Pandora Report 3.16.2018

Calling all owners of pet turtles – make sure you’re practicing some outstanding hand hygiene as there’s been a big Salmonella outbreak associated with the tiny reptiles.

Nerve Agent Attack in UK – Novichok
It’s been a whirlwind since the attempted murder of former Soviet spy Sergei Skripal and his daughter last week in Salisbury. It is now being reported that the Russian nerve agent “Novichok” was used. On Monday, British Prime Minister Theresa May spoke to MPs and said she would give Russia time to explain how they either lost control of the military-grade nerve agent or engaged in a direct attack on British soil. “The nerve agent was top secret back then, especially sensitive because the Soviet Union, under Mikhail Gorbachev, had renounced the use and production of chemical weapons. Its existence came to light thanks to the scruples of a brave scientist named Vil Mirzayanov, who had worked at the State Union Scientific Research Institute for Organic Chemistry and Technology. The institute was described by one of its top officials as ‘the leader in the technology of chemical destruction’.” Novichok is reportedly 5-8 times more toxic than the nerve agent VX and considered more sophisticated. You can read the joint statement from leaders of France, Germany, the United States, and the United Kingdom here, in which they state that “This use of a military-grade nerve agent, of a type developed by Russia, constitutes the first offensive use of a nerve agent in Europe since the Second World War. It is an assault on UK sovereignty and any such use by a State party is a clear violation of the Chemical Weapons Convention and a breach of international law. It threatens the security of us all.” The UK has also expelled 23 Russian diplomats in the wake of the attack.

Bill & Melinda Gates Discuss Bioweapons As Biggest Threat To Humanity
Melinda Gates recently spoke at South by Southwest this past weekend and underscored the vulnerability within the United States to bioterrorism. Both Melinda and Bill have repeatedly cited the vulnerability and seriousness of biothreats, regardless of origin, in our highly connected world. “As the two wrote in their recently released ‘Goalkeepers’ report, disease — both infectious and chronic — is the biggest public health threat the world faces in the next decade. And although Bill Gates said on a press call at the time that ‘you can be pretty hopeful there’ll be big progress’ on chronic disease, we are still unprepared to deal with the infectious variety.” While many are curious as to the reality of this threat, the truth is that infectious diseases are already causing significant damage – consider influenza, Ebola, or even antimicrobial resistance. These are naturally occurring events but there is also the risk of a laboratory incident or a nefarious actor releasing a bioweapon. Response and preparedness efforts are some of our biggest challenges. “In New York City’s hazard mitigation plan, the city indicates that a bioterror attack could have an impact on a similar scale as that of a nuclear weapon. And they say that the likelihood of bioterror attack is far greater.” Just another reason to invest in global health security efforts!

 Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
Have you signed up for our workshop yet? From July 18-20th, you can engage with biodefense experts in the field and those on the front lines of global health security. Our workshop will not only cover pandemic preparedness and vaccine development (it’s the centennial of the 1918/1919 pandemic after all!), but also biosecurity in this age of DIY genome editing and the future of the GHSA.

The Missile Technology Control Regime at 30
A few weeks ago, the James Martin Center for Nonproliferation Studies held an event on the Missile Technology Control Regime and two of GMU’s biodefense graduate students were able to attend and report back to us. Christopher Lien and Shauna Triplett have provided us with detailed accounts of the talks incase you missed the event. Lien notes that “A recurring theme in the discussion centered on the need for consensus within the nonproliferation community. Ambassador Piet de Klerk, former Chair of the MTCR, emphasized that one must maintain a realistic yet ambitious agenda when interfacing with both member states and non-member states. Learning where the ‘red lines’ are in each individual state’s case and crafting an appropriate plan of action lends itself to fostering a culture of consensus.” Triplett highlighted some of the successes and failures, noting that “The reflection of accomplishments also calls for the acknowledgement of shortcomings. The biggest concern for the regime is its inability to keep up with technology. Controls are harder to place on complicated weaponry and strategies have not become any simpler to achieve. The regime is faced with the task to update its objectives in order to meet these long-term challenges.”

Implementing the Global Health Security Agenda: Progress and Impact from U.S. Government Investments
The latest report has been released from USAID on the GHSA and U.S. support. As funding for global health security is being jeopardized but the threat of infectious diseases has not waned, the future of the GHSA and U.S. involvement is highly concerning. “In 2017, there were more than 25 reported public health emergencies in U.S.-assisted GHSA countries. Partner countries detected, led the response to, and contained outbreaks, including dengue fever in Burkina Faso and the Marburg virus in Uganda, by using the improved capacities built with the help of the United States and other GHSA partners. USAID’s broad-base development programs have helped to build capacity in countries to train the next generation of health care workers, strengthen community-based surveillance and improve long-term capabilities to prevent, detect and respond to outbreaks.” Within the report, you can find sections on U.S. government investments in building global health security capacities and examples of implementation across each action package. For example, within the Antimicrobial Resistance (AMR) action package, one example was “In Guinea, Liberia, and Sierra Leone, about 38,000 health care workers, community health agents, and others who come in contact with patients were trained in infection prevention and control (IP ) standards and practices. In Sierra Leone alone, 303 health facilities received training and mentoring to improve IP and prevent the spread of AMR.” In the Real-Time Surveillance action package, “Vietnam piloted event-based surveillance with community engagement in detecting and reporting unusual health events and more than 100 local outbreaks were reported in the first six months as a result. This initial success lead to a plan for national scale-up in 2018.”

U.S. Antibiotic Resistance Surveillance Findings 
CDC surveillance efforts for AMR across several states have found some worrying incidence rates of multi-drug resistance infections. Joint efforts between the CDC and local health departments are a newer approach to not only understanding the burden of AMR within the United States, but also developing response capabilities. Currently, surveillance efforts are scattered, which means that a true understanding of the scope and magnitude of this complex biological burden is rather limited. The latest joint efforts “report that the overall annual incidence of carbapenem-nonsusceptible Acinetobacter baumannii is 1.2 cases per 100,000 persons, and that nearly all the cases were healthcare-associated. The incidence rate is lower than those reported for other invasive, healthcare-associated bacterial pathogens, including carbapenem-resistant Enterobacteriaceae (CRE), methicillin-resistant Staphylococcus aureus (MRSA), and Clostridium difficile.” Interestingly, they found that 99% of patients had some exposure to a healthcare facility or to an indwelling device (catheter, central line, etc.).

Stories You May Have Missed:

• One Health Commission Opportunities Bulletin Board – “The global One Health Community has long called for a mechanism to share and identify relevant educational, employment, and funding opportunities. In past years there have been challenges in making the world aware that the Commission is trying to help in this way, receiving announcement requests, getting them posted on the Opportunities webpage and included in One Health Happenings News Notes in a timely manner.
   Starting in 2018, we are trying a more interactive, honor system-driven, series of online One Health Opportunity Bulletin Boards that will include links to ongoing One Health educational programs. The global One Health Community is encouraged to both submit and review announcements here. (https://goo.gl/58raog).”
• PLOS Disease Forecasting & Surveillance Channel– PLOS has a great new source for forecasting and surveillance research. You can find articles from syndromic approaches to examining viral agents among febrile patients, global influenza seasonality, and more.

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport