Category: Pandora Report

Workshop on Pandemics, Bioterrorism, & Health Security – From Anthrax to Zika
The Summer Workshop on Pandemics, Bioterrorism, and Health Security is next week and if you’re not able to attend, make sure to check out our Twitter @PandoraReport and look for a recap in next week’s newsletter. Fair warning though- after you’ve read about it, you’ll want to attend in 2019!

Biodefense Scholars – Meet the Faces of GMU’s Biodefense: Greg & Saskia
If you’ve ever talked to one of our Schar biodefense graduate students, you know one thing for certain – they’re passionate about the field. This week, we’re excited to show off two of our biodefense doctoral students – Saskia and Greg. “Greg Witt is a fourth-generation engineer who, just three years after graduating with a bachelor’s degree from Penn State, worked his way up to being the lead reactor systems engineer on new nuclear plants for Westinghouse Electric Company in Pittsburgh.” That’s right, Greg came from the world of nuclear reactors and if you’re wondering how that works in a program that focuses on catastrophic biological incidents, program director Gregory Koblentz sums it up like this – “Greg’s experience working at Westinghouse as a nuclear systems engineer might seem to make him an odd fit for the Biodefense Program, but biodefense is a highly interdisciplinary field, so he fits right in.” Next, there’s Saskia Popescu, who is an “epidemiologist working to control infections in Phoenix-area pediatric hospitals. Popescu still volunteers there when she’s at home in Arizona, but her career is on hold as she works on her doctoral dissertation in the Biodefense Program in the Schar School of Policy and Government at George Mason University, where she’s also a graduate research assistant.” Saskia’s dissertation work focuses on healthcare utilization of infection control and how that might leave us vulnerable when it comes to the next outbreak. Dr Koblentz pointed out that “the continuing threat of emerging infectious diseases and rise of antimicrobial resistance around the world means we need people like Saskia who can skillfully bridge the gap between science and policy now more than ever.” These are just two examples of the passionate students at Schar Biodefense – what can we say, the biodefense nerdom is strong at GMU!

AAAS Science Diplomacy & Leadership Workshop 2018                        GMU Biodefense MS student Christopher Lien recently participated in the Science Diplomacy & Leadership Workshop hosted by the American Academy for the Advancement of Science, and his account of the five-day experience will get you thinking about the complexities of international science cooperation. The first day highlighted the three main questions the workshop would address – how does science inform diplomacy, how does diplomacy inform science, and what does science in diplomacy look like today? Lien noted that “Aligning educational policy with science, gaining talent from abroad, facilitating networking across the diaspora communities – these are some of the tasks the scientists are working toward.” In his recap, Lien discusses that following a simulation game regarding international cooperation and science diplomacy, “it became ever clearer to the group that mixing science with diplomacy, and vice-versa, is no easy feat – it takes tactful negotiation, the will to make concessions, and a mutual understanding to bring about meaningful and effective results.”

The Digitization of Biology: Understanding the New Risks and Implications for Governance                                                                          Email viruses? We’re not talking about the spam ones, but rather the ability to send genomes of pathogens via email. If you’re confused, GMU biodefense doctoral student Yong-Bee Lim (I told you they were a passionate group!), Charles Lutes, Diana DiEullis, and Dr. Natasha Bajema, from the WBD Center are here to help clarify with their latest researcher paper – The Digitization of Biology: Understanding the New Risks and Implications for Governance. While everyone is focusing on CRISPR, this team led by Dr. Bajema, sought to address an issue we may be neglecting – the digitization of biology. “The volume of digitized genomic data is on the rise. Over the past several years, scientists have responded to dramatic reductions in the cost of DNA sequencing and synthesis, computing power, and data storage by sequencing greater numbers of gene sequences and the genomes of living organisms and digitizing this information for storage in online databases and analysis on computers. To simplify the creation and modification of living organisms, scientists are identifying standard, interchangeable DNA sequences that code for certain functions, and are building online catalogs to make this information available.” The paper discusses the rapid movement of biological information between the physical and digital worlds and how this exacerbates traditional security risk analysis with select agents. Within the paper, the authors discuss data storage, the information life cycle, and implications for governance, noting that “Developing effective governance to simultaneously manage the risks and promote the opportunities of the life sciences is a difficult undertaking. To address emergent genomic data issues, policymakers must strike a balance between two factors: the perceived risks of genomic data and the incentives to share and use genomic data to foster innovation.”

NTI | bio Competition
Looking to help improve global health security? NTI | bio and the Next Generation Global Health Security Network just announced the 2018 competition for those looking to make a difference. “The NTI | bio program and the Next Generation Global Health Security Network announce the 2018 Next Generation for Biosecurity Competition. This year, NTI | bio will invest up to $15,000 to allow the winning team to implement their proposal with mentorship from experts in the field. Team members also will attend the 5th Annual High Level Global Health Security Agenda (GHSA) Ministerial in Bali, Indonesia on November 5-6, where they will present their proposal to health security leaders from around the world. Each 2018 Next Generation for Biosecurity Competition team can include up to three people and should propose either: (1) develop training and networking opportunities for professionals of all levels to develop an interest and further proficiency in the biosecurity and biosafety fields; or (2) an educational outreach project to raise public awareness around the importance of biosecurity and biosafety. Each team is also asked to engage one or more experts in biosecurity and/or biosafety to assist in implementing their project proposal.”

Health Security Downgraded at the White House
A new commentary from the Center for Strategic & International Studies is drawing attention to the diminishing focus that health security is getting within the Trump Administration. Pointing to the lack of representation within the NSC regarding health security and the dismantling of the global health security and biothreats directorate, J. Stephen Morrison noted that “The decision was simultaneously a slap at Obama’s legacy of elevating health security, investing $1 billion in building capacity to detect and respond to dangerous outbreaks in weak states, under the auspices of the international alliance, the Global Health Security Agenda. With the directorate gone, Trump could be Trump. No longer in his midst is a senior official who might argue on public health grounds for a regular flow of health workers and travelers in the event of another outbreak like Ebola. How big will the price be for eliminating the White House global health security and biothreats directorate?”

Startup Does Gene Editing In-House
For those looking to do in-house gene editing, the lack of experience and laboratory space can be a hindrance. A new company is looking to change that. Hoping to make gene editing and CRISPR more accessible, Synthego will send people a CRISPR-modified cell via mail. Buyers have to provide credentials to show their affiliation with a university or institution, but this removes a lot of the tacit barriers. “For researchers who want to do their own gene editing, the company also makes kits to simplify that. A researcher chooses the gene they want to knock out, and the startup uses its own software and automated factory to make one step in the process–the synthetic guide RNAs that direct a protein to the right place in DNA to make a cut. For those who don’t want to edit cells, Synthego’s scientists use the same guide RNAs to quickly perform edits themselves. The company works on human cells, rather than plant or animal cells, for researchers who want to develop cures and treatments for disease, and in the future, potentially develop ways to prevent disease.”

Novichok Exposure
Sadly, one of the two people exposed to the nerve agent, died on July 8^th. “’We have seen a small but significant improvement in the condition of Charlie Rowley. He is in a critical but stable condition, and is now conscious,’ said Lorna Wilkinson, Director of Nursing at Salisbury District Hospital. ‘While this is welcome news, clearly we are not out of the woods yet. Charlie is still very unwell and will continue to require specialist, round-the-clock care here at Salisbury District Hospital.’ Russian double agent Sergei Skripal and his daughter Yulia fell ill after being targeted with the nerve agent in Salisbury on 4 March. Scientists at the UK’s Defence Science and Technology Laboratory Porton Down confirmed on 4 July that Sturgess and Rowley had been exposed to novichok.”

 How Anti-Vaxxers Might Bring Back Hendra
Hendra virus is an ugly disease and one that can brutally take down humans and horses alike. The good news is that we have a vaccine for horses to prevent the transmission. Unfortunately, the anti-vaxxer movement has extended to veterinary vaccines now, which leaves many to worry that this BSL-4 virus could pose a larger public health threat. Starting with the history of the vaccine for horses, this latest article provides a detailed account of the disease and the current issues when getting horse owners to vaccinate, especially in the era of anti-vaxxer belief in vaccine-induced autism. “Similarly inflated concerns have begun to turn some pet owners away from mainstream veterinary medicine. An article last year in the Brooklyn Paper quoted a vet who had an owner refuse to vaccinate her dog for fear it would develop autism. ‘We’ve never diagnosed autism in a dog,’ the vet said. ‘I don’t think you could.’ No anti-vaccine movement among animal owners has ever gained quite as much traction—or posed such a threat—as the one surrounding the Hendra cases in Australia. Initially, Australian horse owners were reluctant to vaccinate simply because of the cost—about $100 every six months, a significant burden for breeders and rural owners with dozens of animals. But when horse owners began to feel that they were being forced to do something that might just harm the animals they loved, a full-fledged anti-Hendra-vaccine movement blossomed.”

Stories You May Have Missed:

• Rescued Thai Soccer Team in Quarantine – “In addition to treating the boys for potential dehydration, malnutrition and oxygen deprivation, their doctors also plan to closely monitor them for symptoms of diseases that may have been transmitted by animals living in the cave system. The boys and their family members have been told to watch for symptoms such as headache, nausea, muscle pain or difficulty breathing, the reports added.”
• Post-Campylobacter Infection Guillain Barre Syndrome– A new study has reported the incidence of GBS following campylobacter infection. “Guillain Barré syndrome (GBS), which is triggered by autoantibodies produced in response to antigenic stimuli such as certain infections and vaccinations, is the most common cause of acute flaccid paralysis worldwide. Campylobacter, the most common bacterial enteric infection in the USA, is reported to be the most commonly diagnosed antecedent of GBS, yet little information is available about the risk of post-Campylobacter GBS.”

Happy Friday! 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 July 1st, so don’t miss out on the chance to attend at a discounted rate. Before we dispense our weekly dose of all things biodefense, just a friendly reminder that the Pandora Report will be on hiatus next week, but will return the week of June 15th.

Ebola Outbreak in DRC: Updates
Community resistance and mistrust have been reported in the DRC as response efforts and vaccination are underway. Similar issues were also seen during the 2014 West Africa outbreak. Thankfully, cases are reportedly dropping following additional testing capacity. The latest WHO situation report announced a total of 54 cases and 24 deaths, with a case fatality rate of 46.3%. International response to the outbreak is being evaluated and the role of the United States is reportedly less dominant, which have many pointing to the lack of a NSC point person. “The United States has played much less prominent role in the latest Ebola outbreak, raising some questions about the nation’s commitment to global health security but also reflecting that the global capacity to respond to such an outbreak has become much more robust following West Africa’s massive outbreak, the Kaiser Family Foundation (KFF) said today in a policy brief.” The KFF report also notes that “The Trump Administration had installed a well-known global health expert, Admiral Tim Ziemer, as the lead on biosecurity and global health at the National Security Council (NSC) in 2017, but his position was recently eliminated as part of an overall reshuffling of NSC staff under the leadership of new National Security Advisor John Bolton; the move was coincidentally announced the same week the DRC Ebola outbreak was declared. Without this position, other NSC staff have been tapped to lead the U.S. response to the outbreak but have not made any public statements, and no public statements have been made by the current CDC Director. Whether and how to designate a point person on outbreaks is a debate that predates the DRC Ebola outbreak, but the ongoing outbreak has added some urgency to this discussion.” As the deployment of the vaccine is ongoing, many are wondering – what took so long? Schar biodefense PhD alum Christopher K. Brown discusses the barriers to vaccine development and deployment to the public in Africa. Brown notes that”Vaccine development is a complex process. It involves both public and private partners and requires that a variety of funding issues be considered. Competing market forces influence how a vaccine project advances—from discovery to laboratory and clinical trials, and later to registration, regulatory approval, and large-scale manufacturing and implementation.” Further more, Brown highlights that “even comparing Ebola to other diseases that disproportionately affect African countries, it is hard to argue that Ebola is, or ever has been, the best disease on which to focus vaccine research and development resources.”

 GAO Report: Funding and Performance of Key Preparedness and Capacity-Building Programs
The latest GAO report is evaluating the preparedness efforts of HHS to protect the U.S. against infectious disease threats. “Over a 15-year period, HHS awarded about $3 billion to states and others to respond to specific disease threats, such as Zika, Ebola, and H1N1 pandemic influenza. HHS awarded an additional $18 billion for more general public health preparedness and capacity-building activities, such as getting ready for infectious disease threats and terrorist events. We assessed preparedness efforts of states and others and found mixed results. For example, most responder protection and coordination efforts met goals, while efforts in other areas were less consistent.” The GAO report assessed three major preparedness and capacity-building programs within HHS – Epidemiology and Laboratory Capacity for Infectious Diseases (ELC), Hospital Preparedness Program (HPP), and Public Health Emergency Preparedness (PHEP). The preparedness capacity areas were electronic lab reporting, epidemiology capacity, laboratory capacity, and responder protection. “The majority of awardees (states and other jurisdictions) that reported on performance measures in the responder protection area met all performance targets in this area. However, awardee performance in the other three preparedness capacity areas was mixed.”

Economic Burden of Seasonal Flu
Need more reason to get your seasonal flu shot? A new study assessed the economic burden of seasonal flu in the United States through health outcome rates from 2015. The results? “The estimated average annual total economic burden of influenza to the healthcare system and society was $11.2 billion ($6.3–$25.3 billion). Direct medical costs were estimated to be $3.2 billion ($1.5–$11.7 billion) and indirect costs $8.0 billion ($4.8–$13.6 billion). These total costs were based on the estimated average numbers of (1) ill-non medically attended patients (21.6 million), (2) office-based outpatient visits (3.7 million), (3) emergency department visit (0.65 million) (4) hospitalizations (247.0 thousand), (5) deaths (36.3 thousand) and (6) days of productivity lost (20.1 million).” Not surprisingly, seasonal flu is responsible for considerable economic burden, on top of morbidity and mortality within the United States. Just another reason to get your flu shot and encourage others to do the same.

Insufficient Infection Prevention Staffing in Healthcare
A new study finds that hospital infection prevention and control programs are woefully understaffed in the United States. Schar Biodefense PhD student and infection preventionist Saskia Popescu, discusses why this is problematic, not just for healthcare-associated infections, but ultimately hospital preparedness for infectious disease threats. “The 2014 Ebola cluster in Dallas, Texas, underscored the importance of infection prevention practices and preparedness in health care, which adds another layer of complexities to health care programs. Infection preventionists (IPs) who make up the back-bone of these teams are responsible for a range of duties that include surveillance and investigation of health care-associated infections, environment of care rounding, national reporting for quality metrics, isolation rounding, communicable disease reporting, and more.”

CRISPR – Could It Make Jurassic World?
The latest Jurassic Park movie, Jurassic World, is being released soon, and within this installment lurks a genetically modified dinosaur. But just how realistic is it for scientists to bring back an extinct animal…or modify one? “The idea of resurrecting extinct creatures using CRISPR has been discussed at length since the technology was developed. These conversations have largely focussed on the woolly mammoth, which last roamed the Earth 3,300 years ago. In 2015 a team of researchers working at Harvard University took a significant step toward the creation of a creature that would, on an initial approximation, look like a woolly mammoth – a woolly mammoth 2.0 of sorts. Researchers have clearly not yet triggered the live birth of a woolly mammoth, but we have already seen the birth of a living creature previously declared extinct. The Pyrenean ibex, or bucardo goat, was once found in the mountains of northern Spain. The last ever bucardo, affectionately named Celia, died in the year 2000.”

DPRK-U.S. Summit: Back On
The summit between the U.S. and DPRK is back on and is scheduled for June 12th in Singapore. “‘The key outcome of this meeting is to specify what the U.S. and North Korea mean by ‘denuclearization’ and if there is any overlap between these definitions,’ said Gregory Koblentz, associate professor at the Schar School of Policy and Government at George Mason University. ‘If not, then summit still in doubt’.” President Trump is reportedly looking forward to the summit, but many are anxious to see the outcome of such a meeting.

Stories You May Have Missed:

• Hot Temperatures & Antibiotic Resistance – A “new paper in Nature Climate Change that explores the role that climate and other factors play in the distribution of antibiotic resistance in the United States. The study, conducted by researchers with the University of Toronto, Harvard Medical School, and Boston Children’s Hospital, shows that increasing local temperatures are associated with higher levels of antibiotic resistance in three common bacterial pathogens—Escherichia coli, Klebsiella pneumoniae,and Staphylococcus aureus. The researchers also found that higher population densities and antibiotic prescribing rates are associated with higher rates of drug resistance.”
• Netflix Zombie Movie Cargo – Looking for a new zombie summer flick? Netflix has just released a new one that offers an interesting twist on the struggle to survive. “Written by Yolanda Ramke and directed by Ramke and Ben Howling, based on their 2013 short film of the same name, Cargo takes place in a world where a pandemic has decimated the population. Once infected, people have 48 hours before they turn into bloodthirsty maniacs. The government has helpfully issued emergency packets to the populations, which include a stylish watch with a 48-hour countdown mode, and a DIY suicide kit.”

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

Ebola Vaccine Deployment in DRC and Nipah Virus Takes Hold in India 
The Ebola vaccine has been deployed and many are holding their breath to see if not only this new tool works, but if lessons were truly learned from the last outbreak. As of May 21st, there were a totally of 58 cases, including 27 deaths. 28 of these cases were confirmed and 21 were probable. So far, five healthcare workers have been infected, with four of them confirmed and two deaths. “Currently, WHO considers the public health risk to be very high at the national level due to the serious nature of the disease, insufficient epidemiological information and the delay in the detection of initial cases, which makes it difficult to assess the magnitude and geographical extent of the outbreak. The confirmed case in Mbandaka, a large urban centre located on major national and international river, with road and air transport axes, increases the risk both of local propagation and further spread within DRC and to neighbouring countries. The risk at the regional level is therefore considered high. At the global level, the risk is currently considered low.” In response to the outbreak spreading to a larger, metropolitan area, many are wondering what cities nearby should start preparing for potential cases. Such concern is especially pertinent as it was reported that three infected patients fled an isolation ward and posed a potential threat for disease transmission. In efforts to identify potential areas at an increased risk due to travel, researchers used “flight data from the airports in Mbandaka, Kinshasa, and Brazzaville–those nearest Bikoro–EcoHealth Alliance has found the following cities to be most closely connected to the point of origin of the ongoing Ebola outbreak – Pointe-Noire, Republic of Congo, Adidas Ababa, Ethiopia, Brazzaville, DRC, etc.” Border closure is also frequently discussed during outbreaks, but realistically, how would it work? “Researchers who have studied earlier border-crossing outbreaks say the checks amount to little more than political theater. They do little to curb the spread of a disease, but they are likely to apprehend uninfected travelers, slow down commerce, and most importantly, impede the delivery of relief supplies. In a worst-case scenario, health stops may cause infected people to sneak to border crossings where checks haven’t been set up, spreading disease as they go.”  Money is starting to trickle in as the World Bank, the United States, and Germany, have contributed a joint $25 million to the DRC outbreak. The WHO is reportedly working with nine neighboring countries of the DRC to help contain the outbreak and prevent its spread. While all eyes have been on this outbreak, many are trying to draw attention to a very serious outbreak of Nipah virus in India. 10 people have died so far in the outbreak, including a nurse who was treating patients. “The first cases were reported Saturday in a family from Kozhikode, and then India’s Ministry of Health and Family Welfare and the World Health Organization were contacted, Vijayan’s office said Monday via Twitter. Two brothers in their late 20s and their aunt, 50, died from the virus, while their father, 56, remains on life support.” These outbreaks will surely be a topic of conversation during this week’s World Health Assembly at the WHO.

Worrisome White House Actions Surrounding Global Health Security
As Ebola burns through the DRC and India struggles with Nipah virus, the ability (or increasing inability?) for the U.S. to respond to such biological threats is becoming a seriously topic of concern. Within the span of a few days, the Ebola outbreak was declared in the DRC, the White House eliminated the Office of Global Health Security at the NSC, and the White House requested to rescind the $252 million in leftover Ebola response funds. These are just a handful of the the most recent red-flags for the Trump administration and its worrisome approach to health security. Kenneth W. Bernard asks “Has our national security leadership forgotten that, in 2001, anthrax-laced letters killed five and sickened 17 others in multiple states? Or that in 2014, 11 people were treated for Ebola in the United States, resulting in two deaths and widespread panic that nearly shut down the city of Dallas? Or that smallpox killed more people in the 20th century than all the wars of that century combined?” The Editorial Review Board at the New York Times has also cited concerns surrounding the amnesiac approach to Ebola the administration has taken– “The Trump administration has also failed to seek renewed funding from Congress for a global health security initiative begun after the 2014 epidemic. The goal of that initiative was to help high-risk countries prepare for future disease outbreaks in order to prevent pandemics. The White House has touted the success of those efforts but has done nothing to keep them going. And as funds have dried up, the C.D.C. has been forced to scale back or discontinue programs in some of the most vulnerable countries.”

WHO and World Bank Group Team Up for Global Health Security
In response the global threat of infectious diseases, the WHO and Work Bank Group have launched a new monitoring/reporting mechanism. “WHO Director-General Dr Tedros Adhanom Ghebreyesus and World Bank Group President Dr Jim Yong Kim co-led the creation of the Global Preparedness Monitoring Board, launched today on the margins of the 71^st Session of the World Health Assembly. The Board will be co-chaired by Dr Gro Harlem Brundtland, former Prime Minister of Norway and former WHO Director-General, and Mr Elhadj As Sy, Secretary General of the International Federation of the Red Cross and Red Crescent Societies. It will include political leaders, heads of UN agencies and world-class health experts, serving in their individual, independent capacities. ‘The ongoing Ebola outbreak in the Democratic Republic of the Congo is a stark reminder that outbreaks can happen anywhere, at any time,’ said Dr Tedros. ‘Part of being prepared is having a means of assessing progress made at all levels, by all actors, identifying gaps, including in financing, and making sure all actors are working together, pulling in the same direction. I’m proud of the work we’ve done together with the World Bank Group to establish the Global Preparedness Monitoring Board, and delighted that it will be led by such exceptional global health leaders,’ he added.”

Summer Workshop – Global Health Security
Don’t miss the chance to discuss these very issues at the Schar Summer Workshop on Pandemics, Bioterrorism, and Global Health Security. This workshop will include frank discussions with professionals and experts regarding the challenges of global health security, the current Ebola outbreak and vaccine, developing MCM, the democratization of science, and more. The early registration discount will end June 1st, so make sure you register soon!

Pandemic Preparedness in the Wake of Ebola -CSIS Symposium
Schar Biodefense graduate student Stephen Taylor recently attended the Center for Strategic & International Studies (CSIS) event on May 17th, in which global health security leaders from around the world discussed pandemic preparedness. Taylor notes, “Dr. Morrison and Dr. Borio discussed the importance of lessons learned during the 2014-2016 West African Ebola pandemic to global health security. In Nigeria, for instance, where Ebola containment efforts were successful, investments in detection and response capacities made for the Nigerian polio eradication program were instrumental in stopping Ebola. Surveillance systems and trained health care workers were embedded at the community level and field epidemiologists were ready to be deployed.”

 The Smithsonian’s “Outbreak: Epidemics in a Connected World”
Biodefense graduate student Zach Goble is reporting out on the newly opened exhibit at the Smithsonian’s National History Museum of Natural History. The museum “launched Outbreak: Epidemics in a Connected World, a new exhibit highlighting the impact infectious diseases have around the globe. The launching of this exhibit could not be more timely on the 100th anniversary of the 1918 influenza pandemic that shook the world. To officially announce and celebrate the opening of this new exhibit, the American Society for Microbiology (ASM), National Institute of Allergy and Infectious Diseases (NIAID), the National Center for Immunization and Respiratory Diseases (NCIRD) at the Centers for Disease Control and Prevention (CDC), the American Society of Virology (ASV), and Research America all partnered together to brief the public on infectious diseases and the vaccines that stop them in their tracks”

NACCHO Radiation Readiness Twitter Chat
Don’t miss out on this June 5th chat to increase awareness of radiation preparedness. “The NACCHO Twitter handle (@NACCHOalerts) will be hosting the chat using #RadReady. The target audience for the Twitter chat is federal, state, and local health department representatives hoping to learn more about radiation preparedness and engage in conversation with their public health peers on radiation preparedness topics. All Twitter users are also are welcome to participate. Topics scheduled to be covered during this chat include: supporting mass care operations, dispelling common radiation myths, radiation response volunteers, etc.”

2018 George Mason 3MT – Biodefense
You can catch a glimpse at recent biodefense PhD graduate Chris Brown presenting his dissertation in under 3 minutes in the GMU 3MT competition. In the GMU 3-Minute-Thesis competition video, you can watch Chris (5:55-8:50) discussing his work – Protecting Critical US Workers from Occupational Exposure to Emerging Infectious Diseases. Congrats Chris!

Stories You May Have Missed:

• Surviving the 1918/1919 Pandemic– Jose Ameal discusses what it was like living through the 1918/1919 pandemic and the very real fear that was pervasive across the globe. “‘So many dead’, recalls Mr Ameal, now aged 103, of what he saw that autumn of 1918, when he caught the virus known around the world as Spanish flu – a pandemic that is thought to have killed at least 50 million people.”
• Theranos and Ebola – The wondrous possibility of rapid disease detection that was promised with Theranos has been dead for a while now, but recently, a report regarding their attempts to interject themselves into the 2014 Ebola outbreak have been shocking. USAID’s Jeremy Konyndyk details Theranos’s attempts to get involved in the outbreak, despite knowing their tests were flawed. “Whatever their motive, by 2014 they were clearly aware their tech didn’t work. And yet they were actively pitching it for use in the biggest outbreak emergency the world had seen in years.”

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

Have you registered for the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security? Don’t miss out on the early registration discount if you sign up before June 1st! Wondering if it’s safe to go back to romaine lettuce? Make sure to check the farm location as officials are saying this E. coli outbreak has a bigger footprint than that of the 2006 spinach outbreak.

White House Nixes Global Health Security in NSC
Just as Ebola hits the DRC, the National Security Council team responsible for global health security has been disbanded. “The top White House official responsible for leading the U.S. response in the event of a deadly pandemic has left the administration, and the global health security team he oversaw has been disbanded under a reorganization by national security adviser John Bolton. The abrupt departure of Rear Adm. Timothy Ziemer from the National Security Council means no senior administration official is now focused solely on global health security.” Following comments from Bill Gates about our lack of pandemic preparedness and Michael Osterholm’s on the challenges of predicting the next pandemic, a lack of health security coverage in the NSC is extremely worrisome. “Two members of Ziemer’s team have been merged into a unit in charge of weapons of mass destruction, and another official’s position is now part of a unit responsible for international organizations. White House homeland security adviser Tom Bossert, who had called for a comprehensive biodefense strategy against pandemics and biological attacks, is out completely. He left the day after Bolton took over last month.” Global health security threats, whether it be outbreaks, bioterrorism, or laboratory incidents, are only growing in complexity, which makes this particular shake-up deeply concerning for many in the biodefense world.

 New Ebola Outbreak in the DRC
Unfortunately, Ebola is rearing its head again in the DRC. Over the past five weeks, there have been reports of 21 suspected cases and 17 deaths. Two cases have been laboratory confirmed as Ebola and there are dozens of people under observation and contact tracing. “The DRC has become very good at controlling Ebola. The INRB in Kinshasa is more than capable of doing diagnostic tests without having to ship samples out to the United States. Its director, Jean-Jacques Muyembe Tamfum, was the first scientist to encounter Ebola at a time when he was the DRC’s only virologist, and has been involved in every outbreak response since. He and his colleagues have also trained a crack-team of researchers and disease detectives. ‘We’re advanced in public health,’ said Gisèle Mvumbi, a CDC-trained Congolese epidemiologist at the INRB, whom I met when I visited the DRC earlier this year. ‘If you compare us with Europe or the United States, eh, but here in Africa, we are high. We have experience’.” The WHO has officially declared the DRC cases as an outbreak, so now many are wondering if the vaccine will be deployed. The timing of the outbreak though, coincides with Trump’s plans to rescind $252 million that was set aside for Ebola response, citing that the outbreak was declared over in 2016 and that it is excessive spending.

The Characteristics of Pandemic Pathogens
The Johns Hopkins Center for Health Security has just released their new report on the characteristics of naturally occurring microorganisms that could cause a global catastrophic biological risk (GCBR). “The overarching aim of the study was to provide an inductive, microbe-agnostic analysis of the microbial world to identify fundamental principles that underlie this special category of microorganisms that have potential to cause global catastrophe. Such principles could refine pandemic preparedness by providing a new framework or lens through which to survey the threat landscape of infectious diseases in order to better anticipate, prepare for, and respond to GCBR threats.” Within the report, they compile information from 150 experts to discuss modes of transmission, host population dynamics, how human factors and/or complex disasters can elevate pathogens to GCBR, etc.

The Slow Death of Nonproliferation Norms
Charles Blair is taking a hard look at the global shifts in norms regarding the possession and use of chemical weapons. Blair, a GMU biodefense adjunct professor, points to two specific events over the span of just under two weeks, that challenged how the U.S. responds to foreign leaders who take a relaxed approach to CW. Trump’s congratulations to Putin on his re-election and the willingness to meet Kimg Jung-un are “in line with a broad, ominous shift in international attitudes toward chemical weapons and their use. The shift is alarming enough in its own right—but changes in norms that stigmatize chemical weapons directly affect other, and collectively far more important, pillars of the nonproliferation regime.” The rapid international degradation within the nonproliferation regime is surprising, notes Blair, but there were signs starting in 2012 that may have given us a heads up as to the future fissures. Telling moments for norms erosion has been repeatedly seen in the use of chemical weapons in the Syrian civil war and how the international community handles the continued possession and utilization of chemical weapons by the Assad regime. Russia, especially, has been an enabler for Assad and whose actions have been corrosive to the nonproliferation regime. Blair’s interviews include “Gregory Koblentz—director of the Biodefense Graduate Program at George Mason University— (who) discussed ‘just how little Russia cares about these norms and treaties.’ As evidence he cited Russia’s willingness to discount Syrian violations of international norms and to actively shield Damascus from the consequences of violations—by, for example, undermining the Joint Investigative Mechanism, the Fact-Finding Mission, and the overall investigative process in Syria. Koblentz said that because of Russia’s willingness to undermine the chemical weapons regime, he is concerned that Moscow might also be willing to undermine the International Atomic Energy Agency and the Nuclear Non-Proliferation Treaty. Russia, Koblentz said, is ‘the principle vector for the erosion of norms across all the nonproliferation regimes’.” Lastly, Blair underscores the important role the United States has in enforcing nonproliferation norms and the potential for Trump’s recent withdrawal from the Iran nuclear deal, to become a trigger for proliferation. “The irony, of course, is that any US military action against Iran, North Korea, or both would come wrapped in the cloak of norm enforcement—when, quite likely, Trump’s own pursuit of non-normative policies would cause North Korea to keep its nuclear weapons program and Iran genuinely to pursue a program of its own.”

Clade X Table Top
The Johns Hopkins Center for Health Security will be hosting the Clade X exercise next week “to illustrate high-level strategic decisions and policies that the United States and the world will need to pursue in order to diminish the consequences of a severe pandemic. It will address a pressing current concern, present plausible solutions, and be experientially engaging. Clade X is designed for national decision-makers in the thematic biosecurity tradition of the Center’s two previous exercises, Dark Winter (2001) and Atlantic Storm (2005).” The event will run from 9am to 5pm on Tuesday May 15^th and while seats are invitation only, you can livestream it on their Facebook page.

North Korean Ties with Hamas?
Following the assassination of a Palestinian academic with ties to the Hamas resistance, Malaysian police are working to find two Israeli Mossad agents who are considered the culprits.”With elections underway in Malaysia, the murder has been downplayed, but the investigation is in full-on mode. ‘If Israel is behind it, that seems to be an extension of their policy regarding Iranian nuclear scientists,’ said Sonia Ben Ouagrham-Gormley, associate professor at the George Mason University Schar School of Policy and Government’s Biodefense Program in Virginia, via email. ‘In the past few years, several Iranian nuclear scientists were killed, and many suspected Israel of being behind those killings. The problem with assassination is that it is counterproductive: it can cause the scientists to work harder at reaching a working weapon’.”

NASEM Bio, Chem, and Health Security Luncheon – May
Don’t miss out on this May 21^st luncheon held by the National Academies. “May’s event will be chaired and moderated by the National Academies’ Board on Health Sciences Policy. Itfeatures Greg Measer, Regulatory Counsel in the Food and Drug Administration (FDA)’s Office of Counterterrorism and Emerging Threats. He will discuss FDA’s initiative to build a national capacity for post-dispensing monitoring and assessment of medical countermeasures. The session also builds on issues discussed at a 2017 National Academies’ workshop on Building a National Capacity of Monitor and Assess Medical Countermeasure Use in Response to Public Health Emergencies.” If you’re unable to attend the event, we’ve got you covered, as one of our GMU Biodefense graduate students will be attending and reporting out.

Stories You May Have Missed:

• Clinical Outcomes and Trends of Patients with Carbapenem-Resistant Infections – What are the outcomes of patients with carbapenem-resistant infections? GMU biodefense PhD student Saskia Popescu discusses a recent study that evaluates similarities between those with such resistant infections. “The study was conducted in a single-center tertiary-care hospital in St. Louis, Missouri, at which researchers reviewed differences between patients with carbapenem-resistant Enterobacteriaceae (CRE) or carbapenem-resistant non-Enterobacteriaceae (CRNE). Patients with positive CRE or CRNE cultures found from January 2012 to December 2015 were analyzed. However, researchers sought to avoid inclusion of those with colonization instead of true infection, so patients without sepsis and cystic fibrosis were excluded, as were those who were discharged without having received targeted antimicrobial therapy.”

• Experts Discuss 1918 Pandemic and Global Flu Threat – The CDC and Emory University partnered up to hold a symposium in celebration of the 100^th anniversary of the 1918 pandemic, to discuss the next pandemic and how we can prepare. Michael Osterholm and Arnold Monto debated regarding a universal flu vaccine. “Nancy Messonnier, MD, head of CDC’s National Center for Immunization and Respiratory Diseases, said that despite gaps in preparedness, the CDC is better equipped to handle a flu pandemic now than it was in 2009, when a novel H1N1 flu strain first emerged. Technologies, including mobile apps that help consumers find flu shots, and antivirals are putting the power to prevent and fight flu into patients’ hands, she said.