Pandora Report 1.4.2019

Happy New Year! We’re excited to start the new year with a dose of biodefense news. Here’s a good list of what to expect in science this year – hint: you might see some gene-editing and biosafety in there…

 US Healthcare Worker Brought to Nebraska for Ebola Observation
Over the weekend, it was reported that a US healthcare worker was flown from the DRC to  Nebraska Medical Center for close observation following a suspected exposure. “The health worker has no symptoms, the medical center said. If symptoms begin, the patient will be housed in the Nebraska Biocontainment Unit at the center, which was established to treat people who have serious, high-risk diseases. ‘This person may have been exposed to the virus but is not ill and is not contagious,’ said Ted Cieslak MD, infectious diseases specialist with Nebraska Medicine and associate professor of epidemiology in the University of Nebraska Medical Center College of Public Health. The healthcare worker was transported by automobile and private plane to Nebraska. Monitoring could last 2 weeks, but Nebraska Medical Center said it would not provide updates ‘unless the need arises’ or if the person is transferred to the biocontainment unit.” Very little information has been provided about the healthcare worker beyond that they are a 39-year-old physician. The DRC Ebola outbreak continues to stress resources and pose a risk for responders. WHO’s Dr. Tedros tweeted earlier that responders were attacked at Komanda. 10 new cases were reported on Tuesday, bringing the total to 600 cases in this outbreak.

GMU Master’s Open House 
Come learn about how you can earn your MS in biodefense in person or online! We’ll be hosting a Master’s Open House on Thursday, February 21st, at 6:30pm at the Arlington campus. This is a great chance to talk to faculty, learn about the admissions process, and the variety of classes we offer in global health security.

Extensively Drug-Resistant Typhoid Outbreak in Pakistan
The WHO has reported over 5,200 cases of XDR typhoid in an outbreak that began in 2016. “The circulating strain of XDR Salmonella entericaserovar Typhi, which is resistant to five classes of antibiotics, was first reported in the Hyderabad district of Sindh province in 2016 and has been spreading throughout the province since then. After health officials formally agreed to case definitions for non-resistant, multidrug-resistant (MDR), and XDR typhoid, a review of typhoid cases reported from Nov 1, 2016 through Dec 9, 2018 identified 5,274 XDR cases in Sindh province.” Outbreaks of resistant Salmonella Typhi strains have been increasing in frequency in the last few decades, which leaves many without treatment options in resource-stressed areas.

CRISPR and DIY Biohacking – An Infectious Disease Threat to Be Aware of in 2019
Everyone is making lists about which disease or biothreats to look for in 2019, but GMU biodefense doctoral student Saskia Popescu is pushing us not to forget CRISPR and other gene editing technologies. “CRISPR has great potential to improve the human condition through research, medicine, agriculture, etc. With great power though, comes great responsibility; there is a real concern that the technology is moving too fast for its own good and too fast for governance, regulation, and oversight to keep up. Biosecurity experts have been raising the red flag about the disruptive nature of genome editing, pointing out that the manipulation of biological systems and processes can have untold consequences. A recent study published by investigators from George Mason and Stanford universities notes that the technology must be taken seriously and the broader and ever-evolving landscape of biosecurity must be considered. For instance, it is possible that genome editing could one day be used to create biological weapons—think of a totally resistant tuberculosis or an influenza with increased virulence.”

Lisa Monaco Joints Blue Ribbon Study Panel on Biodefense
“The Blue Ribbon Study Panel on Biodefense welcomed former White House Homeland Security Advisor, Lisa Monaco, as a Panel Member. Monaco served as Assistant to the President for Homeland Security and Counterterrorism between 2013 and 2017. She replaces outgoing Panel Member, former Secretary of Health and Human Services Donna Shalala, recently elected to serve as a U.S. Representative for the 27th District in Florida. ‘I am delighted to welcome Lisa Monaco to the Panel. She brings a tremendous wealth of knowledge to our bipartisan team,’ said former Senator Joe Lieberman, Panel Co-Chair. ‘As Homeland Security and Counterterrorism Advisor, Lisa was responsible for advising President Obama on all aspects of counterterrorism policy and strategy, and issues ranging from terrorist attacks at home and abroad to cybersecurity, pandemics, and natural disasters. We have an ambitious agenda for 2019, so Lisa arrives at an ideal time.’ Former Secretary of Health and Human Services Donna Shalala was one of the founding members when the Panel was formed in 2014. She leaves the Panel having played a key role in advancing recommendations for better biodefense preparedness, response, and recovery – particularly at the state, local, tribal, and territorial levels.”

2018 Year in Review – CDC Looks At The Most Pressing Health Threats
The CDC is looking back to name the top health threats of 2018 – from opioid overdoses to Ebola and foodborne illness. One of the listed threats was global health security – “The most effective way to protect Americans from health threats that begin overseas is to prevent, detect, and contain diseases at their source. This year, to advance global health security and protect Americans and U.S. interests, CDC continued to support more than 60 countries in building core capacities in disease surveillance, laboratory systems, public health workforce, and emergency management and operations.” The CDC also discussed the decreasing life expectancy in the United States and challenges of responding to disease outbreaks. Not only is the goal to stop outbreaks, but ultimately prevent them. The ongoing cases of AFM and foodborne outbreaks that halted consumption of romaine lettuce, are all issues the CDC works to understand and prevent in the future.

The Universal Flu Shot Moves Within Reach
This has been almost the holy grail of biodefense – a universal flu shot to potentially halt a pandemic. “How is it possible to protect against a virus that doesn’t yet exist? By looking for the parts that don’t change, says García-Sastre, Professor of Microbiology and Medicine (Infectious Diseases) and Director of the Global Health and Emerging Pathogens Institute at the Icahn School of Medicine. ‘The current vaccine is actually very good at inducing response to the variable regions of the virus,’ says García-Sastre. ‘But there are other parts of the structure of the virus that remain unchanged, or conserved. Our idea for the universal vaccine is to induce antibodies against the conserved areas’.” Genome sequencing advances have allowed the research team to more accurately assess the surface proteins of influenza viruses. “How close is the universal flu vaccine to becoming reality? ‘Our initial findings are promising, but we still need to conduct phase II and phase III trials,’ says García-Sastre. ‘Hopefully, the vaccine could be ready in five years’.”

NIH Hospital Battles Resistant Germ in Sinks
Rare and resistant organisms has been wreaking havoc at the NIH Clinical Center for over a decade. “Researchers tracked the superbugs to sinks in patient rooms amid a freaky outbreak in 2016. Searching through genetic sequences of clinical samples collected as far back as 2006—a year after a new inpatient hospital building opened—researchers identified eight other cases for a total of 12 instances where the sink-dwelling germs had splashed into patients. The aquatic germ in these cases was Sphingomonas koreensis. Such sphingomonas species are ubiquitous in the environment but rarely cause infections. In the NIH patients, however, they were found to cause a variety of problems, including pneumonia, blood infections, a surgical site infection, and a potential urinary tract colonization. Some isolates were resistant to 10 antibiotics tested, spanning three classes of drugs. Three of the 12 affected patients died following their infection. However, they were all also suffering from severe, unrelated infections prior to exposure to the sink-based germs, the NIH researchers note.” Researchers found the germ surviving in sink faucets and fixtures, which is unusual. Replacing faucets, aerators, and mixing valves seemed to do the trick, but researchers found the areas re-colonized. Sink deposal was the next step, as well as upping chlorine concentration and hot water temperatures. “In all, the researchers suspect that ‘a single S. koreensis strain entered the water system soon after construction of the new NIH Clinical Center hospital building in 2004′ and colonized pipes before the hospital opened, while water in the plumbing was stagnant. Then, the germ ‘disseminated throughout the hospital and diversified at multiple distinct locations,’ causing a sporadic, decade-long clonal outbreak.”

Stories You May Have Missed:

  • Higher Risk of Meningitis in College Students– just another reason you want to get vaccinated before starting the campus life! “College freshmen have previously been found to have a higher risk of meningococcal disease in general than other adults their age, and several college MenB disease outbreaks have been reported recently, note the authors, a team from the US Centers for Disease Control and Prevention. The investigators used data from the National Notifiable Diseases Surveillance System and enhanced meningococcal disease surveillance to examine the incidence and relative risk of the disease among college students and non-students aged 18 to 24 years between 2014 and 2016. They also used lab methods to characterize meningococcal isolates.”
  • Measles Cases Grow in Europe – Anti-vaccination movements are growing and Europe is feeling the effects of a severe measles outbreak. “A fresh Guardian analysis of WHO data shows that measles cases in Europe will top 60,000 this year – more than double that of 2017 and the highest this century. There have been 72 deaths, twice as many as in 2017. Health experts warn that vaccine sceptics are driving down immunisation rates for measles, HPV against cervical cancer, flu and other diseases – and that their opinions are increasingly being amplified by social media and by rightwing populists equally sceptical of medical authorities.”

 

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