Pandora Report 3.23.2018

TGIF and Pandora Report day! Tomorrow is World TB Day, in which we celebrate the progress made to eradicate TB, but also recognize the work that still needs to be done. Did you know that 53 million lives were saved through effective TB diagnosis and treatment from 2000-2016? In 2016 alone, there were nearly 500,000 cases of multidrug-resistant TB around the world and it takes $2.3 billion a year to fill the resources needed for existing TB interventions. If you happen to be traveling by air anytime soon, make sure to read these tips from public health experts.

How Prepared Are You For the Next Pandemic? Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
Three days filled with global health security and all things biodefense from anthrax to Zika – what more could you want in a workshop? Learn from the top minds in the field when it comes to pandemic preparedness, vaccine development, biosecurity, etc. Between the centennial of the 1918 influenza pandemic, the recent horsepox synthesis, and the lift on the gain-of-function research moratorium, these three days will be packed with exciting topics and discussions. From July 18-20th, come get your biodefense on with us in Arlington, VA – registration prior to May 1st also gets an early bird discount!

Shining A Spotlight On Soviet Nerve Agents
A nerve agent attack in the UK has made the poison, Novichok, a household name, but also pointed a very large spotlight on Russia’s scientists and defense labs. “Few experts in the rarefied area of chemical weapons defense are willing—or able—to shed further light on them. Information about the Novichok nerve agents is classified, says one U.S. military scientist who, like other U.S. government scientists, declined to speak with Science.” Whatever the plan, this failed attempt for the quick deaths of Skripal and his daughter have left many questions about delivery of the agent and how this heavily guarded secret nerve agent found its way onto UK soil. An article from The Trench discusses the use of these nerve agents, formal accusations from the UK, and compliance of the Chemical Weapons Convention (CWC). “The OPCW experts travel to the UK under Article VIII, 38(e), which qualifies their activity as a ‘Technical Assistance Visit’ to help with the evaluation of an unscheduled chemical (the Novichock agent) is not listed in any of the three schedules in the Annex on Chemicals).  They will likely visit the sites of investigation and collect their own samples (if for no other reason than to validate any laboratory samples they may receive), take all materials and documents related to the forensic investigation back to the Netherlands where the sample will be divided up and sent to two or more designated OPCW laboratories.” On Wednesday, Russian diplomatic and military officials reportedly accused the UK of hiding evidence in the investigation of the attack. “Speaking to a lecture hall of diplomats, Vladimir Yermakov, deputy head of the ministry’s department for non-proliferation, suggested that the UK was ‘hiding facts’ about the case that may later ‘disappear’.” British diplomat Emma Nottingham noted that “Russia has offered us so far no explanation of how this agent came to be used in the United Kingdom and no explanation as to why Russia has an undeclared chemical weapons programme in contravention of international law,”.

Pandemic Preparedness
“Are we prepared for the next pandemic?” Such a question pulls at the string of a much larger web that tends to leave many feeling unsettled. The scary truth is that we’re not ready. We know there will be a pandemic – history, science, and society, all tell us this. Encroachment on nature, increasing globalization and populations, and struggles against more frequent threats like seasonal flu and even antimicrobial resistance, all reveal a severe vulnerability to infectious diseases. Lessons from HIV, Ebola, and Zika, are just the latest and on the centennial of the 1918/1919 influenza pandemic, many hope that we learned from such events and can help prevent future ones. Predictions trickle across many sectors – loss of healthcare worker lives, financial and economic struggle, etc. “Such a pandemic could cause a global stock market crash that obliterates the livelihoods and savings of millions of survivors. ‘A severe and prolonged global pandemic could … hit global GDP by as much as 5-10% in the first year,’ noted the authors of the Bank of America/Merrill Lynch 2015 Global Pandemics Primer report. Oxford Economics has suggested that the cost of a global pandemic, including spillover across industry sectors, could be as great as $3.5tn – an impact far greater than the magnitude of the great financial crisis of 2008.” With funding for the GHSA in peril, the question of preparedness becomes even more relevant…and pessimistic. The tricky thing about infectious disease threats is that we’re not sure where the next one will come from. We have hints and sometimes we’ll get a whiff of which way the wind is blowing before the storm hits, but ultimately, there is so much we can’t predict. Given these challenges, prevention efforts, like those of the GHSA, should be seen as even more critical. Infectious disease prevention strategies are always a good return on an investment. It’s also the unexpected that impacts disease control and surveillance efforts. Local news is one that doesn’t often come to mind when considering epidemiology and infectious disease forecasting. “Epidemiologists rely on all kinds of data to detect the spread of disease, including reports from local and state agencies and social media. But local newspapers are critical to identifying outbreaks and forecasting their trajectories. ‘We rely very heavily on local news. And I think what this will probably mean is that there are going to be pockets of the U.S. where we’re just not going to have a particularly good signal anymore,’ said Majumder, a Ph.D. candidate at the Massachusetts Institute of Technology.”

GMU Biodefense MS Open House & PhD Information Session
Looking to earn a Masters or PhD in a field that’s at the nexus of foreign policy and public health? GMU Biodefense is just the place for that. We’re hosting two information sessions for our biodefense graduate degrees – the MS Open House is next Wednesday at 6:30pm (Arlington Campus) and the next PhD Information Session is on Wednesday, April 18th at 7pm, in Arlington, VA. These are great opportunities to hear from faculty and students in each biodefense program about not only the application process, but also the classes and what it’s like to study what you love!

CDC Selects New Director
Dr. Robert R. Redfield was just announced as the new director for the CDC. Redfield will take over for interim director Dr. Ann Schuchat, who many were hoping would take post. The new director has a background in HIV and is said to be a dedicated researcher and physician. Unfortunately, Redfield also comes with a rather novel history for CDC directors – he has never worked for a public health department. “Critics also point to a resume marred with controversy. In the 1990s, Redfield was accused of falsifying data about an experimental HIV vaccine he worked on. He was eventually cleared of those charges, but the data had to be corrected.” On Tuesday, Sen. Patty Murray (Wash.) raised concerns regarding his appointment, noting that, “This pattern of ethically and morally questionable behavior leads me to seriously question whether Dr. Redfield is qualified to be the federal government’s chief advocate and spokesman for public health.”

Brazil Calls for Country-Wide Yellow Fever Vaccination
Brazil has been battling a yellow fever outbreak since 2017 and vaccine shortages have only fueled the challenges of outbreak response. “Brazil announced yesterday that all citizens should be vaccinated against yellow fever. The country is currently experiencing a spike in cases in what has shaped up to become the largest yellow fever outbreak to hit the country since the 1940s.The Associated Press (AP) reported that Ricardo Barros, Brazil’s health minister, said all 27 of Brazil’s states will be targeted in a vaccination campaign that will aim to reach 78 million people by 2019. Before the announcement, the vaccine was recommended in all but four Brazilian states.”

Importance of GHSA
GMU Biodefense PhD student Saskia Popescu wants clinicians to understand the importance of the GHSA and why US investment is critical. “Like many components of public health and infectious disease, the importance of prevention is often forgotten until an outbreak occurs. Hospital preparedness and infection prevention were not necessarily ‘big ticket’ items in the United States until we had Ebola in Dallas, Texas, but it only takes 1 laboratory incident to remind us of the importance of biosecurity and biosafety.”

Food Defense Conference
The Food Protection and Defense Institute will be hosting this conference on May 22 & 24th in Minneapolis, MN. “As the food system is becoming ever more global, companies need to be prepared to protect not only their products but also their reputation. The Food Protection and Defense Institute will be hosting a 2-day Food Defense Certification Training Course on May 21 & 22, 2018 that will teach food industry professionals how to navigate basic food defense principles, recognize vulnerabilities, and create a tailored food defense plans.”

Stories You May Have Missed:

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 3.16.2018

Calling all owners of pet turtles – make sure you’re practicing some outstanding hand hygiene as there’s been a big Salmonella outbreak associated with the tiny reptiles.

Nerve Agent Attack in UK – Novichok
It’s been a whirlwind since the attempted murder of former Soviet spy Sergei Skripal and his daughter last week in Salisbury. It is now being reported that the Russian nerve agent “Novichok” was used. On Monday, British Prime Minister Theresa May spoke to MPs and said she would give Russia time to explain how they either lost control of the military-grade nerve agent or engaged in a direct attack on British soil. “The nerve agent was top secret back then, especially sensitive because the Soviet Union, under Mikhail Gorbachev, had renounced the use and production of chemical weapons. Its existence came to light thanks to the scruples of a brave scientist named Vil Mirzayanov, who had worked at the State Union Scientific Research Institute for Organic Chemistry and Technology. The institute was described by one of its top officials as ‘the leader in the technology of chemical destruction’.” Novichok is reportedly 5-8 times more toxic than the nerve agent VX and considered more sophisticated. You can read the joint statement from leaders of France, Germany, the United States, and the United Kingdom here, in which they state that “This use of a military-grade nerve agent, of a type developed by Russia, constitutes the first offensive use of a nerve agent in Europe since the Second World War. It is an assault on UK sovereignty and any such use by a State party is a clear violation of the Chemical Weapons Convention and a breach of international law. It threatens the security of us all.” The UK has also expelled 23 Russian diplomats in the wake of the attack.

Bill & Melinda Gates Discuss Bioweapons As Biggest Threat To Humanity
Melinda Gates recently spoke at South by Southwest this past weekend and underscored the vulnerability within the United States to bioterrorism. Both Melinda and Bill have repeatedly cited the vulnerability and seriousness of biothreats, regardless of origin, in our highly connected world. “As the two wrote in their recently released ‘Goalkeepers’ report, disease — both infectious and chronic — is the biggest public health threat the world faces in the next decade. And although Bill Gates said on a press call at the time that ‘you can be pretty hopeful there’ll be big progress’ on chronic disease, we are still unprepared to deal with the infectious variety.” While many are curious as to the reality of this threat, the truth is that infectious diseases are already causing significant damage – consider influenza, Ebola, or even antimicrobial resistance. These are naturally occurring events but there is also the risk of a laboratory incident or a nefarious actor releasing a bioweapon. Response and preparedness efforts are some of our biggest challenges. “In New York City’s hazard mitigation plan, the city indicates that a bioterror attack could have an impact on a similar scale as that of a nuclear weapon. And they say that the likelihood of bioterror attack is far greater.” Just another reason to invest in global health security efforts!

 Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
Have you signed up for our workshop yet? From July 18-20th, you can engage with biodefense experts in the field and those on the front lines of global health security. Our workshop will not only cover pandemic preparedness and vaccine development (it’s the centennial of the 1918/1919 pandemic after all!), but also biosecurity in this age of DIY genome editing and the future of the GHSA.

The Missile Technology Control Regime at 30
A few weeks ago, the James Martin Center for Nonproliferation Studies held an event on the Missile Technology Control Regime and two of GMU’s biodefense graduate students were able to attend and report back to us. Christopher Lien and Shauna Triplett have provided us with detailed accounts of the talks incase you missed the event. Lien notes that “A recurring theme in the discussion centered on the need for consensus within the nonproliferation community. Ambassador Piet de Klerk, former Chair of the MTCR, emphasized that one must maintain a realistic yet ambitious agenda when interfacing with both member states and non-member states. Learning where the ‘red lines’ are in each individual state’s case and crafting an appropriate plan of action lends itself to fostering a culture of consensus.” Triplett highlighted some of the successes and failures, noting that “The reflection of accomplishments also calls for the acknowledgement of shortcomings. The biggest concern for the regime is its inability to keep up with technology. Controls are harder to place on complicated weaponry and strategies have not become any simpler to achieve. The regime is faced with the task to update its objectives in order to meet these long-term challenges.”

Implementing the Global Health Security Agenda: Progress and Impact from U.S. Government Investments
The latest report has been released from USAID on the GHSA and U.S. support. As funding for global health security is being jeopardized but the threat of infectious diseases has not waned, the future of the GHSA and U.S. involvement is highly concerning. “In 2017, there were more than 25 reported public health emergencies in U.S.-assisted GHSA countries. Partner countries detected, led the response to, and contained outbreaks, including dengue fever in Burkina Faso and the Marburg virus in Uganda, by using the improved capacities built with the help of the United States and other GHSA partners. USAID’s broad-base development programs have helped to build capacity in countries to train the next generation of health care workers, strengthen community-based surveillance and improve long-term capabilities to prevent, detect and respond to outbreaks.” Within the report, you can find sections on U.S. government investments in building global health security capacities and examples of implementation across each action package. For example, within the Antimicrobial Resistance (AMR) action package, one example was “In Guinea, Liberia, and Sierra Leone, about 38,000 health care workers, community health agents, and others who come in contact with patients were trained in infection prevention and control (IP ) standards and practices. In Sierra Leone alone, 303 health facilities received training and mentoring to improve IP and prevent the spread of AMR.” In the Real-Time Surveillance action package, “Vietnam piloted event-based surveillance with community engagement in detecting and reporting unusual health events and more than 100 local outbreaks were reported in the first six months as a result. This initial success lead to a plan for national scale-up in 2018.”

U.S. Antibiotic Resistance Surveillance Findings 
CDC surveillance efforts for AMR across several states have found some worrying incidence rates of multi-drug resistance infections. Joint efforts between the CDC and local health departments are a newer approach to not only understanding the burden of AMR within the United States, but also developing response capabilities. Currently, surveillance efforts are scattered, which means that a true understanding of the scope and magnitude of this complex biological burden is rather limited. The latest joint efforts “report that the overall annual incidence of carbapenem-nonsusceptible Acinetobacter baumannii is 1.2 cases per 100,000 persons, and that nearly all the cases were healthcare-associated. The incidence rate is lower than those reported for other invasive, healthcare-associated bacterial pathogens, including carbapenem-resistant Enterobacteriaceae (CRE), methicillin-resistant Staphylococcus aureus (MRSA), and Clostridium difficile.” Interestingly, they found that 99% of patients had some exposure to a healthcare facility or to an indwelling device (catheter, central line, etc.).

Stories You May Have Missed:

  • One Health Commission Opportunities Bulletin Board – “The global One Health Community has long called for a mechanism to share and identify relevant educational, employment, and funding opportunities. In past years there have been challenges in making the world aware that the Commission is trying to help in this way, receiving announcement requests, getting them posted on the Opportunities webpage and included in One Health Happenings News Notes in a timely manner.
     Starting in 2018, we are trying a more interactive, honor system-driven, series of online One Health Opportunity Bulletin Boards that will include links to ongoing One Health educational programs. The global One Health Community is encouraged to both submit and review announcements here. (https://goo.gl/58raog).”
  • PLOS Disease Forecasting & Surveillance Channel– PLOS has a great new source for forecasting and surveillance research. You can find articles from syndromic approaches to examining viral agents among febrile patients, global influenza seasonality, and more.

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 3.9.2018

Nerve agent attacks, horsepox synthesis, and funding global health security, oh my! On top of all the biodefense news we’ve got in store for you this week, we’re also thoroughly excited to announce the 2018 summer workshop on pandemics, bioterrorism, and global health security.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security – From Anthrax to Zika
We’re delighted to release the dates for the summer workshop on all things global health security. The recent publication of the horsepox synthesis study, uncertain future of U.S. investment in global health security, and a severe flu season, are just a handful of the topics we’ll be addressing in this three-day workshop from July 18-20, 2018. Did I mention that it’s also the centennial of the 1918/1919 pandemic? We face unprecedented microbial challenges in this modern age – whether it be the risk of nefarious actors misusing genome editing, antimicrobial resistance, or the speed at which a disease can circumvent the globe. Our workshop is the perfect place to learn from experts in the field and meet with a diverse group of fellow biodefense gurus. If you register before May 1st or are a returning member or GMU alum, you can even get a discount! From anthrax to Zika, our July workshop is the place to be for all things health security.

 The Herculean Challenge of Assessing the De Novo Synthesis of Horsepox 
Nine-headed Hydra or cleaning out the Augean stables? None of these tasks were particularly easy, and neither is truly assessing the risks and benefits of the recent horsepox synthesis. Two of the latest articles analyzing the implications of this research have been released this week in mSphere.  In the editorial, Michael J. Imperiale points to the increased attention on DURC and the debate surrounding the benefits of a new vaccine versus the potential for a nefarious actor to misuse the process. “The two articles posted today come from Gregory Koblentz at George Mason University, who argues that this work was poorly justified on two fronts, scientifically and commercially, and from Diane DiEuliis and Gigi Gronvall from National Defense University and the Center for Health Security at Johns Hopkins University Bloomberg School of Public Health, respectively, who discuss this study in the larger context of how the risks and benefits of dual use research are assessed and managed. (mSphere asked the leadership of Tonix to submit a manuscript, but we received no response.)” Koblentz first underlines the weak scientific foundation for the claim that the horespox synthesis aids in the development of a new smallpox MCM. He states that the “combination of questionable benefits and known risks of this dual use research raises serious questions about the wisdom of undertaking research that could be used to recreate variola virus.” Within his commentary, Koblentz addresses the scientific and commercial rationale for synthesizing the virus as well as the weak scientific basis for its use as a safer alternative for human vaccine use and the lack of demand for a new smallpox vaccine. “At the heart of the dual use research dilemma is the need to assess and balance the benefits and risks presented by an experiment or line of research. This is a difficult task given the largely theoretical risks posed by unknown adversaries in the future and the enticing yet uncertain benefits that the research may eventually yield. Indeed, measuring risks and benefits and weighing them can be a wicked problem that defies simple or straightforward conclusions. The difficulty of the task, however, does not excuse researchers, funders, or journal editors from trying to do so. While the benefits of biotechnology and life sciences research are beyond question, we should not take for granted the benefits of specific experiments or avenues of dual use research.” In their counterpoint article, Diane DiEuliis and Gigi Kwik Gronvall emphasize that the horsepox researchers went through due biosecurity diligence at their research institution, the importance of utilizing an analytical framework for assessing the risks and benefits of DURC, and discuss “relevant components of biosecurity policy and the biodefense enterprise (including the acquisition of medical countermeasures) in the United States.” DiEuliis and Kwik Gronvall point to the horespox synthesis (and the controversy) as an opportunity to evaluate how dual-use risks should be handled, the complicated approach to stockpiling MCM, and “the challenges of forecasting risks and benefits from a particular scientific discovery or technology”. They highlight the National Academies Imperiale report framework for evaluating the capacity for technology to be misused, which includes factors like weighing the use of the technology itself against consequence management, etc. They also note three issues that have been raised by the horespox paper that require additional consideration – “The decision of what to do with a technology or research area that is dual use cannot be black or white, MCMs cannot be a check-the-box procedure for the USG, The synthesis of and booting up of a pathogen should serve as strategic warning that current biosecurity controls and preparedness are insufficient.” DiEuliis and Kwik Gronvall note that “Now that the work has been published, the authors examined the research according to the Imperiale report framework, which aims to provide a systematic way to evaluate biosecurity risks. We again found that while dual use information would benefit highly experienced actors who are intent on misuse, the recreation of smallpox virus may require additional research and development steps than have been described in this publication: smallpox virus is less similar to horsepox virus than horsepox virus is to vaccinia virus, the tools to recreate horsepox virus were originally developed for vaccinia virus, and they might require additional troubleshooting for re-creation of smallpox virus.”

NTI Launches GHS Video: Act Now to Protect U.S. Investment in Global Health Security
The Nuclear Threat Initiative (NTI) has launched a new video urging Congress to act now and ensure funding for global health security. Dr. Elizabeth Cameron, NTI VP, global biological policy and programs, is spear-heading the endeavor to turn the tides and ensure sustained funding for global biodefense. “Without sufficient funding of $208 million a year for the Center for Disease Control (CDC) and $172 million a year at the United States Agency for International Development (USAID), we weaken the global network of protection, increase risk to American lives, and threaten investments from other governments and the private sector. Urge Congress to act now to provide sustained funding for global biodefense.” Cameron notes that “in response to the devastating Ebola crisis of 2014, the United States Congress authorized over $900 million in supplemental funding to support the Global Health Security Agenda (GHSA) for five years to help countries prepare for and address biological threats. This critical funding runs out at the end of fiscal year 2019, placing up to 80% of our global health security efforts abroad – offices, personnel, and programs – at risk. Also at risk?  U.S. health security and extended biodefenses. Without sufficient funding of $208.2 million a year for the Center for Disease Control (CDC) and $172.5 million a year at the United States Agency for International Development (USAID), we weaken the global network of protection, increase risk to American lives, and threaten investments from other governments and the private sector.”

Ominous Biosecurity Trends Under Putin
If you ever needed a reminder of the importance of investing in global health security, this just might provide that cold dose of reality. The latest book from Raymond Zilinskas and Philippe Mauger, Biosecurity in Putin’s Russia, assesses Russia’s actions regarding DURC and biosecurity measures. “They investigate — solely through open sources — the current Russian position. They especially dig into issues such as ‘genetic weapons’ (bioweapons aimed at damaging DNA, potentially of specific individuals or groups) and biodefence research. Their underlying intention throughout seems to be to examine the likelihood that the Russian government is itself willing to engage in banned activities related to biowarfare agents. The book thus becomes a technical-scientific detective story.” This is an in-depth analysis by two top biological weapons specialists – definitely worth the read!

A Nerve Agent, An Ex-Russian Spy, And A Bench in the U.K. 
Speaking of Russia…..a former Russian spy was recently found alongside his daughter in critical condition on a bench in Salisbury. The former spy, Sergi Skripal, and his daughter, Yulia, were found slumped over on Sunday and in desperate need of medical attention. It is now being reported that they were poisoned by a nerve agent, which has raised the suspicion that this was an assassination attempt. “The development forces the British government to confront the possibility that once again, an attack on British soil was carried out by the government of President Vladimir V. Putin, which Western intelligence officials say has, with alarming frequency, ordered the killing of people who have crossed it. Prime Minister Theresa May and her cabinet ministers held a meeting on Wednesday of the government’s emergency security committee to discuss the matter. ‘This is being treated as a major incident involving attempted murder by administration of a nerve agent,’ said Mark Rowley, Britain’s chief police official for counterterrorism and international security.” Twenty-one people are also being treated for exposure to the nerve agent in connection to the attack.

Netflix Documentary – Rajneesh Salad Bar Bioterrorism
Get ready for some Netflix and nerdom on March 16th as the documentary on the largest bioterrorist attack in the United States is released. “In 1984, more than 700 people in The Dalles, OR, contracted Salmonella infections after followers of Rajneesh sprinkled the pathogen on salad bar ingredients in 10 local restaurants. The action was an effort to swing the results of an election.” Don’t miss out on the biosecurity twitter activity during a virtual viewing party – @pandorareport!

#NoImpunity: Will The Newest International Effort to Stop Chemical Attacks in Syria Succeed?
How can we stop the use of chemical weapons if there is no authority on attribution? GMU professor Gregory Koblentz is delving into the latest strategy to hold the Assad regime accountable for their continued use of chemical weapons. Between Russian vetoes that halt OPCW efforts and the death of the Joint Investigation Mechanism, many worry that the lack of punishment will encourage further CW use by the Assad regime. “To fill this gap in the global anti-chemical weapon architecture, France launched an international initiative in January to pressure the Assad regime to halt its use of chemical weapons. The Partnership Against Impunity, which uses the hashtag #NoImpunity on Twitter, is a group of 25 countries motivated by the twin goals of deterring future chemical attacks and bringing to justice the perpetrators of past attacks.” Sure, the sanctions by some of these countries are ultimately more symbolic than behavior-changing, but they are now infusing a dose of public shaming into the mix. “First, by curating a public database that lists all of the front companies and procurement agents used by the SSRC, the Partnership Against Impunity makes it easier for other countries and companies around the world to avoid doing business with Syria’s chemical weapons program. While sanctioning these shadowy companies and middlemen is like playing ‘whack-a-mole,’ it is an essential element of preventing Syria from rebuilding the capabilities that the OPCW destroyed after Syria joined the Chemical Weapons Convention.” The Partnership Against Impunity is also laying “the groundwork for future prosecutions of military officers and government officials who engaged in war crimes” and establishing a “concrete manifestation of the noble goal enshrined in the preamble of the Chemical Weapons Convention ‘to exclude completely the possibility of the use of chemical weapons’.”

 Assessing CRISPR – The Dread And the Awe
Genome editing is a hot topic – both in terms of future possibilities, but also potential peril. GMU biodefense professor Sonia Ben Ouagrham-Gormley and doctoral student Saskia Popescu are teaming up to review two new books on this gene editing technology. First, A Crack in Creation by Jennifer Doudna, one of CRISPR’s creators, who discusses the revolutionary marvel with a mixture of hope and dread. “Doudna became aware of this paradox soon after publishing the seminal 2012 article that announced her discovery. She was surprised and delighted by the technology’s rapid spread and its use in a variety of fields, yet some applications—such as the use of Crispr to edit human embryos, as performed for the first time by Chinese scientists in 2015—made her uneasy about the future of the technology. Unscrupulous individuals’ interest in using Crispr for pure profit made her uneasy as well.” Next, Modern Prometheus by computational biologist and freelance writer, Jim Kozubek. “He ponders the power of genetic manipulation as a gateway to the dehumanization of medicine and the objectification of human beings. Kozubek draws comparisons with ‘Jurassic Park’ and Mary Shelley’s Frankenstein to pose larger questions about genetic engineering—and also to point out that, though people are fascinated with technological advances, they often neglect to consider technologies’ implications, notably on people themselves.”

The U.S. and Global Health Security At A Time of Transition
The Kaiser Family Foundation will be hosting this free event on Monday, March 12th from 2-3:30pm EDT at the Kaiser Family Foundation Barbara Jordan Conference Center in Washington, D.C. This event will seek to explore the future of U.S. global health security efforts, what role the U.S. will play in the future of the GHSA, and more through a panel of experts. “Jen Kates, Vice President and Director of Global Health and HIV Policy, will provide opening remarks, and Anne Schuchat, Acting Director, Centers for Disease Control and Prevention (CDC), will give a keynote address on U.S. global health security efforts. Josh Michaud, Associate Director of Global Health Policy at the Kaiser Family Foundation, will moderate a follow up discussion with Beth Cameron, Vice President for Global Biological Policy and Programs at the Nuclear Threat Initiative (NTI); Rebecca Katz, Associate Professor and Co-Director of the Center for Global Health Science and Security at Georgetown University; Nancy Knight,Director of the Division of Global Health Protection at CDC; and J. Stephen Morrison, Senior Vice President and Director of the CSIS Global Health Policy Center.”

New Paradigms for Global Health: Building Capacity through Science and Technology Partnerships
The American Association for the Advancement of Science and Hitachi Ltd. will be hosting this event on March 21st from 11:30am-12:30pm at the AAS headquarters in New York City. “Why are science and technology partnerships — and science diplomacy — more critical to global health than ever before? Jimmy Kolker, former U.S. ambassador to Uganda and to Burkina Faso and the Obama Administration’s chief HHS health diplomat, offers a practitioner’s perspective on new ways of integrating and advancing global health science, security, and assistance. Public-private and technical partnerships can enable the best experts to build sustainable capacity in low- and middle-income countries, strengthening global health science, policy, systems, and delivery.”

Stories You May Have Missed:

  • The Troubling Truth About Medicine’s Supply Chain –  Maryn McKenna (author of Big Chicken and all around global health guru) is lifting back the curtain on the painful reality that is America’s hospital supply chains. While not something the public generally considers, it’s something we need to start fixing. “Missing IV bags and missing pharmaceuticals seem like unrelated problems, a temporary disruption layered on top of a longstanding problem. But in fact, they are unavailable for the same reason. The United States has allowed the manufacturing of most of its drugs and medical devices to drift offshore, at the end of long, thin supply chains.”

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 3.2.2018

Happy Friday! We’ve got a full plate of biodefense news this week, so we hope you’re hungry for everything from ASM Biothreats 2018 coverage to Gain of Function research, and a side of pandemic budgeting.

ASM Biothreats 2018 – GMU Biodefense Coverage
We’re excited to present our annual coverage of the ASM Biothreats conference from some of GMU’s very own biodefense graduate students. Our overview is a great way to catch up on some of the hot topics and captivating breakout sessions from the conference. You can find a landing page for all the reviews here, which will have links and a brief synopsis for each section the students wrote. GMU biodefense graduate students covered a variety of sessions – from artificial intelligence in biosecurity to the GHSA, future DoD programs in biodefense policy, and BARDA/DARPA projects- we’re reporting it all!

New Pathogen Research Rules: Gain of Function, Loss of Clarity
GMU Biodefense professor and graduate program director Gregory Koblentz is teaming up with Lynn Klotz (co-managing director of Bridging BioScience and BioBusiness LLC), to evaluate the December 2017 release of the latest Gain of Function (GoF) research rules. The DHHS release finally lifted the funding moratorium on GoF research following the controversial projects involving H5N1 in 2011. While the DHHS policy (or “Framework for guiding funding decisions about proposed research involving enhanced potential pandemic pathogens”) is similar to the Office of Science and Technology Policy guidance that was released in January 2017 (the “P3C0 Framework”), it came with the bonus of restoring funding for such research. Unfortunately, there are still considerable concerns with how GoF research is evaluated and if these frameworks have really addressed the gaps. “We, the authors, harbor concerns about adequate oversight of potentially dangerous research, and the framework incorporates several elements that address those concerns. The framework is thorough. It does a good job of laying out the principles and processes through which the Health and Human Services Department will make funding decisions regarding research that involves enhanced potential pandemic pathogens. The framework’s approach to dual-use research of concern is not based on lists of experiments or on specific pathogens, but instead takes a risk-based approach that focuses on the attributes of modified organisms. While the identity of starting organisms is central to existing oversight policy for dual-use research of concern, the framework emphasizes the importance of organisms’ properties once the experiment is over. This more comprehensive approach to dual-use research is a welcome change. Some elements of the new framework, however, remain worrisome.” Koblentz and Klotz point to several limitations of the new framework – it’s too narrow and not broad enough in that it only applies to research funded by DHHS, the terminology and definitions are lacking (especially in the definition of a potential pandemic pathogen), and the review process that was created is a limited. The framework also has new criteria for risks and benefits, which is “inherently problematic” and agreement is often never achieved. “The criteria used to judge which experiments involving enhanced potential pandemic pathogens warrant review by the Health and Human Services Department—and how the risks, benefits, and ethical aspects of such experiments are measured and weighed—are ambiguous enough to provide departmental reviewers wide latitude in their funding decisions. The process and outcomes must be transparent in order to demonstrate that the process is conducted in good faith and that policy is implemented appropriately. The framework, though it recognizes the importance of transparency for maintaining public trust in science, does not go far enough in actually providing the requisite level of transparency.” Lastly, Koblentz and Klotz point to the international considerations as a considerable weakness within the new framework. Sadly, it only applies to research done within the United States and the truth is that this is an international issue and needs global consideration and collaboration.

 2018 NASPAA Student Simulation – Global Health Security
How did you spend your Saturday? Battling a virtual pandemic? We were fortunate to participate as judges at an international collaboration and simulation to test students on their response during a pandemic. The NASPAA-Batten simulation (Network of Schools of Public Policy, Affairs, and Administration) involved a total of 563 students in 117 teams, from 159 universities across 27 countries. Teams represented approximately 336 million fictitious people in 4 fictitious countries per 1 fictitious world and were battling 1 seriously tough outbreak. GMU’s Schar School and the biodefense program were represented in both participants and judges. Professor and graduate program director Gregory Koblentz and PhD student Saskia Popescu were judges while six Schar students participated (four of which were biodefense students!) at the Carnegie Mellon University site in DC – Alexandra Williams (Biodefense MS), Annette Prietto (Biodefense MS), Stephen Taylor (Biodefense MS), Justin Hurt (Biodefense PhD), Fleciah Mburu (MPA), and Ryan Kennedy (MPP). The two finalist teams from the CMU site included biodefense MS students Alexandra and Justin, which means they’ll now move on to the global round where they are competing for the $10,000 prize. GMU biodefense students know how to battle a pandemic – whether it’s simulated or real! From a judge’s perspective, this was a great experience to not only observe how people respond to the complexities of a global outbreak, but also pose questions that help them see all the moving pieces in response.

Blue Panel Study Panel on Biodefense Calls For Strategic Budgeting Tied to New National Biodefense Strategy
The Blue Ribbon Study Panel has released a statement on the desperate need for decision-makers to commit to biodefense funding and recognize it as an imperative component to national security.  “We would do well to remind ourselves that we are really just as vulnerable now as we were then. In addition to the enormous potential toll on human health that intentional or natural outbreaks can inflict, the cost of the relentless rise of outbreaks is also entirely unsustainable based on current funding approaches. Emergency appropriations reach into the billions in direct outlays to the U.S. government. Economic impacts of a catastrophic outbreak could reach into the trillions.” You can also read the OpEd by Sen. Joe Lieberman and Former Gov. Tom Ridge, stating that American lives are worth budgeting for biodefense. “We call upon the president to release the National Biodefense Strategy soon and ensure that his next budget request to Congress conforms to the priorities in this strategy, showing how money requested for biodefense programs support the National Strategy’s goals and objectives.”

CDC Plans for New High Containment Lab
The CDC is asking congress for $350 million to start building the high containment continuity laboratory on their main campus to replace the existing one that has been used since 2005, but requires replacement by 2023. “The existing facility contains a number of BSL4 labs and labs that are one step down the biosafety and biosecurity ladder, BSL 3 enhanced. That’s where research on dangerous avian influenza viruses like H5N1 and H7N9 is conducted. Buildings that house these types of labs simply require a lot of maintenance, explained Dr. Dan Jernigan, head of the CDC’s influenza branch. ‘We’re just faced with the realities of what it takes to maintain something as complex as the high containment lab,’ he said.” The complex design of high containment labs makes them both expensive to build and maintain.

Battelle Takes On Biological Threats With New Software
Between naturally occurring outbreaks, bio-error, and bio-terror, there are a lot of ways infectious diseases can pose a threat to human life and safety. Battelle is seeking to change this through a new software for the U.S. government that “would screen small bits of DNA and assess whether they belong to potentially dangerous genetic sequences.The local research institution is one of six groups awarded an $8.7 million, two-and-a-half-year grant by the Intelligence Advanced Research Projects Activity (IARPA), an organization within the Office of the Director of National Intelligence.” The growing application of CRISPR and other genome editing technologies has underlined the gaps in DNA sequence screening for biosecurity concerns, especially when one considers the recent horsepox synthesis. “In the absence of national or international policy that would monitor bioengineering activity — and the technological gap for keeping an eye on never-before-encountered organisms — Battelle and the other groups awarded the federal contract are trying to figure out how to stay a step ahead. ‘At first I thought it would be too big of a lift for us,’ Dickens said. At the end of January, Battelle researchers completed a first version of the software, which they are now testing and optimizing. It can, for example, analyze a small fraction of an influenza virus’ genetic code and identify or predict whether it has the potential to make people, animals or the environment sick. The tool then assigns the genetic scrap a threat level: dangerous, potentially hazardous or safe. The tool is artificially intelligent enough to detect whether the sample is related to any known specimens, such as botulism or anthrax, and predict the function of never-seen-before DNA sequences.”

Workshop on Women’s Health In Global Perspective
GMU Schar School is hosting this free workshop on March 7-8th in Arlington,VA – don’t miss out! “The Workshop on Women’s Health in Global Perspective seeks to contribute to understanding and improve policy on women’s health and wellbeing around the world. The program includes panels on Communicable and Non-Communicable Disease; Health and Wellbeing; Maternal Health; and Reproductive Technology and Family Planning. It will cover topics such as HPV Vaccine Awareness, Maternal Mortality, and Cross-border Reproductive Care.”

GMU Biodefense Alum Leads NEIC Laboratory 
We love getting to brag about the amazing things that GMU Biodefense students and alum do with their passion for health security. Biodefense MS alum Francisco Cruz was recently named the Chief of the EPA’s National Enforcement Investigations Center (NEIC) Laboratory Branch! “The branch’s primary responsibility is conducting forensics analysis on environmental samples related to criminal and civil cases. The lab is a fully accredited forensics laboratory staffed by 21 chemists who can not only conduct the lab analysis, but also testify in court regarding the science behind the analysis. Additionally, the lab is capable of developing novel analytical methods for rare and difficult matrices that most labs cannot analyze. The lab supports EPA and other federal law enforcement partners with either lab analysis or technical consultation on how to process a sample.” Biodefense alums – don’t forget to stay connected so we can recognize you for all the amazing biodefense work you do!

DARPA Names Pandemic Prevention Platform Researchers
Launched in 2017, the P3 program from DARPA hopes to stop the spread of an outbreak before it becomes a pandemic. “In contrast with state-of-the-art medical countermeasures, which typically take many months or even years to develop, produce, distribute, and administer, the envisioned P3 platform would cut response time to weeks and stay within the window of relevance for containing an outbreak.” DARPA recently announced the institutions that are contracted for the program and will hopefully make progress in the fight against pandemics – MedImmune, Abcellera Biologics Inc., Duke University, and Vanderbilt University.

 The WHO – What Went Wrong from Swine Flu to Ebola?
The WHO has struggled to find its strong foot since 2009’s H1N1 influenza pandemic and then the 2014/2015 Ebola outbreak. With new leadership, many are hoping the WHO’s abilities can be strengthened and some faith restored in their capacity to prevent and respond to international health events. One particular evaluation of this can be found in a chapter of Political Mistakes and Policy Failures in International Relations. “This chapter examines a series of mistakes and the structural, cultural, political and epidemiological factors that contributed to the WHO’s mishandling of the first pandemic of the twenty-first century and the world’s largest ever outbreak of Ebola. The chapter then concludes by examining the reforms currently being implemented to strengthen the WHO’s global health security capabilities and what these signify for the future.”

Stories You May Have Missed:

  • CDC Epidemiologist Missing – “Police investigators are bewildered as they work through the “extremely unusual” circumstances surrounding the missing-person case of Timothy Cunningham, a researcher who vanished Feb. 12, shortly after hearing why he had been passed over for a promotion at the Centers for Disease Control and Prevention (CDC). Cunningham, 35, told colleagues he was not feeling well and left work at CDC headquarters in Atlanta, not long after speaking with his supervisor about why he had not been promoted, Atlanta Police Maj. Michael O’Connor told reporters. Cunningham works in the chronic disease unit at the CDC, not in the part of the CDC that deals with infectious disease, according to authorities.”
  • Iraqi, Dutch, Vietnamese Officials Report Avian Flu Outbreaks – Several countries reported new avian flu outbreaks, including two more H5N8 events at commercial poultry farms in Iraq, an H5 outbreak at a poultry farm in the Netherlands, and the first known H5N6 detection of the year in Vietnam. In Iraq, which has reported ongoing H5N8 activity since early January, authorities reported new outbreaks in Diyala and Baghdad province that began on Feb 13 and Feb 14, respectively, according to a report yesterday from the World Organization for Animal Health (OIE). The investigation said the source of the virus was contact with wild species.”
  • 11 Fall Ill After Suspicious Letter Arrives At Military Base– “Eleven people fell ill after a suspicious letter was opened in an administrative building at Joint Base Fort Myer-Henderson Hall in Arlington, Virginia, on Tuesday, according to the Arlington County Fire Department. A law enforcement official said field tests for the letter all came back negative for any harmful substance, but the FBI is transporting it tonight to its lab in Quantico for further analysis. The law enforcement official said the text of the letter contained derogatory, at time unintelligible and ranting language, and was addressed to a commanding officer at the base. Investigators are still determining what relationship, if any, the sender had with the base. A corporal, gunnery sergeant and a colonel all exhibited symptoms of a burning sensation on their hands and face, according to Specialist Nicholas Hodges who spoke to CNN from the base.”

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 2.23.2018

Happy Friday fellow biodefense friends! Curious about human migrant history? Ancient DNA is giving us some insight into our ancestors movements and habits. FluMist also just got the green light for use next flu season.

 Crossing the Rubicon: Horsepox Synthesis
Julius Caesar is said to have stated “alea iacta est” (the die is cast) as he led his army across the Rubicon river, triggering a point of no return in Roman history. In many ways, the horsepox synthesis is considered a new Rubicon for synthetic biology and the life sciences. While the lead researcher of the project and the private company backing it cite desires to advance progress in the pursuit of a new smallpox vaccine and identifying gaps (“Our hope is that this work will promote new and informed public health discussions relating to synthetic biology, stimulate new evaluation of [horsepox]-based vaccines, and advance the capacity to rapidly produce next-generation vaccines and poxvirus-based therapeutics.“), many are asking if they put profits ahead of public safety. The research team claimed they chose to synthesize the virus because they could obtain it no other way, but a recent article by NPR is challenging this. “There was another possibility, NPR has learned. Evans could have done research on a specimen of horsepox collected from the wild, but he didn’t pursue that alternative. He says using the natural virus might have prevented the pharmaceutical company he is working with from commercializing horsepox as a new vaccine for smallpox. But the head of the company told NPR that he had not been aware that this stored sample of horsepox was potentially available — and would not have wanted to synthesize the virus from scratch if he had known.” So now that we’ve ventured across the river, it seems that we may be learning more about dual-use research in general. Gregory Lewis notes that “Beyond the immediate issue of whether the horsepox work should have been performed (or published), the horsepox synthesis story highlights a more general challenge facing dual-use research in biotechnology: the unilateralist’s curse.” Lewis describes the unilateralist’s curse – “imagine that 100 scientists are individually deciding whether it would be a good idea to synthesize horsepox. All of them act impartially and in good faith: They would only conduct this work if they really thought it was on balance good for humankind. Each of them independently weighs up the risks and benefits of synthesizing horsepox, decides whether it is wise to do so, and acts accordingly. The situation arises from the fact that, if synthesis of horsepox is not to occur, all 100 scientists must independently decide not to pursue it; while if any of the scientists judges the benefits to outweigh the risks, he or she acts unilaterally to synthesize horsepox. Thus there is an ‘action bias’: Horsepox synthesis is more likely to occur when scientists act independently than when they agree to a decision as a group.” Has the quest for the “first strike” in scientific discovery outweighed the risks of dual-use research? The horsepox synthesis has cast a bright light upon the challenges of DURC oversight and the gaps we are struggling to even acknowledge. 

Examining Challenges & Possible Strategies to Strengthen U.S. Health Security
The National Academies of Science have released the latest proceedings of a workshop regarding the progress that has been made in the last 15 years towards improving health security, but also the gaps that exist. “On March 8–9, 2017, the National Academies of Sciences, Engineering, and Medicine’s Forum on Medical and Public Health Preparedness for Disasters and Emergencies hosted a two-day public workshop to acknowledge these persistent issues; to evaluate past, and perhaps inadequate, approaches to addressing them; and to discuss intentional and innovative new solutions. This publication summarizes the presentations and discussions from the workshop.” The report includes proposed priorities and challenges, underlying issues in health security, and potential strategies for strengthening American health security. Such strategies include developing a shared agenda, promoting a culture of learning and sharing, building the evidence base for policy and operations, etc. “Levy called for a paradigm shift toward conceptualizing health care, public health, the business community, and other sectors as parts of a whole that need to be integrated to provide a better environment for the community at large and better care for the community on a day-to-day basis.” Optimizing the exchange of information was also discussed, as was ensuring the interoperability of data across multiple systems. Participants also examined the financial components of health security and making the business case for investment.

 Biohacker’s Remorse
Last year saw contaminated CRISPR DIY kits hit Europe, but it did little to calm the biohacking stunts of Odin CEO Josiah Zayner. In a recent article, Zayner pointed to the moment another biotech CEO dropped trouser and injected himself with an untested herpes treatment mid-conference, as a wakeup call. “’Honestly, I kind of blame myself,’ Zayner told me recently. He’s been in a soul-searching mood; he recently had a kid and the backlash to the CRISPR stunt in October had been getting to him. ‘There’s no doubt in my mind that somebody is going to end up hurt eventually,’ he said.” Zayner says his past actions were efforts to provoke people in the industry who are involved in regulation and ethics in regards to roadblocks for CRISPR and DIY kits, noting that it’s a moral and ethical dilemma. Unfortunately, his sentiments aren’t doing much for those who feel his actions were attention-seeking stunts and he has yet to prove his concern for the DIY CRISPR risks. In case anyone was wondering if Zayner is still up to his old tricks, he also provided his latest video (Gut Hack) in which he attempts to give himself a fecal transplant. While this sounds gross (and it is), what’s more concerning is that an unlicensed and untrained individual is attempting to perform a very specific task that requires a stringent infection control guidelines and procedures. For those of us who have spent years working to perfect policies and practices so this medical procedure can be used to treat patients suffering from Clostridium difficile, this is not something to be taken lightly and isn’t exactly a good indicator that Zayner has learned from his mishaps. 

When Poor Infection Control Results In A Lawsuit
Who is responsible when hospitals decide to neglect infection prevention and control? A critical component to patient safety during medical care, infection control failures can result in the spread of infection – like the transmission of Ebola to healthcare workers. A recent court decision may be setting precedent for infection control responsibility during outbreaks. A Seoul court recently ordered the South Korean government to pay compensation to a patient who acquired MERS-CoV after the government failed to implement infection control. The patient “became infected while being admitted at a hospital in Daejeon where patient 16 was staying. Patient 16 moved there not knowing that had been infected by a different person, identified as patient 1 who infected 28 others, at Pyeongtaek St. Mary’s Hospital in Gyeonggi Province. Patient 1, who had been admitted to St. Mary’s more than two weeks after returning from a trip to Bahrain, a Middle Eastern country, May 4, reported suspected symptoms of MERS with health authorities the morning of May 18. However, the Korea Centers for Disease and Prevention (KCDC) dismissed it, saying the country had no reports of a MERS outbreak.” The court notes that if quarantine would have been implemented appropriately, it could have stopped the spread.

Budgeting for Medical Countermeasures
The Bipartisan Policy Center’s latest report highlights not only the growing concern for infectious disease threats, but also the role of medical countermeasures. Pointing to Project Bioshield and the procurement of 27 medical countermeasures, the white paper “will summarize the progress to date in procuring medical countermeasures and prior congressional funding mechanisms for Project BioShield. It will also discuss ways to optimize funding for medical countermeasures so that the existing public-private partnership can continue to thrive: namely, by restoring the program’s original multi-year funding structure.”

Can Nanoparticles Help Us Battle Antimicrobial Resistance?
As news emerges of an extensively drug-resistant (XDR) typhoid strain in Pakistan, it’s hard to imagine winning the battle of the resistant bug. Can nanoparticles tackle AMR? A research team led by Andrea O’Connor at the University of Melbourne is taking on antimicrobial resistance through nanoparticles and collaboration with a nearby hospital. “Together, the team found that selenium (a mineral that humans require in their diets to boost immunity and aid metabolism) in the form of nanoparticles can stop the growth of bacteria such as ‘Golden Staph’ (Staphylococcus aureus). Their findings are published in the Journal of Colloid and Interface Science. They think the nanoparticles do this by disrupting the membrane around the bacteria. ‘One of the ways that these nanoparticles can attack bacteria is by disrupting that membrane so they make the bacteria leaky, and then things can pass in and out of the bacteria in a way they normally wouldn’t’.” The team hopes that selenium nanoparticles have potential applications for when antibiotic efficiency dwindles, especially in terms of chronic wounds. Their nanoparticles have been tested against nine different kinds of bacteria and have found success against all of them.

 Tales From A Virus Hunter
With CDC and global health security funding in a dire situation, the days of virus hunters trekking through jungles and providing boots-on-the-ground support for outbreaks may be in jeopardy. Dr C.J. Peters is one of the old school virus hunters who tackled Rift Valley Fever and Bolivian hemorrhagic fever in their early days. “Peters was a virus hunter. That often meant spending time in the field, mostly in Latin America but also in Africa, where the work was interesting and the bosses far away. ‘If you’re in the shadow of the flagpole from headquarters, you’re in trouble,’ he explained. ‘Because there will be somebody poking into everything you’re doing.’ Virus hunting today is not what it used to be. There is still adventure to be had, with bold scientists seeking to uncover the mysteries of the unseen world and ultimately benefit human health. But things have also changed.”

Stories You May Have Missed:

  • Flu Vaccine Act– Last week several US senators released their proposal to invest $1 billion in research for a universal flu vaccine over the next five years. “From a total investment of $1 billion, the proposed law would direct $200 million each year over fiscal years 2019 through 2023 to universal flu vaccine research at the National Institutes of Health (NIH), according to a press release from Markey’s office. For comparison, he said the NIH’s National Institute for Allergy and Infectious Diseases (NIAID) spent about $64 million in fiscal year 2017 on universal flu vaccine research.”

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 2.16.2018

 

 White House Budget Hits Public Health
The White House has released their new plan, “Efficient, Effective, Accountable: An American Budget”, which sees an increase in military spending, funds for a U.S.-Mexico border wall, and a 10%  increase in spending from 2017. “The plan also calls for major cuts to Medicare, Medicaid, food stamps and other social programs — reductions that conservatives have long sought. But even with these reductions, which add up to more than $3 trillion in cuts over 10 years, the proposal would not bring the budget into balance because of the lost tax revenue and higher spending on other programs.” The 2019 budget proposal also includes $9.2 billion added after Congress lifted mandatory spending caps. “But the 2019 budget might not be as steady as it seems, because the White House is calling for the creation of three new institutes within the NIH. They include a National Institute for Research on Safety and Quality, which would replace the $324-million Agency for Healthcare Research and Quality within the Department of Health and Human Services (HHS). The Trump plan would also transfer the National Institute of Disability, Independent Living, and Rehabilitation Research from the HHS’s Administration for Community Living, and the National Institute of Occupational Safety and Health (NIOSH) to the NIH from the US Centers for Disease Control and Prevention (CDC).” The plan also includes a cap for how much salary a scientist can draw from an NIH grant (90%), gives NIH an additional $750 million for research towards the opioid crisis ($400 million of which must “be spent on public-private partnerships to develop new treatments”). Unfortunately, this proposed budget significantly weakens public health preparedness and response plans with a 43% reduction in the CDC’s Public Health Preparedness and Response Program. Furthermore, it includes hitting the CDC hard with a 12% reduction and plans to move the strategic national stockpile (SNS) to ASPR. Such plans severely impact global health security as funding for the GHSA is expected to drop. You can read a further overview on the health security outlook by the Johns Hopkins Center for Health Security here. There has also been increasing concern regarding the lack of a nominee for the head of the Office of Science and Technology Policy, especially since the de facto advisor is a 31-year-old political science major from Princeton

GMU Schar School MS Open House
Don’t miss out on our information session next week. This is a great chance to chat with faculty about the GMU Biodefense MS program (both online and in person). “The session will provide an overview of our master’s degree programs, an introduction to our world-class faculty and research, and highlights of the many ways we position our students for success in the classroom and beyond. Our admissions and student services staff will be on hand to answer your questions.” FYI – GMU biodefense students are making headlines for their dedication and passion for health security, come join the nerdom!

Next Generation Global Health Security Mentorship Program
Interested in becoming a mentor  or protege in health security? The NextGen Global Health Security Mentorship Program is a great way to build partnerships and collaborations for those passionate about health security. “The NextGen Global Health Security (NGGHS) Mentorship Program is an annual program aimed at connecting early to mid-career professional and students interested in global health security with experts in the field to enhance professional development. Mentors and Protégés are free to establish a program that suits them best. Meetings can be based on current events, suggested topics and/or other common areas of interest. The pair will maintain correspondence either in person, over the phone or by email, as often as they have decided feasible.” If you’re a GMU biodefense alum, also make sure to update your information in Stay Connected so you’ll get the latest in biodefense program news and opportunities!

The Anniversary of Kim Jong Nam’s VX Assassination
February 13th marked the one-year anniversary of the assassination of Kim Jong Un’s half brother at the Kuala Lumpur airport. Kim Jong Nam was attacked by two women who smeared VX nerve agent on his face. “The women claim they were tricked into believing they were part of a reality show, but the U.S. and South Korea say the murder was orchestrated by Pyongyang. The brazen killing came as North Korea was starting to accelerate its missile tests and countries around the world came under mounting pressure to enforce ever-tightening U.N. sanctions against Pyongyang.” In the wake of the attack, Malaysia is working to distance itself from its previously close relationship with Pyongyang. The murder trial, which started in October of 2017, is set to end in March of this year, with the two women maintaining their innocence. 

Biosafety Failures in UK Lab
The Health and Safety Executive (HSE) released findings from their investigations into more than 40 “mishaps” at specialist labs from 2015-2017. The labs were run by hospitals, private companies, and Public Health England (PHE), which reveals an unfortunate trend across many sectors. “One scientist at a PHE laboratory became sick after contracting Shigella, a highly contagious bacterial infection that causes most cases of dysentery in Britain. The incident led the HSE to send the agency an enforcement letter to improve its health and safety practices.” Incidents range from failure to communicate safety requirements for mailing samples to airflow failures and lab workers acquiring illnesses from lab safety mishaps.

Antimicrobial Resistance: Forging A New Strategy Against An Old Threat
GMU Biodefense students love all things health security and that includes antimicrobial resistance. PhD student Saskia Popescu is tackling the woefully insufficient response we’ve had over the years to this growing threat. Pointing to current challenges, initiatives, and research strategies, Popescu discusses current trends and hopeful plans to combat AMR. “What is to be done? There are several initiatives, like the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator (CARB-X), that seek to infuse life into the research and development of new drugs. There is also a push on health care providers and agriculture to reduce the use of antimicrobials. But these are all long-term solutions that may take years or decades to implement. Although long-term plans are critical, if you were hospitalized today with a highly resistant infection, what would be the short-term plan of action your heath care providers would take?”

ABSA Risk Group Database App
Check out the latest Risk Group Database resource (and app!) from the Association for Biosafety and Biosecurity (ABSA) International. “In many countries, including the United States, infectious agents are categorized in risk groups based on their relative risk. Depending on the country and/or organization, this classification system might take the following factors into consideration: pathogenicity of the organism, mode of transmission and host range, availability of effective preventive measures (e.g., vaccines), availability of effective treatment (e.g., antibiotics), and other factors.”

Blue Ribbon Study Panel on Biodefense Receives Grant to Advance Leadership and Reduce Catastrophic Risk
“The Blue Ribbon Study Panel on Biodefense announced today a $2.5 million grant from the Open Philanthropy Project. The grant allows the Panel to continue its leadership role in assessing our nation’s biodefense, issuing recommendations and advocating for their implementation, and identifying viable avenues for needed change to policy. The grant comes amidst heightened global tensions as North Korea and other regimes seek to develop biological weapons. It also arrives on the 100th anniversary of a catastrophic influenza pandemic that took the lives of millions around the world, a stark reminder of the dangers of biological events.”

Stories You May Have Missed:

  • DHS Announces Finalists in $300k Biothreat Prize Competition –  “The Department of Homeland Security (DHS) Science and Technology Directorate (S&T), in collaboration with the Office of Health Affairs National Biosurveillance Integration Center (NBIC), today announced five finalists for Stage 1 of the Hidden Signals Challenge. The challenge calls for the design of an early warning system that uses existing data to uncover emerging biothreats. The announcement was made at the American Society for Microbiology’s 2018 ASM Biothreats meeting.”
  • Seoul Virus Transmission – Have a pet rat at home? Make sure to practice safe rodent handling and hand hygiene as physicians are seeing cases of rodent-to-human transmission of Seoul virus. “After confirming Seoul virus infection in the Wisconsin patients, the CDC and the Wisconsin Department of Health Services investigated the source of the disease. ‘The outbreak spread from sales or trade of infected pet rats between people’s homes or between ratteries’ – places where rats are bred – ‘in 11 states,’ said Kerins, who coauthored the report.”

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 2.9.2018

Happy Friday fellow biodefense enthusiasts! The Winter Olympics are already starting off with a bang as Korean health officials have confirmed 128 cases of norovirus among security personnel, police officers, and Olympic workers.

WHO Releases List of Blueprint Priority Diseases
The WHO has just released their annual review of the Blueprint list of priority diseases, which includes a special tool for “determining which diseases and pathogens to prioritize for research and development in public health emergency contexts”. While the list includes diseases like Ebola, MERS and SARS, Nipah, and Zika, it is the inclusion of Disease X that highlights the unknowns of infectious diseases in the future.  “Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease, and so the R&D Blueprint explicitly seeks to enable cross-cutting R&D preparedness that is also relevant for an unknown ‘Disease X’ as far as possible.”

BioWatch Documents Left Behind on Flight
Biowatch officials are doing a bit of a damage control at the moment as multiple copies of an official DHS document regarding performances during a bioterrorism simulation were left behind on an airplane prior to the Super Bowl. The errant document offered a critique of how officials performed during a simulated release of the infectious disease anthrax in Minneapolis on the day of the Super Bowl. Other sensitive material was also found, CNN said, without further description.” Ironically, it was a CNN employee who discovered the forgotten papers in the seat-back pocket of a commercial plane. “The reports were accompanied by the travel itinerary and boarding pass of the government scientist in charge of BioWatch, the DHS program that conducted the anthrax drills in preparation for Super Bowl LII in Minneapolis. The reports were based on exercises designed to evaluate the ability of public health, law enforcement and emergency management officials to engage in a coordinated response were a biological attack to be carried out in Minneapolis on Super Bowl Sunday.” CNN waited to publish the incident until after Sunday’s game, but the papers revealed significant areas for response improvement during a bioterrorism incident. While not surprising, the identification of such gaps is critical for improvement however, it is the concerning nature of which they were left behind. Vulnerabilities are always present, but that doesn’t mean we want them being aired in the open for nefarious actors to utilize.

 GMU Biodefense PhD Student Selected As ELBI Fellow 
The Biodefense Graduate Program in the Schar School of Policy and Government at George Mason University is proud to announce that PhD student Yong-Bee Lim has been selected for the prestigious Emerging Leaders in Biosecurity Fellowship (ELBI) program within the Johns Hopkins Center for Health Security. Selected from a group of over 120 international applicants, the 2018 ELBI class includes professionals and scholars with a passion for health security and biosecurity. This year-long fellowship will deepen the biosecurity expertise and broaden the network of those passionate about furthering the field. Yong-Bee was also the recipient of an internship with the Center for Global Security Research at Lawrence Livermore National Laboratory and the SB7.0 Fellowship, which supported his attendance of an international synthetic biology conference in Singapore. His selection also marks the third consecutive year that the Schar School’s Biodefense program has had graduate students named ELBI fellows. Congrats Yong-Bee!

Smallpox Signalling
It’s been a couple of weeks since PLOS One published the horsepox synthesis paper and the truth is that many are still in awe that not only such work was done, but that it was published. Where were broader discussions regarding the merits of this research? Conversations about need to publish it? Moreover, what about the importance of oversight in the private biotech arena and not just those with federal funding? One thing is for certain though, this is a critical moment for life sciences and DURC oversight. “A vaccine against smallpox already exists. The research was carried out unilaterally, without a broader discussion of the merits beforehand. There are apparently few oversight mechanisms when experiments are done with private funding. The restrictions that now cover dual-use research funded by U.S. government — which include an independent review process, and a weighing of the risks and benefits, as well as the ethics — should be expanded to private-sector research.”

Topics of Interest at the DHS Meeting on Sequences of Interest
Synthetic biology has led to the creation of new products, markets, companies, and industries. At the same time, this technology poses potential risks to biosafety and biosecurity, as recently demonstrated by the synthesis of horsepox virus, a cousin of variola, the virus that causes smallpox.  On January 29-30, 2018, the Department of Homeland Security (DHS) Science and Technology Directorate sponsored a workshop to discuss the evolving role of databases that contain genetic sequences of pathogens and toxins that pose safety or security concerns, termed “sequences of interest.” The workshop brought together stakeholders from government, industry, and academia to discuss the need for such databases, review current databases and those under development, explore potential applications and users of these types of databases, and consider the potential risks that they pose due to malicious or inadvertent misuse. The workshop provided a valuable opportunity to explore the scientific and technical aspects of constructing such databases, maintenance and sustainability challenges, and the trade-offs involving functionality, accessibility, affordability, confidentiality, and security. While the workshop did not produce a consensus on the best path forward, it played an important role in educating the participants on the most critical issues and facilitating a dialogue among a diverse range of stakeholders on this important topic.  The workshop also came at a propitious time as stakeholders grapple with the changing landscape of the biotech industry and advances in DNA synthesis technology.  For instance, the International Gene Synthesis Consortium, a group of the leading DNA synthesis companies that have adopted customer and sequence screening protocols to prevent the misuse of their products, has expanded in size and geographic scope and recently updated its biosecurity protocols. The U.S. government is also reviewing the customer and sequence screening guidance it issued in 2010 and is considering whether, and how, to update it.  Should a decision be made to proceed, stakeholder engagement would be a significant part of the review, just as it was a significant part of the guidance’s original development.

The US Can’t Afford to Reduce Public Health Funding
GMU biodefense PhD alum Daniel M. Gerstein is evaluating the decision to reduce funding for global epidemic prevention activities and just how dangerous that would be for the United States. “Recent reporting suggests that the Trump administration is preparing to downsize the Centers for Disease Control’s (CDC) global epidemic prevention activities in 39 of 49 countries starting in 2019 when funding first authorized by Congress in 2014 expires. Such a move is potentially dangerous and could place the U.S. at significant risk.” Gerstein points to the notion of shared responsibility in global health security and how important efforts like the GHSA are for global public health. He also notes that the last decade alone has revealed just how undeniable public health is as a national security issue. “Without renewed funding, the long-term outlook could include weakened global disease surveillance and response systems, less capable partner nations and an increased likelihood of global disease outbreaks that would undoubtedly threaten the U.S.” Wanting more information regarding the implications of CDC cutting back on their global health security funding? Check out this article regarding the funding cliff the CDC is about to fall off.

Biosecurity in Putin’s Russia
The latest book from Raymond A. Zilinskas and Philippe Mauger delves into the biodefense world of Putin’s Russia. “In March 2012, at a meeting convened by the recently reelected Russian president Vladimir Putin, Minister of Defense Serdyukov informed Mr. Putin that a plan was being prepared for ‘the development of weapons based on new physical principles: radiation, geophysical wave, genetic, psychophysical, etc.’ Subsequently, in response to concerns expressed both in Russia and abroad, the Russian government deleted the statement from the public transcript of the meeting. But the question remains: Is Russia developing an offensive biological warfare program?”

Global Monitoring of Disease Outbreak Preparedness
The Harvard Global Health Institute has released their new report that is “a step towards developing a shared framework and monitoring mechanism” for outbreak response and preparedness. “This report is primarily intended for the community of policymakers and researchers concerned about the rising risks of domestic, regional, and global infectious disease epidemics, and the collective failure to take the coordinated actions required to reduce such risks. These risks include the expected health, economic, and societal costs that are borne by countries, regions, and even all nations in the case of pandemics (which are worldwide epidemics). These risks also include the consequences of increasing antimicrobial resistance (AMR) and its spread within regions and globally.” The report focuses on strengthening public health capacity as a foundation, improving S&T, reinforcing risk analysis and incentives for action, strengthening global mechanisms, and revised shared monitoring framework and next steps.

 The Fearsome Future of Flu
This year has been rough for seasonal flu and while it has been a cold dose of reality in terms of hospital response, are we really learning our lesson or just running from fire to fire? 2018 marks the centennial of the 1918/1919 influenza pandemic and with a larger, more connected population, have we made ourselves safer? The next flu virus with pandemic potential will either enhance our response capabilities or exploit our most damning weaknesses. “And influenza viruses excel at the element of surprise. Few would have guessed Mexico as the origin of that 2009 H1N1 pandemic, for example, notes Fukuda. That outbreak was recognized in San Diego—never considered a hotspot—when a little girl happened to seek treatment at a clinic participating in a study focused on diagnosis, Adalja explains. That’s why he believes it is important to build up the diagnostic capacity for frontline clinicians, and not be satisfied with non-specific diagnoses—failing to pin down the specific microbial cause.” Unfortunately, we are still practicing the methods of frenzied response, delayed information sharing, and dangerous hysteria that can spread even faster through social media. These concerns highlight yet another reason why we need a universal flu vaccine.

Johns Hopkins Center for Health Security Event: Healthcare Disaster Resilience
Don’t miss this event at the National Press Club Holeman Lounge on Thursday, February 22nd from 8:30-10am EST. The Johns Hopkins Center for Health Security will release new policy recommendations for building a more effective disaster health system in the United States. Speakers include Dr. Luciana Borio from the White House National Security Council staff, Sally Phillips of HHS, Linda Langston from the National Association of Counties, as well as Drs.Tom Inglesby, Eric Toner, Monica Schoch-Spana from the Center for Health Security.

 Genetic Sequencing and the Dangers of DIY Genome Editing
Nebula Genomics will sequence your genome for just under $1,000 and you can even share it using a blockchain.  “Nebula is the brainchild of geneticist George Church, PhD student Dennis Grishin, and graduate Kamal Obbad, all from Harvard. Mirza Cifric, CEO of Veritas Genetics, which offers a genome-sequencing service for $999, is a founding advisor. When you pay to take a DNA test—through 23andMe, Helix, or Ancestry.com, for example—the company that does the testing owns your genetic data. Nebula wants to sequence people’s entire genomes and let them own it, allowing them to earn digital money by sharing it.” While professionals may be providing your genomic data through these companies, many are looking to actually learn to experiment with genes themselves. DIY gene therapy is becoming increasingly accessible, which has many worried and the FDA issuing a warning to the public. The FDA, on “November 21 cautioned against do-it-yourself (DIY) gene therapies. But even as the agency’s statement also warned that selling gene editing kits aimed at homemade therapeutics is illegal, CRISPR–Cas9 kits are available to buy online, and the number of providers is growing, raising concerns that DIY gene therapy enthusiasts could be putting themselves and others at risk.”

Biodefense Policy Landscape Analysis Tool
B-PLAT is a new tool from Pacific Northwest National Laboratory scientists Rachel Bartholomew and Kristin Omberg that aims to help coordinate national biodefense preparedness. It “captures and presents a slew of information about U.S. efforts to protect its citizens and others around the world from threats as diverse as the flu, diseases like Ebola, threats from terrorists, potential risks to water and food supplies, and myriad other concerns. The tool is freely available. In 2017, PNNL chartered an internally funded working group, the Policy Wranglers, to capture relevant biodefense policy directives, public laws, and corresponding sections of the U.S. Code, in a format conducive to visualization. The resulting tool can be utilized to better understand the current state of the U.S. biodefense enterprise.” A presentation on B-LAT will also be made at ASM’s Biothreats next week as part of a town hall on Tuesday.

Stories You May Have Missed:

  • US Battles IV Bag Shortage During Record-Setting Severe Flu Season – GMU biodefense PhD student Saskia Popescu is looking at the impacts of this IV bag shortage during the severe flu season. “Even prior to Hurricane Maria, the United States was already battling challenges with meeting the demand for IV fluids; however, the storm crippled Puerto Rico-based manufacturing sites for materials. In a news release on January 16, the FDA reported that they were taking additional steps to combat the shortages, such as ‘asking companies to submit data to extend expiration dates for these products.’ They noted that, ‘if expiration dates can be safety extended [for these products], it would allow some near-expiry product that remains at the hospital level to be used’.”
  • DARPA Program to Track Genetic Markers for Past WMD Material Exposure – “The program is being called Epigenetic Characterization and Observation (ECHO), and its endgame is the creation of a field-deployable system that could analyze someone’s epigenome and identify markers of whether or not–in that person’s entire lifetime–been exposed to WMD-associated materials. DARPA officials are billing it as worlds quicker than sending to a lab to test for biological or chemical agents in clothing or hair.”

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 2.2.2018

The world of health security has been busy this week as news of CDC leadership changes and ongoing flu troubles have caused ripples. A new mouse study is also hinting that West Nile virus may cause Zika-like birth defects. Check out Maryn McKenna’s latest article on changing the market for flu shots and the desperate need for innovation.

 CDC’s Plans to Scale Back Global Health Security Activity 
A recent article brought attention to CDC plans that would reduce efforts to prevent and respond to outbreaks on a global scale through the global health security agenda (GHSA). “In an email to U.S. and overseas leaders in its global health center, the CDC said it anticipates that if its funding situation remains the same, it will have to narrow activities to 10 ‘priority countries’ starting in October 2019. The email was reviewed by The Wall Street Journal.” The 10 countries include Vietnam, India, Nigeria, etc. “Reductions now would halt critical work midstream and result in a loss of newly trained local experts, said Tom Frieden, the former CDC director who led the effort until a year ago and is now president and chief executive of Resolve to Save Lives, an initiative working on strengthening epidemic preparedness.” In response to this alarming plan, the Global Health Security Agenda Consortium, Global Health Council, Next Generation Global Health Security Network, and Global Health Technologies Coalition, have drafted a letter to newly appointed HHS Secretary Alex Azar, regarding the serious implications of such actions. Sent to HHS, CDC, OMB, State and NSC leadership, they underline the funding ramifications of scaling back on CDC’s efforts regarding the GHSA. “US investments in global health security and deployed CDC personnel are making America safer today. For example, US investments in surveillance capacity in Cameroon have decreased the disease outbreak response time from 8 weeks to just 24 hours.” The letter highlights the recent Ebola and Marburg outbreaks as prime examples of work within the GHSA, but also what occurs when global efforts are not available or lacking. “As the United States and the world begin to reap the benefits of our investments in better disease preparedness, now is not the time to step back. The ongoing danger that biological threats pose to American health, economic, and national security interests demands dedicated and steady funding for global health security. Congress and the Administration must invest in our deployed global biodefense capability.” Nothing short of serendipitous, the National Academies have also released their report from a workshop on Exploring Partnership Governance in Global Health. “In global health, collaboration frequently occurs through public–private partnerships (PPPs), with public and private parties sharing risks, responsibilities, and decision-making processes with the objective of collectively and more effectively addressing a common goal. PPPs include government and industry as well as partners from a range of other sectors. The workshop examined what role governance assumes in global health PPPs through presentations and discussion on transparency and accountability, operational challenges, legal considerations, barriers and strategies for engagement, examples of governance structures and lessons learned, and measurement. This publication briefly summarizes the presentations and discussions from the workshop”

Antimicrobial Resistance Surveillance Efforts and Needs
While the outcome is not surprising, this first release of the WHO’s surveillance data on AMR isn’t pretty. Surveillance data is revealing high levels of antibiotic resistance are in fact, found worldwide. “WHO’s new Global Antimicrobial Surveillance System (GLASS) reveals widespread occurrence of antibiotic resistance among 500 000 people with suspected bacterial infections across 22 countries. The most commonly reported resistant bacteria were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Streptococcus pneumoniae, followed by Salmonella spp. The system does not include data on resistance of Mycobacterium tuberculosis, which causes tuberculosis (TB), as WHO has been tracking it since 1994 and providing annual updates in the Global tuberculosis report.” The GLASS program includes 52 countries (25 high-income, 20 middle-income, and 7 low-income countries) and was launched in 2015 as a way to better track and understand the complexities of AMR. Wellcome Trust has also just announced a new strategy to combat AMR on an international scale. SEDRIC (Surveillance and Epidemiology of Drug-Resistant Infections Consortium) will work to strengthen country capacity for AMR surveillance and detection. “We need to better understand where patients acquire bacteria that cause infections – are they acquiring bacteria from other patients, from healthcare settings, water or food or the general environment? Drug-resistant infections are, like us, international travellers. We need to track which borders they cross, and how quickly. Without detailed and up-to-date information we cannot effectively intervene.” SEDRIC will work to fix surveillance gaps across countries by focusing on improving global coordination, identifying critical gaps and barriers, and helping countries to adopt sustainable best practice and strategies. These surveillance efforts and strategies are desperately needed to understand the AMR problem at a global level, especially as it was reported that India’s farmed chickens are dosed with colistin (the antibiotic of last resort). 

CDC Director Steps Down
Dr. Brenda Fitzgerald has stepped down from her role as director of the CDC due to conflicts of interest. “Politico reported on Tuesday that Fitzgerald, a physician and former commissioner of the Georgia Department of Public Health, bought shares in a tobacco company a month into her leadership of CDC, an agency charged with safeguarding public health, including reducing rates of smoking. She took over leadership at CDC in July. After advising the HHS secretary of the status of her financial interests and the way in which it limited her ability to do her job, Azar accepted her resignation, HHS said in a statement.” Dr. Fitzgerald began her role in July and is the second of top health positions appointed by the Trump Administration to resign. Dr. Anne Schuchat is now the Acting Director for the CDC. 

GMU Master’s Open House – February 21st
We’re just a few weeks out from the GMU Schar School MS Open House on February 21st and you won’t want to miss this opportunity to talk to faculty about our biodefense graduate degrees. Whether you’re looking to attend in person or online, this is a great opportunity to discuss the application process, curriculum, and how students are supported in their academic and career goals.

 Hawaii’s False Missile Alert and The Woeful State of US Preparedness
For 38 minutes, residents of Hawaii were alerted that a ballistic missile was approaching the island. A deep-dive of this mishap has found that the “emergency worker who sent a false public safety alert on Jan. 13 warning of an imminent  ballistic missile attack on Hawaii believed that a ballistic missile was truly bound for the state after mishearing a recorded message as part of an unscheduled drill,”. A mix-up in communication between shift supervisors regarding when the drill would run led to a trickle-down of confusion as the day-shift workers were notified of a missile threat (as part of the drill). “Following standard procedures, the night-shift supervisor posing as Pacific Command played a recorded message to the emergency workers warning them of the fake threat. The message included the phrase ‘Exercise, exercise, exercise.’ But the message inaccurately included the phrase ‘This is not a drill.’ The worker who then sent the emergency alert failed to hear the ‘exercise’ portion of the message and acted upon the ‘This is not a drill’ part of the message that should not have been included, according to the report.” Furthermore, the computer systems in place that should’ve been a stop-gap did not detect the difference between test alerts and actual alerts. This event is a prime example of the traditional failure in emergency preparedness exercises (and real events) – communication. Such an event, while frustrating, should be utilized as a teaching tool to truly fix the communication gaps. Sometimes it’s the “did that seriously just happen?” events that teach us the most about the fissures in our preparedness.

Flu Wreaking Havoc on Hospitals, Infection Control Practices Struggling
GMU Biodefense PhD student and infection preventionist Saskia Popescu is looking at the current flu situation from the perspective of infection control and healthcare response. “Hospitals are being hit hard by a rapid influx of individuals who are requiring isolation, treatment, and manpower during a time where health care institutions are already suffering from an intravenous (IV) bag shortage. I’ve seen some hospitals go on diversion because they are so inundated with patients that they are unable to accept any more. Hospitals are experiencing shortages of influenza testing kits, conference rooms and outside tents are being set up as triage/waiting areas, personal protective equipment (PPE) stores are being strained. Furthermore, infection prevention and control practices are being stressed against the influx of patients and staff calling in sick. All the while, clinicians are trying to maintain proper isolation precautions. To add insult to injury, a recent study on the transmissibility of aerosols and the role they play in spreading influenza has uncovered some disheartening results.”

Tests Link Syrian Government Stockpile to Largest Sarin Attack
Laboratories performing analysis for the Organisation for the Prohibition of Chemical Weapons (OCPW) have confirmed linkage between the Syrian government’s chemical weapons stockpile and the largest sarin attack of the civil war. “The tests found ‘markers’ in samples taken at Ghouta and at the sites of two other nerve agent attacks, in the towns of Khan Sheikhoun in Idlib governorate on April 4, 2017 and Khan al-Assal, Aleppo, in March 2013, two people involved in the process said. ‘We compared Khan Sheikhoun, Khan al-Assal, Ghouta,’ said one source who asked not to be named because of the sensitivity of the findings. ‘There were signatures in all three of them that matched’.” The test results further reinforce the widespread belief that the Assad regime has not destroyed their chemical weapons supply (and continues to use them), which would violate not only the Chemical Weapons Convention, but also several UNSC resolutions. Russia continues to maintain that the Syrian government has not carried out such attacks and that the OCPW inquiries aren’t reliable, but inspectors continue to find evidence of chemical weapons in Syria. “Independent experts, however, said the findings are the strongest scientific evidence to date that the Syrian government was behind Ghouta, the deadliest chemical weapons attack since the Halabja massacres of 1988 during the Iran-Iraq war.” “A match of samples from the 2013 Ghouta attacks to tests of chemicals in the Syrian stockpile is the equivalent of DNA evidence: definitive proof,” said Amy Smithson, a U.S. nonproliferation expert. “The hexamine finding ‘is a particularly significant match,’ Smithson said, because it is a chemical identified as a unique hallmark of the Syrian military’s process to make sarin. ‘This match adds to the mountain of physical evidence that points conclusively, without a shadow of doubt, to the Syrian government,’ she said.” Furthermore, experts are dispelling the notion that the attacks could have been carried out by rebels, noting that it would be impossible for them to achieve such a coordinated, large-scale attack.

Stories You May Have Missed:

  • South Korea Works to Eradicate Avian Flu Before Olympics – “With the PyeongChang Winter Olympics set to begin on Feb. 9, the South Korean Ministry of Agriculture, Food and Rural Affairs announced Monday that it had confirmed the presence of a highly pathogenic strain of the H5N6 avian influenza virus at two chicken farms south of Seoul, Korea JoongAng Daily reportsThe two farms both are approximately 80 miles to the west of PyeongChang. The government has culled 190,000 chickens at the farm in Hwaseong and another 144,000 at the farm in Pyeongtaek. It also has ordered that 430,000 chickens on farms in a 500-meter radius of the Pyeongtaek farm be slaughtered and has destroyed nearly 500,000 eggs at the Hwaseong farm as a precautionary measure. The government also will inspect and disinfect other farms in the area.”
  • Yellow Fever in Brazil – Cases of yellow fever have jumped in Brazil, based upon data from the Ministry of Health data. “In 1 week, the number of recorded deaths from yellow fever rose from 20 to 53, reported cases rose from 470 to 601, while confirmed cases jumped from 35 to 130, O Globo reported yesterday. All deaths have occurred in Minas Gerais, Sao Paulo, and Rio de Janeiro states. Ministry of Health data lag behind data from state officials, Brazilian media reported. The state health data for Minas Gerais notes 24 deaths (1 more than the federal government count), and Rio de Janeiro recorded 8 deaths (also 1 more than the federal total for that state.)  All reports indicate that Sao Paulo has 21 deaths.”

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 1.26.2018

In this week’s Pandora Report we’re taking a trip down the horsepox synthesis rabbit hole, looking at influenza transmission, and so much more. But first..the Bulletin of the Atomic Scientists just announced that the Doomsday Clock has been moved and is now two minutes to midnight. You can also read the full testimony from Dr. Tom Inglesby, director of the Johns Hopkins Center for Health Security, during the US Senate Committee hearing on the reauthorization of the Pandemic and All-Hazards Preparedness Act. The Senate has also just confirmed Alex Azar as the new head of Health and Human Services.

The Perilous Road of Horsepox Synthesis 
Unless you were in a state of flu-induced delirium, last Friday was a rather big day in with world of dual-use research of concern (DURC) news. The controversial publication of Dr. Evans’ synthesis of horsepox has brought about a flurry of discussion and debate regarding the implications of not only such research, but also the publication of it. Kai Kupferschmidt provided an overview of the history of this paper and what its publication means, so if you’re needing a refresher, I’d start there. As many within the biodefense and biosecurity industry read the paper, it sparked a renewed concern for how such research has exhumed a gap within DURC oversight and publication review. GMU’s biodefense guru and graduate program director Gregory Koblentz expanded upon his thoughts regarding these oversight failures. Pointing to not only the utter disaster that a smallpox re-emergence would be, he also evaluates the PLOS editorial statement and review of DURC work. “Given the serious potential risks that this research could be used to recreate variola virus, the blanket assertion by the PLOS Dual-Use Research Committee that the benefits of this research outweighs the risks is woefully insufficient. The committee dramatically understates the risks and overestimates the benefits this research presents. The U.S. government has outlined a number of factors to consider and questions to ask about dual-use research when weighing the risks and benefits of conducting and publishing such research. Although this research did not fall under current U.S. regulations on dual-use research of concern, the authors and publisher were well aware of the risks that I and others had raised and they had an ethical responsibility to carefully consider those risks before publishing the article.” NTI’s Dr. Elizabeth Cameron, VP of Global Biological Policy and Programs, weighed in on the publication and how it underlines the need for dialogue at a global level to reduce biological risks. Cameron notes that these hurdles aren’t getting smaller and the incremental approach just isn’t getting us where we need to be. “Moving forward, it’s clear that the capability to create and modify biological agents is outpacing governmental oversight and public debate. Now more than ever, scientific stakeholders, private sector actors, and biotechnology leaders should develop and take specific actions to mitigate risk and accelerate biosecurity innovation.” Dr. Tom Inglesby, director of the Johns Hopkins Center for Health Security, has also put forth commentary on the horsepox synthesis, pointing to the lack of clear-cut benefits and and that ultimately, it created a new risk. Inglesby notes that “The most important locus of control should be whether specific research is approved and funded in the first place. When scientists are considering the pursuit of research that has the potential to increase highly consequential national population-level risks, national authorities and leading technical experts on those issues should be part of the approval process. When there are highly consequential international population-level implications, international public health leaders should also be involved. When researchers put forth claims about potential benefits of this work to justify extraordinary risks, those claims ought not be accepted without discussion; those claims should instead be examined by disinterested experts with the expertise to validate or refute them.” GMU biodefense PhD student and infection preventionist Saskia Popescu also discussed the importance of this publication and why medical providers and researchers should be paying attention to the DURC debate.

ASM Biothreats
The American Society for Microbiology will be hosting their annual conference on biological threats from February 12-14 in Baltimore, MD. If you’re not able to attend, we’ve got you covered with in-depth reporting and analysis by some of GMU’s finest biodefense graduate students. Following the conference, we’ll be providing this report-out as we did with the 2017 conference, so make sure to check back for the scoop on all things ASM Biothreats.

Chemical Weapons – No Impunity
The International Partnership Against the Impunity for the Use of Chemical Weapons has just been launched! “Ringing together around 30 countries and international organizations, its purpose is to supplement the international mechanisms to combat the proliferation of chemical weapons. This intergovernmental initiative deals exclusively with the issue of impunity for the perpetrators of chemical attacks worldwide, and is a forum for cooperation in which the participating States have made several commitments that include gathering, compiling, and retaining all available information on those who use chemical weapons, etc.” Efforts like this are increasingly needed as the use of chemical weapons in Syria has been met with little adverse outcome for those at fault. GMU’s Dr. Gregory Koblentz highlighted Syria’s CW killchain, noting that “Bringing these criminals to justice, however, will be a long, slow, and difficult process. Many individuals who comprise Syria’s chemical weapons kill chain were listed in a U.N. Security Council resolution that was vetoed by Russia and China on Feb. 28.” Koblentz also points out that “So far, the only concrete steps to hold these individuals accountable for their actions are financial sanctions and travel bans imposed by the U.S. and European governments. Although the sanctions themselves are largely symbolic, by identifying these individuals and specifying their role in the chemical attacks, the United States and its European allies are laying the groundwork for future prosecutions once Assad is no longer in power.”

Germ Transmission While Flying
Dr. Nereyda Sevilla, George Mason Biodefense PhD 2017 alum, presented the results of her dissertation at the Transportation Research Board (TRB) 97th Annual Meeting held January 7–11, 2018, at the Walter E. Washington Convention Center, Washington, D.C. The information-packed program attracted more than 13,000 transportation professionals from around the world. Nereyda’s poster entitled “Germs on a Plane:  The Transmission and Risks of Airplane-Borne Diseases” was part of the Young Professional’s Research in Aviation Session.  Her research explored the role of air travel in the spread of infectious diseases, specifically Severe Acute Respiratory Syndrome (SARS), H1N1, Ebola, and pneumonic plague. She concluded that modeling showed that the spread of Ebola and pneumonic plague is minimal and should not be a major air travel concern if an individual becomes infected. On the other hand, H1N1 and SARS have higher infectious rates and air travel will facilitate disease spread across the country.

Schar School Career Fair
Schar School students and employers looking for talented graduate students – on Wednesday, February 14th from 2-5pm, GMU’s Schar School will be hosting a Career Fair at the Arlington campus. “The Schar School of Policy and Government at George Mason University, in conjunction with the School for Conflict Analysis and Resolution, will host our annual career and internship fair that attracts more than one hundred employers from federal, business, and non-profit organizations who are eager to meet our outstanding students.” For our readership – this is also a great place to recruit biodefense students who are passionate about health security!

Nonproliferation Review Call For Papers
Calling all writers of the nuclear, chemical, and biological weapons persuasion – the Nonproliferation Review is accepting manuscripts for publication in 2018! “All submitted manuscripts that are accepted for publication in Volume 25 are eligible to win the Doreen and Jim McElvany prize of $5,000, a $3,000 runner’s-up prize, or a $1,000 honorable mention prize. The deadline to submit is July 6, 2018; however, due to the limited number of pages that we can publish in a single volume, eligible articles will be accepted for publication on a rolling basis. It is therefore in authors’ interest to submit early to ensure consideration for the prize. Submissions must contribute new ideas and insights to the nonproliferation field. The Review’s editors welcome submissions on any topic related to weapons proliferation, including but not limited to chemical, biological, radiological, nuclear, and conventional weapons. Example topics include: activities and developments in international nonproliferation regimes; social, political, and economic dynamics of specific countries and regions with regard to weapons development and/or proliferation; new information on policies or weapons programs of specific countries; the spread of knowledge, materials, or technologies with potential destructive applications; the proliferation of new technologies impinging on international security; measures, either existing or proposed, to control proliferation; the causes of proliferation or nonproliferation; the consequences of proliferation, including its influence on strategic stability and its economic or environmental effects; and the relevant activities of non-state actors, such as nongovernmental organizations or terrorists.”

 Influenza Aerosols
A new study has found that influenza aerosol-spread is more common than previously thought, especially in relation to coughing and sneezing. “To measure transmission, each participant sat in a chamber for 30 minutes with his or her face in a large metal cone, part of a ‘Gesundheit machine’ that captures and measures influenza virus in exhaled breath. Patients were also asked to cough, sneeze, and say the alphabet three times. Altogether, researchers collected 218 nasopharyngeal samples and 218 breathing sample sessions. When the team analyzed the samples, they found that a significant number of patients routinely shed infectious virus—not just RNA particles—into particles small enough for airborne transmission. They were surprised to find that 11 (48%) of the 23 fine aerosol samples acquired when patients weren’t coughing had detectable viral RNA, and of those 8 contained infectious virus, suggesting that coughing isn’t a prerequisite for generating fine aerosol droplets.” The latest news points to not only the importance of staying home when sick, but also the ease of transmission of influenza viruses. While many thought transmission was limited to droplets (i.e. heavier particles that were sneezed/coughed out about three feet), this latest analysis may change the dynamics of isolation.

Stories You May Have Missed:

  • Addressing AMR in Lower-Income Countries – Fighting antimicrobial resistance (AMR) is a global challenge, but we need to ensure that our strategies account for a range of countries and the unique barriers they face. “Although traditional efforts to reduce the spread of antibiotic resistance in these countries have focused on antibiotic use in individuals, LMICs must also address the increasing roles of animal and environmental exposures in this public health crisis, write Maya Nadimpalli, PhD, University of Versailles Saint-Quentin-en-Yvelines, France, and colleagues. ‘In particular, current strategies do not prioritize the impacts of increased antibiotic use for terrestrial food-animal and aquaculture production, inadequate food safety, and widespread environmental pollution,’ the authors stress.”

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 1.19.2018

Happy Friday and welcome to your favorite source for all things biodefense! We hope you’re able to avoid the onslaught of respiratory viruses that are circulating right now, but on the off chance that you’re battling a bug, here’s some infectious disease new that won’t get you sick.

Fighting Influenza
Whether you’re fighting the flu or watching the mayhem unfold in the news, you can’t escape influenza right now. We’re getting hit hard with flu season in the United States and the CDC has reported that activity is still rising and we’re not out of the woods yet. You can find the latest flu data here, but what is worrying so many is the hit that hospitals are taking across the country. It’s not just that we’re facing an IV bag shortage due to the devastation Hurricane Maria wreaked upon Puerto Rico, but that hospitals are being overrun with an onslaught of ILI (influenza like illness) patients. Wait times are through the roof, staff are stretched thin, patients are being admitted into overflow areas, hospitals are having to divert patients because they’re so full, triage areas have been set up in parking lots and emergency areas, and hospitals are even struggling to ensure they have enough PPE and influenza tests. This year marks the centennial of the 1918/1919 influenza pandemic, and it seems like what’s going on is out of a history book instead of down the street. As an infection preventionist and infectious disease epidemiologist, it is not surprising or unexpected that we’re running into these issues. It’s easy for people to point to the current situation and use it as an example of why we’re not ready for a flu pandemic – and they’re right, but it shouldn’t take what’s going on to see that. These are not new issues. Infection control and hospital preparedness has been struggling for a long time and it doesn’t take a pandemic to prove it. Even after the surge of funding and focus on hospital preparedness post-Ebola, we still struggle with these issues, but throw in budget cuts and an administration that is set to pull funding away from public health…well, the outlook is dismal.

With so much attention on influenza, pandemic preparedness, and how we’re just not ready for the next great flu pandemic, what kind of household interventions can we apply in our own little ecosystems? Researchers looked at a HPAI H5N1 outbreak and estimated the reduction in primary attack rates for household-based interventions. “We show that, for lower transmissibility strains, the combination of household-based quarantine, isolation of cases outside the household, and targeted prophylactic use of anti-virals will be highly effective and likely feasible across a range of plausible transmission scenarios. For example, for a basic reproductive number (the average number of people infected by a typically infectious individual in an otherwise susceptible population) of 1.8, assuming only 50% compliance, this combination could reduce the infection (symptomatic) attack rate from 74% (49%) to 40% (27%), requiring peak quarantine and isolation levels of 6.2% and 0.8% of the population, respectively, and an overall anti-viral stockpile of 3.9 doses per member of the population.” While we all may not access to anti-virals, the use of quarantine and isolation are all effective strategies. From an infection control standpoint, it can be tough to maintain such efforts in a household where one or two people are sick. When in doubt, wash your hands, cover your cough, and clean those high-touch surfaces/objects!

GMU Biodefense MS Open House
Mark your calendars for the February 21st Master’s Open House at GMU’s Arlington campus! If you’ve been thinking about getting a MS in biodefense (who wouldn’t want to take classes on biosurveillance, historical bioweapons programs, and more?!), this is a great chance to talk to faculty and learn about the admissions process. GMU has biodefense MS programs in person and online, so even if you’re not in the DC-area, you can get your biodefense on.

Smallpox, Horsepox, And The Trouble With Poxviruses
It seems only a few months ago that news broke of a Canadian research team’s de novo synthesis of horsepox. Since then, there has been considerable discussion surrounding not only the biosafety and biosecurity behind research involving an orthopoxvirus, but also the implications of normalizing orthopoxvirus synthesis, and again, if the remaining smallpox stockpiles should be destroyed. The latest report from researchers at the University of Alberta points to the potential smallpox vaccine developments that synthetic viruses could bring. “Virologist David Evans and his research associate Ryan Noyce produced an infectious horsepox virus, which they synthetically reconstructed using a published genome sequence and DNA fragments manufactured entirely by chemical methods. The team went on to show that the synthetic horsepox virus could provide vaccine protection in a mouse model of poxvirus infection.” Unfortunately, the implications of synthesizing an orthopoxvirus aren’t so simple. GMU biodefense professor and program director Dr. Gregory Koblentz evaluated the implications of such synthesis for biosecurity and what would be needed to prevent a reemergence of smallpox. “The synthesis of horsepox virus takes the world one step closer to the reemergence of smallpox as a threat to global health security. That threat has been held at bay for the past 40 years by the extreme difficulty of obtaining variola virus and the availability of effective medical countermeasures. The techniques demonstrated by the synthesis of horsepox have the potential to erase both of these barriers. The primary risk posed by this research is that it will open the door to the routine and widespread synthesis of other orthopoxviruses, such as vaccinia, for use in research, public health, and medicine.” Koblentz notes that while there are potentially legitimate uses for synthesizing orthopoxviruses (safer smallpox vaccine development), it also means that such labs have the potential to produce smallpox from synthetic DNA and emphasized that action is needed now to avoid the misuse of synthetic biology by nefarious actors. “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.” GMU biodefense PhD student Saskia Popescu cited the importance of medical providers understanding the dual-use research of concern debate and that ultimately, biosecurity impacts us all. “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.”

Blue Ribbon SLTT Ability to Respond to Large Scale Biological Events: Challenges and Solutions
If you missed the Wednesday meeting, here’s a recording to catch up on all things biodefense. “State, Local, Tribal, and Territorial Ability to Respond to Large-Scale Biological Events: Challenges and Solutions government officials, federal and academic representatives, and subject matter experts will discuss their perspectives, experiences, challenges, and recommended solutions with regard to SLTT response to large-scale biological events.”

Gene Therapy Hits a Wall With Microbial Resistance
Can gene editing trigger an immune reaction in humans? A new study is suggesting that it may be a risk. “The CRISPR-Cas9 system, which functions as a genetic scissors and tape for editing DNA, is generally derived from either Staphyloccoccus aureus or Streptococcus pyogenes bacteria.” Most of us though, have been exposed to these organisms throughout our lives. “This prior exposure could potentially render the gene editing ineffective, with the body quickly eliminating all the CRISPR–Cas9 proteins. Or worse, it could trigger the kind of immune storm that killed a young gene therapy patient named Jesse Gelsinger in 1999, derailing the field for more than a decade. ‘We share everyone’s excitement about doing Cas9 genome editing, but we want to make sure we have learned from what happened in the gene therapy world and not ignore the possibility that this could become a problem,’ Porteus says. ‘As we’re all thinking about developing Cas9-based therapeutics, we should think carefully about this potential problem’.”

Pediatric Rabies Death
A 6-year-old boy in Florida has died from rabies he contracted after being scratched by an infected bat. The boy’s father reports that he found the sick bat, put it in a bucket, and told him not to touch it however, he did and was scratched. In response, the father had the boy wash his hands thoroughly based off what he read online and opted not to take him to the hospital because the boy didn’t want to get shots. Unfortunately, within a week, the boy became ill and even after attempts at treatment, passed away. Rabies is almost always fatal once symptoms appear, which highlights the importance of seeking care immediately after exposure.

Stories You May Have Missed:

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