Pandora Report: 1.25.2019

Need a Dirty Tissue? You Can Pay $80 For a Box of Them
In what we’re hoping is a joke, a new start up has released a product to help spread germs – Vaev Tissue.“We believe using a tissue that carries a human sneeze is safer than needles or pills,” read the note that came with the product, written by the founder of the company. Wipe your nose with the sullied tissue, and you’ll “get sick on your own terms.” Similar to the chicken pox lollipops being spread around a few years back, this is basically the adult version of trying to pick your poison and get sick when you want to versus by surprise. In the case of Vaev Tissue, the founder emphasizes that this is a luxury product -“That kind of freedom, that kind of luxury to choose—I mean, we customize everything in our lives and we have everything the way that we want it, so why not approach sickness that way as well?” Since there are so many jokes to be made at this ridiculous “luxury product”, we’re just going to let you run with it…

Making Sense of the 2018 National Biodefense Strategy
The National Biodefense Strategy was released in September and “continues to reinforce the broad scope of the biological threat, including naturally occurring infectious disease, the deliberate use of bioweapons by states, and the growing presence of non-state actors—and now acknowledges new stakeholders within biodefense: the enthusiast community, which includes do-it-yourself biologists.” Last week though, Pacific Northwest National Laboratory released a publicly available (and free!) tool, B-PLAT, which stands for the Biodefense Policy Landscape Analysis Tool. Called the “spaghetti monster”,  this tool helps visualize the relationships between agencies, their responsibilities, and the complexity of preparing for and responding to biological threats. “B-PLAT 2.0 aims to tackle a mountain of useful information that, unfortunately, can be cumbersome to navigate. For instance, responsibilities are frequently assigned to multiple designees; it is not uncommon to find one responsibility assigned to five or more agencies, with no delineation of specific roles. It is also common for seemingly overlapping responsibilities to be assigned to disparate agencies. For example, we identified more than 20 responsibilities for disease surveillance across all sources, assigned to at least five federal agencies and all state, local, tribal, and territorial governments. One federal law directs the Department of Health and Human Services to ‘establish a near real-time electronic nationwide public health situational awareness capability,’ while another law tasks the Department of Homeland Security with detecting any ‘biological event of national concern’ by integrating data from human health, animal, plant, food, and environmental surveillance. In B-PLAT 2.0, both of these responsibilities are tagged with the new strategy goal (‘Enable Risk Awareness to Inform Decision-Making’), the old pillar (‘Surveillance & Detection’), and the activity (‘surveillance’) to help users identify similar responsibilities.” In truth, the dynamics of biodefense can be confusing – with so many agencies, programs, products, etc. The effort by B-PLAT to help bring clarity to national biodefense strategies is wholly appreciated.

New Era of Epidemics- A Rival to Climate Change in Risk to Global Businesses
The World Economic Forum recently collaborated with the Harvard Global Health institute to provide a white paper on the impact of infectious disease outbreaks on the business community and society. You can read the report – Outbreak Readiness and Business Impact: Protecting Lives and Livelihoods across the Global Economy here, which notes that “Economists estimate that, in the coming decades, pandemics will cause average annual economic losses of 0.7% of global GDP – a threat similar in scale to that estimated for climate change. As this report makes clear, this is a level of risk that businesses can no longer afford to ignore.” As the Global Risks Report noted last week, the world is considerably vulnerable to emerging infectious disease threats and risks posed by biotechnologies. “‘Outbreaks are a top global economic risk and – like the case for climate change – large companies can no longer afford to stay on the sidelines. Business leaders need to better understand expected costs of epidemics, mitigate these costs and strengthen health security more broadly,’ said Vanessa Candeias, Head of the System Initiative on Shaping the Future of Health and Healthcare and Member of Executive Committee at the World Economic Forum.”

 Biodefense MS and PhD Open Houses
Looking to improve your biodefense knowledge while obtaining a graduate degree? The Schar school Biodefense program is the place for it – from anthrax to Zika, we’ve got you covered. We’ve got two events coming up that you won’t want to miss if you’re looking to invest in your education. Thursday, February 21st (6:30pm) we’ll be hosting a Master’s Open House and on Wednesday, March 20th (7pm) there will be a PhD Open House – both at the Arlington campus. These are great opportunities to hear about the biodefense programs, meet faculty and students, and learn how you can become a biodefense guru through our in-person and online programs.

Chemical Weapons – From Sanctions to ISIS and the Long-term Effects of Sarin
CW news has been quite extensive this week as the EU hit Russia and Syria with sanctions related to chemical weapons use. This is the first time the EU has imposed sanctions for chemical weapons use and are in relation to the ongoing use of chemical weapons in Syria an the poisoning of two in the UK last year. “The EU travel bans and asset freezes target ‘the two GRU [Russia’s intelligence agency] officials … responsible for possession, transport and use in Salisbury (UK) of a toxic nerve agent,’ as well as the head and deputy head of the organization, EU foreign ministers wrote in a statement.” In other news…Iraqi scientist Suleiman al-Afari is reporting that he helped ISIS build chemical weapons when the militants rounded up workers and pressed them into service. While he is a geologist and was hoping to keep his job at the Ministry of Industry and Minerals, they asked him to help make chemical weapons. “Afari knew little about the subject, but he accepted the assignment. And so began his 15-month stint supervising the manufacture of lethal toxins for the world’s deadliest terrorist group. ‘Do I regret it? I don’t know if I’d use that word,’ said Afari, who was captured by U.S. and Kurdish soldiers in 2016 and is now a prisoner in Irbil, the capital of Iraq’s semiautonomous Kurdish region. He frowned, his fingers flicking a gray-stubbled cheek. ‘They had become the government and we now worked for them,’ he said. ‘We wanted to work so we could get paid’.” Afari recounts these events while serving on death row – discussing his recruitment into ISIS and the group’s successful attempt at making sulfur mustard. “Progress on the program appears to have stalled in early 2016, after U.S. and Iraqi leaders launched an aggressive campaign to destroy production facilities and kill or capture its leaders. Yet, the threat has not been entirely erased. Islamic State leaders moved equipment and perhaps chemicals from Iraq to Syria in 2016, Iraqi officials say, and some of it may have been buried or hidden. Moreover, the knowledge and skills acquired from Afari and other veterans of the program undoubtedly still exist, tucked away in computer files, flash drives and in the memories of the surviving participants who scattered as the group’s self-proclaimed caliphate collapsed, Western officials and terrorism experts said.” While there’s a lot of talk about chemical weapons, what are the actual effects? A systematic review was just conducted by the National Toxicology Program (on behalf of the NIH Countermeasures Against Chemical Threats program) regarding the long-term neurological impacts of acute sarin exposure in both humans and animals. For visual and ocular effects- “Case reports or case series have reported that subjects exposed to sarin occupationally or via terrorist attacks complained of vision problems for weeks to years after exposure. There is a consistent pattern of findings that pupil constriction from acute sarin exposure gradually normalizes in the following week to several months. There is a moderate level of evidence from human studies that sarin has negative effects on vision in the intermediate time period including decreases in visual evoked potentials.” For learning, memory, and intelligence- “Experimental studies in rats found consistent sarin-related effects on learning and memory that were apparent for days, weeks, and months after sarin exposure. The evidence from human studies for effects on learning and memory during the initial period is inadequate. In the extended period, there is a moderate level of evidence that sarin exposure is associated with impaired learning and memory based on epidemiological studies and a low level of evidence from experimental animal studies.” The Department of Health and Human Services has also just released resources for fourth generation agents (i.e. Novichoks) – from safety awareness for first responders to medical management guidelines.

Bavarian Nordic Announces Additional Smallpox Vaccine Manufacturing Option
Bavarian Nordic has just announced that BARDA has exercised an option under their contract for smallpox vaccine (freeze-dried MVA-BN). “The option, valued at USD 44 million, will cover qualification of the new fill-finish facility, currently being established at the Company’s manufacturing site in Denmark, as well as transfer and validation of the freeze-drying process. The majority of this contract option is expected to be revenue recognised in 2019 and 2020. This is the second option exercised under the contract. In 2017, BARDA exercised an option of USD 37 million to cover development costs associated with the Phase 3 study required for the eventual approval of the freeze-dried MVA-BN smallpox vaccine. This Phase 3 will be initiated in the first half of 2019.”

Concerns for Flu-drug Resistance
Concerns for resistance to a new flu drug – the antiviral baloxavir marboxil (Xofluza) -are growing as Japanese researchers discussed H3N2 mutations that help support resistance. “Baloxavir is the first novel flu treatment approved by the FDA since it cleared oseltamivir and zanamivir, both neuraminidase inhibitors, in 1999. The FDA approved baloxavir in October 2018. Sporadic resistance to osteltamivir has been reported over the years, and experts have said flu drugs with different mechanisms of action are needed to provide more options for treating resistant flu. The new drug, discovered by Japan-based Shionogi and developed by Roche, is a single-dose treatment approved in the United States for uncomplicated flu in patients ages 12 and older. Japanese researchers who have been monitoring baloxavir’s susceptibility to circulating flu strains said that, during phase 2 and 3 trials, some patients who got baloxavir and were infected with 2009 H1N1 and H3N2 strains containing certain substitutions had longer virus shedding and time to symptom alleviation. The patterns they saw suggested that the incidence of reduced susceptibility to baloxavir was higher than to oseltamivir.”

Ebola Outbreak Updates
Three more cases have been identified in the DRC, bringing the total to 715 cases (49 of which are probable). The DRC Ministry of Health reported 4 more deaths due to Ebola as well. “As part of bat sampling with the US Agency for International Development (USAID) PREDICT project, scientists found Ebola genetic material and Ebola antibodies in a greater long-fingered bat from Nimba district in northeastern Liberia, according to a press release from Columbia University’s Mailman School of Public Health. The project also included researchers from Columbia’s Center for Infection and Immunity and EcoHealth Alliance. The bat species that yielded Ebola evidence is found in West Africa and other regions and is important to agriculture, because they eat insects that damage crops. Unlike other bats, the long-fingered type doesn’t roost in homes or building and instead are found in forests, caves, and mines. According to the report, Liberia’s government is using that information to teach the public about how to avoid exposure and increase their awareness of the animals’ positive impact on the environment.”

Stories You May Have Missed:

  • UK Aims to Cut Antibiotic Use by 15% in 5-year Plan– “The 5-year national action plan calls for a 10% reduction in the number of antibiotic-resistant infections in people by 2025, a 15% decrease in human antibiotic use by 2024, and a 25% decrease in the use of antibiotics in food-producing animals by 2020. To encourage development of new antibiotics, the government will test a new payment model that will reimburse pharmaceutical companies based on how valuable their drugs are to the National Health Service (NHS), rather than on the quantity of antibiotics sold.”
  • Prior Dengue Infection Protects Children Against Zika– “Children who have previously been exposed to dengue virus appear to be protected from getting sick when infected with Zika virus, according to a study published January 22 in PLOS Medicine. The study’s scientific team, led by Aubree Gordon of the University of Michigan and Eva Harris of the University of California, Berkeley, analyzed the large 2016 Zika epidemic in Nicaragua, while focusing on a pediatric cohort with a well-characterized history of exposure to the dengue virus. The cohort, established in 2004 to gather information about dengue in Nicaragua, follows approximately 3,700 children aged two to 14 years old. “What we saw was that having had a prior documented dengue infection in these kids protected them from symptomatic Zika,” Gordon says. “It didn’t protect them from getting infected, but if they got infected, they were less likely to get sick.” Children with prior dengue infection had 38 percent less risk of showing symptoms when infected with Zika than those who were dengue-free. Zika symptoms included fever, rash, conjunctivitis, muscle, joint pain and headache.”

 

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