Pandora Report 1.29.2016

Happy Friday! Now that winter storm Jonas is behind us, we can get back to tackling biodefense updates. Unless you’ve been avoiding the news, you’ve undoubtedly seen the surge in reports on Zika virus. Imported cases are popping up throughout the US, raising concerns about vulnerability and response. We’ll be covering the latest in Zika news, not to mention a pretty amazing disease modeling system, plague history, and how Brazil is prepping for the 2016 Olympics. Fun History Fact Friday: on January 28th, 2000, a US government study finally conceded that the cancer and premature deaths of several workers from a nuclear weapons plant (in service since WWII) were caused by radiation and chemicals and sticking with the nuclear weapon theme, on January 29th, 1964, Dr. Strangelove or: How I Learned to Stop Worrying and Love the Atomic Bomb premiered.

Open Source Disease Modeling: to Combat the Next Pandemic
GMU Biodefense PhD student, Nereyda Sevilla, has teamed up with Global Biodefense to discuss how transportation advances of the 21st century make outbreak preparedness and response extremely difficult. In most cases, health alerts and travel restrictions are reactionary to an outbreak that has already reached epic proportions. In response to this, scientists are working to predict disease spread and potential interventions through disease modeling. Spatiotemporal Epidemiological Modeler (STEM)  is one of these modeling systems that looks at several variables and parameters within the spread of an infectious disease and then models the efficacy of interventions. “The unique nature of STEM is that it is a multi-disciplinary, collaborative modeling platform.  The open-source characteristics of the system allow researchers and programmers to add, compare, refine, and validate different scenarios as well as add denominator data based on specialty.  For example, an infectious disease specialist in dengue working in South America may have unique disease characteristics and population data that could be tailored into STEM.” The best part? STEM is already pre-loaded with country data regarding national borders, transportation networks, air travel, and environmental conditions. Utilizing customized graphs and spatial maps, it can even be used to “create a spatial map of animal pens on a farm and to import that graph into the model to study the spread of a veterinary disease.” STEM can easily be downloaded and even has sample projects that many researchers from around the world have shared, like the 2014 Ebola outbreak, dengue fever, H1N1, etc. STEM is undoubtedly a significant weapon in the global health security arsenal to combat future pandemics.

Zika Virus Outbreak Updates
While 200,000 Brazilian troops are being mobilized to battle mosquitoes in a house-to-house strategy, Zika virus has reached 23 countries. As of January 28th, 2016, the WHO has set up an emergency team to respond to the growing epidemic. Meeting on Monday, the WHO team will decide if the Zika virus outbreak should be treated as a global emergency, as they are predicting “three to four million cases” in the Americas. Fear continues to grow in the US as cases are popping up in Los Angeles Country, CA Virginia, New York, and Arkansas, in a returned travelers. President Obama just called for a speeding up of Zika virus research to battle the growing outbreak. Sydney has also confirmed imported cases. While many worry that returning travelers are bringing the mosquito-borne disease back home, it’s important to note that it’s during the first week of infection that the virus is found in the blood and can be transmitted via mosquitoes.  Vertical transmission (from mother to child) is possible if the maternal infection is near the time of delivery, but there haven’t been cases of Zika virus in breast milk. To date, there has been one case of transmission through blood transfusions and one possibly spread through semen and sexual contact. Researchers are working to piece together the origins of this particular outbreak, but one hypothesis is that it came to Brazil from a major sporting event, specifically the 2014 World Cup. At this point, cases have been seen in 23 countries and the WHO has warned that it’s likely to “spread across nearly all of the Americas”. While no local transmission has occurred in the US, locally acquired cases are occurring in the Commonwealth of Puerto Rico. The CDC has also released interim guidance on the evaluation and testing of infants with possible congenital Zika virus.

Brazil’s Olympic Woes

Courtesy of The Guardian & EPA
Courtesy of The Guardian & EPA

The growing outbreak of Zika virus and subsequent concerns over fetal microcephaly are just another public health issue on the laundry list of concerns for Brazil in their Olympic preparations. Building the infrastructure to support such a massive event is taxing on even the most industrialized country. Despite Brazil’s initial dismissal of water quality issues, there have been flourishing concerns over water safety for Olympians (the linked BBC pictures alone would have me rowing the boat back to land at record speed). 13 of the 40-member US rowing team experienced gastroenteritis after a trial run in a lake. While the exact culprit of the GI illness was never identified, it amplified the already increasing fears regarding water quality. It’s never a good sign when rowers are warned not to splash water or jump in at the end of a race, or when a sailor has to be hospitalized due to a severe MRSA infection after field tests. As we mentioned a few months back, an Associated Press investigation found dangerous viral and bacterial levels in the Olympic and Paralympic water venues. “Extreme water pollution is common in Brazil, where the majority of sewage is not treated. Raw waste runs through open-air ditches to streams and rivers that feed the Olympic water sites. As a result, Olympic athletes are almost certain to come into contact with disease-causing viruses that in some tests measured up to 1.7m times the level of what would be considered hazardous on a Southern California beach.” Water issues aside, vector-borne diseases like Zika virus, dengue, malaria, and even yellow fever, can pose a threat to those attending and participating in the events. The Brazilian health ministry has announced response plans in wake of the growing Zika virus outbreak. These large-scale events also raise security concerns, especially after the Paris attacks. Brazilian officials have promised “to guarantee absolute peace”  during the Olympics.

Congrats to 2015 GMU Biodefense MS alum, Francisco Cruz, on his acceptance as a fellow in UPMC’s 2016 Class of Emerging Leaders in Biosecurity Initiative (ELBI) The UPMC ELBI is a highly selective program that brings together and fosters partnerships within the biosecurity field. Biodefense MS alum, Francisco Cruz, will accompany several other prominent members of the biosecurity community in meetings, conferences, and networking. Congrats Francisco!

DNA Investigations from the Great Plague of Marseille
Always a sucker for a mixture of history and epidemiology, I was excited to come across this archaeological gem. Despite its initial devastation in the fourteenth century, the bubonic plague resurged and hit Europe with another destructive wave, “leading to continued high mortality and social unrest over the next three centuries.” Considered to be the last outbreak of medieval plague in Europe, the Great Plague of Marseille (1720-1722) has provided archaeologists with samples that allowed them to reconstruct the complete pathogen genome. Harnessing DNA from the teeth of victims within the Marseille plague pits, their results point to the disease hiding within the shadows of Europe for hundreds of years. Computational analyst Alexander Herbig notes, “we faced a significant challenge in reconstructing these ancient genomes. To our surprise, the 18th century plague seems to be a form that is no longer circulating, and it descends directly from the disease that entered Europe during the Black Death, several centuries earlier”. While they continue their work on tracing the origins of the disease and its mysterious disappearance, I’m hopeful that archaeogenetics is the new inspiration for future Indiana Jones films…

Stories You May Have Missed: 

  • Listeria Outbreak Associated With Dole Salads- A Dole production plan in Springfield, OH, is being linked to an outbreak of Listeria throughout the US and Canada. Twelve cases were identified in the US and another seven were found across five provinces in Canada. All twelve cases involved hospitalization and there has been one associated death. The CDC is continuing updates here.
  • USDA Updates on Highly Pathogenic Avian Influenza Fall Plan- The USDA has updated their plans to combat the highly pathogenic avian influenza with more details regarding reimbursement on virus elimination activities and additional information on the August 2015 industry survey on preparedness.
  • British Government and Bill & Melinda Gates Foundation Roll Out New Plan to Combat Malaria –  The British government has teamed up with the Bill and Melinda Gates Foundation to pledge three billion pounds to help stop malaria in the next fifteen years. Bill Gates and British Chancellor George Osborne stated, “We both believe that a malaria-free world has to be one of the highest global health priorities.” Britain will invest 500 million pounds a year over the next five years and the Bill and Melinda Gates Foundation have put up $200 million this year and will continue with annual donations.
  • Tales from the Front Lines in the Ebola Fight-  Confusion, disorganization, fear, and communication gaps fill the notes from the ground in this interview with VICE correspondent, Danny Gold, during his time in West Africa during the outbreak.

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Pandora Report 10.23.2015

Happy Infection Prevention Week! Make sure to give any infection preventionists you know a big hug or at least a hearty handshake (only clean hands though!). Not only do we get to celebrate National Infection Prevention week, but it’s also National Biosafety Stewardship Month, so get your party hand sanitizer ready to go and let the frivolity begin! Foodborne illness is the name of the game this week and we’ll be discussing outbreaks. Friendly reminder – the influenza vaccine is available in most offices/clinics now, so get your flu shot as there have already been cases springing up across the US. Fun fact – did you know that a report published this week identified Yersinia pestis in the tooth of a Bronze Age individual, which means there were plague infected humans 3,300 years earlier than we thought!

National Biosafety Stewardship Month – October is National Biosafety Stewardship Month (thanks NIH!) to celebrate and encourage people to focus on biosafety policies, practices, and procedures. Given the lab biosafety issues we’ve seen recently, I think we can all safely (or should I say, “biosafely”?) agree that a little extra attention to these issues and the promotion of better practices is a great thing. Institutions are encouraged to use more of a just culture approach to incident reporting and to promote public transparency. Happy National Biosafety Stewardship Month!

Water Quality for the Olympic Games in Rio De Janeiro, 2016
The 2016 Summer Olympics are fast approaching and with any large event, health issues become a main concern. The WHO is providing technical advice to the Brazilian national authorities regarding public health concerns, as well as to the International Olympic Committee and the Local Organizing Committee. Clean drinking water, sewage pollution, and a host of other health issues can become a nightmare during such a large-scale event. While there aren’t recommendations for specific viral testing of the water, the WHO does encourage additional testing in the event of an outbreak. Sanitary inspections and other preventative procedures are being recommended to avoid outbreaks and public health issues. As we get closer to the 2016 Olympics, it is very likely concerns over vector-borne diseases will be addressed through vector control and public health education.

CDC Launches Redesigned FOOD Tool for Foodborne Outbreaks 

Courtesy of CDC FOOD Tool
Courtesy of CDC FOOD Tool

The CDC has updated their online foodborne illness outbreak investigation tool! The Foodborne Outbreak Online Database Tool (FOOD Tool) allows the user to search the outbreak database by state, food, ingredient, year, location of food preparation, and organism. The FOOD Tool also provides the case information related to the outbreak, so users can see the number of affected persons, hospitalizations, deaths and laboratory-confirmed organisms. This database pulls from CDC’s Foodborne Disease Outbreak Surveillance System (FDOSS) and allows users to not only look at data and trends over time, but also compare their cases to other outbreaks.

Syrian Refugee Resettlement and Why We Should Be Letting Them All In 
Dr. Trevor Thrall, one of our amazing GMU Biodefense professors, has written a piece for The Atlantic on the importance and benefits of taking in all Syrian refugees. Dr. Thrall discusses the limitations of addressing the root cause of the Syrian conflict and how the US and its European allies should take in refugees. Discussing the military alternatives to the Syrian crisis, he states, “going in militarily is not the answer, then. Instead, those civilians under threat should get out. Refugees typically receive support in the countries to which they flee, but the vast numbers involved in this case threaten to overwhelm Turkey, Jordan, and Lebanon, which have so far accommodated the vast majority of the outflow.” Dr. Thrall points out that while resettlement would cost a substantial amount of money, it would cost far less than military intervention and you simply can not ignore the moral superiority in aiding refugees.

Chipotle’s Bad Tomatoes Came From Nation’s Largest Field Producer
To our readers in Minnesota, did you happen to eat at a Chipotle in August? If so, we hope you weren’t one of the affected individuals that contracted Salmonella Newport as a result of contaminated tomatoes. The Minnesota Department of Health investigated the 64 cases resulting from this outbreak, however it was just released that the contaminated tomatoes were actually supplied by Six L’s Packing Co (doing business as Lipman Produce), which is actually one of the largest tomato suppliers in the US. Packing 15 million boxes of tomatoes this past year, Lipman was later dropped as a supplier by Chipotle after learning of the source of contaminated produce. The tomatoes were removed but it’s estimated that during the window of exposure, roughly 560,000 people consumed Chipotle. The good news is that we’re out of the incubation period, so if you happened to eat at a Minnesota Chipotle, you’re in the clear.

Stories You May Have Missed:

  • 80 Illnesses Linked to Shigella Outbreak; CA Seafood Restaurant Closed –  Mariscos San Juan in San Jose, CA is currently closed after the Santa Clara County Health Department connected a recent outbreak of Shigella to their food. While the exact source hasn’t been identified, over 93 people were sickened in relation to contaminated food at the restaurant.
  • Subway to Phase Out Poultry Products Raised With Antibiotics–  On Tuesday, Subway Restaurants announced that they will be transitioning to only serve poultry products that have been raised without antibiotics by early next year. Other chain restaurants, like Chick-fil-A and Chipotle, are jumping on the train to phase out chicken and turkey products that were raised with antibiotics.
  • Scottish Nurse and Ebola Complications – Pauline Cafferkey continues to battle post-Ebola complications. Reports last week noted neurological issues and it was recently reported that she has meningitis after the virus persisted in her brain and CSF after her initial recovery. Ongoing research is looking into the long-term effects of the disease as the West African outbreak was the largest in history and researchers have never had the opportunity to look at chronic issues associated with disease recovery.