Pandora Report: 7.29.2016

Happy Friday! With the Olympics right around the corner, there’s a lot of buzz surrounding the games (not just Aedes mosquitoes) and the athlete living quarters. Make sure to watch the PBS special, “Spillover- Zika, Ebola & Beyond“, on August 3rd at 10/9c. The special will look at the rise of spillover diseases like Nipah and the impact of human behavior on the spread of zoonotic diseases. The Society for Healthcare Epidemiology of America (SHEA) reported a new study that finds three key factors increase the risk for patient-to-patient transmission of the extremely resistant CP-CRE. The Democratic National Convention closed last night and Hilary Clinton made it a point to say, “I believe in science”, which highlights  the stark differences between the candidates on topics like climate change and stem cell research. 

What Damage Could CRISPR Do To The BWC?
Daniel Gerstein points to the approaching Eighth Review Conference of the Biological Weapons Convention and the assessment of new technologies, like CRISPR. Since James R. Clapper, Director of National Intelligence, stated that genome editing is a global danger, many are waiting to see what the convention will say about the future threats of technologies like CRISPR. Gerstein notes that, “if the seven previous review conferences are any indication, the gathering in November will recognize Crispr’s contribution to the biotech field, then enthusiastically declare the convention fit to address any problems it might create. But will that be enough?” The flexible nature of the convention is meant to support the ever-changing world of science and technology, however this also means that any potential bans on experiments are that much more challenging. In his article, Gerstein discusses the assessment of CRISPR as a nonproliferation threat and the risks associated with limiting technological innovation. Despite the challenges of banning certain biotechnologies, there are things that can still be done within the conference. Surveillance and training are imperative, especially in terms of “spotting the development of new pathogens or the modification of existing ones”, and national responsibility needs to be part of this equation. Gerstein’s points on not just national implementation, but also national responsibility emphasizes the transition from a traditional method into an emphasis on people and activities. Practices need to match the pace of biotech development, which means expanding the Implementation Support Unit, strengthening surveillance capabilities, and reinforcing institutional structures. “Those gathering at the review conference in November must seriously consider whether advances in biotechnology have made the existing bioweapons convention obsolete, but they must also ask what more the convention can do, as the reigning body for regulating biological weapons, to ensure that new biotechnologies continue to be used for peaceful purposes only.”

Half of Americans Say Infectious Disease Threats Are Growing  

Courtesy of Pew Research Center
Courtesy of Pew Research Center

The Pew Research Center conducted a recent survey in the wake of the very public Zika virus outbreak. While some may have noted that Americans aren’t as worried about Zika, the survey found that 51% of U.S. adults feel that, compared to 20 years ago, there are more infectious diseases threats to health today. 82% of Americans polled stated that they pay at least some attention to the news regarding infectious disease outbreaks and 58% believe that Zika is a major threat to the health of women who are pregnant. 31% believe that Zika is a major threat to the U.S. population as a whole, while 58% felt it was a minor threat. The poll also found that more people had heard of Ebola at the time of the 2014 outbreak than Zika as a problem right now. Broken down by demographics, those most worried about Zika include older adults, especially women.

Containment: Lessons Learned and Cringe-Worthy Moments2015_0326_Biohazard_Suits
Tuesday nights won’t be the same since Containment ended – what will we do without the asymptomatic super-spreaders like Thomas, the overly gory hemorrhaging, or the suspension of infection prevention practices? Like any science-based show, there are moments of accuracy and moments of pure dramatic exaggeration. Check out our list of the things we enjoyed about the show and some of the more eye-rolling moments. While it’s rare to have a prime-time show involving an outbreak, we’re hoping that the future will hold more scientifically accurate series that will dismantle the hysteria we too often see during public health emergencies.

Australia Utilizes Bioterrorism Algorithm to Predict Flu Outbreaks
Victoria’s health department is currently using a tool, EpiDefend, that can “accurately predict flu outbreaks up to eight weeks in advance.” Combining environmental data, lab results, and more, the tool is funded by the US Department of Defense and designed by the Australian Department of Science and Technology (DST) to aid in Australian disease prediction practices and strengthen global bio-surveillance. ”Our team’s goal is dual-purpose, we want to fulfil our defence charter, protecting our forces against intentionally released biological agents; but disease forecasting will also support the national security and public health areas,” said Tony Lau, defence scientist. EpiDefend incorporates electronic health records (EHR) via the healthcare sector, which means it can be especially powerful, but also requires the presence and reliability of EHR. The system uses an algorithm that is still being refined. “Particle filtering is a technique which helps us close in on the degree of uncertainty by the help of information gathered from particular situation. In other words, it helps the algorithm churn out more precise readings.”

Zika Virus
The Department of Health and Human Services (HHS) has published a webpage on what you need to know about Zika virus. A recent study is estimating that as many as 1.65 million women in Latin American could be infected while pregnant. Researchers, from another study published in the Annals of Internal Medicine, are pointing to a low risk for international Zika spread from the 2016 Olympics in Brazil.  Researchers calculated “the worst-case estimates of travel-associated Zika virus by assuming visitors encounter the same infections exposures as local residents. This is highly unlikely, as visitors would be staying in screened and air-conditioned accommodations, as well as taking personal preventive measures. But under the authors’ pessimistic conditions, they estimate an individual traveler’s probability to acquire infection in Rio de Janeiro is quite low. Specifically, they estimate anywhere from 6 to 80 total infections with between and one and 16 of those infected experiencing any symptoms.” Florida officials announced the investigation of another two potential cases of local-transmission. These new cases have pushed the FDA to curb blood collection in Florida. A new study performed a real-time Zika risk assessment in the U.S, suggesting that 21 Texas counties along the Texas-Mexico border, the Houston Metro area, and throughout the I-35 corridor (San Antonio to Waco) have the greatest risk for sustained transmission. As of July 27th, the CDC has reported 1,658 cases of Zika in the U.S. 

Stories You May Have Missed: 

  • CSIS Curated Conversations on Pandemic Preparedness & the World Bank – The Center for Strategic & International Studies has made its Curated Conversations podcast available on iTunes, which means you can check out the June 3rd episode, “the World Bank President on Preventing the Next Pandemic”. The World Bank Group president, Jim long Kim, discusses funding to help prevent the next pandemic and lessons learned from Ebola.
  • Joint West Africa Biopreparedness Efforts – The DOD is investing in the Joint West Africa Research Group to help improve and sustain biopreparedness within the region. Following the Ebola outbreak, this new program will build upon existing programs and strengthen lab and clinical resources, as well as biosurveillance efforts.
  • Yellow Fever in the Americas? The Pan American Health Organization is currently investigating a case of yellow fever in a man who traveled to Angola. Genetic testing is underway, but there is concern that the virus could ramp up in the Americas during a vaccine shortage.

Pandora Report 6.7.15

We’ve got stories this week about MERS spread in South Korea and Ebola drugs that may already be in your medicine cabinet. We’ve also got some stories you may have missed.

As a reminder, the Early Registration Deadline for the Pandemics, Bioterrorism, and International Security professional education course has been extended to June 15. For more information and registration, please click here.

Enjoy the rest of your weekend!

South Korea Grapples to Contain MERS as 1,369 in Quarantine

The big story this week is MERS in South Korea. Last week we reported that there were five cases. As of Friday, the number has jumped to 36 confirmed cases and three deaths. Hundreds of schools have closed in an effort to prevent further spreading of the disease, which arrived in a 68-year old index patient who had traveled in Saudi Arabia, Qatar, the United Arab Emirates, and Bahrain. Many in public health have been surprised by the extent of the outbreak in South Korea because the virus has not been shown to pass easily from human to human and the health care system is “considered to be sophisticated and modern.”

CNN—“‘This is quite unusual. I think this is the only country, apart from those in the Middle East, that has such a number of cases,” said [Dr. Leo] Poon [a virology expert at the School of Public Health at the University of Hong Kong, who worked on the SARS outbreak more than a decade ago]. “It’s not entirely surprising. In the Middle East, people in Saudi Arabia had hospital outbreaks where a few people got infected. It’s a similar situation at the moment.’”

Drugs to Fight Ebola May Already Be in Your Medicine Cabinet, Study Suggests

A team from USAMRIID, the University of Virginia, and Horizon Discovery Inc. have been working to determine if any existing drugs could be used to fight Ebola. Using 2,635 compounds, including FDA-approved drugs, amino acids, food additives, vitamins and minerals they discovered a possible answer could already be in your medicine cabinet—Zoloft and Vascor.

The LA Times—“But Zoloft (also known by the generic name sertraline) and Vascor (generic name bepridil) had more encouraging results. Of the 10 mice that got Zoloft, seven survived for 28 days. Even better, all 10 of the mice treated with Vascor were still alive 28 days after [Ebola] infection. For the sake of comparison, all of the untreated mice that served as controls were dead within nine days.”

Stories You May Have Missed

 

Image Credit: Shikhlinski

Hendra Virus: Vaccines Available but Underused

By Chris Healey

Horse owners in Australia are reluctant to vaccinate their horses against an emerging viral illness capable of sickening humans.

Hendra virus, an emerging infectious disease of horses and humans, has been responsible for the death of 4 people and dozens of horses in Australia since its discovery during a 1994 outbreak of an acute respiratory illness among horses and stable workers in Queensland, Australia. Laboratory tests performed during that outbreak confirmed horses and humans became sick from identical viral agents.

An epidemiologic investigation revealed flying foxes of the Pteropus genus act as Hendra virus reservoirs. Health officials have hypothesized that horses contract the illness through inadvertent consumption of infected bat urine. Hendra virus spreads to humans who come into contact with body fluids, tissues, or excretions of infected horses. Those who work closely with horses, such as equine veterinarians and stable hands, are most at risk of Hendra virus infection.

Early on, researchers discovered Hendra virus glycoproteins could be exploited as an immunization strategy. Following a human Hendra virus death in 2009, and an exposure in 2010, a vaccine for horses was released in 2012 by Zoetis, Inc. As an animal vaccine, developers were spared arduous human pharmaceutical testing protocols and quickly released the product.

The vaccine, called Equivax HeV, is unprecedented in preventative medicine. Not only is it the first vaccine licensed and commercially available to prevent illness from a BSL-4 agent, a pathogen requiring the highest laboratory safety protocols, but it is also the first veterinary vaccine used to transitively prevent illness in humans.

Similar to how smallpox and measles vaccination prevents spread of their respective illnesses, Hendra-vaccinated horses are less likely to transmit Hendra virus to humans by reducing viral shedding. Equivax HeV provides Hendra protection for the horse and the people who interact with it.

Despite vaccine advantages, horse owners say they cannot afford it. A single administration can cost upwards of $200, and booster administration is needed every 6 months for the life of the horse to maintain immunity. Many are unwilling to pay. As a result, only 11% of horses in Australia are estimated to have received the vaccine.

Health authorities are working to approve guidelines recommending yearly booster administrations, cutting immunity maintenance costs in half.  Veterinarians say more horse owners will choose to vaccinate as attitudes toward occupational safety change. Greater awareness of the danger posed to equine veterinarians and stable hands working with unvaccinated horses is expected to place a stigma on non-vaccinating establishments.

 

(Image Credit: Fainmen)