Pandora Report 10.19.2018

TGIF! Before we begin our weekly biodefense news report…a friendly reminder to avoid raw chicken as there is a considerable outbreak of multidrug-resistant Salmonella Infantis tied to raw chicken across 29 states. Check out this article on the cost and challenges of vaccine development for emerging and emergent infectious diseases.

GMU Biodefense Alum Recognized for Research Regarding Airplane Infectious Disease Transmission
GMU Biodefense doctoral alum Nereyda Sevilla is an expert when it comes to germs on a plane. In her recent article, Sevilla address the “the role of air travel in the spread of infectious diseases, specifically severe acute respiratory syndrome (SARS), H1N1, Ebola, and pneumonic plague. Air travel provides the means for such diseases to spread internationally at extraordinary rates because infected passengers jump from coast to coast and continent to continent within hours. Outbreaks of diseases that spread from person to person test the effectiveness of current public health responses.” She utilizes the STEM (Spatiotemporal Epidemiological Modeler) to assess the transmission potential for outbreaks of SARS, H1N1, Ebola, and pneumonic plague spread between people via air travel. Sevilla finds that “the comparative results of each of the four modeled diseases along with the historical accounts show the importance of the disease characteristics and the impact of the infection rate. A disease that has a long period of illness, such as SARS or H1N1, is expected to cause a higher natural spread than diseases in which the period of illness is brief. In cases in which the period of illness is short, such as pneumonic plague, those individuals affected do not have the same opportunities to infect others as do those people harboring diseases with a longer period of illness.” Due to her efforts to study air travel as a transmission mechanism, Sevilla has been awarded the Uniformed Services University Alumni Association Graduate School of Medicine Graduate of the Year and the 2018 Aerospace Physiology Paul Bert Research Award! Congrats Nereyda!

Blue Ribbon Study Panel Meeting – Biodefense Indicators: Progress in Implementing Key Elements of the National Blueprint for Biodefense
The Blue Ribbon Study Panel is hosting an event on November 14th regarding the role of the Executive Branch in implementing the National Blueprint for Biodefense. “The Panel will focus specifically on illustrative action items among those the Panel felt that the federal government could complete in the three years since releasing the Blueprint in 2015. Objectives include Discuss the development and release of the National Biodefense Strategy and opportunities associated with its implementation, review current biosurveillance and biodetection programs, and efforts to improve situational awareness of biological threats, etc.” Make sure to RSVP by November 8th!

International Infection Prevention Week
This week marks International Infection Prevention Week, which recognizes the importance of infection prevention in healthcare and the infection preventionists working to promote safe patient care. You may be wondering why infection prevention is so important but here are a few reminders – influenza, antimicrobial resistance, Ebola, SARS, MERS, measles, surgical site infections, and Clostridium difficile. Those are all infections that have harnessed the awesome transmission capacity of hospitals due to poor infection prevention. Hand hygiene is just a small piece of this, but without infection prevention, we couldn’t safely seek medical care without the risk of a diverse range of infections. Just remember – infection prevention goes beyond things like MRSA and has a vital role in emerging infectious disease response and global health security.

DRC Ebola Outbreak – Increasing Concern
The WHO convened a meeting on Wednesday of the IHR Emergency Committee to discuss the outbreak in the DRC. Following the meeting, they stated “It was the view of the Committee that a Public Health Emergency of International Concern (PHEIC) should not be declared at this time. But the Committee remains deeply concerned by the outbreak and emphasized that response activities need to be intensified and ongoing vigilance is critical. The Committee also noted the very complex security situation. Additionally, the Committee has provided public health advice below.” There have been 220 Ebola cases and 142 deaths reported. Perhaps one of the most challenging aspects of outbreak containment has been security within the area. Per the WHO release – “This outbreak is taking place in an active conflict zone amidst prolonged humanitarian crises. Approximately 8 major security incidents have occurred in the Beni area in the past 8 weeks. These factors have complicated contact tracing and other aspects of the response. Community mistrust, stemming from a variety of reasons, including the security situation, and people who avoid follow-up or delay seeking care, remain significant problems that require deepening engagement by community, national and international partners.” Laurie Garrett wrote about the significance of this situation given that it is the first Ebola outbreak in a war zone. “The view from the United States is different. Last week, the U.S. State Department deemed the security situation on the ground in the outbreak so dangerous that teams of U.S. Centers for Disease Control and Prevention experts were pulled back more than 1,000 miles away to the Congolese capital of Kinshasa.” Garrett underscores the complexity of the conflict, noting that “In the absence of U.S. engagement, the WHO must take a political lead, which is admittedly not its forte, by pulling national security and legal experts into immediate planning should a worst-case security breach occur. Waiting until a doctor is in the hands of the Mai-Mai Yakutumba, a nurse is raped by the Hamakombo, soldiers from the Congolese army shoot a contact-tracing health volunteer, or rival Mai-Mai factions get into a firefight that involves Ebola Treatment Center workers is a recipe for absolute disaster.”

Viral Misinformation – The Biggest Pandemic Risk 
Heidi J. Larson is highlighting a very real public health issue we’re not discussing – misinformation. “I predict that the next major outbreak — whether of a highly fatal strain of influenza or something else — will not be due to a lack of preventive technologies. Instead, emotional contagion, digitally enabled, could erode trust in vaccines so much as to render them moot. The deluge of conflicting information, misinformation and manipulated information on social media should be recognized as a global public-health threat.” Larson points to the vaccine denial phenomenon and those who pray upon it – “The second-most-dangerous category includes those who see anti-vaccine debates as a financial opportunity for selling books, services, or other products. (Wakefield, who maintains that financial concerns have not affected his research and that he has been unfairly vilified, gave paid testimony against the vaccine and filed a patent that allegedly stood to become more valuable were the vaccine to be discredited.) The next tier of damaging misinformation comes from those who see anti-vaccine debates as a political opportunity, a wedge with which to polarize society.” Among those who help spread misinformation is the “super-spreader” who helps spread misinformation through social media to those who also share the mistrust in vaccines. Ultimately, fixing these sources for misinformation is complex and requires considerable engagement and listening, but also supplying public health with more funding towards educational campaigns.

One Health Day – November 3!
One Health Day is just a few weeks away – what’re you doing to celebrate the importance of One Health? “The goal of One Health Day is to build the cultural will necessary for a sea change in how planetary health challenges are assessed and addressed. One Health Day will bring global attention to the need for One Health interactions and allow the world to ‘see them in action’.  The One Health Day campaign is designed to engage as many individuals as possible from as many arenas as possible in One Health education and awareness events and to generate an inspiring array of projects worldwide.”

Spikes of Pediatric Acute Flaccid Myelitis Illness
In 2014, there were surges of AFM associated with enterovirus D68 but a recent spike in pediatric cases is causing concern. “The US Centers for Disease Control and Prevention (CDC) said today that officials are investigating a spike in acute flaccid myelitis (AFM) cases, mostly in children, that looks similar to increases they saw in the late summer and fall of 2014 and 2016, with 127 cases under investigation in 22 states. So far 62 of the cases—marked by sudden onset of limb weakness and decreased muscle tone—have been confirmed, Nancy Messonnier, MD, director of the CDC’s National Center for Immunization and Respiratory Diseases, said today at a media briefing. More than 90% have been in children, and the average age is 4 years.” While the odds of AFM are rare and not caused by a poliovirus, the symptoms can be similar. Patterns appear to be seasonal and the CDC is working to identify trends and prevention efforts.

ASM Biothreats Call for Abstracts
The deadline is today for you to get an abstract in for the 2019 ASM Biothreats. “2019 ASM Biothreats, January 29–31, in Arlington, Virginia. ASM wants your research on high consequence pathogens, biological threat reduction, product development and policy. ‘Share your research with experts in academia, industry and government, who meet each year to learn from each other. This year, the meeting will focus on four areas: High Consequence Pathogen Research, Biological Threat Reduction, Product Development, and Policy’.”

Bioeducation Tool from FAS & FBI
Check out this app by the Federation of American Scientists and Federal Bureau of Investigation – the Bioagents Education App. This app details nearly 50 biological agents that are relevant to biodefense efforts and have the potential for misuse as a bioweapon.

Stories You May Have Missed:

• 2019 Nuclear Scholars Initiative – Applications are due today for this exciting opportunity. “PONI is now accepting applications for the 2019 Nuclear Scholars Initiative. Those accepted into the Nuclear Scholars Initiative are hosted once per month at CSIS in Washington, DC, where they participate in daylong workshops that include discussions with senior experts, simulations and table top exercises, research reviews, and professional development opportunities. Throughout the sessions the scholars discuss and explore a full breadth of nuclear topics from deterrence, escalation control and modernization to regional dynamics, nonproliferation, nuclear security and the future of arms control.”