key issue remains: financing health security.” Continue reading…

George Mason Global Health Security Student Ambassadors

Saskia Popescu, Biodefense Doctoral Candidate
“While the DRC battles an outbreak of Ebola virus disease and influenza hits the Northern Hemisphere, one might think that antimicrobial resistance was an afterthought at this meeting. The GHSA and those invested in its future are used to putting out fires and still battling the slow burning threats, like antimicrobial resistance, which means that this topic was a frequent point of discussion. Throughout the presentations and sessions, the topic of antimicrobial resistance was frequently brought up, especially in the context of One Health. In the U.S. alone, 23,000 people die a year as a result of resistance infections. The latest WHO reportsreveal a global issue in which the most common infections are increasingly becoming drug resistant. From the agricultural sector to healthcare and the environment, combatting antimicrobial resistance is extremely challenging and many at the meeting vocalized their concerns with such a chimeric dilemma.” Continue Reading..

Annette Prieto, Biodefense MS Candidate
“Although the theme for the 5th Global Health Security Agenda (GHSA) Ministerial Meeting was “Advancing Global Partnerships,” session 3 was the first session that offered insight into the many ways global partnerships can and should be approached for the GHSA 2024. The panel was composed of diverse leaders from different sectors and countries, highlighting the importance of using a multi-sectoral method to achieve the overarching targets of GHSA 2024. The panel discussed a wide range of topics. The first panelist, Dr. Nick Adkin, Deputy Director of Global Health Security, Department of Health and Social Care, United Kingdom, started the session with a specific but enormous problem to global health security: antimicrobial resistance (AMR). AMR affects not only public health, but also trade and food safety.” Continue reading..


GMU Biodefense Student Ambassador GHSA Reflection – Annette Prieto

Annette Prieto, M.S. Biodefense Candidate Schar School of Policy and Government, George Mason University Vice President, Next Generation Global Health Security Network Mason Chapter – USA

Although the theme for the 5th Global Health Security Agenda (GHSA) Ministerial Meeting was “Advancing Global Partnerships,” session 3 was the first session that offered insight into the many ways global partnerships can and should be approached for the GHSA 2024. The panel was composed of diverse leaders from different sectors and countries, highlighting the importance of using a multi-sectoral method to achieve the overarching targets of GHSA 2024.

The panel discussed a wide range of topics. The first panelist, Dr. Nick Adkin, Deputy Director of Global Health Security, Department of Health and Social Care, United Kingdom, started the session with a specific but enormous problem to global health security: antimicrobial resistance (AMR). AMR affects not only public health, but also trade and food safety. As Dr. Adkin stressed, AMR is currently undermining progress already made in the public health field and has the potential to make everyday procedures—like hip replacements and chemotherapy—too risky to perform. Therefore, there is a great need for the global community to work together to fight against AMR. Although it would have been nice to hear how AMR is currently being explicitly battled, it was encouraging to see that many countries had action plans on fighting AMR and that environmental aspects are now being incorporated in the Action Package. Continue reading “GMU Biodefense Student Ambassador GHSA Reflection – Annette Prieto”

NextGen Health Security GHSA Reflections – Jamechia Hoyle

Dr. Jamechia Hoyle, Coordinator Next Generation Global Health Security Network, Visiting Scholar/Assistant Professor, Taipei Medical University, Adjunct Professor, George Mason University – Taiwan/USA

The 5thGlobal Health Security Agenda (GHSA) Ministerial Meeting, hosted by the Government of Indonesia, under the theme “Advancing Global Partnerships” showcased many success stories and overall increased capacity towards realizing a world safe and secure from infectious disease threats. In a time where the Democratic Republic of Congo is facing its 10thoutbreak of Ebola, cholera is spreading throughout Yemen, and the threat of pandemic influenza looms dedicated multisectoral commitments to preparedness are more important than ever. Continue reading “NextGen Health Security GHSA Reflections – Jamechia Hoyle”

GMU Biodefense Student Ambassador GHSA Reflection – Saskia Popescu

Saskia Popescu, MPH, MA, CIC – PhD Candidate, Biodefense George Mason University -USA

The infectious disease threats that jeopardize global health security are vast and evolve as technology becomes more sophisticated, populations grow, and the world gets a bit smaller. Efforts to reduce these vulnerabilities to infectious diseases have to be just as diverse and resilient. Despite strategies at the international, national, and local level, outbreaks continue to stress critical infrastructure. The Global Health Security Agenda (GHSA) seeks to address these vulnerabilities and gaps to help strengthen national capabilities in preparing for, detecting, and responding to infectious disease threats. The GHSA is an especially unique approach to address biological threats as it utilizes multisectoral partners and reaches far beyond the scope of government, non-governmental organizations (NGOs), and academia. In truth, to address the unique predicament of infectious disease, a new strategy was needed and the GHSA is just that. The 5thMinisterial Meeting of the GHSA was recently held in Bali, Indonesia, to address the most pressing issues facing global health security, assess our current state, and look towards the future with the release of the 2024 Framework. Continue reading “GMU Biodefense Student Ambassador GHSA Reflection – Saskia Popescu”

Pandora Report 11.23.2018

We hope you had a lovely Thanksgiving! Salmonella is always a risk with turkey but since our readers are fellow biosafety gurus, we’re pretty sure you’ve already scrubbed the kitchen down to the last microbe! Have you reserved your spot for Dr. Robert Kadlec’s talk Preventing Pandemics and Bioterrorism: Past, Present, and Future on December 4th?

Biosecurity in the Age of Genome Editing
In 2013, researchers demonstrated the use of a new genome editing tool called CRISPR, which allows scientists to add, delete, or modify genes more precisely, faster, and cheaper than ever before. This technology promises major beneficial contributions, yet it has the potential to radically alter the security landscape. A new report, “Editing Biosecurity: Needs and Strategies for Governing Genome Editing,” based on two years of study by researchers from George Mason University, Stanford University, and New America examines the issue and provides concrete and actionable options for policy makers. To discuss the results of the study, New America welcomes Gregory Koblentz, Associate Professor and Director of the Biodefense program at the Schar School at George Mason University; Edward Perello, a research fellow at the Institute for Philosophy and Public Policy at George Mason University; Jesse Kirkpatrick, a New America International Security Program Fellow and Assistant Professor at George Mason University, Megan Palmer, Senior Research Scholar, Center for International Security and Cooperation, Stanford University, and David Relman, Professor of Microbiology & Immunology, Senior Fellow at the Freeman Spogli Institute for International Studies at Stanford University, and Chief of Infectious Diseases at the Veterans Affairs Palo Alto Health Care System. This even will be held on Monday, December 3rd, 2018, from 1-2:45pm EST, at New America. You can RSVP here.

Chemical Weapons – OPCW Meetings 
No, we’re not talking about the strong cologne/perfume a family member wore to holiday dinner, but rather the truly horrifying weapons that utilize chemicals to cause harm. This week the OPCW (Organisation for the Prohibition of Chemical Weapons) is hosting the Conference of the States Parties (CSP23) to the Chemical Weapons Convention & Review Conference (RC4). The CSP23 involves all 193 members of the OPCW and “oversees the implementation of the CWC, promotes the treaty’s objectives and reviews compliance with the treat” while the RC4 is every five years and “is an opportunity for all States Parties to review the operations of the Chemical Weapons Convention and set a strategic direction for the OPCW for the next five years and beyond.” You can find webcasts of the events here. If you’re looking for in-depth reviews of each day, get the scoop from CBW Events, which provides detailed accounts of the day’s events. Alicia Sanders-Zakre of the Arms Control Association is live tweeting as well (@Azakre) throughout the meetings. On Monday, it was reported that the U.S. and the UK were clashing with Russia regarding the new investigation team. “The U.S. and Western powers on Monday clashed with Russia and others over whether the global chemical weapons watchdog could start apportioning blame for poison gas and nerve agent attacks. At a heated session of the Organization for the Prohibition of Chemical Weapons’ annual conference, both sides bitterly fought over a June decision for the group to set up a new investigative team which could name the perpetrators of chemical attacks — a major change in the group’s rules.” An interview with the new Director General of the OPCW, Fernando Arias, was recently published here, where he noted that “I am committed to working with our member-states to protect, defend, and uphold the CWC. This means implementing the mandate given to the organization by the convention, as well as the decisions adopted by the executive council and the plenary body, the Conference of the States-Parties. I will also respect and develop the important work undertaken by my predecessors and their teams.” If you’re needing a refresher on CW, check out the latest book published by the Royal Society for Chemistry, Preventing Chemical Weapons: Arms Control and Disarmament as the Sciences Converge. There was also a publication in Science on preventing chemical weapons as sciences converge – “Concerns about such malign applications of chemical technology are exacerbated by the unstable international security environment and the changing nature of armed conflict, ‘where borderlines between war, civil war, large-scale violations of human rights, revolutions and uprisings, insurgencies and terrorism as well as organized crime are blurred’. It is thus essential that the global community regularly review the nature and implications of developments in chemistry, and its convergence with the life and associated sciences, and establish appropriate measures to prevent their misuse.”

E coli Outbreak – Don’t Eat Romaine Lettuce!
The CDC is warning people not to eat any romaine lettuce amid an E coli O157:H7 outbreak. “So far 32 illnesses have been confirmed in 11 states, and the Public Health Agency of Canada (PHAC) has identified 18 people in Ontario and Quebec infected with the same E coli fingerprint. California (10) and Michigan (7) have reported the most cases, with smaller numbers reported by Connecticut, Illinois, Massachusetts, Maryland, New Hampshire, New Jersey, New York, Ohio, and Wisconsin. Regarding the US cases, the CDC said illness onsets range from Oct 8 to Oct 31, and 13 people have been hospitalized, including one with hemolytic uremic syndrome, a potentially fatal kidney complication. No deaths have been reported.” Reminder – officials have expanded the warning to all romaine lettuce – bagged, mixes, etc.

Review of the Blue Ribbon Study Panel “Biodefense Indicators: Progress in Implementing the National Blueprint for Biodefense”
GMU Biodefense graduate students Michael Krug and Alexandria Tepper have provided us with a recap of this November 14th meeting. “The panel’s initial remarks involved assessing the progress of the federal government to the threat of a biological element, whether it be naturally-occurring, man-made, or accidental, since the release of the panel’s  Blue Ribbon Blueprintin 2015. Senator Lieberman was determined to reinforce the idea that the Blue Ribbon Blueprint should ‘provide a roadmap to improving how we prepare for, defend against, and respond to biological threats of all natures.’ The tone reflected by the chairs acknowledged that the progress made by the federal government has been promising but incomplete.”

Ebola Outbreak Updates & A Tour of the NIH Special Clinical Studies Unit
More peacekeepers and aids have been killed by armed rebels near the Ebola hotspot in the DRC (Beni). Seven UN peacekeepers were killed this weekend. “The action against the armed rebels, who have been responsible for several attacks against civilians in Beni that have stymied response activities, involved the UN mission known as MONUSCO and government armed forces. Their target was the Allied Democratic Forces (ADF).” On Thursday, 13 new cases were reported in the DRC, including 7 cases in Katwa. This brings the total case count  to 386 (339 confirmed, 47 probable, and 219 deaths). “Five of the new cases from Katwa were family members of a confirmed case-patient who died earlier this month. According the Ministry of Health, the family refused vaccination and follow-up before agreeing to be treated in a Butembo Ebola treatment center. The single cases from Oicha and Mutwanga are related to cases from Beni, officials said.” Care for these patients can be tricky when it comes to maintaining infection prevention practices. The NIH just gave a tour of their Special Clinical Studies Unit (SCSU), which is a special isolation unit used for the medical care of patients with high consequence pathogens, like Ebola. ” There, protected by negative air pressure and varying levels of biosecurity, volunteers can be safely exposed to the flu, respiratory syncytial virus (RSV), mosquitoes, or other infectious diseases or vectors for study purposes, without risk to other patients in the Clinical Center. They can also receive care while researchers study their reactions to pathogens in experiments that may lay the foundation for improved vaccines and treatments.”

Review Essay – Rhodeshia’s Improbably Dirty War
Kathleen M. Vogel is reviewing Glenn Cross’s (he’s a GMU Biodefense PhD alum!) account of the Rhodesian use of biological weapons. Vogel points to the recent Salisbury incident – “There are ongoing deliberations by the Organisation for the Prohibition of Chemical Weapons (OPCW), the implementing body of the Chemical Weapons Convention, to determine an international response to this breach of the global norm against chemical-weapons use. The Salisbury incident has underscored long-standing domestic and international concerns about the use of chemical and biological (CB) agents by state and non-state actors.” Cross’s book discusses the sordid history of Rhodesian use of chemical and biological weapons from 1975-1980 – “Dirty War is the culmination of nearly two decades of painstaking research and interviews of dozens of former Rhodesian officers who either participated or were knowledgeable about the top secret development and use of CBW. The book also draws on the handful of remaining classified Rhodesian documents that tell the story of the CBW program. Dirty War combines all of the available evidence to provide a compelling account of how a small group of men prepared and used CBW to devastating effect against a largely unprepared and unwitting enemy. ”

Global Health Security Meets Infection Prevention 
GMU Biodefense PhD student and Global Health Security Ambassador Saskia Popescu gives us a preview of the 5th Ministerial Meeting for the GHSA (more to come, so keep an eye out in the coming weeks!). “Overall, the 5th Ministerial Meeting of the GHSA was a profound experience, not only for an infection prevention epidemiologist like myself, but as a person dedicated to public health and preventing the spread of infectious diseases. It was inspiring to see participants from private industry to government working to help facilitate capacity building from the ground up.  The GHSA is a particularly unique effort in that it brings together so many different people—from private companies to government health officials and even academia. In many ways, this is a perfect example of the diverse efforts needed to address health security vulnerabilities. In a single day, I was fortunate to chat with Swiss health officials on antimicrobial resistance and bioterrorism, university professors on hospital infection prevention as a preparedness tool, and GE healthcare on their efforts to fund health care capability building.”

Stories You May Have Missed:

  • WHO Reports on Global Antibiotic Consumption – “The WHO has been working to strengthen national capacity to monitor antimicrobial consumption across 57 low- and middle-income countries. These efforts have focused on workshops and educational sessions, as well as technical support, to help better understand consumption trends on an international level. In the case of this report, the WHO defined consumption as ‘estimates of aggregated data, mainly derived from import, sales, or reimbursement databases’ while use was defined as ‘data on antibiotics that were taken by individual patients’.”

Review of the Blue Ribbon Study Panel “Biodefense Indicators: Progress in Implementing the National Blueprint for Biodefense”

By Michael Krug and Alexandria Tepper

On November 14th, 2018, the Blue Ribbon Study Panel on Biodefense presented a discussion session entitled “Biodefense Indicators: Progress in Implementing the National Blueprint for Biodefense”. The five-hour event was composed of a series of expert panels spanning multiple fields, agencies, and backgrounds. The panels were moderated by five co-chairs from the Blue-Ribbon Study Panel, including: Senator Joseph Lieberman, Governor Thomas Ridge, Senator Tom Daschle, Representative Jim Greenwood, and Kenneth Wainstein. The discussion centered around the steps being taken to bring the strategies mentioned in the White House’s 2018 National Biodefense Strategy to a reality.

The panel’s initial remarks involved assessing the progress of the federal government to the threat of a biological element, whether it be naturally-occurring, man-made, or accidental, since the release of the panel’s  Blue Ribbon Blueprintin 2015. Senator Lieberman was determined to reinforce the idea that the Blue Ribbon Blueprint should “provide a roadmap to improving how we prepare for, defend against, and respond to biological threats of all natures.” The tone reflected by the chairs acknowledged that the progress made by the federal government has been promising but incomplete. The recent release of the 2018 National Biodefense Strategywas a major step forward in attempting to recognize and fix the shortcomings surrounding the biological threat facing the United States.  Gov. Tom Ridge explained the difficulties facing the Blue Ribbon’s cause, saying “The threat is real. It’s not sexy. Nobody’s talking about it. Whether it’s natural or generated by design, it’s a real problem. I’m interested in discussing today how we go forward as a country.” This statement reverberated the purpose of the panel and the uphill challenges facing the implementation of the National Biodefense Strategy process. Continue reading “Review of the Blue Ribbon Study Panel “Biodefense Indicators: Progress in Implementing the National Blueprint for Biodefense””