Pandora Report: 5.25.2018

Ebola Vaccine Deployment in DRC and Nipah Virus Takes Hold in India 
The Ebola vaccine has been deployed and many are holding their breath to see if not only this new tool works, but if lessons were truly learned from the last outbreak. As of May 21st, there were a totally of 58 cases, including 27 deaths. 28 of these cases were confirmed and 21 were probable. So far, five healthcare workers have been infected, with four of them confirmed and two deaths. “Currently, WHO considers the public health risk to be very high at the national level due to the serious nature of the disease, insufficient epidemiological information and the delay in the detection of initial cases, which makes it difficult to assess the magnitude and geographical extent of the outbreak. The confirmed case in Mbandaka, a large urban centre located on major national and international river, with road and air transport axes, increases the risk both of local propagation and further spread within DRC and to neighbouring countries. The risk at the regional level is therefore considered high. At the global level, the risk is currently considered low.” In response to the outbreak spreading to a larger, metropolitan area, many are wondering what cities nearby should start preparing for potential cases. Such concern is especially pertinent as it was reported that three infected patients fled an isolation ward and posed a potential threat for disease transmission. In efforts to identify potential areas at an increased risk due to travel, researchers used “flight data from the airports in Mbandaka, Kinshasa, and Brazzaville–those nearest Bikoro–EcoHealth Alliance has found the following cities to be most closely connected to the point of origin of the ongoing Ebola outbreak – Pointe-Noire, Republic of Congo, Adidas Ababa, Ethiopia, Brazzaville, DRC, etc.” Border closure is also frequently discussed during outbreaks, but realistically, how would it work? “Researchers who have studied earlier border-crossing outbreaks say the checks amount to little more than political theater. They do little to curb the spread of a disease, but they are likely to apprehend uninfected travelers, slow down commerce, and most importantly, impede the delivery of relief supplies. In a worst-case scenario, health stops may cause infected people to sneak to border crossings where checks haven’t been set up, spreading disease as they go.”  Money is starting to trickle in as the World Bank, the United States, and Germany, have contributed a joint $25 million to the DRC outbreak. The WHO is reportedly working with nine neighboring countries of the DRC to help contain the outbreak and prevent its spread. While all eyes have been on this outbreak, many are trying to draw attention to a very serious outbreak of Nipah virus in India. 10 people have died so far in the outbreak, including a nurse who was treating patients. “The first cases were reported Saturday in a family from Kozhikode, and then India’s Ministry of Health and Family Welfare and the World Health Organization were contacted, Vijayan’s office said Monday via Twitter. Two brothers in their late 20s and their aunt, 50, died from the virus, while their father, 56, remains on life support.” These outbreaks will surely be a topic of conversation during this week’s World Health Assembly at the WHO.

Worrisome White House Actions Surrounding Global Health Security
As Ebola burns through the DRC and India struggles with Nipah virus, the ability (or increasing inability?) for the U.S. to respond to such biological threats is becoming a seriously topic of concern. Within the span of a few days, the Ebola outbreak was declared in the DRC, the White House eliminated the Office of Global Health Security at the NSC, and the White House requested to rescind the $252 million in leftover Ebola response funds. These are just a handful of the the most recent red-flags for the Trump administration and its worrisome approach to health security. Kenneth W. Bernard asks “Has our national security leadership forgotten that, in 2001, anthrax-laced letters killed five and sickened 17 others in multiple states? Or that in 2014, 11 people were treated for Ebola in the United States, resulting in two deaths and widespread panic that nearly shut down the city of Dallas? Or that smallpox killed more people in the 20th century than all the wars of that century combined?” The Editorial Review Board at the New York Times has also cited concerns surrounding the amnesiac approach to Ebola the administration has taken– “The Trump administration has also failed to seek renewed funding from Congress for a global health security initiative begun after the 2014 epidemic. The goal of that initiative was to help high-risk countries prepare for future disease outbreaks in order to prevent pandemics. The White House has touted the success of those efforts but has done nothing to keep them going. And as funds have dried up, the C.D.C. has been forced to scale back or discontinue programs in some of the most vulnerable countries.”

WHO and World Bank Group Team Up for Global Health Security
In response the global threat of infectious diseases, the WHO and Work Bank Group have launched a new monitoring/reporting mechanism. “WHO Director-General Dr Tedros Adhanom Ghebreyesus and World Bank Group President Dr Jim Yong Kim co-led the creation of the Global Preparedness Monitoring Board, launched today on the margins of the 71^st Session of the World Health Assembly. The Board will be co-chaired by Dr Gro Harlem Brundtland, former Prime Minister of Norway and former WHO Director-General, and Mr Elhadj As Sy, Secretary General of the International Federation of the Red Cross and Red Crescent Societies. It will include political leaders, heads of UN agencies and world-class health experts, serving in their individual, independent capacities. ‘The ongoing Ebola outbreak in the Democratic Republic of the Congo is a stark reminder that outbreaks can happen anywhere, at any time,’ said Dr Tedros. ‘Part of being prepared is having a means of assessing progress made at all levels, by all actors, identifying gaps, including in financing, and making sure all actors are working together, pulling in the same direction. I’m proud of the work we’ve done together with the World Bank Group to establish the Global Preparedness Monitoring Board, and delighted that it will be led by such exceptional global health leaders,’ he added.”

Summer Workshop – Global Health Security
Don’t miss the chance to discuss these very issues at the Schar Summer Workshop on Pandemics, Bioterrorism, and Global Health Security. This workshop will include frank discussions with professionals and experts regarding the challenges of global health security, the current Ebola outbreak and vaccine, developing MCM, the democratization of science, and more. The early registration discount will end June 1st, so make sure you register soon!

Pandemic Preparedness in the Wake of Ebola -CSIS Symposium
Schar Biodefense graduate student Stephen Taylor recently attended the Center for Strategic & International Studies (CSIS) event on May 17th, in which global health security leaders from around the world discussed pandemic preparedness. Taylor notes, “Dr. Morrison and Dr. Borio discussed the importance of lessons learned during the 2014-2016 West African Ebola pandemic to global health security. In Nigeria, for instance, where Ebola containment efforts were successful, investments in detection and response capacities made for the Nigerian polio eradication program were instrumental in stopping Ebola. Surveillance systems and trained health care workers were embedded at the community level and field epidemiologists were ready to be deployed.”

 The Smithsonian’s “Outbreak: Epidemics in a Connected World”
Biodefense graduate student Zach Goble is reporting out on the newly opened exhibit at the Smithsonian’s National History Museum of Natural History. The museum “launched Outbreak: Epidemics in a Connected World, a new exhibit highlighting the impact infectious diseases have around the globe. The launching of this exhibit could not be more timely on the 100th anniversary of the 1918 influenza pandemic that shook the world. To officially announce and celebrate the opening of this new exhibit, the American Society for Microbiology (ASM), National Institute of Allergy and Infectious Diseases (NIAID), the National Center for Immunization and Respiratory Diseases (NCIRD) at the Centers for Disease Control and Prevention (CDC), the American Society of Virology (ASV), and Research America all partnered together to brief the public on infectious diseases and the vaccines that stop them in their tracks”

NACCHO Radiation Readiness Twitter Chat
Don’t miss out on this June 5th chat to increase awareness of radiation preparedness. “The NACCHO Twitter handle (@NACCHOalerts) will be hosting the chat using #RadReady. The target audience for the Twitter chat is federal, state, and local health department representatives hoping to learn more about radiation preparedness and engage in conversation with their public health peers on radiation preparedness topics. All Twitter users are also are welcome to participate. Topics scheduled to be covered during this chat include: supporting mass care operations, dispelling common radiation myths, radiation response volunteers, etc.”

2018 George Mason 3MT – Biodefense
You can catch a glimpse at recent biodefense PhD graduate Chris Brown presenting his dissertation in under 3 minutes in the GMU 3MT competition. In the GMU 3-Minute-Thesis competition video, you can watch Chris (5:55-8:50) discussing his work – Protecting Critical US Workers from Occupational Exposure to Emerging Infectious Diseases. Congrats Chris!

Stories You May Have Missed:

• Surviving the 1918/1919 Pandemic– Jose Ameal discusses what it was like living through the 1918/1919 pandemic and the very real fear that was pervasive across the globe. “‘So many dead’, recalls Mr Ameal, now aged 103, of what he saw that autumn of 1918, when he caught the virus known around the world as Spanish flu – a pandemic that is thought to have killed at least 50 million people.”
• Theranos and Ebola – The wondrous possibility of rapid disease detection that was promised with Theranos has been dead for a while now, but recently, a report regarding their attempts to interject themselves into the 2014 Ebola outbreak have been shocking. USAID’s Jeremy Konyndyk details Theranos’s attempts to get involved in the outbreak, despite knowing their tests were flawed. “Whatever their motive, by 2014 they were clearly aware their tech didn’t work. And yet they were actively pitching it for use in the biggest outbreak emergency the world had seen in years.”

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