Pandora Report 11.17.2017

Happy Friday – we hope you had a wonderful time celebrating Antibiotic Awareness Week! As Canada reports rising antibiotic resistance despite decreasing use of antibiotics in humans and animals, it’s important we recognize the importance of stewardship and infection control. November 13-19 marks Antibiotic Awareness week, in which we observe the importance of proper antibiotic use and prescribing practices. In the United States alone, 23,000 people die a year due to an infection that was resistant to antimicrobials. Help stop antimicrobial resistance through antibiotic stewardship.

GMU Biodefense MS student Stephen Taylor

Reflections from the GHSA Ministerial Meeting in Kampala, Uganda
The recent GHSA Ministerial Meeting was not only a success, but also reaffirmed the importance of the agenda and those dedicated to combatting health security threats. We’re excited to provide you with a series of on-the-ground reflections from those who participated through the George Mason Global Health Security Ambassador Fellowship and the Next Generation Global Health Security Network. Within these reflections, you’ll get to hear from Next Generation Coordinator Jamechia D. Hoyle and a wonderful array of international students and professionals. Hoyle notes that “the meeting was called to order during a time where health security professionals were addressing a plague outbreak in Madagascar and a local Marburg outbreak in the host country, Uganda.  This alone was a vivid reminder that health security must remain a priority.” The reflections present unique outlooks on the meeting and range from detailed descriptions of the sessions to visiting the Uganda Virus Research Institute, and more. Make sure you catch reflections from GMU biodefense MS students Anthony Falzarano and Stephen Taylor!

Did Russia Accidentally Provide the Best Evidence of the Syrian Government’s Involvement in Sarin Attacks?
Russia has been trying to downplay the Syrian government’s role in chemical weapons attacks, but their latest press conference may have just backfired on them. The November 2nd press conference in which Russian officials responded to the Organization for the Prohibition of Chemical Weapons – UN Join Mission, included a presentation that revealed a bit more than anticipated. “The presentation included a series of slides, which included diagrams of two types of chemical bombs, designated the MYM6000 and M4000. Remarkably, the Russian presentation appears to be the first-time images of these munitions have been made public, and before the press conference, no other references to MYM6000 or M4000 bombs appear online.” GMU Biodefense Graduate Program Director and Professor Dr. Gregory Koblentz noted that “‘these designations match bombs declared by Syria to the OPCW’, although there appears to be no open source material that provides specifics about the types of bombs declared to the OPCW. In the press conference the source of the diagrams are described as being provided ‘by certain organisations’, but no more specifics are given.” The Russian presentation diagrams provide some pretty clear matches between munitions found during investigations into the attacks. “The only way for the Russian or Syrian governments to now deny the M4000 bomb was used is to produce detailed photographs of the M4000 bomb, showing the same parts indicated above, or, if the Syrians still claim all these bombs were destroyed after 2013, declassify and publish further information about the bomb.”

The Center for Global Security Research – Student Internship                     The Center for Global Security Research, Lawrence Livermore National Laboratory is now accepting applications for Spring 2018 student internships! “The Center for Global Security Research (CGSR) was established at Lawrence Livermore National Laboratory (LLNL) in 1996 to bring together experts from the science, technology, and policy communities to address pressing national security challenges. For more than 20 years, CGSR has engaged diverse perspectives on topics important to national security, deterrence, diplomacy, dual-use technology, arms control, nonproliferation, peacekeeping, cyber defense and energy security.”

A Field Test of CRISPR
Researchers are getting to test, for the first time, treatment of a genetic disorder with gene-editing tools infused into the patient’s blood. The 44-year-old man suffers from Hunter syndrome, which is a metabolic disorder. “The company (Sangamo Therapeutics) inserts a replacement copy of the gene, using gene editing to snip the DNA helix of liver cells in a specific place near the promotor, or on-off switch, for the gene for a protein called albumin. The cells fix the damage by inserting the DNA for the new gene, supplied by the researchers along with the gene editor’s DNA scissors, and the gene’s activity is then controlled by the powerful albumin promotor. The idea is to turn these modified liver cells into a factory for making the enzyme missing in Hunter syndrome.” This is an exciting step forward for gene-editing technologies and their ability to treat chronic diseases. Curious what CRISPR looks like in action? Check out this video here.

Call for Papers- Women’s Health in Global Perspective
World Medical & Health Policy’s call for papers on Women’s Health in Global Perspective seeks to contribute to understanding and improve policy on women’s health and wellbeing around the world. Manuscripts on all factors that influence health outcomes for women will be considered, including social determinants such as education, nutrition, poverty, violence, access to health care, job opportunities and personal freedom.  The 2018 Workshop on Women’s Health in Global Perspective will follow a successful 2016 workshop by the same name (see video at http://www.ipsonet.org/conferences/whgp/2016-womens-health-in-global-perspective-videos), which resulted in a special issue http://onlinelibrary.wiley.com/wol1/doi/10.1002/wmh3.212/full and an ongoing series of articles in WMHP highlighting global women’s health issues and their implications for economic, political and social development. Abstract submission deadline (250 words): December 15, 2017. Contact: Bonnie Stabile, Co-Editor, bstabile@gmu.edu

Three Decades of Responding to Infectious Disease Threats
NIAID Director Anthony Fauci has been fighting infectious diseases in his role since 1984. After 30+ years of work, Dr. Fauci undoubtedly has some fascinating stories, whether it be from the beginning of the HIV pandemic or SARS. “Initial responses to a newly recognized disease, now known as HIV/AIDS, in the early 1980s were criticized as being too slow, the essay notes. ‘The insidious emergence of HIV/AIDS and the lack of due attention by policymakers illustrate how some outbreaks that start subtly can grow to global proportions if they are not aggressively addressed early on,’ Dr. Fauci writes. Between the early 1980s and the early 1990s, federal funding for HIV/AIDS research increased markedly, reaching $1 billion by the end of 1992. The accelerated government response supported both research and research infrastructure, and yielded advances in countering the HIV/AIDS pandemic domestically and internationally. Ultimately, notes Dr. Fauci, sustained support for scientific research coupled with political and community engagement helped transform HIV/AIDS from a nearly universally fatal disease to a condition that can be managed with appropriate treatment.”

The One Health Commission’s Call to Action for Social Scientists
“The One Health Commission, a 501(c)(3) global non-profit organization based in the U.S., stresses recognition of human, animal, and ecosystems interconnections and facilitates collaboration of all professions required to achieve global and planetary health. The One Health Social Sciences Team invites social scientists of all disciplines to become involved in the One Health community. By forging new and innovative partnerships, collaborations across human, animal, plant and ecosystem health communities will collectively enable betterment of health and well-being for all.” To learn more and get involved please contact the One Health and Social Sciences Working Group at ohss@onehealthcommission.org.

What Should The US National Biodefense Strategy Look Like?                                                                                                     The complex nature and painful lessons of biological threats, regardless of source, have challenged U.S. biodefense efforts for decades. As the Blue Ribbon Study Panel on Biodefense pointed out in their report, there is a general lack of clear leadership and coordination. The 2016 National Defense Authorization Act required that the DoD, DHHS, DHS, and USDA, all develop a national biodefense strategy and plan for implantation. Laura H. Kahn has provided a handful of critical strategies that are necessary. “First, human-intelligence-based monitoring of rogue nations and militant groups that use bioweapons is critical. Second, a national strategy must include a plan for disease surveillance of humans and animals, with a view to predicting the next naturally occurring epidemic. This kind of work is difficult, because there are so many viruses that could spill over from other mammals or birds into humans.” Kahn also highlights laboratory security and the importance of high-containment lab biosecurity, review of the Federal Select Agent Program, investigation of large-scale wildlife die-offs, and recognizing the importance of One Health. “Threat to one component in this triad threatens them all. For that reason, animal and environmental health must be taken just as seriously as human health—which requires devoting personnel and resources to monitoring them, which requires sufficient funding for entities like the EPA and the Fish and Wildlife Service.” Kahn also draws attention to the recent GAO report on biological threat awareness and the need to share information and resources. “Most distressingly, the current administration appears willfully ignorant of scientific issues, while at the same time disinclined to fund critical scientific efforts. The White House Office of Science and Technology Policy, which is intimately involved with biodefense issues, remains leaderless and understaffed.” Overall, a national biodefense strategy will not be easy, but it must be as comprehensive and wholistic as the biological threats we face.

The World’s Deadliest Diseases: How Is Biotech Fighting Them?
Biotech has an increasingly important role of health security and infectious disease response. As we saw with CRISPR this week, it has the capacity to help treat chronic conditions, but what about infectious diseases? Rapid diagnostics and development of medical countermeasures are critical during outbreaks and can determine if an epidemic will turn into a pandemic. Ute Boronowsky, pulling on Robert Herriman’s list of the five deadliest diseases, is looking to the biotech approaches for such biothreats. Whether it be plague or amebic meningoencephalitis, biotech advances are providing new avenues for treatment and response. Naegleria fowleri (the amoeba that causes the fatal meningoencephalitis) can be difficult to track within water sources and treatment is even trickier. “In 2015, investigational breast cancer and anti-leishmania drug miltefosine was used successfully on a 12-year-old girl at the Arkansas Children’s Hospital. However, when the same drug was used on two other patients, one of them died, and the other suffered from major neurological damage. This year saw a new therapeutic approach when scientists at the Virginia Commonwealth University found evidence that Naegleria relies on matrix metalloproteases to degrade the host extracellular matrix during infection, identifying these enzymes as potential therapeutic targets.” Other biotech advances, like prion disease therapy kinase inhibitors on the unfolded protein response, or the latest Ebola vaccine, all highlight the importance of biotech advances in combatting infectious diseases.

Stories You May Have Missed:

  • Legionella in Disneyland – GMU biodefense PhD student Saskia Popescu is looking at the latest outbreak of Legionnaires’ disease and how it highlights the challenges of prevention. “There are many factors that may attribute an outbreak, such as warming climates, a large aging population, and increased attention on the disease, which all lead to a better chance of infections being reported. The recent outbreak in Disneyland is a good reminder of the inherent challenges with disinfection efforts and continued vigilance that is needed to ward off this bacterial infection. It is also a reminder that outbreaks can happen anywhere there is a water source, even Disneyland, or other areas that somehow seem to be untouchable.”
  • Bulgaria and South Africa Battle HPAI – The two countries are dealing with outbreaks related to highly virulent strains of avian influenza. “A US vaccine company announced that the US Department of Agriculture (USDA) has conditionally approved the first DNA avian flu vaccine for chickens. Also, the United Nations Food and Agriculture Organization (FAO) provided a snapshot of current highly pathogenic H5 observations and what could play out in the upcoming season, and Chinese researchers reported new findings on airborne spread of avian flu based on sampling in a live-poultry market.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 11.10.2017

Looking for a great podcast? Check out the American Society for Microbiology’s Meet the Microbiologist – especially the latest episode on biopreparedness and biosecurity with Gigi Kwik Gronvall. From island emergency preparedness to antimicrobial resistance and monkeypox, we’ve got you covered for all things biodefense this week.

Top 5 Challenges in Emergency Preparedness: An Island Perspective
Imagine dealing with a natural disaster or health security threat like a major outbreak, but instead of being on mainland where you can rapidly get aid, you’re on an island. GMU Biodefense MS student Tara Hines provides unique insight into emergency preparedness for islands and how these efforts must overcome unusual challenges. From the health security perspective, there are always challenges, but what would be the biggest ones if you were on an island, like Bermuda? “The great part about biodefense is that it integrates public health, public safety, and basic science to provide health security. This interdisciplinary approach lets us tap into all of these areas to identify potential problems and suggest possible solutions, before a disaster strikes. Plus, biodefense work can be done anywhere and is crucial everywhere!” Tara addresses the challenges of not only collaboration and communication, but also military history and capacity, and several other factors that come into play. Make sure to read about her take on these response efforts and what it has been like responding to such events from an island.

Center for Health Security – ELBI Fellowship Application Now Open
If you’re looking to become an EBLI fellow with the Center for Health Security, good news – applications are now open! “The Emerging Leaders in Biosecurity Fellowship is an opportunity for talented career professionals to deepen their expertise, expand their network, and build their leadership skills through a series of sponsored events coordinated by the Johns Hopkins Center for Health Security.” The GMU Biodefense program is proud to have seen four students selected for this prestigious fellowship. For more insights into the ELBI fellowship, check out 2017 fellow and current GMU biodefense PhD student Saskia Popescu’s take on her ELBI experience. If you are a GMU biodefense student or alum looking to apply and hoping to get a golden ticket (aka letter of recommendation) from Dr. Koblentz – make sure to email him ASAP and make sure to send him your CV/resume/statement letter prior to December 4th.

Summit on Global Food Security and Health: “Integrating Global Food Security and National Security: Problems, Progress, and Challenges”
We’re excited to see this amazing summit on food security and national security is right around the corner. Don’t miss your chance to attend this November 15th event at the Schar School of Policy and Government, Founders Hall Auditorium. “The Fourth Annual Summit on Global Food Security and Health will take place George Mason University’s Schar School of Policy and Government on Wednesday, November 15, 2017 at our Arlington Campus from 9:00 am to 5:00 pm in the Founders Hall Auditorium at 3351 Fairfax Drive, Arlington, Va. The conference is co-sponsored by the Stimson Center, RTI International, and The Policy Studies Organization. Our focus this year is on the interrelationship between food security and national security, progress and challenges under Feed The Future (FTF) and the Global Food Security Act, and the growing importance of food security private-public partnerships, resilience, critical indigenous food security challenges, nutrition and health issues.  Summit speakers will represent a wide array of government, international organization, NGO, private sector, and academic experts. Our Summit follows the issuance of a recent USAID Feed The Future 2017 Progress Report, the enactment of the July 2016 Global Food Security Act, the related completion of new USAID global food security and food aid strategies, and the issuance of USAID’s December 2016 Feed The Future Global Performance Evaluation. The Summit will follow the World Food Prize Conference in Des Moines, Iowa , October 18 – 20 which addresses opportunities for innovative agriculture to eliminate the scourge of global hunger and poverty. Our GMU Summit takes place during a particularly important period marked by protracted uncertainty about U.S. support for International food aid, global food security, and foreign aid.” The event is free, but make sure you RSVP!

Antimicrobial Resistance, WHO Agriculture Recommendations, & USDA’s Not-So-Subtle Shade
AMR is slowly becoming the “I told you so” of infectious disease threats. Even Alexander Fleming warned of a day when antibiotics would no longer be effective. “Back in 2013, the UK’s chief medical officer Dame Sally Davies started warning the world that antibiotic resistance posed a deadly threat to humanity. But, she believes, that her lack of hard data meant few people took her seriously. ‘One crucial thing that got the whole world to take climate change seriously was the Stern Review on the Economics of Climate Change back in 2006’ she explains. ‘So we launched our own Stern Review – and found superbugs will kill us before climate change does’.” Reports since then have also highlighted the millions that will die every year due to AMR, but we’re still struggling with incentives for drug discovery and development. “Superbugs are a classic example of market failure – Dame Sally gave a timeline and a point of no return that we have to solve or we’re FUBAR. Government is too linear, industry sees no profit, VC’s don’t see any capital, labs have other problems and NGOs struggle to innovate.” While efforts to invigorate industry are underway, the WHO’s new recommendations are addressing AMR from the agriculture angle. The latest report is calling for a reduction in antimicrobial use across the board in food-producing animals and the halting of use in healthy animals for growth. “The formal guidelines issued by the WHO further recommended that when animals are diagnosed with a bacterial infection, antibiotics that are considered critically important for human medicine should not be used for treatment or to prevent the spread of the infection within a herd or flock, unless tests indicate those drugs are the only treatment option. Instead, antibiotics used for the treatment of sick animals should be chosen from those the WHO considers least important to human health.” Responding to these new recommendations, the USDA has thrown some not-so-subtle shade in their recent press release. The USDA Acting Chief Scientist, Dr. Chavonda Jacobs-Yong, has stated that the WHO recommendations are “not in alignment with U.S. policy and are not supported by sound science. The recommendations erroneously conflate disease prevention with growth promotion in animals.” Fighting AMR is a like fighting a chimeric hydra – a multi-headed, regenerating beast made of different animals – all dangerous and different. What herculean effort will be required for us to win the battle of the superbug?

Schar School Master’s Open House – Biodefense MS
It’s the last MS Open House of the season and you won’t want to miss this opportunity to learn about our biodefense graduate programs and talk to faculty. Next Wednesday, November 15th at 6:30pm at GMU’s Arlington campus, you can get the scoop on earning your master’s degree in biodefense on campus or remotely – don’t miss out!

Panel Discussion: Security in the New Era of Targeted Sanctions
Don’t miss the Fall 2017 Symposium hosted by the National Security Law Journal on November 13th at 11:30am! Hosted at GMU’s Founders Hall Auditorium, you can hear from a distinguished panel of attorneys and policy experts specializing in foreign policy, economics, and current events for this event, two of whom are George Mason professors. Dr. Gregory Koblentz, Dr. Mark Katz, and Dr. Adam Smith, will be panelists on this great symposium – infact, Dr. Koblentz will be speaking on the role of sanctions in responding to Syria’s use of chemical weapons. Mark sure to RSVP by emailing symposium@nslj.org

Chasing a Killer – Hunting Monkeypox
While we talk of pandemic flu and synthetic biology, it’s easy to forget some of the more mysterious, and yet, equally sinister natural outbreaks that are occurring. The Congo Republic is currently battling a surprising outbreak of monkeypox, which is a cousin of smallpox. “Over the past year, reports of monkeypox have flared alarmingly across Africa, one of several animal-borne diseases that have raised anxiety around the globe. The Congolese government invited CDC researchers here to track the disease and train local scientists. Understanding the virus and how it spreads during an outbreak is key to stopping it and protecting people from the deadly disease.” In fact, the U.S. has experienced its own monkeypox outbreak – in 2003 due to an exotic pet that was imported (sounds like the beginning of that movie Outbreak…). Zoonotic spillover is normally how these outbreaks begin and while monkeypox is not as deadly as smallpox or ebola (a mortality rate of around 10%), researchers are working to understand the ecology of monkeypox hosts and reservoirs. Take a minute to check out this article as there are some wonderful photos and maps that will take you along for this on-the-ground virus hunting expedition.

CBFP Biosciences Fellowship Program
CBFP welcomes applications from early to mid-career biological scientists working in government ministries, government-operated biological science laboratories, and/or research and diagnostic facilities with experience in laboratory operations, research, and diagnostics from Jordan, Lebanon, and Turkey. Only applications from these three countries will be considered. Selected fellows will conduct a science exchange fellowship of up to six months in duration to engage in research at a host institution including, but not limited to, the United States, Europe, and the Middle East beginning no earlier than September 2018. Applications are due December 17th, so make sure to apply here!

Canada To Prioritize Biothreat Reduction During G7 Presidency        In 2018, Canada will assume the G7 presidency role and Global Affairs Associate Deputy Minister Mark Gwozdecky has made it known that the country will prioritize biological threat reduction. “Infectious diseases have plagued mankind since the dawn of time. They’ve proven to be ruthless, persistent and all too adaptive and have been responsible for unparalleled death, suffering and economic loss,” Gwozdecky said.” He pointed to the recent outbreak of bubonic plague in Madagascar, which has infected more than 1,300 people, as an example of the ongoing challenges facing public health officials.” Efforts will also focus on the growing issue of antimicrobial resistance and the threat of biological weapons. Canada has continued to prioritize the full spectrum of biological threats and importance of biosecurity and biosafety within labs through its BSL4Znet network, which is a global information and resource sharing program to protect against biothreats. “While these threats, both natural and intentional are formidable, they are not beyond our means to overcome,” he said. “Key to this, however, will be enhanced cooperation, collaboration and collective effort.” “We look forward to engaging all of our partners to identify new ways, means and opportunities to strengthen global biological security,” Gwozdecky added.

The U.S. Government and Global Health Security
The Henry J. Kaiser Family Foundation’s latest issue brief focuses on the roe of the U.S. government and global health security. Ranging from a number of threats like Ebola, HIV, and SARS, global health security efforts are vital and must be as diverse and adaptable as the infectious diseases they thwart. “U.S. funding for its primary global health security programs –activities primarily carried out by the U.S. Agency for International Development (USAID), Centers for Disease Control and Prevention (CDC), and Department of Defense (DoD) – has remained relatively flat from FY 2006 ($390 million) through FY 2017 ($402 million), with episodic funding spikes through supplemental funding mechanisms reflecting specific outbreak events, including Ebola in FY 2015 ($1 billion) and Zika in FY 2016 ($145.5 million). The Administration has proposed reduced global health security funding for FY 2018 ($353 million).” This comprehensive report addresses the current global situation of infectious disease outbreaks and reviews U.S. government efforts and funding.

Stories You May Have Missed:

  • Financial Misappropriations, Ebola, and The Red Cross – The Red Cross organization recently confirmed that nearly $6 million in donated funds were misappropriated during the 2014 Ebola outbreak. “The organisation’s own investigations uncovered evidence of fraud, with more than $2.1m (£1.6m) lost in Sierra Leone, probably stolen by staff in collusion with local bank officials, according to a statement. In Guinea, a mixture of fake and inflated customs bills cost it $1m.” Investigations found the prices of relief goods and payrolls were inflated and while this isn’t the first time corruption has been associated with humanitarian relief, the Red Cross has yet to issue an apology.
  • Minnesota’s Drug-Resistant TB Outbreak– Minnesota’s Ramsey County is battling a deadly multi-drug resistant tuberculosis (MDR-TB) outbreak. “Six of the 17 have died, with three of those deaths being directly attributed to tuberculosis, said Kris Ehresmann, director for Infectious Disease at the Minnesota Department of Health, on Monday. Of the 17 cases, 14 were in the Hmong community and 10 are associated with individuals who participate in activities at a senior center, Ehresmann said.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 11.3.2017

Welcome to your weekly dose of all things biodefense. Today we get to celebrate Global One Health Day, in which the goal “is to build the cultural will necessary for a sea change in how planetary health challenges are assessed and addressed.”

High-Containment Laboratories: Coordinated Actions Needed to Enhance the Select Agent Program’s Oversight of Hazardous Pathogens
The latest U.S. Government Accountability Office (GAO) report is focusing on high-containment labs and how we can enhance the Select Agent Program’s oversight of hazardous pathogens. “Safety lapses continue to occur at some of the 276 laboratories in the United States that conduct research on select agents—such as Ebola virus or anthrax bacteria—that may cause serious or lethal infection in humans, animals, or plants, raising concerns about whether oversight is effective. GAO was asked to review the federal oversight approach for select agents and approaches from other countries or regulatory sectors. This report (1) evaluates the extent to which the Select Agent Program has elements of effective oversight and strategic planning documents to guide it, and (2) identifies approaches selected countries and regulatory sectors have used to promote effective oversight.” The Select Agent Program is managed through a partnership between DHHS and USDA, which oversees how labs handle these deadly pathogens. The biosecurity and biosafety failures that have occurred in recent years highlights the challenges of not only performing such work, but also oversight. The GAO report found that the Select Agent Program hasn’t assessed the risks of its current structure, has reviews that may not target the highest-risk activities, continues to have significant workforce and training gaps, etc. Eleven recommendations were made, which range from “To improve transparency, the CDC director of the Select Agent Program should work with APHIS to determine what additional information about laboratories’ use of select agents, incidents, and violations of the select agent regulations is appropriate for the program to share with registered laboratories” to “improve independence, the Administrator of APHIS should formally document the reporting structure for the APHIS component of the Select Agent Program from the APHIS director of the program to the Administrator of APHIS”. You can read the full report here or get the highlights here.

GHSA Ministerial Meeting
Last week’s Ministerial Meeting at Kampala was a success and a great time to reflect on GHSA accomplishments from member countries. You can get all the information here regarding the success stories across GHSA members. We will also be reporting on stories from those attendees who were able to join NextGeneration GHSA for the meeting, so don’t miss out on some great deep-dives from GMU biodefense students and their stories from Kampala!

COMMENTARY: Pandemic preparedness and missed opportunities             CIDRAP Director Dr. Michael T. Osterholm is honing in on a dogma for so many within public health – we need pandemic preparedness and we’re just not prepared. Unfortunately, sometimes our efforts to change this can result in a backfire. “Last week PATH issued a report titled, Healthier World, Safer America: A US Government Roadmap for International Action to Prevent the Next Pandemic. PATH, a leading international nonprofit organization, is widely recognized for its work to save lives and improve health, especially among women and children.” “The PATH report, if it commented only on epidemic preparedness, would be a home run. But by stating that the recommendations in the report will stem the risk of the next pandemic, the report ends up contributing to the ongoing mischaracterization about what pandemic preparedness truly means and what is needed to reduce any impact of a future pandemic. Understanding the difference between a pandemic and epidemic is absolutely necessary for consequential preparedness and response planning and action to be accomplished.  Let me illustrate the difference between the two and why it matters.” Osterholm points to this very vital misstep that can easily add confusion when working towards preparedness. He highlights the substantial difference between pandemics and epidemics and that ultimately, before we can truly address preparedness and response, we need to sincerely understand the discrepancies. Osterholm also highlights the biothreats we should be worried about for potential pandemics – influenza and antimicrobial resistance. Osterholm points to these two pandemic concerns while highlighting the importance of the GHSA, the vital role of early and effective detection to epidemic diseases, and that pandemic clocks are ticking. “The influenza and antimicrobial pandemic clocks are ticking; we just don’t know what time it is. Misunderstanding and misrepresenting what we need to do to be better prepared takes an understanding of what a pandemic is and what it isn’t. To date we are not doing a very good job of understanding that point and responding accordingly. The PATH report is a clear reminder.”

Early Insights from Madagascar’s Plague Outbreak: Lessons Learned from Ebola?
Have we really learned some of those difficult lessons from Ebola? Joshua Hutton, Doctoral Candidate at the University of Sussex is evaluating the current plague outbreak in Madagascar under the lens of Ebola. Hutton looks at the epidemiology and cultural impact of these diseases, their similarities and differences, and what lessons can be learned. Hutton looks at the health systems within Madagscar and the Ebola-affected West African countries, noting that Madagascar has 1 doctor per 100,000, while Liberia has 0.1 and Sierra Leone has 0.2 per 100,000. “Furthermore, both Ebola and plague elicit very strong emotional reactions. Ebola has been sensationalized by popular books and major motion pictures (such as Outbreak). Its haemorrhagic symptoms, exaggerated in popular culture, instil fear and remain memorable as an object of cultural anxiety.” “Despite these similarities, there are some obvious differences that affect the public health responses to these outbreaks. The first is that plague is a very different pathogen from Ebola. While Ebola is a virus, Y. pestis is a well-characterised bacterium. One important implication of this difference is that while treatments for Ebola remain elusive, antimicrobials to combat plague do exist. Plague is curable when caught early enough. This not only helps the response, but also reduces the heavy emotional burden placed on healthcare workers who felt helpless caring for Ebola patients without a treatment.” Hutton also notes the differences between public health responses, especially by the WHO – highlighting the lessons learned from the Ebola outbreak. “The early response to this anomalous outbreak of pneumonic plague in Madagascar seems to suggest that lessons are being learned from the Ebola outbreak. While there are distinct differences between the two outbreaks – not the least the availability of rapid diagnostics to identify infected individuals and the availability of antibiotics to treat them – the broader context, the rapid response, and the engaging of local communities produce a cautious optimism for the future.

US-Malaysia Workshop on BWC
The November 30-December 1st workshop at the Council Chamber, Palais des Nations, will focus on BWC-relevant developments by international experts. This workshop will feature expert presentations about global activities during the past year that strengthen the BWC. The purpose of the workshop is to inform States Parties about recent developments relating to national implementation, cooperation and assistance, preparedness and response, and science and technology; and to exchange ideas about their relevance to the Convention.

 My Time As An Emerging Leader in Biosecurity Initiative Fellow                         Take a journey down the biosecurity rabbit hole with GMU biodefense PhD student Saskia Popescu and her experience as a fellow at the Johns Hopkins Center for Health Security. “The Johns Hopkins Center for Health Security has maintained a fellowship since 2012 that seeks to provide opportunities for biosecurity professionals and helps to broaden their careers through contacts and experiences. The Emerging Leader in Biosecurity Initiative (ELBI) program is something I’ve been striving to join for years. I’ll admit it – it wasn’t my first time applying and while this is a highly competitive group, I was definitely disappointed when I didn’t get that acceptance email. Fortunately, 2017 was my year and I was selected as an ELBI fellow and that’s where this adventure begins.” Popescu describes her experiences at the three workshops, the engagement with some of the top minds in the field, and just how much fun it can be to geek out with fellow biosecurity nerds.

Fourth Annual Summit on Global Food Security and Health
Don’t miss this great opportunity to focus on the interrelationship between Food Security and National Security! Held at GMU’s Schar School of Policy and Government on Wednesday, November 15th, you’ll want to make sure you register for this full-day summit! “The conference is co-sponsored by the Stimson Center, RTI International, and The Policy Studies Organization. Our focus this year is on the interrelationship between food security and national security, progress and challenges under Feed The Future (FTF) and the Global Food Security Act, and the growing importance of food security private-public partnerships, resilience, critical indigenous food security challenges, nutrition and health issues. Summit speakers will represent a wide array of government, international organization, NGO, private sector, and academic experts. Our Summit follows the issuance of a recent USAID Feed The Future 2017 Progress Report, the enactment of the July 2016 Global Food Security Act, the related completion of new USAID global food security and food aid strategies, and the issuance of USAID’s December 2016 Feed The Future Global Performance Evaluation. The Summit will follow the World Food Prize Conference in Des Moines, Iowa , October 18 – 20 which addresses opportunities for innovative agriculture to eliminate the scourge of global hunger and poverty. Our GMU Summit takes place during a particularly important period marked by protracted uncertainty about U.S. support for International food aid, global food security, and foreign aid.”

Preppers: On the Frontline of U.S. Preparedness
Are you prepared for an apocalyptic event? GMU Biodefense PhD student and VP of marketing at Emergent BioSolutions student Rebecca Fish is taking us on a deep-dive into the world of preppers. “In 2015, Emergent BioSolutions undertook a multi-phase research project to better understand the prepper movement.  A random sample of 1,022 people aged 18-65 was surveyed to explore prepping behavior.  Findings suggested that the average prepper is not as extreme as many television programs would have you believe.  Rather, your average prepper is an ordinary person trying to do his/ her best for his/her family by preparing for emergency events.  The defining characteristic of a prepper is a belief in self-sufficiency and a desire to be prepared for whatever life throws at you.” This study found some interesting data on preppers – 67% are married and 43% earn over $100,000 per year, while 45% hold a college or advanced graduate degree. The volume and commitment of preppers is also indicative of a market for MCM product and other CBRNe products. “After the 2011 Fukushima Daiiche nuclear disaster in Japan, potassium iodide tablets stocked out everywhere due to overwhelming demand. Similarly, during the Ebola crisis, CBNBC reported that sales of one type of full-body protective suit increased 131,000 percent on Amazon. Gas masks and Ebola survival guides shot up the rankings as well.” As a further example, twenty four percent of preppers in our research own a gas mask.  These data suggest that preppers have demonstrated interest in CBRNe supplies and represent a market for some preparedness supplies.” Fish not only provides new insight into the Prepper community, but also encourages us to start learning more about this group and their interests in preparedness.

BARDA Industry Day
Don’t miss out on BARDA Industry Day next week, from November 7-8th, at the Ronald Reagan Building. “BARDA remains committed to engaging with our industry and government partners to fulfill our mission, saving lives and protecting America through the research and development of medical countermeasures against serious threats. The theme of BARDA Industry Day 2017 is: Innovation in products and partnerships for flexible, dynamic response capabilities.” The keynote speakers will be Robert Kadlec, Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services, and Senator Tom Daschle, Founder and CEO of the Daschle Group.

 New Biosecurity Threats Appear in Less Familiar Forms                                    Following the anthrax attacks in 2001, focus within biodefense and biosecurity fell upon bioterrorism and the potential attack that could impact millions of Americans. Since then, health security has evolved to include a wider range of potential issues and threats – natural, manmade, and accidental. GMU biodefense PhD student Saskia Popescu highlights some of these newer threats and that while they may be less familiar to health professionals, it is vital we involve them in the narrative of hospital preparedness. Discussing the gaps within U.S. biodefense efforts, genetic engineering, and how dual-use research impacts bio-vulnerability, Popescu implores infectious disease practitioners to soak in this knowledge. “How can we, as infectious disease practitioners, prepare or respond? First, knowledge is key. It is crucial to understand the threats, whether they are a natural outbreak, a lab breach you read about, or even just a review of the signs and symptoms of organisms we tend to worry about but may not see in the United States (such as severe acute respiratory syndrome, Middle East respiratory syndrome, anthrax, etc). Researchers should also consider the implications of their work and take the necessary review processes to ensure the proper biosecurity measures are taken.”

Should FEMA Be a Stand Alone Agency?                                                                            GMU Biodefense PhD alum Daniel M. Gerstein is at it again – evaluating DHS and the potential for major realignments in the Department. “As Congress considers reauthorizing the Department of Homeland Security, principles guiding any major realignments could include assessing whether the organization would be performing operational or staff management functions. Additionally, those principles could examine whether mission effectiveness would be improved through those major realignments and whether implemented changes would introduce new points of friction or inefficiency.” Gertstein notes several major realignments under consideration – replace the National Protection and Programs Directorate at DHS with a new Cybersecurity and Infrastructure Security Agency, remove FEMA from the DHS and make it a stand-alone department, and standing up a counter WMD organization. “As part of comprehensive department legislation, these realignments should be considered with an eye towards increasing operational effectiveness and efficiency while minimizing organizational friction in the transformed organizations and avoiding loss of key support relationships.”

Stories You May Have Missed:

  • The Unforgiving Math That Stops Pandemics– Another prime example of herd immunity and the importance of vaccination – “When talking about vaccination and disease control, health authorities often invoke “herd immunity.” This term refers to the level of immunity in a population that’s needed to prevent an outbreak from happening. Low levels of herd immunity are often associated with epidemics, such as the measles outbreak in 2014-2015 that was traced to exposures at Disneyland in California. A study investigating cases from that outbreak demonstrated that measles vaccination rates in the exposed population may have been as low as 50 percent. This number was far below the threshold needed for herd immunity to measles, and it put the population at risk of disease.”
  • Biosecurity Implications for the Synthesis of Horsepox, an Orthopoxvirus– Gigi Gronvall evaluates the biosecurity and biodefense implications of the recent horsepox synthesis. “The ability to recreate horsepox, or smallpox, will remain no matter what policy controls are put into place. It will be impossible to close off all avenues for nefarious misuse of gene synthesis, or misuse of biological materials more broadly. As a result, we advocate for the implementation of policy, regulations, and guidance that will make illicit recreation harder, more burdensome, more detectable, and, thus, more preventable without having sweeping negative consequences for the research enterprise. As part of our biosecurity efforts, we must also encourage and enable scientists to participate actively and to do all they can to safeguard their technical fields from irresponsible or illicit actions.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 10.27.2017

TGIF and Pandora Report day! Buckle up because we’ve got an abundance of biodefense news that covers GHSA, chemical weapons, synbio, and more.

 Global Health Security – WHO & PATH Reports and GHSA Ministerial Meeting
As the Global Health Security Agenda Ministerial meeting in Kampala, Uganda takes place this week, several reports were released highlighting the deficiencies in global biosecurity and biosafety efforts, as well as the importance of investing in global health security. Fortunately, on the eve of the GHSA Kampala summit, the Trump administration endorsed the future of the GHSA. Don’t forget to stay tuned to our weekly reports as two GMU Biodefense graduate students are participating (as recipients of the George Mason Global Health Security Ambassador Fellowship) in the Ministerial meeting alongside NextGen GHSA and they’ll be reporting on their experiences in the coming weeks. The first report this week is from NTI, which called on countries to improve biosecurity after WHO demonstrated that there are substantial biosecurity/biosafety gaps worldwide. NTI analyzed 39 Joint External Evaluation (JEE) peer reviews and mapped the related biosecurity and biosafety related scores. Here are their findings: “74% of the assessed countries demonstrated limited or no capacity for a whole-of-government national biosafety and biosecurity system. 64% of the assessed countries demonstrated limited or no capacity for biosafety and biosecurity training and practices. 41% of the assessed countries demonstrated limited or no capacity for linking their public health and security authorities during a suspected or confirmed biological event.” The map they’ve created is also a great visualization for how truly weak biosecurity and biosafety efforts are on a global scale. NTI also used this information to track commitments and biosecurity assistance and partners. The next report comes from PATH, which just released their work: Healthier World, Safer America: A US government Roadmap for International Action to Prevent the Next Pandemic The latest PATH analysis focuses on global health security and global efforts to respond to threats. “This paper aims to examine the benefits of investments in pandemic preparedness, as well as recommends the US Administration and Congress come together behind a comprehensive US strategy, robust investments, and continued vigilance both at home and abroad. The recommendations focus on global leadership, a US plan for international action, and research and development; underpinned by the risks of unsustainable funding, with special focus given to the Ebola supplemental funding sunset set to occur in FY2019.”

Reauthorizing & Improving The Department of Homeland Security
Don’t miss the recent National Interest series by GMU Biodefense PhD alum Daniel Gerstein  on the DHS reauthorization bill. This three-part series starts with a focus on why it’s time to improve the Department of Homeland Security. Gerstein notes that “reauthorization of the Department of Homeland Security is vital to clarifying responsibilities and setting expectations for the continued evolution of the department.” The second part in the series highlights methods for fixing the fractured department. “The question is not whether reauthorization of DHS is necessary. It  most definitely is. However, we should also ask whether the bill goes far enough and what other issues should a comprehensive DHS bill encompass? This second commentary considers whether the DHS structure with  relatively weak central authorities should be reevaluated. Interestingly, each successive secretary has sought to consolidate power and authorities at the department level. Is it time to legislate this outcome? ” Lastly, Gerstein addresses why updating the DHS Acquisition System matters. “This third commentary considers how to better align the department’s requirements, research, development and acquisition processes. Currently, the processes are not synchronized and should be harmonized to better align these critical departmental systems.”

Global Health Security Forum 2017 
Don’t miss out on this November 7th event hosted by the Center for Strategic & International Studies. The all-day event will be held at the CSIS headquarters and will even include an entire session on “Hurtling Toward a Genomic 9/11”! Don’t miss out on the “CSIS’s annual flagship conference on the top challenges facing U.S. and global security. This year’s Forum will focus on national security priorities ten months into the Trump Administration and one year prior to U.S. midterm elections.”

 The Collision Of Civil War And Threat Of Global Pandemics
Infectious disease outbreaks can be challenging for even the most stable country and those experiencing civil war are even more impacted by such biological events. Currently, there are 30 civil wars going on around the world – between cholera in Yemen, polio in Syria, and yellow fever in the DRC, countries that have experienced civil war also tend to experience infectious disease outbreaks. “The Daedalus issue, “Civil War & Global Disorder: Threats and Opportunity,” explores the factors and influences of contemporary civil wars. The 12 essays look at the connection of intrastate strife and transnational terrorism, the limited ambitions of intervening powers, and the many direct and indirect consequences associated with weak states and civil wars. Barry and Wise believe there is significant technical capacity to ensure that local infectious outbreaks are not transformed into global pandemics. But those outbreaks require some level of organized and effective governance—and political will. Prevention, detection, and response are the keys to controlling the risk of a pandemic. Yet it’s almost impossible for these to coincide in areas of conflict.” Civil war impacts not only communication, but access to health resources and can challenge early detection and response of outbreaks. Moreover, the traditional hotspots for emerging infectious diseases (tropical and subtropical areas where spillover is likely) are also areas continually “plagued by civil conflict and political instability.”

Chemical Weapons and Syria
On Tuesday, Russia vetoed a vote at the United Nations Security Council that would “renew a mandate to continue an investigation into who was responsible for the use of chemical weapons during Syria’s civil war.” The Joint Investigative Mechanism (JIM) was initially set up in 2015 to help identify those responsible for chemical attacks and is currently reviewing the April nerve agent attack in Khan Sheikhoun. “But Russia could not get enough support and instead used its veto to block adoption. Russia, along with the UK, China, France and the US, have veto powers at the Security Council. It is the ninth time Russia has blocked action against its ally Syria, something rights group Amnesty called ‘a green light for war crimes’.” The United States has already released a statement through the State Department – “We are disappointed, we are very disappointed that Russia put what it considered to be political considerations over the Syrian people who were so brutally murdered,”.

The Good, The Bad, and The Ugly of Pandemic PredictionPreparation, and Medical Countermeasure Communication 
Pandemic preparedness often feels like a teetering game of picking your poison. Will we see an avian influenza like H7N9 or will it be a novel disease? The CDC “evaluates every potentially dangerous strain, and gives them two scores out of 10—one reflecting how likely they are to trigger a pandemic, and another that measures how bad that pandemic would be. At the top of the list, with scores of 6.5 for emergence and 7.5 for impact, is H7N9.” While there isn’t strong transmission capacity between humans with the H5 and H7 viruses, the H7 strains are more worrisome in that they require fewer mutations to get to that point. Our efforts against avian influenza pandemics go beyond surveillance, and also focus on vaccine responses. “In the meantime, vaccines are being developed to match the viruses seen in the fifth and current epidemic. Other control measures have waxed and waned. When the first of the epidemics struck, Chinese health ministries closed markets and slaughtered birds. But as Helen Branswell reports in STAT, some of those containment efforts became more lax in 2015 and 2016.” Preparedness and response exercises can also gives great insight into problems that may arise when dealing with a pandemic. A recent pandemic simulation was held during the World Bank’s annual meeting in Washington D.C., in which participants addressed everything from hospital closures to mass quarantine. “For the World Bank simulation, organizers looked at the impact on travel and tourism of an outbreak of a mysterious respiratory virus in a hypothetical country. Discussions during the 90-minute session were off the record. But in interviews after the event, organizers said the step-by-step scenario made the theoretical possibility seem very real for participants. In particular, it drove home the need for speedy, accurate information-sharing and strong coordination within and across governments and institutions.” These kinds of exercises are crucial to not only address gaps, but bring together a variety of people that will be critical to pandemic response and recovery. The Johns Hopkins Center for Health Security also just released their self-guided exercise scenario that focuses on communication dilemmas that occur during development of medical countermeasures. The exercise is aimed at public health communicator and risk communications researchers, and revolves around a novel coronavirus outbreak in 2025. “Over a 3-year period, the virus spreads to every US state and more than 40 countries, where case fatality rates vary depending on the capabilities of local health systems. In the United States, an existing drug is repurposed to treat SPARS symptoms while federal regulators work with a pharmaceutical company to fast-track the production of a SPARS vaccine. The response differs in other nations. What follows is a nationwide vaccination effort and lingering strains on the US healthcare sector from a steady stream of patients seeking treatment for serious post-SPARS complications.”

Security Implications of Genome Editing – Meeting of Experts in Hanover
Earlier this month, a meeting of scientists and experts on policy and security gathered to discuss the potential implications of genome editing technologies like CRISPR. GMU Biodefense professor Dr. Sonia Ben Ouagrham-Gormley attended, noting that “Over 100 CRISPR scientists form all over the world (China, India, U.S., Europe, Africa), and policy and security experts gathered in Hannover, Germany,  to discuss the security implication of the new gene-editing technique CRISPR.The group reviewed various threat scenarios and discussed potential policy responses. The meeting was particularly successful as both the scientists and security experts engaged in a productive dialogue about the importance of ensuring security without hampering the use of this new technology to promote progress in medicine and agriculture among other things.” The conference focused on establishing proactive international dialogue about genome editing and incorporating experts that range from ethics and philosophy to economics and political science. “Many workshop participants emphasised that it is vital to support and sustain a culture of responsibility and integrity in research and innovation and to engage with stakeholders. Moreover, researchers and policy makers must commit to continuing an open and inclusive dialogue that builds trust. As with other new and emerging technologies, a lack of communication about any uncertainties may undermine public confidence in science. Scientists and security experts should listen to concerns or fears regarding the misuse of genome editing, and provide their expertise on what is and is not likely.”

Synthesizing Biological Threats—A Small Leap From Horsepox to Smallpox
GMU biodefense PhD student Saskia Popescu discussed dual-use research concerns with GMU professor and graduate program director Dr. Gregory Koblentz and how these relate to healthcare and infectious disease professionals. Drawing on the recent horsepox synthesis, Dr. Koblentz emphasized how this opens Pandora’s box even wider for potential smallpox synthesis and misuse of synbio. Popescu highlighted these concerns and how important it is for healthcare workers to be aware of such events and vulnerabilities. “From the healthcare perspective, it may not seem like something we should worry about, but the direction of gene editing and dual-use research of concern is something that is intrinsically linked to public health. Nefarious outcomes of such experiments, regardless of the origin or intent, will inevitably make their way into an emergency department, urgent care, or worse, the community. Although we may not be seeing the implications today, as medical providers and healthcare workers, we must keep our ears to the ground, listening for these biotech advancements, and then thinking through what they mean for us tomorrow.”

Step Away From The Backyard Poultry
Do you keep poultry in your backyard? If so, you may want to rethink it as the number of Salmonella infections related to contact with backyard poultry has quadrupled since 2015. “This year, nearly every state has been pecked by outbreak strains; only Alaska and Delaware can crow about dodging them. The Centers for Disease Control and Prevention has confirmed 1,120 cases. Nearly 250 of those involved hospitalization, and one person died.But that is likely just scratching the surface of the real numbers, according to CDC veterinarian Megin Nichols. ‘For one Salmonella case we know of in an outbreak, there are up to 30 others that we don’t know about,’ she told the AP.” The issue is that chickens and other fowl can carry organisms without having symptoms and shed them in their feces. While some hatcheries will test prior to selling their birds, it’s important that owners be aware of the risks for such infections.

The Schar School of Policy & Government Presents: Strategic Trade and International Security: Policy and Practice
This Brown Bag Seminar Presentation by Dr. Andrea Viski is the place to be on Thursday, November 2nd, from noon to 1:30pm. “Dr. Andrea Viski is the founder and director of the Strategic Trade Research Institute, an independent organization dedicated to providing authoritative research on issues at the nexus of global security and economic trade. She is also the editor-in-chief of the Strategic Trade Review, a peer reviewed journal dedicated to sanctions, export controls, and compliance. She previously worked for Project Alpha at King’s College London and for the Stockholm International Peace Research Institute (SIPRI). She has published numerous articles and book chapters in the areas of strategic trade controls, nuclear non-proliferation, and international law. Dr. Viski received her Ph.D. from the European University Institute, her M.A from Georgetown University’s Institute for Law, Science and Global Security, and her B.A in International Politics from Georgetown University’s School of Foreign Service.” The seminar will be at Founders Hall 602, 3351 Fairfax Drive, Arlington, VA 22201.

Stories You May Have Missed:

  • Uganda’s Marburg Outbreak – Uganda has just confirmed the death of a 50-year-old woman as a result of the hemorrhagic fever, Marburg. “The victim, a 50-year old woman, died on October 11 at a hospital in eastern Uganda after “she presented with signs and symptoms suggestive of viral hemorrhagic fevers”, the minister said. The woman had nursed her 42-year old brother who died on September 25 with similar signs and symptoms and also participated in cultural preparation of the body for burial, she added.”
  • Big Chicken – Are you reading the latest book by Mary McKenna on antibiotic misuse in the poultry industry? “In Big Chicken, McKenna lays out in extensive detail the unintended consequences that resulted from experiments performed at Lederle Laboratories in December 1948 when scientist Thomas Jukes began adding trace amounts of the antibiotic aureomycin (later to be known as chlortetracycline) to chicken feed. The discovery that the drug could quickly fuel growth in chicks raised in confinement revolutionized the poultry industry, turning chicken into America’s favorite protein.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 10.20.2017

Happy Friday and welcome to our weekly rundown of all things health security!

Smallpox Could Again Be A Serious Threat
GMU Biodefense professor, graduate program director, and all around health security grand master, Dr. Gregory Koblentz, is working to make sure we’re not ignoring the threat of smallpox due to synthetic biology. The problem isn’t just within the amazing capabilities of synbio, but its dual-use nature, meaning that it has the potential to be misused by nefarious actors. This concern has become even greater with the horsepox recreated by Canadian researchers who demonstrated not only capability, but also the low cost of such work. It’s not a far jump from horsepox to smallpox, especially when we have mail-order DNA fragments available at prices that continue to lower. Koblentz notes just how much of a disaster a re-emergence of smallpox would be on a global level, especially since it’s highly contagious and routine immunization has long been gone. “If resurrecting horsepox virus provides a roadmap to synthesizing smallpox virus, then why would anyone try to synthesize it? Because there are potentially legitimate uses for. Tonix claims that the horsepox virus is a good candidate for developing a new, safer smallpox vaccine. Unfortunately, the current legal and technical safeguards against the synthesis of smallpox virus are weak and fragmented. There is no clear international legal or regulatory framework to prevent the synthesis of smallpox virus. The WHO has a policy banning the synthesis of the smallpox and regulating who can produce and possess large fragments of smallpox DNA, but it hasn’t been widely adopted by states. Furthermore, there is no mechanism—at either the national or international level—for detecting or punishing violations of this policy.” Aside from some substantial gaps in regulations, there are some voluntary industry screening processes however, these are pretty limited and tend to be minimal at best. Koblentz points out that there is still time to get ahead of the pox in this case – specifically by rallying international organizations, national governments, the DNA synthesis industry, and the synbio community. Check out his recommendations and comments in the article here!

Global Health Security Supplement – CDC’s EID Journal
Don’t miss out on this ahead-of-print alert for the December edition of the CDC’s Emerging Infectious Disease journal. Volume 23 will include a section on global health security, with articles on the contributions made by the CDC and other partners, establishment of the CDC Global Rapid Response Team, and Joint External Evaluations. There’s also a great commentary by Dr. Michael T. Osterholm on the unfinished journey of global health security. “All countries need to have the laboratory, trained workforce, surveillance, and emergency operations capabilities to prevent, detect, and respond to disease threats. Only when these accomplishments are realized can we truly be on the road to global health security for infectious diseases. Until then, the goal of global health security remains an unfinished journey.”

GMU Biodefense PhD Info Session – October 26th!
Don’t miss your last chance to catch our biodefense PhD info session before applications are due! On Thursday, October 26th at 7pm at our Fairfax campus, we’ll be hosting this session where you can meet with professors, current students, and find out how much fun getting a PhD can be. Where else can you study everything from synbio to Ebola and even how to stop biological threats? GMU Schar School’s Biodefense program is just the place for all things health security.

The Worrying State of Epidemic Preparedness & Global Spread of Hemorrhagic Fever Viruses: Predicting Pandemics
University of London professor Sanjeev Krishna studies neglected infectious diseases and like so many, wasn’t surprised at the 2014/2015 Ebola outbreak. He notes that globally, we could’ve been better prepared to handle the outbreak and that vaccine development, among other things, is critical. “At the start of this year an organisation was launched to lead the way, the Coalition for Epidemic Preparedness Innovations (CEPI). Its mission is to bring politicians, academics, drug firms and philanthropists together to help prepare for the next epidemic. It was launched at the World Economic Forum in Davos in January, and is backed with $620m (£466m) from the governments of Norway, Germany, Japan, Canada, Belgium and Australia and the world’s two largest health charities the Wellcome Trust and the Bill and Melinda Gates Foundation. It is working to establish the lab and distribution infrastructure and access to funds needed to rapidly develop vaccines in a crisis.” CEPI Chief Executive Richard Hatchett has continually emphasized the importance of recognizing warning signs and investing in prevention efforts. Hatchett points out that the biggest lesson from Ebola, like so many outbreaks, is that we simply can’t be complacent about diseases with epidemic potential. Vaccine development can take a while and is costly (some say it’s about $1 billion per vaccine) and it’s taken groups like the Bill and Melinda Gates Foundation and Wellcome Trust to really support some of these efforts when government investments have been lacking. These gaps in preparedness and funding are worrisome in the event of a pandemic flu. “Sir John Bell, scientist at Oxford University and author of the UK’s life sciences industrial strategy, agrees on the threat posed by flu, noting that the last flu pandemic in 1918 killed 50m to 100m people, around 3-5pc of the world’s population at the time. ‘The experience of the epidemic in 1919 should give ample cause for concern about the impact of such an event globally,’ he says.” The truth is that we’re still working to prepare and respond to these biological events, but the real question is – will we learn from our mistakes? You can also read Dr. Alaa Murabit’s comments on the challenges of securitizing health and how this UN High-Level Commissioner is tackling global health issues. Epidemics usually occur when health systems are unprepared.” These words ring especially true this week, during International Infection Prevention week (read below). Hemorrhagic viruses and hantavirus have shown an uncanny ability for epidemic expansion, whether it be through people or rodents across significant geographical areas. “The ultimate goal is to develop a resilient global health infrastructure. Besides acquiring treatments, vaccines, and other preventive medicine, bio-surveillance is critical to preventing disease emergence and to counteracting its spread. So far, only the western hemisphere has a large and established monitoring system; however, diseases continue to emerge sporadically, in particular in Southeast Asia and South America, illuminating the imperfections of our surveillance. Epidemics destabilize fragile governments, ravage the most vulnerable populations, and threaten the global community.” The truth is that we so frequently follow the pattern of poorly prepared health systems responding to epidemics and governments re-alligning preparedness efforts only after the event. The current world is in a state of flux to fix these health issues despite constant external stressors like conflict, growing populations, migration, climate change. Despite these challenges, it is vital we strengthen our health systems to more effectively and efficiently identify biological threats, prevent them, and respond to them.

Measuring Radiation Doses in Mass-Casualty Emergencies                 We’re getting a double-dose of GMU biodefense in this fascinating article on radiation measurement. GMU biodefense professor and graduate program director Dr. Gregory Koblentz and doctoral candidate Mary Sproull (who is also a radiation guru at the Radiation Oncology Branch of the National Cancer Institute at the National Institutes of Health) are teaming up to address diagnostic challenges and technologies in the event of a nuclear attack. This article is especially relevant with tensions rising between the United States and North Korea in the wake of nuclear tests. In the event of something this horrific, one of the challenges is to appropriately and accurately diagnosis and treat radiation-related injuries. “Fortunately, new types of diagnostics to address this critical need are being developed in the field of radiation biodosimetry. Radiation biodosimetry is the estimation, through observation of biological variables, of received dose from previous radiation exposure; the new diagnostics use changes in various biological markers to estimate the severity of radiation doses.” Koblentz and Sproull highlight several gaps within U.S. preparedness related to biodosimetry, especially in terms of surge capacity and how such diagnostic capabilities may be challenged in a large-scale event. They also point to research into new assays, like those using newly identified radiation biomarkers. Lastly, Koblentz and Sproull focus on recommendations to better integrate biodosimetry, whether it be integrating medical management of radiation injuries into healthcare provider education or equipping federal response teams with deployable point-of-care biodosimetry diagnostic capability.

Meeting of the Blue Ribbon Study Panel on Biodefense – National Biodefense Strategy: Implementation and Implications
Don’t miss this event at the Hudson Institute on Thursday, November 2nd from 10:30am to 2pm. “This meeting of the Study Panel will address implementation of the National Biodefense Strategy and its implications for the Office of Management and Budget, congressional authorization and appropriation, leadership, coordination, collaboration, and innovation. Thought leaders will draw upon current and previous experiences with implementing national strategies and high-level policy directives. These speakers will also share their thoughts on: (1) the biological threat, the priority they place on biodefense, and efforts to address their concerns; (2) what the Administration should consider as it goes about populating the Implementation Plan for the National Biodefense Strategy; and (3) how Congress should use the Strategy and its Implementation Plan to inform its biodefense oversight and legislative activities.” Make sure to RSVP here by October 30th if you’re attending in person – the event will also be webcast.

Doreen and Jim McElvany Nonproliferation Challenge
Don’t miss out on this wonderful opportunity through the James Martin Center for Nonproliferation Studies (CNS) to encourage innovative thinking and help address nonproliferation. “The James Martin Center for Nonproliferation Studies (CNS) and its journal, the Nonproliferation Review, aim to spur new thinking about nonproliferation and disarmament.To advance this goal, the Doreen and Jim McElvany Nonproliferation Challenge will recognize the most outstanding new ideas and policy proposals published in Volume 25 (2018) of the Nonproliferation Review. The Challenge will award a grand prize of $5,000, a $3,000 runner’s-up prize, and a $1,000 honorable mention prize.”

The Evolution of the Islamic State’s Chemical Weapons Efforts               The Islamic State has grown increasingly comfortable with using chemical weapons and Columb Strack is taking us through the evolution of their practices. While their use of chemical weapons seems to have been abandoned since the loss of Mosul in June 2017, intelligence sources have suggested that a new chemical weapons cell has been established within the Euphrates River Valley. “The Islamic State’s use of chemical agents in Iraq and Syria is characterized by three phases. During the initial phase, which encompasses the first year of the caliphate’s existence (between June 2014 and June 2015), chemical attacks drew on tried and tested techniques, adapted to include widely available industrial chemicals—mainly chlorine and phosphine—from stockpiles captured as part of the group’s territorial expansion. These attacks were carried out using crude delivery mechanisms, in most cases adding canisters of chemicals to roadside or vehicle-borne improvised explosive devices (IEDs). The second phase, from July 2015 to January 2017, represents the enhanced capability the group had achieved by combining the production of sulfur mustard agent with the means to deliver it using projectiles, such as mortar bombs and improvised rockets. During this period, chemical attacks were carried out simultaneously across the caliphate, from Syria’s Aleppo province in the west to Iraq’s Kirkuk province in the east, indicating the existence of multiple operational units with the required expertise. Attacks peaked in April 2016, with eight separate recorded chemical attacks in one month. The third phase began with the last recorded chemical attack in Syria on January 8, 2017, and ended with the Islamic State’s apparent abandonment of its CW production following the loss of Mosul in July 2017.” Strack traces the history of intent and methodology development from two decades of experimentation by other militant groups. Strack also discusses experiments and sources for the weapons, including the seizure of military sites where chemical weapons could have been stored. Lastly, he discusses the slow degradation of capability that occurred following airstrikes against facilities and individuals, but that ultimately, the Islamic State has “the capability not only to transfer the know-how to produce toxic chemicals via secure online communications to operatives already living in target countries, but also to ship materials, including explosives, undetected.”

Blue Ribbon Study Panel on Biodefense- Animal Agriculture Vulnerabilities
Diseases that impact animals and have the potential to cross over to humans, let alone impact the agriculture industry, can be devastating. The Blue Ribbon Study Panel on Biodefense has just released their report evaluating the threats to animal agriculture and how this can not only impact human health, but also the U.S. economy. “In December 2014, a highly pathogenic strain of avian influenza entered the United States via migrating wild birds. The ensuing outbreak resulted in the largest animal health disaster ever experienced by the United States. Federal and state governments spent $879 million on outbreak response. The outbreak impacted 21 states, lasted until the middle of 2015, and led to the depopulation of more than 50 million birds on 232 farms. Subsequent trade bans impacted as many as 233,770 farms. The total cost to the U.S. economy was estimated at $3.3 billion. In 2015, the agriculture, food, and related industries contributed $992 billion (5.5%) to U.S. gross domestic product (GDP), making it one of the largest sectors of the U.S. economy. Given its critical importance to food safety and availability in the United States and around the world, protecting this sector is a matter of national security.” The report covers the threat to food and agriculture, zoonoses, how federal response is organized, collaborative efforts like biosurveillance, and the innovative work within next-generation medical countermeasures.

Why You Should Be Celebrating International Infection Prevention Week                                                                                                                                         Are you celebrating infection control this week? GMU Biodefense PhD student Saskia Popescu is pointing out how vast the role of infection prevention is across healthcare and why we should all be celebrating it. “October 15-21, 2017 marks International Infection Prevention Week and while this may seem like a week where we rally around hand hygiene, it’s much bigger than that. Infection prevention goes beyond the nuances of hand hygiene and expands to almost every corner of medical care and healthcare. Whether it be a dental clinic, operating room, or even an outpatient treatment center, infection prevention plays a vital role in keeping patients and healthcare workers safe. Not convinced? On any given day, the Centers for Disease Control and Prevention estimates that roughly 25 people in the United States will acquire a healthcare-associated infection (HAI). In a given year, it’s estimated that 722,000 HAIs occur, of which 25,000 of those patients die due to the infection. Realistically, it’s believed that the annual number of HAIs within the United States is closer to 2 million, which is astounding.”

Monkeypox in Nigeria
Nigeria is currently experiencing an outbreak of monkeypox after confirming three cases. “Since Sep 22, there have been 60 reports of suspected monkeypox cases from across Nigeria. The laboratory analysis showed that 12 suspected cases from the Bayelsa state were not positive for monkeypox. The NCDC said that all patients with suspected and confirmed monkeypox are currently receiving supportive medical care and improving. The NCDC offered no further details on the confirmed cases, besides noting that they were from Bayelsa state. The agency said the likely source of infection is through primary zoonotic transmission, and cautioned Nigerians to avoid contact with squirrels, rats, and any animals that appear sick.” Samples are currently being analyzed at the WHO regional office in Dakar, Senegal.

Stories You May Have Missed:

  • Did Disease Impact the Fall of Rome?– We know that disease can have devastating consequences on societies and even ancient Rome experienced several outbreaks of smallpox and plague, but just how impacting were these biological events? “Rome was far from the only advanced society shaken to its core by the explosive force of infectious diseases. The medieval Black Death sent some leading-edge polities (like the communities of Italy) backward, while opening the space for the ascent of others, such as England. The lethal role of pathogen exchange in the European conquest of the New World is relatively famous, if still imperfectly understood.”
  • Supportive Care Recommendations for Ebola Patients– Treatment for patients afflicted with Ebola can be tricky and there’s often little time to get the right mixture. “The study, by a team of international experts, was published yesterday in The Lancet. The authors write that at the beginning of the outbreak in 2013, case-fatality rates were 70%, but that number was lowered significantly (to 40%) as supportive care practices improved over the course of the outbreak. Using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, the authors present evidence-based recommendations for patient care during the next Ebola outbreak. Oral hydration and intravenous hydration had the strongest recommendation. When administered properly, the measure carries no risk of transmission to healthcare workers, the experts say. and making sure patients, especially the very young, are adequately hydrated is a necessary supportive measure.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 10.13.2017

What could be spookier than a Friday, 13th, in October? Actually, a few things – antimicrobial resistance, biological weapons, plague in Madagascar…..

The Trump Administration’s Misaligned Approach to National Biodefense
This recent publication from Reid Kirby is casting light upon the calamitous state of current and future U.S. biodefense efforts. Kirby points to several factors that will ultimately impact the new administration’s ability to create a new national biodefense strategy – the dysfunction rampant throughout the White House, the anti-science culture that continues to bubble up, a general inability to appoint fill key positions in a timely manner, and the disparage between the Trump administration’s ability to strategize and execute effective actions. “Again, how is the Trump administration doing so far in national biodefense? To answer this question, it is helpful to think in terms of ways, means, and ends – where the “ends” amount to security itself, the “ways” are formation of strategy, and the “means” are execution of strategy. What is concerning about the Trump administration is that the ways and means through which it pursues biodefense policy are fundamentally mismatched with the execution of meaningful biodefense ends.” Kirby highlights these failures through several examples, like the administration’s continued disrespect for science, whether it be climate change or nuclear energy. The administration’s resistance against government-sponsored research (and science in general), is in direct opposition to what a new biodefense strategy will need. “The Trump administration’s worldview, and its inability to distinguish between defense and security, may well be incompatible with a biodefense strategy. Biodefense is a scientific and technological endeavor.” Kirby states that “the administration has expressed a desire to formulate a comprehensive biodefense strategy, but the ways and means it is marshalling are not in alignment with achieving that goal. The future of US biodefense is at significant risk.

North Korea’s Biological Weapons Program – The Known and Unknown
The Harvard Kennedy School’s Belfer Center has just released a new report on North Korea’s biological weapons program. There’s been significant attention recently on their nuclear program however, there is still speculation regarding the real capacity for a biological weapons program. Bioweapon programs are always challenging to determine from the outside – so much of the equipment has dual-use capacity that makes external monitoring inaccurate at best. The new report utilizes publicly available information and interviews with experts to investigate the knowns and unknowns of North Korea’s BW program. Researchers “examine where policy on North Korea’s BW stands. We focus our analysis on the policies of South Korea and the United States, rather than at an international level, as North Korea has had limited participation in the Biological Weapons Convention (BWC).” The report also provides recommendations on how to improve assessment and surveillance efforts, not to mention current policies regarding North Korea’s BW program. Within this report, you’ll also find sections regarding means of delivery, strategic and tactical usage, gaps in current policies, how to improve nonproliferation policy, etc.

GMU Biodefense MS Open House – October 19th
Next week, GMU’s Schar School will be hosting a Masters Open house for prospective students, which means you get another chance to learn about our engaging and exciting Biodefense MS programs! You’ll be able to speak to faculty, learn about admissions, and how you can study biodefense on campus or remotely, at 6:30pm on Thursday, October 19th at our Arlington campus.

Biodefense: Federal Efforts to Develop Biological Threat Awareness
The most recent report from the U.S. Government Accountability Office (GAO) is drawing attention to biothreat awareness and how key agencies, like the DHS, DoD, USDA, HHS, and EPA, work to develop such awareness, regardless of the origin of the threat. The report highlighted three categories of efforts – intelligence gathering, scientific research, and analysis activities. “Federal agencies with key roles in biodefense share biological threat information through many different mechanisms designed to facilitate collaboration among government partners, including working groups and interagency agreements. For example, agency officials reported using collaborative mechanisms to coordinate activities and avoid duplication and overlap. However, as GAO and others have noted, opportunities exist to better leverage shared resources and inform budgetary tradeoffs. Recent legislation requires key biodefense agencies to create a national biodefense strategy that has the potential to help address these issues, by, among other things, supporting shared threat awareness. Until the strategy is developed, the extent to which it will meet this need is unknown.” Due to the variety of sources that biological threats can originate from, this report was established to review how federal agencies not only develop, but also share threat information and how this impacts future biodefense efforts. GAO utilized policies, directives, and strategies that were all related to biodefense to appropriately assess processes and the main agencies that would have critical roles within biodefense efforts.

NASA Backs Research on Evolution of Viruses in Extreme Environments Understanding how viruses adapt and infect hosts is a critical component to predicting movement and hopefully, prevention. NASA has recently funded Portland State biologist Ken Stedman to study viral evolution and how hybrid viruses work. “The study stems from a bizarre virus Stedman discovered in a hot spring at Lassen Volcanic National Park five years ago. The virus’s genetic code is derived from both DNA and its evolutionary predecessor, RNA. The vast majority of life on Earth switched its genetic code from RNA to DNA about four billion years ago, so the fact that this virus has both is highly unusual, according to Stedman.” The NASA grant will allow Stedman and his research team to study hybrid viruses, who they infect, and how they were able to adapt to such extreme environments.

Pandora Report Twitter
Feeling like you need a little extra biodefense information and humor in your life outside of our weekly reports? Check out our Twitter account (@PandoraReport) for a pretty constant stream of not only informative headlines, but also a taste of the hysterical biodefense community. The hidden world of biosecurity/biodefense twitter nerdom is pretty outstanding and probably the best thing on twitter (well, we may be a bit biased, but find out for yourself!).

Seychelles Identifies A Case of Plague
As Madagascar is struggling against a severe outbreak of plague, a nearby chain of islands, Seychelles, has just identified its first imported case. Seychelles is currently working to prophylactically treat fifteen people who were in close contact with the 34-year-old man who fell ill after returning from Madagascar. This is the first case that has spread beyond Madagascar, so officials are working diligently to avoid secondary cases. The WHO is currently sending 1.2 million antibiotics to Madagascar to fight the plague outbreak that is rapidly spreading, especially since many of the cases are pneumonic. Currently, there have been 50 deaths and 500 cases in Madagascar since the outbreak began in August.

Backing the Global Health Security Agenda
After months of speculation and concern regarding the Trump administration’s support for the future of the GHSA, Secretary of State Rex Tillerson brought forth a wave of relief. In a recent keynote speech, Tillerson “voiced support for US collaboration on global infectious disease issues, including ongoing efforts to battle threats such as HIV and malaria. He also signaled US support for extending to 2024 the Global Health Security Agenda (GHSA), a partnership of 50 nations, international organizations, and nongovernmental organizations geared toward building countries’ capacity to prevent and respond to infectious disease threats.” While discussing the importance of the President’s Emergency Plan for AIDS Relief (PEPFAR), he also highlighted that HIV/AIDS is not the only biological threat that needs addressing, commenting that the GHSA was a useful framework. Tillerson noted that “While we’ve made tremendous progress since GHSA was launched in 2014, considerable work remains. That is why the United States advocates extending the Global Health Security Agenda until the year 2024. the United States commitment to working in multi-sectoral partnerships to counter infectious diseases through the Global Health Security Agenda will remain constant,”.

Strategies Against Antimicrobial Resistance
We’ve been waging war on antimicrobial resistance (AMR) for decades now, but the truth is that future strategies may require thinking outside the box. Here are some of the potential avenues for helping to stop the global burden of microbial resistance – utilizing the human micro biome to help develop new antimicrobials and deploying tiny semiconductors – “A minuscule amount of drug with some light can treat some of the worst superbug infections we tested in clinical strains acquired from a Colorado hospital,” Nagpal says. “Of course, more work and extensive studies in preclinical and clinical trials need to be done before we can administer these quantum dots to patients. However, this initial study shows a lot of promising features.” Efforts also includes infection killing polymers, changing the culture of research to move away from siloing and towards efforts across multiple channels, making existing antibiotics stronger, etc. In fact, if you want to see how AMR spreads around the world, check out this graphic from Pew Charitable Trusts.

Stories You May Have Missed:

  • Puerto Rico’s Post-Hurricane Infectious Disease Woes – Following the destruction of Hurricane Maria, Puerto Rico is now working against the clock of infectious diseases. “Four deaths in Hurricane Maria’s aftermath are being investigated as possible cases of a disease spread by animals’ urine, Puerto Rico’s governor said Wednesday amid concerns about islanders’ exposure to contaminated water. A total of 10 people have come down with suspected cases of leptospirosis, Gov. Ricardo Rossello said at a news conference.”
  • The Interesting Case of the World’s First Vaccine– a recent report on a 115-year-old smallpox vaccine vile is shedding light onto the ingredients of this revolutionary medical countermeasure. “With the evolution of science and the advanced tools now used to conduct it, it has become clear that vaccinia — the virus used in modern smallpox vaccines — is neither cowpox nor horsepox. Whether it is a virus that formerly infected some species of animals — rodents, maybe — or is something that evolved in laboratories through the deliberate mingling of pox viruses isn’t clear.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 10.6.2017

Welcome to your favorite weekly dose of biodefense news!

George Mason University Global Health Security Ambassador Fellowship
We’re excited to announce the selection of two GMU Biodefense students, Anthony Falzarano and Stephen Taylor, as recipients of the George Mason Global Health Security Ambassador Fellowship. As GMU Global Health Security Ambassadors, they will be attending the 4th Annual GHSA Ministerial Meeting in Kampala, Uganda as part of the Next Generation Global Health Security Network delegation. The Next Generation Network engages and facilitates contributions by emerging scholars, scientists, and professionals from government and non-governmental institutions to the Global Health Security Agenda (GHSA) and other global health security projects. The NextGen Network is led by Jamechia Hoyle, who is not only an infectious disease guru, but also an adjunct professor at GMU, teaching Global Health Security Policy. The GHSA meeting, which will take place from October 25-27, is the world’s premier meeting on global health security and will be attended by senior representatives of the Ministries of Health, Agriculture, Finance, and Security from more than 50 GHSA member states as well as implementing partners from civil society and the private sector. The theme of this year’s meeting is Health Security for All: Engaging Communities, Non-Government Actors, and the Private Sector.                                                                                                                                                       Thanks to the generous support of the Schar School, our Biodefense graduate students will be able to provide you with detailed accounts of the meeting from the front row. Following the GHSA meeting, we will be publishing their experiences and thoughts on the summit, so you’ll want to stay tuned. Anthony is a microbiologist and environmental engineer, who focuses his research on antimicrobial resistance, food and agriculture microbiology, and microbial enhanced oil recovery. Anthony also worked with Ohio State University’s Medical Center to study biofilms as a public health burden. Stephen is a biologist and Peace Corp-alum where he served in Mozambique  teaching biology, information technology, and English. Since 2015, he has worked for the U.S. Department of Agriculture at the Animal Parasitic Diseases Laboratory in Beltsville, Maryland.

Blue Ribbon Study Panel: U.S. Not Prepared to Identify Perpetrators of Biological Crimes, Terrorism, Proliferation, and Warfare
The Blue Ribbon Study Panel just released information on their recent special meeting, Biological Attribution: Challenges and Solutions, which sought to better understand the ability of the U.S. government to accurately identify pathogens and their sources, “attribute the use of biological weapons with scientific and other forms of evidence; and explore the processes used for investigative, legal, policy, and political decisions involving biological attribution.” “Effective prosecution depends on the ability to quickly and accurately attribute crimes to their perpetrators,” said Ken Wainstein, meeting chair, and former Homeland Security Advisor and United States Attorney. “In the aftermath of a biological attack, we need to find out who did it, how they did it, what disease agent they used, and where they obtained it. The biological threat is real and growing, and the Nation needs this attribution capability now.” Adds former Senate Majority Leader Tom Daschle, whose office received some of the anthrax letters in 2001, “We face some major challenges in microbial forensics and biological attribution, but we can overcome many of them. We need to do what we can to eliminate them now, before we find ourselves under attack again. We can’t afford to have another investigation drag on for years.” The Panel also addressed the impact of the President’s FY2018 budget request on biodefense efforts and how it could eliminate critical health security functions.

Fostering an International Culture of Biosafety, Biosecurity, and Responsible Conduct in the Life Sciences
GMU biodefense MS alum Kathleen Danskin and PhD student Elise Rowe are tackling the importance of biosecurity, biosafety, and responsible conduct in life sciences. Citing the lack of an internationally agreed upon definition and approach to disseminating lessons, they highlight “how these concepts are covered by relevant international treaties, international organizations, and professional organizations. While there are some efforts under way, opportunities exist to evaluate and strengthen the culture of biosafety, biosecurity, and responsible conduct in the life sciences in order to prevent the loss, theft, misuse, and diversion of biological agents, related materials, technology, or equipment, and the unintentional or intentional exposure to (or release of) biological agents.” Responding to this gap, Danskin and Rowe propose three changes: partnership between international regimes, organizations, and professional organizations to share and enhance best efforts, use of the nuclear safety and security culture as a model for creating organizational culture within life sciences, and that the international community should amplify efforts to recognize “champions of change” at the state level. “Challenges remain on how best to address the issue of operationalizing the concept of a culture of biosafety, biosecurity, and responsible conduct in order to address goals such as: (1) reducing the occurrence of laboratory-acquired infections (LAIs), incidents, and near misses, (2) ensuring that biosafety, biosecurity, and responsible conduct receive adequate attention, (3) ensuring that organizational members share the same beliefs and attitudes about risks, LAIs, and near misses, (4) increasing commitments to biosafety and biosecurity, and (5) assessing the breadth and strength of a biosafety and biosecurity program.”

Reasonable Doubts: Foreseeing Failures in WMD Security
GMU biodefense MS alum Greg Mercer is evaluating the historical failures in WMD security and what we can take away from such terrifying events. Pulling on examples from the live anthrax spores being mailed due to poor DoD lab practices to antinuclear protesters managing to get into the Oak Ridge nuclear facility, Mercer addresses serious system failures and a “culture of complacency”. Unfortunately, since the creation of nuclear weapons, there has been a colorful history of accidents and close calls. Mercer cites such examples to point out that while not spectacularly dramatic (I’m thinking of something like the film, The Rock), they nonetheless highlight significant vulnerabilities. “As a class, these organizational problems are not unique to the management of WMD. Insights into their nature, and into the sorts of practices that could help to anticipate and remedy them, may also be found further afield. Especially within the broader study of national security, a new literature has begun to emerge proposing either a new framing of the issues, or identifying tools and ideas that might be employed to guard against recurring ‘complacency’.” Mercer points to analyses, like those from Janne E. Nola, which suggest grass-roots changes that aim at fixing things at the organization level. What is to be done though? Some suggest the use of red teaming, while others point to forecasting and prediction, as a means to identifying risks and vulnerabilities. “History shows that warning signs are often ignored until disaster strikes, and that disaster is the engine of change. In the United States, the public demands change. If better institutional checks are to be placed on American nuclear and biological security, it will take a public outcry like the one that follows a disaster. The public will have to demand that the country’s nuclear- and biological-defense enterprises stop stepping out to the brink, and instead avert the disasters foreshadowed by the many uncomfortable compromises and accidents we have seen.”

Madagascar Battles Plague
The death toll has risen to twenty as government officials are banning public gatherings in the country’s capital. While plague is endemic to the country and causes roughly 400 cases a year, this spike in cases and the swift spread is concerning the WHO after already 114 cases have been reported since August. “More than half of recorded cases – 73 out of 133 – are pneumonic plague, the most virulent form, which is passed through person-to-person transmission. If it is not treated, pneumonic plague can be fatal within 24 hours. The epidemic also involves bubonic plague, which is spread by rats and kills about 50% of people it infects.” The WHO has released $300,000 in emergency funds and is asking for $1.5 to support outbreak response as the disease has quickly spread to several cities and outbreak season (September-April) is just beginning. You can read the latest WHO report on the outbreak here.

HBO VICE’s Contagion Episode
Check out the latest VICE episode regarding two interesting topics – Russian hacking and contagions. “The outbreak of an infectious disease sparks worldwide panic nearly every year. And as humans cluster themselves in denser cities and encroach closer to the wildlife harboring disease, the chances of a devastating global pandemic only intensifies. But scientists are finding that diligent surveillance of these threats could help keep the next nightmare disease at bay. VICE founder Suroosh Alvi went to Uganda to see how vulnerable humans are to a new pandemic and the options there are for staving it off.”

Bavarian Nordic Wins Up-to-$539M BARDA Contract for Smallpox Vaccine BARDA has contracted with Bavarian Nordic to ensure the U.S. Strategic National Stockpile has smallpox vaccine in the form of freeze-drived Imvamune. “The contract consists of an initial $100 million base award toward manufacturing and storage of Imvamune vaccine bulk—the third bulk contract inked between the company and BARDA. The two earlier bulk contracts total a combined $233 million. In addition, the contract includes two initial options: Up to $299 million toward the filling and freeze-drying of Imvamune produced under the three bulk awards and up to $140 million toward clinical development, regulatory commitments, and portions of the establishment and validation of fill/finish activities.” This new contract will cover roughly 13 million doses at $48 per dose.

The Risk of Adoption of Chemical and Biological Weapons by Non-State Actors in the EU                                                                                                                                             James Revill addresses growing concern over the potential for non-state groups to utilize chemical or biological terrorism within the European Union. Pulling on historical events involving CBW use by non-state actors, he addresses the current and future risks. “To achieve this, the article analyses six interlinked clusters of factors that can be seen as important in assessing the risk of whether or not to adopt such weapons. These are: the perceived relative advantage of CBW and their utilities; the complexity of such weapons; their ideological compatibility; the role of organisational structures; the visibility and ‘fashionability’ of such weapons; and the wider environmental context.” Overall, Revill finds that while there is potential for sophisticated CBWs to do great harm, they are unlikely, and the use of a “scruffy low-level chemical weapon” is much more realistic.

ABSA International 60th Annual Biological Safety Conference
October is national Biosafety Month, so don’t miss out on this conference held by the Association for Biosafety and Biosecurity on October 13-18th in Albuquerque, New Mexico. The conference will include special meetings like public health interest groups, next generation/new biosafety professionals shared interest group meetings, and great networking opportunities for biosafety and biosecurity professionals!

How the 1918 Flu Pandemic Revolutionized Public Health
As the centennial of the 1918/1919 pandemic approaches, it encourages us to really look at what has changed and what we’ve learned from such a global catastrophe. Public health itself has evolved – no longer restricted by the antiquated policies that were marked with eugenics and social stigma. At the time, influenza was not a reportable disease either, which meant that public health surveillance was shotty at best and quarantine efforts were usually too little, too late. “The lesson that health authorities took away from the catastrophe was that it was no longer reasonable to blame an individual for catching an infectious disease, nor to treat him or her in isolation. The 1920s saw many governments embracing the concept of socialized medicine—healthcare for all, delivered free at the point of delivery.” Now, disease surveillance and epidemiology are a cornerstone of public health, not to mention the development of the WHO in 1946. The 1918 flu pandemic forced us to change our approach to public health, but also taught a vital lesson – infectious disease was a global problem and not isolated to a single country, region, or group of people.

Biosafety Governance
The Federal Experts Security Advisory Panel (FESAP) just released their report on ensuring institutional compliance with biosafety, biocontainment, and laboratory biosecurity regulations and guidelines. FESAP recommendations are crucial, as they are supposed to be followed within research facilities that perform work with human, plant, and/or animal infectious agents and toxins. “The United States has a comprehensive biosafety, biocontainment, and biosecurity oversight system designed to protect laboratory workers, public health, agriculture, the environment, and national security. Biosafety and biocontainment oversight rests on a foundation of federal regulations, guidelines, and policies and is provided at multiple levels. Oversight of day to day research activities is largely a responsibility of the institutions and the investigators conducting the research with direct biosafety oversight being implemented at the local level.” In efforts to ensure compliance and build a culture of responsibility, FESAP has released guidance that aims to ensure biosafety, biosecurity, and biocontainment, while encouraging research. Some of the regulations and guidelines include: “conduct regular assessments of committees, offices, and departments with responsibilities for biosafety and biosecurity oversight to assess their function and strengthen their performance when necessary” and “promote transparency regarding institutional biosafety and biosecurity oversight.” The report also includes federal regulations and guidelines regarding research conduct, environmental regulations, dual-use research of concern oversight at the institutional level, etc.

Stories You May Have Missed:

  • BioShield Adds Ebola Vaccine To SNS & BARDA Industry Day – Project Bioshield, responsible for acquiring MCM against CBRN agents, is now adding two Ebola treatments and two vaccines to the Strategic National Stockpile (SNS). The new additions include “a single-dose vaccine licensed by Merck, a prime-boost vaccine regimen from Johnson & Johnson, and monoclonal antibody treatments from Mapp Biopharmaceutical and Regeneron Pharmaceuticals.” If you’re looking to get more information on MCM, you can also attend the 2017 BARDA Industry Day on November 7-8, at the Ronal Reagan Building. Presented by ASPR (Assistant Secretary for Preparedness and Response), the conference will give individuals the opportunity to learn about the past, present, and future of BARDA, MCM development opportunities, experiences partnering with BARDA, and more. Robert Kadlec, Assistant Secretary for Preparedness and Response, will be the keynote speaker for the event.
  • Bioweapons and Virtual Terrorism – Considering the threat of biological weapons and virtual terrorism? It was recently estimated that the cost of a bioweapon is 0.05% the cost of a convention weapon that would produce the same casualties per square kilometer. What are your thoughts on the author’s notion that biological weapons are “comparatively easy, using common technology available for the production of some antibiotics, vaccines, foods, and beverages, and delivery systems such as spray devices from an airplane, boat, or car are commonly available”?
  • History and Future of the Global HIV/AIDS Response: A Conversation with Dr. Michael Merson and Dr. Stephen Inrig– The Center for Strategic and International studies will be hosting this event on Monday, October 16th from 10-11:30am. Drs. Merson and Inrig will discuss the origins and evolution of the global HIV/AIDS response, as well as critical current and future issues affecting the fight against the disease worldwide, which were recently highlighted in papers issued by the CSIS HIV Working Group.  “This ambitious book provides a comprehensive history of the World Health Organization (WHO) Global Programme on AIDS (GPA), using it as a unique lens to trace the global response to the AIDS pandemic. The authors describe how WHO came initially to assume leadership of the global response, relate the strategies and approaches WHO employed over the years, and expound on the factors that led to the Programme’s demise and subsequent formation of the Joint United Nations Programme on HIV/AIDS (UNAIDS). The authors examine the global impact of this momentous transition, portray the current status of the global response to AIDS, and explore the precarious situation that WHO finds itself in today as a lead United Nations agency in global health. The global response – the strategies adopted, the roads taken and not taken, and the lessons learned – can provide helpful guidance to the global health community as it continues tackling the AIDS pandemic and confronts future global pandemics.” The event will be webcast live from the event page. Please register by clicking the “Register” button above and contact Sara Allinder, sallinder@csis.org, with questions.
  • MoBE 2017 Symposium to highlight research on the Microbiology of the Built Environment – October 10-12th, in Washington, D.C.  The event will highlight recent research on the Microbiome of the Built Environment and explore ways to bridge the gaps between research and applications. More specifically, The MoBE 2017 Symposium will bring together leading researchers and stakeholders to discuss MoBE findings pertinent to human health, safe drinking water, healthy built environments and urban design. Ed Yong of The Atlantic, Susan Lynch of the University of California at San Francisco and Marc Edwards of Virginia Tech will provide keynote addresses.

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 9.29.2017

 Homeland Security Struggles to Fund ChemBio Defense & The Invisible Threat Looming budget cuts within DHS are doing little to qualm concern that state and local infrastructure is simply unprepared to handle a biological or chemical attack. “In terms of bsecurity, ‘we are much better prepared than we were’ post-9/11, said Tom Inglesby, director of the Center for Health Security at the Johns Hopkins School of Public Health in Baltimore, Maryland. ‘But we are not where we need to be, and the progress is, in some cases, somewhat fragile’.” Internationally, the use of chemical weapons in Syria and growing tensions with North Korea are continual reminders that preparedness is vital. “The department’s science and technology directorate took a 28 percent budget cut when the omnibus bill for fiscal year 2017 was signed in May, and the chemical biological defense division is ‘taking a cut much more significant than that’ in fiscal year 2018, said John Fischer, division director. The directorate in May released a budget overview for congressional justification, which stated over $58 million would be put toward chemical, biological and explosive defense research and development for 2017, assuming a continuing resolution would remain in effect for the rest of the fiscal year. Less than $53 million was requested for 2018, according to the document. DHS did not respond to requests for an interview.” 2018 will be a year of harsh budget reductions for biosurveillance and chemical detection programs, as border security will be headlining in terms of priority. The surge of biodefense funding that was seen post-Amerithrax has certainly waned, but there is also concern for complacency and a tendency to go from fire to fire instead of working to establish robust and effective prevention and response mechanisms. Overall, this fiscal tightening will surely have an impact on prevention, identification, and response strategies for biological and chemical threats, leaving many people holding their breath that the blowback won’t be severe.

 Now more than ever, it is important we change the narrative of lackluster efforts to defend against biological threats. Budgetary slashing, lowering of barriers, and an era of increasing globalization and rapid international travel – these are all the things that should remind us that biological threats are not a figment of science fiction. “What was unthinkable back in the day is now quite common and easy,” Inglesby said. “Genetic engineering is now possible with kits from boxes at younger and younger ages with less and less training.” The dual-use nature of biological research not only has the capacity to lower the barriers to bioweapon development, but can also muddy the waters when determining if research is  offensive or defense. “That’s not the only challenge facing those sounding the alarm about biothreats. Government scientists worry that there aren’t enough biologists working on this problem. “We have relatively few biologists working in national security,” Matheny told FP. “This is one area where we’re just starting to catch up to the fact.” While the future of NBACC is still not set, such uncertainty has rippling effects when it comes to staffing. While we consider biological threats a multi-faceted enemy – natural, intentional, or accidental, it is now biodefense efforts that are facing attacks at multiple fronts. The recent de novo synthesis of smallpox has brought many of these concerns to fruition. Whether it be through the advancement of life sciences that poses dual-use risk, severe budgetary cuts, or a shifting focus onto border walls, we cannot afford to allow this threat to be invisible much longer.

 GMU Schar School MS Open House – October 19th
Have you ever wanted to study what you love to further your career? GMU’s MS in Biodefense is just that chance and we’ve got an open house coming up so you can get all the information on it. On Thursday, October 19th at 6:30pm at our Arlington campus, we’ll be hosting an information session about our in-person and online biodefense MS program. From anthrax to Zika, GMU is the place for all things biodefense!

Navigating Our Way Out of the Jungle: Modernizing Meat Inspection
It’s been over 111 years since the famous Meat Inspection Act of 1906 and we’re still struggling to keep food safety efforts at a pace that can beat risks from farm to table. “What triggered such a shift after decades of poor industry practice? The year prior, in 1905, a book by Upton Sinclair was published in a series, which would then be published in entirety in early 1906. The Jungle brought forth the unsavory and grotesque underbelly of the American meat system. Although this may not have been the focus of his book, readers took away from it that their trusted source for meat was corrupt and lacked safety mechanisms. Within the year, the Federal Meat Inspection Act was established.” Pew Charitable Trusts is working to help evaluate and strengthen the meat and poultry industry and to help reduce the impact that contamination has within the U.S. population (2 million are sickened annually due to contamination). “A June 2017 report from Pew and Cargill, an American privately held global corporation based in Minnetonka, Minnesota, highlighted some of these concerns and established an open dialogue to develop recommendations. They addressed the need to establish a risk-based oversight system, which would incorporate data from across the food-safety system. The guidance also included better risk communication, a modernized approach to slaughter inspection that would include current technology and pathogen-specific appropriate levels of protection, among other components.” Food safety and security is truly the soft underbelly of American and it’s vital that we modernize such efforts.

BBC Pandemic
If you’re one of our readers in the UK, make sure to take advantage of this new outbreak tool through the BBC. The BBC Pandemic app can be downloaded onto your phone and may just help us understand how future outbreaks spread. “Through the app, BBC Pandemic will be conducting two experiments: the National Outbreak, which is open to anyone in the UK from 27th September 2017; and the Haslemere Outbreak, a closed local study that is only open to people in the town of Haslemere, Surrey, and runs for 72 hours starting on Thursday 19th October 2017. In the National Outbreak, the app will track your approximate movement at regular intervals over a 24 hour period. (Don’t worry, it won’t know exactly where, or who you are.) It will also ask some questions about your journeys and the people you spent time with during those 24 hours. All data collected will be grouped to ensure your anonymity, and a research team from the University of Cambridge and the London School of Hygiene and Tropical Medicine will use it to predict how a flu pandemic might spread across the country – and determine what can be done to stop it.” If you’re still not sold on it, here’s another reason why apps like this can truly help future pandemic response – data modeling. Despite our best efforts, epidemiological models are only as good as the data we have available. Simulation efforts help response efforts coordinate resources and plan accordingly however, if our modeling isn’t a decent representation of the population due to limited data, it won’t be that effective. Getting information from a broad range of people helps strengthen such efforts.

Recommendations for Incentivizing the Development of Therapeutics, Diagnostics, and Vaccines to Combat Antibiotic-Resistance 
The Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB) has been working since 2015 to curb the threat of resistant germs. The group has found that current economic efforts are insufficient and through three working groups on incentives (for vaccines, diagnostics, and therapeutics), they have released a new report. Identifying 46 critical issues that are preventing the development of new/improved products and providing 64 recommendations to address them, this new report is a robust 42 pages worth the read. For example, regarding human health and incentives for vaccine use, the group found that “federal and nonfederal stakeholders lack a common understanding about the current and potential economic value and societal impact of vaccines that can reduce AMR.” Their recommendation for this issue: “Analyses on the cost and societal impacts associated with new vaccine development and administration in the AMR arena developed via a multi-agency process that involves at least CDC, the Centers for Medicare and Medicaid Services (CMS), and the Treasury Department, in partnership with industry and public health stakeholders.” Within each section, you can find issues and recommendations categorized by economic, R&D, regulatory, and behavioral. The United Nations Foundation and the Wellcome Trust has also released a new report regarding the global efforts that have been sustained to fight AMR. “The report, published a year to the day that the United Nations (UN) General Assembly agreed to address the root causes of AMR and take action to tackle the problem, shows that many nations are following up on their pledge to encourage more responsible use of antimicrobials in human medicine and agriculture. Out of 151 countries recently surveyed, 85% say they are developing or have developed national action plans on AMR and 52% have a fully developed plan that addresses the One Health spectrum of human, animal, and environmental sectors.”

 Chemical & Biological Attacks: Underground Transport Restoration Project
After four years, this DHS-sponsored project is finally wrapping up their work studying the methods for chem-bio agent dispersion in subways. “Sandia National Laboratories’ engineer Bob Knowlton has worked on this challenge for a dozen years. His team has developed scientific sampling methods to determine the extent and nature of the contamination. Sampling also is essential to confirm the decontamination was effective and the site is safe to re-enter. Sandia researchers and their collaborators at other national laboratories and local, state and federal agencies have looked at everything from how to clean subway stations and grimy tunnels to where a surrogate for anthrax would go when released inside the New York City subway system and the best way to decontaminate a subway car.” Check out their findings on this project and from the 2016 large-scale testing they did in a mock subway system.

Little Island of Horrors – Vozrozhdeniya 
During height of the Soviet offensive bioweapons program, an ideal island, like Vozrozhdeniya, was the perfect place to test cutting-edge biological weapons. Present day, the island is a sad reminder of one of the largest state-sponsored bioweapons programs. “The island’s secrets have endured, partly because it isn’t the kind of place where you can just turn up. Since Vozrozhdeniya was abandoned in the 1990s, there have only been a handful of expeditions. Nick Middleton, a journalist and geographer from Oxford University, filmed a documentary there back in 2005. ‘I was aware of what went on, so we got hold of a guy who used to work for the British military and he came to give the crew a briefing about the sorts of things we might find,’ he says. ‘He scared the pants off me, to be honest’. Aerial photographs taken by the CIA in 1962 revealed that while other islands had piers and fish-packing huts, this one had a rifle range, barracks and parade ground. But that wasn’t even the half of it. There were also research buildings, animal pens and an open-air testing site. The island had been turned into a military base of the most dangerous kind: it was a bioweapons testing facility.” An isolated secret, this island was the testing ground for some of the worst pathogens. It was also chosen as a holding place for “the largest anthrax stockpile in human history” and while the cache’s location was never disclosed, the pits were visible from space, which meant that the U.S. pledge $6 million towards a clean-up project. Sadly, this isn’t a resolution as the open-air testing done on the island has surely left residual microbial burden, not to mention the burial pits of infected animals. Make sure to read about Dave Butler’s journey to this island and how even now, it still instills fear.

Stories You May Have Missed:

  • China to Open BSL-4– The first certified BSL-4 lab in China will be opening this year. The research institute, located in Wuhan, represents a partnership with the Chinese Academy of Sciences and the Wuhan government. “The lab is part of a 10-year-plan by the Ministry of Science and Technology that proposes to build five to seven BSL-4 laboratories by 2025 as well as one BSL-3 lab in every province. It was built with technology and equipment imported from France, and some of its future research staff have visited France for BSL-4 training. Although construction was finished in 2015, the lab has since undergone multiple assessments, Yuan Zhiming, director of the Wuhan branch of CAS, told the Science and Technology Daily. ‘The lab will become a public platform for Chinese scientists to conduct research into dangerous viruses,’ Yuan said.”
  • Signature Science-led Team awarded $2.9M contract to develop advanced genomic computational technologies in support of IARPA’s Functional Genomic and Computational Assessment of Threats Program – “The Intelligence Advanced Research Projects Activity (IARPA) awarded Signature Science, LLC a $2.9M contract for the development of new computational tools to screen DNA sequences to detect biological threats that may manifest from synthetic microbial manipulation. The challenge is to overcome the speed and precision limitations of contemporary synthetic DNA screening practices to rapidly detect and isolate a prospective threat within a segment of DNA. The research team will re-tool bio-threat detection methods, and focus detection efforts on functional genetic elements to increase analytic speed and precision, thereby dramatically improving predictive capacity to isolate the toxic gene that constitutes the threat.”
  • Medieval Plague Gives Insight Into Human Pollution History – “A recent study indicates that much less lead occurs naturally in the air than we thought—in fact, there should be almost none. Scientists measured lead trapped in an ice core from the Swiss-Italian Alps. They found that lead levels dropped dramatically only once in the past 2,000 years, during a time that coincided with the Black Death pandemic. This means that in Europe, lead levels in the air have been elevated for thousands of years. Most people think about air pollution as a problem that began with the Industrial Revolution, but we’ve been spoiling the quality of our air for a very long time. It has harmed our health throughout history, from Medieval Europe to the Roman Empire to Ancient Egypt and Peru, and continues to do so today.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 9.22.2017

Happy Friday! Are you a fan of antibiotics and their ability to fight off microbial threats? So are we, which makes the recent WHO report that much scarier. Since this latest report points to the dire situation of antibiotic development, we’re super-sizing the focus on the antimicrobial resistance and super bugs this week.

Fifteen Years of Public Health Emergency Preparedness  & AJPH Special Edition
Make sure not to miss the special edition of the American Journal of Public Health (AJPH), focusing on public health emergency preparedness. Within this edition there are great articles on science in emergency response at the CDC, children’s health in emergency preparedness, evolution of the field, funding, etc. One of the best parts was the Editor’s Choice – From Anthrax to Zika: Fifteen Years of Public Health Emergency Preparedness. This article discusses public health threats, regardless of origin, and how they can lead to national emergencies. “Our current frame of reference is shaped by the events of September 11, 2001. In response to the terrorist attack, the US Congress set up appropriations to support state, local, tribal, and territorial public health departments nationwide; these funds are administered through a cooperative agreement from the Centers for Disease Control and Prevention (CDC) to fortify national security. The Public Health Emergency Preparedness (PHEP) cooperative agreement helps health departments strengthen their abilities to effectively respond to a range of public health threats, including infectious diseases; natural disasters; and biological, chemical, nuclear, and radiological events. As a result, the CDC and the PHEP community have played critical roles over the past 15 years in preventing, responding to, and rapidly recovering from public health threats ranging from anthrax (2001) to Zika (ongoing currently as of publication). Responses to these public health threats highlight the need for preparedness efforts to protect people and support communities when disaster strikes.” The authors discuss the impact of the 2001 Amerithrax attacks on public health countermeasures and response, and then the 2009 pandemic of H1N1 during the school year. They also touch on food safety and biosurveillance, which caught the 2015 E. coli and meningitis B outbreaks in Oregon, not to mention the recent impact of Zika and Ebola. “These are just a few examples of public health preparedness capabilities that the CDC identified in its 2011 guidance document issued to aid in the development of successful public health preparedness programs. The articles in this issue of AJPH provide detailed accounts of preparedness in action, showcasing competencies in biosurveillance, incident management, community resilience, information management, countermeasures and mitigation, and surge management. These articles demonstrate how and why public health agencies, health care systems, and communities play a vital role in protecting and securing the nation’s public health.”

CARB-X: Fighting AMR through Public-Private Partnerships
GMU biodefense MS alum Nick Guerin is taking us through the journey of fighting resistant organisms and the importance of antimicrobial stewardship partnerships. Guerin looks to the new CARB-X strategy at curbing the impending threat of antimicrobial resistance (AMR). “One possible protection against AMR is the development of new medical countermeasures (MCMs). The strategies to find the best MCMs crisscross multiple organizations and functions, namely through either public or private initiatives. However, such divided efforts create limitations that might best be overcome through comprehensive public-private collaborative efforts.” Not only does Guerin highlight the details of CARB-X and other partnerships, but he also addresses past approaches and failures in fighting AMR. “AMR’s threat demands expedient solutions; the decade’s long wait for new antibiotics cannot continue. AMR poses one of the most difficult development requirements for these new MCMs, one that public and private sectors haven’t overcome on their own.”  

Global Health 2030 Symposium  
The second annual Global Health 2030 Symposium will be held on October 4th at the United Institute of Peace in Washington, D.C. “Experts, academics, and practitioners will be exploring the Science of Health: Bridging Epidemics and Technology. Join us as we convene the community to prepare for the growing health challenges at home and abroad. Learn about the latest technology and global health innovations combating widespread epidemics and improving disaster response. The keynote address, ‘The Persistence of Epidemics and Our Response’ will be given by Dr. Michael Cowan, Executive Director, Association of Military Surgeons of the United States.”

Space – The Next Microbial Frontier?
How do bacteria act in space? Sure, we know the microgravity can permanently alter bacteria and make them even better at reproducing, but we need to really understand why this happens and how it might impact our health during space exploration. “In an experiment planned by researchers at the University of Colorado at Boulder and carried out on the ISS, cultures of Escherichia coli bacteria were doused with the antibiotic gentamicin sulphate, which usually kills off E. coli quite easily. Out in space, it was a totally different story. ‘We knew bacteria behave differently in space and that it takes higher concentrations of antibiotics to kill them,’ says one of the researchers, Luis Zea. ‘What’s new is that we conducted a systematic analysis of the changing physical appearance of the bacteria during the experiments’.” Their experiment found that E. coli reacted with a 13-fold increase in cell numbers and reduced their cell volume by almost 75%. This reduction in size can make treatment with antimicrobials tricky as there is a smaller surface area for them to interact with. Researchers also found that the bacteria increased cell envelope thickness and outer membrane vesicles. “The bacteria threw up extra shields by thickening their cell walls and outer membranes, and growing in clumps so a shell of outer cells could protect the inner ones from getting exposed. ‘Both the increase in cell envelope thickness and in the outer membrane vesicles may be indicative of drug resistance mechanisms being activated in the spaceflight samples,’ says Zea. ‘And this experiment and others like it give us the opportunity to better understand how bacteria become resistant to antibiotics here on Earth’.” While more research is needed, perhaps this environment will be the new proving ground for novel antimicrobials and tougher processes. If nothing else, this just gives me a lot of appreciation for how tough space disinfection is.

How China’s AMR Outbreak Revealed the Changing Landscape of Infection Control                                       The news that a Chinese hospital lost five patients to a severe strain of drug-resistant Klebsiella pneumoniae left many concerned about the growing threat of antibiotic resistance. The strain of K. pneumoniae was not only highly resistant, but also hypervirulent and highly transmissible, which is just about everyone’s worst nightmare when it comes to antimicrobial resistance. GMU biodefense PhD student and infection preventionist Saskia Popescu takes a look at this outbreak and how it reveals the changing landscape of infection control. “The recent report from the Chinese ICU outbreak points to the increasing threat of microbial resistance and the desperate need to address prevention efforts in terms of both stewardship and infection control. As the landscape changes for both medical care and biothreats, it is important that infection prevention and control efforts be a part of this evolution. We must consider these practices and hospital programs when modernizing healthcare and public health. These infectious disease events can, and should, teach us about the diverse range of issues hospitals face and how we can better prevent the spread of infection through active, instead of passive, efforts. “

Attribution of Biological Crime, Terrorism, and Warfare: Challenges and Solutions                                                                                                                                         The latest Blue Ribbon Study Panel on Biodefense event, highlighting biocrimes and biowarfare, will be on October 3rd from 10am-1pm. “Effective prosecution and decisions regarding U.S. response depend on accurate attribution of biological attacks. Despite ongoing biological crimes and suspected development of biological weapons for the purpose of attacking the Nation, the United States has yet to establish this capability fully. The Study Panel will host a special focus meeting entitled Attribution of Biological Crime, Terrorism, and Warfare: Challenges and Solutions. This meeting of the Study Panel, chaired by former Homeland Security Advisor Ken Wainstein and former Senate Majority Leader Tom Daschle, will address the current states of science, investigations, and intelligence for biological attribution and the extent to which they inform strategic, operational, and tactical decisions; and provide a better understanding of the ability of the United States to identify pathogens and their sources correctly, attribute biological crimes, terrorism, proliferation, and warfare to their perpetrators, using scientific and other forms of evidence and information, and explore the processes used for investigative, legal, policy, and political decisions involving biological attribution.”

Cryptology History Symposium
GMU biodefense PhD alum Craig Wiener will be presenting his dissertation research at the October Center for Cryptology History Symposium. His research, “Penetrate, Exploit, Disrupt, Destroy: The Rise of Computer Network Operations as a Major Military Innovation”. Don’t miss out on this opportunity to listen to Craig discuss his research “determining the origins of computer network exploitation and computer network attacks in the U.S. intelligence community.”

Health Security Call for Papers – Extended Deadline
The call for papers on communication and health security deadline has been extended to December 31st, 2017. “A special feature in Health Security will be devoted to analysis of the current communication environment and efforts to effectively communicate during outbreaks of infectious diseases and other health threats. The journal seeks papers that address the wide range of policy, practice, and research issues relevant to communication in large-scale health events. The special Journal section devoted to communication and health security will be published in the March/April 2018 issue of Health Security. Scholarly and review articles, descriptions of practice, and opinion and commentary pieces are welcome. Manuscripts can be up to 5,000 words exclusive of the abstract, tables, figures, and references. Please consult the journal website for specific submission instructions.”

Stories You May Have Missed:

  • Biosecurity Luncheon – NAS– Don’t miss the September 27th luncheon and “informal discussion on Global Catastrophic Biological Risks (GCBRs), led by the Director of the Johns Hopkins Center for Health Security, Dr. Thomas Inglesby. Dr. Inglesby will review the Center’s recent attention on GCBRs, and how the synthesis of horsepox by a Canadian researcher has moved the needle on the necessity of discussing these potential future events. This meeting is the second in a series of biological, chemical, and health security discussions to address compelling topics and to provide a forum for engagement among the DC-based community interested in biosecurity issues. The lunch will take place at the Keck Center of the National Academies of Sciences, Engineering, and Medicine (located at 500 Fifth Street NW, Washington, DC). The event is free and lunch will be provided, but space is limited, so you must register to attend this event.” Make sure to register here!
  • CDC & Its Partners’ Contributions to Global Health Security– A new report from Emerging Infectious Diseases is highlighting the challenges many countries face when attempting to comply with the WHO’s IHR. “The US Centers for Disease Control and Prevention (CDC) works with countries and partners to build and strengthen global health security preparedness so they can quickly respond to public health crises. This report highlights selected CDC global health protection platform accomplishments that help mitigate global health threats and build core, cross-cutting capacity to identify and contain disease outbreaks at their source. CDC contributions support country efforts to achieve IHR 2005 compliance, contribute to the international framework for countering infectious disease crises, and enhance health security for Americans and populations around the world.”
  • San Diego Battles Hepatitis A – San Diego is battling a deadly hepatitis A outbreak, in which sixteen people have died. Shortly after announcing it had become a public health emergency in San Diego, Los Angeles reported cases and has declared an outbreak. Sanitary conditions, especially in public bathrooms, have been considered one source of transmission and many cases have been within the homeless population. The outbreak has “infected 421 since November, ravaging San Diego’s large homeless and illicit drug-using population. It could eventually cost the county health department up to a million dollars, a local health official estimated.” While there hasn’t been a point source identified, efforts are being taken within homeless shelters and even bleaching of streets are underway. Many are pointing to the lack of affordable housing in San Diego as a catalyst for homelessness and the certain laws and practices that push homeless people into smaller areas, which can facilitate the spread of disease. “It was a wake-up call that this is killing people,” Norris said. “It’s killing people we know. It’s killing our neighbors.” “We’re not a third world country,” added McConnell, the community advocate. “We should quit acting like we are.”

Thank You For Reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 9.15.2017

Global Health and the Future Role of the United States
The latest report from the National Academies of Science Engineering, and Medicine, is now available! “Growing forces for globalization have increased the interconnectedness of the world and our interdependency on other countries, economies, and cultures. Monumental growth in international travel and trade have brought improved access to goods and services for many, but also carry ongoing and ever-present threats of zoonotic spillover and infectious disease outbreaks that threaten all.” The report includes chapters on investing in global health for America and how such investments protect U.S. interests, the effects of globalization, and looking into the future. There are individual chapters on infectious diseases like pandemic influenza and global health security as national security, TB, and how we can enhance productivity and economic growth. “By investing in global health over the next 20 years, there is a chance to save the lives of millions of children and adults. Beyond these health benefits to individuals, global health is directly linked to economic productivity and growth worldwide. According to the Lancet  Commission on Investing in Health, the return on investments in global health can be substantial—as the benefits can exceed the costs by a factor between 9 and 20, for low-income and lower middle-income countries, respectively. Worldwide, investing in core capacities to prevent, detect, and respond to infectious disease outbreaks through the development of multidisciplinary ‘One Health’ systems focused on the interface of human and animal health can result in an estimated savings of $15 billion annually from the prevention of outbreaks alone.” The report emphasizes the importance of continued commitment to global health and that ultimately, aid is truly an investment in global health, which benefits us all. Disease knows no borders and an outbreak anywhere is an outbreak everywhere. Melinda Gates also recently discussed the importance of foreign aid, noting that “If we don’t make these investments in global health, my argument to people is, you’re going to see a lot more things like Ebola in our own country, and we’ll be dealing with them in our own health clinics because borders are porous,”.

GMU Biodefense Graduate Program Information Sessions 
Don’t miss out on the chance to learn about our PhD program on September 21st! You can join the info session at 7pm at the GMU Arlington Campus. The GMU Schar School PhD info session will also include a panel of current PhD students to discuss their experiences and answer questions. This is also a great chance to chat with faculty and learn about admissions. Where else can you study a range of topics that include biosurveillance, select agents, global health security, and policy with such an engaged group of faculty and students?

Tom Frieden Launches New Global Health Initiative
Former CDC director Dr. Tom Frieden is launching a new program to combat not only global cardiovascular disease, but also infectious diseases. The new initiative Resolve to Save Lives, will be located in New York City, and “will prevent heart attacks, strokes, and epidemics with the goal of saving 100 million lives and making the world safer from epidemics.” The initiative has $225 million in backing over the next five years by major funders including the Chan Zuckerberg Initiative, Bloomberg Philanthropies, and the Bill and Melinda Gates Foundations. Frieden hopes to work with major players like the WHO and CDC “to persuade more countries to ban trans fats and lower the salt content in foods and shore up defenses against disease outbreaks”.

Johns Hopkins Center for Health Security ELBI Workshop
The Johns Hopkins Center for Health Security Emerging Leaders in Biosecurity Initiative (ELBI) recently hosted their last event for the 2017 class. The 2017 group capped off their fellowships with a day of engaging lectures and discussions including talks from FBI SSA Ed You, STAT reporter Helen Branswell, MIT’s Peter Carr, and more. The group was able to tour the Ginkgo Bioworks and George Church labs while chatting with Andy Weber, George Church, Patrick Boyle, Tom Knight, and Devin Leake about the future of synbio and biotechnology. Last but not least, the fellows participated in a viral storm exercise, which challenged them through a real-world scenario that required policy, security, public health, and science responses on a global scale. GMU biodefense PhD student Saskia Popescu attended as a member of the class, noting that “one of my favorite parts from this workshop was getting to hear from Tom Inglesby and several analysts from the CHS regarding their research and initiatives they’ve worked on. Learning about projects like Outbreak Observatory, data-driven outbreak response (outbreak science), and healthcare capacities during natural disasters, was fascinating and really opened my eyes to the range of topics the CHS is involved in.”

Biological Engagement Programs: Reducing Threats and Strengthening Global Health Security Through Scientific Collaboration
Don’t miss out on this latest eBook addressing biological engagement programs and the health security perspective. “Biological engagement programs are a set of projects or activities between partner countries that strengthen global health security to achieve mutually beneficial outcomes. Engagement programs are an effective way to work collaboratively towards a common threat reduction goal, usually with a strong focus on strengthening health systems and making the world a safer place. Cooperative programs are built upon trust and sharing of information and resources to increase the capacity and capabilities of partner countries.” You can download the PDF here – make sure not to miss the chapter “Strengthening Biosecurity in Iraq: Development of a National Biorisk Management System”, co-authored by GMU biodefense professor and graduate program director, Dr. Gregory Koblentz.

NAS Symposium on Cooperative Threat Reduction (CTR) for the Next Ten Years and Beyond
The National Academy of Science will be hosting this symposium on September 18-19 at the Keck Center in Washington, D.C. “In 2009 the National Academy of Sciences (NAS) report Global Security Engagement: A New Model for Cooperative Threat Reduction concluded that expanding and updating U.S. Government Cooperative Threat Reduction (CTR) programs in both form and function would enhance U.S. national security and global stability. The NAS Committee on International Security and Arms Control (CISAC) is convening a symposium to examine how CTR has evolved since that time and to consider new approaches for CTR programs and related WMD elimination efforts to increase their ability to enhance U.S. security. The symposium is sponsored by the Project on Advanced Systems and Concepts for Countering Weapons of Mass Destruction (PASCC) in the Naval Postgraduate School and will be open to the public. A ‘meeting in brief’ document will be issued by NAS after the symposium. For detailed information on this event and a draft agenda please visit:  www.nas.edu/cisac.”

Stories You May Have Missed:

  • GAO Report on Medical Devices for Infectious Disease Rapid Diagnosis – The latest GAO report is looking to the capabilities and challenges of technologies that allow for the rapid diagnosis of infectious diseases. Diagnosis of bio-threats is a crucial component to prevention and control, which makes the efficacy of these technologies critical. “Some stakeholders GAO spoke to identified the need for more clinical studies to establish the benefits of these technologies. Implementation challenges included reluctance by medical users to adopt these technologies, due to factors such as (1) lack of familiarity with such technologies, (2) costs and resources to use them, and (3) reluctance to order, and pay for, all of the tests for a given multiplex assay. Further, in some situations, positive test results for rare diseases are more likely to be false positives; thus systematic testing for such diseases may result in wasted resources to address all patients who test positive.”
  • CSIS Event: The New Barbarianism- don’t miss out on this event organized by the CSIS Global Health Policy Center on Monday, September 18th, from 6:30-9pm at the Newseum. “This hour-long film explores the recent surge of violence we’ve witnessed against the health sector across multiple wars, both new and old, and the accompanying shredding of international humanitarian norms”. Make sure to register here.