The Pandora Report

It has unfortunately been an exceptionally busy week for those of us studying terrorism, bioterrorism, and pandemics. With new developments in the Boston bombing case,  the ricin letters, and H7N9 in China seemingly happening by the hour, we can guarantee only that news included in this week’s report is current as of this (Friday) morning. In the meantime, our thoughts and good wishes remain with Boston.

Castor bean - image via Mary Do
Castor bean – image via Mary Do

Ricin Letters Suspect Paul Kevin Curtis Quickly Identified by Earlier Letters

Paul Kevin Curtis is accused of mailing three letters – one to Mississippi Senator Roger Wicker, one to President Obama, and one to a local justice of the peace – containing the toxin ricin. While the FBI has positively identified the toxin, further testing is needed to determine the concentration and purity of the substance. Curtis, who was identified in part by his signature on the letters – Curtis’ sign off of “KC” on the ricin letters matched previous letters sent to Senator Wicker’s office. Curtis’ family maintains he is mentally ill, and had refused to take appropriate medication.  Now the question becomes – is this terrorism? Keep an eye out for the Mason viewpoint.

ABC News – “Investigators trying to determine who sent ricin-tainted letters to President Obama and other officials quickly traced the messages and signature of the letter to Paul Kevin Curtis, an Elvis impersonator who had written to officials in the past and consistently signed his letters “I am KC and I approve this message,” according to an FBI affidavit.About 15 members of a hazmat team, some totting M4 rifles, entered Curtis’ house today and set up an evidence-gathering area outside. Curtis was formally charged today with sending mail that contained a threat to kill or harm the president and with sending mail containing a threat to injure the president.”

Chinese Government Suspects Human-to-Human Transmission of H7N9 Bird Flu

China is unfortunately following a storied pattern of waiting until critical information is leaked before acknowledging it openly  – according to unofficial sources, as many as 40% of H7N9 cases had no contact with poultry. Exacerbating the pandemic potential of H7N9 are theunique difficulties associated with developing a vaccine to the strain – it’s proven very hard to culture in the lab. However, don’t panic just yet. Even if the virus proves capable of limited human-to-human transmission, further mutations rendering it “casual contact” transmissible would be necessary for a pandemic.

US News – “As the Chinese government openly begins to speculate about the possibility of human-to-human transmission of the H7N9 bird flu strain, an international team of experts, including some from the World Health Organization, have been deployed to investigate the disease in the country. If true, the development would quickly raise concerns of the disease outbreak leading to a pandemic. Flu experts have long warned once a particularly deadly strain of the flu, as H7N9 appears to be – it has killed 17 of the 87 people it has infected – becomes transmissible between humans, it can quickly spread.”

4-year-old bird flu ‘carrier’ worries China

A four-year old in China has emerged as an asymptomatic carrier of H7N9, further complicating epidemiological efforts in the area to discover the source of the outbreak – if you don’t know who’s sick, determining how they became sick becomes very tricky. It is known that the boy’s family handled poultry and fish. Although health investigators are currently looking at “family clusters” of infection,  human-to-human transmission is not suspected.

CNN – “Doctors say the discovery of a 4-year-old carrier of the H7N9 bird flu virus who shows no symptoms of the potentially lethal virus is a worrying development that could make the spread of the infection more difficult to monitor. The Beijing Municipal Health Bureau said the boy was detected from a group of close contacts of the first infection in Beijing and the laboratory results showed the boy was an asymptomatic carrier of the disease.”

Terrorism Updates:

Watertown, Mass., Shut Down in Manhunt for Second Boston Marathon Suspect

The two suspects in the Boston Marathon bombing have been identified as brothers Tamerlan and Dzhokhar Tsarnaev, with the former killed during the night. The manhunt continues throughout Watertown for the Dzhokhar Tsarnaev, who has already killed an MIT police officer and hijacked a car. Residents of the Boston suburb are being ordered to remain indoors as police officers comb the area. The two suspects are believed to be of Chechen descent, but have lived in the United States for several years.

ABC News – “”The at-large suspect is considered armed and extremely dangerous. Police are going door to door in search for the second suspect.’We believe this is a terrorist, we believe this is a man that’s come here to kill people,’ Boston Police Commissioner Ed Davis said.”

Up to 40 Dead in Texas Blast

While preliminary investigations at the fertilizer plant in West, Texas indicate an industrial accident, a full investigation into the source of the explosion will take six months. We’ve included it as a potential act of terrorism due to it’s proximity to Waco (less than 20 miles) and  it’s occurring within two days of both the 20th anniversary of the end of the Waco, Texas siege (today) and the Boston Marathon bombing (Monday). Current numbers indicate 160 injured and at least 35 dead or missing.

Wall Street Journal – “[Mayor] Muska, who is one of more than 30 volunteer firefighters in the city, was on his way to help colleagues put out the initial fire at West Fertilizer Co. that began around 6 p.m. Central time on Wednesday night. Volunteer firefighters in the town of about 2,800 people roughly 80 miles south of Dallas tried to extinguish the fire at the industrial facility.About two hours later, a thunderous explosion ripped through the plant, registering as strong as a magnitude 2.1 earthquake, according to federal seismologists. It sent a column of smoke hundreds of feet into the air.”

The Pandora Report

Highlights include the H7N9 update, funding for the NBAF, using flight patterns to stop pandemics, North Korean biosurveillance, and why biotech companies matter. Happy Friday!

North Korean bioweapons are coming for us all (Credit: Karl Baron)

Report on 3 in China Who Died From Bird Flu Points to Severity of Strain

Update: 43 cases, 10 fatalities

H7N9 continues apace in China, with the total number of cases up to 43. The virus is especially difficult to track because birds are asymptomatic carriers. While the number of laboratory-confirmed cases is closely monitored, it’s possible there are many more human cases going unnoticed due to a milder disease presentation. Still, there have been no confirmed cases of person-to-person transmission, and scientists in the US have just received the first batch of the virus, and are working on developing a diagnostic.

New York Times – “A report on three of the first patients in China to contract a new strain of bird flu paints a grim portrait of severe pneumonia, septic shock and other complications that damaged the brain, kidney and other organs. All three died…During a telephone news briefing on Thursday, Nancy J. Cox, of the influenza division at the Centers for Disease Control and Prevention, said that several features of H7N9 were particularly troubling: it causes severe disease, it has genetic traits that help it infect mammals and humans probably have no resistance to it.”

Obama proposes $714M for Kansas biodefense project

The National Bio- and Agro-Defense Facility has received the strongest funding endorsement to date from the Obama Administration, with $714 million included for the lab in the President’s FY2014 budget. The lab is slated to replace Plum Island as the nation’s premier   research center on agricultural pathogens.

Wall Street Journal – “Republican Sen. Pat Roberts of Kansas said the recommendation signals the administration’s support for building the $1.15 billion lab, which will study large animal diseases and develop measures to protect the nation’s food supply…Roberts said the proposal will require additional financial commitments from Kansas, which will be worked out by Republican Gov. Sam Brownback and legislators…Kansas agreed when it was awarded the project to contribute 20 percent of the cost of construction. Thus far, the state has issued $105 million in bonds and $35 million from the Kansas Bioscience Authority.”

New tool to identify air travelers with infectious disease developed

Researchers in Toronto, after studying the 2009 H1N1 pandemic, developed basic guidelines for passenger screenings during a pandemic. The results are relatively intuitive – screening passengers as they leave a region in which the pathogen is spreading is more useful than screening them upon arrival at their final destination.

Medical News – “Dr. Khan used his experience analyzing air traffic patterns to review the flights of the nearly 600,000 people who flew out of Mexico in May 2009, the start of the H1N1 pandemic. He found that exit screening would have caused the least disruption to international air traffic. In fact, all air travelers at risk of H1N1 infection could have been assessed as they left one of Mexico’s 36 international airports. Exit screening at just six airports in Mexico coupled with entry screening at two airports in Asia (Shanghai and Tokyo) would have allowed for screening of about 90 per cent of the at-risk travelers worldwide.”

APG working on biosurveillance in response to North Korea threats

Anything that is related to biological warfare and is also called the Kracken is automatically included in the Pandora Report. Here, the Kracken is a 15ft high thermal, acoustic, and infrared sensor.

Baltimore Sun – “While the danger of missiles is more pressing, Army officials said developing better capabilities to detect biological warfare threats has also been a priority for the past six years. The Joint Program Executive Office for Chemical and Biological Defense is working with APG’s Edgewood Chemical Biological Center on the program, which is called the Joint United States Forces Korea Portal and Integrated Threat Recognition, or JUPITR. The program will also serve to detect naturally occurring biological threats. A key part of the program is the Kraken, which Army officials described as ‘a massive, multifunctional, all-seeing sensor suite designed to rapidly establish a defensive perimeter.'”

Funding Issues Stymie Pandemic Preparation

Collaboration between the biotech industry and the US government has been notoriously difficult, starting with the threat of breaking Bayer’s patent on Cipro during the Amerithrax attacks and continuing into today. While relations have improved, and the hurdles to a successful working relationship are significant, we can’t afford to not work on this.

Genetic Engingeering and Biotechnology News – “Despite product success Acambis has had a bumpy ride with its funding. ‘Any biotech that believes developing products to serve public health emergencies is access to easy money needs to think again,’ Dr. Lewin cautioned. ‘Collaborating with the U.S. government is different from working in the biotech world. You have to produce a proposal for the government to digest, a cost of around $400,000, and if you don’t get the contract that’s all money down the drain.'”

The Pandora Report

Highlights include H7N9, China’s SARS lessons, H5N1, the seminal UN global arms treaty, bird flu bureaucracy, and the problems with the term “WMD”. Happy Friday!

H7N9 Update: 14 cases, five fatalities, no evidence of person-to-person transmission

(image credit: Matt Karp)
(image credit: Matt Karp)

Scientists race to gauge pandemic risk of new bird flu

We’re keeping a very close eye on news about the H7N9 avian flu strain emerging from China. To date there have been fourteen cases with five fatalities.   Unlike the H5N1 strain of avian influenza, this is the first time we’re seeing H7N9 in humans. It’s pandemic potential is still considered low due to its current inability to transmit person-to-person. However, although there have been no confirmed cases of person-to-person transmission, it’s been reported that a person caring for one of the people who died of H7N9 has since developed similar, flu-like symptoms.

Reuters – “Genetic sequence data on a deadly strain of bird flu previously unknown in people show the virus has already acquired some mutations that might make it more likely to cause a human pandemic, scientists say. But there is no evidence so far that the H7N9 flu – now known to have infected nine people in China, killing three – is spreading from person to person, and there is still a chance it might peter out and never fully mutate into a human form of flu.”

Ten years after SARS, what has China learned?

The short answer? It depends on whom you ask. China has improved its communication with the international and scientific community. However, there have been complaints about the lack of clear communication by the Chinese government with its own people, particularly at the time of the virus’ original emergence.

Xinhua – “The news of two men dying from a new variant of bird flu has reminded Chinese of the SARS pandemic that hit the country one decade ago. Many are wondering if the government will handle the situation any better than it did in 2003, should another pandemic break out…Now, on the 10th anniversary of the pandemic, fear is spreading following reports of two Shanghai men who died from H7N9 avian influenza, a strain that has not previously been detected in humans. That fear was aggravated this week after four more patients in neighboring Jiangsu Province were confirmed to have contracted the virus. All four are in critical condition.”

Cambodia reports 10th bird flu case this year

In all the chatter about H7N9, H5N1 seems almost tame. While it may seem high, ten cases in four months is in keeping with expected numbers.

Xinhua – “A six-year-old boy from Southwestern Kampot province was confirmed to have contracted with Avian Influenza H5N1, bringing the number of the cases to 10 and the death toll remained at eight in 2013, a health expert said Wednesday. ‘The boy was admitted to the Kantha Bopha Hospital in Phnom Penh on March 31 for severe pneumonia, and he was tested positive for H5N1 at the Instituts Pasteur on Tuesday,’ Dr. Denis Laurent, deputy director of the hospital, told Xinhua.’The boy is still alive, but in severe conditions (sic).”

UN general assembly passes first global arms treaty

Including everything from battle tanks to light weapons, this is the first UN treaty “aimed at controlling the trade in conventional weapons”, and prohibits the sale of conventional weapons to state in violation of arms embargoes, in support of terrorism, war crimes, genocide, or in use against civilians (it doesn’t regulate domestic sales of arms).

The Guardian – “The United Nations…vot[ed] it through by a large majority despite earlier being blocked by three countries. Member states represented in the UN general assembly voted by 154 to three, with 23 abstentions, to control a trade worth an estimated £46bn a year. The landmark deal went to a vote after Syria, Iran and North Korea – all at odds with the US – blocked its adoption by consensus….It is expected to come into force after the first 50 ratifications next year”

Clinical Notes: Bird Flu Vaccine Delayed at FDA

It’s been an avian-themed report. This piece included in commiseration with of all of us just now getting around to taxes – filing paperwork appropriately with the government is apparently as important for billion-dollar corporations as it is for the rest of us.

MedPage – “GlaxoSmithKline’s (GSK) human vaccine against H5N1 avian influenza did not win approval from the FDA, but only on technical grounds that should not keep it off the market for long, the company said. Called Q-Pan H5N1, the product is meant to be stockpiled in case the H5N1 virus becomes capable of causing a pandemic. It received a unanimous endorsement from an FDA advisory committee last November. Nevertheless, GSK said last week that it had received a so-called complete response letter from the agency, indicating that approval was not immediately forthcoming. The company said it was ‘triggered due to an administrative matter that has recently been rectified.'”

Soapbox we love: Let’s All Stop Saying ‘Weapons of Mass Destruction’ Forever

The title says it all. It was arguably too broad when it was just chemical, biological, radiological (mass destruction? a rad bomb? really?) and nuclear, and it seems to only be getting broader.

Wired – “In fact, as a fascinating paper by W. Seth Carus at the National Defense University shows, the Defense Department’s definition of the term has long been problematic. For years, its official definition included ‘high explosives,’ to make it consistent with the federal statute that Harroun ran up against. But ‘most military weaponry relies on high explosive charges,” Carus writes, ‘meaning that even the mortars and grenades used by infantrymen might qualify as WMD.’ The doctrinal answer was ultimately to limit the definition to “chemical, biological, radiological and nuclear weapons capable of a high order of destruction or causing mass casualties.”

The Pandora Report

Highlights include H5N1: to mutate or not to mutate, the Galveston Lab we’ve all shaken our heads at this week (we all lose a vial of virus sometimes), the UK stepping-up its bioterror prevention, the new foot-and-mouth vaccine (cloven-hoofed animals matter too – a lot, actually), antibiotic-resistant jumping from farm animals to us, and what may soon be a mumps outbreak in Richmond. Happy Friday!

short-tailed cane mouse aka Guanarito target #1
short-tailed cane mouse aka Guanarito target #1

H5N1 viral-engineering dangers will not go away

Technically we tweeted this story on Wednesday, but it presented such a nice summation against the gain-of-function research that we wanted to include it here. Not because we agree, but because the points are coherent and well-argued.

Nature – “Rather than use the avian flu moratorium to seek advice, listen and foster debate, many influenza scientists engaged in an academic exercise of self-justification. There was a single large open meeting, at the Royal Society in London, which engaged a wider audience, including bioethicists. The recent calling off of the moratorium by 40 flu researchers alone — not funders, governments or international bodies — says it all. The flu community simply hasn’t understood that this is a hot-button issue that will not go away.”

Texas Biolab Loses Deadly Virus

Before everyone freaks out, it’s only Guanarito virus – yes, losing a vial of any virus from a BSL-4 lab is not great, and yes, if you’re going to lose a vial of something, it would be better if it didn’t cause hemorrhagic fever, but 1) Guanarito virus’ natural host is thought to be  Venezuelan “short-tailed cane” mice, 2) it doesn’t replicate in US rodents, and 3) it’s not transmissible person-to-person.  And before we start a heated discussion about the disturbingly impressive ability of viruses to evolve and adapt to new hosts, 4) the vial in question is thought to have been destroyed internally.

ABC News – “The Galveston National Laboratory lost one of five vials containing a deadly Venezuelan virus, according to the University of Texas Medical Branch, which owns the $174 million facility designed with the strictest security measures to hold the deadliest viruses in the country. Like Ebola, the missing Guanarito virus causes hemorrhagic fever, an illness named for “bleeding under the skin, in internal organs or from body orifices like the mouth, eyes, or ears,” according to the Centers for Disease Control and Prevention.”

UK: Biological attacks ‘getting easier for terrorists’

Intelligence officials in the United Kingdom have prioritized the fight against bioterrorism, using lessons from the 2012 London Olympics to inform their revamped strategy.

The Telegraph – “Charles Farr, the Director of the Office for Security and Counter-Terrorism [in the United Kingdom], said that extremists have ever greater access to the information and technology required to create and spread germ agents or other biological weapons…Factors facilitating such attacks include the availability of formulae and other information on the internet; increasing teaching of biological sciences at universities, and ‘greater availability of technology,’ he said. Mr Farr, a former MI6 officer, declined to give further details of the threat, but the Home Office report hints at a range of new precautions.

Scientists develop new foot and mouth vaccine

Foot-and-mouth disease is like the be-all-end-all of animal diseases – it’s tremendously infectious, has a high mortality rate, and because we don’t vaccinate (for trade reasons – when you vaccinate an animal, when that animal is later tested for FMD it’s impossible to tell whether it has the antibodies because it was vaccinated or because it actually had the disease – if the latter, no one wants to eat it), the disease would spread like wildfire. Also, current policy dictates “containment” (read: mass culling) rather than “treatment”, which means mountains of burning carcasses. Very scary and very possible.

The Guardian – “Scientists have developed a new kind of vaccine that could prevent devastating outbreaks of foot and mouth disease among livestock. The “synthetic” vaccine was created by taking protein shells that encase the virus and strengthening them, so the vaccine can be used in warm countries without refrigeration. The technique overcomes major shortcomings of existing foot and mouth vaccines, which are made with live virus. The infectious risk means the conventional vaccine must be produced in high containment facilities, which are costly to build and maintain. Vaccines made from the live virus are also fragile, and degrade unless they are kept cool.”

Study Shows Bacteria Moves From Animals to Humans

Bessie the cow might just be another weapon in the arsenal of the superbug. This possibility is especially disturbing given our ongoing difficulties countering antibiotic-resistant bacteria we make ourselves.

The New York Times – “A new study used genetic sequencing to establish that a strain of antibiotic-resistant bacteria has been transmitted from farm animals to people, a connection that the food industry has long disputed. Representative Louise M. Slaughter, Democrat of New York, said the study by researchers in Britain and Denmark, which drew on data from two small farms in Denmark, ‘ends any debate’ about whether giving antibiotics to livestock is a risk to humans”

LOCAL: Mumps virus infiltrates Richmond, VA campus

Before this launches a debate about the importance of vaccination, all but just six students on the Richmond campus have had  the MMR vaccine. What this illustrates instead is that no vaccine is 100% efficacious in every instance (MMR is approximately 95%).

The Collegian – “As of Tuesday, 15 cases of mumps have been confirmed on campus, said Dr. Lynne Deane, the director of the Student Health Center. Mumps is a communicable viral illness and typically carries symptoms like fever, head and body aches, tiredness and swollen or tender glands in the jaw, according to the Virginia Department of Health (VDH) Web site.Tests administered to other students are still being processed, she said. In total, 39 students have been tested for the virus since January, Deane said…The cluster of mumps outbreaks has not been limited to Richmond. Loyola University, Maryland, has seen at least 12 cases of mumps arise in the past month, according to CBS news Baltimore.”

The Pandora Report

Highlights include lyssavirus, a treatment for Ebola, predicting the next pandemic, stressing out bacteria, weapons inspection in Syria, and Flu’s grappling hooks. Happy Friday!

Experts Sound Global Alert Over Deadly Bat Virus

Lyssavirus is a close cousin of rabies, both in terms of presentation and its potentially years-long incubation period. The virus does not transmit well person-to-person, though the possibility of such was enough to prompt a terse warning from the doctors involved is this case – “In short, people should stay away from bats.”

The Jakarta Globe – “Experts on infectious diseases on Thursday warned people to stay away from bats worldwide after the recent death of an eight-year-old boy bitten in Australia. The boy last month became the third person in the country to die of Australian bat lyssavirus (ABLV), for which there is no effective treatment…Other lyssavirus strains circulate in bats in the United States and Europe and the experts said their warning applies to wherever bat or flying fox populations exist.”

Chemical Compounds That Halt Virus Replication Identified

It has been literal months since we’ve mentioned Ebola, which is actually pretty good news. What better way to break the radio silence than with news of a potential treatment?

Science Daily – “In this study, researchers identified a new chemical class of compounds that effectively blocked genetically diverse viruses from replicating by limiting RNA production by the virus in cell culture. These indoline alkaloid-type compounds inhibited a number of viruses from replicating, including Ebola…’Because the production of viral RNA is the first step in successful replication, it appears that we have uncovered an Achilles heel to halt virus replication,’ said [lead author] Filone. ‘These compounds represent probes of a central virus function and a potential drug target for the development of effective broad-spectrum antivirals for a range of human pathogens.'”

UCLA-led team predicts China, Egypt could be new-flu hot spots

The team cross-referenced areas with high incidences of  H3N2 (in humans) and H5N1 (in birds) respectively, while also looking for large numbers of swine (which can be infected with both strains from both hosts, and can therefore reassort the virus before passing it along). The results? China and Egypt.

Los Angeles Times – “UCLA postdoctoral researcher Trevon Fuller and colleagues published their work online on March 13 in the U.S. Centers for Disease Control and Prevention journal Emerging Infectious Diseases…Fuller and his colleagues used new techniques to assess conditions in a number of places to see how likely a reassortment event might be. While a new pandemic could possibly emerge from a number of combinations of flu strains, the team focused on reassortment between human H3N2, a version of which was prevalent in the U.S. this flu season; and avian H5N1, a widespread bird fluthat has been rare in humans so far but has proven deadly among the hundreds of people it has infected.”

Bacterial byproduct offers route to avoiding antibiotic resistance

Researchers at Princeton are using bacteria’s natural susceptibility to oxidative stress to develop safer antibiotics. Contrary to popular  belief, “oxidative stress” does not refer to one’s state of being upon entering the Metro, but rather is a bacterial state induced as a result of increasing bacterial production of reactive oxygen species [ROS].

Princeton News – “In a recent paper in the journal Nature Biotechnology, first author Mark Brynildsen, a Princeton assistant professor of chemical and biological engineering, reported that scientists can force bacteria to increase their production of a class of molecules called reactive oxygen species, which can either kill the bacteria outright or make them far more vulnerable to antibiotics. Bacteria normally produce reactive oxygen species during growth. Small amounts don’t hurt them because of certain protective enzymes within the bacteria, but too much of the substances can lead to “oxidative stress.” The researchers decided this weakness could be exploited.”

Syria’s chaos complicates task for chemical weapons investigators

Syria continues apace, with rebels and the Assad regime swapping allegations regarding chemical weapons use. Now it’s just the simple matter of getting an inspections team into the middle of a civil war to attempt to collect biological samples. Weapons inspecting – not for the weak.

NBC News – “Secretary-General Ban Ki-moon said Thursday that he had agreed to conduct an investigation of allegations of an attack in the northern city of Aleppo. The government and the opposition have accused each other of carrying out that attack on Tuesday…Ralf Trapp, a German who works on disarmament and non-proliferation issues, specializing on chemical and biological weapons, said…a big question will be how soon the UN and the Organization for the Prohibition of Chemical Weapons – of which Trapp is a former official — can get a team into Aleppo. He said the team would have to be large and varied, with security officers and medical officers as well as inspectors. But each day lost will influence the speed with which the investigation can be concluded, he said, because as more time elapses before biological sampling occurs, more sophisticated DNA and other toxicological testing is required.”

A viral grappling hook: Flu virus attacks like a pirate boarding party

Included in part because there was a pirate simile in the title. Leave me alone, it’s Friday. But also, read the article, because it’s an interesting presentation of flu’s mechanism,  and because it used a pirate simile in the title.

Phys.org – “When the virus encounters a cell—in your lung, for example—that cell may engulf the virus inside an internal membrane called an endosome. To escape that bubble, the virus fuses its membrane with the endosome’s, opening a window into the cell’s interior…To fuse the two membranes, the virus carries a protein called hemagglutinin (the “H” in H1N1). Triggered by the acidic environment of an endosome, that protein will extend from the viral membrane and attach, like a grappling hook, to the endosome’s membrane. When enough hooks are set, they draw the membranes together until they fuse.”

 

The Pandora Report

Highlights include NCov’s mechanism of action, Dengue in Key West (Spring Breakbone?)(sorry, very sorry), the ongoing debate around stocking up on vaccines we may never use, will Assad use biological weapons?, Zithromax and irregular heartbeats, and using bacteria to deliver vaccines for us. Happy Friday!

Novel Virus Entry Portal Found

On the heels of the WHO confirming the 15th case of NCov, it’s now known that the virus utilizes the DPP4 host cell protein for entry.

The Scientist – “Dutch researchers have identified the host cell protein that allows a recently discovered coronavirus to enter its target cells, according to a study published today (March 13) in Nature. The structure of the protein, called DPP4, appears to be conserved between bats and humans, suggesting that the new findings will help shed light on zoonotic transmission of the virus, as well as provide a target for potential vaccines.”

Mosquito-borne dengue virus lands in Key West

Dengue, also known as “breakbone fever”, continues to be one of the most significant “neglected” tropical diseases, with its occurence  seeing a 30-fold increase over the last five decades. It’s re-emergence in the US, therefore, is disturbing but unfortunately not especially surprising.

LA Times – Although the mosquito-borne dengue virus was thought to be fully eradicated in the continental United States, the Centers for Disease Control and Prevention confirmed Wednesday that the tropical disease had indeed returned…after reviewing 93 dengue cases diagnosed in Florida in 2009 and 2010, study authors identified a specific strain of the virus in patients who had not recently traveled outside the country. The strain differed from those cases in which the patient had recently traveled.”

Wary of Attack With Smallpox, U.S. Buys Up a Costly Drug

This debate strikes at the heart of preparedness – do we invest in the smallpox vaccine now, in the off chance a bioterrorist attack with the pathogen occurs, or spend the money elsewhere and risk catastrophic casualties? While those of you born before 1980 (the year we stopped vaccinating) may be shrugging internally, there is some debate about the potency of the vaccine 20 years on. There’s not an easy answer.

New York Times -“The United States government is buying enough of a new smallpox medicine to treat two million people in the event of a bioterrorism attack, and took delivery of the first shipment of it last week. But the purchase has set off a debate about the lucrative contract, with some experts saying the government is buying too much of the drug at too high a price.”

Syria might be prepared to use chemical and biological weapons – US national intelligence director

Meanwhile, in Syria, (unverfiable) reports continue that Assad has already begun using chemical weapons on the rebels. Once again, it’s a poorly-kept secret that Syria had (has?) a clandestine BW program.

Radio Free Russia – “The erosion of the Syrian regime’s authority is accelerating and the ‘increasingly beleaguered’ government, which has been unable to defeat insurgents with conventional weapons, might be prepared to use chemical weapons, according to James R. Clapper, the director of national intelligence.”

FDA says Zithromax can cause fatal irregular heart rhythm

Zithromax, an anti-biotic used to treat everything from respiratory infections to STDs, is now known to cause “potentially fatal” tachycardia.

Reuters – “Last May, a study in the New England Journal of Medicine compared the risk of cardiovascular death in patients who took Zithromax with those who took several other antibiotics, including amoxicillin. It found that patients who took Zithromax, made by Pfizer Inc, had higher rates of fatal heart rhythms.”

Researchers trick bacteria to deliver a safer vaccine

Ha! Stupid bacteria. No, we’re kidding – any step towards development of elderly-, child-, and immunocompromised-friendly vaccines is good news.

R&D Magazine – “Vaccines that employ weakened but live pathogens to trigger immune responses have inherent safety issues, but Yale University researchers have developed a new trick to circumvent the problem—using bacteria’s own cellular mistakes to deliver a safe vaccine. The findings, published online in Nature Communications, suggest new ways to create novel vaccines that effectively combat disease but can be tolerated by children, the elderly, and the immune-compromised who might be harmed by live vaccines.”

The Pandora Report

Highlights include our CRE soapbox (it’s only 4%!), NCov updates, the surprising news about flu droplets (oh it’s surprising), Hong Kong  and the risks of high population density, the resilience of viruses, and an overview of pandemics. Happy Friday!

The Gesundheit II machine collects the breath exhaled from flu sufferers.   (Credit: Donald Milton)
The Gesundheit II machine collects the breath exhaled from flu sufferers.
(Credit: Donald Milton)

CDC- Making Health Care Safer

Drug-resistant CRE (carbapenem-resistant Enterobacteriaceae) has been in the news often this week, following the CDC’s warning about the bacteria. Now, clearly this is a concern, but before we freak out let’s look at some of the figures behind this story. First, the statistic regarding CRE’s case fatality- almost every news source we’ve seen has indicated it’s 50% – aren’t what they seem. What the sources don’t say is that it’s 50% if, and only if, the infection becomes septicemic. Septicemia as a result of almost any bacterial infection is very dangerous. Second, CRE is really only of concern amongst the immunocompromised and those in long-term treatment for prior conditions. If you’re a healthy adult in possession of an active immune system, you’re chances of becoming infected are minuscule. Third, yes the rate of infection from CRE has increased in the last decade, but again let’s keep the actual number in mind – four percent.

Antibiotic-resistant pathogenic bacteria are a real concern, and steps should absolutely be taken to mitigate their growth and prevent their spread. However, disproportionately scaring the public is not the way to do that, and can be detrimental in the long run – the “boy who cried wolf” anyone? But our soapbox aside, check out the CDC’s review if you haven’t already.

CDC – “Untreatable and hard-to-treat infections from CRE germs are on the rise among patients in medical facilities. CRE germs have become resistant to all or nearly all the antibiotics we have today. Types of CRE include KPC and NDM. By following CDC guidelines, we can halt CRE infections before they become widespread in hospitals and other medical facilities and potentially spread to otherwise healthy people outside of medical facilities.”

Novel coronavirus infection – update

Yesterday the WHO reported another fatality from the novel coronavirus, bringing the total number of cases up to 14 and the fatalities to eight. This case is of special concern because it remains unclear how the man became infected.

WHO – “The Ministry of Health in Saudi Arabia has informed WHO of a new confirmed case of infection with the novel coronavirus (NCoV). The patient, a 69-year-old male, was hospitalized on 10 February 2013 and died on 19 February 2013. Preliminary investigation indicated that the patient had no contact with previously reported cases of NCoV infection and did not have recent history of travel.”

Study provides new clues to how flu virus spreads

According to this study, the tiny aerosol droplets of flu we exhale when sick contain nine-times the amount of virus than the larger cough/sneeze generated droplets. So the next time an infected colleague/friend/loved one walks toward you, make them stop four feet away and calmly explain that their breath is infectious. (GMU Biodefense is not responsible for the implications of you calling the breath of a colleague/friend/loved one infectious).

Medical Express – “People may more likely be exposed to the flu through airborne virus than previously thought, according to new research from the University of Maryland School of Public Health. The study also found that when flu patients wear a surgical mask, the release of virus in even the smallest airborne droplets can be significantly reduced. ‘People are generally surprised to learn that scientists don’t know for sure how flu spreads,’ says Donald Milton, M.D., Dr.P.H., who directs the Maryland Institute for Applied Environmental Health and led the study of influenza virus aerosols published in the journal PLoS Pathogens…”

Hong Kong Prison Homes Spur Virus Risk Decade After SARS

Population density remains an important factor in understanding pandemic potential, and Hong Kong is close to the top of the list in terms of people-per-square-mile. As housing prices continue to increase, many of the city’s 7.2 million residents are settling for smaller and more cramped living quarters.

Bloomberg – “Hong Kong electrician Chan, who shares a mold-stained toilet with his neighbors, says he’d move out if it weren’t for the rising cost of accommodation. Last year, residents were forced to bathe using a shared kitchen sink for six months when a plastic shower hose in the communal bathroom broke, Chan said…Chan Sung-ming says the coughs and sneezes echoing through the plywood walls of his windowless, 60- square foot Hong Kong apartment get him thinking: is there a bug going around and could it be deadly?”

Virus overcomes ‘enormous hurdle’ to survive

Wonderful. As if viruses aren’t good enough at surviving against all possible odds in the first place. For things that technically aren’t alive (I know, I know, I read the piece about viral immune systems as well – they’re still undead in my book), they are disturbingly resilient.

Futurity – “Researchers have uncovered a virus inside a host with a non-standard nuclear genetic code—one that differs from the standard genetic code that almost all living things use to produce proteins.’The finding is significant because it shows that these viruses can overcome what appears to be an insurmountable change in the host genome,’ says researcher Derek J. Taylor, professor of biological sciences at the University at Buffalo.’So the fact that we haven’t previously seen any viruses in these species with a modified genetic code may not be because the viruses can’t adapt to that shift. It may be that we haven’t looked hard enough.'”

Bioterrorism and the Pandemic Potential

A good overview of the basics of pandemics (I tend to disagree with their bioterror assessment, but to each their own!)

STRATFOR – “”The potential for a disease to spread is measured by its effective reproduction number, or R-value, a numerical score that indicates whether a disease will propagate or die out. When the disease first occurs and no preventive measures are in place, the reproductive potential of the disease is referred to as R0, the basic reproduction rate. The numerical value is the number of cases a single case can cause on average during its infectious period. An R0 above 1 means the disease will likely spread (many influenza viruses have an R0 between 2 and 3, while measles had an R0 value of between 12 and 18), while an R-value of less than 1 indicates a disease will likely die out. Factors contributing to the spread of the disease include the length of time people are contagious, how mobile they are when they are contagious, how the disease spreads (through the air or bodily fluids) and how susceptible the population is. The initial R0, which assumes no inherent immunity, can be decreased through control measures that bring the value either near or below 1, stopping the further spread of the disease.”

The Pandora Report

(Image Credit: Cody Hough).

Highlights include secondary transmission of vaccinia through sex, humidity – good for something?!, two new cases of H1N1 in Taiwan, another H5N1 fatality in Cambodia, viruses with immune systems, and avian influenza (no, not that one- it’s H7N3) in Mexico. Happy Friday!

Vaccinia as an…STD?

This is one of the ongoing problems with the ACAM2000 vaccine – it sheds. More specifically, you shed for a couple days after receiving the vaccine. Which means you can pass it on, in a number of different ways.

MMWR – “On June 24, 2012, CDC notified Public Health Services, County of San Diego Health and Human Services Agency, of a suspected case of vaccinia virus infection transmitted by sexual contact. The case had been reported to CDC by an infectious disease specialist who had requested vaccinia immune globulin intravenous (VIGIV) (Cangene Corporation, Berwyn, Pennsylvania) for a patient with lesions suspicious for vaccinia. The patient reported two recent sexual contacts: one with a partner who recently had been vaccinated against smallpox and a later encounter with an unvaccinated partner. Infections resulting from secondary transmission of vaccinia virus from the smallpox vaccinee to the patient and subsequent tertiary transmission of the virus from the patient to the unvaccinated partner were confirmed by the County of San Diego Public Health Laboratory.”

Higher Indoor Humidity Inactivates Flu Virus Particles

High levels of humidity – the bane of DC metro riders, women who straighten their hair, and people who don’t like being able to drink their air – are apparently very good for keeping the flu at bay:

Science Daily – “Higher humidity levels indoors can significantly reduce the infectivity of influenza virus particles released by coughing, according to research published February 27 in the open access journal PLOS ONE by John Noti and colleagues from the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention. The researchers tested the effect of relative humidity on the capacity of flu virus released in a simulated ‘cough’ to re-infect cells. They found that an hour after being released in a room at a relative humidity of 23% or less, 70-77% of viral particles retained their infectious capacity, but when humidity was increased to about 43%, only 14% of the virus particles were capable of infecting cells.”

 Two New H1N1 Deaths in Taiwan

Full credit to Taiwan and China: during the Chinese New Year a huge swath of the population travels, creating a really tremendous logistical challenge in terms of disease surveillance. Both states have nonetheless managed to keep a sharp eye on new cases of influenza:

The China Post – “The H1N1 flu strain claimed two lives this month, as the number of diagnosed influenza cases surged due to increased travel over Chinese New Year, the Centers for Disease Control (CDC, 疾病管制局) said yesterday. During the recent flu season, 365 cases of influenza were reported, resulting in 29 deaths, according to the CDC, which has attributed 26 of the deaths to the H3N2 virus strain and three deaths to H1N1. The first victim to be claimed by H1N1 earlier this month, a 48-year-old man, had reported flu-like symptoms of fever, soreness and pain on Jan. 19, but did not seek medical attention until Jan. 24. The man died on Feb. 5 despite the efforts of doctors. The second victim, a 38-year-old woman, became feverish and felt discomfort on Feb. 14, but did not receive medical attention until Feb. 18 when she was rushed to the ER. She was resuscitated but died on Feb. 21.”

Ninth New Human Case of Avian Influenza H5N1 in Cambodia in 2013

The man was known to have come in contact with infected poultry in his village. Cambodia is having difficulty halting the disease incidence due to the ongoing practice of slaughtering poultry within residences. This practice is also thought to explain the disproportionately high incidence of the disease amongst children – approximately 20 of the 30 cases of H5N1 in Cambodia have occurred in children under the age of 14.

WHO – “The ninth case, a 35-year-old man from Kbal Ou village, Me Sar Chrey commune, Stueng Trang district in Kampong Cham province, was confirmed positive for influenza H5N1 on 23 February 2013 by Institut Pasteur du Cambodge. He developed fever on 8 February 2013 and his condition worsened on 10 February 2013 with fever, frequent cough, and dyspnea….The man is the ninth person this year and the 30th person to become infected with the H5N1 virus, and the 27th person to die from complications of the disease in Cambodia.”

Viruses pass major test to enter ranks of living

What do you think? Should viruses be classified as “living”?

Discovery News – “Viruses can acquire fully functional immune systems, according to new research that bolsters the controversial theory that viruses are living creatures. Until now, scientists thought that viruses existed only as primitive particles of DNA or RNA, and therefore lacked the sophistication of an immune system. The study, published in the journal Nature, is the first to show that a virus can indeed possess an immune system, not to mention other qualities commonly associated with complex life forms.”

Avian Influenza Outbreak in Mexico Raises Concerns about Price Speculation

Just as a FYI – stick it in the back of your mind for the time being.

The Poultry Site – “The dreaded avian influenza has returned to central Mexico again this year, this time causing significant poultry deaths in Guanajuato state, writes Carlos Navarro, Editor of SourceMex. The outbreak of the H7N3 virus—which had forced poultry farmers in the state of Guanajuato to destroy more than 2 million birds as of the end of February — affects municipalities in northern Guanajuato as well as in Jalisco state.”

In Case You Missed it (you wouldn’t have if you followed us on Twitter!)

– Analysis: Emerging deadly virus demands swift sleuth work
– New Bioterrorism Vaccine Gets First Test In Humans
– Brazil dengue cases almost triple as new strain spreads
DHS awards contract for utilities plant at NBAF

The Pandora Report

credit: Alex Alishevskikh
The Russian Meteor (image credit: Alex Alishevskikh)

Highlights include person-to-person transmission of the NCov, new drug to stop drug-resistant flu, plant viruses: yes they exist, sweat more to prevent TB, blacklegged ticks are spreading an unnamed disease (blackleggedia?), and did the meteor bring a virus which will kill us all? More news to come. Happy Friday!

Note: No updates on the deaths of two people in China from H5N1 – the cases were of particular concern due to the inability of health investigators to establish connections between either case and infected poultry. Person-to-person? We’ll keep you posted. 

Human-to-Human Spread of New Virus Lifts Threat to EU

The UK patient infected with the novel coronavirus (NCov) after travelling in the Middle East has died, raising the number of deaths to seven (out of thirteen known infections). The virus was not thought to be contagious until two family members of the sickened UK patient also became infected.

Bloomberg – “Two probable cases of human-to-human transmission of the new coronavirus that’s killed six people increase the pathogen’s threat to the European Union, according to the bloc’s disease-tracking agency. The appearance of a mild case of the disease caused by the virus also raises concern because it suggests more people may be infected than are known, have few or no symptoms, and are spreading the bug to others, the European Centre for Disease Prevention and Control said in a report late yesterday.”

New Flu Drug Stops Drug-Resistant Strains of Virus in Its Tracks

One of the reasons why the Influenza viruses are so difficult to handle is their phenomenal ability to mutate. Due the prevalence and high infectivity of the viruses, drug resistance is understandably a  cause for serious concern. A group of University of British Columbia researchers are seeking to mitigate this concern by developing drugs which inhibit neuraminidase binding in drug-resistant strains.

Science Daily – “Published online February 21 in the journal Science Express, the study details the development of a new drug candidate that prevents the flu virus from spreading from one cell to the next. The drug is shown to successfully treat mice with lethal strains of the flu virus. In order to spread in the body, the flu virus first uses a protein, called hemagglutinin, to bind to the healthy cell’s receptors. Once it has inserted its RNA and replicated, the virus uses an enzyme, called neuraminidase, to sever the connection and move on to the next healthy cell.”

Enemies no longer

Plants don’t get a lot of attention here at GMU Biodefense, which is unfair because they’re so prevalent. Plants have feelings too, right? Well no, but they can still catch viruses.

The Economist – “History casts a long shadow. Many of the first bacteria to be discovered were agents of disease, and that is how most people perceive bacteria to this day, even though less than 1% of them are pathogens. Something similar is turning out to be true of viruses, as Marilyn Roossinck of Pennsylvania State University told the AAAS meeting in Boston. Dr Roossinck works on plant viruses and she has assembled evidence suggesting a lot of such viruses are harmless to their hosts, and in some cases may actually be beneficial. That has implications for biology. It also has implications for agriculture.”

Scientists Unveil Secrets of Important Natural Antibiotic

So I have some bad news everyone. Apparently in addition to making you happier and prolonging your life, exercise may also save you from TB. Or, to be explicit, the secretion of the natural antibiotic dermcidin in sweat effectively kills bacteria which may enter at open cuts or wounds. The bad news? This makes avoiding exercise that much harder.

Science Daily – “These natural substances, known as antimicrobial peptides (AMPs), are more effective in the long term than traditional antibiotics, because germs are not capable of quickly developing resistance against them. The antimicrobials can attack the bugs’ Achilles’ heel — their cell wall, which cannot be modified quickly to resist attack. Because of this, AMPs have great potential to form a new generation of antibiotics.”

New tick-borne bacteria found in Shasta County

Blacklegged ticks are well established vectors for Lyme disease. However, the arthropods are now apparently carrying a recently discovered bacteria, Borrelia miyamotoi, which causes an as-yet-unnamed disease. The bacterium was first found to be pathogenic to humans in 2011, with the first US cases occurring in New England in January of this year. It’s now been found on the West Coast.

The Record Searchlight – “The bacteria have been found in ticks in 19 of California’s counties, including Shasta, Siskiyou and Trinity counties, according to the state Department of Public Health. Symptoms of the disease are similar to Lyme disease, which is caused by a bacteria called Borrelia burgdorferi, according to the state…It could be that the disease hasn’t been found in Shasta County, or anywhere else in California, because no one has been looking for the bacteria in sick people, district Vector Ecologist John Albright told the trustees during a board meeting Tuesday.”

Oddball Piece: Chelyabinsk meteor brought a dangerous virus to Earth?

OK, technically this shouldn’t be an oddball piece. There are whole scientific theories dedicated to the possibility of life on our planet being starting with alien bacteria, right? It’s just, we saw this and immediately thought, “Killer Viruses from Outer Space!!” Which made us laugh. So we included it. Happy Friday? [extra points if you can tell us what a “canny bolide” is]

The Voice of Russia – “This space guest which paid us a visit could actually be a Trojan Horse and physical damage from its explosion could be nothing compared to other potential dangers. This canny bolide that managed to sneak away from telescopes might have brought new viruses or bacteria to Earth.”

The Pandora Report

Highlights include H5N1 is making health investigators in China very nervous, the reasons why we are still leery of mutating it in the lab, bureaucratese strikes PAHPA, polymer sheets in bandages = less infection, the US fighting Ebola, and human life! now featuring bacteria. Happy Friday!

Bird Flu Death In China Sparks Fear Of Human-Transmitted H5N1 Strain

OK, now before you start making plans for that bird-flu apocalypse bunker, just put down the canned beets and listen for a sec.  It’s too early to tell. It’s entirely possible the health investigators missed a link. But also, and forgive the soapbox, this is exactly why things like a scientific moratorium on the potential aerosolization of H5N1 is so potentially dangerous.

International Business Times – “Health authorities in Guiyang, Guizhou province, announced that the 21-year-old woman, Shuai Pengyue, died on Wednesday due to multiple organ failure as a result of the flu. Shuai was one of two women reported in the area to have contracted the new strain of the avian influenza. Health officials have investigated the two of them and concluded that neither patient was in contact with poultry before showing symptoms of the illness. Victim proximity is important to note because typically, the bird flu is contracted by being in contact with poultry. In this case, health officials worry this could be signs that the H5N1 strain can now be transmitted between humans.”

The Deadliest Virus

This clearly isn’t a black and white issue, and both sides of the debate raise valid points. Here’s a good presentation of why we aren’t all gung-ho H5N1.

Harvard Magazine – “BIRD FLU (H5N1) has receded from international headlines for the moment, as few human cases of the deadly virus have been reported this year. But when Dutch researchers recently created an even more deadly strain of the virus in a laboratory for research purposes, they stirred grave concerns about what would happen if it escaped into the outside world. ‘Part of what makes H5N1 so deadly is that most people lack an immunity to it,’ explains Marc Lipsitch, a professor of epidemiology at Harvard School of Public Health (HSPH) who studies the spread of infectious diseases. ‘If you make a strain that’s highly transmissible between humans, as the Dutch team did, it could be disastrous if it ever escaped the lab.’…Lipsitch, who directs the Center for Communicable Disease Dynamics at HSPH, thinks the risks far outweigh the rewards. Even in labs with the most stringent safety requirements, such as enclosed rubber ‘space suits’ to isolate researchers, accidents do happen. A single unprotected breath could infect a researcher, who might unknowingly spread the virus beyond the confines of the lab.”

Senate Panel Approves Revised Biodefense Proposals

PAHPA reauthorization, new and apparently improved in the Senate. The extent of the improvement? Changing bill language from “redployment” to “reassignment”. Yes, apparently this is a significant difference. No, representative was available to clarify why/how. No, we are not speculating.

NTI – “The Senate Health, Education, Labor and Pensions Committee sent the full chamber its own version of the Pandemic and All-Hazards Preparedness Reauthorization Act in place of a bill approved by the House of Representatives last month. The proposals are nearly identical, but the latest text would still require House endorsement upon receiving Senate approval. Congress failed in its previous session to reconcile separate reauthorization drafts endorsed by each side. ‘This was a reauthorization of this important act, and … we not only reauthorized it, we made it better,’ Senator Richard Burr (R-N.C.) said in a morning session to mark up the legislation.”

Polymer controls bacteria and prevents antibiotic resistance

If viable, the potential implication of such bandages would be significant, especially in areas of higher risk of infection –  triage centers during a disaster or soldiers in theatre, for example.

The Engineer – “Researchers at KTH Royal Institute of Technology in Stockholm have discovered an antibacterial polymer that can be used in products including sportswear and bandages. It is claimed the discovery could be an important breakthrough in the search for environmentally-friendly ways to control bacteria while preventing antibiotic resistance and resistant bacteria.‘We have managed to find an antibacterial polymer that attaches stably to cellulose and therefore cannot be released into the environment,’ said Josefin Illergård, a chemistry researcher at KTH.”

US offers Shs26b to fight Ebola, Marburg

It’s bad form here at Mason Biodefense to go too long without talking about Ebola, but luckily the virus is remaining quiet. So instead, a little blurb about US efforts to keep it that way.

Uganda Daily Monitor – “The $10m (about Shs26b) project dubbed Emerging Pandemic Threat Programme aims at equipping doctors and veterinarians to strengthen their coordination in carrying out joint research and and treatment of zoonotic diseases.”

We are living in a bacterial world, and it’s impacting us more than previously thought

Are humans still human if the majority of our genome is derived from a common ancestor we share with bacteria? Is that a silly question? Maybe. For a thorough and thought-provoking piece on the role of bacterial species in our humanity, read below.

Phys.org – “Throughout her career, the famous biologist Lynn Margulis (1938-2011) argued that the world of microorganisms has a much larger impact on the entire biosphere—the world of all living things—than scientists typically recognize. Now a team of scientists from universities around the world has collected and compiled the results of hundreds of studies, most from within the past decade, on animal-bacterial interactions, and have shown that Margulis was right. The combined results suggest that the evidence supporting Margulis’ view has reached a tipping point, demanding that scientists reexamine some of the fundamental features of life through the lens of the complex, codependent relationships among bacteria and other very different life forms.”