Pandora Report 8.19.2016

The Olympics are winding down and now many are waiting with bated breath to see if those attending the games will bring back more than just memories to their home countries. A recent study revealed that people infected with Ebola were 20% more likely to survive if they were co-infected with malaria-causing Plasmodium parasites.  Yellow fever continues to burn through the DRC and many are wondering if it could become the next pandemic as it’s on the brink of spreading to Europe and the Americas.  The UN has finally acknowledged the role it played in the cholera epidemic that hit Haiti following the devastating earthquake six years ago. The UN acknowledgement comes after years of cited reports and public outrage regarding the importation of the disease as a result of UN peacekeepers. China has reported several cases of human infection with avian influenza (H7N9). While human-to-human transmission has not occurred, it can’t be ruled out.

From Anthrax to Zika – We’ve Got You Covered 

We’re always on the lookout for new pieces written on biowarfare and this week brought some gems to the table. Get the scoop on Russia’s old anthrax bioweapons program and how genomic sequencing revealed more details into both the program and the “biological Chernobyl” that was Sverdlovsk. Researchers like Paul Keim, Matthew Meselson, and Jeanne Guillemin, have been looking to unravel the outbreak in Sverdlovsk and that it wasn’t “unreasonable to suspect that the Soviets would have tried to create a superstrain” of the disease. Interestingly, “the team didn’t see any evidence that Soviet engineers had tried to grow a strain that was resistant to drugs or vaccines, or that they had genetically engineered the bacteria in any way” and there were actually few changes within the genome. You can read more about the genome sequence from the Sverdlovsk 1976 autopsy specimens here.  The good news is that through Keim’s work, it is possible to review anthrax genome sequences from any future outbreaks and determine if it is some leftover Soviet weapon strain or another source. The CDC recently published an overview of biological warfare in the 17th century within the Emerging Infectious Diseases journal. You can venture through time to look at the siege of Candia during the Venetian-Ottoman War of the 17th century. “Plague was first detected in Reval on August 10, 1710, while the army from Russia was still approaching the city. Reval was not besieged, and the Russians merely camped outside the city while attempting to isolate it. The army dumped corpses into a stream that flowed into Reval, but evidence does not show that the dead were plague victims, nor does evidence exist that clarifies whether the intent was contamination of the water supply or disposal of bodies. Original accounts provide no evidence to suggest that Russians hurled bodies into the city, much less plague-infected bodies.”

ISIS’ Chemical Weapon Use: A Serious Threat On The Rise

Senior DoD consultant, Zamawang Almemar is discussing the rising threat of chemical weapons and why the “international community must respond aggressively to this threat and prevent ISIS’ ability to access chemical raw materials and transform them into weapons.” The recent chemical attacks on Kurdish civilians aren’t the first and probably won’t be the last. From President Saddam Hussein to ISIS, the threat of chemical weapons and use of mustard gas (sulfur mustard) has been a consistent tool in warfare. Almemar points to the psychological impact of chemical weapons use against the Peshmerga and that ISIS also employs these tactics to benefit from the lack of protective gear and preparedness within the Kurdish military and civilians. “The Kurdish Peshmerga forces undoubtedly continue to win the war against ISIS with conventional weapons on the battlefield and with help from the U.S. and coalition forces. However, when it comes to unconventional weapons, such as chemical weapons, they are lacking even the most basic protective equipment”. Given the consistent use of these weapons, now is the time for the international community to help supply basic protective gear for both Peshmerga forces and Kurdish civilians, to help prepare and defend against ISIS chemical weapons attacks.

Does the U.S. Need a Rapid-Response Fund for Infectious Diseases?

Greg Mercer talked about this a few weeks back, but I think we can all safely say the answer to this question is a rather enthusiastic “YES”. The Congressional standoff with Zika funds has brought the role of federal emergency funds into the limelight. The good news is that it sounds like lawmakers have learned from this situation and it’s sounding more and more like the next health spending bill will emphasize the creation of a reserve fund for the CDC to use in the next public health crisis. “The House version of the bill, which would fund the federal health agencies for the fiscal year that starts in October, has a $300 million “rapid response reserve fund” for infectious diseases. It’s a smaller version of an idea that Democratic lawmakers and current and former Obama administration officials have been promoting for months, ever since it became clear that Congress was incapable of anything close to a rapid response to Zika.” While there’s no guarantee and it will require the spending bill to be completed before President Obama leaves office, it’s a step in the right direction. The question now becomes, is this enough? Many are pointing out that while this is a great start, $300 million is simply not enough and the fund needs to be labeled as an emergency fund, not a rapid response reserve. CDC Director Tom Friden as been fighting the funding battle for over six months now, pointing to the rising case counts and growing presence of local transmission. “If you were going to do something like create a vaccine, $300 million would be entirely used up by that,” Frieden said. “If you were going to do something like a rapid response while you kind of assessed the disaster … that obviously is enough to get started. It’s not going to provide all of the funding, but it would allow you not to be so stuck.”

Report Details DoD Chem/Bio Defense Programs 

The DoD 2016 report to Congress was released recently, describing the research and development practices that have used to combat chemical and biological threats. In fact, the DoD’s Chemical and Biological Defense Program (CBDP) has provided funding for the new plague drug that was recently approved as a medical countermeasure. “The DoD faces CB threats that are complex, diverse, and pose enduring risks to the Joint Force and Homeland,” the new report said. The variety, origin, and severity of these threats continues to grow while resources shrink. DoD said it performed basic research in genetic engineering and nanoelectromechanical systems related to defense against CB threats, and supported the response to the Ebola outbreak in West Africa, among other initiatives.” Despite their work and progress, there are still challenges when it comes to biosafety, which were noted in regards to the shipping of live anthrax spores from a DoD lab. Budget reductions are expected to translate into a decrease in ChemBio defense research funding, which makes the job of combatting an increasingly complex threat that much more difficult. As the report notes, “this environment translates into increasingly complex program management decisions with no margins for error due to a lack of sufficient and predictable resources.” As Almemar previously noted, the recent use of chlorine gas by Syrian government forces and the ongoing use of chemical weapons by ISIS all point to the imperative need for continued support and funding for chemical weapon defense.

BARDA Medical Counter Measures Industry Day

The Biomedical Advanced Research and Development Authority (BARDA) and the Office of Acquisitions Management Contracts and Grants (AMCG) will be hosting their annual conference to provide a better understanding about federal medical countermeasure requirements. The October 18-20th event in Washington, DC, will allow participants to interact with BARDA and AMCG staff, and network with private sector colleagues. During the conference, participants will also learn about BARDA’s strategies and goals for FY2017 and beyond, challenges of dealing with emergency, as well as current, infectious diseases, new initiatives, and roles and responsibilities of BARDA, AMCG, and private sector partners.

Zika Virus – Emergency State of Affairs

The CDC has declared a public state of emergency in Puerto Rico over Zika virus. Last week saw over 1,900 new cases reported in Puerto Rico, which brings the total case count to over 10,690. Concerns are growing after the massive flooding in Louisiana and the potential risk for increased Zika virus transmission. While flood water may wash away eggs, the risk for containers and abandoned housing as a breeding ground for mosquitoes may support further transmission. Forbes has posted the winners and losers of $81 million in Zika funding hereWhat are the legal implications of employee-related Zika virus infections? Legal teams around the U.S. are starting to gear up for the potential legal ramifications and how employers and/or employees will respond to infections. Check out this personal account of a patient infected with Zika, who experienced the challenges of getting medical care in the U.S.  As of August 17th, the CDC has reported 2,260 cases within the U.S. You can find a timeline of the spread of Zika here.

Stories You May Have Missed:

  • The Women Protecting Us From the Next Pandemic– If you caught the PBS special, Spillover, you saw Dr. Jonna Mazet talk about the powers of the global surveillance system, PREDICT. Having detected over 800 viruses that have pandemic potential, her work looks to the relationships between humans, animals, and nature to predict the next pandemic. “The entire world is vulnerable. … It’s proven to us every single year when influenza comes around. [Viruses occur] as people search for new occupations, as more [development] pushes into wildlands, as there’s more contact between people and wildlife, which are the natural hosts. We’re seeing increases in these spillover events and diseases. …”
  • Smallpox Rising From the Grave? 
    Courtesy of UK DailyMail
    Courtesy of UK DailyMail

    Following Russia’s frozen anthrax problem, many are worried that something much more sinister, like smallpox, could be found in the permafrost. Siberia, like the rest of the world, dealt with smallpox outbreaks in the 19th century. One particular outbreak was in a town that saw 40% of the population die and resulted in the rapid burial under the permafrost soil. With the eroding river banks and disappearing permafrost, time will tell if there are more zombie microbes awaiting their rise from the permafrost grave.

  • Michigan Pigs & H3N2 – The pigs in Michigan are battling H3N2 influenza. Two more county fairs have reported cases within their pigs, with the first testing positive on August 9th. Twenty pigs have tested positive at the Cass County fair, where over 300 pages were displayed. While humans can acquire H3N2 from close contact with infected pigs, the illness is considered mild in humans.

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