Pandora Report: 8.24.2018

by spopescu, posted in Pandora Report

Welcome to your weekly dose of biodefense news. Boston’s BSL-4 lab, the NEIDL (not the best choice of a name…) is now open!

GMU Biodefense Graduate Degrees – Open Houses & Back to School
Interested in advancing your biodefense education to the Master’s or PhD level? Check out one of our upcoming open houses to chat with faculty and current students to learn more about the curriculum, admission requirements, and why GMU’s biodefense program is the place for all things health security, from anthrax to Zika. The next MS Open House will be on Thursday, September 20th at 6:30pm and the PhD Open House is on Wednesday, September 12th at 7pm – both are at the Arlington Campus. Already a biodefense student? Make sure you’re registered for classes as the fall semester is just around the corner. This fall brings about some great biodefense courses at GMU – don’t miss out on Dr. Andrew Kilianski’s course on biosurveillance (FYI – as a participant in the summer workshop on health security, his presentation was among the best, so you’ll want to get an entire semester learning from him!), Dr. Phillip J. Thomas’s Food Security course (after all, food safety is really America’s soft underbelly), and NextGen GHSA’s Jamechia Hoyle’s course on global health security policy (Jamechia has traveled the globe working on the GHSA, so her stories alone will make this a truly captivating class). Those are just a few of the courses offered this fall, so make sure you take advantage of the amazing faculty we have.

Ebola Outbreak – Updates
Case counts from the DRC outbreak have grown as the latest WHO situation report revealed 102 cases and 59 deaths. “As of 20 August 2018, a total of 102 confirmed and probable EVD cases, including 59 deaths, have been reported. Of the 102 cases, 75 are confirmed and 27 are probable. Of the 59 deaths, 32 occurred in confirmed cases and 27 remain probable. A total of 13 cases have been reported among health workers, of which, 12 are confirmed and one has died. Since the onset of the outbreak, a total of 10 case-patients have recovered from the disease and were discharged and re-integrated into their communities.” The WHO also reports that 95% of the 1,782 case contacts have been traced and a total of 2,179 people have been vaccinated.

Conference Report: Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
East Bay Biosecurity’s Brian Wang is not only a doctoral student studying synthetic organic chemistry at UC Berkley, but also a purveyor of biosecurity. In his recent write-up of the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security, he gives insight into the workshop through the eyes of a synthetic biology researcher. “The Summer Workshop on Pandemics, Bioterrorism, and Global Health Security was a testament to how such communication between stakeholders can be effective, as it brought together participants from a diverse set of backgrounds to discuss a multitude of difficult biosecurity-related issues. While speakers often mentioned how the isolation of different perspectives on how to confront biosecurity challenges has led to needless conflict in the past, the environment of the workshop itself provided a clear contrast to that historical backdrop, as participants with different backgrounds frequently interacted in lively discussions.”

GMU Biodefense Student Awarded AAUW Grant
We’re excited to announce that GMU biodefense MS student Janet Marroquin received a Career Development Grant from the American Association of University Women. “Marroquin is a mother, first-generation immigrant, the first in her family to go to college and a minority in a male-dominated health security field. She aspires to support female empowerment through continuous community service and alumni mentorship programs. ‘It’s heartwarming to see that women are being recognized as having more barriers in certain academic fields,’ said Marroquin, noting an AAUW study that student debt disproportionately impacts women.” Congrats Janet!

 Anniversary of the Ghouta Sarin Attack
It’s been five years since the horrific and deadly sarin attack in Ghouta, near Damascus in Syria. One of the most horrific chemical attacks in history, estimates put the deaths around 1,400 and roughly 3,500 people displaying neurotoxic symptoms. You can find a comprehensive overview of the attack and intelligence gathering efforts after here. “The UN report said several surface-to-surface rockets capable of delivering significant chemical payloads were identified and recorded at investigated sites. In Muadhamiya, the UN team were filmed inspecting an expended rocket motor found near the Rawda Mosque. In their report, they said the ordnance they found in the area was about 140mm wide and had an engine with 10 jet nozzles. They did not identify it, but arms experts said it was a Soviet-era 140mm surface-to-surface artillery rocket, known as the M-14.” This attack was sadly not the last to take place in warn-torn Syria, as the Assad regime has taken a liking to the use of chemical weapons despite international prohibition. You can also read first-hand accounts from rescue teams on the ground following the attack, to truly understand the horrors of such an event. “On that horrible day, we all became medics. Though I’m a trained dentist, I remember running to the hospital to help where I found a scene worse than any nightmare. Brave civilians came to the hospitals and volunteered to do anything – operate water pumps to wash the gas off the victims’ bodies, supply fuel, and even evacuate casualties. The attack was so massive in its scale that all these volunteers still weren’t enough to care for everyone. Rescue teams entered affected houses and evacuated all those inside with no time to examine them individually. None of them wore protective material; none of them had any.” So where are we now? Despite continued use of chemical weapons, there has been virtually no progress made to punish the Assad regime. Russia has repeatedly protected Syria against inspections and UN efforts, leaving many to call for #noimpunity. The majority of states parties in the Chemical Weapons Convention (CWC) recently adopted a decision to expand the mandate of the Organization for the Prohibition of Chemical Weapons (OPCW). “It paves the way for The Hague-based organisation to later identify or, at least, create the conditions for the identification of those responsible for chemical weapons attacks. It also strengthens chemical weapons control because the OPCW will now hopefully be able make reliable statements on who is responsible for the continuing use of chemical weapons.” The US, UK, and France also just released a joint statement in the wake of the anniversary of the attack- “Our position on the Assad regime’s use of chemical weapons is unchanged. As we have demonstrated, we will respond appropriately to any further use of chemical weapons by the Syrian regime, which has had such devastating humanitarian consequences for the Syrian population. We welcome the establishment of attribution arrangements at the Organization for the Prohibition of Chemical Weapons (OPCW), in accordance with its authority under the Chemical Weapons Convention, as confirmed by the decision of the Conference of States Parties”

The Art of Russian Disease Misinformation 
This week researchers announced that during efforts to improve social media communication for public health workers, they stumbled across a scary finding – “trolls and bots skewing online debate and upending consensus about vaccine safety. The study discovered several accounts, now known to belong to the same Russian trolls who interfered in the US election, as well as marketing and malware bots, tweeting about vaccines. Russian trolls played both sides, the researchers said, tweeting pro- and anti-vaccine content in a politically charged context.” One of the researchers, Mark Dredze, from Johns Hopkins noted that “By playing both sides, they erode public trust in vaccination, exposing us all to the risk of infectious diseases. Viruses don’t respect national boundaries.” Unfortunately, this isn’t a novel event. During the 1980s, the Soviets worked to spread misinformation about HIV/AIDS.  “A few years ago, historian Douglas Selvage discovered the blueprint for a fake news campaign. It was a 1985 cable from the Stasi, the former East German police, outlining how the Soviet Union and its allies were working to promote the idea that AIDS was an American biological weapon. ‘We are carrying a complex of active measures, in connection with the appearance in recent years, of a new, dangerous disease in the United States: Acquired Immuno Deficiency Syndrome, or AIDS’.” The lie that HIV was a biological weapon is even more ironic considering this was at a time when the Soviet bioweapons program was secretly continuing efforts to develop biological weapons, despite agreeing to the 1972 Biological Weapons Convention. “Back in the 1980s, the rumor that AIDS was human-made was based partially on a report written in 1986 by Russian-born biophysicist Jakob Segal. ‘It was very successful,’ explains Selvage. ‘The local press picked up on it. And then also British newspapers picked up on it. It started to spread around the world.’ Even U.S. newspapers picked up the story. Papers read specifically by African-American and gay communities, both of which were being devastated by the epidemic. ‘AIDS/Gay Genocide’ read a headline in the Gay Community News, based in Boston, which quotes Segal extensively.” Efforts to create mistrust in public health, especially vaccines, can be deadly and in the midst of a large measles outbreak across Europe, we can’t afford to ignore these attacks.

Smallpox – The Virus We Can’t Shake
What happens in VECTOR freezers, stays in VECTOR freezers? That’s the hope at least when it comes to smallpox. There will probably always be concern regarding the remaining stockpiles in CDC and VECTOR freezers, but a recent exercise at UNSW Sydney sought to test how frontline responders, researchers, and policymakers would respond to a smallpox outbreak originating in Fiji. Spoiler: we’re not prepared and it didn’t turn out well. “In the event of global spread, first responders would need to isolate 70% of smallpox patients and track and vaccinate at least 70% of their contacts. If this dropped to less than 53%, it would take over four years and 2 billion doses of vaccine to bring the epidemic under control. The existing World Health Organisation stockpile contains 35 million doses of vaccine. The vaccine could be diluted in such an emergency, but resources to effect large scale isolation and quarantine would be the main problem.” GMU biodefense PhD student Saskia Popescu recently emphasized why there is continued concern for smallpox, but also why frontline providers should brush up on this long-forgotten virus. “As such, smallpox and the actuality of its threat is a complex topic for which there is a spectrum of answers. Most medical providers alive today have not seen a case of smallpox outside of a textbook. For this very reason (and all those listed previously) I advise clinicians to take a moment and remind yourself about the disease. Remember the importance of isolation precautions and take 5 minutes to refresh your memory on what smallpox looks like in a patient before the never event of an outbreak becomes a reality.”

CRISPR and Gene Editing: Bio-Security/Safety Considerations and Best Management Practices
Don’t miss out on this webinar from the Next Generation GHSA on Wednesday, August 29th at 1pm ET. The talk will be led by Dr. Sengupta. “Dr. Aparupa Sengupta received her Bachelor and Master of Science degrees in Biotechnology and Microbiology from Bangalore University, India. She then worked  as a Research Assistant in an Indian Council of Medical Research Lab in the field of Immunology and Microbiology in India before coming to the US in 2008 for her graduate studies. She completed her second Master of Science in Plant Molecular Genetics and Biotechnology (specializing in Biofuel research) in 2009 and a doctorate in Biological Sciences (specializing in Environmental Microbiology and Applied Plant Biochemistry) in 2014 , from Michigan Technological University, Houghton, Michigan. During her PhD. studies, in summer 2011, she worked as a Scientist Intern in the Environmental Microbiology Lab of US Army Corps of Engineers in Vicksburg, Mississippi in the field of Biodiesel production.” You can join the webinar here.

China’s African Swine Fever Containment Woes
Just another reason why you should take the Food Security class Dr. Phillip J. Thomas is teaching this semester…. African swine fever (ASF) is causing considerable concerns in the Chinese porcine industry. “’The entry of ASF into China is really a very serious issue,’ says Yang Hanchun, a swine viral disease scientist at China Agricultural University in Beijing. Given the scale of China’s pork sector, the economic impact could be devastating, Yang says, and the outbreak puts a crucial protein source at risk. From China, the virus could also spread elsewhere; if it becomes endemic, ‘it will represent a major threat for the rest of the world, including the American continent,’ says François Roger, an animal epidemiologist at the Agricultural Research Center for International Development in Montpellier, France.”

Stories You May Have Missed:

  • The Junior Disease Detectives: Operation Outbreak – “The Centers for Disease Control and Prevention (CDC) has partnered with the U.S. Department of Agriculture (USDA) and 4-H to develop “The Junior Disease Detectives: Operation Outbreak,” a graphic novel intended to educate youth audiences about variant flu and the real disease detective work conducted by public and animal health experts when outbreaks of infectious diseases occur. This graphic novel follows a group of teenage 4-H members who participate in a state agricultural fair and later attend CDC’s Disease Detective Camp in Atlanta. When one of the boys becomes sick following the fair, the rest of the group use their newly-acquired disease detective knowledge to help a team of public and animal health experts solve the mystery of how their friend became ill.”
  • FDA Challenge: Infectious Disease NGS Diagnostics for Biothreats – “To encourage the development and improvement of Infectious Diseases Next-Generation Sequencing (ID-NGS) analytical methods, precisionFDA – the community platform for NGS assay evaluation and regulatory science exploration – has launched the precisionFDA CDRH Infectious Disease NGS Diagnostics Biothreat Challenge. Professional and citizen scientists are invited to test their bioinformatics skills and software tools in a challenge to identify pathogens from the FDA-ARGOS database within host samples using NGS short-read data.”

Pandora Report 8.17.2018

by spopescu, posted in Pandora Report

Happy Friday fellow biodefense nerds! Welcome to your weekly roundup of all things global health security. If you’re finding yourself a food source for mosquitoes and ticks this summer, just a friendly heads up – the associated diseases are on the rise (hint: climate change may be a big reason).

The Lingering Scare of Smallpox
The recent FDA approval of TPOXX to treat smallpox, a disease eradicated since 1980, has many wondering, especially those of us born in a time where the vaccine was not necessary, why so much attention is being raised. It’s an easy thing to forget – the peril of a disease long since eradicated, but the threat of smallpox is very much still a concern in biodefense. Between the concerns of a laboratory biosecurity/biosafety incident at the two remaining stockpile locations or the chance that a frozen corpse (aka corpsicle) who died of smallpox could defrost as the Arctic permafrost melts. Did I mention the risk of a de novo synthesis like the horsepox one in Canada? These are the reasons we haven’t been able to shake the nightmare that is smallpox. “The greatest threat is advances in synthetic biology, which could permit a rogue lab to re-engineer a smallpox virus. In 2016, researchers in Canada announced that they had created horsepox using pieces of DNA ordered from companies. A synthetic smallpox virus could be even more dangerous than the original, because it could be designed to spread more easily or with ways to survive new therapies.” While we eradicated smallpox and proved that such a feat was possible, there is the painful reality that such efforts left an unvaccinated and inherently vulnerable population.

Biological Events, Critical Infrastructure, and the Economy: An Unholy Trinity
Biodefense graduate student Stephen Taylor is reporting on the latest Blue Ribbon Study Panel. “At its recent meeting about resilience, the Blue Ribbon Study Panel on Biodefense explored the potential impacts of a biological event on critical infrastructure in the United States, as well as the best way to approach risk mitigation.  Ann Beauchesne, former Senior Vice President of the National Security and Emergency Preparedness Department at the U.S. Chamber of Commerce, summed up critical infrastructure as ‘the critical services for our society and the backbone our economy.’  Projected increases in global travel, trade, and development all rely on critical infrastructure, magnifying the potential impact of insults to infrastructure systems.  Concurrently, biological threats are also on the rise. As the world warms and urbanizes, natural infectious disease outbreaks manifest in unexpected places.”

Ebola, Healthcare Workers, and the Pandemic Potential in Vulnerable Countries 
Every day brings news of the Ebola virus disease outbreak along the eastern border of the DRC. On Thursday, cases jumped by seven – one of whom is a healthcare worker. The outbreak is up to 73 cases, 46 of which are confirmed and 27 are probable. 43 deaths have been reported. Nearly a thousand people are under surveillance as contacts of cases and healthcare workers are again, experiencing increased risk of transmission. On Tuesday, it was reported- “that health worker Ebola infections could amplify the current outbreak in the Democratic Republic of Congo (DRC), the country’s health ministry today reported five more confirmed cases, including four involving health workers at a health center in Mangina. The other is a patient recently treated at that facility.” The hope is that the new vaccine can help put an end to the outbreak and curb the risk for healthcare workers. The recent outbreak draws attention yet again, to the inherent danger that infectious disease outbreaks pose in vulnerable countries. We’ve seen how fast and unexpectedly such outbreaks can spread beyond international borders (SARS, MERS, Ebola, etc.), which means that these are global health security issues. The 2013-2016 Ebola outbreak taught us a “great deal about how to respond in a fragile state setting. Traditional leaders and faith leaders played an important role in communicating necessary information and behavior change requirements to isolated groups who did not necessarily trust the government or health care workers.” Preventative measures like stronger public health and healthcare infrastructure can make a world of difference. “Preventative investments can mean the difference between life and death for people in those countries and the difference between an outbreak being contained or becoming an epidemic. As we face repeated outbreaks of infectious diseases, including new pathogens, it is essential that U.S. policy-makers continue funding the operations that make containment possible.”

BWC Meeting of Experts
Don’t miss out on the daily reports from Richard Guthrie on the latest MX. You’ll definitely want to check out days six and seven, where national implementation and preparedness were discussed. How would countries respond to a potential act of bioterrorism? Guthrie notes that “Concerns were raised about whether bodies such as the World Health Organization should be engaged with any assessment of the cause of an outbreak if there were indications it was deliberate in case this brought the health body into the security realm with potential negative consequences for other health work. A number of contributions to the discussion noted that health officials would have different roles to officials looking to attribute the cause of an attack and there was a need to ensure that effective ways of operating together were established. An example of the challenges was given in WP.10 from the USA in the section on ‘preservation of evidence’.” The response and preparedness measures for each country can be complex and challenging when considering the global context of the BWC. For example, Saudi Arabia discussed its own preparedness measures for natural events during times when influxes of people were expected (pilgrimages).

 The Economic Burden of Antimicrobial Resistance and the Drive For Intervention
A recent study enumerated the economic cost of antimicrobial resistance per antibiotic consumed to inform the evaluation of interventions affecting their use. Their model utilized three components – correlation coefficient between human antibiotic consumption and resulting resistance, economic burden of AMR for five key pathogens, and the consumption data for antibiotic classes driving resistance in these organisms. “The total economic cost of AMR due to resistance in these five pathogens was $0.5 billion and $2.9 billion in Thailand and the US, respectively. The cost of AMR associated with the consumption of one standard unit (SU) of antibiotics ranged from $0.1 for macrolides to $0.7 for quinolones, cephalosporins and broad-spectrum penicillins in the Thai context. In the US context, the cost of AMR per SU of antibiotic consumed ranged from $0.1 for carbapenems to $0.6 for quinolones, cephalosporins and broad spectrum penicillins.” Ultimately, they found that the cost of AMR per antibiotic frequently exceeded the purchase cost, which should encourage policy and consumption changes.

NASEM Report: Cooperative Threat Reduction Programs for the Next Ten Years and Beyond
The latest report from the National Academies is now available regarding the Cooperative Threat Reduction (CTR) Program. “The Cooperative Threat Reduction (CTR) Program was created by the United States after the dissolution of the Soviet Union to provide financial assistance and technical expertise to secure or eliminate nuclear weapons delivery systems; warheads, chemical weapons materials, biological weapons facilities, and nuclear, biological, and chemical weapons technology and expertise from the vast Soviet military complex. In a 2009 report, Global Security Engagement: A New Model for Cooperative Threat Reduction, the National Academy of Sciences (NAS) recommended adoption of a modified approach to thinking about CTR, including the expansion of CTR to other countries and specific modifications to CTR programs to better address the changing international security environment.” The report has insight from some of the time minds in the field of biological threats – Elizabeth Cameron, David Franz, James Le Duc, etc.

Stores You May Have Missed:

  • Key Global Health Positions and Officials in the USG – Have you ever wondered who is in charge for global health programs throughout the government? Look no further than this comprehensive list by the Kaiser Family Foundation.
  • CEPI Collaborative for Lassa Fever Vaccine– “In a deal worth up to $36 million to advance the development of a vaccine against Lassa fever, the Coalition for Epidemic Preparedness Innovations (CEPI) today announced a new partnership with Profectus BioSciences and Emergent BioSolutions.”

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

Biological Events, Critical Infrastructure, and the Economy: An Unholy Trinity

by spopescu, posted in Commentary

by Stephen Taylor, GMU Biodefense MS student 

At its recent meeting about resilience, the Blue Ribbon Study Panel on Biodefense explored the potential impacts of a biological event on critical infrastructure in the United States, as well as the best way to approach risk mitigation.  Ann Beauchesne, former Senior Vice President of the National Security and Emergency Preparedness Department at the U.S. Chamber of Commerce, summed up critical infrastructure as “the critical services for our society and the backbone our economy.”  Projected increases in global travel, trade, and development all rely on critical infrastructure, magnifying the potential impact of insults to infrastructure systems.  Concurrently, biological threats are also on the rise. As the world warms and urbanizes, natural infectious disease outbreaks manifest in unexpected places. Anthrax and ricin-laced letters to U.S. political leaders in 2001 and 2013, respectively, represent only the vanguard of a new age of deliberate biological threats.  Gene editing and synthetic biological technologies, as demonstrated by the de novo synthesis of horsepox virus in 2017, offer ever-evolving tools for creating potent biological weapons.  The Dutch Ministry of Defense has projected that the world is likely to face a large-scale biological attack in the next 10-15 years. America must be prepared for the contingency that biological threats and critical infrastructure collide. Continue reading “Biological Events, Critical Infrastructure, and the Economy: An Unholy Trinity” →

Pandora Report 8.10.2018

by spopescu, posted in Pandora Report

Biological Weapons Convention – Meeting of Experts
The 2018 Biological Weapons Convention Meeting of Experts (MX) is underway and we’ll be reporting out, but if you need a daily dose of news, check out the latest via these great sources – the Implementation Support Unit’s Twitter @BWCISU, live UN video feed, and the detailed daily reports from Richard Guthrie. In his first report of the MX, Guthrie discusses the new set up of meetings – “This series of meetings is the most recent iteration of work programmes held between the five-yearly Review Conferences of the Convention that are commonly known as the ‘inter-sessional process’.  The Eighth BWC Review Conference in 2016 was unable to agree on the contents of a new inter-sessional process but was able to agree to delegate further discussion on what might be in such a process to the Meeting of States Parties (MSP) held in December 2017.  The 2017 MSP agreed to the holding of five distinct MXs in each of 2018, 2019 and 2020.  Each year would also include a week-long MSP towards the end of the calendar year.” You can also read the Joint NGO Position Paper to the BWC, which was organized by Filippa Lentzos and underscores not only the importance of NGO involvement, but outlines several key components to strengthen cooperation and assistance, development in science and technology, etc. You can watch the delivery of the statement here (starting at 03:02:00). The Meeting of Experts will continue through August 16th, and we’ll be sure to keep you posted about any updates in the mean time!.

DRC Ebola Outbreak Update
The DRC continues to manage an outbreak in North Kivu, with 44 reported cases of Ebola virus disease. Of these cases, 17 are confirmed and 27 are probable. 54 suspected cases are also being investigated. “The health ministry said officials are putting contingency plans in place in Goma, in case the virus reaches the city. Elements of the plan include identifying an isolation unit at the city’s North Kivu Provincial Hospital, putting border officers at city entry points, and beginning social mobilization activities.”

The June 2018 Cologne Ricin Plot 
In June, German police unearthed a ricin plot by a Tunisian extremist in Cologne. “German intelligence had learned that Sief Allah H. had bought various materials via the internet, including more than a thousand castor beans and an electronic coffee grinder. During the police raid, a powdery substance was found, which subsequently tested positive for ricin. Holger Münch, head of Germany’s Federal Criminal Police Office (BKA), stated shortly after the raid, ‘There were pretty specific preparations for such a crime, using, if you want, a bio-bomb. This is a unique case, at least for Germany’.” There has been increasing counterterrorism concerns regarding the use of ricin by terrorists and extremists. The Cologne incident is particularly unique in that if the main suspect, Sief Allah H, is proven guilty, it will be the first time a jihadi terrorist has produced ricin in the West. “Equally troublingly, the case suggests radicalized individuals are indeed able to produce a biological weapon using internet tutorials. Though the Islamic State is in rapid decline in Syria and Iraq, the manuals and how-to instructions for explosives and other weapons are still available online. This material, which is being shared via Telegram channels and other forms of communication, still has the potential to inspire jihadis across the globe.” Make sure to also read the interview with British CBRN expert Hamesh de Bretton-Gordon in which he notes the greatest CBRNE concerns he has, from “the continued active use of chemical weapons against civilians in Syria” to “the Novichok attack in Salisbury. We now know that the Russians have an asymmetric capability in Novichok that overmatches NATO’s ability to defend against it. If the Russians used it tomorrow, we would certainly be found wanting and that will continue to be the case until we’ve got necessary defensive measures in place.”

Impact of the Global Medical Supply Chain on SNS Operations and Communications: Proceedings of a Workshop
The latest report from the National Academies of Science is out regarding supply chains and strategic national stockpile operations. “The Centers for Disease Control and Prevention (CDC) established the Strategic National Stockpile (SNS) with a focus on procuring and managing medical countermeasures (MCM) designed to address chemical, biological, radiological, and nuclear events and attacks by weapons of mass destruction. The stockpile is a repository of antibiotics, chemical antidotes, antitoxins, vaccines, antiviral drugs, and other medical materiel organized to respond to a spectrum of public health threats. Over time, the mission of the SNS has informally evolved to address other large-scale catastrophes, such as hurricanes or outbreaks of pandemic disease, and rare acute events, such as earthquakes or terror attacks. When disaster strikes, states can request deployment of SNS assets to augment resources available to state, local, tribal, or territorial public health agencies. CDC works with federal, state, and local health officials to identify and address their specific needs and, according to the stated mission of the SNS, ensure that the right resources reach the right place at the right time.” Within the report, there are discussions on the gaps within the global medical chain, supply chain issues related to the SNS, the role of strategic communication, etc.

MERS & The Role of Hospitals
The latest World Health Organization (WHO) global summary and risk assessment on Middle East respiratory syndrome-coronavirus has reinforced the notion that hospitals are amplifiers for the disease. While little has changed epidemiologically, the ongoing healthcare-related outbreaks are worrisome for longterm infection control. Of the six recent clusters reported from Saudi Arabia (hit the hardest with 83% of all cases), three were related to healthcare transmission. “Maria Van Kerkhove, PhD,  an epidemiologist who is the WHO’s technical lead for MERS-CoV, said the report’s findings are a reminder that the disease remains a global health threat. ‘This high threat respiratory pathogen has shown the potential to cause large outbreaks with substantial public health, security, and economic consequences,’ she told CIDRAP News.”

How CMS Rules Impact Infection Prevention Programs
Speaking of infection control and hospitals….GMU biodefense doctoral student and infection preventionist Saskia Popescu breaks down the concerning role that policy changes for healthcare reimbursement from the Centers for Medicaid and Medicare (CMS) have on infection prevention programs. “Moreover, these changes would not change much in terms of burden and workload for infection preventionists. The same types of reporting are required, and high rates of HAIs are still linked with financial penalties. In fact, there is concern that these proposed changes could give the impression that less work will occur, leading to a reduction in staffing for infection control programs, which has, ironically, already been cited as the cause of high HAI rates and even referred to by union leaders and workers as proof of staffing needs.” The strength of infection control programs within hospitals is critical to stopping not only the spread of spread of multi-drug resistant organisms, but also working to combat healthcare-associated infections, and making sure hospitals are better prepared for infectious disease threats like MERS, SARS, and Ebola.

Stories You May Have Missed:

  • Aggressive New Tick Species Moves Through The U.S. – “The tick (Haemaphysalis longicornis), referred to as the ‘longhorned tick’ or the ‘bush tick,’ was first identified in New Jersey in November 2017 on a sheep in Hunterdon County. Recently, the tick has been detected in Union and Middlesex counties of New Jersey as well, according to the New Jersey Department of Agriculture. However, New Jersey is not the only state to have identified the tick—it has now been reported in 8 US states.”

Pandora Report: 8.3.2018

by spopescu, posted in Pandora Report

 Ebola Returns to the DRC and A Lesson in Outbreak Response Failures 
Unfortunately, days after declaring the outbreak over, the DRC has reported four laboratory-confirmed cases of Ebola. The Ministry of Health is also reporting 26 people with hemorrhagic illness signs and symptoms. At this point, there has not been connective evidence between the new outbreak and the last one. The concerning aspect of this outbreak is its location – Beni, within the Magina health district, which is an active conflict zone and poses unique challenges for response efforts. “This new cluster is occurring in an environment which is very different from where we were operating in the northwest,” said Peter Salama, MD, WHO Deputy Director-General, Emergency Preparedness and Response. “This is an active conflict zone. The major barrier will be safely accessing the affected population.” As the DRC continues work to implement control and response measures, a new book from British physician Oliver Johnson and Irish Diplomat Sinead Walsh, is lifting the lid on the botched response to the 2014-2016 outbreak in west Africa. “In Getting to Zero, the duo show how a litany of mistakes made in distant offices in New York, Washington, London and Geneva, combined with poor leadership in Sierra Leone and a weak health service, created a catastrophe that could have been prevented. Among those coming under fire are the British army, the Department for International Development and the US Center for Disease Control. The sharpest criticism is levelled at the WHO, which was slow to declare the Ebola outbreak an international emergency, but also failed to heed early alarm calls made by medics who were working in horrific conditions in the Kenema hospital, where British nurse Will Pooleycontracted the virus.” The news comes just after a new species of Ebola virus was found in bats in the northern part of Sierra Leone.

UK Biological Security Strategy 
The latest policy paper from the British Department for Environment, Food & Rural Affairs, Department of Health and Social Care, and Home Office, has just been released. Outlining everything from the strategy to main assumptions of 2020 and beyond, the policy paper focuses on a response plan that includes understanding the threat, mechanisms for prevention, detection, response, and building a strong science base inclusive of industry and academia. “The strategy also recognises the importance of intervening early to prevent biological threats from emerging, or from spreading once they emerge. To this end, it sets out how we will make best use of our international activity to help reduce the risks to the UK and our interests, at home and overseas. This includes our engagement with international partners (at local, regional and national levels) and forums.” Some of the main assumptions to 2020 and beyond include: the world will continue to become more physically interconnected through travel and migration – affecting both natural health security and deliberate threats, advances in medical technology, genetic engineering and biotechnology will hold significant potential for UK prosperity and growth, etc. Their strategy is also inclusive of relevant national and international programs like the National Counter-Proliferation Strategy to 2020, the Global Health Security and UK Antimicrobial Resistance Strategy, etc.

Three Days Delving into Pandemics, Bioterrorism, and Global Health Security 
If you missed our three-day workshop last month, here’s a quick recap – be warned though, once you read it, you’ll want to join us at the 2019 workshop! “Attendees included people from Health and Human Services, the Department of Defense, and private industry such as Merrick & Company and Emergent Biosolutions. I was surprised to also see people from Sandia National Labs, the Pentagon Force Protection Agency, and even other universities. The diversity of the group led to some thought-provoking conversations surrounding topics like cyberbiosecurity and responding to biosecurity as ‘a wicked problem’. The workshop participants were an engaging group that left me re-thinking how I approach many of these biodefense topics.The workshop began with conversations surrounding how we might analyze biological threats not only from a social and cultural ecological perspective, but also through the resiliency of prevention practices. If we can’t always prevent, how do we respond? MIT’s Sanford Weiner posed such questions to the group, followed by a presentation on the swine flu pandemic of 1976 and discussion on how much the U.S. has learned from mass immunization history, especially compared to the UK.”

CRISPR Woes
CRISPR-Cas9 has been hailed as a revolutionary genome editing tool that will help cure disease. Unfortunately, cell repair following CRISPR enzyme snips isn’t working like we had hoped. “The discovery gives insight into why CRISPR-Cas9 gene editing works remarkably well in nearly every cell attempted, though not with equal success in all cells. ‘If you want to treat sickle cell anemia, your chances of success are inextricably tied to the efficiency with which you can replace the mutated sickle cell gene with the correct one,’ said UC Berkeley postdoctoral fellow Chris Richardson, first author of a paper describing the findings.” While CRISPR can be extremely precise in its ability to target specific DNA sequences, the tricky part is what comes after, when the cell has to repair the damage. “The enthusiasm for using CRISPR-Cas9 for medical or synthetic biology applications is great, but no one really knows what happens after you put it into cells,” Richardson said. “It goes and creates these breaks and you count on the cells to fix them. But people don’t really understand how that process works.”

The High Cost of A Measles Outbreak
Have you ever wondered how large the bill might be for responding to an outbreak of measles? This vaccine-preventable disease is a particularly troublesome foe for public health and infection prevention efforts as its airborne transmission makes control efforts extremely difficult. A new study has just reported the $395,000 price-tag for the New York City health department’s efforts during a 2013 measles outbreak that sickened 58 people. “The first patient was an unvaccinated adolescent who returned to New York City while infectious after visiting London. The outbreak, centered in the orthodox Jewish community, marked the city’s biggest measles outbreak since 1992. With the first case reported in March, health officials spent the next 4 months fielding reports of suspected cases, interviewing patients, reviewing medical and immunization records, tracing contacts, and doing community outreach. The 58 cases came from two neighborhoods of Brooklyn, many of them members of eight extended families, and involved six generations of transmission. Of the total, 45 (78%) were at least 12 months old and weren’t vaccinated due to parental refusal or intentional delay. Twelve patients were younger than 12 months old and were too young to be immunized with measles, mumps, and rubella (MMR) vaccine. One patient was an adult who reported a history of receiving a measles-containing vaccine as a child.” You can read more about the financial impact of a measles outbreak here, where GMU biodefense doctoral student Saskia Popescu was a part of the response efforts.

News You May Have Missed:

  • Trump Taps New White House Science Adviser – Meteorologist Kelvin Droegemeier has been tapped to take over the position and end the void at the White House for the Office of Science and Technology Policy. “Droegemeier would be the first non-physicist to serve as White House science adviser since Congress established the OSTP in 1976. “I think he is a very solid choice,” says John Holdren, who led the OSTP for eight years as Obama’s science adviser. “He is a respected senior scientist and he has experience in speaking science to power.” An expert on extreme-weather events, Droegemeier has been vice-president for research at the University of Oklahoma in Norman since 2009. Last year, Oklahoma Governor Mary Fallin, a Republican, appointed him as the state’s secretary of science and technology.”

Pandora Report: 7.27.2018

by spopescu, posted in Pandora Report

Happy Friday! While everyone is celebrating the last few weeks of summer, your favorite source for all things biodefense isn’t slowing down. Make sure to read Laurie Garrett’s comments on why we’re in the next HIV pandemic and how the global strategy is seriously flawed.

 NASEM Report: Biodefense in the Age of Synthetic Biology
GMU Biodefense student and Research Fellow for Institute for Philosophy and Public Policy, Sarah W. Denton, recently attended the NASEM public briefing on their new report – Biodefense in the Age of Synthetic Biology. Denton notes that “While the framework draws on previous works (e.g., Tucker 2012and the 2004 Fink report), what makes this report unique is its use of the Design-Build-Test (DBT) process as the foundation for its capability-assessment. DBT is the ‘iterative process of designing a prototype, building a physical instantiation, testing the functionality of the design, learning from its flaws, and feeding that information back into the creation of a new, improved design’.” Check out her detailed recap of the event and the report, including the noticeable absence of “the potential benefits and safety concerns related to developments in synthetic biology”.

 

DARPA’s Prepare Program 
Filippa Lentzos and Jez Littlewood are asking – what exactly does DARPA’s Prepare program actually prepare for? “Called ‘Prepare’ (short for ‘Pre-emptive Expression of Protective Alleles and Response Elements’), the program aims to develop programmable modulators that temporarily boost protective genes, either before or after exposure, to biological, chemical, or radiological health threats. Inadvertently, however, the project may contribute to rising international tensions in the biological field. The program might push the limits of what is allowable under international security treaties, particularly the 1972 Biological and Toxin Weapons Convention (BTWC).” Underscoring the importance of the US being a role model for BTWC compliance, they note that programs like Prepare further the gray zone of biodefense that makes communication of intent that much more important. “The Prepare program continues to expand US biodefense gray-zone activities—and states keeping a close eye on the US biodefense enterprise may well question the program’s intent. Some might feel threatened by it. A small number—concerned about new threats highlighted by US activities, or in preparation for a sudden change in the US attitude toward the absolute prohibition of biological weapons—might even take reciprocal action, initiating additional gray-zone biodefense activities of their own. The result could be a downward security spiral in which greater offensive know-how on all sides leads to increased danger of biological attack against more states.” Lentzos and Littlewood note that programs of this nature must work to proactively disclose information regarding intent through compliance reports and encourage the peer review of national biodefense programs as a confidence-building measure.

DRC Declares Ebola Outbreak Over
The DRC has officially declared the end of the outbreak after it was initially identified in early May. This outbreak marks the 9th that the DRC has seen and involved 54 cases and 33 deaths. “Though the country is experienced in managing Ebola outbreaks, health minister Oly Ilunga Kalenga, MD, said in a statement today that officials noted early warning signs that the outbreak had the potential to evolve into a major crisis. Illnesses emerged in two remote, heavily forested health zones at the same time and health workers were infected, a factor known to intensify the spread of the virus.” This news comes as scientists announced that women may be able to transmit the disease well over a year after infection. The trigger for this realization was a female patient in Liberia at the end of the outbreak in 2015. The woman fell ill after giving birth, which has raised questions regarding the immune suppression that occurs during pregnancy and how that may trigger Ebola relapses. This finding has raised considerable concern for not only the spread of the disease, but also stigma for survivors.

The Hot Zone Turns Into A TV Show
We’ve all read, or at least heard of, the infamous Ebola book, The Hot Zone, by Richard Preston. While the theatrics of its more dramatic moments can be laughed at, for many, it inspired us to get into the field of biodefense or infectious diseases. National Geographic is now working to bring it to the small screen with a scripted miniseries. It’s been a disappointing road for those of us yearning for a decent infectious disease show, but I’m cautiously optimistic based off National Geographic’s recent efforts to bring truth to TV in their Genius series. Production begins this fall in Toronto and South Africa.

 The Frustrating Predicament of PPE Compliance
GMU Biodefense doctoral student and infection preventionist Saskia Popescu is shedding light on some painful truths about healthcare worker PPE compliance. “I’ve heard lectures on Clostridium difficile where the presenters commented on how prevalent isolation failures are when caring for C diff patients, noting that it’s often best to just accept this reality and instead emphasize environmental cleaning and good hand hygiene to combat the spread. The truth is that health care workers, especially nurses, are moving a million miles a minute and running in and out of patient rooms, which makes the burden of PPE understandable. Unfortunately, this doesn’t mean lax isolation precautions should be accepted or encouraged.” Popescu points to a recent study that evaluated PPE failures and that “a total of 280 failures were observed, including 102 violations (deviations from practice), such as entering an isolation room without PPE or not wearing the PPE correctly, etc.”

Blue Ribbon Study Panel – The Cost of Resilience: Impact of Large-Scale Biological Events on Business, Finance, and the Economy
Don’t miss this event next week regarding biothreats and economic impacts. “Despite recognition of the important role of industry and other private sector elements in defending the nation against biological threats, the United States has yet to adequately plan for and support private sector engagement in preparing for biological incidents. To examine private sector roles and responsibilities before, during, and after the response to large-scale biological events, the Blue Ribbon Study Panel on Biodefense will hold a public special focus meeting on July 31, 2018 to address The Cost of Resilience: Impact of Large-Scale Biological Events on Business, Finance, and the Economy.”

Low Antibiotic Levels in the Environment Encourage Resistance 
It doesn’t get more One Health than antimicrobial resistance. AMR is the perfect example to reveal how the environment, animal, and human health are all tied together and a new study is highlighting this through the role of environmental antibiotic levels and their role in resistance. “In a study published in the journal mBio, researchers with the University of Exeter Medical School, the University of Hong Kong, and drug-maker AstraZeneca report that even when bacterial communities in wastewater are exposed to small amounts of the antibiotic cefotaxime, selection pressure for clinically important antibiotic-resistant genes occurs. Moreover, they also found that the selection pressure for resistance may be just as strong as when exposed to high concentrations of the drug. The findings are important because they suggest that environments that are commonly found to have trace amounts of antibiotics, such as hospital effluent and rivers and streams that receive wastewater, could be an important, and overlooked, breeding ground for antibiotic-resistant bacteria”. You can read the study here.

Stories You May Have Missed:

  • 23andMe Teams Up With Glaxo – If you’ve used 23andMe, your DNA is likely to be used for the development of new drugs due to a new partnership (with consent of course.). “Home DNA test results from the 5 million customers of 23andMe will now be used by drug giant GlaxoSmithKline to design new drugs, the two companies announced Wednesday. It’s the biggest partnership yet aimed at leveraging the increasingly popular home genetic testing market, in which customers pay for mail-in saliva tests that are analyzed by various companies.”

NASEM Report: Biodefense in the Age of Synthetic Biology

by spopescu, posted in Commentary

Written by: Sarah W. Denton, Research Fellow, Institute for Philosophy and Public Policy, George Mason University; Research Assistant, Science and Technology Innovation Program (STIP), The Woodrow Wilson International Center for Scholars

On June 19, 2018, the National Academies of Sciences, Engineering, and Medicine (NASEM) held a public briefing timed with the release of a new report titled, Biodefense in the Age of Synthetic Biology. The panel – comprised of the committee chair, Dr. Michael Imperiale, and four authors of the report, Dr. Patrick Boyle, Dr. Peter Carr, Dr. Diane DiEuliis, and Dr. Jill Taylor– gathered to present their research to the public and provide an opportunity for an in-person and online question and answer session.

During this briefing, the panel discussed the study’s concern-assessment framework (Figure 1). The framework consists of four factors that can be used to assess the level of concern for current and future synthetic biology capabilities. Notably, rather than attempting to assess the levels of concern presented by various technologies (e.g., CRISPR/Cas9), this framework focuses instead on assessing capabilities “that potentially pose a concern because of the harm they might enable.”[i]

While the framework draws on previous works (e.g., Tucker 2012and the 2004 Fink report), what makes this report unique is its use of the Design-Build-Test (DBT) process as the foundation for its capability-assessment. DBT is the “iterative process of designing a prototype, building a physical instantiation, testing the functionality of the design, learning from its flaws, and feeding that information back into the creation of a new, improved design.”[ii]Specifically, the committee found it useful to conceptualize current and future technological developments in terms of the ways in which they enable the DBT cycle, granting that it is entirely possible for some technologies to have impacts across    multiple phases of the DBT cycle.[iii]For example, the committee identified potential points of concern in all phases of the DBT process in their analysis of the level of concern relating to the re-creation of known pathogens.[iv] Continue reading “NASEM Report: Biodefense in the Age of Synthetic Biology” →

Pandora Report: 7.20.2018

by spopescu, posted in Pandora Report

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
This week Schar Biodefense hosted a three-day workshop on all things health security, from anthrax to Zika. Highlights from the first two days include a rousing discussion by Dr. Robert House surrounding medical countermeasures and the potential for nefarious actors to highjack the immune system, Sandy Weiner delving into the history of the 1976 influenza pandemic, GMU professor and virologist Dr. Andrew Kilianski breaking down some hard realities of biosurveillance, and Edward You of the FBI discussing the importance of working with the DIY biohacker community and protecting the bioeconomy. While the workshop continues through today, make sure to check back next week for more coverage.

 Vaccine Causing Polio in Africa? Context From An Expert
GMU Biodefense PhD alum Christopher K. Brown sat down with Lucien Crowder of the Bulletin of the Atomic Scientists to discuss vaccine derived polio and the implications of these outbreaks. Brown discussed the vaccine production process, how they can cause an “infection light”, and the current outbreak in the DRC. “In the Democratic Republic of the Congo, a vaccine-derived type 2 poliovirus is responsible for the current outbreak, even though it is no longer a component of the live, attenuated oral vaccine that most countries use (when, that is, an oral, attenuated vaccine is used instead of a fully inactivated injectable formulation that is safer but potentially less effective). Despite a World Health Organization–led switch from the three-type, or trivalent, vaccine to a bivalent preparation, the vaccine-derived type 2 virus continued to spread from person to person undetected, slowly mutating to regain the neurovirulence that can cause paralysis in those who are infected. Now, to stop the current outbreak, health officials are deploying a monovalent vaccine formulated specifically for type 2 poliovirus. The key is to reach susceptible individuals—namely, those who did not receive the trivalent option previously—with the vaccine before the virulent strain of the virus does. If enough people are vaccinated, the mutated, vaccine-associated strain will not continue to infect new people and the outbreak will subside.” Brown took care to discuss how these incidents are high-jacked by the anti-vaccination movement, but that “the argument that vaccines cause injury often focuses on the myth that certain chemicals in vaccines—including preservatives, like Thiomersal, that are no longer used in vaccine formulations—cause autism. The polio outbreak in the Democratic Republic of the Congo is a case in which a strain of virus that was rendered safe for vaccinating most people has regained some of its disease-causing abilities through genetic mutation. That’s sort of similar to why bugs that are more common problems in developed countries, like staphylococcus and gonorrhea, stop responding to antibiotics: They acquire genetic mutations that make them resistant to certain drugs. What is most important here is to consider the level of risk associated with vaccine-linked outbreaks, or cases of paralysis, compared to the effects of polio in an unvaccinated population. While the attenuated poliovirus in the vaccine itself may lead to no more than four or five cases of paralysis among every million individuals vaccinated, there would likely be thousands of cases of serious disease among a million exposed, unvaccinated people.”

Why Aren’t We More Worried About The Next Epidemic?
In the past couple of months, we’ve seen outbreaks of Ebola, MERS, Zika, Nipah virus, Rift Valley fever, and Lassa fever – so why aren’t we more worried about the next epidemic? Globalization makes the movement of people and goods easier and faster – consider that 107 countries received frozen vegetables now being recalled for Listeria. The good news is that information technology allows us to know about these outbreaks and have the ability to notify necessary agencies and resources at a rapid pace. “Several major factors are to blame for why the world is seeing more of these increasingly dangerous pathogens. The combination of massive widespread urbanization, explosive population growth, increased global travel, changing ecological factors, steady climate change and the exploitation of environments is driving an era of converging risk for outbreaks, experts say.” Dr. Thomas Inglesby, director of the Johns Hopkins Center for Health Security, noted that ‘We don’t know when the next Ebola outbreak will come but we do know it will come again, and again, and again’.” Outbreaks like SARS and Ebola have shown the devastating impact outbreaks have on not only the healthcare system, but also the economy. Unfortunately, emergency preparedness and healthcare response is a tough problem to fix. The CDC director of the Center for Global Health, Rebecca Martin, stated that “Gaps in public health emergency response capabilities remain a serious vulnerability for the entire world,” she added. “While we don’t know when or where the next pandemic will occur, we know one is coming”. We know the next pandemic is coming, the unknowns are from where, when, and what it will look like. This makes response, including medical countermeasures, that much more difficult. R&D is a critical component to this, but as Dr. Inglesby noted, “The problem with public health in particular and with R&D is what we’re ultimately trying to do is prevent bad things from happening. When you succeed, it’s relatively invisible ― so the public doesn’t get to see why investment is so important.” Inglesby also recently highlighted the six ways countries can prepare for the next pandemic. From enhancing capabilities to develop new vaccines/medical countermeasures, to investing in more robust public health systems, there are several ways we can facilitate stronger national capacity to respond to pandemics.

Crucial Steps Forward: the National Academies of Science’s 2018 Study, “Enhancing Global Health Security through International Biosecurity and Health Engagement Programs”
GMU biodefense MS student Alexandra Williams recently attended the NASEM meeting regarding global health security through international biosecurity and health engagement programs. Within her recap, Williams discusses the background of CBEP (Cooperative Biological Engagement Program) and CTR (the DoD’s Cooperative Threat Reduction program), noting their efforts to strengthen health security within the U.S. and abroad. “As challenges continue to arise in timely and accurately detecting and responding to disease outbreaks—as we saw in 2014 with Ebola in West Africa, and in 2016 with Zika—U.S. health and security agencies are working to better meet these challenges, and examine how they need to evolve to meet unforeseen hurdles that lay ahead. This NASEM study is timely and critical because it addresses and examines these issues head-on, and will serve as the launch point for how the U.S. can rethink, reshape, and improve its already critical and successful work in biosecurity and global health security.”

Book Review – Dirty War: Rhodesia and Chemical Biological Warfare
Glenn Cross, GMU biodefense PhD alum, has taken great care to investigate and detail the history of Rhodesia’s chemical and biological warfare program against insurgents from 1975 to 1980. If you’re on the fence about adding a new book to your reading list, check out Ryan Shaffer’s latest review. “Organized topically, the book’s preface offers a brief overview of Rhodesia’s colonial history and demographics, discussing the ethnic and racial divisions arising from a white minority’s control of the government over a disenfranchised and mostly rural black African population. Cross describes the Rhodesian War with emphasis on “the regime’s inability to defeat decisively a growing guerrilla insurgency through conventional arms alone.” (39) He explains the conflict’s evolution in the context of post-war British decolonization and the manner in which the Unilateral Declaration of Independence was designed to maintain white minority rule, as well as the ensuing international sanctions that isolated Rhodesia. By the late 1960s, government opponents shifted strategy, believing the only way to change the country was to forcibility seize control. Meanwhile, the CIO had penetrated the opponents’ ranks, gathering intelligence and setting up the Selous Scouts to work against the guerrillas.” Shaffer notes that “the book is a well-researched study that sheds light on the reasons a government broke international norms to use CBW, a tactic more likely to target local non-state actors than foreign militaries.”

 Antibiotic Prescribing Failures in Urgent Care Centers
Disrupting antibiotic resistance is challenging due to not only the vast array of sectors that play a role, but also the cultural components. Prescribing habits are one of those culturally-engrained practices that can be difficult to alter. A new study has found that antibiotic stewardship is desperately needed in urgent care facilities. “Researchers with the Centers for Disease Control and Prevention (CDC), the University of Utah, and the Pew Charitable Trusts report that 45.7% of patients who visited urgent care centers in 2014 for respiratory illnesses that don’t require antibiotics end up with prescriptions for those conditions, followed by 24.6% of patients treated in emergency departments (EDs), 17% of patients who went to medical offices, and 14.4% of patients who visited retail clinics. The findings are based on analyses of 2014 claims data from patients with employer-sponsored health insurance. Previous estimates of outpatient antibiotic prescribing by some of the same researchers had pegged the amount of unnecessary prescribing at 30%, a number that some experts believe is conservative. Study coauthor David Hyun, MD, a senior officer with Pew’s antibiotic resistance project, said the findings suggest that could very well be the case.” The sad reality is that these numbers are likely to be higher across the U.S. as inappropriate prescribing practices are a systemic issue. This finding is one piece of the puzzle, which underscores the progress that needs to be made. Fortunately, countries are working to reduce antimicrobial resistance and while it’s slow, some movement forward is better than none at all.

Rift Valley Outbreak in Uganda
Uganda has reported an outbreak of Rift Valley fever across two districts. Rwanda is also reporting cases in animals and potential cases in humans. “The WHO said the affected districts are in the ‘cattle corridor’ that stretches from the southwest to the northeast regions of the country. ‘The outbreak in Uganda is occurring at a time when Kenya is having a large RVF outbreak and Rwanda is experiencing an epizootic, with suspected human cases,’ the WHO said. In Kenya, where an outbreak has been under way since May, four more Rift Valley fever cases have been reported, raising the outbreak total as of Jul 4 to 94, 20 of them confirmed. Ten deaths have been reported. Illnesses have been reported in three counties: Wajir, Marsabit, and Siaya. The country’s agriculture ministry has reported several outbreaks in animals over the past few months, especially in areas that had experienced flooding after heavy rainfall.”

Stories You May Have Missed:

  • The Strange and Curious Case of the Deadly Superbug Yeast- Maryn McKenna discusses the latest resistant bug we’re worrying about – “It’s a yeast, a new variety of an organism so common that it’s used as one of the basic tools of lab science, transformed into an infection so disturbing that one lead researcher called it “more infectious than Ebola” at an international conference last week. The name of the yeast is Candida auris. It’s been on the radar of epidemiologists only since 2009, but it’s grown into a potent microbial threat, found in 27 countries thus far.”

Crucial Steps Forward: the National Academies of Science’s 2018 Study, “Enhancing Global Health Security through International Biosecurity and Health Engagement Programs”

by spopescu, posted in Commentary

By: Alexandra Williams, GMU MS Biodefense ‘18

This past Monday, July 16, 2018, the National Academies of Sciences, Engineering, and Medicine (NASEM) held an important meeting at their headquarters in Washington, D.C. At this meeting, they discussed with U.S. government security and health agencies the future of global health security, disease surveillance, and biosecurity, as well as the challenges and gaps that exist in meeting international and domestic health security missions and mandates. This second and final NASEM committee public meeting was a follow-up to their first meeting in April 2018. In these two meetings, NASEM was charged with examining and better understanding the Cooperative Biological Engagement Program (CBEP) of the U.S. Department of Defense (DoD)’s Cooperative Threat Reduction (CTR) program—CBEP being a forefront program for biosecurity and health security—and other U.S. government stakeholders in health security. An overview of the July 16, 2018 meeting can be found here. Additional information can be found via the National Academies of Sciences project information page. Continue reading “Crucial Steps Forward: the National Academies of Science’s 2018 Study, “Enhancing Global Health Security through International Biosecurity and Health Engagement Programs”” →

Pandora Report – 7.13.2018

by spopescu, posted in 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 8th. “’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.”

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