Pandora Report: 7.5.2019

Welcome back to your source for all things biodefense – we hope you had a lovely holiday week! Thankfully, the test results at Facebook headquarters ruled out the initial concern of sarin in envelopes – phew!

U.S. Army Makes Synbio A Priority 
What role will synthetic biology play in the modern military? The U.S. Army is working to find out by investing resources into the world of synbio. “Dimitra Stratis-Cullum, who is overseeing the research in synthetic biology for the U.S. Army Research Laboratory’s Combat Capabilities Development Command, detailed the effort on Thursday at the fourth annual Defense OneTech Summit. U.S Army labs have long had a mandate to study biology, but in April, the lab quietly elevated the study of synthetic biology to one of its top ten priorities. ‘Synthetic biology is one of the Lab’s top ten research priorities. That means we are working across the laboratory and with other regional partners to double the effort that was previously being executed under the Living Materials program,’ said Army spokesperson T’Jae Gibson Ellis. The Army did not provide specific numbers on the size of the Living Materials program. The research is being overseen by Gen. Mike Murray, the head of the U.S. Army’s newly established Futures Command.” From cloaking to forecasting what adversaries might be doing this with novel tech, “It’s one of the things we look at,” Status-Cullum said. “We try to also look at what is the common barrier, level of control, to what extent that could be implemented in situ [meaning in nature, as opposed to in a lab] in military environments… [we are] trying to really understand that and then use that to forecast.”

Opioid Epidemic Drives Infectious Disease Spike
Combatting the overwhelming problem of addiction we’re experiencing the United States is no easy task and researchers are now seeing implications of this opioid epidemic. “Now, public-health officials are worried about a surge in bacterial and viral infections linked to opioid misuse that threatens to compound the crisis. This surge includes an unprecedented rise in bacterial infections — including those caused by Staphylococcus aureus, a bacterium that’s frequently resistant to antibiotics — and a spike in new cases of HIV and hepatitis associated with injecting opioids that risks undoing decades of progress in corralling these diseases. Research groups around the country are working to understand, identify and treat these outbreaks. But the lack of solid data on the number of new cases, and where they’ll crop up next, as well as stigma associated with drug use that can prevent people with infections from seeking early treatment, is hindering efforts.” From drug-resistant organisms to hepatitis A, these unique patient populations carry an inherent risk and even after treatment, they are easily lost to follow-up. “The social component to predicting these outbreak patterns is crucial, Bobashev says. People who used drugs during the height of the HIV epidemic in the 1990s learnt safe injection practices, he says, but newer users are more likely to use riskier methods, such as sharing needles. “They don’t have good practices and they don’t have good connections with people who have been injecting drugs for a long time,” Bobashev says. In an unpublished analysis, his group’s model predicted that HIV outbreaks related to opioids would be concentrated within small geographic pockets, rather than spread over a wider area, as researchers would expect with non-drug-related outbreaks.”

GMU Biodefense Alum Announced As Deputy Director of EPA’s National Enforcement Investigations Center
We’re so happy to announce that Francisco Cruz, a GMU biodefense alum, is now the Deputy Director of NEIC at the EPA! “As Laboratory Branch Chief, Francisco oversaw the implementation of ELMS in laboratory operations, resulting in significant decreases in overall turnaround time for NEIC analytical products. Prior to his position at NEIC, Francisco was a Biologist with EPA’s Chemical, Biological, Radiological, and Nuclear Consequence Management Advisory Division (CBRN CMAD). In that role, Francisco provided operational guidance to federal, state, and local responders in the areas of biological decontamination and emergency response. Additionally, Francisco collaborated with EPA researchers on novel decontamination approaches focusing on practical, field-deployable methods. During his time in EPA Region 3, Francisco served as a Federal On-Scene Coordinator leading federal responses to releases of hazardous substances and oil spills. Francisco responded to several large environmental disasters, including Hurricane Sandy and Hurricane Irene. In addition to emergency response, Francisco provided training, exercise development, and preparedness planning to 33 counties throughout Virginia and West Virginia. Francisco began his career in EPA Region 3 as a Community Involvement Coordinator, serving as a Public Information Officer for several Superfund sites and emergency responses, including the Deepwater Horizon Gulf Oil Spill. Francisco holds a B.A. in Biological Sciences from the University of Delaware, a Graduate Certificate in Critical Analysis and Strategic Responses to Terrorism from George Mason University, and a M.S. in Biodefense from George Mason University. Additionally, Francisco was Fellow in the Emerging Leaders in Biosecurity Initiative through The Johns Hopkins Center for Health Security.” Congrats Francisco!

 The U.S. Department of Defense’s Role in Health Security
The Center for Strategic and International Studies (CSIS) has just released their report on the current capabilities and recommendations for the DoD’s health security efforts. “The DOD contributes to overall U.S. health security through programs specifically aimed at countering biological threats from all sources—through public health activities coordinated with civilian counterparts at home and abroad and through research and development of medical countermeasures aimed at protecting U.S. Forces against health risks throughout the world. Additionally, military forces are available for disaster response anywhere in the world when necessary to augment civilian capabilities, as seen in the 2014–15 West African Ebola crisis.” “A solid and consistent U.S. policy framework has steadily evolved over the past few decades that identifies health as a national security issue and calls for a broad-based, inclusive national response to addressing the issue of health security. Most recently, the National Biodefense Strategy (NBS) released in October 2018 and the subsequent implementation plan provide structure for an ongoing national deliberation coordinated by a secretarial-level steering committee providing input to the national security adviser. Now is the time to more fully integrate DOD’s unique expertise and capabilities in a more cohesive and efficient manner. This paper provides a broad overview of DOD health security activities and capabilities and also offers select concrete recommendations for strengthening the coherence and integration of DOD activities, with a special emphasis on leadership, novel diseases and new dangerous forms of resistance, surveillance, building host country capacities, and expanded exercises.”

Celebrating the Rollout of CBRNResponder Network and 10 Years of CBRN Office Partnerships
Just a few more weeks until the “FEMA CBRN 10th Anniversary event on Wed, July 17, 2019, 12:00 PM – 5:00 PM at the United States Navy Memorial, 701 Pennsylvania Avenue, NW, Washington, DC 20004. Our keynote speaker is Mr. James F. McDonnell, Assistant Secretary Department of Homeland Security, Countering Weapons of Mass Destruction Office. Please join us to celebrate 10 years of the CBRN Office’s work with federal, state, and local partners strengthening our nation’s readiness to respond. The program features a look ahead at how FEMA and the nation are building a new 21st-century resilience paradigm, followed by federal, state, and local partners discussing how they are using CBRN tools and technology to make a difference. Highlighting the afternoon is the rollout of the CBRN Responder Network, the CBRN Office initiative that is building a national standard to help responders and emergency operations decisionmakers get the real-time information they need.”

A Manhattan Project for Biodefense: Taking Biological Threats Off the Table 
Don’t miss out on this July 11th event hosted by the Blue Ribbon Study Panel on Biodefense. They’ll be holding “a meeting to discuss A Manhattan Project for Biodefense – a national, public-private research and development undertaking to defend the Nation against biological threats. Representatives from local, federal, academia, and the private sector will speak to the Panel about the biological threat (which includes biological terrorism, warfare, accidental releases, and naturally occurring diseases like pandemic influenza), innovative and leading biodefense R&D efforts, resource shortfalls, and catastrophic biological risk.”

Ebola Outbreak Updates
Now at 2,369 cases since 15 were just reported, this outbreak is reaching the year mark. The latest situation report from the WHO notes that case-fatality rates are 67%, meaning that 2/3 of patients with the disease are dying. “Yesterday USAID (United States Agency for International Development) announced it would give the DRC $98 million to help fight the outbreak. ‘With this funding, USAID is providing lifesaving assistance, including infection prevention and control activities, training for health care workers, community engagement interventions, promotion of safe and dignified burials, and food assistance for people and communities affected by Ebola. This assistance is also bolstering preparedness efforts in Goma city for communities at risk of Ebola,’ the agency said in a press release. No American personnel have been on the ground in DRC since last September, when they were removed because of threats of violence.” For those of you working stateside and looking to prepared your facility, here’s a helpful PPE matrix that will help determine which PPE is needed to avoid occupational exposure.

Stories You May Have Missed:

  • African Swine Fever Back in Bulgaria– “On Wednesday Bulgaria’s Food Safety Agency said in a statement on its website that, a second outbreak of African swine fever in domestic pigs was confirmed in Bulgaria. The statement also said that 14 pigs were fattened in a small farm in the village of Zhernov near Danube River, some 210 km northeast of Sofia and that’s where the disease has been found. All actions have been taken to eliminate the outbreak and stop its spreading such as setting up a safety zone and an observation area around the outbreak, the statement said that there were no industrial pig farms in the observation area.”

Pandora Report: 6.28.2019

Summer Workshop – Early Registration Discount Ends Soon
Just a few more days to get your early registration discount and we’ve only got a few spots left – make sure to grab yours! We’re excited to have top professionals and researchers in the health security field speak to the biological threats we’re facing- from securing the bioeconomy to vaccine development and pandemic preparedness, you’ll want to be there for the 3.5 days of all things pandemics, bioterrorism, and global health security.

Re-thinking Biological Arms Control for the 21st Century
Dr. Filippa Lentzos discusses the challenges of biological arms control in the face of synthetic biology and technological advances. “Innovations in biotechnology are expanding the toolbox to modify genes and organisms at a stagger- ing pace, making it easier to produce increasingly dangerous pathogens. Disease-causing organisms can now be modified to increase their virulence, expand their host range, increase their transmissibility, or enhance their resistance to therapeutic interventions. Scientific advances are also making it theoretically possible to create entirely novel biological weapons, by synthetically creating known or extinct pathogens or entirely new pathogens. Scientists could potentially enlarge the target of bioweapons from the immune system to the nervous system, genome, or microbiome, or they could weaponize ‘gene drives’ that would rapidly and cheaply spread harmful genes through animal and plant populations.” Lentos notes that “The political backdrop to these technical advances in biotechnologies and other emerging technologies is also important. There is increased worldwide militarization, with global military spending at an all-time high since the fall of the Berlin Wall. Unrestrained military procurement and modernization is creating distrust and ex- acerbating tensions. In the biological field, the proliferation of increasingly sophisticated biodefense capacities, within and among states, can lead to nations doubting one another’s intentions.”

GAO – Biodefense: The Nation Faces Long-Standing Challenges Related to Defending Against Biological Threats
The GAO testified before a House committee on their efforts to identify and strengthen U.S. biodefense and here are their overall findings in a report. Despite President Trump signing off on the Pandemic and All-Hazards Preparedness and Advancing Innovations Act (PAHPA) on Monday, there is still a lot of work to be done. “Catastrophic biological events have the potential to cause loss of life, and sustained damage to the economy, societal stability, and global security. The biodefense enterprise is the whole combination of systems at every level of government and the private sector that contribute to protecting the nation and its citizens from potentially catastrophic effects of a biological event. Since 2009, GAO has identified cross-cutting issues in federal leadership, coordination, and collaboration that arise from working across the complex interagency, intergovernmental, and intersectoral biodefense enterprise. In 2011, GAO reported that there was no broad, integrated national strategy that encompassed all stakeholders with biodefense responsibilities and called for the development of a national biodefense strategy. In September 2018, the White House released a National Biodefense Strategy. This statement discusses GAO reports issued from December 2009 through March 2019 on various biological threats and biodefense efforts, and selected updates to BioWatch recommendations made in 2015. To conduct prior work, GAO reviewed biodefense reports, relevant presidential directives, laws, regulations, policies, strategic plans; surveyed states; and interviewed federal, state, and industry officials, among others.” GAO identified several challenges in the ability for the U.S. to defend against biological threats: “Assessing enterprise-wide threats. In October 2017, GAO found there was no existing mechanism across the federal government that could leverage threat awareness information to direct resources and set budgetary priorities across all agencies for biodefense. GAO said at the time that the pending biodefense strategy may address this. Situational awareness and data integration. GAO reported in 2009 and 2015 that the Department of Homeland Security’s (DHS) National Biosurveillance Integration Center (NBIC)—created to integrate data across the federal government to enhance detection and situational awareness of biological events—has suffered from longstanding challenges related to its clarity of purpose and collaboration with other agencies. DHS implemented GAO’s 2009 recommendation to develop a strategy, but in 2015 GAO found NBIC continued to face challenges, such as limited partner participation in the center’s activities. Biodetection technologies. DHS has faced challenges in clearly justifying the need for and establishing the capabilities of the BioWatch program—a system designed to detect an aerosolized biological terrorist attack. In October 2015, GAO recommended that DHS not pursue upgrades until it takes steps to establish BioWatch’s technical capabilites. While DHS agreed and described a series of tests to establish capabilities, it continued to pursue upgrades. Biological laboratory safety and security. Since 2008, GAO has identified challenges and areas for improvement related to the safety, security, and oversight of high-containment laboratories, which, among other things, conduct research on hazardous pathogens—such as the Ebola virus. GAO recommended that agencies take actions to avoid safety and security lapses at laboratories, such as better assessing risks, coordinating inspections, and reporting inspection results. Many recommendations have been addressed, but others remain open, such as finalizing guidance on documenting the shipment of dangerous biological material.”

ABSA 1st International Biosecurity Symposium Call for Papers
“You are now able to submit papers for ABSA’s 1st International Biosecurity Symposium. The symposium will take place May 12-15, 2020 in Minneapolis, Minnesota. We anticipate having attendees from all over the world and approximately 20 commercial exhibits. The professional development courses will take place Tuesday, May 12, 2020. The symposium presentations (platform/poster) will take place Wednesday, May 13 to Friday, May 15, 2020. The Call for Platform/Posters Abstract submission deadline is July 31, 2019 at 5pm Central.”

Blue Ribbon Panel – U.S. Is Not Prepared for Biological Incidents – Testimony
June 26th- “Dr. Asha George, Executive Director of the Blue Ribbon Study Panel on Biodefense, served as an expert witness this afternoon before the House Oversight and Reform Subcommittee on National Security. Chaired by Rep. Stephen Lynch (MA), the Subcommittee is evaluating the readiness of the U.S. government and healthcare system, including hospital and emergency professionals, to respond to naturally occurring pandemics and biological attacks that could be perpetrated by state and non-state actors. The Subcommittee also is investigating the growing threat of antimicrobial-resistance, as well as the implications of this challenge for U.S. national security. ‘Our Panel has assessed and continues to assess the state of our country’s biodefense. We scrutinize the status of prevention, deterrence, preparedness, detection, response, attribution, recovery, and mitigation – the spectrum of activities necessary for biodefense,’ said Dr. George. ‘As expected, we found both strengths and weaknesses, including serious gaps that four years after the release of our Panel’s Blueprint for Biodefense in 2015 continue to make the nation vulnerable. In short, the nation is not prepared for biological outbreaks, bioterrorist attacks, biological warfare, or accidental releases with catastrophic consequences’.” This is especially relevant as many are wondering what Congress is doing to respond to health security threats.

Ebola Outbreak – Updates
As of Wednesday, the outbreak has reached 2,277 cases and security threats are increasingly making response efforts challenging. “In its weekly situation report on the outbreak, the WHO said Ebola activity continues with steady and sustained intensity, with security incidents returning to Beni—one of the outbreak’s former major hot spots—and armed group movements in Musienene and Manguredjipa impeding access to a health area next to Mabalako’s hardest-hit area. Another concern it aired is a tense security situation in neighboring Ituri province cities Bunia and Komanda in the wake of attacks in early June. Over the past few weeks, indicators show hints of easing transmission intensity in the two biggest recent epicenters, Katwa and Butembo. However, the optimism is offset by new cases in previously affected areas, including Komanda, Lubero, and Rwampara. For example, over the past week, Komanda reported its first case after going 11 days without one.”

A Dose of Inner Strength to Survive and Recover from Potentially Lethal Health Threats
“Breakthroughs in the science of programmable gene expression inspired DARPA to establish the PReemptive Expression of Protective Alleles and Response Elements (PREPARE) program with the goal of delivering powerful new defenses against public health and national security threats. DARPA has now selected five teams to develop a range of new medical interventions that temporarily and reversibly modulate the expression of protective genes to guard against acute threats from influenza and ionizing radiation, which could be encountered naturally, occupationally, or through a national security event. The program builds from the understanding that the human body has innate defenses against many types of health threats, but that the body does not always activate these defenses quickly or robustly enough to block the worst damage. To augment existing physiological responses, PREPARE technologies would provide a programmable capability to up- or down-regulate gene expression on demand, providing timely, scalable defenses that are proportional to anticipated threats. Service members and first responders could administer these interventions prior to threat exposure or therapeutically after exposure to mitigate the risk of harm or death.”

Global Community Bio Summit 3.0
From October 11-13, you can attend this community biotechnology initiative at MIT Media Lab. “The Community Biotechnology Initiative at the MIT Media Lab is organizing the third annual Global Summit on Community Biotechnology this October 11 to 13, 2019! Our goal is to provide a space for the global community of DIY biologists / community biologists / biohackers / biomakers and members of independent and community laboratories to convene, plan, build fellowship, and continue the evolution of our movement. You can learn more about last year’s Summit, including our program, here. While all are welcome, space is limited, so we are prioritizing active practitioners in the community with an emphasis on diversity across geographic, cultural, ethnic, gender, and creative backgrounds. We will add accepted participants to the directory on a rolling basis with the goal of accepting everyone interested in joining.”

Stories You May Have Missed:

  • Tackling Dirty Sinks – Did you ever think your hospital sink could be a disease reservoir? “Earlier this year, there were studies that identified sink proximity to toilets as a risk factor for contamination. Bugs like Klebsiella pneumoniae carbapenemase-producing organisms tend to be prolific in moist environments and are often pervasive in intensive care unit sinks and drains. Researchers found that sinks near toilets were 4-times more likely to host the organisms than those further from toilets. More and more, infection prevention is having to look at hospital faucets and sinks for their role in hosting microbial growth. This was also a topic of interest at last week’s annual conference of the Association for Professionals in Infection Control and Epidemiology (APIC 2019). Investigators with the University of Michigan Health System discussed how they worked to identify vulnerabilities and potential sink designs that might contribute to bioburden and biofilm in hospital faucets. Assessing 8 different designs across 4 intensive care units, the research team ultimately found that those sinks with a more shallow depth tended to allow higher rates of contamination (ie, splash of dirty water) onto equipment, surfaces, and patient care areas. In some instances, the splash of contaminated water could be found up to 4 feet from the sink.”


Pandora Report: 6.21.2019

Pandemics, Bioterrorism, and Global Health Security – From Anthrax to Zika Workshop 
Less than one month until our workshop and just a couple weeks to get your early registration discount…have you signed up? This 3.5 day workshop is the place to be to learn the challenges facing the world at the intersection of national security, public health, and the life sciences. The workshop faculty are internationally recognized experts from the government, private sector, and academia who have been extensively involved with research and policy-making on public health, biodefense, and national security issues. Topics range from protecting the bioeconomy, to biosecurity, vaccine development, disease risk assessments, and more!

Pandemic Preparedness in the Face of Fake News
Biopreparedness is challenging enough…but when you throw in the growing threat of mis/disinformation…this can seem like a feat requiring nothing short of a Herculean effort. “When the next pandemic strikes, we’ll be fighting it on two fronts. The first is the one you immediately think about: understanding the disease, researching a cure and inoculating the population. The second is new, and one you might not have thought much about: fighting the deluge of rumors, misinformation and flat-out lies that will appear on the internet. The second battle will be like the Russian disinformation campaigns during the 2016 presidential election, only with the addition of a deadly health crisis and possibly without a malicious government actor. But while the two problems — misinformation affecting democracy and misinformation affecting public health — will have similar solutions, the latter is much less political. If we work to solve the pandemic disinformation problem, any solutions are likely to also be applicable to the democracy one.” From misinformation regarding the source of a disease or outbreak, to that involving treatments that work…the implications can make or break “society’s ability to deal with a pandemic at many different levels.”

A Call for Cooperation in a New Cyberbiosecurity Landscape
Vulnerabilities within cyberbiosecurity range from biomanufacturing to farm-to-table enterprises, but it will take a true collaboration within these fields to drive change. “The life sciences now interface broadly with information technology (IT) and cybersecurity. This convergence is a key driver in the explosion of biotechnology research and its industrial applications in health care, agriculture, manufacturing, automation, artificial intelligence, and synthetic biology. As the information and handling mechanisms for biological materials have become increasingly digitized, many market sectors are now vulnerable to threats at the digital interface. This growing landscape will be addressed by cyberbiosecurity, the emerging field at the convergence of both the life sciences and IT disciplines. This manuscript summarizes the current cyberbiosecurity landscape, identifies existing vulnerabilities, and calls for formalized collaboration across a swath of disciplines to develop frameworks for early response systems to anticipate, identify, and mitigate threats in this emerging domain.”

Australian Health System Capacity to Handle a Bioattack
How well do you think the U.S. health system would handle a smallpox bioattack? Researchers in Australia tested out the health system capacity in Sydney against this very scenario. “We used a model for smallpox transmission to determine requirements for hospital beds, contact tracing and health workers (HCWs) in Sydney, Australia, during a modelled epidemic of smallpox. Sensitivity analysis was done on attack size, speed of response and proportion of case isolation and contact tracing. We estimated 100638 clinical HCWs and 14595 public hospital beds in Sydney. Rapid response, case isolation and contact tracing are influential on epidemic size, with case isolation more influential than contact tracing. With 95% of cases isolated, outbreak control can be achieved within 100 days even with only 50% of contacts traced. However, if case isolation and contact tracing both fall to 50%, epidemic control is lost. With a smaller initial attack and a response commencing 20 days after the attack, health system impacts are modest. The requirement for hospital beds will vary from up to 4% to 100% of all available beds in best and worst case scenarios. If the response is delayed, or if the attack infects 10000 people, all available beds will be exceeded within 40 days, with corresponding surge requirements for clinical health care workers (HCWs). We estimated there are 330 public health workers in Sydney with up to 940,350 contacts to be traced. At least 3 million respirators will be needed for the first 100 days. To ensure adequate health system capacity, rapid response, high rates of case isolation, excellent contact tracing and vaccination, and protection of HCWs should be a priority. Surge capacity must be planned. Failures in any of these could cause health system failure, with inadequate beds, quarantine spaces, personnel, PPE and inability to manage other acute health conditions.”

Developing a PPE Selection Matrix for Preventing Occupational Exposure to Ebola
Preparing your workplace for a potential Ebola patient? Check out this matrix for choosing PPE. GMU Biodefense alum Chris Brown co-authored this helpful article to guide healthcare workers, laboratories, and other work environments in avoiding occupational exposure to Ebola virus. “The matrix applies to a variety of job tasks in health care, laboratories, waste handling, janitorial services, travel and transportation, and other sectors where workers may be exposed to the Ebola virus during outbreak events. A discussion of the information sources and decision-making process for developing the matrix forms the basis of the recommendations. The article then emphasizes challenges and considerations for formulating the matrix, including identifying information sources to help characterize occupational exposures, aligning recommendations among stakeholders with varying viewpoints, and balancing worker protections with feasibility concerns. These considerations highlight issues that remain relevant for preparedness efforts ahead of future US cases of Ebola or other emerging infectious diseases. OSHA developed a personal protective equipment selection matrix to help employers protect workers from exposure to Ebola virus in the event of future US cases. Toward facilitating preparedness for cases associated with outbreaks, this article discusses the matrix of personal protective equipment recommendations, which apply to a variety of job tasks in healthcare, laboratories, waste handling, janitorial services, travel and transportation, and other sectors where workers may be exposed to the Ebola virus during outbreak events.”

NTI Report – A Spreading Plague: Lessons and Recommendations for Responding  to A Deliberate Biological Attack
“To address this preparedness deficit, NTI | bio, Georgetown University’s Center for Global Health Science and Security, and the Center for Global Development offer recommendations for urgent action in a new paper, A Spreading Plague: Lessons and Recommendations for Responding to a Deliberate Biological Event. Drawn from a senior leaders’ tabletop exercise held in advance of the Munich Security Conference on February 14, 2019, the paper presents key findings and organizers’ recommendations for critical improvements, including within the United Nations system, to prevent catastrophic consequences of deliberate and other high-consequence biological events.” Pulling from a tabletop exercise, the report highlights five emergent themes – international coordination, information sharing, investigation and attribution, and financing for response and preparedness.

Ebola Outbreak Updates 
With nearly 50 cases reported over 3 days, this outbreak is not showing signs of slowing. “Over the weekend, the ministry of health in the Democratic Republic of the Congo (DRC) recorded 28 new cases of Ebola, and will likely confirm another 20 new cases today. With nearly 50 cases in 3 days, the outbreak is experiencing another spike in activity following the discovery of cases in neighboring Uganda last week. According to the World Health Organization’s (WHO’s) Ebola dashboard, the outbreak total now stands at 2,168 cases. In addition to the newly confirmed cases, there were 19 fatalities over the weekend, including 8 that took place in the community.” As cases spilled over into Uganda, there is growing concern that the porous border will continue to made control measures unsuccessful. “The footpaths show the close kinship between the two countries, where most people have relatives on both sides of the border. But as Ebola rages they are a source of worry for health workers and local authorities trying to prevent any further cross-border contamination. Eastern Congo has battled the Ebola outbreak since last August and last week the disease spread to Uganda, where two people died of the hemorrhagic fever. ‘This border is very porous,’ said James Mwanga, a Ugandan police officer in charge of the Mpondwe border post. ‘You will not know who has passed if the person went through the unofficial border posts, in most cases. Now there is anxiety and so on. We have heightened our alertness’.” Moreover, there has been concern over hospital infections and a desperate call for financial support. “During recent meeting in Kinshasa, Tedros met with the DRC’s prime minister, opposition leaders, religious officials, and other partners, the WHO said in a statement yesterday. He also traveled to Butembo, which has been one of the main epicenters, to meet with community and religious leaders, business representatives, and nongovernmental organization representatives.Also, he strongly appealed to other countries across the world to support the health responders in the DRC. Tedros said the WHO needs $98 million to fund the response, but it has received only $44 million, leaving a $54 million gap, a shortfall he said must immediate be addressed. ‘If the funds are not received, WHO will be unable to sustain the response at the current scale,’ he said, adding that other partners face funding gaps and that response decisions risk being driven by financial capacity rather than operational needs.”
The Engineering Biology Research Consortium has just released this roadmap “to provide researchers and other stakeholders (including government funders) with a compelling set of technical challenges and opportunities in the near and long term. Our ongoing roadmapping process was initiated in response to the recommendations put forth in the 2015 National Academies report, Industrialization of Biology, and was partially supported by the National Science Foundation. With this inaugural release of the Roadmap, EBRC endeavors to provide a go-to resource for engineering/synthetic biology research and related endeavors. Further details can be found in the overview section, including a brief discussion of societal and security considerations. The EBRC Technical Roadmapping Working Group led the development of the roadmap scope and content. Collective insight and input was leveraged from more than 80 leading scientists and engineers, including academic, industry, and student members of EBRC and from the broader research community. Since mid-2018, the working group has held five workshops and countless teleconferences to develop the content and engage discussion around the roadmap. The result is a collaborative effort of the engineering biology research community and represents the community’s vision for the future of the field.”
Biodefense World Summit
If you missed this event over the last week, you can catch two articles covering a few talks. “At the 5th Annual Biodefense World Summit, Luther Lindler, PhD, science advisor for Bio Programs, Technology Centers, S&T Directorate of DHS, discussed the work that DHS has been doing to help beef up US biodefense efforts. Within the DHS S&T program, there are 5 major mission areas: prevent terrorism and enhance security; secure and manage our borders; enforce and administer our immigration laws; safeguard and secure cyberspace; and ensure resilience to disasters. Imagine trying to prevent microbial contamination or security threats from the Port of Los Angeles, which encompasses 7500 acres, with 30,000 containers arriving per day and $285 billion in cargo per year.”  “One of the hardest aspects of biodefense, though, is integrating new technology to truly make a difference. Every day, there are advancements in tech; yet, it can be challenging to truly discern how these new tools can help global health security and prevent the next pandemic. In a Biodefense presentation that called on the use of data technology and forecasting to help tackle the next epidemic, Dylan George, PhD, BS, vice president of technical staff at In-Q-Tel and associate director of BNext, discussed integrating novel and available data technologies into public health processes to not only help guide interventions, but also to establish more efficient response practices and improve situational awareness.”
Stories You May Have Missed:
  • Global Trust in Healthcare, Scientists, and Vaccines – “The Wellcome Global Monitor, conducted as part of the Gallup World Poll 2018, is designed to provide a baseline to gauge how attitudes evolve over time and to help guide policies to improve public engagement on science and health issues. The data were published today. The survey included more than 140,000 people ages 15 and older from more than 140 countries, Wellcome Trust said today in a press release. It added that the survey shows the first glimpse into what people think about the issues for many countries, including Colombia, Nigeria, South Africa, and Vietnam. Among the key findings were that three quarters of the world’s population trust doctors and nurses more than anyone else on healthcare issues. And 72% trust scientists.”
  • Dirty Hospital Sinks: A Source for Contamination – “For decades we’ve been taught that hand hygiene is the most critical aspect of infection control. Although that may be true, what about the sinks and faucets? These oft overlooked areas can easily pose infection control risks. How clean can your hands really be if the sink and faucet are heavily contaminated and dirty? The topic of slime and biofilm is increasingly being brought up as we focus more on vulnerabilities in health care and the role of environmental contamination. Earlier this year, there were studies that identified sink proximity to toilets as a risk factor for contamination. Bugs like Klebsiella pneumoniae carbapenemase-producing organisms tend to be prolific in moist environments and are often pervasive in intensive care unit sinks and drains. Researchers found that sinks near toilets were 4-times more likely to host the organisms than those further from toilets.”

Pandora Report: 6.14.2019

It’s nearly July, have you signed up for the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security, to get your early registration discount? Also – as you enjoy the summer weather, practice bat safety, as the CDC has warned that they post the biggest rabies threat in the United States.

How World War II Spurred Vaccine Innovation
Dr. Kendall Hoyt discusses the link between war and disease, and how WWII helped bring forth a renaissance of vaccine development. Did we mention she’ll be speaking at our summer workshop next month? “As the Second World War raged in Europe, the U.S. military recognized that infectious disease was as formidable an enemy as any other they would meet on the battlefield. So they forged a new partnership with industry and academia to develop vaccines for the troops. Vaccines were attractive to the military for the simple reason that they reduced the overall number of sick days for troops more effectively than most therapeutic measures. This partnership generated unprecedented levels of innovation that lasted long after the war was over. As industry and academia began to work with the government in new ways to develop vaccines, they discovered that many of the key barriers to progress were not scientific but organizational.”

Ebola Outbreak – Expanding into Uganda 
By June 12th, the Ugandan Ministry of Health had confirmed three cases of Ebola along the DRC border. In many ways, this was the scenario public health officials had been expecting and fearing. “For 10 months, Uganda has closely monitored its porous border with the DRC for crossover cases, yet, despite numerous alerts, no cases have been detected until now. ‘In preparation for a possible imported case during the current outbreak in DRC, Uganda has vaccinated nearly 4,700 health workers in 165 health facilities (including in the facility where the child is being cared for); disease monitoring has been intensified; and health workers trained on recognizing symptoms of the disease. Ebola Treatment Units are in place,’ the WHO regional office for Africa said in a news release.” Given the growth of the outbreak and now cases in Uganda, many are wondering why the WHO has not declared this outbreak a PHEIC (public health emergency of international concern). This may change though, as the WHO Director-General Dr. Tedros has convened an Emergency Committee under the International Health Regulations for Friday (FYI, this is the third time the Emergency committee has met to discuss the outbreak and classification as a PHEIC). Concerns for the delay in declaring PHEIC have been present for months – “The legal criteria for a PHEIC have been met. The International Health Regulations (2005) (IHR) empower the WHO Director-General to declare a PHEIC. A PHEIC is an extraordinary event with public health risk to other countries that requires a coordinated international response. IHR criteria include public health impact, novelty and scale, and movement of persons. The WHO Director-General must also consider health risks, potential international spread, and EC guidance, among other factors.”

Fighting Global Pandemics By Starting One
In the latest video installment from the Bulletin of the Atomic Scientists’s Say What? series, the hot topic of gain-of-function research is being discussed. “Researchers say making new strains of the H5N1 flu virus in a secure lab can help them see what might happen naturally in the real world. Sounds logical, but many scientists oppose it because the facts show most biosafety labs aren’t really secure at all, and experts say the risks of a mutated virus escaping outweigh whatever public health benefit comes from creating them. But now the US government is funding these same labs again to artificially enhance potentially pandemic pathogens. In this installment of the Bulletin’s video series that provides a sharp view of fuzzy policy, Johns Hopkins University computational biologist Steven Salzberg explains why arguments by researchers in favor of risky viral research aren’t persuasive.”

Burden of Disease Exposures- Reasons to Invest in Hospital Response
GMU biodefense doctoral student and infection preventionist Saskia Popescu discusses the impact that communicable disease exposures have on hospitals. “The time spent responding to an exposure means less time for patient care and infection prevention, but can also result in health care workers having to stay home if they’re exposed and immuno-naïve. A new survey sought to understand the impact for infection preventionist and staff nurses when an exposure to a communicable disease occurs. Investigators wrote in the American Journal of Infection Control (AJIC) regarding this very issue and surveyed staff nurses in a New York hospital network and infection preventionists at the 2018 Association for Professionals in Infection Control and Epidemiology annual conference, as well as members of the Association for Professionals in Infection Control and Epidemiology chapters.  A total of 150 nurses and 228 infection preventionists responded with some insight into just how time-consuming these exposures are. Data regarding workload increase for each exposure was captured in 2 questions asking participants to rank the overall increase in daily workload for each of these exposures (0-3 scale, with 0 meaning not applicable and 3 meaning a dramatic increase in workload of more than 60 minutes), and to explain the 3 most time-consuming activities for outbreak and exposure activities. Infection preventionists reported the most time-consuming outbreaks/exposures resulted from mumps/measles, tuberculosis, gastrointestinal viruses, and multidrug-resistant organisms. For an exposure to Clostridioides difficile, lice or scabies, and influenza, there was a more than 60-minute workload increase for nurses.”

There’s Limited Time To Make America Safer From Epidemics
Dr. Tom Frieden and Margaret Hamburg shine a light on a harsh truth – we’re on tight window if we want to avoid a pandemic. “In one week, the World Bank will decide how to allocate more than $50 billion in development funding to lower income countries. The World Bank should dedicate some of its International Development Association (IDA) funds – say, 5 percent, or about $1 billion per year over three years – to help countries become better prepared for infectious disease outbreaks.” “Disease outbreaks can wipe out years of investments and severely damage development. Economic losses can dwarf the cost of response – the World Bank estimates that SARS cost the global economy $54 billion in little over half a year and that a severe flu pandemic could cost more than $3 trillion, nearly five percent of global GDP. Because of its global reach, the World Bank is in the best position to take the lead on this critical effort, but the United States delegation has one week to make sure it does so at its annual meeting on June 17. The total needed to close preparedness gaps is estimated at about $4.5 billion annually, less than $1 per person per year. An additional $1 billion infusion each year for the next three years will provide a tremendous jump start – and is a bargain the United States cannot afford to miss.”

Russian Biologist Plans for More CRISPR Babies
Just went you thought the CRISPR baby drama was over (or at least being managed)…. “A Russian scientist says he is planning to produce gene-edited babies, an act that would make him only the second person known to have done this. It would also fly in the face of the scientific consensus that such experiments should be banned until an international ethical framework has agreed on the circumstances and safety measures that would justify them. Molecular biologist Denis Rebrikov has told Nature he is considering implanting gene-edited embryos into women, possibly before the end of the year if he can get approval by then. Chinese scientist He Jiankui prompted an international outcry when he announced last Novemberthat he had made the world’s first gene-edited babies — twin girls. The experiment will target the same gene, called CCR5, that He did, but Rebrikov claims his technique will offer greater benefits, pose fewer risks and be more ethically justifiable and acceptable to the public. Rebrikov plans to disable the gene, which encodes a protein that allows HIV to enter cells, in embryos that will be implanted into HIV-positive mothers, reducing the risk of them passing on the virus to the baby in utero. By contrast, He modified the gene in embryos created from fathers with HIV, which many geneticists said provided little clinical benefit because the risk of a father passing on HIV to his children is minimal.”

Stories You May Have Missed:

  • Microbial House Designs– “There’s a little mischievousness about bringing all these things and making them visible,” said Mr. Pallrand’s wife, Rachel Mayeri, who based the tile designs on electron microscopy images. “These things we tend to think of as being kind of ugly and want to hide — mold spores and mildew growing in our bathtub, and bacterial colonies that are on all the surfaces of your house — they’re all noncharismatic animals, but they’re really crucial to our lives.”


Pandora Report: 6.6.2019

Happy Thursday! That’s right – you’re getting your weekly dose of biodefense news a tad early, but don’t worry, we’ll be back to our normal schedule next week! Have you registered for the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security? From anthrax to Zika, we’ll be covering all the topics, debates, and threats related to health security.

GMU Welcomes New Faculty Member – Dr. Ashley Grant
We’re excited to announce that Dr. Ashley Grant, a lead biotechnologist at the MITRE Corporation, is joining the Biodefense Program as an Adjunct Professor to teach BIOD 620: Global Health Security Policy. Dr. Grant was previously the Senior Biological Scientist at the Government Accountability Office where she led government-wide technical performance audits focused on biosafety and biosecurity issues. Dr. Grant was an American Association for the Advancement of Science (AAAS) Science and Technology Fellow in the Chemical and Biological Defense Program Office in the Department of Defense and also worked at the National Academies of Science on the Committee on International Security and Arms Control. Her work focused on international security, nonproliferation, and medical countermeasures against chemical and biological threats. She completed the Field Epidemiology Course at the Naval Medical Research Center (NMRC) in Lima, Peru and was a Visiting Graduate Researcher at the Instituto Nacional de Enfermedades Virales Humanas J. Maitegui (INEVH) in Pergamino, Argentina. Dr. Grant received her PhD in experimental pathology and a MPH in epidemiology from the University of Texas Medical Branch at Galveston. Her graduate work focused on investigating pathogenesis and potential countermeasures for viral hemorrhagic fevers under biological safety level (BSL)-4 conditions. In addition, she received a MA in National Security Studies from the Naval War College and a BS in Chemistry and a BS in Business Economics and Management from the California Institute of Technology.

Congress Passes the Pandemic and All-Hazards Preparedness and Advancing Innovation Act
On Tuesday, June 4th, the House “passed the Pandemic and All-Hazards Preparedness and Advancing Innovation Act. The bill reauthorizes existing statute governing public health efforts at the Department of Health and Human Services. Additions made by the bill – some of which were recommended by the Blue Ribbon Study Panel on Biodefense – address biodetection, hospital preparedness, medical countermeasures and response. Many of these programs will enable HHS to better defend the nation against biological threats. Both chambers of Congress have passed the bill, and it will now go to President Trump for signature. ‘Naturally occurring diseases and biological weapons continue to endanger our nation,’ said Governor Tom Ridge, Panel Co-Chair. ‘The Panel is pleased to see that Congress addressed 15 of our recommendations in this legislation, which will help the nation better prepare for, detect, respond to, and recover from large-scale biological events, bioterrorism or other biological events’.”

National Biodefense Science Board Public Meeting
“The June 10-11, 2019 meeting of the National Biodefense Science Board will focus on early results and progress reports from four new programs that were designed to strengthen disaster health preparedness, response and recovery: the Regional Disaster Health Response System; BARDA DRIVe; ASPR’s new Incident Management Team; One Health; and the National Biodefense Strategy. As part of the evolution of the National Disaster Medical System, NBSB will discuss disaster veterinary medicine and National Veterinary Response Teams. The board will also address issues facing the medical community, including disaster medicine training for community physicians and advance practice physicians and learn about ways to develop and operationalize core competencies for disaster medicine.”

 Exploring Lessons Learned from a Century of Outbreaks
Check out the latest from the proceedings of a 2019 NAS workshop on outbreak readiness. “In November 2018, an ad hoc planning committee at the National Academies of Sciences, Engineering, and Medicine planned two sister workshops held in Washington, DC, to examine the lessons from influenza pandemics and other major outbreaks, understand the extent to which the lessons have been learned, and discuss how they could be applied further to ensure that countries are sufficiently ready for future pandemics. This publication summarizes the presentations and discussions from both workshops.” Within this document, you can access sections on global preparedness progress for the next pandemic influenza, building local and national capacities for outbreak preparedness, pandemic vaccine considerations, etc. “The participants in this workshop examined the lessons from major outbreaks and explored the extent to which they have both been learned and applied in different settings. The workshop also focused on key gaps in pandemic preparedness and explored immediate and short-term actions that exhibited potential for the greatest impact on global health security by 2030. Workshop speakers and discussants contributed perspectives from government, academic, private, and nonprofit sectors. This workshop opened with a keynote address and a plenary presentation, followed by three sessions of presentations and discussions. Additionally, panelists, forum members, and attendees were given the opportunity to assemble into small groups and asked to consider potential priority actions and strategies for systematizing and integrating outbreak and pandemic preparedness so that it is a routine activity from the local to global levels.”

Inside Britain’s Top Secret Research Laboratory 
Have you ever wanted to tour Britain’s top secret laboratory? If Porton Down has been on your wish list, here’s your chance to get a virtual tour. “The BBC was given access inside Porton Down to see what the highly secretive facility was like and, for the first time ever, entered a cleansed version of a level four laboratory. This level is where the Defence Science and Technology Laboratory team analyse some of the world’s deadliest viruses – Ebola and Marburg.”

 DRC Ebola Outbreak Updates 
The outbreak has officially reached 2,000 cases and aid groups in “the region called for pushing the reset button on the response. In its daily update yesterday, the DRC said the outbreak passed the 2,000-case bar on Jun 2. Officials said that, although the landmark is concerning, the health ministry sees some positive signs, including a slight improvement in the security situation, though the situation remains volatile and unpredictable. The ministry added that most incidents related to community resistance have been resolved by community leaders, sensitizers, and psychosocial experts.” For many, the question is still – who is attacking Ebola responders and why? “The first is that local political figures are fomenting and even organizing the attacks as a way of undermining their rivals, presumably officials of the central government or local leaders aligned with them. Many analysts hold that it was actually the national government that set the stage for the use of the Ebola crisis as a political tool, and Gressly largely echoed that account. Last December, he noted, just days before presidential elections, national electoral officials announced that voting would be suspended in the two largest cities in the outbreak zone, Beni and Butembo.” “At least one type of attack appears very much linked: Many of the incidents seem to be outbursts by members of the community who have heard the rumors and believe them. An Ebola team will arrive in a neighborhood to bury a suspected Ebola patient or vaccinate their relatives, and people will throw rocks and chase the team out. Similarly, doctors and nurses at regular health facilities have been threatened by mobs, who are angry that the health workers refer Ebola patients to treatment centers. In one case, a nurse was killed. But there has also been an increase in seemingly well-coordinated assaults by well-armed assailants. More than half-a-dozen times, gunmen have shot up Ebola treatment centers and health facilities where Ebola teams are based, including on April 19, when a group of armed men burst into a hospital where an Ebola team was meeting and killed an epidemiologist with the World Health Organization.”

African Swine Fever and China’s Pork Industry
A highly virulent virus meets a $128 billion dollar industry and we’re not sure which will win. “The virus that causes the hemorrhagic disease is highly virulent and tenacious, and spreads in multiple ways. There’s no safe and effective vaccine to prevent infection, nor anything to treat it. The widespread presence in China means it’s now being amplified across a country with 440 million pigs—half the planet’s total—with vast trading networks, permeable land borders and farms with little or no ability to stop animal diseases.” Despite 50 years of efforts, there has been no vaccine for this devastating disease and “even if China is able to stop the virus transmitting from pig to pig, two other disease vectors may frustrate eradication efforts: wild boars and Ornithodoros ticks. These are the natural hosts of African swine fever virus and are widely distributed in China, though it’s not yet known what role they are playing in spreading the disease there. Zhejiang province, south of Shanghai, has about 150,000 wild boars.”

Stories You May Have Missed:

  • U.S. Measles Cases Top 1,000 – “Federal officials yesterday said US measles cases have reached 1,001, the first time since 1992 that cases have been in quadruple figures, while experts continued to urge vaccination and underscored the safety of the vaccine. Health and Human Services (HHS) Secretary Alex Azar said in an HHS news release, ‘We cannot say this enough: Vaccines are a safe and highly effective public health tool that can prevent this disease and end the current outbreak’.”
  • Nipah Virus in Indian Man – “The Indian government today confirmed that a 23-year-old man from Kerala has a Nipah virus infection, and another 86 case contacts are being monitored for the deadly disease, according to the Deccan Chronicle. Officials said the patient, a college student, is hospitalized and in stable condition. They also said two of the case contacts have fevers, and two nurses who took care of the 23-year-old were also experiencing fevers and sore throats.”
  • GM Fungus Kills 99% of Malaria Mosquitoes – “Trials, which took place in Burkina Faso, showed mosquito populations collapsed by 99% within 45 days. The researchers say their aim is not to make the insects extinct but to help stop the spread of malaria. The disease, which is spread when female mosquitoes drink blood, kills more than 400,000 people per year. Worldwide, there are about 219 million cases of malaria each year. Conducting the study, researchers at the University of Maryland in the US – and the IRSS research institute in Burkina Faso – first identified a fungus called Metarhizium pingshaense, which naturally infects the Anopheles mosquitoes that spread malaria. The next stage was to enhance the fungus. ‘They’re very malleable, you can genetically engineer them very easily,’ Prof Raymond St Leger, from the University of Maryland, told BBC News.”


Pandora Report: 5.31.2019

Happy Friday! Before we get started with the biodefense news of this week, you should know that the CDC has reported there have now been 971 cases of measles this year, “topping the 1994 modern-record level, and it warned that if a pair of large outbreaks in and around New York City continue over the summer and fall, the United States could lose its measles elimination status”.

 Extended Workshop Registration Discount 
We’re excited to announce that the early registration discount has been extended to July 1st, which means you have more time to register for the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security. This is a great “three and a half-day workshop, non-credit summer workshop designed to introduce participants to the challenges facing the world at the intersection of national security, public health, and the life sciences. The workshop faculty are internationally recognized experts from the government, private sector, and academia who have been extensively involved with research and policy-making on public health, biodefense, and national security issues.” We hope to see you in July and if you’re a returning student, GMU alumni or current student/faculty, or large group, you’re eligible for an additional discount.

Possible European Origin of the Spanish Influenza
What happens when you get a military historian and a virologist together to discuss the 1918 pandemic? A fascinating insight into a possible European origin and all sorts of things we might not have considered. “When we reconsider the virology and history of the Spanish Influenza Pandemic, the science of 2018 provides us with tools which did not exist at the time. Two such tools come to mind. The first lies in the field of ‘gain of function’ experiments. A potential pandemic virus, such as influenza A (H5N1), can be deliberately mutated in the laboratory in order to change its virulence and spreadability. Key mutations can then be identified. A second tool lies in phylogenetics, combined with molecular clock analysis. It shows that the 1918 pandemic virus first emerged in the years 1915–1916. We have revisited the literature published in Europe and the United States, and the notes left by physicians who lived at the time. In this, we have followed the words of the late Alfred Crosby: who wrote that ‘contemporary documentary evidence from qualified physicians’ is the key to understanding where and how the first outbreaks occurred. In our view, the scientists working in Europe fulfill Crosby’s requirement for contemporary evidence of origin. Elsewhere, Crosby also suggested that ‘the physicians of 1918 were participants in the greatest failure of medical science in the twentieth century’. Ours is a different approach. We point to individual pathologists in the United States and in France, who strove to construct the first universal vaccines against influenza. Their efforts were not misdirected, because the ultimate cause of death in nearly all cases flowed from superinfections with respiratory bacteria.”

 Ebola Outbreak Updates and Why The Response Must Be Elevated
Good news – cases have been declining in the past few week…unfortunately the increasingly complex situation has made any progress difficult to measure. “Part of the decline reflects fewer cases in Katwa, which has been the main Ebola epicenter over the past several weeks. At the same time, smaller hot spots such as Mabalako, Kalunguta, and Mandima are experiencing rising cases. For example, the WHO notes that Mabalako has reported 23% of newly confirmed cases over the past 3 weeks. Aside from a drop in cases, the WHO said in its latest situation report that it sees other encouraging signs, including lower proportions of nosocomial (healthcare-related) infections and community deaths. Also, it said outbreak responders are reporting higher proportions of contacts registering when cases are detected. It said, however, that weekly fluctuations in the indicators that health officials track have been reported in the past, and it’s still not clear if the surveillance system has the ability to identify all new cases in areas with ongoing security problems. ‘Operations are still regularly hampered by security issues, and the risk of national and regional spread remains very high,” the WHO said’.” Many charities are now calling for the outbreak to be designated as a crisis and efforts to be enhanced. “Whitney Elmer, country director of DRC for Mercy Corps, said that declaring the equivalent of a level-three emergency would bring ‘manifold benefits’ by clarifying the roles of agencies, allowing greater access to resources and attracting greater global attention. ‘There has never been an epidemic of this complexity or size in the DRC,’ said Elmer, adding that the crisis requires a new structure in line with its scale. The global humanitarian coordination body, Inter-Agency Standing Committee, will consider the call when it meets on Wednesday. Among the factors to be considered are the scale and complexity of an epidemic, and the risk of a failure to respond effectively. A level-three emergency, now known as a system-wide scale up, does not indicate the severity of the crisis, but is activated where there is a mismatch between need and agencies’ ability to respond. On Tuesday, Mike Ryan, assistant director-general of the World Health Organization’s emergency preparedness and response programme, said progress had been made in fighting Ebola, including a drop in transmission of the disease in health facilities.”

Dangerous Levels of Antibiotics Found in World Rivers
“Concentrations of antibiotics found in some of the world’s rivers exceed ‘safe’ levels by up to 300 times, the first ever global study has discovered. Researchers looked for 14 commonly used antibiotics in rivers in 72 countries across six continents and found antibiotics at 65% of the sites monitored. Metronidazole, which is used to treat bacterial infections including skin and mouth infections, exceeded safe levels by the biggest margin, with concentrations at one site in Bangladesh 300 times greater than the ‘safe’ level.”

Stories You May Have Missed:

  • Fertility Clinics Asking for CRISPR Help – “The condemnation of the Chinese scientist who created the world’s first genome-edited babies last year was far from universal: A fertility clinic in Dubai emailed He Jiankui on December 5 — just a week after he announced the births — asking if he could teach its clinicians ‘CRISPR gene editing for Embryology Lab Application.’ Although the English is somewhat tortured, the meaning was clear, Dr. William Hurlbut of Stanford University, who has advised He on the bioethics of his work for several years, told STAT: The fertility center was interested in offering CRISPR embryo editing to its patients. Its opening line is, ‘Congratulations on your recent achievement of the first gene editing baby delivered by your application!’ Hurlbut planned to reveal the email at a panel of the World Science Festival in New York City on Tuesday evening, but shared it with STAT before the event. Hurlbut said He received ‘other inquiries’ making a similar request. When He asked Hurlbut for advice on how to respond, Hurlbut said, ‘I told him not to reply’.”
  • Experimental Ebola Cure Could Protect Against Nipah – “An experimental drug has protected monkeys against infection with Nipah virus, a lethal disease and emerging pandemic threat for which there is no approved vaccine or cure, scientists reported on Wednesday. The antiviral drug, remdesivir, is also being tested against the Ebola virus in the outbreak now underway in the Democratic Republic of Congo. The only current treatment for Nipah virus infection is a monoclonal antibody that is still experimental; it was tested during an outbreak in India last year.”


Pandora Report: 5.24.2019

Happy Friday fellow fans of biodefense! We hope you had a lovely week and are ready to get your dose of all things health security…starting with the role of investors in pushing restaurant chains to cut antibiotics in the meat supply.

 Summer Workshop – Get the Early Registration Discount!
Just a couple more weeks to get this early registration discount – are you registered? This 3.5 day workshop will be a great place to hear from experts in the biodefense field, but also network and learn about the current biological threats we face. “The spectrum of biological threats is diverse, including naturally occurring disease outbreaks such as SARS, Zika, and Ebola, lapses in biosafety, dual-use research of concern, and the threat of bioterrorism. A severe disease outbreak, whether natural or man-made, can affect not just public health, but also public safety and national security. Pandemics and bioterrorist attacks will confront government agencies and the private sector with the need to make high-impact decisions with limited information during a rapidly evolving situation. Further complicating this domain is the dual-use nature of biology: the knowledge, skills, and technology developed for legitimate scientific and commercial purposes can be misused by those with hostile intent. Research with dangerous pathogens and the development of advanced biotechnologies such as synthetic biology and genome editing poses a dilemma for policy-makers and researchers who seek to maximize the benefits of such research while minimizing the risks. Thus, public health, law enforcement and national security agencies, the pharmaceutical and biotech industries, and the academic life sciences community need to develop new types of expertise, adopt new types of risk assessment and risk management strategies, and learn to collaborate with each other.” Make sure to register before June 1st for your discount! You can also get an additional discount if you’re a returning participant, part of a large group, or GMU alum/current student or faculty.

 Portable Isolation Unit: Coast Guard-Developed System for Evacuating Infectious or Contaminated Patients 
GMU Biodefense alum Dr. Jen Osetek is giving us a special look into how the Coast Guard developed systems for safer transport of highly infectious patients. “The Ebola outbreak of 2014-2015 was notable for a number of important reasons: it was the largest outbreak in history, there were affected Americans (both overseas and domestically), and it was the catalyst for the development of new capabilities that could help transport infected or potentially infected people. One such capability is the Department of Defense’s Transportation Isolation System (TIS) that was featured in the March 15, 2019 issue of Global Biodefense. Another critical solution was the U.S. Coast Guard-developed Portable Isolation Unit (PIU), manufactured by ISOVAC Products and formerly known as the Operational Rescue Containment Apparatus (ORCA®). This was specifically designed to be used in situations involving a rotary-wing maritime evacuation and will allow infected (or potentially infected) patients to be transported without risk of contaminating the aircrew or aircraft.  Due to this mission, it was designed to be used with stokes litter and NATO litter, among others.  he PIU is an FDA-approved positive-pressure device that utilizes a powered air-purifying respirator to supply air to the patient while filtering the exhaust air through a CBRNE cartridge. As a positive pressure apparatus that can filter inlet and exhaust air the PIU can withstand the mechanical force or rotor wash at hover during the hoist phase or rotary wing casevac/medevac evolutions. This is an important aspect of the design that enables its safe use in a variety or challenging operations and environments. The unit is battery operated and capable of running continuously for 4 hours. The PIU is constructed from Gore’s ChemPak® membrane barrier that is utilized in other CBRNE individual protective items. A window is installed for patient visibility and is supported by two flexible rods to prevent contact with the patient’s head and face. Glove ports present on both sides of the PIU are manufactured with Gore’s UltraBarrier® material and allow for limited patient interaction with rescue personnel. As a single-use item, the PIU contains the infectious agent or hazardous chemical contaminant during transport, which after use, is decontaminated for final disposal.”

Blue Ribbon Study Panel – A Manhattan Project for Biodefense: Taking Biological Threats off the Table
The Blue Ribbon Study Panel on Biodefense is hosting this event on July 11th – “Eighty years ago, the United States began leading a research and development effort to produce the world’s first nuclear weapons. Military and federal agencies, academia, industry, government contractors, and predecessors of today’s national laboratories worked together – with a great deal of support from Manhattan, NY and other localities – to establish overwhelming military superiority for the Allies during World War II. Their efforts effectively ended the war. Today, the challenge is defense against the biological threat, for which we are at a decided disadvantage. No matter what the source – intentional, accidental, or natural – the Nation and the world are at catastrophic biological risk. We need to tale this threat off the table for good. Please join the Panel on July 11, 2019, when we hold a meeting to discuss a Manhattan Project for Biodefense – a national, public-private research and development undertaking to defend the Nation against biological threats. Representatives from the same sorts of organizations that contributed to the original Manhattan Project will gather to talk with the Panel about the biological threat, cutting edge biodefense research, needed resources, and business risk. We will also talk about universal flu vaccine as an example of public-private interagency activity.” Make sure to RSVP by July 3rd – the event is available in person and online.

Immune to Drugs: AMR Could Kill 10 Million Per Year and Building New Models to Support the Ailing Antibiotic Market 
Remember that time we kept having increasing antimicrobial resistance but not a lot of people were paying attention? Well, “the United Nations created the Interagency Coordinating Group on Antimicrobial Resistance, and published a report with international agencies and experts noting that without immediate global action, the crisis of drug resistance bacteria and viruses could lead to an economic catastrophe as bad as the 2008-2009 global financial crisis, and by 2030 could force as many as 24 million people into poverty. And it hits home more often than we know. In the U.S., antimicrobial resistance causes more than 2 million infections and 23,000 deaths per year – the equivalent of a Boeing 747 crashing each week.  Financially, it is projected that due to lost wages, hospital stays and premature death, the U.S. lost about $35 billion in 2008 to antibiotic-resistant infections, and this number continues to rise.” Guess what is the root cause of breeding resistance? Hospitals. “Just days ago Senator Chuck Schumer of New York called for the CDC to declare a state of emergency over a fast-spreading outbreak of Candida Auris, a drug-resistant fungus that has infected more than 600 New Yorkers in health centers. But in New York, the state is trying to fight back not with hospital changes or environmental changes, but with technology. ;Given the amount of money it takes to battle these superbugs, and that the states are paying for all the Medicare and Medicaid patients, it makes sense as a money-saving initiative for states to be investing in genomic DNA and informatics,’ says Evan Jones, CEO of OpGen, a genomics and informatics company working with the New York Department of Health.” In the face of the dying antibiotic market, BARDA director Rick Bright recently discussed new approaches to bring some life back into the R&D we desperately need. “Now is the time to build new business models and novel partnerships that foster a robust end-to-end enterprise, making critically needed antimicrobials available to patients. At BARDA, we recognize the complexity of this challenge and are optimistic about what can be achieved. In the near term, these new models must not rely on exits to large pharma, but will benefit from decreases in market fragmentation and leveraging economies of scale. The industry needs to move toward market strengthening by leveraging capital in new ways across a broad portfolio of products with a long-term view and realistic revenue projections. BARDA simply cannot continue to provide non-dilutive investment, only to have companies collapse and their newly minted antibiotics shelved or lost completely. We will focus on bold ideas and new partnerships, utilizing its unique authorities to stimulate innovation, streamline R&D and successfully commercialize critically needed antibiotics. Thereby, ensuring greater health security for our nation. In addition, the biotech and pharmaceutical industry must join in pursuing better, sustainable business models for antimicrobials.”

Biosecurity Workshop – Engaging Young Scientists from the Global South in Biosecurity Diplomacy
Young scientists from the Global South working on topics related to the Biological Weapons Convention are invited to participate in the workshop Engaging Young Scientists from the Global South in Biosecurity Diplomacy. “The workshop will be financed under the auspices of European Union Council Decision 2019/97/CFSP in support of the BWC, managed and implemented by UNODA. The workshop aims to bring together up to 20 young and talented scientists from the Global South working on topics related to the BWC. Participants will be selected on the basis of their professional backgrounds and accomplishments. Young female scientists from the Global South are particularly encouraged to apply. The workshop recognizes that scientific and technological innovation, and youth and women’s empowerment and inclusion in multilateral BWC discussions, are essential to the realization of a world free from biological weapons. The workshop will provide an informal and interactive space for young scientists from the Global South to share their knowledge, insights and concerns, and to provide their vision for the future of responsible bioscience in their own countries. It will also encourage the development of networks of young professionals and provide an opportunity for capacity development in biosafety and biosecurity.”

 Ebola Outbreak Updates and the Role of Nosocomial Transmission
The UN Health Chief recently warned of the very high risk that Ebola will spread – especially in the face of community mistrust for health workers and government officials. “Efforts to combat the epidemic have been hobbled by attacks on treatment centers and health workers; deep suspicion of the national government, which is managing the eradication efforts; and growing mistrust of the international medical experts who have struggled to steer patients into the treatment centers, according to interviews with dozens of family members, politicians, doctors and health workers in recent weeks. When a doctor was killed, and treatment centers attacked by gunmen or set on fire, front-line health workers suspended their work, giving the virus time to spread. Some medical and aid groups have decided to pull some of their personnel from the very areas where Ebola has hit hardest. So far nearly 1,150 people have died in the outbreak, according to the World Health Organization. But that is a significant undercount, aid groups said in interviews. Health workers have been turned away regularly from homes where someone has died, leaving them unable to test for Ebola.” Healthcare workers are increasingly on edge with the attacks and threats, as 19 more cases were reported on May 22nd.  GMU Biodefense doctoral student and infection preventionist Saskia Popescu also discusses the trend of healthcare worker cases in this outbreak. “During the 2013-2016 outbreak, health care workers in West Africa were 32 times more likely to be infected with Ebola. Earlier this week, a nurse was reported as the latest case in this trend, bringing the total of health care worker infections to 99. On Friday, the World Health Organization situation report noted that this number had increased to 101 and now accounted for 6% of the cases. Of these health care worker cases, there have been 34 deaths. The continued need for more health care workers, especially in the wake of frequent threats and violence, makes the possibility of nosocomial transmission that much more real. The enhanced personal protective equipment (PPE) alone is difficult for a novice and can be a considerable source of exposure. Bringing in local health care workers and staff is critical to maintaining local engagement and earning trust in this rapidly evolving environment, however, the tacit knowledge of caring for an Ebola patient is complicated on the best of days.”

ASPR FY2020 Budget-In-Brief 
Check out the latest on the Office of the Assistant Secretary for Preparedness and Response (ASPR) and its FY2020 budget. “ASPR is funded through appropriations to the Public Health and Social Services Emergency Fund. The Fiscal Year (FY) 2020 budget request is $2.6 billion, which is $26 million above the FY 2019 enacted budget. This funding level supports the launch of a new pediatric disaster care initiative to enhance care to infants and children during emergencies; coordination of the National Biodefense Strategy (NBS); support for emergency operations planning and response; and, advanced development of MCMs through procurement, storage, and deployment. These investments ensure that ASPR can fulfill its unique role in protecting Americans from the impact of natural disasters, terrorist threats, and emerging infectious diseases. The request provides: $1.6 billion for the Biomedical Advanced Research and Development Authority (BARDA), including $322 million for Advanced Research and Development (ARD); $180 million for Combating Antibiotic Resistant Bacteria (CARB); $735 million for Project BioShield (PBS); and, $256 million for pandemic influenza (PI). $620 million for the Strategic National Stockpile (SNS) to manage and deliver life-saving MCMs during a public health emergency. $258 million for the Hospital Preparedness Program (HPP) to support cooperative agreements and other programs and initiatives that improve surge capacity and enhance health care readiness. $106 million for Preparedness and Emergency Operations (PEO), the National Disaster Medical System (NDMS), and the Civilian Volunteer Medical Reserve Corps (MRC) to support federal staff and local volunteers in preparing for and responding to public health emergencies and disasters, including training, modernization of equipment, and creation of a pediatric disaster care pilot initiative. $51 million for ASPR’s policy, planning, acquisitions, grants, financial management, business operations, and executive leadership.”

 PHEMCE Multiyear Budget
Have you read the 2017-2021 fiscal budget for the Public Health Emergency Medical Countermeasures Enterprise (PHEMCE)? “For the five-year period Fiscal Years (FYs) 2017–2021, this report provides estimates for HHS total spending which would be $24.8 billion, a $4.4 billion, or 22 percent, increase compared with the projection for FYs 2016–2020, which was $20.4 billion. The five-year funding total aggregates MCM-related spending estimates for NIH, BARDA, SNS, and FDA includes estimates of these replenishment costs, would be incurred by the SNS beginning in FY 2020. This change accounts for approximately $900 million of the estimated total $4.4 billion increase described below. This report developed the spending estimates as follows. For FY 2017 and FY 2018 the enacted annual appropriation levels were used and for FY 2019 the President’s Budget was used. The out-year funding levels (FY 2020 and FY 2021) for NIH, BARDA, SNS, and FDA were developed without regard to the competing priorities considered in the budget development process and that must be considered as Congressional budget submissions are developed. These estimates are subject to change in the future.”

Managing an Exposure- Why the EMR is Lacking
Since measles is on the rise, the concern for exposure in an emergency department or healthcare setting is very real. Unfortunately, managing such an event can be problematic with existing electronic medical records systems. “One of the most problematic aspects of an exposure is determining who is involved—both patients and staff alike. If the source case was a patient, the staff involved in their care must be identified, and if the source case is a health care worker, then the exposure list is usually longer as it involves both the individual’s patients and colleagues. For a disease like measles, which is highly contagious and infectious, we must also account for any patients exposed in waiting areas and other public areas where the patient went without the proper isolation (this includes considering patients on the same air-handling unit) Since the incubation period is usually 10-12 days, this often leaves little time for response efforts. One of the tools we often use to identify those involved in an exposure (for both notification and even prophylaxis purposes) is the electronic medical record (EMR) system. The EMR allows us to rapidly pull a list of staff who were involved in the care of a patient (assuming the patient was the index case)…or at least it should. ”

Stories You May Have Missed:

  • CRISPR Used to Tackle Superbugs -“‘We are getting to the point where there are organisms that are resistant to every known antibiotic,’ says Michael Priebe, a doctor who heads the spinal cord injury service at the VA medical center. ‘My fear is that as we are in this arms race, there gets to the point where we are not able to keep up with the enemy — the resistant bacteria. The superbugs take over, and we have nothing to defend against it,’ Priebe says. So Priebe enlisted Evans to help develop a different way to fight superbugs. It’s a new kind of antibiotic made out of viruses that have been genetically modified using the gene-editing tool CRISPR. ‘What CRISPR is able to do is something that we’ve not been able to do before. And that is, very selectively modify genes in the viruses to target the bacteria,’ Priebe says.”
  • Alleged Use of CW By the Assad Regime in Northwestern Syria – “The United States continues to closely watch the military operations by the Assad regime in northwest Syria, including indications of any new use of chemical weapons by the regime. Unfortunately, we continue to see signs that the Assad regime may be renewing its use of chemical weapons, including an alleged chlorine attack in northwest Syria on the morning of May 19, 2019. We are still gathering information on this incident, but we repeat our warning that if the Assad regime uses chemical weapons, the United States and our allies will respond quickly and appropriately. The May 19 alleged attack in northwest Syria is part of a violent campaign by the Assad regime that violates a ceasefire that has protected several million civilians in the greater Idlib area. This renewed Syrian regime offensive has targeted the communities of that area, which include a large number of Syrians who were already displaced from violence in others parts of Syria, and has destroyed known health facilities, schools, residences, and internally displaced person camps. The regime’s attacks against the communities of northwest Syria must end.”

Pandora Report: 5.17.2019

GMU Biodefense Spring Graduates 
It’s that time of year and we’re so excited to celebrate the graduation of several  students from the Schar Biodefense graduate program. Congrats to Carlos Alvarado, Nicolas Bertini, Anna Cannone, Anthony Falzarano, Kelsey Gloss, Megan Hudson, Kate Kerr, Mimish Kothari, Christopher Lien, Jessica Lovett, Janet Marroquin-Pineda, Annette Prieto, Jessica Smrekar, and Stephen Taylor, for their hard work in earning a MS in biodefense! (Hint – check out those white NextGen Health Security sashes). We can’t wait to see what amazing things you’ll accomplish and the impact you’ll have in the world of biodefense.

Biodefense Graduate Student Awards
We’d also like to show off two new graduates who were just awarded for their dedication to the field of biodefense during their studies and as role models for others within the program. Jennifer Osetek was awarded the Outstanding Doctoral Student in Biodefense award and Stephen Taylor was the recipient of the Outstanding Biodefense Student Award. “Stephen’s passion for biodefense and global health security was shaped by his experience as a Peace Corps volunteer in Mozambique. He not only observed first-hand the impact of infectious diseases on the local community, he even suffered a bout of malaria himself. Thankfully he made a full recovery and went on to enroll in our program.” Jen’s dissertation, “The Last Mile: Removing Non-Medical Obstacles in the Pursuit of Global Health Security asks the question, “Does the current approach to public health response planning and execution adequately incorporate all known obstacles to delivery of care and resources?” Drawing on evidence from multiple disease outbreaks over the last thirty years, her answer is an emphatic no. To fill this important void in the literature on global health security, Jen introduced the concept of non-medical obstacles, which are material and intangible factors that slow or prevent the timely delivery of available critical healthcare resources to populations in need during a public health emergency. ”

Outbreak Updates – Ebola in the DRC  and Measles in the U.S.
The onslaught of Ebola cases hasn’t let up in the DRC as 15 more cases were reported this week and the incidents of vandal and violence have continued. The outbreak is now at 1,720 cases, with 1,136 deaths. The attacks have been increasingly making response efforts strained and pose a challenge for maintaining community trust. “’Identifying specific groups responsible for specific attacks is difficult. Many of these groups resist control by the central government and they see this public health response as a threat posed by the government,’ explained Gregory D. Koblentz, Director of the Biodefense Graduate Program at George Mason University.’  Others have a more general suspicion of outsiders. Finally, health centers and health care workers may be caught in the cross-fire of competition between different groups. The conflict between so many armed groups is a toxic stew that makes public health campaigns exceedingly difficult.” South Korea is stepping in to assist by providing “$500,000 in cash assistance will help fund the response plan developed by the DRC’s health ministry along with 15 international organizations, including the World Health Organization (WHO). It added that with DRC’s outbreak pushing into its 10th month, the international community’s engagement and support is all the more needed. The donation isn’t South Korea’s first for Ebola. In 2014 the country sent a disaster relief team to help with West Africa’s Ebola outbreak and in 2018 it provided $1.5 million to the WHO’s emergency fund to help address Ebola in the DRC.” For the United States, measles is still on the rise as the case counts have passed 800. “The new cases boost the current US total to 839 from 23 states, with many of the cases linked to 10 outbreaks in seven different states: New York, Michigan, New Jersey, California, Georgia, Maryland, and Pennsylvania. The modern record of 963 cases occurred in 1994, the year the federally funded Vaccines for Children program began, an event that stabilized the number people vaccinated against the disease and set the stage for measles elimination in 2000. Added to the outbreak list this week is Maryland. The Maryland Department of Health (MDH) said five cases have been confirmed this year as of May 9. It said cases have been localized to a small geographic area involving three zip codes. Two are centered in Baltimore and one is in Pikesville, a suburb just northwest of the city Of the 75 new cases, more than half appear to be linked to large outbreaks in New York City and New York’s Rockland County, both centered in Orthodox Jewish communities.”

U.S. Government Global Health Security Strategy
The White House recently released their strategy for combating global health security threats. The approach includes three goals – strengthening partner country global health security capacities, increasing national support for global health security, and a homeland prepared for and resilient against global health security threats. “Promoting global health security to detect and mitigate outbreaks early remains a core tenet of our National Security Strategy. United States Government investments in global health security can help prevent the spread of human and animal infectious diseases and protect populations at home and abroad, including those serving in our Armed Forces. Furthermore, investments that focus on prevention and preparedness are far more cost-effective than responding to infectious disease epidemics. To maximize global health security and preparedness for infectious disease threats, all countries must address global health security challenges.” The strategy also addresses the technical and geographic priorities for the CDC and USAID including the monitoring, evaluation, sustainability, and transition to country ownership. You can also read about the US government’s health security activities.

Summer Workshop – Are you Registered?
If you’re looking to strengthen the preparedness within your workplace or simply hoping to understand the complex biological threats that stress global health security, check out our workshop this July. “Threats to global health security continue to evolve due to the changing nature of conflict, advances in science and technology, globalization, and the growing threat posed by emerging infectious diseases and pandemics. Pandemics, Bioterrorism and Global Health Security: From Anthrax to Zika is a three and a half-day workshop, non-credit summer workshop designed to introduce participants to the challenges facing the world at the intersection of national security, public health, and the life sciences. The workshop faculty are internationally recognized experts from the government, private sector, and academia who have been extensively involved with research and policy-making on public health, biodefense, and national security issues.” Signing up before June 1st will get the early registration discount and large groups/returning attendees/GMU faculty or students are also eligible for an additional discount.

Senate HELP Committee Leaders Applaud Passage of Legislation to Combat Bioterrorism and Pandemics
The senate has passed the Pandemics and All-Hazards Preparedness and Advancing Innovation Act. The act “supports and strengthens America’s ability to prepare for and respond to the full range of public health threats we face, both naturally occurring or as a result of a deliberate attack on our country. ‘When it comes to combatting pandemics or biological attacks, being prepared is everything,’ said Senator Burr. ‘Today, our nation has an incredible response framework that brings the private and public sectors together to address a range of public health threats, both natural and man-made. As these threats grow increasingly complex, however, it is critical that our capability to respond keeps pace. I am pleased my Senate colleagues joined me in supporting this legislation that ensures America’s biodefenses are ready for the public health challenges of the 21st century’.”

 Germ Warfare and Why Max Brooks is Worried
The author of World War Z is worried about bioterrorism, and here’s why… “The first is that my paranoid notions of corpse diggers and lab smugglers are pathetically outdated compared with what’s coming at us now. The age of the homegrown bioterrorist is right around the corner, a time where anyone with a little cash and access to the internet will be able to cook up designer plagues. Lab equipment that used to cost millions of dollars can now be purchased on the cheap from eBay. Knowledge that used to require a Ph.D. and top-security clearance is available on the dark web or, in many cases, in open-source publications for the whole world to view. Even worse, breakthroughs in genetic manipulation will allow tomorrow’s lone wolf to harvest a seemingly harmless bug anywhere in nature and tweak it just enough to wipe us out. If that first fact wasn’t bad enough, the second is even worse. We, the public, you and I, are the ones letting it happen. Because we’ve conquered so many diseases, and therefore don’t have to worry about the specters that killed and crippled our grandparents, we’re starting to question the science that saved us. Thanks to the anti-vaxxer movement, I’m writing this piece from a city (Los Angeles) that in late April quarantined hundreds of people exposed to a disease that was officially eliminated in the United States. And that’s just measles. Just wait till polio makes a comeback! And what if that polio, or an entirely new disease, doesn’t come from nature? In February, a Coast Guard lieutenant named Christopher Paul Hasson was arrested with a cache of firearms and ammo. In an email, he had allegedly sought to ‘acquire the needed/ Spanish flu, botulism, anthrax.’ Pulling that off right now might have been difficult, to say the least. But if he had, in an age of anti-vaxxers and alternative facts, he might have killed more people than all our past enemies put together.”

Soviet Efforts to Eliminate Plague
Tying into our discussions last week on the Soviet Union’s efforts to eliminate plague,  more attention has been placed on the significant work they employed towards this monumental goal. While some progress was made, there was a divergence between the promotion of success and what scientists were actually able to achieve. In fact, Soviet scientists stated in the 1960s that there hadn’t been a human case of plague since 1928. “Local authorities would say, ‘It’s eradicated’ or ‘We don’t have an outbreak.’ Because they ignored the outbreak, it would spread to other republics of the Soviet Union,” says Sonia Ben Ouagrham-Gormley, a biodefense researcher now at George Mason University who also coauthored the CNS reports on the Soviet anti-plague system. When the plague broke out on the border of Kazakhstan and Uzbekistan, for example, Kazakh scientists would try to contact their colleagues across the border, who were kept from telling the truth. But, says Ben Ouagrham-Gormley, “if they were told the colleague was on vacation, most of the time that meant he was out in the field responding to the outbreak.” Sadly, the shear size of the country proved challenging to truly complete the task and “Beginning in the 1960s, as reality intruded, the Soviet anti-plague system shifted from total eradication to control. The scientists knew that plague outbreaks among humans tended to follow rodent outbreaks in any local area. So they would conduct plague surveillance by systematically testing animals.”

New Maps Reveal First Global Estimate of Anthrax Risk
Check out this new resource for understanding the risks of anthrax at a global level. “Newly published maps reveal, for the first time, where anthrax poses global risks to people, livestock and wildlife. Popularly viewed as a frightening airborne agent of bioterrorism, the bacteria that causes anthrax infections naturally occurs in the soil on every continent and some islands. The maps, published today in Nature Microbiology, are the result of 15 years of data collection covering 70 countries compiled by Emerging Pathogens Institute associate research professor Jason Blackburn and his colleagues. Until now, the geographic distribution of anthrax has not been mapped globally. ‘Our main purpose was to describe where anthrax occurs, or is likely to occur, across the globe, and to illustrate sub-national areas where surveillance is necessary,’ Blackburn says. ‘Anthrax is a disease that affects both animals and humans, and it is most commonly associated with rural and agricultural communities which contend with it nearly worldwide. Our maps will help countries and health authorities focus on specific anthrax-prone areas to target control and surveillance’.”

Is Antibiotic Development Now the Road Less Traveled?
“Although attention has been focused on the use of genetically modified bacteriophages to fight a highly resistant infection in a young girl, the antibiotic pipeline is not just drying up…but dying. This isn’t news though; in fact, we’ve known about it for a while. It’s been decades since a novel antibiotic hit the market and, as antimicrobial resistance surges, the treatment options are becoming increasingly scarce.  Recent attention has been focused on the bankruptcy of the biotech company Achaogen. It’s likely you haven’t even heard of them, let alone know that they filed for bankruptcy a few weeks ago. The reason this bankruptcy is worrisome is that Achaogen’s antibiotic, plazomicin, was actually approved by the US Food and Drug Administration in June 2018 and, despite its efficacy against multidrug-resistant Enterobacteriaceae, it failed to keep the company afloat. The cost-prohibitive nature of antimicrobial research and development is all but ensuring that the pipeline for development is drying up. Not only does the Achaogen bankruptcy highlight the costly nature of antimicrobial development, but it’s even more worrisome that a company that was solely focused on such efforts couldn’t stay in business even with the financial push and support from the National Institutes of Health, the Biomedical Advanced Research and Development Authority (BARDA), and the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator (CARB-X).”

Stories You May Have Missed:

  • Creating Bacteria With a Synthetic Genome – “Scientists have created a living organism whose DNA is entirely human-made — perhaps a new form of life, experts said, and a milestone in the field of synthetic biology. Researchers at the University of Cambridge on Wednesday reported that they had rewritten the DNA of the bacteria Escherichia coli, fashioning a synthetic genome four times larger and far more complex than any previously created. The bacteria are alive, though unusually shaped and reproducing slowly. But their cells operate according to a new set of biological rules, producing familiar proteins with a reconstructed genetic code.”
  • Army Planning to Begin User Acceptance Testing of Malaria Drug Tafenoquine – “The U.S. Army Medical Research Acquisition Activity (USAMRAA) located at FT. Detrick, MD, has issued a solicitation outlining plans to conduct User Acceptance Testing for the malaria prophylactic drug (Tafenoquine) brand name Arakoda. The announcement (W81XWH-19-R-0052) supports sourcing of one commercial lot of ~120,000 tablets (7,500 packages) of Tafenoquine brand name Arakoda immediately, with options to procure up to 3 orders of 3,750 packages each.”






Pandora Report: 5.10.2019

Welcome to your weekly source for all things biodefense- Have you registered for the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security? The early registration discount has been extended to June 1st, so make sure you reserve your spot! The theme of this week’s biodefense news follows one of the most ancient diseases – plague.

Living with Plague- Lessons from the Soviet Union’s Antiplague System
Plague is one of those zoonotic diseases that has done some damage over the millennia and the Soviet Union is one that has worked to eradicate the disease. “During the 20th century, one of the most extensive plague-eradication efforts in recorded history was undertaken to enable large-scale changes in land use in the former Soviet Union (including vast areas of central Asia). Despite expending tremendous resources in its attempt to eradicate plague, the Soviet antiplague response gradually abandoned the goal of eradication in favor of plague control linked with developing basic knowledge of plague ecology. Drawing from this experience, we combine new gray-literature sources, historical and recent research, and fieldwork to outline best practices for the control of spillover from zoonoses while minimally disrupting wildlife ecosystems, and we briefly compare the Soviet case with that of endemic plague in the western United States.” The authors note that “living with emergent and reemergent zoonotic diseases—switching to control—opens wider possibilities for interrupting spillover while preserving natural ecosystems, encouraging adaptation to local conditions, and using technological tools judiciously and in a cost-effective way.” Looking for more information on the anti-plague system of the Soviet Union? Check out GMU biodefense professor and antiplague system guru Sonia Benouagrham-Gormley.

Schar School Security Studies Program Ranked No. 2 in Nation
What can we say, the Schar School is the place to be for security studies like biodefense! “The Schar School of Policy and Government’s “security studies” program is ranked No. 2 in the country according to the March 12, 2019 survey in U.S. News and World Report. While the ranking is for ‘security studies’ programs, that term encompasses three of the Schar School’s strengths:”

“We continue to do what we do well, which is deliver a classroom experience grounded in both theory and practice in the field,” Schar School dean Mark J. Rozell said. “Our program is made up of full-time faculty who are both scholars and practitioners. Students see that investment by the school in their success.”

Review of Books on the Anti-Vaccination Movement
Trying to make sense of the anti-vaccine movement? Check out this review on three books that address vaccines, the anxieties that follow them, and distrust in the whole process. These reviews provide detailed insight into the books and what they mean in the context of the challenges surrounding the anti-vaccination movement. “Several recent books by doctors, scientists, and journalists have delved further into the history and science of vaccines and immunity, and the anxieties that accompany them. In Calling the Shots: Why Parents Reject Vaccines, Jennifer Reich, a sociologist who has also written about child protective services, brings meticulousness and sensitivity to this emotional issue. One parent tells Reich that she lies about having vaccinated her children to avoid disapproval from pro-vaccine neighbors: ‘I think it’s to the point where we need to keep quiet about our health choices if we are not within a like-minded community’.”

Biocrimes and Misdemeanors – This Week in Virology Podcast
Check out the latest podcast from ASM on biocrimes with guest Dr. Jens Kuhn (who just so happens to be a lecturer at our summer workshop!). “Jens Kuhn returns to TWiV to explain Select Agents, Priority Pathogens, Australia List Pathogens, Risk Group Agents, biosafety, biosecurity, and biosurety.”

First Utilization of Genetically Modified Bacteriophage Used to Treat Resistant Infection
In a pretty astounding first, a British teenager has recovered from a considerable drug-resistant infection following treatment with a genetically modified virus. Patients with cystic fibrosis, like the young British girl, frequently battle resistant infections that often lead to death. Following a severe post-lung transplant infection, doctors tried a new treatment involving engineered bacteriophages to treat her drug-resistant Mycobacterium abscessus. “Spencer and her colleagues contacted Graham Hatfull, a professor of biological sciences at the University of Pittsburgh who specializes in phage research. Hatfull searched a collection of 15,000 phages he has assembled with his students. He identified one that appeared to be good at killing the bacterium, Mycobacterium abscessus, which was causing the girl’s infection. (As it turns out, the phage he identified, known as ‘Muddy,’ was discovered in a rotting eggplant.) Hatfull’s team also identified two other phages that could be useful, which they then genetically modified in a way they hoped would boost their ability to zero in on and kill the bacterium attacking the teen. ‘Using genetic approaches with genome engineering, we were able to assemble this collection of three phages that we could then combine in a cocktail to use for treatment. They not only infect, but kill efficiently,’ Hatfull says.”

Urgent Steps Are Needed Against Ebola
Things are only getting worse in the DRC as cases have surged past 1,500 and 100 new cases were reported in 5 days. While this isn’t the first time the DRC has faced Ebola, this is one that is proving a formidable force against international efforts. Dr. Tom Inglesby and Dr. Jennifer Nuzzo discuss the urgent actions needed to help prevent this outbreak from spreading out of control. “First, countries and international donors must provide the finances the DRC, WHO, and their partners need to contain this outbreak. WHO depends on countries and donors to respond to emergencies. On April 30, WHO Director Tedros Ghebreyesus said in a statement that ‘WHO and its partners cannot tackle these challenges without the international community stepping in to fill the sizeable funding gap.’ In the same statement, the WHO said that only half of the currently requested funds have been received, ‘which could lead to WHO and partners rolling back some activities precisely when they are most needed’.” Expansion of the vaccine supply is also critical, they note, as well as a large-scale vaccination campaign. “Second, new security strategies are needed to allow public health workers to contain the virus. Violence in the region is a central reason the epidemic continues to worsen despite broad containment efforts. The DRC and the UN peacekeeping force, known as MONUSCO, have not been able to control the violence enough to allow public health response activities to proceed without interruptions. Failing to develop a security strategy risks the possibility that Ebola could spread to neighboring countries, a situation that would greatly exacerbate Ebola’s human and economic costs and further erode security in the region.” The WHO has just released their plans to adapt a specific Ebola vaccine strategy to the DRC to account for insecurity and community feedback – you can read the release here.

GMU Biodefense Student Awarded ASIS National Capital Chapter Security Education Foundation Scholarship
Congrats to GMU Biodefense MS student Jessica Smrekar for securing the prestigious scholarship! Jessica notes that “This scholarship is awarded to those with academic excellence within the field of security. My work in biosecurity, both in academic and career, represents an underserved area of security that the Chapter recognizes as a vital part of the field. I will be graduating in May 2019 with my Master’s in Biodefense from George Mason University and I have used my academic opportunities to begin a career in biosecurity. Through my work, I have had the pleasure of working an internship within the Department of Health and Human Services Office of the Assistant Secretary of Preparedness and Response. My position was in the Office of Strategy, Policy, Planning and Requirements working on biosecurity policy development and implementation of National Biodefense Strategy goals. During the ceremony, I was delighted to hear that this was the first time the Chapter broke the rules and awarded not one, but two George Mason students with a scholarship. The President stated the board was extremely impressed with our submissions and academic work and it was a quick decision to make this novel decision. Impressed enough that after the ceremony, I was offered the chance to educate other chapter members on biosecurity and conduct a presentation of biosecurity at a future Chapter meeting. I am honored to say I will be presenting an introduction of biosecurity to the National Chapter of ASIS this coming fall and look forward to continue working within this organization.”

Stopping the Gaps in Epidemic Preparedness
“A more productive, integrated approach to research would encompass disciplines such as context-specific social science, clinical and data sciences, and genomics and involve pursuit of innovative study designs and improved regulatory pathways. If trials of diagnostics, drugs, and vaccines became routine parts of responses to epidemics, with open multiyear and multicountry protocols prepared in advance, we could prevent potential lifesaving tools from being left to gather dust on shelves. Effective prevention and response require strong public health systems that provide equitable, universal access to high-quality health care. Effective health care cannot be available if health care workers are not protected. In every outbreak, health care workers have died. Here, infection control and vaccines can make all the difference, allowing people to be treated without putting caregivers, nurses, doctors, and support staff at unacceptable risk.”

The Case of the Raw Marmot and Plague
A couple in Mongolia recently died of bubonic plague following consumption of a raw marmot in the pursuit of health benefits. “The ethnic Kazakh couple died in Bayan-Ulgii, Mongolia’s westernmost province bordering Russia and China. It is not clear what treatment they received, if any. The incident prompted local panic. The government ordered a quarantine for six days for the region, preventing scores of tourists from leaving the area. At least one aircraft was examined by health officials in contamination suits. After no new cases appeared by Monday, the quarantine was lifted.”

 8 Zoonotic Diseases Of Most Concern in the U.S. 
Speaking of zoonotic diseases… the CDC just released information on the eight zoonotic diseases shared between animals and people of most concern int he U.S. “‘Every year, tens of thousands of Americans get sick from diseases spread between animals and people. CDC’s One Health Office is collaborating with DOI, USDA, and other partners across the government to bring together disease detectives, laboratorians, physicians, and veterinarians to prevent those illnesses and protect the health of people, animals, and our environment,’ said Casey Barton Behravesh, M.S., D.V.M., Dr.P.H., director, One Health Office, CDC.” These diseases include zoonotic influenza, salmonellosis, West Nile virus, plague, emerging coronaviruses, rabies, brucellosis, and Lyme disease.

Stories You May Have Missed:

  • UV Light Disinfection: A New Infection Prevention Tool – “In the battle against health care-associated infections and emerging infections, hospitals and infection prevention programs are constantly looking for new ways to prevent the transmission of organisms. From alcohol-based hand sanitizers to the advent of electronic surveillance systems, technology has helped infection preventionists (IPs) compete with increasing biotechnology in medicine. One of these new technologies tackles a particularly hard area for infection control—the environment. Cleaning and disinfecting these environments, especially patient rooms, is an imperfect process prone to human error. Although we seek to do our best, the rapid pace of health care and patient care means turning over a room after discharge is often a matter of life and death. Unfortunately, along with the fast pace often comes mistakes and, ultimately, it’s exceedingly hard to clean and disinfect every possible item and surface within a patient’s room. A new technology, though, is harnessing UV light to clean those hard-to-reach areas and even ceilings.”
  • Support the JASON Science-Advisory Group“For nearly 60 years, the scientists on the panel — the Jasons — have provided the US government with unvarnished, independent advice on matters ranging from classified military developments and nuclear weapons to artificial intelligence and global warming. Its members are a roll call of elite and illustrious scientists. The Pentagon said its decision was economic: it was cancelling all but one study, on electronic warfare, and it made no financial sense to renew the full contract. This decision would have effectively ended the group’s work — but then, on 25 April, it received a last-minute reprieve. The National Nuclear Security Administration (NNSA) — a branch of the energy department that maintains the country’s nuclear-weapons arsenal — offered new funding for the Jasons. This summer, the group will now be able to hammer out around a dozen studies for federal agencies, including the NNSA. But the new contract runs only until 31 January 2020; previous DOD contracts lasted for five years.”


Pandora Report: 5.3.2019

Happy Friday and welcome to May! To start the month off right, here’s the download of the Max Brooks graphic novel, Germ Warfare: A Very Graphic History. 

Summer Workshop – Discount Extended!
We’re excited to announce that the early registration discount for the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security has been extended to June 1st. In this 3.5 day workshop, you’ll hear from experts in the field on virology, public health response, biosecurity, vaccine development, synthetic biology, and so much more. Make sure to register prior to June 1st for an early discount and if you’re registering as a returning student, GMU alum/student/faculty, or part of a large group, you’re eligible for an additional discount. Join us in July for this exciting biodefense event!

U.N. Issues Warning on Growing Antimicrobial Resistance
In a new report from the United Nations, the threat of antimicrobial resistance is front and center. Citing a World Bank simulation that notes deaths due to AMR could rise to 10 million by 2050 if no action is taken, the U.N. highlighted a desperate need to innovate, invest, and accelerate progress in countries. “This is a silent tsunami,” said Dr. Haileyesus Getahun, director of the U.N. Interagency Coordination Group on Antimicrobial Resistance, which spent two years working on the report. ‘We are not seeing the political momentum we’ve seen in other public health emergencies, but if we don’t act now, antimicrobial resistance will have a disastrous impact within a generation’.” “Health officials are struggling to understand the scope of the problem because many countries are ill-equipped to monitor drug-resistant infections. In a survey the United Nations conducted for the report, 39 of 146 nations were unable to provide data on the use of antimicrobials in animals, which experts say is a major driver of resistance in humans as resistant bacteria get transferred to people through contaminated food and water. ‘We are flying pretty blind and working hard to get some clear vision,’ said Sally Davies, the chief medical officer of England and a leader of the United Nations panel. As a first step, the report calls on member states of the United Nations to create national stewardship plans to reduce the unnecessary use of antimicrobials.”

Measles Updates and Why Anti-vaxxers Should Face Isolation and Fines
The U.S. topped 700 measles cases this week as 78 cases were reported in the last week. “Thirteen outbreaks—defined as three more related cases—have now been reported in 2019 so far, and account for 94% of all cases. Nine outbreaks are currently active, up from six reported the previous week. The CDC today spelled out all the details and implications of this year’s surge in cases in an early report in Morbidity and Mortality Weekly Report (MMWR) and in its weekly case update.” Juliette Kayyem is taking a stand on anti-vaxxers, noting that they are dangerous and should face isolation, fines, and arrests. “It is time we stop viewing the anti-vax movement and its adherents’ responsibility for the measles outbreak as a public health problem. With more than 700 reported cases confirmed in 22 states, it is now a public safety crisis, and the tools of public safety — arrests, fines, isolation — are absolutely necessary. The initial steps we have taken are essential: prohibit non-vaccinated children from public spaces, including schools; promote educational efforts; and, in extreme cases, force isolation on pockets of populations that might have been exposed to the outbreak, as is happening now in the University of California system. But these efforts impact the children who might have been put at risk by the decision of individuals not to vaccinate. Viewed through the lens of public safety, it is the parents who should be punished. Why not make them pay for the harms they are causing?Fines for the increased public safety burdens put on these communities by a few ought not to be the responsibility of all. In many states, when hikers ignore warnings that certain trails are too dangerous and then have to be rescued, the fees for the rescue must be paid by the hikers. It’s a fine for making a self-centered decision that placed an unreasonable burden on a larger community. Measles should be no different.”

Are Frontline Hospitals Ready for a Patient With Ebola?
GMU biodefense doctoral student and infection preventionist Saskia Popescu, discusses the gaps in frontline healthcare facilities and what this means for bioprpearedness efforts. “Now fast forward to 2019…how prepared are these frontline facilities today? Unlike the treatment centers, they do not receive funding or undergo assessments of their biopreparedness and frankly, there are a lot of competing interests for hospital administrators to invest in the costly PPE for Ebola. Although some hospital systems have run drills on their preparedness for high-consequence pathogens, they are also typically the systems that maintain a heightened level of readiness, and for most of the other facilities it is less likely Ebola or other special pathogens are getting much attention. Investigators sampled 5 major frontline hospitals in Maricopa County, Arizona, to perform a gap analysis in how their response would be for a patient with Ebola or another high-consequence pathogen. From entering the hospital through the emergency department to cleansing and disinfecting protocols, the investigators evaluated whether health care workers could still answer the questions that were heavily drilled into these hospitals in 2014.”

Trends in Foodborne Pathogen Transmission in the U.S.
Just how much foodborne illness are we seeing in the United States? The CDC just released a new study in their MMWR regarding surveillance from 10 sites across the U.S. from 2015-2018. “During 2018, FoodNet identified 25,606 cases of infection, 5,893 hospitalizations, and 120 deaths. The incidence of infection (per 100,000 population) was highest for Campylobacter (19.5) and Salmonella (18.3), followed by STEC (5.9), Shigella (4.9), Vibrio (1.1), Yersinia (0.9), Cyclospora (0.7), and Listeria (0.3). Compared with 2015–2017, the incidence significantly increased for Cyclospora (399%), Vibrio (109%), Yersinia (58%), STEC (26%), Campylobacter(12%), and Salmonella (9%). The number of bacterial infections diagnosed by CIDT (with or without reflex culture§) increased 65% in 2018 compared with the average annual number diagnosed during 2015–2017; the increase ranged from 29% for STEC to 311% for Vibrio. In 2018, the percentage of infections diagnosed by DNA-based syndrome panels was highest for Yersinia (68%) and Cyclospora (67%), followed by STEC (55%), Vibrio (53%), Shigella(48%), Campylobacter (43%), Salmonella (33%), and was lowest for Listeria (2%).”

The Future of the SNS
While most of us know of the Strategic National Stockpile (SNS), for much of the population, this critical aspect of preparedness and biodefense is likely an unknown. A new article addresses what the SNS is and its future in biodefense. “Consequently, one of the most surprising features about the stockpile is that in all likelihood, it is probably incomplete. The reason for this is that although the stockpile includes what are presumed to be the best medical countermeasures for a broad range of potential biothreats—we don’t know the exact inventory because the identity of the contents are closely held —there is an even broader range of potential biothreat agents that an adversary could use in an attack. And stockpiling countermeasures for every conceivable individual agent is currently not feasible because countermeasures for some biothreat agents do not even exist yet—and even if they did, the continuous maintenance of copious countermeasures may not be logistically or financially feasible. There is also the possibility that an adversary could select or engineer an agent that is simply resistant to all-known medications.”

Ebola in the DRC- What’s the Latest News?
Officials from the WHO recently visited the frontlines of the Ebola outbreak in the DRC. Both WHO Director-General Tedros Adhanom Ghebreyesus and WHO Regional Director for Africa Matshidiso Moeti visited Butembo, following deadly attacks and 14 new cases. “In a statement, the two said they were profoundly worried about the situation and acknowledged that recent surges in infections are the result of setbacks each time the response sustains violent attacks. Most of the response activities—such as community engagement, vaccination, and case investigation—have restarted following a slowdown after the attacks that killed Mouzoko and injured two others, the WHO said. It notes, however, that the torrent of cases in recent weeks is further straining resources.” As the situation worsens in the DRC, financial concerns are growing as only half of the response budget is funded. “In a statement issued 30 April 2019, WHO Director-General Dr. Tedros Adhanom Ghebreyesus expressed his worries about handling increasing cases counts in a volatile ground situation while under-funded. ‘We are entering a phase where we will need major shifts in the response,” said Dr. Tedros. WHO and partners cannot tackle these challenges without the international community stepping in to fill the sizeable funding gap.’ Dr. Tedros made these remarks during a WHO delegation visit to Butembo, the site of the 19 April killing of WHO epidemiologist Dr. Richard Mouzoko by armed men while he and colleagues were working on the Ebola response.”

Rapid Response Teams- 10 Years of Collaborating on Public Health Emergencies
“In 2008, to enable faster, more efficient responses to emergencies, the FDA launched a network of state-based Rapid Response Teams (RRT), comprised of multi-agency, multi-disciplinary teams that operate by the principles of the Incident Command System/National Incident Management System to respond to human and animal food emergencies. In an emergency, the Rapid Response Teams coordinate efforts to align the response activities of agencies that may have overlapping jurisdiction to prevent harm to consumers as quickly as possible. These teams have become valued partners in responding to outbreaks from contaminated human and animal foods, conducting large-scale recalls, and ensuring availability of safe foods during a natural disaster. The FDA can respond more rapidly during an emergency by leveraging the relationships and resources with local, state, and federal partners for the common public health goals we share.”

Meet the Virus Hunters
In the face of this mounting Ebola outbreak in the DRC, Bill Gates has written about the “real-life Sherlock Holmes who helped discover Ebola” and the response team (RST) that helped control the outbreak. “But identifying a virus on a microscope is only the first of many steps to stopping an outbreak. So, with no real idea of what he was up against, Peter headed to Zaire to hunt for patient zero. He and his colleagues drove from village to village in a Land Rover, collecting information about who was sick and where they had been before symptoms appeared. Peter’s experience with Ebola was just the beginning of a long career fighting infectious disease. He was one of the first microbiologists to study AIDS, and in 1995, he became the founding executive director of UNAIDS. During his 13-year tenure, he coordinated the global response to HIV/AIDS through the discovery of the first treatments for the disease and the peak of the pandemic. After a brief stint at the Imperial College London and as a fellow with our foundation, he became the director of the London School of Hygiene and Tropical Medicine where he still teaches today.” “In just a little more than two years since it was created, the RST has already assisted in controlling 11 outbreaks in seven countries. The team has deployed to scenarios ranging from a diphtheria outbreak at a Rohingya refugee camp in Bangladesh to a plague flareup (yes, that plague) in Madagascar. Here’s how the RST works: as soon it becomes clear that an outbreak is underway, the local government (or, in rare cases, the WHO) requests their help. Not every team member is needed for every outbreak—sometimes you need an epidemiologist and a data scientist but not a microbiologist—so the first step is to identify who needs to go. The chosen team then has 48 hours to get their visas squared away, pack up any special equipment, and get to the airport for their flight to the outbreak zone.”

Beyond the Biocontainment Unit: Improving Pathogen Preparedness for Health Workers
“These specialized designations within hospitals have allowed for 10 Regional Ebola and Other Special Pathogen Treatment Centers (RESPTCs) that not only work to enhance preparedness for high-consequence diseases, but have also taught us some critical lessons and provided novel insight into what this level of preparedness means for hospitals.  A recent article published in Health Security focused on the impact that the creation of the BioContainment Unit (BCU) at Johns Hopkins Medical Center brought to infection prevention, preparedness, and evening nursing. The investigators found that beyond ensuring they could care for multiple patients with high-consequence pathogens, the BCU supported institutional efforts including research, educational training, and strengthening infection prevention practices. The BCU also facilitated preparedness networks and collaborative efforts. Within their article, the investigators pointed to several specific examples of how the hospital’s investment in the BCU impacted other facets of health care efforts.”

Stories You May Have Missed:

  • Dr. Frances Kelsey vs. Chemie Grünenthal – “In 1960, Frances Kelsey was a recently appointed medical reviewer at the U.S. Food and Drug Administration. The new drug application (NDA) for Kevadon, or thalidomide as it is better known, was her second file. ‘They gave it to me because they thought it would be an easy one to start on,’ she said. ‘As it turned out, it wasn’t all that easy.’ The applicant was William S. Merrell Inc. of Cincinnati, an American pharmaceutical company with plans to manufacture thalidomide under license from Chemie Grünenthal, a family-owned West German company. As it turned out, Grünenthal had a record of rushing bad and inadequately tested drugs to market.”