Pandora Report 5.6.2016

May has arrived, summer is upon us, and we’ve got your weekly biodefense scoop..Thursday was Hand Hygiene Day – don’t forget that clean hands save lives! Check out these wonderful infographics on the impact of vaccines on battling infectious diseases in the 20th century. A recent study published in the Journal of the American Medical Association (JAMA) found that 30% of oral antibiotics prescribed in U.S. outpatient healthcare facilities (urgent cares, etc.) are unnecessary. Hocking a loogie may now be a diagnostic method as researchers have found that people have saliva fingerprints. The study revealed that this new analysis could lead to non-invasive methods of disease detection. Think you know your chem-bio weapons? Take a quiz to see if your knowledge is expert level or if you need a review from anthrax to Zika. 

Potential Anthrax Attack Foiled in Kenya 
Screen Shot 2016-05-04 at 7.07.53 AM Kenyan police are claiming to have foiled a “large-scale” bioterrorism attack using anthrax. Three individuals associated with a terrorist group with links to ISIS were arrested. The terrorist group was not named but was noted to have a presence in Kenya, Somalia, Libya, and Syria. Police stated that “Mohammed Abdi Ali, a medical intern at a Kenyan hospital, was in charge of a ‘terror network… planning large-scale attacks akin to the Westgate Mall attack‘ in which 67 people were killed in 2013 in Kenya’s capital, Nairobi.” Mr. Ali is said to have a network that includes medical professionals who would have the tacit knowledge to develop anthrax bioweapons. The Kenyan police chief, Joseph Boinnet, posted the official documents on his Twitter. While there has been no additional information on the terrorist group or the details of their planned bioweapons attack, we’ll continue to keep you updated as more information is released.

Let Loose Your Inner Epi With EpiCore
Ramp up your epidemiology game with the EpiCore community. EpiCore is a joint effort from Skoll Global Threats Fund, HealthMap, ProMED, and TEPHINET. EpiCore is a virtual community that brings together epidemiologists using new surveillance methods. It’s “a new system that is finding and reporting outbreaks faster than traditional disease surveillance methods alone. EpiCore enables faster global outbreak detection and reporting by linking a worldwide member network of health experts through a secure online reporting platform.”

Whole Foods Salad Bar Attack
The FBI has recently arrested a man in Ann Arbor, Michigan, who poured a liquid onto items in the prepared foods bars. Reminiscent of the Rajneeshee attack in 1984, investigators are taking the situation very seriously. Authorities found that the man was spraying mouse poison in fresh foods at three Ann Arbor grocery stores. “According to the FBI, an investigation points to the man spraying a mixture of what is believed to be mouse poison, hand cleaner, and water on open food bars in three stores in the town over the last couple of weeks.” The FBI has also noted that the suspect had visited other grocery stores in recent months and they are currently investigating if those other stores were involved in the poisoning. Would you consider him a bioterrorist or prankster?

Is Texas A New Hot Zone?
Between Ebola and Zika, Texas hasn’t been able to catch a break from emerging infectious diseases (EID’s). The Center for  Strategic & International Studies (CSIS) discusses that the EID attraction to the Lone Star State really began back in 2003 with the first urban dengue fever epidemic in decades. Texas is also “now an epicenter of Chagas disease and leishmaniasis transmission in the United States (parasitic infections transmitted by kissing bugs and sandflies, respectively), as well as murine typhus (transmitted by fleas) and West Nile virus infection.” Many are wondering, why Texas? What makes Texas such a nexus for infectious diseases? CSIS points to several factors – poverty (large population + poverty rate around 16% = ranking one or two in terms of having the largest volume of people below the poverty line), urbanization (when combined with poverty, this rapid growth means the crowded poor neighborhoods are perfect for opportunistic disease), being a global commercial and migration hub (coastal gateway ports), and climate change. These four qualities have created the perfect blend for both emerging and neglected infectious disease presence in Texas. Fortunately, Texas has a strong emergency management system and heightened public health department investment and resources. While Ebola and Zika have surely reinforced preparedness practices in Texas, are they enough? You may remember in December, we recounted the Trust for America’s Health report on state specific preparedness for preventing, detecting, diagnosing, and responding to outbreaks. States were graded on a scale of 1-10 (10 being the best score). Interestingly, Texas was ranked right in the middle with a score of 5. Despite all their recent EID events, I’m surprised Texas is not ranked higher (Delaware, Kentucky, Maine, New York, and Virginia ranked highest with a score of 8). If Texas is the new epicenter of emerging and neglected infectious diseases, let’s hope their capabilities and capacity to respond to such diseases improves in the future.

Lessons Learned from TV/Movie Outbreaks
The CW recently began their new miniseries, Containment. While any show or movie on an outbreak instantly captures my interest, this one is particularly captivating for the same reasons as Outbreak – it’s so bad, it’s good. A recent ranking of the most plausible pathogen and zombie virus outbreaks in movies points to our affinity for outbreak movies with poor scientific backing. I’m a fan of watching these movies, and now Containment on Tuesday evenings, to see not just how wrong people can get outbreak response, but what they think the general public wants to see when it comes to a dramatic epidemic depiction. Did I mention the plethora of epidemiology/infection control faux pas? We’ve all watched a movie or show with a disease outbreak and picked out some ridiculous (and usually hilarious) blunders. The Pandora Report is now starting a list of ways the show demonstrates how NOT to stop/prevent an outbreak. We’re hoping to publish the list after the season ends and would love to include anything YOU find while watching it. Whether it’s the ridiculous infection prevention habits, over-the-top quarantine practices, or SWAT house calls, we want to know what you find while watching the show. Please email (spopesc2@gmu.edu) or tweet with #GMUBiodefense and we’ll incorporate them into our overall list.

Zika Updates
The WHO has released a one-year overview of the outbreak, pointing to the reasons why “an obscure disease became a global health emergency.” They emphasized the potential staying power of the virus and the challenges of diagnostic testing in the field. Many experts are predicting that once there is local transmission in the U.S., Zika virus will become endemic and a “constant low-level threat” requiring annual vaccination. The FDA has issued Emergency Use Authorization to approve the first commercial U.S. Zika virus test. “The Zika Virus RNA Qualitative Real-Time RT-PCR test from Focus Diagnostics, a Quest Diagnostics wholly-owned subsidiary, is a proprietary molecular test is intended for the qualitative detection of RNA from the Zika virus in human serum specimens.” Prior to this, all testing was done at specific laborites designated by the CDC and had limited availability to physicians. The availability of a rapid test will allow for more accurate and timely surveillance and diagnoses. Brazil has reported roughly 1,300 Zika-linked microcephaly cases.  Researchers are finding that mosquitoes infected with the bacterium, Wolbachia, may help stop the spread of Zika. “We are pretty sure that mosquitoes carrying Wolbachia will have a great impact on Zika transmission in the field,” said Luciano A. Moreira, a biologist at the Oswaldo Cruz Foundation in Belo Horizonte, Brazil, and the lead author of a new report on the researchers’ findings, published on Wednesday in the journal Cell Host & Microbe. There is also a growing concern about the potential impact the virus may have in the U.S. as researchers have found Zika in Asian tiger (Aedes albopictus) mosquitoes. This particular mosquito has a larger range within the U.S. and travels farther north. As of May 4, 2016, the CDC has reported 472 travel-associated cases in the U.S.

Stories You May Have Missed:

  • Ebola Survivor Household Contacts At Higher Risk – a recent study in Sierra Leone found that nearly half of household contacts of Ebola survivors contracted the illness. The risk of infection was correlated with level of exposure, but researchers also found that it varied by age. “The adjusted risk also varied by age: 43% for children under 2 years, 30% for those 5 to 14 years; 41% for those 15 to 19, 51% for adults 20 to 29 years, and more than 60% for adults over 30.”
  • Ebola Re-Emergence Involves Virus With Reduced Evolutionary Rate – A recent study found that the mutational rate has waned a bit in the Ebola virus that re-emerged in Liberia. Performing genomic comparisons of the virus in flare-ups, the research “team saw declining genetic divergence in the flare-up strains, perhaps due to diminished evolutionary rates in individuals with persistent infection. Still, the sequence data supported the notion that the flare-ups involved strains related to those in the main outbreak, ruling out re-introduction from a reservoir animal or transmission of distinct strains from active infections elsewhere”.
  • Chinese Espionage and Traded Nuclear Information –  a former Florida Power & Light manager is accused of trading nuclear information for cash to aid a Chinese nuclear power company. He was “recruited by Szuhsiung Ho, also known as Allen Ho, to help China General Nuclear Power Co. develop special nuclear material in China, according to the grand jury indictment.”

 

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