Pandora Report: 7.12.2019

 Summer Workshop Welcomes New Instructor
We’re excited to announce that Nancy Connell will be joining us for the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security next week. Dr. Connell “is a Senior Scholar at the Johns Hopkins Center for Health Security and a visiting Professor in the Department of Environmental Health and Engineering at the Johns Hopkins Bloomberg School of Public Health. She is a microbial geneticist by training. Dr. Connell’s work at the Center is focused on advances in life sciences and technology and their application to a number of developments in the areas of biosecurity, biosafety and biodefense.  Her research projects analyze novel biotechnologies that might impact the development of Global Catastrophic Biological Risks (GCBR) in ecosystems, and the development of surge capacity for medical countermeasure manufacturing and other response mechanisms in the event of a global pandemic or other global catastrophic event.  Dr. Connell is a member of the Board on Life Sciences and is a National Associate of the National Academies of Sciences, and she completed a six-month sabbatical as Visiting Scholar at the Board on Life Sciences.  Dr. Connell is a member of the US-CDC’s Biological Agent Containment Working Group in the Office of Public Health Preparedness and Response and was recently appointed the serve on the National Science Advisory Board for Biosecurity. Before joining the Center, Dr. Connell was Professor and Director of Research in the Division of Infectious Disease in the Department of Medicine at Rutgers New Jersey Medical School and the Rutgers Biomedical Health Sciences.  Dr. Connell’s major research focus was antibacterial drug discovery in respiratory pathogens such as M. tuberculosis and B. anthracis. Dr. Connell chaired the Institutional Biosafety Committee of Rutgers University and directed NJMS’s biosafety level three containment laboratory beginning in 1997. Her recent work focused on the use of predatory bacteria as novel therapeutics for treatment of Gram negative bacterial infections, including MDR strains and select agents. Dr. Connell was continuously funded by the NIH, the Department of Defense and DARPA, industry, and/or other sources from 1992 to 2018.  She received a PhD in microbial genetics from Harvard University.” If you’re not able to make the workshop next week, keep an eye on the @PandoraReport twitter for updates.

Is the U.S. Ready for A Tech War?
GMU Biodefense doctoral alum Daniel Gerstein discusses technological priorities and how the US invests in technological advances related to national security. “Today, important technology development changes are underway that could dramatically affect world order. The continued shift in global research and development spending highlights how far U.S. dominance has eroded. In 1960, when considering federal, industry and academia, the United States accounted for 69 percent of the global R&D. By 2016, the United States accounted for only 28 percent of the global R&D. With such a shift, it is no wonder that U.S. technology leadership and superiority can no longer be assured.” Gerstein notes that “the Trump administration should develop technology priorities, and technologies considered vital to U.S. economic and national security should receive investments to stimulate advances and promote U.S. leadership. The administration’s recent call to have greater industry investment in basic research, in lieu of government funding, seems shortsighted and should be reconsidered given the emerging tech war. A reevaluation of programs such as export controls, programs for approving foreign investment transactions, and intellectual property protections would also be useful to both protect and promote U.S. technology.”

Ebola Outbreak – Cases Surge with Violence – and How the CDC Made a Synthetic Ebola Virus to Test Treatments
Recently, the WHO Director General, Dr. Tedros, warned that instability in the DRC is fueling the Ebola outbreak. “In an interview with The Guardian, World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus, PhD, said the political climate in the Democratic Republic of the Congo (DRC) is preventing an end to the current Ebola outbreak. ‘The root cause of the problem is lack of peace, the lack of a political solution. The incidence of Ebola, malaria and cholera is the symptom,’ Tedros told the British newspaper. ‘I know we can finish this Ebola outbreak…But at the same time it can come back because all the [political and security] conditions remain the same.’ The DRC outbreak expanded by 10 cases today, to 2,428 cases, according to the WHO’s online Ebola dashboard. Tedros’s comments come 1 day after the UK’s International Development Secretary, Rory Stewart, returned from a trip to the DRC and called on G7 world leaders to increase funding for outbreak response. ‘There is a real danger, that if we lose control of this outbreak, it could spread beyond DRC’s borders to the wider region and the wider world. Diseases like Ebola have no respect for borders and are a threat to us all,’ Stewart said in a Department for International Development (DID) news release.” Ebola has been challenging response efforts since 2013 and the CDC has been working to combat testing and treatment roadblocks through a unique strategy – a synthetic Ebola virus. Helen Branswell recently discussed how the CDC created a synthetic version of the Ebola virus to help guide diagnostic tests and experimental treatments…and it ended up working. “The research, conducted in the agency’s most secure laboratories — BSL4 — showed that even though the tests and two of the treatments being used in the field were developed based on earlier variation of Ebola viruses, they continue to be effective against the virus causing the current outbreak, the second largest on record. The results, reported Tuesday in the journal Lancet Infectious Diseases, are encouraging, but also raise questions about why outside research groups have not received direct access to viral specimens from the DRC and instead had to create a synthetic version. The paper noted that there have been no Ebola samples available to the scientific community from the past four outbreaks in the DRC. Those outbreaks occurred in 2014, 2017, and 2018.”

Mason Hosts Department of Homeland Security Centers of Excellence 2019 Summit 
“George Mason University will host Homeland Security Challenges: Evolving Threats and Dynamic Solutions, a Department of Homeland Security Centers of Excellence Summit, July 31-Aug. 1 at its Arlington Campus. The summit is an opportunity to gather some of the nation’s best academic, public, and private sector leaders to discuss strategies for advancing the DHS mission. Sponsored through the DHS Science and Technology Directorate Office of University Programs, the Department of Homeland Security Centers of Excellence network is a consortium of universities conducting groundbreaking research to address homeland security challenges by developing multidisciplinary, customer-driven, homeland security science and technology solutions and helping train the next generation of homeland security experts. The summit provides a platform for creating connections, fostering collaborations and inspiring new ideas to address homeland security challenges. It also provides an opportunity to highlight student research and innovative problem solving.”

ASPR Updates- the SNS and Biodefense Strategy Summit 
The Office of the Assistant Secretary for Preparedness and Response (ASPR) just released several good resources for the biodefense community. First, they’re celebrating the 20th anniversary of the Strategic National Stockpile (SNS) and you can find some great information on it here. “When state, local, tribal, and territorial responders request federal assistance to support their response efforts, the stockpile ensures that the right medicines and supplies get to those who need them most during an emergency. Organized for scalable response to a variety of public health threats, this repository contains enough supplies to respond to multiple large-scale emergencies simultaneously.” Next, ASPR provided the transcripts from the Biodefense Summit that occurred in April. “The Biodefense Summit, was held on April 17, 2019 in Washington, D.C.  The Summit aimed to engage the biodefense stakeholder community to inform national biodefense enterprise efforts to counter biological threats, reduce risk, prevent, prepare for, respond to, and recover from biological incidents. The Summit informed stakeholders of the implementation of the National Biodefense Strategy. “

Arizona Battles Hepatitis A
Arizona is working to contain an outbreak of hepatitis A and GMU biodefense doctoral student Saskia Popescu discusses how they’re incorporating healthcare providers into these efforts. “Despite making great strides in reducing the burden of HAV, Arizona is experiencing a growing outbreak that began in late 2018. Currently, there have been 424 cases and 3 deaths documented since November 2018, with a 79% hospitalization rate. The outbreak has spread to 7 counties within Arizona, including the largest—Maricopa. A total of 48% of Arizona’s HAV cases have occurred in those individuals who are homeless and report drug use, 25% of cases have been in those reporting using drugs (ie, no reported homelessness), and 22% of cases are in individuals with no identified risk factors. Public health investigators found that 28% of the cases have been in patients who are currently or were recently incarcerated. Five percent of the HAV cases in this ongoing Arizona outbreak have been reported in patients who report homelessness, but no drug use.  More recently, an employee at a restaurant in Maricopa County tested positive for HAV and may have exposed people visiting the restaurant over a 9-day period from late May to June. Public health officials are encouraging those patrons to get vaccinated against HAV to reduce the risk of transmission.”

Worldwide Reduction in MERS-CoV Cases Since 2016
In the latest CDC Morbidity and Mortality Weekly Report, they note the overall decline in MERS-CoV cases and mortality since 2016. “From 2012 through May 31, 2019, Middle East respiratory syndrome coronavirus (MERS-CoV) has infected 2,442 persons and killed 842 worldwide. MERS-CoV is currently circulating in dromedary camels in Africa, the Middle East, and southern Asia; however, most cases of human infection have been reported in the Arabian Peninsula. Large hospital outbreaks in 2014 and 2015 motivated affected countries to substantially invest in prevention and control activities. To estimate the potential number of MERS cases and deaths that might have been averted since 2016 had the risk levels of 2014–2015 continued, we analyzed case-based data on laboratory-confirmed human cases of MERS-CoV infections reported to the World Health Organization. We categorized cases as either secondary (human-to-human transmission) or community-acquired (presumed camel-to-human transmission). In addition, we used case-based data on date of onset (for symptomatic infections) or report (for asymptomatic infections), outcome (died/recovered), and dates and sizes of reported clusters of human-to-human–transmission cases”.

Self-destructing Mosquitoes and Sterilized Rodents: the Promise of Gene Drives
What might the consequences of this novel biotech be? In the face of potential eradication of disease and alteration of an entire animal population’s genome, researchers have very real concerns. “As soon as researchers began to make gene drives regularly in labs, animals developed resistance against them — accumulating mutations that prevented the drives from spreading. In tests of two drives inserted into fruit flies, for example, genetic variants conferring resistance formed frequently. Most commonly, mutations alter a sequence that CRISPR is set to recognize, preventing the gene from being edited. In experiments with caged mosquitoes, Crisanti and Target Malaria researcher Tony Nolan watched a gene drive gradually decrease in frequency over multiple generations owing to resistant mutations at the target gene. The results rocked the field. Would resistance render gene drives impotent? Not necessarily — if researchers select the right target. Some genes are highly conserved, meaning that any change is likely to kill their owners. Picking these genes as a drive target means fewer mutations and less resistance. In September 2018, Crisanti and his team crashed a population of caged Anopheles gambiae mosquitoes with 100% efficiency by making a drive that disrupts a fertility gene called doublesex. With the drive in place, female mosquitoes cannot bite and do not lay eggs; within 8–12 generations, the caged populations produced no eggs at all. And because it is crucial for procreation, doublesex is resistant to mutations, including those that would confer resistance to a drive construct.” “Before Kevin Esvelt ever built a single CRISPR-based gene drive, he’d wake up in cold sweats thinking about the ramifications. ‘I realized, oh hey, this isn’t just going to be about malaria, this is potentially going to be something any individual who can make a transgenic fruit fly could build to edit all the fruit flies.’”

Stories You May Have Missed:

  • UK Works to Test New Payment Model for Antibiotics – “In an effort to stimulate the development of new antibiotics, Britain’s National Health Service (NHS) yesterday announced the launch of a trial for a new pilot program that will pay drug companies for antibiotics using a subscription-style model. Under the program, NHS will pay pharmaceutical companies up front for access to effective antibiotics, rather than reimbursing them based on the quantity of antibiotics sold. The idea behind the program is to delink profit from the volume sold, pay for antibiotics based on their public health value, and encourage the development of new antibiotics.”

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