Pandora Report: 2.26.2016

It’s been quite a week for global health security. Even the X-Files covered worldwide pandemics (that’s right, multiple diseases), CRISPR-Cas9, and military vaccination programs. Measles is hitting Nigeria hard as Lagos state officials announced the deaths of 20 children related to the outbreak. A recent study released by the University of Pennsylvania’s Annenberg Public Policy Center found that more than one third of participants believed Zika virus was a conspiracy theory related to genetically modified mosquitoes. Maybe they were also watching the X-Files? Before we begin, meningitis vaccine efforts were celebrated at the Meningitis Vaccine Project (MVP) conference, due to success within Africa’s meningitis belt.

GMU Biodefense Students Awarded UPMC Biosecurity Fellowship
We’re happy to announce that two GMU Biodefense students have been selected as Fellows for the UPMC Emerging Leaders in Biosecurity Initiative (ELBI)! Congrats to biodefense MS alum Francisco Cruz, and PhD candidate Siddha Hover! “The Emerging Leaders in Biosecurity Initiative is a competitive fellowship program designed to create and sustain an energetic, multidisciplinary, and intergenerational biosecurity community made up of motivated young professionals as well as current leaders. UPMC has selected 28 US and international emerging leaders in biosecurity from a wide array of backgrounds, including biological science, medicine, policy, the military, law, public health and the private sector.” Siddha Hover works for BAI, Inc. as an embedded contractor with the Department of Homeland Security, where she serves as DHS’s sole treaty analyst. In her role, she is responsible for reviewing all relevant DHS-sponsored research and activites for compliance with applicable arms control agreements. Siddha is currently pursuing her PhD in Biodefense. She holds a MSc in Biodefense from George Mason University and a MSc in International Relations from the London School of Economics. Siddha notes that, “the GMU Biodefense program provided me with the foundational knowledge necessary to confidently begin a career in biodefense and enabled me to successfully apply for the ELBI Fellowship.” Francisco is a biologist in the Field Operations Branch of the U.S. Environmental Protection Agency’s (EPA) Chemical, Biological, Radiological, and Nuclear Consequence Management Advisory Division (CBRN CMAD). As CBRN CMAD’s Biologist, Francisco provides operational guidance to federal, state, and local responders in the areas of decontamination and emergency response related to biological incidents. Francisco holds a B.A. in Biological Sciences from the University of Delaware. During his time at GMU, Francisco earned a Graduate Certificate in Critical Analysis and Strategic Responses to Terrorism, and earned his M.S. in Biodefense in December 2015. Congrats to Siddha and Francisco in their work furthering the field of global health security and representing GMU Biodefense in the ELBI program!

GMU Biodefense Course Sampler- “Biosecurity as a Wicked Problem”
If you’re on the fence about going back to school, curious about our program, or just want to hear what a class in biodefense would be like, check out our course sampler on Wednesday, March 2nd, at 7pm, in our Arlington Campus in Founders Hall, Room 502. “The United States and the world face unprecedented threats to global biosecurity, including emerging infectious diseases, pandemics, natural disasters, bioterrorism, and laboratory accidents. Find out about the challenges posed by these threats and strategies for enhancing global health security.” How many times can you sample a course from not only an expert in the field, but also the director of the program? Dr. Koblentz will be your host for this evening lecture on biodefense, dual-use research, CRISPR-Cas9, biosecurity, and much more. Can’t attend in person? Don’t worry – we’re also live-streaming here. Come join us for a look behind the curtain of not only our GMU graduate programs, but also the world of global health security.

CRISPR and The Battle of Genetically Modified Mosquitoes 
CRISPR-Cas9 technology has been a hot topic since it was discovered and things have only ramped up since a Chinese research team announced last Spring that they successfully edited human embryo genes. While many raised concerns over “designer babies” and genetically modified livestock, the case for genetically modified mosquitoes has also been discussed. What if science could modify mosquito capabilities to carry disease? CRISPR-Cas9 research is getting much closer to making this a reality with the help of two research teams. “The first group, led by Valentino Gantz and Ethan Bier at the University of California–San Diego, and Anthony James at the University of California–Irvine, engineered a gene drive carrying a pair of genes designed to kill the malaria parasite inside the mosquito.The second group, led by Nikolai Windbichler, Andrea Cristanti, and Tony Nolan at the Imperial College London, developed a more brute force approach, building a gene drive that breaks an important mosquito gene and renders the females sterile—a strategy designed to decimate a mosquito population. Both groups reported that, when the genetically modified insects were crossed with wild ones, as much as 99 percent of the offspring carried the modified genes, a clear sign that the gene drives were working.” While field tests are still necessary to establish efficacy, it’s important to note the researchers are taking great strides to ensure public buy-in given the sensitivity of such work. Gene drive is becoming more accessible and the applications appear limitless however, ethical use of this pioneering innovation is crucial for future work.

Climate Change & Zika Virus – What’s the Link?
Somewhere between reporting on CRISPR-Cas9 mosquitoes and Zika updates, it seems like a perfect place to discuss what kind of impact climate change is having on infectious diseases…especially Zika virus. GMU Biodefense MS student and one of our contributors, Greg Mercer elaborates on the role climate change may have on the growing geographical distribution of mosquitoes that pose some of the biggest threats. Greg points out that “exactly how climate change drives the spread of Zika and other diseases is hard to define. In 2013, researchers at the University of Arizona published a paper examining the effect of climate factors on dengue and its Aedes vectors. Their conclusion highlighted just how far scientists still have to go in understanding the climate-disease link: ‘Climate influences dengue ecology by affecting vector dynamics, agent development, and mosquito/human interactions,’ they wrote, but ‘although these relationships are known, the impact climate change will have on transmission is unclear.’ Climate change introduces additional complications into an already complex system, the study authors explained: It’s difficult enough to understand how weather, climate, human interaction, or mosquito behavior contribute to the spread of a virus.” Researchers are now comparing the global distribution of Aedes mosquitoes and the spread of Zika, which leaves many to wonder if the threat of global disease will evolve with that of global climate change.

BARDA Seeks Advanced Public Health Consequence Modeling
The Biomedical Advanced Research and Development Authority (BARDA) is currently working to find partners that can aid in the development of a modeling system that would support federal decision makers in their planning and response to CBRN events. “The tools developed under this acquisition will assist Federal decision makers with medical and public health decision making for the advanced development and implementation of an integrated National medical countermeasures infrastructure (e.g., vaccines, therapeutics, diagnostics, and medical devices).” They’re hoping to build partnerships to establish a network for medical consequence modeling, simulation, visualization, and decision support. BARDA plans to include two functional areas within the network, 1- decision support, reach back, analysis, and modeling (DREAM), and 2- professional services and systems integration (PSSI). “These activities include assisting government decisions makers during the development of preparedness plans, the implementation of response strategies, and communications with a wide variety of stakeholders, both during day to day operations and in the course of declared public health emergencies as part of the BARDA Modeling Coordination Group.” Each functional area will have multiple Indefinite Delivery/Indefinite Quantity (IDIQ) awards that can be earned and they are encouraging interested stakeholders to submit proposals.

To Zika and Back 

Courtesy of the Council on Foreign Relations
Courtesy of the Council on Foreign Relations

As Zika virus continues to spread and South Africa reports the first of their cases, many are wondering how these outbreaks tend to go from 0-60 in a hot minute. NIAID director, Anthony Fauci, discusses the reality of disease surveillance and revealed this slide during an interview, of which you can see the global examples of emerging and re-emerging infectious diseases. Dr. Fauci points to the unpredictable nature that is public health and global health security. Global public health is still reeling from the effects and imperfect response of Ebola 2014, coupled with the scrutiny of a response to H1N1 that was considered too zealous. I’ve always considered public health and disease prevention to be the kind of work where few realize when you’ve done your job correctly but when you fail, it’s something you’ll be hearing about for decades. Global health security is challenging on a good day and public health tends to get little funding, especially in the countries that need it most. After the devastation of Ebola and all the after-action reports, many are wondering how did we miss the rise of Zika virus? Dr. Ken Stuart, director of the Center for Infectious Disease Research in Seattle, says, “We were unaware of the severity of the disease … [and] were unaware this virus had the capability for getting distributed so rapidly.” Regarding the funding issues that often plague infectious disease efforts, he noted that “this really goes back to funding priorities. Much of the funding devoted to infectious disease today is in reaction to outbreaks. Therefore, we’re not generally prepared to respond quickly. In other cases there are diseases that are very rare but they have an advocacy group that generates research activities. In the case of diseases like Zika, which were isolated in remote areas of the world where that population had no resources or advocacy group, there was no push to do research.We’re not stuck with what we’ve got. There are conversations between federal funding agencies and private organizations to try to prioritize the utilization of their resources, and I would say the NIH has been a leader in supporting the fundamental research that actually, probably positions us best to be prepared to respond to these disease outbreaks.” In other Zika news, a CDC team just arrived in Brazil to study the associated birth defects and the White House is urging Congress to provide emergency funds to support Zika response efforts, rather than just re-directing funds from Ebola-related projects. You can also see a map tracing the spread of Zika and some background here. As of February 24, the CDC has reported 107 travel-associated cases in the U.S.

The Rise of Chikungunya
I always thought it sounded like the name of a monster and in some ways, that’s pretty spot on. The Pan American Health Organization (PAHO) reported 16,668 confirmed and suspected cases of Chikungunya in 2016 so far. Colombia shouldered the majority of 2016 disease burden, with a spike of 1,189 new cases added to their previous count of 5,752. The PAHO is still playing catch-up on their year-end reporting for 2015, but it looks like 28,722 additional infections were added to their 2015 data. These updates mean that this region experienced 726,478 cases in 2015, and with the the new cases reported as of February 19, this current outbreak has been responsible for 1.89 million infections. Starting in 2013, this outbreak began on St. Martin and has been gaining traction ever since. Hopefully with the mosquito-control efforts related to Zika virus, the mosquito population also responsible for Chikungunya will begin to decline.

Stories You May Have Missed:

  • Breaking Down the Barriers of MDRO’s:  Scientists in the UK have discovered how drug-resistant bacteria create and maintain their defensive wall. Using the Diamond Light Source machine to “investigate in tiny detail a class of bugs known as Gram-negative bacteria”, they were able to find a defensive wall and it’s assembly beta-barrel machinery (BAM). This new research means that future treatments can aim at preventing bacteria from building these defense measures versus just attempting to attack the bacteria itself.
  • Melbourne Measles Outbreak – 14 cases have already been confirmed in the suburb of Brunswick, of which 2 were children from a primary school. Students that attend the same school and are not fully immunized were instructed to stay home to avoid exposure.
  • E. coli Outbreak in Raw Milk – Not surprisingly, a recall has been issued related to unpasteurized raw milk from a local dairy farm in Fresno, CA. 10 people have been confirmed with Shiga-toxin producing E. coli 0157:H7. Thankfully the shelf-life of the product has passed and public health officials, while stating that the investigation is on going, have confirmed that no health alert was issued since the product is believed to no longer be within the marketplace. Moral of the story – avoid raw, unpasteurized milk.

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