Pandora Report: 2.8.2019

Happy Friday and welcome to our weekly biodefense round-up! This is our favorite time of year as we get to provide some great summaries of ASM Biothreats 2019 from our student reporters.

ASM Biothreats 2019
We’re excited to present our student coverage from the ASM Biothreats conference. This was an engaging few days with lots of discussion surrounding high consequence pathogen research, biotechnology, and the threat of infectious disease. From converging technologies and biorisks to global perspectives on biodefense, we’ve got coverage of some great panels and sessions with the world’s top biodefense experts. Check out the landing page here, which provides insight into our student reporters and links to their individual summaries of the events.

Ebola in the DRC – Time to Sound the Alert?
Is it time to sound the global alarm for the DRC Ebola outbreak? As two more cases were reported and cases have reached nearly 800, many wonder if the outbreak should be declared a Public Health Emergency of International Concern (PHEIC). This outbreak has been particularly challenging – from an election to armed conflict and mass displacement, it has challenged response efforts in new ways. A new article in The Lancet discusses this very issue, noting that “The legal criteria for a PHEIC have been met. The International Health Regulations (2005) (IHR) empower the WHO Director-General to declare a PHEIC. A PHEIC is an extraordinary event with public health risk to other countries that requires a coordinated international response. IHR criteria include public health impact, novelty and scale, and movement of persons. The WHO Director-General must also consider health risks, potential international spread, and EC guidance, among other factors.The report of the EC in October, 2018, expressed concern about armed conflict and new cases without known links, but advised against a PHEIC ‘at this time’. Unlike past statements, the EC did not say ‘the conditions for a PHEIC have not been met’. The DRC epidemic meets PHEIC criteria and has for some time. The IHR empower a PHEIC for ‘potential’ cross-border transmission, without waiting until international spread has occurred. The Ebola epidemic in DRC is unfolding amid regional conflict, as attacks on medical staff coincide with subsequent spikes in cases. As the authors emphasize, the WHO and its partners must work together and with others to ensure success, as international solutions to these events are only becoming more challenging and complicated. “We must plan for a future in which political violence and instability become the new abnormal.” You can also see photos from the frontline of this outbreak here.

Removing Non-medical Obstacles in the Pursuit of Global Health Security 
Speaking of strengthening global health security…GMU biodefense alumni Dr. Jennifer Osetek discussed this very issue in her doctoral dissertation. Jen received her Bachelor of Arts from Drew University in 2003. She has been a commissioned officer in the Coast Guard Reserve since 2007, teaches with Penn State University, and works as a CBRNE analyst with the Coast Guard. She received her Master of Homeland Security in Public Health Preparedness from the Pennsylvania State University in 2008. Her dissertation focused on the very real issue of non-medical obstacles – While traditional public health responses are typically focused on pharmaceutical interventions, historically there have been outside obstacles that have a major influence on the success or failure of a response. Despite their importance, these impediments are typically studied retroactively instead of being a major component of pre-planning and execution considerations. This dissertation proposed a new framework introducing four major classes of Non-Medical Obstacles (NMOs): security, logistics, communications, and social/cultural issues. When the impact of these NMOs are better understood and incorporated into future public health responses, it will be possible to provide more effective and efficient care to populations in need.

 U.S. Experiment Aims to Created Gene-Edited Human Embryos
Despite the scrutiny over He announcing he had used CRISPR to edit the DNA of human babies, a scientist in New York is working to create gene-edited human embryos. “In contrast, Dieter Egli, a developmental biologist at Columbia University, says he is conducting his experiments ‘for research purposes.’ He wants to determine whether CRISPR can safely repair mutations in human embryos to prevent genetic diseases from being passed down for generations. So far, Egli has stopped any modified embryos from developing beyond one day so he can study them. Egli hopes doctors will someday be able edit embryonic human DNA to prevent many congenital illnesses, such as Tay-Sachs disease, cystic fibrosis and Huntington’s disease. In the lab, Egli is trying to fix one of the genetic defects that cause retinitis pigmentosa, an inherited form of blindness. If it works, the hope is that the approach could help blind people carrying the mutation have genetically related children whose vision is normal.”

Antimicrobial Resistance – A Neglected Biodefense Focus
It’s easy to think that biodefense is about defending against bioterrorism or the next pandemic…or even some laboratory accident..mostly because it is all these things but also so much more. Antimicrobial resistance isn’t a flashy topic and it certainly isn’t getting its own apocalyptic outbreak movie anytime soon (hint for Hollywood, this is the topic we’re missing) but it’s been a largely growing microbial threat since antibiotics were first discovered. Pew Charitable Trusts has been working hard to combat AMR and recently discussed the role it has in U.S. biodefense efforts. “Antibiotic-resistant bacteria are not only a threat to public health in the United States, but also to national security. The federal government has recognized that antibiotic-resistant pathogens complicate soldiers’ wounds, exacerbate casualties associated with both natural and manmade emergencies, and can be weaponized by our nation’s enemies. Consequently, the first U.S. National Biodefense Strategy, released last year, highlights the need to reduce the emergence and spread of such superbugs both domestically and internationally, and accelerate the development of new drugs, diagnostic tests, and vaccines. Rick Bright, director of the Biomedical Advanced Research and Development Authority(BARDA)—part of the Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response—is among those leading the strategy’s implementation.”

One Health-Social Sciences Initiative (OHSS) Webinar in Spanish – El enfoque de “Una Salud”
The One Health Social Sciences (OH-SS) Initiative is hosting a free webinar series to feature inspirational speakers addressing the role of the social sciences in advancing animal, human, and environmental health systems. We are pleased to offer a webinar to our Spanish-speaking colleagues working to promote One Health and social science concepts in research, practice, and policy in Latin America. El Enfoque de “Una Salud” en Latinoamérica: Perú y México, A focus on “One Health” in Latin America: Peru and Mexico, will be held on Tuesday, Feb 26, 2019, from 10:00 AM – 11:00 AM EST (UTC-5). The Webinar is free to attend but you must RSVP.

Stories You May Have Missed:

• Letter Pushes for Congressional Action to Stimulate Antibiotic Development – “A coalition of drug makers, infectious disease experts, and public health advocates yesterday called on US lawmakers to pass measures that could “jumpstart” the development of critically needed antibiotics. In a letter sent to lawmakers in the Senate and the House of Representatives, stakeholders from large and small pharmaceutical companies and organizations including the Infectious Diseases Society of America, the Pew Charitable Trusts, and Trust for America’s Health asked Congress to ‘swiftly enact a package of incentives that would sustainably reinvigorate the pipeline of antibiotics while ensuring patient access and appropriate stewardship’.”
• Concerns for Resistant Flu Medications – “Microbial resistance is not reserved solely for bacteria and antibiotics; the truth is that viruses are wholly capable of mutating to become resistant against medications. Consider HIV—the virus has the ability to mutate and continue viral production in the presence of the antiretroviral drugs that are used to kill it. The same concerns exist for influenza viruses, which already mutate quite rapidly.  In late January, investigators published findings that a new influenza antiviral drug may not be as effective as originally anticipated. Marketed as a competitor for existing medications Tamiflu (oseltamivir) and Relenza (zanamivir), this new medication is called Xofluza (baloxavir marboxil) and is recommended for flu treatment. Although Xofluza doesn’t prevent the flu like the vaccine, if taken within 48 hours of becoming sick with symptoms, such antiviral drugs can help lessen the symptoms and shorten the duration of sickness. The driving point of Xofluza is that it is offered as a single dose while Tamiflu requires twice daily doses for 5 days.”