Pandora Report 11.4.2016

Happy Friday! We’ve got some great news – you can now watch our book launch and panel from the Biological Threats in the 21 Century event via YouTube here. Whether you missed out on attending or want a recap, you can get all the biodefense goodies there. UNMC was recently awarded $19.8 million to build an Ebola and advanced infectious disease training center. Their new center will include a training, simulation, and quarantine section, with the hope of training healthcare workers to treat patients with Ebola and other highly infectious diseases. A recent study found that limited access to Ebola diagnostic and supportive pathology assays facilitated the failure of initial 2014 outbreak control efforts, regardless if the setting was a resource-rich or resource-poor location.  Shocking news – hand hygiene is one of the biggest issues in norovirus infections.

3rd Annual Summit on Global Food Security and Health 
GMU’s Schar School of Policy and Government will be hosting this informational event on Wednesday, November 16th from 10:30am-5:30pm. Speakers include experts from organizations such as the Association of Public Land Grant UniversitiesBread for the World, the International Medical Corps and the US Agency for International Development: Academics will discuss their research on Food Security with an eye to improving access, addressing challenges and developing partnerships to improve global food security and related health outcomes. Organized with the support of the Center for Strategic and International StudiesThe Farm Journal FoundationThe Global Harvest Initiative, Policy Studies OrganizationWorld Medical & Health Policyjournal; Center for the Study of International Medical Policies and Practices (CSIMPP) in the Schar School of Policy and Government at George MasonUniversity; American Public University; and World Food Policy. The conference is free and open to the public, but registration is required. Contact Professor Bonnie Stabile bstabile@gmu.edu with any questions.

FDA Manipulation of Media
A new report from the Scientific American is drawing attention to the FDA’s arm-twisting of journalists “into relinquishing their reportorial independence”. Their investigators found that NPR and a series of other news outlets had a deal with the FDA-  get news announcements early but the FDA would dictate whom their reporters could and couldn’t interview. “This kind of deal offered by the FDA—known as a close-hold embargo—is an increasingly important tool used by scientific and government agencies to control the behavior of the science press. Or so it seems. It is impossible to tell for sure because it is happening almost entirely behind the scenes. We only know about the FDA deal because of a wayward sentence inserted by an editor at the New York Times.” The Scientific American was able to obtain supportive documents via the Freedom of Information Act, which revealed that despite their public demeanor, the FDA denies many reporters access and grows their own group of journalists that will follow their rules. Much of this is held together with the journalistic practice of embargo – a deal between source and journalist that the story won’t be published prior to a specific date/time. This is actually pretty common in the science world, but it can actually create an aura of favoritism and bias. The issue with the FDA situation is far deeper though – aside from getting early access to stories and agreeing not to publish before the agreed date/time (embargo), the other rules stated that journalists could not seek outside comment and in a nutshell, had to give up the ability to do independent reporting. In the end, this kind of control of the media and journalistic favoritism reveals things about both sides of the agreement, but also emphasizes the need for transparency and re-thinking of the embargo system.

BWC 8th Review Conference sheet-1
The eighth RevCon is fast approaching and if you’re behind as to what’s happened since the last RevCon, check out UNLOG’s (The United Nation’s Office at Geneva) Think Zone and the latest information. You’ll also find some great articles from GMU’s Biodefense faculty in there – like Dr. Koblentz’s article on dual-use and Dr. Sonia Ben Ouagrham-Gormley’s article on gene drive. Better yet, check out the BWC RevCon Series from the International Law and Policy Institute. These three papers discuss a series of issues related to the BWC and RevCon. The first, Divide and Delegate: the Future of the BWC, focuses on the pursuit of BWC aims outside RevCons and the normative strengths and operational weaknesses. LPI2, Keeping Up With the Science, looks to support enhanced science and technology review processes. LPI3, is a joint effort by GMU’s very own Biodefense Director, Gregory Koblentz, and the author of your favorite new book (Biological Threats in the 21st Century), Filippa Lentzos. The third paper, Risks, Trade-Offs & Responsible Science , looks at the security trade-off risks of the increasing volume of labs and scientists working on dangerous pathogens. They note that “the 2016 BWC Review Conference must encourage states to implement stringent national biosafety, biosecurity and dual-use research regulations; task the science advisory group to develop clear, internationally- recognized guidelines governing dual-use research of concern (DURC); establish a working group to revise the CBMs; and encourage states to participate in the CBM mechanism as well as more interactive information exchanges such as peer review and compliance assessment.”

RevCon will take place from November 7-25th in the Palais des Nations and a general agenda is available here. Gabrielle Tarini writes that this RevCon will be a “pivotal opportunity for countries to take action to ensure that the treaty remains a relevant and useful tool for preventing the development, spread, and use of biological weapons. A failure by member states to invest the necessary attention, time, and political capital in the conference could mean decreased interest and weakened multilateral engagement in a treaty that was the first to ban an entire category of weapons of mass destruction.” Moreover, the BWC should have a dedicated process, like that of the CWC, to inform and advise member states, pointing to the need for a great capacity to have expert-led meetings and continuous monitoring. Lastly, Tarini highlights that this RevCon will be an opportunity to strengthen and revise the intersessional process and framework. “The treaty should be restructured, with a stronger steering body and increased time for preparation and multilateral engagement. Adding more meetings, and limiting what gets discussed at each of those meetings, would allow the BWC to begin operating more like an international organization and would provide oversight equivalent to that for other nonproliferation treaties.” Can everyone help verify the BWC? Some are saying open source monitoring may just be that sweet spot.

Increasing Transparency in Biodefense: A 2016 Visit to a German Military Medical Biodefense Facility  screen-shot-2014-09-22-at-21-57-41
Filippa Lentzos is taking us on a journey through German biodefense practices and why transparency is so vital for these programs. Citing Germany as a prime example of countries going above and beyond their voluntary BWC efforts, she delves into the world of Germany’s biodefense activities. She notes the visitors were highly encouraged to review Germany’s most recent CBM submission and briefed on the Institute of Microbiology’s safety and health regulations. “Few restrictions were placed on us other than those related to safety and security. We were free to view rooms, lab equipment and installations. The type and scope of access was to be determined by Institute staff on a case-by-case basis. Any access denials could derive from national security, biosafety and health regulations, data privacy issues, unpublished scientific results or ongoing lab work. If access or certain information was refused, the Institute would explain the particular considerations and o er alternatives.” The Bundeswehr institute focuses on three main CBRN tasks – ensuring protection and an ability of the armed forces to act under CBRN threats, preventing vulnerability to potential CBRN threats and weapons via preventative measures, and limiting the consequences should a CBRN event ever occur. The medical biodefense responsibilities focus more on the ability to rapidly diagnose and identify pathogens, distinguishing natural outbreaks from intentional, and controlling outbreaks. The official noted on their visit that within the institute, there are 65 staff and 18 externally funded fixed-term positions over three departments (bacteria/toxins, viruses/intracellular pathogens, and medical biological reconnaissance and bioforensics). From genome sequencers to electron microscope rooms, check out Filippa’s report for a virtual tour of this amazing biodefense facility.

Assessing the Epidemic Potential of RNA and DNA Viruses  screen-shot-2016-11-02-at-7-19-56-am
Researchers from the University of Edinburgh are looking at zoonotic viruses and their transmissibility. The Ebola outbreak in 2014 highlighted the needed to better understand what kinds of pathogens, especially zoonotic, were likely to emerge as potential epidemics. Given the vast diversity and high rates of viral evolution, this was no easy task. “Of human transmissible virus, 37 species have so far been restricted to self-limiting outbreaks. These viruses are priorities for surveillance because relatively minor changes in their epidemiologies can potentially lead to major changes in the threat they pose to public health.” Researchers used the basic reproductive number, R0, as a means of answering this question. They looked at hundreds of viral species and then categorized them into 4 levels with epidemic potential in humans. They found that the taxonomic diversity is wide, but bounded and most human infective viruses are closely related to viruses of other mammals. Transmissibility within the human population is a key determinant, as well as the R0 threshold of>1. “We currently have few clues to help us predict which mammalian or avian viruses might pose a threat to humans and, especially, which might be transmissible between humans. One argument in favor of experimental studies of these traits, including controversial gain of function experiments, is that they could help guide molecular surveillance for high-risk virus lineages in nonhuman reservoirs.The first line of defense against emerging viruses is effective surveillance. A better understanding of which kinds of viruses in which circumstances pose the greatest risk to human health would enable evidence-based targeting of surveillance efforts, which would reduce costs and increase probable effectiveness of this endeavor.”

Spikes in C-diff and MDRO’s 
Halloween may be over but the rise of the resistant bugs is still going on. A recent study looked at the changing epidemiology of MDRO’s (multi-drug resistant organisms) within a specific healthcare network. While they were able to observe a significant reduction in MRSA, there was a sharp rise in other MDRO’s and C-diff (Clostridium difficile). Examining eight years of data from a Utah-based health network, researchers looked at 22 hospitals clinics to establish trends in C-diff and other MDRO’s. Of the 900,000 patient admissions, 1.4% tested positive for an MDRO and/or C-diff. MRSA was by far the most common MDRO (51% of MDRO infections) but they did see a 32% decrease in MRSA infections over the eight years. “Researchers, however, observed a 222% increase in C difficile and a 322% increase in ESBL-positive bacteria. The data also showed that 70% of all MDROs and C difficile cases originated from an ambulatory setting.” There has also been a significant rise in ESBL’s, which points to a need to refine and revise screening protocols. Overall, this points to the complexity and ever-changing habits of infection prevention and control.

Zika Updates
A recent study is showing that Zika infections have caused reduced fertility and low testosterone in male mice. The ECDC has updated their Zika epidemic rapid risk assessment, noting that “although continuing, vector-borne transmission seems to be slowing down in Central American countries and the Caribbean. The outbreak continues to evolve in Mexico and the southern part of the US, as weather conditions still favour seasonal vector activity. In addition to the Americas, cases have been reported in some Asian countries.” Researchers are working to use the Wolbachia bacteria (which naturally infect several mosquito species) against diseases like Zika and dengue. Overcoming the hurdle of infecting Aedes (a species not naturally infected with Wolbachia), they found that the bacteria was able to survive in the mosquito and then was a passed down through generations…but the best news is that those mosquitoes infected with Wolbachia weren’t able to pass dengue. When the Wolbachia-infected mosquitoes were infected with dengue, the virus couldn’t replicate and spread in the mosquito’s salivary glands (i.e. couldn’t be transmitted). This new technique shows some pretty remarkable abilities to reduce the capabilities of Aedes species to spread diseases like Zika, chikungunya, and yellow fever. The CDC has reported, as  of November 2nd, 4,128 cases in the U.S.  Interestingly 53 people in Minnesota have been found to be infected.

Stories You May Have Missed: 

  • Pandemic Simulations – The Ebola outbreak in 2014/2015 taught us a great many lessons regarding international preparedness and response to infectious disease outbreaks. As a result of this, the World Bank Group and the Bill and Melinda Gates Foundation is starting a new project to conduct the first set of pandemic simulation exercises. “President Jim Yong Kim, Bill Gates and Chancellor Angela Merkel of Germany will jointly host simulation exercises on pandemic preparedness for the Heads of State and private sector leaders during the next World Economic Forum in Davos in January 2017 and the G-20 Heads of State meeting in July 2017.  In preparation for the two major events, the World Bank will collaborate with the technical team from WHO, WEF and the German government to conduct similar exercises for G20 technical staff and and G20 Ministers of Health. Simulation exercises help make a theoretical possibility real, by allowing policymakers to role-play and map out gaps and concrete solutions to those gaps along with their peers.”
  • New Genetic Mutations in Antibiotic BW Agent– Researchers at Lawerence Livermore National Laboratory (LLNL) recently found a new genetic mutation in antibiotic-resistant tularemia (Francisella tularensis). Tularemia is a Category A Select Agent, which means it is a prime concern for bioterrorism and public safety. “This perspective allows you to see mutations that are new that we didn’t know about. If you don’t do this type of study, you’re going to miss other mechanisms that cause resistance in the bacteria. So by doing a genome-wide study, it gives you a much more complete picture about what’s going on,” said LLNL biologist and lead author Crystal Jaing. “The study found resistance-conferring mutations in a hypothetical protein, an asparagine synthase, and a sugar transamine/perosamine synthetase in addition to observing known variants.”

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