Pandora Report: 4.19.2019

Happy Friday all! We hope this morning finds you well and ready for your weekly dose of all things biodefense. As we’re getting closer to the May 1st discount deadline, have you registered for the Summer Workshop on Pandemics, Bioterrorism, and Health Security?

 Measles Cases Continue to Grow and the Implications for Biodefense
90 new cases have been identified in the last week, bringing the 2019 cases to 555 which means we’re on track to see more cases in 2019 than any years since the disease was eradicated in the U.S. in 2000. “So far this year 20 states have confirmed measles, including Maryland, which recorded its first case of the year. Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Kentucky, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Oregon, Texas, and Washington, have all recorded cases. The number of affected states is likely to increase to 21, as Iowa today reported that a person from the northeastern part of the state was diagnosed as having measles, and likely contracting the disease on a recent trip to Israel. The Iowa Department of Public Health (IDPH) said the case-patient has been complying with health officials.” Even worse, the WHO has reported that globally, measles cases have risen 300%. The U.S. measles outbreak also has implications for biodefense though, as response efforts are draining resources we depend upon for future outbreaks and even bioterrorism attacks. “This reemergence of measles teaches us two things. First, our public health system needs additional resources if it is to control the occurrence and spread of disease throughout the nation.Second, since local governments — including New York City — are having to spend their limited public health resources to contain diseases like measles, they will not be sufficiently prepared for large-scale biological events such as a bioterrorist attack or an infectious disease pandemic. If measles draws down New York’s resources now, the city will be less able to withstand the next major biological event. Devastation could be vast and swift, followed quickly by an impact on the national economy that we cannot afford.” While many might see vulnerabilities and weaknesses, the measles outbreaks have also shown that these surveillance systems do work and that vaccination programs can be rapidly initiated…so sure, we have work to do, but in many ways we have shown the progress that’s been made.

 Book Review – The Alphabet Bomber: A Lone Wolf Ahead of His Time
Looking for a new book? GMU Biodefense doctoral alum Dr. Keith Ludwick has provided us with a great review of Jeffrey D. Simon’s latest book on the Alphabet Bomber. “While not necessarily a textbook, A Lone Wolf Terrorist Ahead of His Time offers insight of use to a wide variety of individuals including scholars, practitioners, and students. By presenting detailed information about the history of Kurbegovic, his terrorist attacks and plots, and arrest, Simon provides a resource for future investigators and practitioners from which to draw information and details pertinent to their work. Of note, investigators who seek information about the ‘early’ use of chemical weapons by lone wolf terrorists, Kurbegovic’s case, as presented by Simon, would be particularly interested in Simon’s discussion. Kurbegovic’s represents a lone wolf who assimilated one of the largest caches of chemical weapon precursors to date (Simon, 2019, p. 115). While he did not realize his goal of fully developing or deploying a chemical weapon, it is apparent that his terrorist attacks were escalating, he had the necessary material, the motivation, and the knowledge to develop and deploy such a weapon.”

Altering an appreciative system: Lessons from incorporating dual-use concerns into the responsible science education of biotechnologists
“An important instance of this problem is the relationship between the potential of scientific advances which can greatly enhance human well-being but also find application in new or enhanced weapons of mass destruction. Clearly, preventing such weapons from becoming a normal part of conflict during a period of rapid scientific and technological change in the sciences will require an integrated system of laws and regulations implementing the international agreements. Yet it will also require that the scientific community, through their daily practice and norms of professional conduct, support the efforts to maintain and further develop relevant international treaties that seek to limit the spread of and outlaw such weapons. The purpose of this paper therefore is to examine the utility of Vickers’ concept of an Appreciative System for developing a systematic theoretical framework for understanding what change mechanism is efficacious in the education of scientists regarding the extent to which new ideas about ethics and professional responsibility can be grasped, acknowledged and applied.”

First U.S. Patients Treated With CRISPR – Gene-Editing Trials Begin
A new CRISPR study has been approved in the U.S. to help fight cancer at the University of Pennsylvania. “One patient had multiple myeloma, and one had sarcoma. Both had relapsed after undergoing standard treatment. The revelation comes as several other human trials of CRISPR are starting or are set to start in the U.S., Canada and Europe to test CRISPR’s efficacy in treating various diseases.”

 Your Cell Phone is Helping Spread Ebola
I’d be lying if I didn’t consider wiping down my phone with a disinfecting wipe when I first read that headline, but the truth is much more painful and harder to change…which is why Laurie Garrett is pulling back the curtain on the impact valuable minerals have in global health security. “One set of actions, however, can and should be taken immediately by the Trump administration, the U.N. Security Council, the G-20, and international trade offices in countries with significant mobile phone and laptop production and manufacturing facilities. It concerns the vast mineral riches in the soils of North Kivu, sales of which finance weapons purchases for all of the rival forces in the region and constitute a key incentive behind the ongoing violence. Conflict seems to have deepened in North Kivu alongside the spectacular global growth in the mobile phones market, which has made the locally plentiful black stones of columbite-tantalite, or coltan, potentially more valuable than Congo’s gold, diamonds, uranium, and other minerals and gems. (The mineral trade brings as much as $1.4 billion per year.) Coltan is a heat-resistant mix of compounds that conduct high-energy signals inside laptops, electric cars, and cell phones, allowing compressed signals to display videos and games without exploding and batteries to safely store energy. Médecins Sans Frontières and other NGOs doing humanitarian work in the region noted a clear increase in regional violence in 2018, and rape, possibly linked to higher coltan demand. Coltan is labeled a ‘conflict mineral’, which, like ‘blood diamonds,’ is meant to be shunned. Nine years ago, the U.N. Security Council passed Resolution 1952, calling for an end to the trade in conflict minerals and stipulating that ‘all States, particularly those in the region, regularly publish full import and export statistics for natural resources including gold, cassiterite, coltan, wolframite, timber, and charcoal and enhance information sharing and joint action at the regional level to investigate and combat regional criminal networks and armed groups involved in the illegal exploitation of natural resources’.” Of note – the outbreak has now topped 1,290 cases and last week, the WHO decided not to declare it a PHEIC. This outbreak is also increasingly difficult to control, as it was reported that a physician had fallen ill with the disease and had 534 contacts now requiring epidemiological efforts.

The Infectious Disease Physician Well is Running Dry
GMU biodefense doctoral student and infection preventionist Saskia Popescu discusses what the shortage of infectious disease physicians truly means for biodefense efforts. “Right now, there is an Ebola outbreak raging in the Democratic Republic of the Congo (DRC), measles spreading throughout many states due to increased rates of vaccine exemptions, and resistant microorganisms continuing to spread globally. These are just a few of the infectious disease concerns we face, but that doesn’t paint a full picture of the nuanced care these physicians provide—from complex secondary infections to health care-associated infections, there is a desperate need to fix this problem. We rely on infectious disease physicians for managing complex antibiotic regimens with comorbidities. Moreover, they are often the only providers with experience in identifying these vaccine-preventable diseases. In terms of future needs, consider the threats we know vs the ones we haven’t really experienced. Pandemics, novel diseases, newly resistant organisms, nefarious uses of synthetic biology, and even bioterrorism—these are all events or scenarios that we worry about in biodefense, and infectious disease physicians play an absolutely critical role.”

Scientists: We kept pig brains alive 10 hours after death. Bioethicists: “Holy shit”
And the award for best headline this week goes to Vox‘s Brian Resnick regarding this new finding that researchers were able to revive 23 dead pig brains after slaughter. “In a paper that reads a bit like an adaptation of Mary Shelley, researchers at Yale University describe how they were able to partially revive disembodied pigs’ brains several hours after the pigs’ death. First, the researchers took 32 brains from pigs slaughtered for food and waited four hours. Then they hooked them up for six hours to a system called BrainEx, which pumped those brains full of oxygen, nutrients, and protective chemicals. At the end of the 10 hours, the scientists found that the tissue of the pig brains was largely intact, compared to controls. Individual brain cells were up and running, performing their basic duties of taking up oxygen and producing carbon dioxide. To be clear: The neurons in these brains were not communicating, so there was no consciousness. But the cells were alive — and that alone is a very big discovery.” Following this announcement, there was likely an audible sigh from every bioethicist in the world. “’My first reaction was holy shit,’ says Hank Greely, a Stanford law and ethics professor who reviewed the findings and co-authored a commentary on the paper in Nature. ‘The conventional wisdom is brain cells die, irretrievably, after about 10 to 12 minutes without oxygen — and that’s part of the scientific underpinning for the definition of brain death, the definition of death in humans. The idea [that] after four hours with no oxygen, or glucose, or anything else, most of the cells in the pig’s brain would start functioning again? That’s astounding.’ It’s so astounding, he says, that perhaps we should reconsider the definition of death. And we should definitely consider the unexplored ethical implications of partially reviving a dead animal. Because, what if, even for a moment, that pig brain felt something?”

Base Editor Tool Accidentally Mutates RNA While Editing Targeted DNA
Whoops? “When researchers first reported 3 years ago that they had created base editors, a version of the powerful genome-editing tool CRISPR, excitement swirled around their distinct powers to more subtly alter DNA compared with CRISPR itself. But the weaknesses of base editors have become increasingly apparent, and a new study shows they can also accidentally mutate the strands of RNA that help build proteins or perform other key cellular tasks. Researchers say this could complicate developing safe therapies with the technology and hamper other research applications. Human diseases from sickle cell to Tay-Sachs are caused by a single mutation to one of the four DNA bases—adenine, guanine, cytosine, and thymine—and CRISPR has often had difficulty swapping out the bad actors. That’s in part because CRISPR cuts double-stranded DNA at targeted places and then relies on finicky cell repair mechanisms to do the heavy lifting of inserting a corrected DNA sequence for a mutation. Base editors, in contrast, chemically change one DNA base into another with enzymes called deaminases, which doesn’t require a cut or help from the cell.”

Stories You May Have Missed:

  • Family Duo Sold Body Parts Infected With HIV, Hepatitis – “A father and son have been federally charged for allegedly selling body parts on the black market they knew were contaminated with infectious diseases. Donald Greene Sr. was charged with wire fraud in relation to a years-long operation that involved selling diseased cadavers to unwitting researchers, the Associated Press reports. His son, Donald Greene II, was charged with intentionally concealing a crime. The family duo was associated with the Biological Resource Center of Rosemont, Ill., which provided human remains donated to science to medical professionals for a fee.”
  • Salmonella and the Case of the Tainted Tuna– “Late yesterday the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) announced that a line of frozen tuna tainted with Salmonella Newport is associated with illnesses in 13 people in seven states, resulting in two hospitalizations. Jensen Tuna of Houma, Louisiana, voluntarily recalled the frozen ground tuna product associated with the outbreak yesterday. The frozen tuna is individually packaged in clear, 1-pound bags and only sold wholesale in 20-pound boxes.”




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