Pandora Report: 3.29.2019

GMU Biodefense Student Accepts CGSR Position At Livermore National Lab
We’re excited to announce that biodefense MS student Anthony Falzarano is now working with in the Center for Global Strategy Research at Lawrence Livermore National Lab. The Center for Global Security Research works on emerging national security challenges – particularly CBRN – and serves as a bridge between the fields of science, technology, and national security policy. CGSR also does substantial work with concepts of United States deterrence and strategic stability internationally. Falzarano noted that “I found the job thanks to a referral from Dr. Koblentz, and I’m super excited to apply all of the knowledge and concepts that I have been learning in all of my classes to real world US security policy work.”

 Beth Cameron Joins the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security 
Just another reason you’ll want to attend our summer workshop in July – NTI’s Beth Cameron has just joined as a speaker on all things global health security! Dr. Cameron is currently Vice President of Global Biology Policy and Programs at NTI and previously served as the senior director for global health security and biodefense on the White House National Security Council (NSC) staff, where she was instrumental in developing and launching the Global Health Security Agenda and addressed homeland and national security threats surrounding biosecurity and biosafety, biodefense, emerging infectious disease threats, biological select agents and toxins, dual‐use research, and bioterrorism. We are thrilled to have Dr. Cameron join our team of instructors and hope to see you in July!

The True Dollar Cost of the Anti-Vaccine Movement
Vaccines are pretty awesome and I, for one, am grateful to have grown up in a time when there wasn’t a debate about their usage or government conspiracies surrounding them. Unfortunately, we’re in a different situation today and there are some very real consequences of the anti-vaccine movement. Aside from the hundreds of cases of vaccine-preventable diseases, associated deaths, long-term health consequences, and strain such illnesses takes up on the healthcare and public health system…they’re really, really expensive. Maryn McKenna is breaking down the real implications of this anti-vaxxer movement – from the $800,000 price tag on one child’s tetanus treatment to the public health response price tag of $1.6 million in Washington state. “The numbers can grow much bigger still. Researchers at the CDC estimated that handling 107 cases of measles that occurred in 2011 cost state and local health departments between $2.7 million and $5.3 million. In 2014, 42 people came down with the disease after passing through Disneyland at the same time as a never-identified person with measles—and subsequently infected 90 additional people in California, 14 more in other states, and a further 159 people in Canada. The cost of controlling the outbreak, just in California, totaled almost $4 million. And in 2017, a five-month outbreak of measles in Minnesota infected 79 people and cost the state $2.3 million. The funding to support that work isn’t being conjured out of the air. It’s coming from the budgets of public agencies, which have already been facing years of cuts and have no secret stashes of discretionary money to spend.” McKenna notes that “But we can quantify the medical and public health response. It is the bottom lines on hospital bills, for medical care that would not otherwise have been necessary. (In the tetanus case, the hospital has declined to say whether the parents or their insurance will pay, or whether the hospital will eat the cost as charity care.) It’s lab work that was never budgeted for, hotel charges and gas for investigators sent out on the road, overtime hours for state police rushing emergency doses of immunotherapy across the state. Those costs are being paid by state governments, and by federal agencies such as the CDC that give states grants and loan them personnel. State and federal budgets are public money—which means those necessary bills for unnecessary outbreaks are being paid by all of us. The toll of illness may be confined to individuals, but the cost of responding to outbreaks related to vaccine refusal is a bill that we are all being compelled to pay.”

Synthetic Biology Could Bring a Pox on Us All
It wasn’t so long ago that a NIH scientist stumbled across smallpox vials in a cold-storage room and it definitely wasn’t during a time of increased concern for synthetic biology. From CRISPR babies to garage DIY biohacking kits, it seems like the last few years have been inundated with synbio conversations. Throw in the horsepox synthesis experiment in 2017 and you’ve got quite a heated conversation about the potential for synthetic biology to bring back some pretty horrible diseases we’d like to forget. “The trio published their findings in the scientific journal PLOS One in January 2018—and the blowback was swift and brutal. Critics accused Evans and Noyce of opening a Pandora’s box that could send humanity back to the dark ages of disease. The Washington Post’s editorial board wrote that ‘the study could give terrorists or rogue states a recipe to reconstitute the smallpox virus.’ Tom Inglesby, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, denounced the research on National Public Radio: ‘Anything that lowers the bar for creating smallpox in the world is a dangerous path.’ Gregory Koblentz, director of the biodefense program at George Mason University, warned in the journal Health Security that the synthesis of horsepox ‘takes the world one step closer to the reemergence of smallpox as a threat to global health security’.” The fallout of this research brought forth more concerns regarding smallpox defense, if we should destroy the samples, and the safety of synthetic biology. Sure, DARPA has launched Safe Genes and Ginkgo Bioworks is helping to improve screening tools, but “even these automated checks can’t prevent determined buyers from obtaining samples through less scrupulous vendors on the black market. As with computer viruses, new strains appear from the ether before society is aware they exist. The same is true for trying to keep ahead of potentially lethal synthetic DNA.”

Resistant Genes Found in Wastewater
Wastewater treatment plants in seven European countries have shown to carry antibiotic resistant genes. Researchers “found that the amount of resistance genes was higher in the wastewater from countries with higher antibiotic use and aligned with the levels of antibiotic resistance found in clinical isolates in the countries. The results are consistent with the north-to-south pattern that’s been observed in studies of antibiotic resistance and consumption in Europe. The genes that were detected conferred resistance to several classes of antibiotics, including genes that confer multidrug resistance and are of high concern in clinical settings. The study also identified mobile genetic elements that enable bacteria to share and spread resistance.”

Can Cockroaches in Hospital Environments Harbor MRSA?
“Cockroaches. The mere use of the word elicits shudders and retches, even more so when you consider how these critters are often associated with disease and a lack of cleanliness. These insects have an affinity for human excrement and trash, which leads many of us to hit the panic button when we see them. They’re gross when found in a home, but imagine if you stumbled across a cockroach within a hospital…Not only is it a huge patient and staff dissatisfier to see one of these insects scuttling across the floor during medical treatment, but it presents a major issue for hospital administration, which can’t easily exterminate an entire hospital with insect spray. And unfortunately, the concern over cockroaches in hospitals goes beyond just the “ick” factor; the bugs can also put patient safety at risk from an infection control perspective. Urban pests are a big enough concern that the World Health Organization (WHO) put together a report regarding the public health significance of pests in 2008. Guess which pest landed first in the table of contents? That’s right—the cockroach. Following the laboratory work, the team found that the prevalence of MRSA varied a bit between the 2 kinds of cockroaches that were captured. These 2 different kinds are the most common in domestic, industrial, and residential areas. The Periplanets americana cockroaches had a MRSA prevalence of 52.77%, while the Blattella germanica cockroaches had a prevalence of 43.33%.”

Hospital Utilizes Drones to Transport Samples
Imagine flying blood samples and other laboratory specimens across a hospital campus. Sure, you could transport them in a car or by foot…or you could fly them via drone. That’s exactly what is happening in North Carolina. “With the approval of the Federal Aviation Administration and North Carolina’s department of transportation, UPS and Matternet will conduct routine daily flights that transport medical samples. Previously, WakeMed relied on courier cars, which were subject to road delays. The drone-led deliveries entail a medical professional first loading the drone with a medical sample or specimen, such as a blood sample. From there, the drone will fly along a predetermined route to a fixed landing pad at WakeMed’s main hospital and central pathology lab.” Imagine the biohazard spill if the drone went down….

Russian Disinformation and Measles
As GMU Biodefense graduate program director Gregory Kolbentz noted, “Russia has a long history of using disinfo to compromise global health for their own political reasons: from smallpox eradication in India in 1970s to AIDS in Africa in the 1980s to measles today. No health issue is too important for the Kremlin to hijack for its own purposes.”  In the face of a 20-year high in measles cases across Europe, Russia is reportedly playing a large role in disinformation. “According to the recent study Weaponized Health Communication: Twitter Bots and Russian Trolls Amplify the Vaccine Debate, the same bots and trolls linked to Russia’s Internet Research Agency which spread discord in the 2016 US elections are the same ones feeding disinformation and contributing to the current measles crisis in Europe.  This same study attributes 93% of the vaccine narrative on Twitter originating or being amplified by Russian trolls and/or bots.”

Artificial Intelligence in Global Health
Check out this April 1st event hosted by the Bill & Melinda Gates Foundation, the Rockefeller Foundation, and the U.S. Agency for International Development’s (USAID’s) Center for Innovation and Innovation (CII). “The Aspen Global Innovators Group invite you to join us Monday, April 1st at the Aspen Institute in Washington DC for the launch of a new report and a panel conversation with experts from the public and private sector on the opportunities and challenges of exploring and applying artificial intelligence in global health. With the findings of the new report, AI in Global Health: Defining a Collective Path Forward, as background and context, the panel will discuss some of the most promising use cases of AI in healthcare, the opportunities and challenges to scaling AI in global health, and how the global health community can best accelerate the development and scale of AI in global health.”

Stories You May Have Missed:

  • Late Flu Push Means a Longer Season – “The US flu season is already a long one, with illness activity still widespread in 44 states and expected to continue for several more weeks, the Centers for Disease Control and Prevention (CDC) said in its latest weekly update. Though the level of clinic visits for flu peaked in February, the latest markers show little change from the previous week, with H3N2 viruses causing an increasing number of infections. Though 2009 H1N1 has been predominant for most of the season, H3N2 has caused more illnesses for 3 weeks in a row now.”

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