Pandora Report 11.16.2018

We’re back from the 5th Ministerial Meeting of the Global Health Security Agenda (GHSA)! We’ll be reporting out on this event in the coming weeks, so keep an eye out for all things GHSA. Influenza season is ramping up and you’ll want to check out the latest article on looking beyond the decade of vaccines.

Preventing Pandemics and Bioterrorism: Past, Present, and Future
We’re just weeks away from this exciting event – are you registered? Preventing Pandemics and Bioterrorism: Past, Present, and Future is a special event in celebration of the 15th anniversary of the George Mason University Biodefense Program at the Schar School of Policy and Government. We invite you to attend this exciting opportunity to hear from Dr. Kadlec of ASPR about lessons learned for pandemic preparedness since the 1918-1919 influenza pandemic, plans for implementing the new National Biodefense Strategy, and the importance of education for the future of biodefense. Following his speech and Q&A session, you are invited to an informal reception for academic and professional members of the biodefense community to socialize and network. Make sure to RSVP soon as seats are limited for this December 4th event.

Russian Disinformation & the Georgian “Lab of Death”
A recent BBC investigation has found some disturbing information regarding Russian media making false claims about a U.S.-funded lab in Georgia. “The Russian Foreign Ministry, Defence Ministry and pro-Kremlin media claimed recently that untested drugs were given to Georgian citizens at the lab, resulting in a large number of deaths. The US has accused Russia of disinformation in order to distract attention away from incidents such as the Salisbury poisonings.” This episode is part of a series the BBC is providing on disinformation and fake news.

Ebola Outbreak Updates
The Ebola virus disease outbreak in the DRC continues to grow. 15 cases were reported on Monday as well as another violent attack in Beni. “WHO Director-General Tedros Adhanom Ghebreyesus, PhD, said on Twitter that he had been briefed on a violent attack that occurred in Beni on the night of Nov 10. ‘All WHO staff safe, but my heart goes out to families who have lost loved ones in this appalling and unacceptable attack, which we condemn in the strongest terms,’ he wrote. According to a local media report translated and posted by H5N1 Blog, which focuses on infectious disease news, at least five civilians were killed and several children kidnapped in an attack by rebels with the Allied Democratic Forces (ADF) in Beni’s Mayimoya district. The report said two other people were killed in two other attacks the same day in Beni’s Runwenzori neighborhood, one linked to ADF rebels and the other by suspected Mai Mai militia members.” The latest situation report lists 333 cases and 209 deaths, with 31 new confirmed cases reported during the reporting period (Nov 5-11). Early this morning, the DRC announced three more cases and 1 death. Health officials are also reportedly planning to launch a clinical trial of three antibody treatments and an antiviral drug, within the area. These drugs are currently in utilization in the Ebola treatment centers within the area but only under compassionate use. The UK is contributing funds to help Uganda step up prevention and preparedness efforts as well. “On a recent visit to The Medical Research Council/Uganda Virus Research Institute (URVI) and the London School of Hygiene and Tropical Medicine Research Unit in Entebbe, UK Minister for Africa Harriett Baldwin announced that the UK will support Uganda’s National Task Force with up to £5.1 million ($6.6 million USD) to support Ebola preparedness and prevention efforts in Uganda. This funding will support surveillance in high-risk districts at the border with the Democratic Republic of Congo (DRC); risk reduction communication in communities; infection prevention and control measures as well as provide for improved case management.” Peter Salama, WHO Emergency Response Chief, has noted that the outbreak could last another six months – “It’s very hard to predict timeframes in an outbreak as complicated as this with so many variables that are outside our control, but certainly we’re planning on at least another six months before we can declare this outbreak over,”.

ELBI Fellowship Application Opens
The Emerging Leader for Biosecurity Initiative (ELBI) run by the Center for Health Security is now accepting applications. This is a great opportunity that several Biodefense students have been able to take advantage of for the last several years. GMU Biodefense has had several fellows – Yong-Bee Lim  is currently an ELBI fellow and Saskia Popescu, Siddha Hover, and Francisco Cruz have represented our biodefense program in previous years. If you’re a current GMU biodefense student or alumni and are interested in applying and plan to request a letter of recommendation from the Biodefense program director, please do so ASAP. Dr. Koblentz asks that applicants send a copy of their application materials (personal statement, essay, and current resume or cv) and an unofficial GMU transcript by December 5, 2018.

 One Health in the 21st Century Workshop
The One Health in the 21st Century workshop will serve as a snapshot of government, intergovernmental organization and non-governmental organization innovation as it pertains to the expanding paradigm of One Health. One Health being the umbrella term for addressing animal, human, and environmental health issues as inextricably linked, each informing the other, rather than as distinct disciplines. This snapshot, facilitated by a partnership between the Wilson Center, World Bank, and EcoHealth Alliance, aims to bridge professional silos represented at the workshop to address the current gaps and future solutions in the operationalization and institutionalization of One Health across sectors. The workshop will be held on November 26th at the Wilson Center. You can RSVP here.

USDA ARS 5th International Biosafety & Biocontainment Symposium: Biorisk and Facility Challenges in Agriculture
Registration is open for this February 11, 2019 event! The symposium will provide 2.5 days of scientific presentations and exhibits regarding agricultural biosafety and biocontainment.

WHO Report on Surveillance of Antibiotic Consumption
The WHO has just released their report on global antibiotic consumption and the surveillance methods surrounding efforts to reduce antimicrobial resistance. “Since 2016, WHO has supported capacity building in monitoring antimicrobial consumption in 57 low- and middle-income countries through workshops, trainings and technical support. At this stage, 16 of these countries were able to share their national data with WHO. Other countries are currently in the process of data collection and validation.In total, 64 countries and Kosovo1 contributed data on antibiotic consumption for this report, with the bulk of data coming from the European region and countries with pre- existing, mature surveillance systems. The consumption data showed wide intra- and interregional variation in the total amount of antibiotics and the choice of antibiotics consumed. The overall consumption of antibiotics ranged from 4.4 to 64.4 DefinedDaily Doses (DDD) per 1000 inhabitants per day.”

Stories You May Have Missed:

  • Influenza Vaccine Efficacy Among Patients with High-Risk Medical Conditions in the U.S. – Researchers utilized data from the US Influenza Vaccine Effectiveness Network from 2012-2016 to analyze vaccine effectiveness (VE) “of standard-dose inactivated vaccines against medically-attended influenza among patients aged ≥6 months with and without high-risk medical conditions. Overall, 9643 (38%) of 25,369 patients enrolled during four influenza seasons had high-risk conditions; 2213 (23%) tested positive for influenza infection.Influenza vaccination provided protection against medically-attended influenza among patients with high-risk conditions, at levels approaching those observed among patients without high-risk conditions. Results from our analysis support recommendations of annual vaccination for patients with high-risk conditions.”



Pandora Report: 11.3.2018

November 3rd is One Health Day – how are you celebrating? Just a friendly reminder that the Pandora Report will be on hiatus next week as we’ll be attending the GHSA Ministerial Meeting. Follow us on Twitter (@PandoraReport) to get live updates from Bali!

Schar School of Policy and Government Hosts Preventing Pandemics and Bioterrorism: Past, Present, and Future
Join us on December 4th for Preventing Pandemics and Bioterrorism: Past, Present, and Future, featuring Robert Kadlec, M.D., Assistant Secretary for Preparedness and Response (ASPR)  Health & Human Services, Office of the Secretary. We are excited to announce this special event in celebration of the 15th anniversary of the George Mason University Biodefense Program at the Schar School of Policy and Government. We invite you to attend this exciting opportunity to hear from Dr. Kadlec about lessons learned for pandemic preparedness since the 1918-1919 influenza pandemic, plans for implementing the new National Biodefense Strategy, and the importance of education for the future of biodefense. Following his speech and Q&A session, you are invited to an informal reception for academic and professional members of the biodefense community to socialize and network. Make sure to RSVP here to save your spot!

GMU Master’s Open House
Now is your time to start a future in biodefense – earn a MS in biodefense at George Mason University! Whether it’s online or in person, we’re the place to be for all things health security – from anthrax to Zika. In fact, we’re sending two of our graduate students to the Global Health Security Agenda Ministerial Meeting in Bali next week to act as student ambassadors! Don’t miss the Master’s Open House on Thursday, November 15th at 6:30pm at our Arlington Campus. This is a perfect opportunity to chat with faculty and learn about the admissions process, what it takes to earn a degree in biodefense, and the type of courses you’ll get to enjoy (hint: they’re seriously awesome and diverse).

NextGen GHSA Side Event – Bali
Will you be at the GHSA Ministerial Meeting next week? Look for our two GMU student ambassadors and attend this wonderful event! The Next Generation Global Health Security Network was established in 2014 to engage and facilitate contributions by emerging scholars, scientists, and professionals from government and non-governmental institutions to the Global Health Security Agenda and other global health security initiatives. During the GHSA NextGen Side Event, Tuesday, November 6 from 7:30-9:00, conference attendees will have an opportunity to learn about the innovative project from the winning team of the NTI-sponsored “Biosecurity Competition”, collaborative projects with other GHSA partners, and upcoming priority activities aligned with the strategic vision to promote education, innovation and participation of our members in the GHSA.

NTI’s 2018 Next Generation for Biosecurity Competition
Speaking of the GHSA Ministerial Meeting…NTI|bio has just announced the winner of their collaboration with the Next Generation Global Health Security Network – the 2018 Next Generation for Biosecurity Competition. “NTI | bio, in partnership with the Next Generation Global Health Security Network, is pleased to announce the winners of the 2018 Next Generation for Biosecurity Competition: Peter Babigumira Ahabwe, Infectious Diseases Institute, Uganda; Dr. Frances Butcher, Oxford School of Public Health, UK; and Javier Rodriguez, National Commission of Atomic Energy, Argentina. Their proposal, ‘Act Like a Pro: Scenario-Based eLearning for the Next Generation of Biosecurity Learners,’ is an openly accessible online platform for students and entry-level professionals.  The ‘Act Like a Pro’ platform will also feature a forum for peer-to-peer discussion, monitored by a biosecurity expert. The winning team was selected from proposals received across 14 countries and six continents.  Proposals were evaluated by an international expert panel of 24 judges from seven countries across five continents.  The winning team will receive $15,000 to implement their proposal and will be honored during the GHSA Ministerial.  This competition underscores the importance of promoting a global cadre of multi-sectoral, young professionals dedicated to reducing catastrophic biological risks.”

Stay Connected – GMU Biodefense
Are you a GMU biodefense alum or current student? Make sure to update your information with our Stay Connected program so that we can share the latest news with you and brag about the awesome things you’re doing!

One Health Day
The connection between human, animal, and environmental health is undeniable. Check out this TED talk on human canaries in the coal mine, which discusses veterinary pathology and disease transmission between humans and animals. On November 3rd, we celebrate this day internationally – “One Health Day answers the urgent need for a One Health trans-disciplinary approach towards solving today’s critical global health challenges. It is a timely initiative that gives scientists and advocates a powerful voice for moving beyond current provincial approaches to emerging zoonotic infectious diseases, antimicrobial resistance, climate change, environmental pollution, food safety, comparative/translational medicine and many other problems, to a holistic default way of doing business.”

Conversation with Director Robert Redfield of CDC: The Latest on the DRC Ebola Outbreak
Don’t miss this even on Monday, November 5th, from 10-11am in the Dirksen Senate Office Building. “Robert Redfield, Director for the Centers of Disease Control and Prevention, will join Tom Inglesby, Director of the Johns Hopkins Center for Health Security, for a moderated discussion followed by time for questions and answers. The purpose of this seminar is to discuss the latest events in the DRC Ebola outbreak, the serious challenges involved and the possible trajectory of the outbreak, how CDC and the US government are involved, and what is needed to control the outbreak. Our goal is to provide the Hill community and other stakeholders with the most valuable and current information on this outbreak and how the United States is participating in the international response.” You can RSVP here.

Pandora Report YouTube Channel 
On top of bringing you a weekly dose of biodefense news, we also have a YouTube channel for informative videos! The latest upload is a speech Dr. Koblentz (GMU biodefense graduate program director and professor) gave at the 2016 UN Security Council meeting.

Stories You May Have Missed:

  • Ebola Outbreak Update – “Health officials in the Democratic Republic of the Congo (DRC) said yesterday that an Ebola case has been detected in a previously unaffected health zone, which is located between the two current hot spots, and that eight more cases have been confirmed, based on reports yesterday and today. Also, the World Health Organization (WHO) again said the increase in Beni and Butembo is concerning, as security incidents threaten residents and frontline workers and pockets of resistance pose tough challenges”. The total case counts are now 285 with 250 confirmed and 180 deaths.
  • New MERS-CoV Cases – “The World Health Organization (WHO) today released an overview of eight new MERS cases reported in Saudi Arabia from Sep 17 to Oct 15. Of the eight cases, three proved fatal. With the new cases, the total global number of laboratory-confirmed MERS-CoV (Middle East respiratory syndrome coronavirus) cases reported to WHO since 2012 is 2,262 with 803 associated deaths. Three of the new cases were in Riyadh, and two were in Buraydah. Taif, Najran, and Asyah also reported one new case each. None of the patients were healthcare workers, and all but one were men. Patients’ ages ranged from 22 to 66.”


Pandora Report 10.26.2018

Happy Friday! Halloween is next week but Europe is already taking measures against some of the scariest germs out there – antibiotic resistant microbes. The European Parliament just adopted two laws to limit the use of antimicrobials in food-producing animals.

U.S. National Security Action Plan: Strengthening Implementation of the International Health Regulations
This newly released plan is based upon the 2016 Joint External Evaluation and an effort coordinated by ASPR. “The U.S. Health Security National Action Plan follows an intensive Joint External Evaluation (JEE) of U.S. capacities in May 2016, which was conducted as part of our commitment to the domestic implementation of the International Health Regulations (IHR) (2005)—an international legal framework for global health security, where countries build their own health security capacities and take part of a global surveillance and response network created through the IHR. As a result, the activities proposed in the plan address capacity gaps found by national and international subject-matter experts during the JEE and also further the multi-sectoral and multi-disciplinary approach promoted by the IHR to adequately prevent, detect, and respond to public health security threats.” The plan reinforces participation in the GHSA and emphasizes the importance of working across multiple sectors and disciplines to help prevent, detect, and respond to public health threats.

GMU Biodefense Journal Club Meeting
Are you a current GMU biodefense graduate student? Don’t miss out on the next meet-up with a fun group of fellow biodefense nerds, where you can chat about it all- from anthrax to Zika. The next meeting is on November 5th and the topic of discussion will be the 100th anniversary of the 1918/1919 flu, so check your email for the location info, etc.

 Anticipating Emerging Biotech Threats
GMU Biodefense professor Sonia Ben Ouagrham-Gormley teamed up with Kathleen Vogel to discuss CRISPR and its potential as an emerging biotech threat. “In light of literature on the sociotechnical dimensions of the life sciences and biotechnology and literature on former bioweapons programs, this article argues that we need more detailed empirical case studies of the social and technical factors shaping CRISPR and related gene-editing techniques in order to better understand how they may be different from other advances in biotechnology — or whether similar features remain. This information will be critical to better inform intelligence practitioners and policymakers about the security implications of new gene-editing techniques.” Ouagrham-Gormley and Vogel note the importance of considering issues with off-target effects and replication of experiments when evaluating CRISPR and its popularized ease of use and diffusion.

2018 Arizona Biosecurity Workshop
Don’t miss this two-day workshop in Phoenix, AZ, on December 13th/14th. Held at the Arizona State University campus, “this two-day workshop focuses on community engagement with biosecurity concerns in an applied and practical manner. The goal of this workshop is to foster awareness and to stimulate conversation about the ethical, moral and social implications of biosecurity.” You can view the agenda here.

Ebola Updates
On Saturday, 11 civilians were killed and many more attacked in the town of Mayongose, on the outskirts of Beni. UN Secretary-General Atonio Guterres “condemned Saturday’s attack in the town of Mayongose on the outskirts of Beni, in which at least 11 civilians were killed, and several more were injured and abducted. He said he is also ‘deeply troubled’ by reports that on Friday, two Congolese health workers helping to combat the Ebola outbreak, were killed in Butembo by armed militia. Such attacks continue to hamper humanitarian access in the conflict-torn region and prevent health workers from tackling the outbreak.” Cases in Beni have topped 100 and on Thursday, 3 new cases and 2 deaths were reported in Beni, which brings the total case count to 247, including 150 deaths. “In its regular situation report, the WHO said top concerns are the spike in cases over the past 4 weeks, especially in Beni, and the security challenges response teams are facing in Beni and Butembo. ‘Continued security incidents severely impact both civilians and frontline workers, forcing suspension of EVD response activities and increasing the risk that the virus will continue to spread,’ it said. Vaccination in Beni could not take place in Beni on Oct 21 because of community demonstrations in the wake of attacks the day before, the WHO added. It also said investigations continue into the steady stream of confirmed cases that aren’t from known transmission chains, a sign that the virus continues to spread undetected.” Response efforts have also been an issue as the “The director of the Centers for Disease Control and Prevention said Tuesday that he argued that American experts should stay in the outbreak zone of the latest Ebola epidemic but was overridden by others in the Trump administration because of security concerns. ‘Those decisions are security decisions that really are outside the realm of my public health expertise,’ said the director, Robert Redfield, who said he made a case to the Department of Health and Human Services about why public health experts should remain in the outbreak area but that, at the end of the day, his argument didn’t win out.” Due to security concerns, the CDC withdrew workers from the outbreak several weeks ago. Stephen Morrison of CSIS noted that “There’s a fear of making a mistake and getting clobbered by Congress. There’s a fear of a Benghazi-type situation, that Americans might be targeted,” he said. “We’re looking at possible change of power in the House of Representatives in another 14 days.” (In 2012, an Islamic militant group attacked US government facilities in Benghazi, Libya, leading to the deaths of four Americans.)”

The Dangers of Forced Quarantine
The efficacy of forced quarantine has been questioned for years. Many experts have underscored that this antiquated measure desperately needs to be evaluated in light of the growing threat of a pandemic in this globalized, heavily populated world. From the HIV/AIDS epidemic to Ebola, the stigma that has been associated with disease does little to aid response efforts. “Perhaps the greatest danger of forced quarantines that isolate the poor and vulnerable is that they often don’t work. By eroding trust in public health measures, they undermine the ultimate goal of protecting societies from the spread of disease. People find ways to break free. It is thus possible that giving patients and the public more choices—and the option to quarantine themselves—could in some instances be more effective at fighting off pandemics than police or military-enforced quarantine.”

The Price of Pandemic Prevention
The Coalition for Epidemic Preparedness Innovations (CEPI) just released a new study regarding the cost of developing vaccines for 11 epidemic infectious diseases. Accounting for the constraints of vaccine pipelines and challenges of R&D, their findings are particularly helpful for pandemic prevention efforts. “The cost of developing a single epidemic infectious disease vaccine from preclinical trials through to end of phase 2a is US$31–68 million (US$14–159 million range), assuming no risk of failure. We found that previous licensure experience and indirect costs are upward drivers of research and development costs. Accounting for probability of success, the average cost of successfully advancing at least one epidemic infectious disease vaccine through to the end of phase 2a can vary from US$84–112 million ($23 million–$295 million range) starting from phase 2 to $319–469 million ($137 million–$1·1 billion range) starting from preclinical. This cost includes the cumulative cost of failed vaccine candidates through the research and development process. Assuming these candidates and funding were made available, progressing at least one vaccine through to the end of phase 2a for each of the 11 epidemic infectious diseases would cost a minimum of $2·8–3·7 billion ($1·2 billion–$8·4 billion range).”

Stories You May Have Missed:

  • UK Parliament Emphases AMR As A Priority – “The report by members of the House of Commons’ Health and Social Care Committee warns that “modern medicine will be lost” if the government does not take more aggressive action to reduce inappropriate use of existing antibiotics and promote development of new antibiotics. ‘Visible and active Government leadership needs to be restored to tackle AMR,’ members of the committee wrote in the report. ‘We therefore urge the Prime Minister to work closely with her relevant ministers to raise the profile of AMR both at home and on the international stage’.”


Pandora Report 10.19.2018

TGIF! Before we begin our weekly biodefense news report…a friendly reminder to avoid raw chicken as there is a considerable outbreak of multidrug-resistant Salmonella Infantis tied to raw chicken across 29 states. Check out this article on the cost and challenges of vaccine development for emerging and emergent infectious diseases.

GMU Biodefense Alum Recognized for Research Regarding Airplane Infectious Disease Transmission
GMU Biodefense doctoral alum Nereyda Sevilla is an expert when it comes to germs on a plane. In her recent article, Sevilla address the “the role of air travel in the spread of infectious diseases, specifically severe acute respiratory syndrome (SARS), H1N1, Ebola, and pneumonic plague. Air travel provides the means for such diseases to spread internationally at extraordinary rates because infected passengers jump from coast to coast and continent to continent within hours. Outbreaks of diseases that spread from person to person test the effectiveness of current public health responses.” She utilizes the STEM (Spatiotemporal Epidemiological Modeler) to assess the transmission potential for outbreaks of SARS, H1N1, Ebola, and pneumonic plague spread between people via air travel. Sevilla finds that “the comparative results of each of the four modeled diseases along with the historical accounts show the importance of the disease characteristics and the impact of the infection rate. A disease that has a long period of illness, such as SARS or H1N1, is expected to cause a higher natural spread than diseases in which the period of illness is brief. In cases in which the period of illness is short, such as pneumonic plague, those individuals affected do not have the same opportunities to infect others as do those people harboring diseases with a longer period of illness.” Due to her efforts to study air travel as a transmission mechanism, Sevilla has been awarded the Uniformed Services University Alumni Association Graduate School of Medicine Graduate of the Year and the 2018 Aerospace Physiology Paul Bert Research Award! Congrats Nereyda!

Blue Ribbon Study Panel Meeting – Biodefense Indicators: Progress in Implementing Key Elements of the National Blueprint for Biodefense
The Blue Ribbon Study Panel is hosting an event on November 14th regarding the role of the Executive Branch in implementing the National Blueprint for Biodefense. “The Panel will focus specifically on illustrative action items among those the Panel felt that the federal government could complete in the three years since releasing the Blueprint in 2015. Objectives include Discuss the development and release of the National Biodefense Strategy and opportunities associated with its implementation, review current biosurveillance and biodetection programs, and efforts to improve situational awareness of biological threats, etc.” Make sure to RSVP by November 8th!

International Infection Prevention Week
This week marks International Infection Prevention Week, which recognizes the importance of infection prevention in healthcare and the infection preventionists working to promote safe patient care. You may be wondering why infection prevention is so important but here are a few reminders – influenza, antimicrobial resistance, Ebola, SARS, MERS, measles, surgical site infections, and Clostridium difficile. Those are all infections that have harnessed the awesome transmission capacity of hospitals due to poor infection prevention. Hand hygiene is just a small piece of this, but without infection prevention, we couldn’t safely seek medical care without the risk of a diverse range of infections. Just remember – infection prevention goes beyond things like MRSA and has a vital role in emerging infectious disease response and global health security.

DRC Ebola Outbreak – Increasing Concern
The WHO convened a meeting on Wednesday of the IHR Emergency Committee to discuss the outbreak in the DRC. Following the meeting, they stated “It was the view of the Committee that a Public Health Emergency of International Concern (PHEIC) should not be declared at this time. But the Committee remains deeply concerned by the outbreak and emphasized that response activities need to be intensified and ongoing vigilance is critical. The Committee also noted the very complex security situation. Additionally, the Committee has provided public health advice below.” There have been 220 Ebola cases and 142 deaths reported. Perhaps one of the most challenging aspects of outbreak containment has been security within the area. Per the WHO release – “This outbreak is taking place in an active conflict zone amidst prolonged humanitarian crises. Approximately 8 major security incidents have occurred in the Beni area in the past 8 weeks. These factors have complicated contact tracing and other aspects of the response. Community mistrust, stemming from a variety of reasons, including the security situation, and people who avoid follow-up or delay seeking care, remain significant problems that require deepening engagement by community, national and international partners.” Laurie Garrett wrote about the significance of this situation given that it is the first Ebola outbreak in a war zone. “The view from the United States is different. Last week, the U.S. State Department deemed the security situation on the ground in the outbreak so dangerous that teams of U.S. Centers for Disease Control and Prevention experts were pulled back more than 1,000 miles away to the Congolese capital of Kinshasa.” Garrett underscores the complexity of the conflict, noting that “In the absence of U.S. engagement, the WHO must take a political lead, which is admittedly not its forte, by pulling national security and legal experts into immediate planning should a worst-case security breach occur. Waiting until a doctor is in the hands of the Mai-Mai Yakutumba, a nurse is raped by the Hamakombo, soldiers from the Congolese army shoot a contact-tracing health volunteer, or rival Mai-Mai factions get into a firefight that involves Ebola Treatment Center workers is a recipe for absolute disaster.”

Viral Misinformation – The Biggest Pandemic Risk 
Heidi J. Larson is highlighting a very real public health issue we’re not discussing – misinformation. “I predict that the next major outbreak — whether of a highly fatal strain of influenza or something else — will not be due to a lack of preventive technologies. Instead, emotional contagion, digitally enabled, could erode trust in vaccines so much as to render them moot. The deluge of conflicting information, misinformation and manipulated information on social media should be recognized as a global public-health threat.” Larson points to the vaccine denial phenomenon and those who pray upon it – “The second-most-dangerous category includes those who see anti-vaccine debates as a financial opportunity for selling books, services, or other products. (Wakefield, who maintains that financial concerns have not affected his research and that he has been unfairly vilified, gave paid testimony against the vaccine and filed a patent that allegedly stood to become more valuable were the vaccine to be discredited.) The next tier of damaging misinformation comes from those who see anti-vaccine debates as a political opportunity, a wedge with which to polarize society.” Among those who help spread misinformation is the “super-spreader” who helps spread misinformation through social media to those who also share the mistrust in vaccines. Ultimately, fixing these sources for misinformation is complex and requires considerable engagement and listening, but also supplying public health with more funding towards educational campaigns.

One Health Day – November 3!
One Health Day is just a few weeks away – what’re you doing to celebrate the importance of One Health? “The goal of One Health Day is to build the cultural will necessary for a sea change in how planetary health challenges are assessed and addressed. One Health Day will bring global attention to the need for One Health interactions and allow the world to ‘see them in action’.  The One Health Day campaign is designed to engage as many individuals as possible from as many arenas as possible in One Health education and awareness events and to generate an inspiring array of projects worldwide.”

Spikes of Pediatric Acute Flaccid Myelitis Illness
In 2014, there were surges of AFM associated with enterovirus D68 but a recent spike in pediatric cases is causing concern. “The US Centers for Disease Control and Prevention (CDC) said today that officials are investigating a spike in acute flaccid myelitis (AFM) cases, mostly in children, that looks similar to increases they saw in the late summer and fall of 2014 and 2016, with 127 cases under investigation in 22 states. So far 62 of the cases—marked by sudden onset of limb weakness and decreased muscle tone—have been confirmed, Nancy Messonnier, MD, director of the CDC’s National Center for Immunization and Respiratory Diseases, said today at a media briefing. More than 90% have been in children, and the average age is 4 years.” While the odds of AFM are rare and not caused by a poliovirus, the symptoms can be similar. Patterns appear to be seasonal and the CDC is working to identify trends and prevention efforts.

ASM Biothreats Call for Abstracts
The deadline is today for you to get an abstract in for the 2019 ASM Biothreats. “2019 ASM Biothreats, January 29–31, in Arlington, Virginia. ASM wants your research on high consequence pathogens, biological threat reduction, product development and policy. ‘Share your research with experts in academia, industry and government, who meet each year to learn from each other. This year, the meeting will focus on four areas: High Consequence Pathogen Research, Biological Threat Reduction, Product Development, and Policy’.”

Bioeducation Tool from FAS & FBI
Check out this app by the Federation of American Scientists and Federal Bureau of Investigation – the Bioagents Education App. This app details nearly 50 biological agents that are relevant to biodefense efforts and have the potential for misuse as a bioweapon.

Stories You May Have Missed:

  • 2019 Nuclear Scholars Initiative – Applications are due today for this exciting opportunity. “PONI is now accepting applications for the 2019 Nuclear Scholars Initiative. Those accepted into the Nuclear Scholars Initiative are hosted once per month at CSIS in Washington, DC, where they participate in daylong workshops that include discussions with senior experts, simulations and table top exercises, research reviews, and professional development opportunities. Throughout the sessions the scholars discuss and explore a full breadth of nuclear topics from deterrence, escalation control and modernization to regional dynamics, nonproliferation, nuclear security and the future of arms control.”

Pandora Report 10.12.2018

 GMU Biodefense Master’s Open House 
On Thursday, November 15th, at 6:30pm, we’ll be hosting an Open House on the MS programs within Schar School. This is a great chance to learn about the online and in-person biodefense MS programs, admission criteria, and chat with faculty. Make sure to RSVP here!

Review of the Blue Ribbon Study Panel “Fits and Starts: Reactionary Biodefense” 
GMU Biodefense graduate students Alexandria Tepper and Michael Krug review the latest Blue Ribbon Study Panel event in case you missed it on October 9th. “The event kicked off with an in-depth recollection by Sen. Daschle of October 16th, 2001; the day that letters containing Bacillus anthracis spores were opened in the Hart Senate Building. “Confusion and chaos” were the words the senator used to describe the situation that ensued when one of his interns opened the letter and aerosolized the fine white powder, exposing 28 staff members to the deadly B. anthracis. He expressed the helpless feeling that overcame him when he received a phone call describing the situation. As he rushed to the Hart Senate Building, he recalled the disorganization of the federal investigators during the bio-threat, as responders were devastatingly unprepared for such an event. The lack of standardized protocols became startlingly evident when the exposed staff members were cleared to return home in the same clothes worn during the attack. Fortunately, no one was killed in this specific attack and Sen. Daschle attributed that to a select few individuals who stepped up to lead the treatment and recovery process.”

Event Summary and Analysis for “The Implications of Chemical Weapons Use in Syria”
George Washington University graduate student Wardah Amir discusses the IISS event hosted last week regarding CW use in Syria. “The 2013 deal would not have been possible without Russian cooperation. At the time U.S.-Russian interests overlapped on eliminating Syria’s chemical weapons program. Unfortunately, U.S. and Russian cooperation did not last long enough to hold users of chemical weapons in Syria accountable. While the OPCW Executive Council believes in working towards accountability, Russia’s unwillingness is shown by its failure to cooperate.The deal was proof that international cooperation could help achieve results. The framework inevitably led to the creation of the OPCW Fact-Finding Mission, the Declaration Assessment Team, and the OPCW-UN Joint Investigative Mechanism.  Without Russian cooperation, or the active participation of the international community on addressing chemical weapons use, results will be harder to achieve.”

 Technologies to Address Global Catastrophic Biological Risks 
The Johns Hopkins Center for Health Security has just released a new report that discusses how investment in 15 promising technologies could make us more prepared and better at responding to biological incidents. “While systems to respond [to an outbreak] are in place in many areas of the world, traditional approaches can be too slow or limited in scope to prevent biological events from becoming severe, even in the best of circumstances,” wrote the Center authors. “This type of response remains critically important for today’s emergencies, but it can and should be augmented by novel methods and technologies to improve the speed, accuracy, scalability, and reach of the response.” The technologies were grouped into 5 categories – disease detection, surveillance, and situational awareness, infectious disease diagnostics, distributed medical countermeasures manufacturing, medical countermeasure distribution, dispensing, and administration, and medical care and surge capacity. Within the report, there is a focus on technologies like remote sensing for agricultural pathogens, hand-held mass spectrometry for diagnostics, synthetic biology for manufacturing medical countermeasures, etc. The authors note that “To realize the promise of these technologies will require significant dedicated effort and investment. While this is occurring for vaccine development, and to some extent for surveillance, other needs for pandemic and GCB event prevention and response must be addressed if we are to confront these threats in a serious way. One possible approach to closing these gaps would be through the formation of a consortium of technology developers, public health practitioners, and policymakers aimed at understanding pressing problems surrounding pandemic and GCB risks, and jointly developing technology solutions.”

Blue Ribbon Study Panel Report – Holding the Line on Biodefense: State, Local, Tribal, and Territorial Reinforcements Needed
The Blue Ribbon Study Panel on Biodefense just released their latest report, which underscores the need for first responders. “How we respond to biological events – especially those large in scale and impact – is now out of balance with how we prepare,” said former Secretary of Health and Human Services Donna Shalala, Panel Member, who co-chaired the January 2018 meeting in Miami that informed many of the report’s recommendations. “There are a number of steps we can take right now to better position SLTT governments, as well as hospitals, pharmacies, and other private sector organizations to respond immediately and then in tandem with federal support.” Within the report, there are eight recommendations, including – Unify and establish a new National Emergency Medical Services system, including the creation of a National Emergency Medical Services Agency at the Department of Health and Human Services,  Improve distribution of the Strategic National Stockpile and other stores of pharmaceuticals, equipment, and essential medical supplies, with enhanced training and assured access to pharmacy readiness data, etc.

Post-Florence Giant Mosquitoes
Like something out of a horror movie, North Carolina is getting hit with “mega-mosquitoes” following Hurricane Florence. “‘These giants have zebra-striped legs and are two to three times as big as the normal bloodsuckers encountered during summer, said Michael H. Reiskind, an assistant professor in the Department of Entomology at North Carolina State University. ‘Definitely noticeably bigger,’ he said. ‘If you see mosquitoes often, then you’re going to say, ‘Wow, that’s a big mosquito’.” While they don’t carry human diseases, these massive mosquitoes can carry dog heart worm.

Bacteriophages and Their Application For Fighting Antimicrobial Resistance
Researchers and medical providers alike are searching for the next effective tool against antibiotic resistant infections. One such tactic is bacteriophage therapy – a natural enemy to bacteria. Laura H. Kahn writes that “In addition to minimal governmental research funding, the pharmaceutical industry hasn’t been interested in developing phage therapies because of regulatory and patentability concerns. But these concerns can be readily addressed. Phages adapted to newly evolved, resistant bacteria could be analogous to updated influenza vaccines that get approved each year without undergoing time-consuming Investigational New Drug (IND) approval processes. Novel technologies to isolate, bioengineer, and produce phages at scale could be patented. For example, phages have been engineered to reduce bacterial biofilms.”

 Ebola Outbreak Update
Seven additional cases were announced in the DRC on Wednesday, bringing the total to 188 and 118 deaths. “The DRC’s ministry of health said the recent spike in cases in these areas confirms that case contacts during the initial wave of cases in August and September who avoided follow-up and vaccination have now been infected. Beni has been a hotbed of anti-response activity, especially the neighborhood of Ndindi. ‘The factors contributing to this situation are mainly misinformation, non-collaboration of the population with the response teams and insecurity,’ the Health Ministry said in its daily update. ‘More than two months after the declaration of the epidemic, the community continues to prevent the safe and dignified burial, and at-risk contacts still refuse vaccination and 21-day follow-up.'” As of Wednesday, “four administrative measures will be put in place in Beni, the new epicenter of the outbreak, the health ministry said. The steps include making it illegal to harbor a suspected Ebola patient, using security forces to monitor and implement safe burials, requiring families to show official death certificates before obtaining a burial certificate, and obligating all health professionals (including traditional healers) to report suspected cases to Ebola treatment centers.”

Stories You May Have Missed:

  • Poliolike Illness Found in Children – “Health officials in Minnesota and Colorado are among the states investigating acute flaccid myelitis (AFM) cases in children, raising concerns about another possible uptick in the rare condition, similar to steep rises seen in 2014 and 2016. The hallmark of AFM is a sudden onset of limb weakness associated with spinal cord inflammation. In 2014, a large outbreak coincided with a national outbreak of severe respiratory illness causes by enterovirus D68 (EV-D68), but intensive investigations have not consistently found a specific pathogen in spinal fluid samples. In an Oct 5 statement, the Minnesota Department of Health (MDH) said it is investigating six AFM cases that have occurred in children since the middle of September. Health officials are collecting information about the cases from health providers and are in contact with the CDC, the MDH said.”


Event Summary and Analysis for “The Implications of Chemical Weapons Use in Syria”

by Wardah Amir, Graduate Student in the Security Policy Studies Program, The George Washington University

On September 14 2013, a deal was reached between the United States and Russia which set a deadline for the destruction of the declared Syrian chemical weapons stockpile. While the original deadline set by the deal was not met, on June 23 2014 the last of Syria’s declared chemical weapons had been successfully removed out of the country amidst its civil war. Despite these efforts, chemical weapons were continuously used in the Syrian Arab Republic. In April this year, Douma fell victim to yet another chemical attack. Roughly 40 to 70 lives were lost. Continue reading “Event Summary and Analysis for “The Implications of Chemical Weapons Use in Syria””

Review of the Blue Ribbon Study Panel “Fits and Starts: Reactionary Biodefense”

By Alexandria Tepper and Michael Krug, GMU Biodefense

On October 9th, 2018, the Blue Ribbon Study Panel on Biodefense presented a discussion session entitled “Fits and Starts: Reactionary Biodefense”. The five-hour event was composed of a series of expert panels spanning multiple fields, agencies, and backgrounds. The panels were moderated by four co-chairs from the Blue-Ribbon Study Panel, including: Former Senator Joseph Lieberman, Former Governor Thomas Ridge, Senator Tom Daschle, and Kenneth Wainstein. The discussion centered around the steps taken, 17 years later, since the anthrax events of 2001. Continue reading “Review of the Blue Ribbon Study Panel “Fits and Starts: Reactionary Biodefense””

Pandora Report 10.5.2018

TGIF! This week has been pretty busy in the world of biodefense, so before we get into ricin, Insect Allies, the new Biodefense Strategy, and all the other stuff in between, make sure you’ve got a cup of coffee or tea because you won’t want to miss anything.

Attempted Ricin Attack Via Mail?
On Monday, federal authorities responded to suspicious envelopes sent to senior U.S. officials, including President Trump. “The Pentagon Force Protection Agency on Monday detected a suspicious substance, believed to be the poison ricin, on two envelopes at a mail facility on Pentagon grounds in Northern Virginia, the officials said. Initial tests indicated that the envelopes, addressed to Mattis and Adm. John M. Richardson, the chief of naval operations, contained the toxic material.” The Secret Service later noted that a letter was also addressed to President Trump. However, on Wednesday “U.S. investigators have nearly ruled out terrorism after envelopes sent to a Pentagon mail sorting facility were falsely flagged for the possible presence of the deadly poison ricin, U.S. officials said on Wednesday. A Pentagon spokeswoman said tests so far showed that the alert was triggered by castor seeds, which ricin is derived from, as opposed to the deadly substance itself.” Late Wednesday, the FBI arrested a Navy veteran who is suspected to have sent the envelopes containing castor beans. “Defense officials had suspected that the letters contained ricin, but a Pentagon spokeswoman said on Wednesday that they actually contained castor beans, the raw material from which ricin is made. She said the F.B.I. was investigating.”

 Insect Allies – Agricultural Friend or Biosecurity Foe?
A DARPA project, Insect Allies, has come under fire this week regarding its potential for spiraling out of control, but also the chance it could be perceived as a biological weapon. “Darpa launched the Insect Allies research program in 2016, budgeting $45 million over four years to transform agricultural pests into vectors that can transfer protective genes into plants within one growing season. That would be exponentially faster than modifying crops through a gene drive, which would breed specific traits into a species over several generations. (Gene drives have been proposed to reduce mosquito fertility, halting diseases like malaria.)” A recent publication in Science drew attention to the concerns for such technology being used for nefarious purposes. The authors underscored that the profound implications of releasing a horizontal environmental genetic alteration agent range from regulatory to economic, biological, and even to societal. “In the context of the stated aims of the DARPA program, it is our opinion that the knowledge to be gained from this program appears very limited in its capacity to enhance U.S. agriculture or respond to national emergencies (in either the short or long term). Furthermore, there has been an absence of adequate discussion regarding the major practical and regulatory impediments toward realizing the projected agricultural benefits. As a result, the program may be widely perceived as an effort to develop biological agents for hostile purposes and their means of delivery, which—if true—would constitute a breach of the Biological Weapons Convention (BWC).” Following this publication, DARPA Program Manager of Insect Allies, Dr. Blake Bextine, released a statement. Bextine notes that “Technologies dealing with food security and gene editing certainly do have a higher bar than most for transparency, research ethics, and regulatory engagement, and I believe Insect Allies meets that raised standard. DARPA structured Insect Allies as a university-led, fundamental research program, and has invited in representatives from U.S. regulatory agencies from the very beginning of the program to offer perspectives and learn about the work. The researchers working with DARPA are free to publish their results, encouraged to discuss their efforts, and coordinate with regulatory agencies to facilitate the transition of their technologies from laboratory demonstrations to—someday in the future—powerful new tools that can bolster the toolkit for responding to fast-moving or unanticipated threats to the global food supply.” The UDSA, EPA, and FDA have been involved throughout DARPA’s project as regulatory bodies, but there are are concerns that the requirements (a minimum of three kill switches) are not enough. Many worry that this is an example of a dangerous project done simply to prove we have the capabilities instead of asking if we should (cue Ian Malcolm line from Jurassic Park).

Horsepox Synthesis – A Biosecurity Zombie
We’re not quite done with DURC and since this resurrected poxvirus news occurred in October, we’ll stick with a zombie theme. 2017 was the year of the horsepox synthesis (here’s a refresher), but a recent PLOS Pathogens publication by David Evans and Ryan Noyce stoked the embers of the debate. Within their opinion piece, Evans and Noyce discuss the DURC implications of their work and note that their interest in testing the horsepox virus “as a potentially safer vaccine was prompted by phylogenetic and historical evidence suggesting that smallpox vaccines might have originated in horses.” They also note that ” the authors respect the concerns that have been expressed about this work, but note that our lives have been profoundly improved by technologies, like genetic engineering, that were once viewed as threats to humanity”. Ultimately, Evans and Noyce state that the bigger challenge is actually education. On the heels of their comments, Ed Yong from The Atlantic discusses how this study revealed some flaws in DURC and genome synthesis experiments. Yong discusses the claims Noyce and Evans make regarding the benefits of the horespox synthesis and that while some may not agree with the flurry of concern, there are others that worry the tacit knowledge barriers are deteriorating. Filippa Lentzos noted the intensity of academia and the pursuit of funding/publications that can encourage moral hazard and a lack of transparency. Bioethicist Kelly Hills remarked that she “sees a sense of impulsive recklessness in the interviews that Evans gave earlier this year. Science reported that he did the experiment ‘in part to end the debate about whether recreating a poxvirus was feasible.’ And he told NPR that ‘someone had to bite the bullet and do this.’ To Hills, that sounds like: I did it because I could do it. ‘We don’t accept those arguments from anyone above age six,’ she says.” Much of the debate highlights the lack of training for scientists to anticipate the consequences of their work. “More broadly, Hills says, there’s a tendency for researchers to view ethicists and institutional reviewers as yet more red tape, or as the source of unnecessary restrictions that will stifle progress.” As Lentzos emphasized, these topics need to be addressed and discussed with scientists starting earlier on in their careers – at the undergrad level.

ETA of the Next Pandemic: Shorter Than You’d Think
If you’re reading a biodefense newsletter, you’re likely some one who understands and appreciates the potential threat that infectious disease outbreaks pose. Unfortunately, not everyone truly comprehends this issue. “Pandemic disease is arguably one of the greatest threats to global stability and security. But investments to contend with such outbreaks have declined to their lowest levels since the height of the Ebola response in 2014, with U.S. federal dollars cut by over 50 percent from those peak levels.” Hits to funding, personnel gaps in departments, elimination of the NSC Global Health Security Office, and a general lack of focus have raised concerns for the current state of U.S. biodefense. From Ebola in the DRC to H7N9 in China, and even the quarantined flights in NYC, it’s becoming increasingly difficult to ignore the impending pandemic. While the White House released their strategy, the biodefense community awaits the execution of such efforts.

 A Multi-Disciplinary Approach to Multi-Disciplinary Threats
GMU Biodefense MS student Janet Marroquin discusses the latest Biodefense Strategy. “A new Biodefense Steering Committee is now housed under HHS and supported by various other agencies including the Dept. of State, Dept. of Defense (DOD), U.S. Drug Administration, Dept. of Homeland Security (DHS), and the Environmental Protection Agency, in order to ensure implementation. Additionally, there is an interagency Biodefense Coordination Team that also engages with non-governmental stakeholders for a multi-disciplinary effort in implementing the Strategy. Reassuringly, this interagency stakeholder collaboration began with the drafting of the Strategy by DOD, DHS, HHS, and Department of Agriculture that ensured support for a comprehensive One Health approach to health security.”

Dutch Expel Four Russian GRU Members Attempting to Hack OPCW
Don’t mess with the OPCW – “Dutch security services say they expelled four Russians over a cyber attack plot targeting the global chemical weapons watchdog. The operation by Russia’s GRU military intelligence allegedly targeted the Organisation for the Prohibition of Chemical Weapons in The Hague in April. The OPCW has been probing the chemical attack on a Russian ex-spy in the UK.” British Prime Minister May and Prime Minister Rutte released a joint statement, noting that “This attempt, to access the secure systems of an international organisation working to rid the world of chemical weapons, demonstrates again the GRU’s disregard for the global values and rules that keep us all safe.” The Dutch Ministry of Defence has released a detailed account of the operations and their findings, which you can access here, revealing the use of cell phone records, taxi receipts, and more to track the GRU team. This comes after it was a revealed that the Dutch had also expelled Russians over plans to hack into a Swiss chemical laboratory where the novichok “nerve agent samples from the Salisbury attack were analysed”. The OPCW released a statement on Thursday regarding the incident, noting that “The Netherlands is the OPCW’s host country and, as such, is in charge of ensuring and exercising due diligence in protecting the OPCW Headquarters. The OPCW thanks the Netherlands for its actions and will remain in contact in regards to any further developments. The OPCW takes very seriously the security of its information systems and networks. Since early 2018, the Organisation has observed increased cyber-related activities. The Director-General has informed OPCW Member States about these activities and the OPCW Technical Secretariat has undertaken measures to mitigate them.”

DRC Ebola Updates
Four additional cases of Ebola were reported over the past few days and security concerns are growing. Nearly 13,000 people have been vaccinated, but all the new cases were in the recent hot spot of Beni. This area has challenged response efforts due to civil unrest. “Tthe DRC outbreak coordinator held a press conference in Beni to detail the impact the recent community protests had on the outbreak response. He said contact tracing dipped from 98% to 50% during the protest days, held in the wake of deadly violence between rebels and DRC armed forces, and that the actions slowed active case finding and port-of-entry monitoring. Ndjoloko Tambwe Bathe, MD, said the protest sidelined vaccination activities for 3 days and brought sample testing to a halt on Sep 25. Also, he said the actions hurt disinfection efforts and impeded the supply of personal protective equipment for health providers.” The outbreak has now resulted in 161 cases and 105 deaths. On Wednesday, it was announced that three volunteers with the International Committee of the Red Cross, were injured in an attack by villages. This attack prompted “the ICRC to suspend burials in the area, health officials said on Wednesday. The attack on an ambulance transporting the body to a cemetery in North Kivu province’s Beni region is the latest disruption to efforts to control the current outbreak, which is believed to have killed 106 people since July.”

GMU Biodefense Journal Club
Current GMU biodefense students – check out the newly formed journal club! Check your email from Thursday, but keep the evening of Monday, October 15th open if you’d like to geek out with some of your fellow biodefense classmates. This will be a great, stress-free (a journal article is way more fun than a book club!) environment to get your health security nerdom on.

UNODA BWC October Newsletter
The BWC Implementation Support Unit has just released the latest newsletter, where you can get the scoop on the recent Meeting of Experts. “Up to 100 States Parties, two Signatory States and one Non-Signatory State participated in the MXs. In addition, various UN entities, international and regional organizations and 26 non-governmental organizations and research institutes also attended. The proceedings of the MXs were livestreamed via UN Web TV.” As you read the letter, it’s important to remember the importance of the BWC and the ISU, as funding has been problematic. U.S. Ambassador to the BWC, Robert Wood, recently tweeted that “Unfortunate news from the BWC Chair today that there are insufficient funds for the December Meeting of States Parties and the BWC Implementation Support Unit“.

 Achieving the Trump Administration’s National Biodefense Strategy
GMU Biodefense PhD alum Daniel M. Gerstein discusses the recent release of the biodefense strategy and how it can be successful. “In addressing this bipartisan issue, the administration largely builds on the biodefense strategies of the George W. Bush and Barack Obama administrations. Common areas across the three strategies include recognition of the global nature of biological threats; the need to collaborate with a range of key stakeholders including foreign partners, state and local authorities and industry; and the need for risk-based decisionmaking in preparedness and response activities. Like those of his predecessors, the Trump strategy was accompanied by an implementation document which provided additional details on how the goals and objectives would be achieved.”

The U.S. Government Engagement in Global Health – A Primer
The Henry J Kaiser Family Foundation just released their report on how the U.S. is responding to global health threats. “This primer provides basic information about global health and U.S. government’s response in low- and middle-income countries. Although it focuses primarily on the U.S. government, it is important to acknowledge the role played by other countries, multilateral organizations, and private sector actors such as non-governmental organizations (NGOs), foundations, corporations, and others, in the global health response. The first several sections provide an overview of the field of global health and describe current global health issues.” Overall, the report underscores the long history of U.S. engagement in global health and the myriad of agencies and programs that facilitate such efforts. Given this long history and the investment in global health, the U.S. has a critical role in responding to existing and future health events on a global level.

Infection Preventionists and Antimicrobial Stewardship Programs, A Marriage in Progress
GMU Biodefense doctoral student and infection preventionist Saskia Popescu discusses the relationship between infection prevention practitioners and antimicrobial stewardship programs. “These findings shed light into the existing antimicrobial stewardship program structure within health care facilities, as well as the challenges of incorporating infection preventionists into these programs. Although the role of infection prevention is obvious within the antimicrobial stewardship program, infection preventionists lack a clear set of responsibilities. The integration of the infection preventionists into antimicrobial stewardship programs should be evaluated and strengthened to establish a more wholistic and responsive program.”

Stories You May Have Missed:

  • Officials Worried About African Swine Fever – “Humans are suspected to have caused the recent spread to Belgium, where eight cases were confirmed, as of September 25, according to the World Organisation for Animal Health.
    The most recent cases, however, were reported September 25 in a Chinese slaughterhouse in Hohhot, the capital of Inner Mongolia, according to the organization. There have been 29 outbreaks in China since the first case was reported August 3. China has culled nearly 40,000 pigs in response, according to the the organization’s database.”
  • Beef Recall Due to Salmonella and Listeria Outbreak – “The US Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced two meat-related recalls raw beef because of possible contamination with Salmonella Newport, and ready-to-eat ham products that may be tainted with Listeria monocytogenes. Today the FSIS said JBS Tolleson, Inc., of Tolleson, Ariz., is recalling about 6.5 million pounds of raw beef products that may be contaminated with SalmonellaNewport. This includes ground beef, chuck, and burgers sold through several retailers, including Walmart, Cedar River Farms Natural Beef, and Showcase.”

A Multi-Disciplinary Approach to Multi-Disciplinary Threats

by Janet Marroquin, GMU Biodefense

Nearing the two year anniversary of the Biodefense Strategy Act and twelve years after the Amerithrax incident that changed the course of biodefense, a new National Biodefense Strategy has been released by the U.S. Department of Health and Human Services (HHS). In 2016, the Biodefense Strategy Act produced a congressional requirement for the White House to create a new biodefense strategy in response to a 2015 Blue Ribbon Study Panel report that determined the 2009 National Strategy for Countering Biological Threats to be inadequate in effectively protecting the U.S. from biological threats.  Policy recommendations made by the Panel and various other advisory councils, including the President’s Council of Advisors on Science and Technology, the National Security Council, and the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (see previous Pandora Report article on the M.I.A. biodefense strategy) included the following: Continue reading “A Multi-Disciplinary Approach to Multi-Disciplinary Threats”

Pandora Report 9.28.2018

Happy Friday biodefense gurus! October is right around the corner, which means the flu vaccine will be available soon. Make sure to get vaccinated this season, as the CDC just announced that 80,000 people died of the flu during the 2017/2018 season, which is the highest death toll in 40 years.

GMU Global Health Security Ambassador
We’re excited to announce that two graduate students from the Schar biodefense program will be attending the 5th GHSA Ministerial Meeting in Bali, Indonesia. The two students, Annette Prieto and Saskia Popescu, will observe the Global Health Security Agenda in action and the the GHSA 2024 planning. Following their attendance in early November, we’ll be providing a report out on the events. Meet our two GMU Global Health Security Ambassadors – Annette Prieto has a background in Microbiology and Immunology and is currently a Biodefense student in the Master’s Program here at George Mason University. Before coming to George Mason, Annette focused on medical Microbiology at the University of Miami before moving into the laboratory and becoming a Teacher’s Assistant. From there, Annette became an Adjunct Instructor at Daytona State College and taught for a year before entering the Biodefense Program. Annette is also a part of the Next Generation Global Health Security Network. Saskia Popescu is a biodefense doctoral candidate at GMU and infection preventionist. She worked as an infection preventionist during the Dallas Ebola cluster, a 2015 measles outbreak, and is an external expert for the ECDC. She is a 2017 ELBI fellow and trained infectious disease epidemiologist. Saskia’s research focuses on the utilization of infection control in the U.S. healthcare system and it’s impact on biodefense. Make sure to check back in the weeks following their trip to learn about their experiences at the ministerial meeting.

Why Poor Pandemic Preparedness is Deadly
Ebola response efforts in the DRC are struggling and were suspended earlier this week, after violence between rebels and armed forces. While outbreak response in Beni have resumed, events like these are a prime example of why outbreaks can quickly spread beyond control and ultimately emphasize the need for pandemic preparedness. Drs. Tom Inglesby and Eric Toner from the Johns Hopkins Center for Health Security recently discussed the importance of investing in biopreparedness and how their Clade-X tabletop revealed many of the existing weaknesses. “Could a natural or man-made pandemic happen today? Yes. New lethal viruses are emerging from nature, and dizzying developments in biotechnology mean that biological weapons no longer are the sole province of a few state-sponsored programs — a manufactured pandemic could be unleashed by a rogue regime or by terrorists utilizing one of the thousands of laboratories around the world capable of making a dangerous pathogen. If the worst-case scenario unfolds, strong pandemic preparedness planning would save millions of lives. But progress is possible only with effective leadership.”

Rebuilding Health Security in the Wake of Ebola
GMU Biodefense graduate student Stephen Taylor discusses the latest talk from Georgetown University on global health security following the 2013-2016 Ebola outbreak. “In the midst of this disaster, the U.S. Centers for Disease Control turned to health security experts at the Georgetown Center for Global Health Science and Security to support the expansion and augmentation of the Guinean public health infrastructure.  Dr. Alpha Barry, Dr. Erin Sorrell, Dr. Claire Standley, and Ms. Aurelia Attal-Juncqua supported on-the-ground efforts to develop and implement improved health security policy that would make Guinea more resilient against future infectious disease outbreaks.  The Guinean government’s priorities for capacity and capability building were to prevent further outbreaks of zoonotic diseases, improve the capacity of surveillance laboratories and capabilities of the healthcare workforce to identify outbreaks, and to better respond to outbreaks by streamlining and coordinating emergency response operations.  On September 14th, 2018, as part of its Global Health Security Seminar Series, Georgetown University hosted a panel discussion of Dr Sorrell, Dr. Standley, and Ms. Attal-Juncqua on their efforts in Guinea.”

 The AMR Challenge
The United Nations (UN) General Assembly was held this week and one particular topic captured our attention – antimicrobial stewardship and a new initiative to combat resistance. “The AMR Challenge is a way for governments, private industries, and non-governmental organizations worldwide to make formal commitments that further the progress against antimicrobial resistance. The challenge encourages a One Health approach, recognizing that the health of people is connected to the health and animals and the environment. The AMR Challenge launches at the United Nations (UN) General Assembly in September 2018. Organizations can make commitments beginning September 25, 2018 until September 2019. CDC will feature commitments throughout the year. At the 2019 UN General Assembly, antimicrobial resistance will continue to be a priority topic for world leaders.” Within the Challenge, there are commitments to tracking and sharing data, reducing the spread of resistant germs through infection prevention and control, improving antibiotic use, decreasing antibiotics and resistance in the environment, and investing in vaccines, therapeutics, and diagnostics.

NASEM – Review & Assessment of Planetary Protection Policy Development Processes
How do we protect the Earth from contamination following space exploration? How can we avoid bringing microorganisms from Earth to other planets and solar system bodies? The latest NASEM report discusses how scientists tackle these issues and implement such policies. As you read the text, you’ll also see one of the Center for Health Security’s ELBI fellows in there – Betsy Pugel of NASA. “For decades, the scientific, political, and economic conditions of space exploration converged in ways that contributed to effective development and implementation of planetary protection policies at national and international levels. However, the future of space exploration faces serious challenges to the development and implementation of planetary protection policy. The most disruptive changes are associated with (1) sample return from, and human missions to, Mars; and (2) missions to those bodies in the outer solar system possessing water oceans beneath their icy surfaces.” This gives new insight into a field we may not be considering in health security – what about interstellar health security?

The Spanish Flu, Epidemics, and the Turn to Biomedical Responses
We already discussed the impact of poor pandemic preparedness, but what about biomedical efforts? A recent article from AJPH discusses the role of the 1918/1919 pandemic in bringing biomedical approaches to the forefront of outbreak response. “A century ago, nonpharmaceutical interventions such as school closings, restrictions on large gatherings, and isolation and quarantine were the centerpiece of the response to the Spanish Flu. Yet, even though its cause was unknown and the science of vaccine development was in its infancy, considerable enthusiasm also existed for using vaccines to prevent its spread. This desire far exceeded the scientific knowledge and technological capabilities of the time. Beginning in the early 1930s, however, advances in virology and influenza vaccine development reshaped the relative priority given to biomedical approaches in epidemic response over traditional public health activities. Today, the large-scale implementation of nonpharmaceutical interventions akin to the response to the Spanish Flu would face enormous legal, ethical, and political challenges, but the enthusiasm for vaccines and other biomedical interventions that was emerging in 1918 has flourished.”

HHS Sponsors TPOXX
Speaking of biomedical measures…the Department of Health and Human Services (HHS) just announced its sponsorship of a new formulation of the world’s first approved smallpox treatment – TPOXX. This purchase will be used for the Strategic National Stockpile and will work with Siga Technologies to develop an IV formulation of the drug. “Purchase of TPOXX in pill form and development of an IV formulation will be completed under a contract between Siga Technologies and the Biomedical Advanced Research and Development Authority (BARDA), part of the HHS Office of the Assistant Secretary for Preparedness and Response. BARDA will use funding from the Project BioShield Special Reserve Fund. The contract can be extended for up to 10 years and $629 million if necessary to complete development of the IV formulation.”

NASEM – Engaging the Private-Sector Health Care System in Building Capacity to Respond to Threats to the Public’s Health and National Security
Don’t miss the latest NASEM report on the intersection of preparedness and healthcare. From Ebola patients to natural disasters, and even terrorism, the private-sector healthcare system plays a critical role in response. “As a result, disasters often require responses from multiple levels of government and multiple organizations in the public and private sectors. This means that public and private organizations that normally operate independently must work together to mount an effective disaster response. To identify and understand approaches to aligning health care system incentives with the American public’s need for a health care system that is prepared to manage acutely ill and injured patients during a disaster, public health emergency, or other mass casualty event, the National Academies of Sciences, Engineering, and Medicine hosted a 2-day public workshop on March 20 and 21, 2018. This publication summarizes the presentations and discussions from the workshop.”

USDA ARS 5th International Biosafety & Biocontainment Symposium
ABSA has just announced this event being held on February 11-14, 2019 in Baltimore, Maryland. “The focus of the symposium will be Biorisk and Facility Challenges in Agriculture. Seven professional development courses will address topics including life science security, facility maintenance and operational issues, agricultural risk assessment, emergency response and preparedness for livestock disease outbreaks, waste management, and strategic leadership. Courses will be held on Monday, February 11. There will be 2 1/2 days of scientific presentations covering various topics including; governance updates, design methodologies, deferred maintenance, rabies, occ health laboratory to the field, gene editing, risk management and communication, and many others. The poster and networking reception will be held on Wednesday, February 13, attendees will have the opportunity to meet with presenters and discuss their presentations. Exhibits showcasing the latest biosafety, biosecurity, and biocontainment products and services will be open February 12-13.”

Next Generation Biosecurity Webinar 
Don’t miss this webinar today, Friday 9.28, at 11am (CDT, Mexico City). Hosted by Next Generation GHSA, this webinar will be with Luis Alberto Ochoa Carrera, Coordinator of Biosafety and Biochemistry of the GHSN and Coordinator of the Biosafety Laboratory Level 3 of the National Reference Laboratory (InDRE) of Mexico.

Stories You May Have Missed:

  • Airplanes and Airports – Hubs for Germs: GMU biodefense doctoral candidate Saskia Popescu discusses the latest on germ transmission during air travel. “Most people have a general sense that air travel tends to involve exposure to germs. Whether it’s through the thousands of people we will come into contact with, the sick person next to us on the plane, or the dirty surfaces, many of us get a sense of unease knowing there is a real chance we may arrive at our destination with a microscopic companion.”