Pandora Report: 11.15.2019

We’re back and we’ve got quite a packed newsletter for you, so grab a beverage and get ready for the warm fuzzies of biodefense news.

Failing to PREDICT the Next Pandemic
A few weeks back, it was announced that funding for the PREDICT program would cease after $207 million was sunk into the initiative. GMU biodefense MS student Michael Krug has provided a deep-dive into what PREDICT worked towards, the debated success, and what its cancellation means. “However, even with the billions of dollars spent on ensuring a robust global biosurveillance network, it remains unknown if this network can predict what the next disease will be or where the next outbreak will occur.” Read more here.

An Antibiotic Eclipse – Scenario or Future?
GMU Biodefense doctoral alum and infection preventionist Saskia Popescu discusses the looming threat of antibiotic resistance and what a future with little to no treatment options would look like. From dwindling options for secondary infections related to influenza to declining surgeries, a future without antibiotics is dim. Popescu highlights what this looks like and how we’re quickly approaching it through both the drying antibiotic pipeline, but also limited surveillance, and challenges in changing both stewardship and infection control measures. The existential threat of antimicrobial resistance is very real and Popescu provides a scenario portraying the economic and human costs that antimicrobial resistance could impose on society 30 years from now, if it is not addressed soon. You can read the full article here. This is an especially relevant topic as the CDC just released new data, finding that annually, 2.8 million resistant infections and 35,000 related deaths occur in the United States. The CDC report notes that “However, deaths decreased by 18 percent since the 2013 report. This suggests that prevention efforts in hospitals are working. Yet the number of people facing antibiotic resistance in the United States is still too high.”

Event Recap – People, Pigs, Plants, and Planetary Pandemic Possibilities 
If you happened to miss this November 5th event, no worries – GMU biodefense doctoral student Stevie Kiesel has provided an in-depth summary of the panel and discussions. Kiesel notes that the panel had insightful discussions on the need to understand local context and empower people and local public health communities. Local context is important for combating misinformation and getting a more accurate understanding of conditions on the ground. For example, the public health community must understand why a country may be disincentivized to report a disease outbreak in its early stages, when it is more easily controlled. Authoritarian governments who maintain tight messaging control may not want to admit to an active outbreak, or the economic drawbacks of announcing an outbreak may be so severe that leaders try to hide what’s going on. You can read more here.

Pandemic Policy: Time To Take A Page Out Of The Arms Control Book
Rebecca Katz is holding back no punches in her latest article on the broken policy approaches we have to international outbreak accountability, and frankly, it’s long overdue. Full disclosure, the first line is one of my favorites – “Last month, the World Health Organization (WHO) was reduced to the equivalent of playground pleading: ‘But you promised!’” Katz highlights that in the face of countries failing to meet their obligations within the International Health Regulations (IHR), the WHO has little recourse to act and frankly, the path to accountability isn’t particularly clear. Ultimately, this problem could be solved though, if instead of rewriting the IHR, we modeled such treaties in the image of the Biological Weapons Convention (BWC) to help convene regular review conferences, discuss developments, and establish a regulatory response that could help drive accountability. “As the former US representative to the BWC, Charles Flowerree, wrote, treaties ‘cannot be left simply to fend for themselves’.”

The 5th Annual Pandemic Policy Summit at Texas A&M University
GMU Biodefense doctoral student Rachel-Paige Casey has provided an in-depth review of this important summit earlier this week. The objective of each Summit is to convene researchers, medical professionals, practitioners, private sector experts, NGO representatives, and political leaders to examine issues in pandemic preparedness and response, health security, and biodefense. The foci of this year’s Summit were the promises and perils of technology; BARDA leadership through its history and today; the effect of the anti-vaccine movement on pandemic preparedness and response; and ongoing outbreaks. Key discussions included the inadequacy of biopreparedness, worries regarding emerging biotechnologies, the modern vaccine hesitancy movement in the US, and the leadership and future of BARDA. You can read more about the summit here.

Catalyst- A Collaborate Biosecurity Summit 
Don’t miss this February 22, 2020 event in San Francisco. “Catalyst will be a day of collaborative problem-solving for a broad range of people invested in the future of biotechnology, including synthetic biologists, policymakers, academics, and biohackers. We aim to catalyze a community of forward-looking individuals who will work together to engineer a future enhanced by biology and not endangered by it.The summit is free to attend for everyone accepted, and the application only takes a few minutes. We expect participants to come from diverse backgrounds, and welcome applicants who do not work professionally in biosecurity or biotechnology, who are early in their careers, and who are skeptical of how biosecurity discussions are typically framed. You can apply to attend here.

Firehosing – the Antivaxxer Strategy for the Transmission of Misinformation
Researchers Christopher Paul and Miriam Matthews of Rand introduced this idea in 2016 and it’s proving to be pretty accurate for how anti-vaccine advocates are pushing out their opinions. Lucky Tran of The Guardian recently made the link between antivaxxers and the strategy of firehosing, which entails a massive flow of disinformation to overwhelm the audience. Just like it sounds, firehosing involves pushing out as many lies as frequently as possible to overwhelm people with information and making it nearly impossible for a logical response to combat that much disinformation. Tran stumbled across this application by seeing it on a television show with anti-vaccine influencers like Jay Gordon and he employed this strategy. “Anti-vax influencers such as Jay Gordon and Andrew Wakefield can keep repeating disproved claims – and in the case of Wakefield, doing so despite having had his medical license revoked – because their lying effectively debases reality and gains them followers and fame in the process.” The Rand study can be found here, which originally discussed firehosing in the context of Russian propaganda – as it has two “distinctive features: high numbers of channels and messages and a shameless willingness to disseminate partial truths or outright fictions. In the words of one observer, ‘[N]ew Russian propaganda entertains, confuses and overwhelms the audience’.” In the face of this relatively new tactic, there is a desperate need to remove false anti-vaccine content from social media and websites, and to put more pressure on media and news platforms to not provide support for such guests/conversations.

Crowd-Control Weapons – Are They Really Non-Lethal?
The term “non-lethal” or “less-than-lethal” gets thrown around a lot when it comes to crowd/riot-control weapons but just how non-lethal are these methods if they’re overused? Physicians for Human Rights (PHR) dug into this very issue because frankly, the use of these weapons is quite common and if they’re not used properly, or with the proper training, they can be devastating. Routine use or misuse of agents like tear gas can be deadly. The PHR conducted several investigations into their use by governments in Bahrain, Georgia, Kashmir, Turkey, and other countries and ultimately, what they found was some pretty startling misuse that can result in long-term health outcomes or even death. They put together a report and factsheets on specific “non-lethals” like acoustic weapons, rubber bullets, stun grenades, tear gas, and even water cannons. Within each factsheet, you can read about the history, how they work, device types, health effects, legality of use, and considerations and policy recommendations. Within the report, they reviewed usage of the weapons including things like people who suffered injuries or even death. As protests occur in China, the use of sonic weapons for crowd control are a very real reminder of the fine line we walk when using “non-lethals”.

Ebola Outbreak Updates and Vaccine Approval 
This week, the European Medicines Agency (EMA) approved the V920 vaccine for Ebola Virus Disease (EVD) and it is already being administered in the Democratic Republic of the Congo. The ongoing EVD outbreak in the Democratic Republic of the Congo (DRC) started in August 2018 and has now exceeded 3,000 cases and 2,000 deaths. Since the 2014-15 outbreak in West Africa, advances in medical research produced new vaccination and therapeutic options. The V920 vaccine, developed and produced by Merck, was tested during the outbreak and showed a 97% efficacy rate and protects against the Zaire species, which is the strain responsible for the current outbreak. Johnson-and-Johnson is also beginning trials for its investigational EVD vaccine. Johnson-and-Johnson’s vaccine requires two doses, a barrier for patient compliance, and does not contain any antigens from the Ebola Bundibugyo species of the virus. Dr. Dan Lucey, professor of medicine at Georgetown University, wrote an editorial in the British Medical Journal about the new treatments for EVD. Dr. Lucey’s article reviews the findings and shortcomings of the four-arm randomized controlled trial (RCT) evaluating the efficacy of four potential EVD treatments: ZMapp, remdesivir, mAb114, and REGN-EB3. The RCT was discontinued when a strict statistical threshold for decreased mortality was reached REGN-EB3, a monoclonal antibody drug. The punchline for the efficacy of REGN-EB3 is that it is efficacious if administered during the early stage of the disease but not as the diseases progresses. Lucey recommends continuing research on EVD treatments that are successful at later stages of the diseases. Last but not least, the article applauds the rigor and difficulty of this randomized-controlled trial given it was conducted during the outbreak, making it a precedent-setting achievement.

GMU Biodefense Alum Changing the Face of Aerospace Physiology 
We’re excited to share some of the achievements of one of GMU’s biodefense alum – Nereyda Sevilla, a May 2017 doctoral graduate in Biodefense, who is a civilian aerospace physiologist for the Defense Health Agency working as Acting Director of the Military Health System Clinical Investigations Program. She was also recently awarded the Air Force Medical Service Biomedical Specialist Civilian of the Year Award and the Air Force Meritorious Service Medal. If you’d like to see more of Nereyda’s hard work in action, check out the article she and the Spatiotemporal Epidemiologic Modeler (STEM) Team published in the Sept 2019 edition of Health Security,  “STEM: An Open Source Tool for Disease Modeling.” (Volume 17, Number 4, 2019).

Phase 3 Trial of Modified Vaccinia Ankara Against Smallpox
In the last Pandora Report, we discussed the FDA approval of the new smallpox vaccine JYNNEOS, that was tested by USAMRIID. The vaccine, developed by biotechnology company Bavarian Nordic, will enter the market under the name JYNNEOS. You can read about the Phase 3 efficacy trial of JYNNEOS (a modified vaccinia Ankara, MVA) as a possible vaccine against smallpox in the latest New England Journal of Medicine. GMU Biodefense professor and director of the graduate program, Dr. Gregory Koblentz noted that one of the key findings of this Phase 3 efficacy trial is that even though the FDA has approved a two-dose regimen for MVA (since it is a non-replicating vaccine that uses an ), a single dose of MVA provided the same level of protection as a single dose of the replicating vaccinia vaccine ACAM 2000. “At day 14, the geometric mean titer of neutralizing antibodies induced by a single MVA vaccination (16.2) was equal to that induced by ACAM2000 (16.2), and the percentages of participants with seroconversion were similar (90.8% and 91.8%, respectively).” An additional advantage of MVA over ACAM 2000 is that the former can be administered by a subcutaneous injection while the latter requires scarification through the use of a bifurcated needle. The article concludes that “No safety concerns associated with the MVA vaccine were identified. Immune responses and attenuation of the major cutaneous reaction suggest that this MVA vaccine protected against variola infection.”

Key Global Health Positions – A Who’s Who in the U.S. Government
Have you ever wondered who helps support global health within the U.S. government?  The Kaiser Family Foundation (KFF) has created a substantial list on not only the positions, but also who (if anyone) is occupying them. From the Department of Health and Human Services to the Department of the Treasury, you’ll want to utilize this list to not only realize the scope of global health efforts within the USG, but also who you might need to get in touch with.

Stories You May Have Missed:

  • African Swine Fever Continues to Spread in Asia – Unfortunately, this outbreak isn’t showing signs of letting up… “The update shows new outbreaks in Vietnam, Cambodia, Laos, the Philippines, South Korea and on the Russian side of the Chinese border reported during the first week of November. Meanwhile, formal confirmation is awaited of ASF outbreaks in Indonesia. The FAO reports that more than 4,500 pigs are said to have died in 11 regencies/cities in North Sumatra. Dead pigs were also found in a river. FAO is liaising with the Indonesian authorities to ‘confirm the cause and explore needs’.”

Event Summary: People, Pigs, Plants, and Planetary Pandemic Possibilities

By Stevie Kiesel, GMU Biodefense PhD student

November 5 was a great day for doing your civic duty. If you were near Arlington, Virginia, you could stop by your polling place to vote and then head to George Mason University (GMU) for a panel discussion. The discussion, co-sponsored by the GMU Next Gen Global Health Security Network and the GMU Biodefense Discussion Group, centered on the One Health concept, a “collaborative, multisectoral, and transdisciplinary approach” with “the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment.” While One Health is not a new concept, humanity’s increasing interconnectedness makes it ever more relevant. For example, as humans expand into new geographic areas, they come into closer contact with animals, increasing the risk of zoonotic disease spread. Additionally, habitat disruptions—whether caused by farming practices, deforestation, or climate change—can provide novel ways for diseases to pass to animals and then on to humans. Successful public health policy thus requires “the cooperation of human, animal, and environmental health communities.”

The panel included Dr. Jarod Hanson and Dr. Taylor Winkleman, who both have military experience as well as veterinary backgrounds, and Dr. Michael E. von Fricken, who specializes in vector-borne diseases around the world. These speakers brought their real-world experience on topics such as disease surveillance, funding for disease prevention, information sharing and collaboration with international partners, and the fight to get good information to all stakeholders during a disease outbreak. Throughout this discussion, three needs emerged: (1) to empower local public health actors and understand local context, (2) to focus more on prevention, and (3) to convert policies and plans into action. Continue reading “Event Summary: People, Pigs, Plants, and Planetary Pandemic Possibilities”

The 5th Annual Pandemic Policy Summit at Texas A&M University

By Rachel-Paige Casey, GMU Biodefense PhD student

Earlier this week, the 5th annual Pandemic Policy Summit was hosted at Texas A&M University by the Scowcroft Institute of International Affairs in the Bush School of Government and Public Service. Most of the Summit’s events were conducted under Chatham House rule, prohibiting attribution of comments and insights to an individual or organization. The objective of each Summit is to convene researchers, medical professionals, practitioners, private sector experts, NGO representatives, and political leaders to examine issues in pandemic preparedness and response, health security, and biodefense. The foci of this year’s Summit were the promises and perils of technology; BARDA leadership through its history and today; the effect of the anti-vaccine movement on pandemic preparedness and response; and ongoing outbreaks. Key discussions included the inadequacy of biopreparedness, worries regarding emerging biotechnologies, the modern vaccine hesitancy movement in the US, and the leadership and future of BARDA.

A commonly recited phrase throughout the panels underscored a concern shared throughout attendees and speakers – “lessons learned to lessons observed.” Over the many health crises, lessons were largely observed and not learned, maintain the distressing paradox of inadequate biopreparedness despite clear evidence of the emerging and re-emerging pathogens threatening human, animal, and environmental health. The 2014-15 West Africa Ebola Virus Disease (EVD) epidemic was a gruesome showcase of failures in imagination, policy, capabilities, and management; however, it was just one among many in recent history. Since the turn of the century, the same failures were apparent in the SARS, H1N1, and Amerithrax events. Four primary causes of the aforementioned failures were proposed: complacency, competing priorities, confusion about risk, and overdependence on government capabilities and capacities. Though not necessarily easy to fix or adjust, the underlying roots of preparedness and response failures can be thwarted. The goal of the Summit is to discern how to address these failures and improve policy, collaboration, and leadership for quicker and more successful prevention, detection, and response to health crises like outbreaks and bioterror attacks. Simply put, how do we learn lessons instead of just observing them? Continue reading “The 5th Annual Pandemic Policy Summit at Texas A&M University”

Pandora Report: 11.1.2019

We hope you had a spooky Halloween – zombie flies, anyone? The Pandora Report will be off next week but rest assured, we’ll be back the week of November 15th!

Haphazard Success Against Ebola and the Future of Predict
More Ebola virus disease cases have been reported in the DRC and despite over 240,000 vaccinations, there have been 3,260 cases and 2,177 deaths. In 2014, the U.S. worked to combat the largest outbreak in history and in the process, learned critical lessons both abroad and at home. Unlike last time, in which the presence of the U.S. military was seen as a hopeful arrival, the existing violence in the DRC and the delicate nature of response means that no US resources will be deployed to assist. “The outbreak today offers a better look at global pandemics to come — ones that begin in regions where international public health workers are unable to move freely to contain the spread of a virus, where the U.S. Army would not be welcomed with open arms.” Moreover, this outbreak has been a particularly painful reminder that despite intentions, trust can not be bought with hundreds of scientists/troops or shiny new equipment – core institutional mistrust can make or break a country’s acceptance of foreign support. Sure, we were able to swoop in during the 2014 outbreak, but that simply isn’t the case in the current one and our preparedness and response efforts must account for this critical aspect of assisting foreign outbreaks. In the midst of this complex situation, a research program that worked to identify zoonotic spillover as a predictive tool, has been defunded. Predict is a program that was launched in the last decade and cost just over $200 million, but worked to learn from the H5N1 scare and the increasing threat of zoonotic diseases and their spillover into humans. By collecting biological samples, it identified over 1,000 news viruses and trained thousands of people across 30 countries to help strengthen medical research at an international level. “Dennis Carroll, the former director of USAID’s emerging threats division who helped design Predict, oversaw it for a decade and retired when it was shut down. The surveillance project is closing because of ‘the ascension of risk-averse bureaucrats,’ he said. Because USAID’s chief mission is economic aid, he added, some federal officials felt uncomfortable funding cutting-edge science like tracking exotic pathogens.” In many ways, this is seen as a devastating blow to global health security, while others have questioned the true utility of the program. There are two things we can take away from the defunding of Predict though – public health and health security efforts do struggle to maintain funding, and perhaps we need to have more conversations regarding the efficacy of predictive approaches. For many, this has been a reminder that investment in critical response efforts are more beneficial, rather than those who seek to predict what the next biothreat will be.

Tracc Event: Sanctions and Illicit Flows
The Terrorism, Transnational Crime and Corruption Center (Tracc) will be hosting an event on November 13th from noon-2pm at GMU’s Van Metre Hall. The event will present “a multi-organizational perspective on sanctions and why they are instituted, and how they are evaded.  The diverse analytical presentations on the Middle East will focus on the networks that are behind this deceptive behavior and the means used to counter this harmful activity. Panelists (including GMU biodefense professor and graduate program director Dr. Gregory Koblentz) will describe how the United States and other countries have used sanctions to prevent the proliferation of chemical weapons to Syria, deter the use of these weapons during that country’s civil war, and hold perpetrators of chemical attacks accountable. Additionally, we will discuss the means by which risk actors evade sanctions and how data can protect government and corporate entities from risk exposure related to sanctions evasions networks.” Lunch will be provided and RSVP is required, so make sure to click here or email traccc@gmu.edu

Upcoming Vaccines and Medications for Infectious Diseases
The US Army Medical Research Institute of Infectious Diseases (USAMRIID) announced that a new smallpox vaccine, which it tested, just received FDA approval. Smallpox is an infectious viral disease in which patients experience flu-like symptoms and a widespread rash; it has no cure. The vaccine, developed by biotechnology company Bavarian Nordic, will enter the market under the name JYNNEOS. BlueWillow Biologics just received FDA clearance for trials on an investigational new drug (IND) that, if approved, will be the company’s upcoming next-generation anthrax vaccine. This vaccine, currently called BW-1010, is administered intranasally. Anthrax is an infectious disease with four types of infection: cutaneous, inhalation, gastrointestinal, and injection. All four types of anthrax can lead to serious illness or death if left untreated. Tuberculosis (TB) is an infectious bacterial disease characterized by lung damage, and it has become resistant to a slew of antibiotics. According to the WHO, there were 10 million cases of tuberculosis and 1.4 million disease-related deaths in 2018. This experimental vaccine has been tested on 3,500 adults in the TB-endemic areas of South Africa, Kenya and Zambia. Also, the vaccine study showed partial efficacy of 50% in preventing a dormant infection from advancing to a disease state. Though 50% efficacy would normally be considered low for a vaccine, this would still be a huge improvement for millions of TB-affected people around the world each year. A phase II trial is underway for a novel antifungal drug called Olorofim, which is showing promise as a treatment against Lomentospora prolificans infections. Lomentospora prolificans is a rare mold that is resistant against current antifungal treatments.  Additionally, a 2018 study showed that Olorofim was also effective against Aspergillus species.

Schar School Biodefense Open Houses
From anthrax to Zika, Schar School is the place to be for all things biodefense. Next week you can attend the last PhD Open House of the year – on Thursday, November 7th at 7pm at our Fairfax campus. This is a great opportunity to meet current students, chat with faculty, and find out more about our biodefense doctoral program. If you’re looking to do a MS in biodefense (online or in person), the Master’s Open House is November 13th at 6:30pm at the Arlington campus.

The Gut Microbiome and Pathogens
If you peruse through your local grocery market, you will likely find fermented drinks like kombucha and kefir, which are just a couple of the popular items praised for providing probiotics for microbiome health. The human microbiome is the collection of genetic material of all the microbes (bacteria, fungi, protozoa, and viruses) living on and in the body and it aids in efficient digestion as well as protection against disease-causing invaders, like bacterial pathogens. According to Baumler and Sperandio, “pathogenic bacteria exploit microbiota-derived sources of carbon and nitrogen as nutrients and regulatory signals to promote their own growth and virulence.” Additionally, microbiota can operate as either fighters or promoters of viral infections. Research discovered and continues to explore connections between the health of the gut microbiome and a range of conditions and ailments such neurodegenerative and systemic autoimmune diseases, cancer, and depression. Ongoing research at universities, laboratories, and institutes will surely reveal more insights into the relationships and interactions between the body’s flora and pathogenic activity. As further breakthroughs regarding the nexus of the microbiome and pathogens occur, the Pandora Report will feature those discoveries and findings.

Bringing On the Big Guns Against African Swine Fever
In what sounds like a video game, South Korea is employing drones and snipers along the demilitarized zone to prevent wild boars from spreading African swine fever (ASF) throughout the country. Cases have sprung up in South Korea near the North Korean border only last month, resulting in the culling of over 150,000 pigs. Snipers, civilian hunter teams, and drones with thermal vision are now being utilized to track the boars that might be carrying the devastating disease. South Korea isn’t the only country on the offense to avoid an outbreak – the United States has been working to avoid cases that could devastate the porcine industry. Unfortunately, many researchers have noted that we could have worked towards a vaccine that would’ve avoided so much of this situation. Despite 15 years of research on a vaccine at the U.S. Agriculture Department, the program and team was disbanded due to budgetary moves and limited resources in 2004 and it wasn’t until 2010 that efforts resumed. ASF is a prime example of not only One Health, but how we often prove to be our own worst enemy when it comes to disease prevention.

People, Pigs, Plants, and Planetary Pandemic Possibilities Event
Don’t miss out on next week’s GMU One Health Day Panel Discussion hosted by GMU Next Gen Global Health Security Network and the GMU Biodefense Discussion Group. From 4:30-6:30pm in Van Metre Hall at the Arlington campus, you can grab a slice of pizza and engage in discussions with panel members from health security, emerging infectious diseases, and more. This panel will discuss the One Health approach through the various lens of their real world experiences. Discussions and interactions with the audience will address insightful views of innovation and emerging technology developments for biosafety and biosecurity. So, come join the Next Gen Network as we investigate what it means to utilize the One Health approach in the biodefense realm! Space is limited, so make sure to RSVP to reserve your spot.

News of the Weird
Is your stomach a brewery? Well you’re not alone. A North Carolina man was experiencing a bizarre occurrence – he kept getting drunk without a drop of alcohol. Seven years after a DWI and years of arguing that he truly hadn’t consumed any alcohol, he was diagnosed with a rare disorder – “auto-brewery syndrome”. That’s right, his body was creating a plethora of alcohol-fermenting yeasts and would go into overdrive whenever he had a heavy carbohydrate meal. In this case, he was treated with antifungals but relapsed when he snuck some of the forbidden foods – pizza and soda.

Stories You May Have Missed

  • How is the EU Battling Drug-Resistant Gonorrhea? In the United States, there is a national surveillance program, which was established in 1986, and tracks antimicrobial susceptibility of Neisseria gonorrhoeae strains throughout STD clinics. A new report in 2017 found considerable trends in gonorrhea incidence, noting that it is the second most reported STD with roughly 820,000 cases each year. Abroad, multi- and extensively drug-resistant gonorrhea (MDR and XDR NG) poses a considerable problem. The European Centre for Disease Control (ECDC) has recently created a 2019 response plan to control and manage these varying levels of resistant gonorrhea throughout Europe.
  • TED Talk – Vaccinating Vampire Bats and Pandemic Lessons – Could we anticipate the next big disease outbreak, stopping a virus like Ebola before it ever strikes? In this talk about frontline scientific research, ecologist Daniel Streicker takes us to the Amazon rainforest in Peru where he tracks the movement of vampire bats in order to forecast and prevent rabies outbreaks. By studying these disease patterns, Streicker shows how we could learn to cut off the next pandemic at its source.

Pandora Report: 10.25.2019

Happy Friday! We’re excited to provide you with the latest in biodefense news. We’ve even added a new section (News of the Weird) for those health security stories that make you chuckle/shake your head in disbelief.

GMU Biodefense Open Houses
You’ve got two more chances to attend the Schar School Open Houses to learn about our PhD and Master’s programs – don’t miss out! The PhD Open House will be on Thursday, November 7th at 7pm at our Fairfax campus, and the Master’s Open House will be held on Wednesday, November 13th, at 6:30pm at the Arlington campus. This is a great opportunity to learn about our biodefense programs, the coursework, application process, and chat with faculty. You can find more information and RSVP here.

Global Health Security Index is Released 
On Thursday, a joint project and report was released by the Nuclear Threat Initiative (NTI), the Johns Hopkins Center for Health Security, and the Economist Intelligent Unit (EIU). Several recent biological events – the ongoing Ebola outbreak, the 2014 Ebola outbreak in West Africa, the Zika outbreak, and so on – made clear that there was a terrible lack of preparedness to infectious disease outbreaks. The Index confirms and expands upon this worrisome realization. The Global Health Security Index assessed 195 countries across six categories with 34 indicators, and through 140 questions via public information. The short story? No one is prepared to handle a pandemic or global catastrophic biological event. 92% of the studied nation lack security checks for people accessing dangerous biological materials. From infection prevention efforts to capacity to acquire medical countermeasures, this index is immensely detailed and helpful in understanding the scope of global health security and what it truly means. Some of their findings also include – fewer than 5% of countries show a requirement to test their emergency operations annually, 77% do not demonstrate a capability to collect ongoing to real-time lab data, most countries lack foundational health systems capabilities for epidemics or pandemic response. Out of 100, the average GHS Index sore was 40.2, while high-income countries had an average score of 51.9. Key recommendations derived from the GHS Index include:

  • Governments should pledge to address their respective health security risks
  • Every country should maintain transparency and regular measurement of its health security capabilities and capacities
  • New or updated financing mechanisms should be established to fill the gaps highlighted by the Index

The Index was created to highlight gaps in the prevention, detection, and rapid response capabilities and capacities of nations against major biological events. Further, the Index aims to catalyze action and accountability in governments, public and private sector entities, and civil society toward improved biosecurity and biosafety. The full 2019 report containing the background, methodology, findings, recommendations, and country profiles is available here.

Nuclear Aspirations of Turkey
Recent and alarming statements made by Turkish President Recep Tayyip Erdogan insinuate that Turkey may exit the Nuclear Non-Proliferation Treaty (NPT) and procure its own nuclear weapons as it seeks supremacy in the Middle East. His first suggestion of nuclearizing was during an AKP party rally in September 2019, at which he bemoaned the restriction on Turkey acquiring nuclear weapons. At the recent UN Assembly, Erdogan purported that either no countries should be allowed to possess nuclear weapons or all countries should be allowed, another not-so-subtle hint at Turkey’s nuclear intent. This prospect is especially daunting not only because the world may see the creation of a new nuclear state but also because the United States maintains an arsenal of nuclear weapons within Turkish borders. There is current deliberation within the Pentagon about removing 50 B-61 nuclear bombs from the Incirlik Air Base in southern Turkey, weapons housed there since the Cold War to discourage Soviet ground forces. Such an evacuation comes with both physical and political risks. Of course, relocating nuclear material is no simple feat, an activity requiring substantial security, but the potential political repercussions are of greater concern. Withdrawal could instigate a stronger relationship between Turkey and Russia, because the removal could be interpreted by Turkey as a pivot away from NATO. Additionally, withdrawal of weapons from Turkey may catalyze withdrawal requests from other NATO members like Belgium or Germany. Though it would take years for Turkey to develop a nuclear program and there is expert speculation that his recent insinuations are intended to highlight the asymmetry of the treaties like the NPT, his true intent is unclear. The Pandora Report will continue to follow the statements and actions from Turkeys for future updates.

Save the Date – People, Pigs, Plants, and Planetary Pandemic Possibilities- One Health Day Panel Event
On Tuesday, November 5th, the GMU Next Gen Global Health Security Network and the GMU Biodefense Discussion Group are sponsoring a GMU One Health Day Panel Discussion! Pizza will be served before the panel starts, so join us at 4:30PM to grab a slice and discuss biodefense with the panelists.  The event will take place from 4:30pm to 6:30pm in Van Metre Hall at the GMU Arlington Campus. This panel will discuss the One Health approach through the various lens of their real world experiences. Discussions and interactions with the audience will address insightful views of innovation and emerging technology developments for biosafety and biosecurity. So, come join the Next Gen Network as we investigate what it means to utilize the One Health approach in the biodefense realm. You can register for the event here.

Drug Resistant E coli – An Unlikely Source
Combating antimicrobial resistance is one of those tasks that often seems so complex and challenging, we may never truly recover. From poor antibiotic stewardship to usage in agriculture and even a drying pipeline in drug development, this problem is particularly resistant (pun intended) to resolution. Pulling from Dr. Koblentz’s term for biosecurity, it might be that antimicrobial resistance (AMR) is a wicked problem. When we start to look at the origin of resistant microbes and how they’re being shared between people, animals, and the environment, there is a considerable concern for the role of animals farmed for human consumption. Maryn McKenna has long highlighted the considerable role of antibiotic usage in chickens and has recently written on the role of antibiotic resistance in animals, but a new study is shedding light on how food might not be a source for some infections. Recently published in The Lancet Infectious Diseases, a team of researchers performed epidemiological surveillance on extended-spectrum β-lactamase-producing Escherichia coli isolates (ESBL-E coli). The goal was to understand this organism as a source for bacteremia (blood infection) and the role of the food chain in supporting such resistant infections. What they found was startling – while ESBL-E coli was found frequently in sewage and retail chicken, it was rare in other meats and plant-based foods. Moreover, most human bacteremia ESBL E coli in their study actually involved human-associated sequence types, meaning that the non-human reservoirs were not as much the culprit. Ultimately, this means that as we work to combat drug resistance through targeted efforts, we should give more credence to the role of human transmission.

Oseltamivir vs. Influenza
If you’ve read Stefan Elbe’s book Pandemic, Pills, and Politics, you’ll appreciate this recent study even more when it comes to the hot topic of Tamiflu (oseltamivir). The wonder drug oseltamivir was touted as a medical countermeasure and response to influenza and potential pandemics. While Elbe heavily discusses the creation, questionable efficacy, and politics surrounding Tamiflu in his book, a new study has shed some light on its efficacy against the H1N1 subtype responsible for the 1918/1919 pandemic. While oseltamivir phosphate is effective against this particular reconstructed strain of influenza, they also found it was vulnerable to escape through resistant mutations. As the authors note, “Nevertheless, we conclude that oseltamivir would be highly beneficial to reduce the morbidity and mortality rates caused by a highly pathogenic influenza virus although it would be predicted that resistance would likely emerge with sustained use of the drug.” We’ll have to put this “double-edged sword” category of medical countermeasures against pan-flu…

Too Great A Thing to Leave Undone: Defense of Agriculture
This event hosted by the Bipartisan Commission on Biodefense is only weeks away – are you registered? Even if you’re not able to attend in person in Colorado, you can live-stream the November 5th event to ensure you don’t miss any of the critical conversations on defending US agriculture.

Novichoks To Be 86’d
Since the 2018 use of Novichok poison against a former Russian spy in the UK, there has been increased scrutiny regarding the control and proliferation of such chemicals. Richard Stone recently wrote on the ominous future of Novichoks after the October 9th meeting of the Executive Council of the Organization for the Prohibition of Chemical Weapons (OPCW), which would bring them under the treaty’s regime. “This is a historic milestone for the treaty,” says Gregory Koblentz, a chemical and biological weapons expert at George Mason University in Fairfax, Virginia. This is not the first time Novichoks have been discussed in relation to bans and their use as tools for assassination, but adding them to the CWC’s list has been long fought by treaty nations worried that their ingredients would also be regulated. You can read a review of what happened here, but the truth is that there has been a long need to control this class of nerve agents. Developed by the Soviet Union during the Cold War, their use in 2018 was a turning point for not only their control, but also their place within the Chemical Weapons Convention. Next month, the Schedule 1 listing (i.e. amending the CWC and putting Novichoks on their list of chemical weapons in which signatories are required to declare and destroy) will be discussed and voted upon. “It’s not like Novichoks are relics of the past,” Koblentz says. “These are weapons that are still killing people.”

News of the Weird
No, it’s not Groundhog Day and you’re not stuck in a time loop – there is yet another measles exposure at Disneyland. Sure, it’s the happiest place on earth – if you’re vaccinated. A friendly reminder to all our readers, if you’re looking to indulge in some Disney Dole Whip or visit the new Star Wars park, make sure your MMR is up to date.

China Drafts Biosecurity Laws
Between the outbreak of African Swine Fever (ASF) that’s threatening global heparin supply and the continued fallout of He Jiankui’s CRISPR baby drama, conversations revolving around China and biosecurity have been pretty consistent. This week though, China’s draft biosecurity law was submitted to the National People’s Congress Standing Committee for discussion and deliberation. Focused on protecting the country’s biological resources and biotech industry, it also points to the importance of prohibiting the misuse of biological agents or biotech. Not only do the laws include provisions on preventing bioterrorism and managing antimicrobial resistance, they also emphasize an early warning system and emergency response efforts in addition to risk assessments. “The draft also reiterated China’s commitment to the building of a community with a shared future for humanity through efforts in achieving biosecurity.”

Stories You May Have Missed:

  • PTSD and a Link Within Infections – When assessing risk for infections, we need to start considering mental health issues, like PTSD. A new study actually sought to evaluate the relationship between PTSD and prevalence of infections. “The investigators found that not only were the majority of PTSD cohort members younger than 60 years and female, but they also had a higher proportion of diagnosis of anxiety disorders and depression. Ultimately, they found that those with PTSD diagnosis were at an increased risk for infections than those without a diagnosis. There were more diagnoses of urinary tract infections in those women with PTSD than those without, while skin infections were more prevalent in men with PTSD diagnoses than women with PTSD diagnosis. The findings related to urinary tract infections was the strongest evidence of a relationship between PTSD diagnosis and risk of infection.”

Pandora Report: 10.18.2019

Happy Friday to our fellow biodefense gurus! We hope you had a lovely week and are ready to enjoy a healthy dose of health security news. To start things off with a bang… it was recently reported that the terror group JAD has been working to make bombs fused with poisonous ingredients.

Rejected! 
Science and Global Security, the peer-reviewed nonproliferation journal based at Princeton University, has rejected Ted Postol’s article that called into question the findings of the Organization for the Prohibition of Chemical Weapons (OPCW) and the UN Joint Investigative Mechanism (JIM) that the Syrian government attacked the town of Khan Sheikhoun with the nerve agent sarin on April 4, 2017. This rejection follows a scathing critique of the article by Bellingcat as well as public criticism of the journal by Biodefense Program director, Gregory Koblentz. In response to his rejection, Postol has resigned from his position on the editorial board of Science and Global Security. Science has a great write-up of the latest developments in this controversy. According to Koblentz, “Postol has abused his affiliation with MIT and his reputation as a whistleblowing missile defense expert to promote a series of conspiracy theories over the last six years whose only common theme is to exonerate the Assad regime for gassing its own people. A clear indication of Postol’s motivation is that he still publicly embraces a long-discredited theory that there was no sarin attack at Khan Sheikhoun and that the incident was staged as a “false-flag operation” by the Syrian opposition. Given this record of disinformation on the use of chemical weapons in Syria, allowing Postol to publish in a peer-reviewed nonproliferation journal would be akin to letting Andrew Wakefield publish an article about vaccines and autism in JAMA or Alex Jones to opine in the Columbia Journalism Review about media coverage of the mass shooting at Sandy Hook. This episode is an important reminder that in an age of disinformation, scientific journals have a special responsibility to ensure that their peer review processes are designed to ensure the integrity of the research they are publishing.

People, Pigs, Plants, and Planetary Pandemic Possibilities
Here’s your chance to register for this November 5th event at GMU to celebrate One Health Day. This panel will discuss the One Health approach through the various lens of their real world experiences. Discussions and interactions with the audience will address insightful views of innovation and emerging technology developments for biosafety and biosecurity. So, please come and join in the discussion as we collectively investigate what it means to operationalize the One Health concept for the biodefense realm and global health security challenges! Space is extremely LIMITED and will be capped at 35 participants, so register as soon as possible to ensure your spot in the audience. The final day to register for the event is November 1st – you can reserve your spot here.

House Homeland Security Subcommittee to Evaluate Bioterrorism Preparedness
Yesterday, Rep. Donald Payne, the Chairman of the Subcommittee on Emergency Preparedness, Response, and Recovery, held a hearing entitled Defending the Homeland From Bioterrorism: Are We Prepared?. In her testimony to the Subcommittee yesterday, Dr. Asha M. George (Executive Director of the Bipartisan Commission on Biodefense), spoke as an expert witness, urging the Subcommittee to utilize the findings of the 2015 Bipartisan Commission report to help remedy the lack of preparedness against biological terrorism. “Dr. George noted that the federal government has spent millions to develop, improve, and deploy technology in hopes of rapidly detecting biological attacks. Effective environmental surveillance should assist with pathogen identification and provide early warning. ‘Unfortunately, as this Committee is well aware, the equipment designed to detect airborne biological contaminants do not perform well and have not progressed significantly since their initial deployments’.”

Putting the Cart Before the Horsepox
The Alliance for Biosecurity, a consortium of companies that develop medical countermeasures against biological threats, has a new member: Tonix Pharmaceuticals. Tonix burst onto the biodefense scene in 2017 when it was revealed that the company funded the synthesis of horsepox virus, an extinct orthopoxvirus closely related to variola, the virus that causes smallpox. Tonix is promoting its TNX-801 smallpox vaccine candidate which is based on the horsepox virus. As Gregory Koblentz, Biodefense Program director, has previously written “the claimed benefits of using horsepox virus as a smallpox vaccine rest on a weak scientific foundation and an even weaker business case that this project will lead to a licensed medical countermeasure.” The business case for Tonix’s new vaccine took a major hit last month when the Food and Drug Administration (FDA) approved Bavarian Nordic’s Jynneos vaccine (formerly known as Imvamune) to prevent smallpox and monkeypox. Jynneos provides a safer alternative to the ACAM 2000 smallpox vaccine and can be given to a wider population. With two licensed smallpox vaccines now in the Strategic National Stockpile, it is less likely that the Biomedical Advanced Research and Development Authority (BARDA) would be willing to invest in a third vaccine based on an unproven platform.

Predicting Man-Made Pandemic Risks
Lynn Klotz, a member of the Scientists Working Group on Biological and Chemical Security at the Center for Arms Control and Non-Proliferation, has published a new analysis of the risks posed by research with lab-created avian-influenza viruses that have been modified to be transmissible in mammals through the air. According to Klotz, there are at least fourteen labs worldwide working on such viruses. Based on newly available data, Klotz calculates that over the course of five years, there is about a 16% probability of an accidental release into the community. Given the estimated 5% to 40% probability that such a virus could seed a pandemic, these calculations should be ringing alarm bells in the global health community.

Ebola Outbreak Updates 
International and DRC public health responders are cautiously optimistic as another week of low case numbers was reported. With three new cases, the total is up to 3,227, however there is increasing concern with those hot spots being in areas of limited security, there will be a resulting increase in transmission. Thankfully, the patient under investigation for Ebola in Sweden has been ruled out following negative lab findings, but there are lessons we can take away from this experience. “While this was a fortunate situation, it should be seen as a reminder to those of us in health care, especially infection prevention, to conduct an internal audit to see how well the training and process mapping has persevered since 2014. Despite the efforts that were put in place nationally, like the tiered health care approach to special pathogens, many in frontline facilities struggle to maintain readiness.” A new article on influencing factors in the development of state-level movement restrictions in response to Ebola during the 2014/2015 outbreak was just published – noting some important findings from interviews with 30 people who had knowledge of the state-level Ebola policy development. Representing 18 diverse jurisdictions, findings from these interviews yield critical components that we’ll need to consider in the future, like science and evidence versus public fears and that “According to interviewees, politics played a limited role in the formation of Ebola policies in most cases. The midterm elections, gubernatorial elections, and prospective 2016 presidential campaigns were mentioned as important influencers of monitoring and movement restriction policies in several states, but the policy development process largely reflected collegial relationships between elected officials and public health professionals.”

Mapping the Synthetic Biology Industry and Biosecurity Implications 
Sarah Carter and Diane DiEuliis recently wrote on this growing industry and biotech platform, noting that there are inherent risks for biosecurity as many of the practitioners come from a variety of backgrounds and may not realize the implications. In their analysis, they interviewed dozens of people in the industry and U.S. government. Ultimately, they focused on the areas for best practice, further discussion, and mapped the landscape of industrial tools and their capabilities.”We found that the landscape of the synthetic biology industry features an emerging and diverse set of horizontal tools being applied across many vertical sectors in a complex and interconnected ecosystem of companies. The availability of these tools and how the industry will develop into the future has significant implications for policymakers and others concerned about the potential for misuse and the vulnerabilities of these capabilities.”

Cutting Edge Chemical and Biological Defense Science: Topics at CBD S&T 2019
If you’re planning to attend this November event (or need a reason to), here are some hot topics that will be presented at the 2019 Chemical and Biological Defense Science & Technology Conference hosted by DTRA.

Involve An Infectious Disease Physician – Improve Patient Outcomes
Infection preventionist and GMU Biodefense alum Saskia Popescu discusses a new study that sheds light on just how much of a difference involving an infectious disease physician can make. “For hospitalized patients, the concern for infections related to invasive medical devices (central lines, Foley catheters, etc.) is very real. Bloodstream infections are a serious concern for patients and infection preventionists alike. Unfortunately, Candida fungal infections are all too common in the bloodstream. It is estimated that there are 25,000 bloodstream infections related to Candida annually in the United States and that roughly 40% of those patients ultimately die from the infection. For health care-associated infections, candidemia is the 4th most common. New research from the Washington University School of Medicine in St. Louis, published in The Lancet Infectious Diseases, actually found that when an infectious disease physician oversaw care of a patient with candidemia, the mortality rate declined by 20% .”

Building Biosafety Capacity in Our Nation’s Laboratories
An analysis by Chung, Bellis, Pullman, O’Connor, and Shultz in the latest issue of Health Security evaluated the biosafety practices of public health laboratories (PHLs) and clinical laboratories in the United States since the 2014 Ebola Virus Disease epidemic exposed several vulnerabilities. After the outbreak revealed gaps in biosafety practice, the Enhanced Laboratory Biosafety Capacity Project was born to support the enhancement of biosafety practices over a 3-year period. Over $24 million was provided by the CDC’s Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases to 63 health departments for the Project. The research team constructed nine performance indicators for public health and clinical laboratories to assess the efficacy of the Project’s primary objective to improve biosafety practices in the 63 awarded laboratories. The assessment concluded that although not all Project targets were reached, there were overall improvements in biosafety practices and heightened emphasis on the importance of biosafety. The article is available to read for free through October.

Stories You May Have Missed:

  • Europe Has Drop in Veterinary Antibiotic Sales – In a small win for combatting antibiotic resistance, “Data from the EMA’s latest European Surveillance of Veterinary Antimicrobial Consumption (ESVAC) report show a 32.5% decline in sales of antibiotics for food-producing animals from 2011 through 2017, with sales of two antibiotic classes considered critical for human medicine—polymyxins and third- and fourth-generation cephalosporins—falling significantly.”

 

Pandora Report: 10.11.2019

 

GMU Biodefense Graduate Program Open House
Have you considered expanding your education and experiences through a graduate degree in biodefense? Learn more about our MS (online and in-person) and PhD programs in our upcoming Open Houses! The Master’s Open House will be held on Thursday, October 17th at 6:30pm at our Arlington campus, and the PhD Open House will be on Thursday, November 7th, at 7pm at the Fairfax campus. We invite you to learn more about our programs by attending an open house. You will have the opportunity to discuss our graduate programs with program directors, faculty, admissions staff, current students, and alumni. The current schedule is reflected below, but be sure to sign up for emails from the Schar School’s Graduate Admissions Office to be notified of future admissions events!

What Can We Glean from a Bean: Ricin’s Appeal to Domestic Terrorists
GMU biodefense doctoral student Stevie Kiesel breaks down the use of ricin and its application as an agent of domestic terror. “Just as policymakers have been slow to acknowledge and act upon the threat of domestic CBRN terrorism, timely extant research on the issue is scarce as well. In this article, I focus on ricin as an agent of domestic terror. As government agencies acknowledge the threat domestic terrorism poses, policymakers and law enforcement should take ricin seriously as a potential weapon. To understand the plausibility of ricin’s use as a weapon, I reviewed a number of journal articles, news articles, and court records from 1978 through 2019 and compiled data on 46 incidents of ricin acquisition and/or use. Of these 46 incidents, 19 could be credibly tied to terrorism, 19 were not related to terrorism, and 8 were unclear. The most common motivation after terrorism was murder (10 instances). Of the 19 terrorist incidents, 58% were committed by extreme right-wing terrorists, a term that here encompasses the following ideologies: neo-Nazi/neo-fascist, white nationalist/supremacist/separatist, religious nationalist, anti-abortion, anti-taxation, anti-government, and sovereign citizen.”

GMU One Health Day Panel Discussion                                          Save the date for this November 5th event sponsored by the GMU Next Gen Global Health Security Network and the GMU Biodefense Discussion Group. “One Health Day is November 3 – Connecting Human, Animal, and Environmental Health. One Health is the idea that the health of people is connected to the health of animals and our shared environment. Learn why One Health is important and how, by working together, we can achieve the best health for everyone. [CDC} Did you know that animals and humans often can be affected by many of the same diseases and environmental issues? Some diseases, called zoonotic diseases, can be spread between animals and people. More than half of all infections people can get can be spread by animals – a few examples include rabies, Salmonella, and West Nile virus.” On November 5th, you can listen to the panel from 5-7:10pm in Van Metre Hall at the GMU Arlington Campus. Panel members include Michael E. von Fricken,  PhD, MPH   GMU Global Health and Community Health Security, Dr Jason Hanson,   DVM, PhD, DACVPM,  Associate Editor at Program for Monitoring Emerging Diseases, Willy A. Valdivia-Granda, CEO, ORION INTEGRATED BIOSCIENCES, INC., and Dr Taylor Winkleman,  DVM, CEO, Winkleman Consulting, LLC. “This panel will discuss emerging ONE HEALTH approaches through the various lens of their real world experiences in the world of Global and Community Health, national security arenas, and the international biodefense security domain. Discussions and interactions with the audience will address insightful views of innovation and emerging technology developments for biodefense leveraging data mining, genomics of infectious diseases, implementation of algorithms for the development of medical countermeasures against known and unknown biothreats, one health biosurveillance challenges in detecting infectious diseases, and strategies for integrating the efforts of health security professionals and biotech experts working together to improve the health of people, animals — including pets, livestock, and wildlife —as well as the environment. Common types of professionals involved in One Health work include disease detectives, human healthcare providers, veterinarians, physicians, nurses, scientists, ecologists, as well as policy makers.”

Ebola Outbreak Updates
After two weeks of halted response efforts due to security concerns, things are resuming in the DRC. “The WHO said though the decline in cases is encouraging and gains have been made in the response, several challenges remain and that the current trends should be interpreted with caution.” On Wednesday, case counts reached 3,207 with 2,144 deaths and 441 suspected cases being investigated. There was concern over a Swedish patient admitted for Ebola testing, but results have come back negative.

Biosafety Levels in Laboratories – Whats the Difference?
We throw around the term “BSL-4” around a lot, but how well do you actually know the different biosafety levels? “The United States is home to several types of laboratories that conduct medical research on a variety of infectious biological agents to promote the development of new diagnostic tests, medical countermeasures, and treatments. To promote safe medical research practices in laboratories studying infectious agents, the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health have established four BSLs. The levels consist of requirements that have identified as protective measures needed in the laboratory setting to ensure the proper management of infectious agents to avoid accidental exposure or release into the environment. The BSL designations, ranked from lowest to the highest level of containment, are BSL-1, BSL-2, BSL-3, and BSL-4. The BSL designations outline specific safety and facility requirements to achieve the appropriate biosafety and biocontainment. The BSL is assigned based on the type of infectious agent on which the research is being conducted. The CDC has designed an infographicto help visualize the differences between each level. Each level builds on the previous level, adding additional requirements.”

African Swine Fever: An Unexpected Threat to Global Supply of Heparin
In a conversation I never thought I’d have in healthcare…the outbreak of African swine fever (ASF) is hitting heparin supplies at a global level – what a prime example of One Health! “Since August 2018, China has culled more than one million pigs in efforts to contain the spread of ASF within the country. Widespread culling of pigs consequently affects the supply of raw materials needed to produce heparin, which is derived from mucosal tissues in pig intestines. Heparin is a critical anticoagulant drug used to treat and prevent the formation of blood clots in blood vessels in healthcare. As pig herds continue to become infected and culled, should the United States form contingency plans in the event of a heparin shortage?”

Getting Ahead of Candida auris 
“As IDWeek 2019 continued into the weekend, there was no shortage of information for those seeking to prevent and control infectious diseases. For many of us, the threat of antimicrobial resistance has been a major challenge and one for which guidance is desperately needed. Challenging organisms, like Candida auris, make infection prevention efforts in health care that much more difficult and patient care intrinsically more dangerous. In a presentation at the meeting, the presenting author and medical epidemiologist, Snigdha Vallabhaneni, represented the US Centers for Disease Control and Prevention (CDC), while co-authors included experts from health care and public health from California, Connecticut, and CDC.  Researchers emphasized that over 1600 patients have been identified in the United States to have C auris infections or colonization. Of those confirmed cases, risk factors were identified, which include high-acuity post-acute care admissions – like long-term acute care hospitalizations, colonization with carbapenemase-producing organisms (CPOs), or hospitalization abroad.”
 
2019 White House Summit on America’s Bioeconomy
“On October 7, 2019, The White House hosted the Summit on America’s Bioeconomy. The Summit marked the first gathering at The White House of our Nation’s foremost bioeconomy experts, Federal officials, and industry leaders to discuss U.S. bioeconomy leadership, challenges, and opportunities. The bioeconomy represents the infrastructure, innovation, products, technology, and data derived from biologically-related processes and science that drive economic growth, improve public health, agricultural, and security benefits. Bioeconomy outputs are incredibly diverse, and future applications limitless in terms of both application and value, including new ways to treat cancer; enable novel manufacturing methodologies for medicines, plastics, materials, and consumer products; create pest and disease resistant crops; and support DNA-based information systems that can store exponentially more data than ever before. Advances realized over the past two decades have resulted from the unique U.S. innovation ecosystem and the convergence between biology and other disciplines and sectors, such as nanotechnology and computer science. The U.S. bioeconomy – spanning health care, information systems, agriculture, manufacturing, national defense, and beyond – is growing rapidly with increasing impact on our Nation’s vitality and our citizens’ lives. Biotechnology represents 2% of the U.S. GDP, or $388 billion. To remain a world leader in the bioeconomy, the U.S. must foster an ecosystem that puts innovative research first in addition to promoting a strong infrastructure, workforce, and data access framework.”

Social Media and Vaccine Hesitancy                                                    As of this year, vaccine hesitancy is listed one of the WHO’s 10 big threats to global health. Vaccine hesitancy is the foot-dragging or refusal to vaccinate yourself or your children, when vaccines are available. Social media are platforms for the dissemination of both accurate and inaccurate information regarding vaccine safety and benefits. Unfortunately, vaccine content shared on social media is overwhelmingly anti-vaccine material and often lacking scientific or medical evidence. According to Ana Santos Rutschman at Saint Louis University, malicious bots are being used to more efficiently disseminate vaccine misinformation on these platforms. Fortunately, major platforms are instituting policies to curb the spread of vaccine misinformation and support the spread of accurate information from credible sources. Though misinformation remains abundant online, these new policies are promising steps toward eliminating erroneous data. Santos Rutschman “believe[s] social media can and should be redesigned to facilitate the promotion of accurate vaccine information.”

Stories You Might Have Missed:

  • UK Report Cites Lack of AMR Progress-“A paper issued yesterday by policy institute Chatham House concludes that not enough progress has been made on recommendations from a series of reports that alerted the world to the rising threat of antimicrobial resistance (AMR). The AMR Review, commissioned in 2014 by former UK Prime Minister David Cameron and chaired by British economist Lord Jim O’Neill, outlined the threat of AMR to global public health and highlighted the potential costs of inaction in eight separate reports issued over 2 years. Among the highlights from the first AMR Review paper were two startling figures—that drug-resistant infections could cause the deaths of 10 million people by 2050 and could cost the global economy up to $100 trillion if the problem was not addressed in the coming years.”

 

 

What Can We Glean from a Bean: Ricin’s Appeal to Domestic Terrorists

By Stevie Kiesel

Stevie is a part-time PhD student in the GMU Biodefense program, and a full-time transportation security analyst. Her area of study is extreme right wing terrorism and WMD.

In June 2019, FBI leadership testified to the House Oversight and Reform Committee that “individuals adhering to racially motivated violent extremism ideology have been responsible for the most lethal incidents among domestic terrorists in recent years, and the FBI assesses the threat of violence and lethality posed by racially motivated violent extremists will continue.” In September 2019, the Department of Homeland Security published a Strategic Framework for Combating Terrorism and Targeted Violence, which acknowledges that “white supremacist violent extremism…is one of the most potent forces driving domestic terrorism” and “another significant motivating force behind domestic terrorism has been anti-government/anti-authority violent extremism.” A few weeks later, William Braniff, director of START at the University of Maryland, testified to the Senate Homeland Security and Governmental Affairs Committee that “among domestic terrorists, violent far-right terrorists…are responsible for more…pursuits of chemical or biological weapons…than international terrorists.” Just as policymakers have been slow to acknowledge and act upon the threat of domestic CBRN terrorism, timely extant research on the issue is scarce as well. In this article, I focus on ricin as an agent of domestic terror. As government agencies acknowledge the threat domestic terrorism poses, policymakers and law enforcement should take ricin seriously as a potential weapon.

To understand the plausibility of ricin’s use as a weapon, I reviewed a number of journal articles, news articles, and court records from 1978 through 2019 and compiled data on 46 incidents of ricin acquisition and/or use. Of these 46 incidents, 19 could be credibly tied to terrorism, 19 were not related to terrorism, and 8 were unclear. The most common motivation after terrorism was murder (10 instances). Of the 19 terrorist incidents, 58% were committed by extreme right-wing terrorists, a term that here encompasses the following ideologies: neo-Nazi/neo-fascist, white nationalist/supremacist/separatist, religious nationalist, anti-abortion, anti-taxation, anti-government, and sovereign citizen. The remaining incidents were committed by Islamist terrorists (16%), Chechen nationalists (10%), or their exact ideology was unclear (16%). Continue reading “What Can We Glean from a Bean: Ricin’s Appeal to Domestic Terrorists”

Pandora Report: 10.4.2019

What’s New with Novichoks?
Gregory Koblentz, Director of the Biodefense Program, and Stefano Costanzi, a chemistry professor at American University, have published an article in The Nonproliferation Review about recent efforts to add Novichok nerve agents to the Chemical Weapons Convention’s list of Schedule 1 chemicals which are subject to the highest level of verification. Novichok become a household word after Russian agents used this new type of chemical weapon in the attempted assassination of Sergei and Julia Skripal in Salisbury, United Kingdom in March 2018, but there is still a good deal of public confusion about this family of nerve agents. In “Controlling Novichoks After Salisbury: Revising the Chemical Weapons Convention Schedules,” Koblentz and Costanzi clarify the identity of the nerve agent  used in the Salisbury incident and evaluate two proposals regarding Novichoks that will be considered by the Organization for the Prohibition of Chemical Weapons (OPCW) in November. This will be the first time the CWC’s Schedules have been revised since the  treaty was opened for signature in 1993.

Bipartisan Commission on Biodefense Cyberbio Convergence Recap & The Germy Paradox
GMU Biodefense graduate student Georgia Ray has provided us with a detailed summary of this Commission event. We’d also like to show off her blog, Eukaryote Writes, which just so happens to delve into bioweapons and how close we’ve gotten to actual use. Georgia notes “I’ve heard a lot about ‘nuclear close calls.’  Stanislav Petrov was, at one point, one human and one uncomfortable decision away from initiating an all-out nuclear exchange between the US and the USSR. Then that happened several dozen more times. As described in Part 1, there were quite a few large state biological weapons programs after WWII. Was a similar situation unfolding there, behind the scenes like the nuclear near-misses?” In Georgia’s in-depth review of the Cyberbio Convergence event, she notes that “Tom Dashchle described biosecurity as a cause area with ‘broad support but few champions’ and agreed with the importance of creating career paths and pipelines into the field. (Great news for optimistic current Biodefense program students like myself.) The panel also agreed on the importance of education starting earlier, through STEM education and basic numeracy skills.”

1918/1919 Pandemic Museum Exhibit
Check out the Mutter Museum for a permanent exhibit on the influenza pandemic that hit Philadelphia, PA. “On Sept. 28, 1918, in the waning days of World War I, over 200,000 people gathered along Broad Street in Philadelphia for a parade meant to raise funds for the war effort. Among the patriotic throngs cheering for troops and floats was an invisible threat, which would be more dangerous to soldiers and civilians than any foreign enemy: the influenza virus. Officials went ahead with the parade despite the discouragement of the city health department about the ever-spreading virus. Within 72 hours of the parade, all the hospital beds in Philadelphia were full of flu patients. Within six weeks, more than 12,000 people died — a death every five minutes — and 20,000 had died within six months.” Named “Spit Spreads Death”, the exhibit opens on October 17th and will include interactive maps, artifacts, and images. Personal stories and accounts from historians brings this exhibit to life and drives home the message.

The Story of Technology
GMU biodefense doctoral alum Dr. Daniel Gerstein has the latest book for you to add to the reading list – The Story of Technology.  “Technology–always a key driver of historical change–is transforming society as never before and at a far more rapid pace. This book takes the reader on a journey into what the author identifies as the central organizing construct for the future of civilization, the continued proliferation of technology. And he challenges us to consider how to think about technology to ensure that we humans, and not the products of our invention, remain in control of our destinies? In this informative and insightful examination, Dr. Daniel M. Gerstein–who brings vast operational, research, and academic experience to the subject–proposes a method for gaining a better understanding of how technology is likely to evolve in the future. He identifies the attributes that a future successful technology will seek to emulate and the pitfalls that a technology developer should try to avoid. The aim is to bring greater clarity to the impact of technology on individuals and society.” As General David Petraeus (former commander of the troop surge in Iraq, US Central Command, and Coalition Forces in Afghanistan, and former director of the CIA), noted “Gerstein brings a unique perspective to The Story of Technology, as both a national security expert and a technologist. He examines, in a compelling fashion, the inextricable link between humans and technological advancement—and specifically how the latter has granted America security, economic, and societal advantages. But he also cautions, rightly, that many of the foundations on which these advantages have been built are eroding, threatening our interests and perhaps even redefining what it means to be human. This book is a must-read for our national leaders, technology specialists, and general readers alike.”

Starting with the focus on food safety that we saw within the FDA Food Safety Modernization Act (FSMA), the FDA is launching a new tool to help ensure food safety and security occurs in the U.S. “The new Food Safety Dashboard launched today is part of FDA-TRACK, which is one tool the FDA uses to monitor certain FDA programs through key performance measures and projects, and regularly updates to ensure transparency to the public. While we expect that it will take several years to establish trends in the data, the initial data show that since 2016, the majority of companies inspected are in compliance with the new requirements of the preventive control rules. Additional FDA data also show that overall, industry has improved the time it takes to move from identifying a recall event to initiating a voluntary recall, from an average of four days in 2016 to approximately two days in 2019. In fact, comparing the FSMA data with our recall data shows the bigger picture, demonstrating the effectiveness of preventive measures as food recalls once again have reached a five-year low.”
Ebola Outbreak Update
As cases continue to be identified, albeit slowly (total is now 3,198),  much focus has been on community resistance as new research is being released. Researchers “explored community resistance using focus group discussions and assessed the prevalence of resistant views using standardized questionnaires. Despite being generally cooperative and appreciative of the EVD response (led by the government of DRC with support from the international community), focus group participants provided eyewitness accounts of aggressive resistance to control efforts, consistent with recent media reports. Mistrust of EVD response teams was fueled by perceived inadequacies of the response effort (“herd medicine”), suspicion of mercenary motives, and violation of cultural burial mores (“makeshift plastic morgue”). Survey questionnaires found that the majority of respondents had compliant attitudes with respect to EVD control. Nonetheless, 78/630 (12%) respondents believed that EVD was fabricated and did not exist in the area, 482/630 (72%) were dissatisfied with or mistrustful of the EVD response, and 60/630 (9%) sympathized with perpetrators of overt hostility. Furthermore, 102/630 (15%) expressed non-compliant intentions in the case of EVD illness or death in a family member, including hiding from the health authorities, touching the body, or refusing to welcome an official burial team.” GMU Biodefense doctoral alum Saskia Popescu notes that “This research shed light on many of the suspected social dynamics that challenge response efforts but also delved into detail of what is needed to refine education and community outreach to truly be effective.” The U.K. has issued Tanzania travel warnings over a probable Ebola death. “The U.K. advised travelers to Tanzania to be aware of a ‘probable’ Ebola-related death in the East African nation, its Foreign and Commonwealth Office said Tuesday in a statement on its website. About 75,000 British nationals visit Tanzania every year, it said.”
James F. McDonnell, a presidential appointee who over the last two years downsized the Department of Homeland Security’s efforts to prevent terrorism involving weapons of mass destruction, has agreed to resign. McDonnell’s resignation, department sources said, comes at the request of acting Homeland Security Secretary Kevin McAleenan and would become effective at noon on Thursday, according to an email McDonnell sent his staff at 12:57 p.m. EDT on Wednesday. McDonnell’s seven-sentence memo did not provide a reason for his resignation, saying only it was ‘time for a new leadership team to take things to the next level’.”
“Perhaps one of the increasingly more apparent challenges of battling antimicrobial resistance is that of surveillance. This presentation by Michael Y. Lin, MD, MPH, of Rush University Medical Center, discussed the Illinois XDRO Registry. Created in 2013, this data source for XDROs focuses on carbapenem-resistant Enterobacteriaceae (CRE), carbapenemase-producing Pseudomonas aeruginosa, and Candida auris. The registry essentially allows health care facilities to access data to identify if patients being admitted have a history of colonization or infection with the aforementioned organisms.  Data is submitted through hospitals and allows for alerts to be created, automatically, which are sent via email, page, or even a text to the hospital’s infection preventionist when the patient is admitted. Perhaps one of the increasingly more apparent challenges of battling antimicrobial resistance is that of surveillance. This presentation by Michael Y. Lin, MD, MPH, of Rush University Medical Center, discussed the Illinois XDRO Registry. Of those patients who were unknown to the facilities, 33% were not in contact precautions when the alert occurred, indicating that it is highly beneficial for reducing disease transmission.”

Stories You May Have Missed:

  • EEE Cases Continue in Michigan – “The threat from Eastern Equine Encephalitis is continuing to grow, especially in Michigan where state health officials now say 12 counties have confirmed having human or animal cases of EEE. The mosquito-borne virus usually infects only about seven people annually, but there have been 28 human cases reported so far this year across the country. Nine people have died.”

 

Event Recap: Cyberbio Convergence – Bipartisan Commission Biodefense

By Georgia Ray

The Blue Ribbon Study Panel on Biodefense has, with the additional support of Representative Chrissy Houlahan (PA), been rechristened as the Bipartisan Commission on Biodefense. On September 17, 2019, they hosted an event on cyberbiosecurity.

Houlahan spoke on three issues relevant to the theme of this panel, “the Cyberbio Convergence”:

  • Growing importance of cybersecurity as it relates to biological threat data (She is currently working on a report about this.)
  • The future impact of China on the US’ bioeconomy.
  • Educating people in the U.S., including recruiting and incentives for joining the US’ biosecurity enterprise

Former Senator of South Dakota Tom Dashchle described biosecurity as a cause area with “broad support but few champions” and agreed with the importance of creating career paths and pipelines into the field. (Great news for optimistic current Biodefense program students like myself.) The panel also agreed on the importance of education starting earlier, through STEM education, and basic numeracy skills.

Each session consisted of a panel of two or three experts on a particular aspect of the biosecurity-cybersecurity confluence. The experts made statements and answered a few questions from the Commission. Continue reading “Event Recap: Cyberbio Convergence – Bipartisan Commission Biodefense”