Pandora Report 2.15.2019

Summer Workshop on Pandemics, Bioterrorism, and Health Security
We’re excited to announce that the Summer Workshop is now open for registration! From July 15-18, you can participate in 3.5 days filled with topics ranging from vaccine development to bioterrorism response, cyber biosecurity, global health security, biosecurity implications of CRISPR and GoF research, and so much more! Even better, if you register before May 1st, you can get the early-bird discount. We also have discounts available for returning attendees, large groups, and GMU affiliates. This is a great opportunity to learn from the top minds in the field – we hope to see you there!

Talking Biodefense with Senator Daschle
Next week GMU Schar School of Policy and Government at George Mason University will be hosting an informal discussion about key issues in biodefense with former Senator Thomas Daschle, founder of the Daschle Group and a Panel Member on the Blue Ribbon Study Panel on Biodefense. The event will be held on February 19 but is open only to Schar/GMU faculty, students, and alum. If you haven’t registered, feel free to email biodefense@gmu.edu with your GMU account for a registration link.

GMU Biodefense Student Named ELBI Fellow
For a fourth year, Schar Biodefense has a graduate student selected for the Johns Hopkins Health Security Emerging Leaders in Biosecurity (ELBI) program. Congrats to biodefense doctoral student Justin Hurt on being selected for this prestigious fellowship! In addition to his part-time studies, he is an active duty officer in the United States Army, specializing in chemical, biological, radiological, and nuclear (CBRN) matters and is currently detailed to the Federal Bureau of Investigation as a Defense Liaison in the Weapons of Mass Destruction Directorate (WMDD), where he advises the Assistant Director and WMDD staff on interagency operations and capabilities and assists in policy development. His recent experience includes positions as a section leader for the Defense Threat Reduction Agency’s CBRN/WMD Military Advsory Team program, the Army’s WMD programs manager and capabilities development coordinator with the Manuever Support Center of Excellence at Fort Leonard Wood, and as a CBRN Technical Escort Response Detachment Commander, as well as command of both chemical and infantry organizations. Justin also originated and leads the Intergancy Counter-WMD Training and Education Working Group, a collaborative inter-departmental organization dedicated to sharing WMD-related training programs and opportunities throughout the government service. His primary research interests lie in improving public-private sector education and cooperation in mitigating international spread of pandemic disease and improving biosafety procedures and training in the expanding number of pathogenic organism research facilities around the world. On being selected, Justin noted that “ELBI represents an annual cohort of future thinkers, advisors, and policy makers in biodefense that come from a wide variety of unique backgrounds and skills that bring together new viewpoints and knowledge applied to tackling some of the nation’s biggest emerging challenges, such as the illicit use of new biotechnologies or the threats to a growing bioeconomy. To be able to participate with such a highly qualified group of developing leaders in this nascent field is really humbling and I will endeavor to contribute and learn as much as I can along the way. I believe the education and perspectives I have gained from studying in George Mason University’s Biodefense Program and the interactions I have beeen fortunate enough to have had during the past two years with the Schar School have prepared me well for contributing in a significant way to the EBLI Fellowship. GMU’s Biodefense students are likewise an incredibly diverse, motivated, and highly intelligent group of future scholars and I’m proud to be able to represent them as a group and the outstanding faculty and staff of the Schar School in this opportunity, and I want to thank my professors, fellow students, and the school’s staff in supporting not only my educational development but also my desire to broaden – and I know that participating in the ELBI program will be a fantastic adjunct to my challenging and rewarding studies at GMU.” Dr. Gregory Koblentz, GMU biodefense graduate program director stated that “Justin is an outstanding student who combines a wealth of practical experience with a passion for biodefense policy. I know Justin will make an important contribution to the Center for Health Security’s objective of building a network of professionals working at the nexus of health, science, and security. This is the fourth year in a row that a student from the Schar School’s Biodefense Program has been selected to participate in the ELBI program. I am gratified to see that the excellence of our students and their unique ability to bridge the gap between science and policy is recognized and valued by the biosecurity community.”

Gain of Function H5N1 Research Resumes 
GoF research involving H5N1 is set to resume…without review comments as the review panel has kept mum. “HHS cannot make the panel’s reviews public because they contain proprietary and grant competition information” – regarding the two labs approved to run such experiments. “The outcome may not satisfy scientists who believe certain studies that aim to make pathogens more potent or more likely to spread in mammals are so risky they should be limited or even banned. Some are upset because the government’s review will not be made public. ‘After a deliberative process that cost $1 million for [a consultant’s] external study and consumed countless weeks and months of time for many scientists, we are now being asked to trust a completely opaque process where the outcome is to permit the continuation of dangerous experiments,’ says Harvard University epidemiologist Marc Lipsitch.” One of the experiments- “Kawaoka’s grant is the same one on H5N1 that was paused in 2014. It includes identifying mutations in H5N1 that allow it to be transmitted by respiratory droplets in ferrets. He shared a list of reporting requirements that appear to reflect the new HHS review criteria. For example, he must immediately notify NIAID if he identifies an H5N1 strain that is both able to spread via respiratory droplets in ferrets and is highly pathogenic, or if he develops an EPPP that is resistant to antiviral drugs. Under the HHS framework, his grant now specifies reporting timelines and who he must notify at the NIAID and his university.” Overall, many are concerned regarding the lack of transparency surrounding the decision to approve such research, especially with the amount of work that has gone into collaborative and informative discussions to help guide policy.

Ebola Outbreak Updates & Hot Zone Drama
On Wednesday, four more cases of Ebola were identified in the DRC and close-calls have prompted testing in Uganda. “A family’s transport of a Ugandan man who died on Feb 8 in the DRC’s outbreak region across the border and back into Uganda sparked intensive contact tracing, location of the body, and sample testing, according to a statement yesterday from the World Health Organization (WHO) African regional office. The 46-year-old man was a construction worker who had been living and working the DRC for the past 8 years. He was first admitted to the hospital in Bunia, one of the towns in Ituri province that has reported Ebola cases, in November 2018 with symptoms that included chest pain and a sometimes-bloody cough. After learning of the incident, Uganda’s health ministry—with support from the WHO—intercepted the man’s relatives and the vehicle with the dead body in it before they reached their village in Tororo district. A ministry burial team and surveillance officer took oral swabs, conducted a verbal autopsy, and made plans to conduct a safe and dignified burial.” If you’re still not getting enough Ebola conversations in your life, watch out for the latest National Geographic series – The Hot Zone. Adapted from the book by Richard Preston, this prime-time drama will likely provide the eagle-eyed biodefense nerd some good scientifically inaccurate depictions of the disease and response measures.

Safeguarding the Bioeconomy Event 
The NextGen Global Health Security Network & GMU Biodefense Discussion Group are hosting an event with guest speaker FBI Supervisory Special Agent Edward You. This event will be held on February 21st at 7:30pm in Arlington, and is exclusive to current Schar students and faculty. Seating is limited and to reserve your spot (RSVP is required), please contact jmarroq2@gmu.edu or staylo30@gmu.edu

Fighting Tuberculosis in the Wake of Hurricane Maria
GMU Biodefense doctoral student Saskia Popescu discusses the challenges of continuing TB control in the wake of a natural disaster. “Responders from the US Centers for Disease Control and Prevention (CDC)’s Division of Global Migration and Quarantine, Puerto Rico Department of Health, and the CDC’s Division of Tuberculosis Elimination have provided insight into their experiences following Hurricane Maria via notes from the field published in a January CDC Morbidity and Mortality Weekly Report. The authors emphasized several unique facts that challenged public health efforts in Puerto Rico. For example, less than a week after the hurricane, 84% of hospitals there had no electrical power or fuel for generators, and within the span of 2 weeks there had been 2 declarations of major disasters due to Hurricane Maria and Hurricane Irma, which passed 57 miles north.
Prior to the storms, the Puerto Rico Department of Health Tuberculosis Control Program (PRTB) worked to prepare at its six regional clinics. The department “provided all patients receiving treatment for active TB with a 1-month supply of anti-TB medications before the hurricane and encouraged patients to tell health officers at shelters about their diagnosis if they had to be relocated from their homes.” Furthermore, the Puerto Rico Health Department worked to educate and inform shelters of the potential risk for tuberculosis transmission. They also provided guidance for screening procedures that extended beyond tuberculosis. ”

The True Burden of Resistant Infections
We’ve been basing the burden of resistant infections in the U.S. on data that might not be accurate anymore. “For several years now, the most frequently cited number has been 23,000 deaths a year, a figure put forward by the US Centers for Disease Control and Prevention (CDC) in a 2013 report on the most dangerous antibiotic-resistant pathogens. The CDC calculated that number—and the estimate of more than 2 million illnesses a year caused by antibiotic-resistant bacteria—using data from the National Healthcare Safety Network, the Emerging Infections Program, the National Antimicrobial Resistance Monitoring System, the National Center for Health Statistics, and hospital surveys.” For many of us in infection prevention, this number has always seemed smaller than what we really saw on the hospital units. The CDC is working though, to update this as it’s likely these are quite conservative numbers. “Michael Bell, MD, deputy director of the Division of Healthcare Quality Promotion at the CDC, agrees. He contrasts death data with birth data, which is based on an event that generally happens in a controlled setting, with people present to record it. ‘Death data is very different,’ he said. ‘We don’t have that degree of control about understanding when someone dies, how they die, where they die, and with whom they die.’ There are other challenges in estimating US deaths from drug-resistant infections, including a lack of universal reporting of antibiotic-resistant pathogens and the absence of ICD-10 codes—the alpha-numeric codes used by physicians, health insurers, and public health agencies—that specifically denote diagnoses of multidrug-resistant infections, which are the most severe and life-threatening forms of bacterial infection.”

Zika As An Occupational Hazard for Laboratory Biomedical Research Workers
GMU Biodefense doctoral alum Chris Brown is addressing the risk that Zika poses for laboratory workers. In a letter to the editor, he and Jill Shugart describe “several reports of laboratory and biomedical research workers having been potentially exposed to Zika virus, including as a result of sharps injuries. Also emphasizes the importance of implementing appropriate controls, including proper PPE and worker training, to prevent future Zika exposures.”

Stories You May Have Missed:

  • FDA Takes New Steps to Secure Drug Supply Chain– “A key element of the U.S. Food and Drug Administration’s mission is focused on helping to ensure that all products we regulate, including drugs available to consumers, are safe and of high quality. This means working to ensure greater accountability in our nation’s drug supply chain. As part of these efforts, today, the agency is launching a new pilot project in which participants representing the drug supply chain (e.g., manufacturers, repackagers and other stakeholders) can pilot the use of innovative and emerging approaches for enhanced tracing and verification of prescription drugs in the U.S. to ensure suspect and illegitimate products do not enter the supply chain. Eligible entities may apply to participate in the program. The pilot will inform the development of the enhanced electronic, interoperable track-and-trace system for industry set to go into effect in 2023 as part of the Drug Supply Chain Security Act. This new program will pilot technologies that may become part of our enhanced expectations for reliable track-and-trace systems. The new system will be aimed at reducing diversion of drugs distributed domestically and will help keep counterfeit drugs from entering the supply chain, and ultimately, reaching patients.”

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