Pandora Report 6.30.2017

Happy Friday to all our amazing readers – we hope you have a lovey holiday weekend! Don’t miss the July 1st deadline for an early registration discount to the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security.

Preventing Pandemics and the Necessity of Funding Prevention
Next January will mark the centenary of the 1918-1919 pandemic influenza, but what have we really learned since then? The looming threat of antimicrobial resistance is slowly surrounding us, as is the increasing biothreat of zoonotic disease. Globalization, encroachment into animal habitats, and recent models that predict a 60-day global spread for a virulent strain of airborne flu virus, all paint a rather gloomy reality for the future of health security. So what are we doing? Not enough. That’s usually the answer in public health- a field of which you can comfortably say society likes to contribute the bare minimum. A highly pathogenic influenza virus that could engulf the globe in a pandemic isn’t the storyline for a horror movie, but rather something that even UN panels note is “not an unlikely scenario”. “Pathogens are not only terrifying, they’re expensive. The 2003 SARS epidemic cost $30 billion in only four months. A flu pandemic of a severity that occurs every few decades could contract the global economy by 5 percent — some $4 trillion”. Here’s where the economics of preventative public health come into play – vaccines are expensive to make and there’s little incentive when we’re not in the eye of a disease storm. Moreover, global health security is challenging. Politics makes disease response and preparedness a sensitive topic, especially during an outbreak. The key lesson to remember though, is that an outbreak anywhere is really an outbreak everywhere. So what preparedness tactics can we start utilizing? “The project is called CEPI — the Center for Epidemic Preparedness Innovations. After the world’s failure to control Ebola quickly in 2014 and 2015 cost 11,000 lives and at least $6 billion, three global experts proposed a vaccine development organization with $2 billion in start-up funding. Harvard, the National Academy of Medicine and the United Nations all created commissions that proposed ways to avoid another catastrophe. Among other steps, all endorsed vaccine development.” CEPI aims, in the next five years, to develop vaccine candidates for Lassa fever, Nipah, and MERS. “Creating vaccines is not the same as guaranteeing that people who need them can get them. CEPI will require its awardees to sell vaccines to the poorest and lower-middle-income countries (more likely, to donors who will buy vaccine for them) at the lowest possible price.” Perhaps one of the most poignant comments from this article was that the threat to this goal is not scientific, but rather political, highlighted by short attention spans. The World Bank has initiated it’s “pandemic bond” to aid in outbreak response should there be a public health crisis like that of Ebola in 2014. “The catastrophe bond, which will pay out depending on the size of the outbreak, its growth rate and the number of countries affected, is the first of its kind for epidemics. It should mean money is disbursed much faster than during West Africa’s Ebola crisis.” The Pandemic Emergency Fund (PEF) will offer coverage to those countries eligible for financing from the IDA (International Development Agency), which is dedicated to helping the poorest countries. Head of derivatives and structured finance at the World Bank’s capital markets department, Michael Bennett, noted that “if a trigger event occurs, instead of repaying the bond in full, some or all of the principal is transferred to the PEF trust fund. So essentially the investors are acting like insurance companies. The objective of offering the risk in both forms is that the bonds and swaps appeal to different types of investors, and therefore … we are creating the broadest possible investor pool for this risk,”. The PEF would provide more than $500 million in coverage over the next five years. Efforts to provide financial support to outbreaks before they reach pandemic potential are vital. It is estimated that had the PEF been available during the 2014 Ebola outbreak, $100 million could have been mobilized as early as July 2014, which may have prevented the outbreak spreading so rapidly and costing $2.8 billion. “The annual global cost of moderately severe to severe pandemics is estimated at roughly $570 billion, or 0.7 percent of global income, the World Bank said.”

Ebola Burial Teams 
The 2014/2015 Ebola outbreak in West Africa was not only the worst in history, but taught us a great many lessons about outbreak control. One of the most extraordinary lessons learned was just how valuable burial teams could be. Funerals became a significant source for disease exposure and transmission, especially for loved ones of the deceased, as washing and handling the body was customary. In effort to combat this high-risk activity, public health responders established burial teams comprised of paid volunteers, who would collect the bodies from homes and aid in their burial. The teams would don PPE and work with families to ensure they avoided exposure. Dignified burial through these teams helped ease much of the concern for families regarding the treatment of their loved one. A recent study published in the PLOS Neglected Tropical Disease Journal evaluated the impact of these burial teams using modeling and data from 45 unsafe community burials and 310 people who were identified as having contact with the infected bodies. Researchers found that those who cared for the Ebola patient just before their death were at greatest risk, meaning that caring for an infected loved one at home was far riskier than bringing them to a healthcare facility. The study estimates that the safe and dignified burials performed by Red Cross volunteers (the burial teams) prevented between 1,411 and 10,452 cases of Ebola. “Hundreds of paid volunteers took on the grim task of collecting bodies from people’s homes in full personal protective gear, while also having to manage the grieving families and communities. They were ordinary West Africans, such as teachers and college students. Many carried out the relentless and dangerous work for months. Some were stigmatised in their communities, because people became scared they might bring the virus home with them. In reality, they were helping to stem world’s worst ever Ebola outbreak.” In the end, the Red Cross burial teams managed over 47,000 burials, carried out more than 50% of all burials during the outbreak, and consisted of 1,500 volunteers.

Instructor Spotlight – Workshop on Pandemics, Bioterrorism, & Global Health Security
We’re nearing the last few weeks before our workshop and your opportunity to get the early registration discount, so don’t miss out! This week we’re happy to show off not only the director of this workshop, but also of our GMU biodefense graduate program – Dr. Gregory Koblentz. If there was a biodefense Jeopardy, Dr. Koblentz would not only be the reigning champion, but would also have Alex Trebek doubled over in laughter. Gregory Koblentz, PhD, MPP, is an Associate Professor in the Schar School of Policy and Government and Director of the Biodefense Graduate Program at George Mason University. During 2012-2013, he was a Stanton Nuclear Security Fellow at the Council on Foreign Relations. Dr. Koblentz is also a member of the Scientist Working Group on Chemical and Biological Weapons at the Center for Arms Control and Non-Proliferation in Washington. He previously worked at Georgetown University, the Executive Session for Domestic Preparedness at Harvard University, and the Carnegie Endowment for International Peace. He is the author of Strategic Stability in the Second Nuclear Age (Council on Foreign Relations, 2014), Living Weapons: Biological Warfare and International Security (Cornell University Press, 2009) and co-author of Tracking Nuclear Proliferation (Carnegie Endowment for International Peace, 1998). He serves on the editorial boards of Nonproliferation Review, World Medical and Health Policy, and Global Health Governance. His teaching and research interests focus on international security, weapons of mass destruction, terrorism, and homeland security. He received his PhD from the Massachusetts Institute of Technology, his Master in Public Policy from the John F. Kennedy School of Government, and his BA from Brown University. For more information, see https://schar.gmu.edu/about/faculty-directory/gregory-koblentz. Don’t miss your chance to not only learn from Dr. Koblentz, but also chat with him and other experts in the field at our workshop July 17-19th!

Can CRISPR Tackle Zika?
GMU Biodefense PhD student Saskia Popescu is looking at CRISPR and its application as a vector-borne disease prevention tool. “Whether it be the latest announcement that CRISPR reversed Huntington’s Disease in mice or that it could provide rapid diagnostic improvements, the technology is being considered a breakthrough for many diseases and conditions, including vector-borne diseases.” Drawing on a recent TED Talk by famed molecular biologist, Dr. Nina Federoff, she highlights the potential for GMO mosquitoes to be used as a biological control tool. Federoff points to the public perception issues that come with GMO products, which was seen in Key Haven, Florida when GMO mosquitoes were to be trialed as a means to prevent dengue and Zika cases. “Concluding her talk with a plea to the audience, Dr Federoff emphasized the need to dig past misinformation and hype to truly look at the science of this work and the substantial benefits that can come from biological control efforts and the science of genetic modification.”

The Case of the Missing Sarin
Dugway Proving Ground is under the spotlight again for mishandling of dangerous substances. The same Army lab was responsible for mishandling Anthrax in 2015, during which they sent 575 shipments of live samples across the U.S. Unfortunately, the latest reports are looking to Dugway as the source for potentially losing a small amount of sarin. The inspector general for the DoD released a report highlighting the findings that a contractor used by the facility was not maintaining inventory properly. “Dugway stored its sarin in a two-container system. The sarin was stored in a primary container, which is then stored inside a secondary container. But officials only checked the secondary containers when doing inventory, and did not check inside the primary container, so they did not know if all the sarin was still in the containers, the inspector general found. ‘Therefore, custodians cannot identify and account for leaks, evaporation, or theft that may have occurred,’ the inspector general found. ‘Furthermore, Dugway officials did not immediately notify the chemical materials accountability officer of a 1.5-milliliter shortage of … sarin identified during an April 19, 2016, inventory nor did they properly document the results of that inventory,’.” The report found that the contractor and Dugway used varying methods for container sealing but that the amount missing is relatively small. Fortunately, sarin evaporates and degrades very quickly. Overall the report highlights the operations and procedures for handling the chemical agent put workers at an increased risk and encouraged the Army to evaluate and improve practices immediately.

The Moral Question of Bioengineering
The financial and technical hurdles for biotechnology and gene-editing have been decreasing over the years and Stanford is taking a unique approach to their budding bioengineers – asking moral questions. During their final exams for the university’s Intro to Bioengineering course, the students are asked several questions – at what point will the cost of printing DNA to create human life equal the cost of teaching a student at Stanford?  If you and your partner are planning to have kids, would you start saving for college tuition, or for printing the genome of your offspring? These questions represent much of the debate and concern regarding gene editing – the rapid decrease in cost and the morality of just how far the technology can and will take researchers. Many note that just because we can, doesn’t mean we should. Stanford professor Drew Endy emphasizes the decrease in costs, which was initially prohibitive when the technology was developing. Regarding the last question, “about 60 percent say that printing a genome is wrong, and flies against what it means to be a parent. They prize the special nature of education and would opt to save for the tuition. But around 40 percent of the class will say that the value of education may change in the future, and if genetic technology becomes mature, and allows them to secure advantages for them and their lineage, they might as well do that. There is clearly no right answer to the second question, and students are graded on their reasoning rather than their conclusion. But when both questions are considered together, they suggest, Endy says, that ‘in the order of a human generation, we’ll have to face possibilities that are much stranger than what we’re prepared for’.”

Stories You May Have Missed:

  • John Oliver Takes on Anti-Vaxxers – If you’re a fan of the HBO host, make sure to check out his recent episode of  “Last Week Tonight” in which he points out just how dangerous the anti-vaccine movement really is. “Some have even developed an ‘alternative vaccine schedule’ in which the inoculations can be delivered less frequently and over a longer period of time. ‘That sounds like a decent compromise because it’s the middle-ground position, right?”’Oliver said on ‘Last Week Tonight’ on Sunday. ‘The problem is, it’s the middle ground between sense and nonsense. It’s like saying, ’It would be crazy to eat that entire bar of soap, so I’ll just eat half of it’.”
  • Yemen’s Growing Cholera Outbreak– Yemen is currently experiencing the worst international outbreak of cholera, with 200,000 suspected cases and an average of 5,000 new cases reported daily. The WHO and UNICEF have gotten involved as there have already been 1,300 deaths in the past two months. “By calling the outbreak the “world’s worst” UNICEF and WHO hope to speed international aid efforts to the war-torn country. “This deadly cholera outbreak is the direct consequence of two years of heavy conflict,” said a press statement from UNICEF. ‘Collapsing health, water and sanitation systems have cut off 14.5 million people from regular access to clean water and sanitation, increasing the ability of the disease to spread.’ In addition to a lack of public health infrastructure, UNICEF estimated that 30,000 dedicated local health workers who play the largest role in ending this outbreak have not been paid their salaries for nearly 10 months.”

 

Pandora Report 6.16.2017

Temperatures may be soaring but we’ve got all your biodefense news, including a frosty story on frozen diseases coming to life!

Big Data Takes on Epidemics
The potential applications for big data are vast and we’re just now starting to get a taste for how it can be utilized during an outbreak. Rapid access to data sets and available personnel to handle modeling is a challenge during emergent situations however, many are pointing out just how the data science revolution can be used to fight diseases. Metabiota Senior Director of Data Science Nita Madhav has put together a list of the five ways big data analytics are changing the fight against epidemics. First, better genetic data through genome sequencing that can help speed up genetic analysis during an outbreak. Second, cell phone mobility data. This is particularly interesting as it was used during the Ebola outbreak in 2014, which allowed experts to tract contacts of cases as a means of prevention. Cell phone mobility data also provides information on movement during outbreaks. Third, social media data, which can be used to predict peaks and perform sentiment analysis (think vaccination skepticism), but also as a means of pushing public health messaging. Fourth, mapping high risk areas. “Machine learning techniques can now yield global, high-resolution maps pinpointing where epidemics are likely to emerge and take hold. These techniques make use of remotely-sensed and other geographic data about environmental, human and animal factors to estimate how many people live in the riskiest places. For example, this type of analysis helped map likely locations for Zika virus to thrive and even identified areas where the virus would later establish itself, including southern Florida.” Last but not least, large-scale simulations, which allow epidemiologists to take all the data we currently have and generate tons of simulations to reveal gaps in response mechanisms. “These simulations help fill in gaps in observed data using synthetic outbreaks and deliver novel insights into possible outcomes of outbreaks, including expected numbers of illnesses, hospitalizations, deaths, employee absences and monetary losses. Ultimately, these insights can help inform the world about epidemic risks and the best ways to mitigate them.”

Chemical Weapons & ISIS
New analysis from Conflict Monitor by IHS Market is drawing attention to a significant reduction in chemical weapons used by ISIS in Syria in 2017 as well as a concentration of the chemical attacks in Iraq. The report highlights that 71 allegations of ISIS CW attacks have occurred since 2014 (41 in Iraq and 30 in Syria) however, the only alleged use in Syria in 2017 was on January 8th at Talla al-Maqri. “The operation to isolate and recapture the Iraqi city of Mosul coincides with a massive reduction in Islamic State chemical weapons use in Syria”, said Columb Strack, senior Middle East analyst at IHS Markit. “This suggests that the group has not established any further CW production sites outside Mosul, although it is likely that some specialists were evacuated to Syria and retain the expertise.” In response to ISIS use of chemical weapons, the U.S. Department of the Treasury’s Office of Foreign Assets Control (OFAC) is taking action against ISIS leader, Attallah Salman ‘Abd Kafi al-Jaburi (al-Jaburi), who was involved in several attacks ranging from vehicle-borne improvised explosive devices (VBIEDs) to the development of chemical weapons. OFAC is also taking action against Marwan Ibrahim Hussayn Tah al-Azaw, an Iraqi ISIS leader. “As a result of today’s action, all property and interests in property of these individuals subject to U.S. jurisdiction are blocked, and U.S. persons are generally prohibited from engaging in transactions with them.” OFAC Director John E. Smith noted that “today’s actions mark the first designations targeting individuals involved in ISIS’ chemical weapons development,” and that “the Department of the Treasury condemns in the strongest possible terms the use of chemical weapons by any actor, and will leverage all available tools to target those complicit in their development, proliferation, or use.”

Pandemics, Bioterrorism, & Global Health Security Workshop Instructor Spotlight
This week we’re excited to share that Sanford Weiner will be our instructor spotlight! Sanford is a Research Associate in the Center for International Studies at the Massachusetts Institute of Technology, and a Visiting Fellow at Imperial College, University of London. For several decades he has done international comparative policy studies of public health agencies, and research on national security policies and environmental policies. He has published on policymaking at the Centers for Disease Control, the phase-out of CFCs, toxic substance control, and innovation in the Air Force. He is currently studying responses to pandemic flu in Europe and the United States, and the politics of alternative energy projects. He directs a Professional Education summer course at MIT on “Technology, Innovation and Organizations.” He has also taught in professional education courses for the Royal Society Technology Fellows (London), the National University of Singapore, UC San Diego, and in Stockholm. Before MIT he was on the research staffs of the School of Public Policy at UC Berkeley, the Health Policy Center at Brandeis, and the Harvard School of Public Health. Sanford looks to the need for organizational innovation and adaptation to address new threats, the politics of public health emergencies, and the importance of risk assessment and making evidence-based public health decisions. If you’re looking to talk about taking lessons from pandemic flu and applying them to polio, Zika, bioterrorism, and even Ebola, you won’t want to miss his lecture during our workshop!

The Awakening of Frozen Permafrost Diseases
Climate change has an undeniably impact on infectious diseases. Whether it be the vectors that spread them, movement of animals that act as hosts, or an increasing encroachment of humans into animal habitats, we simply can’t deny that the two are wholly interconnected. Unfortunately now we get to add zombie diseases to the list. Well, maybe not a zombie virus, but a bacteria or virus that has been trapped in the icy permafrost for thousands of years and is now waking up. “Climate change is melting permafrost soils that have been frozen for thousands of years, and as the soils melt they are releasing ancient viruses and bacteria that, having lain dormant, are springing back to life.” Last year we saw anthrax cases in the Arctic Circle due to exposure from infected reindeer carcasses that were exposed due to the melting of the frozen soil and snow. “As the Earth warms, more permafrost will melt. Under normal circumstances, superficial permafrost layers about 50cm deep melt every summer. But now global warming is gradually exposing older permafrost layers. Frozen permafrost soil is the perfect place for bacteria to remain alive for very long periods of time, perhaps as long as a million years. That means melting ice could potentially open a Pandora’s box of diseases.” Nothing like a good permafrost to keep the bacteria happily frozen and alive! What is so worrying about the melting permafrost is a range of threats – buried bodies of people who died from smallpox, unknown viruses or bacteria that we’ve never seen before, or even a resistant organism that changes the course of antibiotics forever.

Angry Birds – The Flu Version
While this isn’t the title of the latest game, the projectile you should be worried about is actually avian influenza droplets. China is currently battling against HPAI H7N9  outbreaks in poultry across three provinces. “Chinese health officials detailed four outbreaks in two OIE reports. Two occurred in different locations in Inner Mongolia province in the north, one at a large layer farm that began on May 21, killing 35,526 of 406,756 susceptible poultry. The remaining birds were culled to curb the spread of the virus.The other outbreak began Jun 5 at a poultry farm in Inner Mongolia’s Jiuyuan district, which led to the loss of 55,023 birds, including 2,056 that died from the disease.” These outbreaks spark fear for a number of reasons – the mass culling of birds is always economically devastating, the risk to human life, and really, the potential for sustained human-to-human transmission due to a few genetic tweaks that could result in a pandemic. That’s right, just three mutations should switch H7N9 into a lethal human-killing virus that has pandemic potential. H7N9 is one of the more concerning avian influenza strains because it’s already been known to do damage in terms of human cases (of the 1,500 cases, 40% died). “‘As scientists we’re interested in how the virus works,’ says Jim Paulson, a biologist at The Scripps Research Institute. ‘We’re trying to just understand the virus so that we can be prepared.’ That’s why he and his colleagues recently tinkered with a piece of the H7N9 flu — a protein that lets the virus latch onto cells. It’s thought to be important for determining which species the virus can infect. ‘So it’s not the whole virus,’ says Paulson. ‘It’s just a piece — just a fragment — that we can then study for its properties’. What they studied is how different changes affected the virus’ ability to bind to receptors found on the surface of human cells.” Paulson’s group found that just three tiny mutations made it able to sustain human transmission. This brings about the dual-use research of concern (DURC) and gain-of-function (GoF) research dilemma though – while we’re using it for good, couldn’t a person with bad intentions come along and turn it into a weapon? Or a lab error that results in an outbreak? While some argue for the need of GoF research, others agree with the 2014 White House moratorium that halted federal funding for such work. Ron Fouchier of Erasmus Medical Center in the Netherlands notes that, “‘The rest of the world is moving forward with this type of experiment already,’ says Fouchier, whose genetic experiments with a different bird flu virus sparked a public outcry in 2011. And so the U. S. can either join or not join. It’s up to them, but the work will continue,’.” Topics like avian influenza, pandemics, and dual-use/GoF research are all issues we’ll be discussing in the workshop this July, so don’t miss out!

Boston University’s BioLab Nears Approval
This hotly debated BSL-4 lab has been a source of contention between researchers and surrounding neighbors for over a decade. Boston University received a $200 million federal grant nearly 15 years ago to build the regional lab as a new source for work with deadly pathogens however, neighborhood activists have been halting work since the beginning. Despite the ongoing debate, the lab is just one vote away from approval. “Supporters say it will speed the development of new vaccines and cures.  But after 15 year of fighting, the neighborhood that’s home to the lab is making a final push to keep the diseases away from the busy urban hub.”

The Scary Reality Behind WHO’S Updated Essential Medicine List
GMU Biodefense PhD student, Saskia Popescu, is taking a deeper dive into the recent announcement by the WHO regarding their reformatting of the EML list. The antibiotics sections haven’t seen an overhaul like this for 40 years, so what’s really afoot? Last week we discussed the changes- the categorization of antibiotics into three groups (ACCESS, WATCH, and RESERVE). Each list has a series of antibiotics and recommendations (i.e. for RESERVE, these are antibiotics which should be treated as the last resort of accessible antibiotics and should be used in “tailored” situations when other medications have failed. RESERVE antimicrobials should be targeted in national and international stewardship programs). While the updates make sense, they reveal a much deeper concern for developing countries and the growing threat of microbial resistance. “This extensive change to the EML highlights the dire situation that we are progressing towards in terms of microbial resistance. The EML provides the most basic medicine needed for patient care and its focus on antibiotic stewards highlights the stark reality even in the most dire of environments.”

Stacking Countermeasures for Layered Defense 
DTRA’s Joint Science and Technology Office’s (JSTO) Toxicant Penetration and Scavenging (TPS) research program is working to better defend us against chemical and biological weapons. “One such weaponized threat is the use of organophosphonates in an attack. These nerve agents inhibit acetylcholinesterase (AChE), an essential enzyme responsible for neurological function. Irreversible inhibition of AChE may lead to muscular paralysis, convulsions, bronchial constriction and death by asphyxiation. One of the projects in the TPS uses engineered DNA-enzyme nanostructures to create multi-enzyme pathway biocatalysts. These new biocatalysts are designed to process the destruction of chemical agents and their degradation compounds.”

Stories You May Have Missed:

  • MERS and Infection Control – There are endless opportunities when working in infection prevention & control to say, “I told you so” and the ongoing hospital MERS outbreaks only fuels that fire. “The World Health Organization (WHO) today provided new details on three MERS-CoV clusters in Saudi Arabia involving 32 out of the 35 cases reported between Jun 1 and Jun 10. The clusters are in three different hospitals in Riyadh. Cluster 2 is related to cluster 1, as the first case-patient in a second hospital initially visited the emergency room of the hospital implicated in cluster 1. According to the WHO, he was asymptomatic following the visit in hospital 1, and he continued to receive kidney dialysis sessions in the second hospital. The cluster involves the index case plus five healthcare workers and household contacts.The third cluster is not related to clusters 1 or 2. To date four cases are associated with this hospital; the index case involves a patient who had camel contact. Three healthcare workers have also been diagnosed.”

Pandora Report 3.10.2017

Looking for a great podcast on CRISPR? Check out RadioLab – they also have a captivating one on patient zeroes throughout history!

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security: From Anthrax to Zika 
If you’re looking to learn more about global health security, synethic biology, biosecurity, and what exactly “biodefense” entails, you’ll want to mark your calendar for the GMU Biodefense three-day, non-credit summer workshop on July 17-19, 2017! Participants will look at the challenges facing the world at the intersection of national security, public health, and the life sciences. Instructors for the workshop range from FBI special agents to biodefense professors and USAMRIID commanders. The workshop will look at the spectrum of biological threats – including naturally occurring disease outbreaks such as SARS, Zika, and Ebola, lapses in biosafety, dual-use research of concern, and the threat of bioterrorism. From now until May 1st, you can take advantage of the early bird registration discount!

Glaring Gaps: America Needs A Biodefense Upgrade
GMU biodefense PhD alum Daniel M. Gerstein is emphasizing the need to strengthen American biodefense capabilities. “Recent legislation has called for a comprehensive biodefense strategy. If carried out in a thorough and systematic way, and properly funded, this will be a great improvement for the country and the world.” Gerstein notes that while the National Defense Authorization Act for Fiscal Year 2017 called for a joint biodefense effort, there is still a desperate need for a structured and systematic approach. Perhaps one of the biggest issues Gerstein found is the current view of biodefense as a series of programs. Approaching global health security threat requires us to view biodefense as a complex system, not a series of programs. To fix the glaring gaps in U.S. biodefense efforts, he notes that any remedy will have to accept the complexity of the problem and that there is no single panacea. Internal coordination, improvement of diagnostics and treatment, and technology management are all things that must be addressed to strengthen American biodefense. “Export controls in the United States, for example, actually hinder international collaboration. Exchanging pathogen strains used in the development of medical countermeasures, diagnostics, and bio-surveillance remains difficult – even, at times, for close international partners. In one case, the United States was attempting to share a strain of the Ebola-Reston pathogen with the government of Australia, but export laws prevented this sharing, so the strain was instead acquired from the Philippines, where the strain originated.” While we’ve made great strides since the Amerithrax attacks, there is much to be done to create a systematic and resilient biodefense strategy.

Chemical Weapons Reportedly Used in Mosul
The WHO has recently activated an emergency response plan with several partners to help treat twelve people for potential exposure to chemical weapons in Iraq. “Lise Grande, the UN humanitarian coordinator in Iraq, called for an investigation. ‘This is horrible. If the alleged use of chemical weapons is confirmed, this is a serious violation of international humanitarian law and a war crime, regardless of who the targets or the victims of the attacks are,’ she said in a statement.” Many are pointing to ISIL as the likely culprit since they hold the majority of west Mosul and have a history of rudimentary use of chemical weapons.

China’s Growing Bird Flu Worries  
Despite a recent surge in human A(H7N9) cases, the WHO has stated that the risk of an epidemic remains low. Even with this release, the development of two distinct strains in a disease that has a mortality rate hovering around 30%, has many worried. “That will probably force development of a second small stockpile of emergency vaccine to be rolled out if the virus becomes more transmissible and threatens to turn into a pandemic, a scientist at the Centers for Disease Control and Prevention said. Flu specialists from around the world gathered in Geneva this week to assess the global influenza situation and discuss with vaccine companies which viral strains should be in next winter’s flu shots. China has had 460 lab-confirmed human cases of H7N9 bird flu this winter, said Dr. Wenqing Zhang, head of the W.H.O.’s global influenza program. That is the most in any flu season since the first human case was found in 2013.” Interestingly, around 7% of the new H7N9 cases were resistant to drugs like Tamiflu, which has many researchers working to make a H7N9 seed vaccine, including a secondary one due to the split strains. Coming on the heels of this outbreak, US officials have announced that highly pathogenic avian influenza (HPAI) was found in a commercial poultry farm in Tennessee. 700 birds died from infection and almost 73,000 were destroyed. The farm is a contracted supplier of chicken meat for the U.S.’s biggest supplier, Tyson, which released an announcement on March 5th regarding testing of local birds, etc.

Global Health Security Index Development
Johns Hopkins Center for Health Security recently received a grant from the Open Philanthropy Project and the Robertson Foundation to coordinate with the Nuclear Threat Initiative (NTI) and the Economist Intelligence Unit (EIU) to develop a Global Health Security Index. “The mission of the index is to encourage progress towards a world that is capable of preventing epidemics of international impact (either natural, accidental or deliberate) from arising, or, should, prevention fail, respond quickly to contain them.” The first phase of the project will aim at developing framework that can measure a country’s level of health security. While the GHSA and JEE are processes to increase transparency, preparedness, and country capabilities, the goal of this index is to fill the gaps in motivation and also the factors that are not in the hands of the health sector.

Antimicrobial Resistance in Pets: Are We Ignoring A Looming Threat? 
GMU biodefense PhD student Saskia Popescu is looking at the threat of antibiotic resistance, but from a somewhat forgotten patient population – our pets. The recent WHO list of worrisome antimicrobial resistant bugs has drawn a lot of attention to the growing threat of an antibiotic apocalypse however, sometimes it takes a personal experience to look outside the box. Pulling from experiences of dealing with drug resistance in her dog to the loss of SeaWorld’s controversial orca, Tilikum, Popescu notes the rising threat of AMR brewing in domesticated animals. Sadly, it seems that many veterinarians and infectious diseases researchers have been drawing attention to the role of household animals in antimicrobial resistance and yet, just like the human issue, it’s not getting the attention it deserves. In her article, Popescu points to the need to start addressing the full circle of microbial resistance, starting with our furry friends.

Stories You May Have Missed:

  • Constraining Norms for Cyber Warfare Are Unlikely – GMU Biodefense PhD alum, Brian M. Mazanec, is talking to the Georgetown Journal of International Affairs about the realities of norms for cyber warfare. The question of whether constraining international norms for cyber warfare will emerge and thrive is of paramount importance to the unfolding age of cyber conflict. Some scholars think that great powers will inevitably cooperate and establish rules, norms, and standards for cyberspace. While it is true that increased competition may create incentives for cooperation on constraining norms, Mazanec argues that norm evolution theory for emerging-technology weapons leads one to conclude that constraining norms for cyber warfare will face many challenges and may never successfully emerge.
  • ABSA International Webinar- Behaving Safely in the Laboratory: Understanding Complexities of Building and Sustaining a Culture of Safety–  ABSA is hosting a 2-hour webinar session for three days. “The webinar will be offered Monday, April 3; Wednesday, April 5 and Friday, April 7, 2017.  Millions of dollars on engineering.  Thousands of dollars on PPE.  Hundreds of hours spent writing SOPs – and in one instant all of these controls can be negated with one inappropriate behavior.  Behavior is the bridge between written plans and desired outcomes.  But what does it take to behave safely?  Day 1 will focus on what it takes for an individual to behave safely – as behavior requires five critical items – and without these items – sustained behavior cannot occur. Day 2 will focus on motivating behavior – the differences between leadership and management – and the motivating factors which are extrinsic, systemic, and intrinsic. Day 3 will focus on building and sustaining a ONE SAFE culture – blending the efforts of the workforce, leadership, and safety officials.”
  • High Flu Activity Throughout the U.S. – The CDC has warned that the U.S. is still experiencing high flu activity in all regions. This flu season has seen elevated pediatric mortality, with six reported last week, bringing the total to forty pediatric deaths. “The CDC said there have been more hospitalizations and clinical visits for influenza-like illness (ILI) at this point in the flu season than in 2012-13, another season when H3N2 strain predominated. The CDC said the cumulative overall rate is 39.4 hospitalizations per 100,000 people. During the 2012-13 flu season, the rate was (38.2 per 100,000).”

 

Pandora Report 12.16.2016

Sick to your stomach? Make sure to tweet about it! Seriously – the UK Food Standards Agency is using social media to track stomach bugs like norovirus. Before we venture down the biodefense rabbit hole, have you ever wondered what would happen if college students tried to hack a gene drive?

GMU Biodefense PhD Writes ‘Groundbreaking’ Thesis on Cyber Warfare– GMU Biodefense PhD graduate, Craig Wiener, is talking about his PhD experience and the amazing work he did on his dissertation. Craig’s story is pretty unique – between the commute from his position at the Department of Energy’s National Nuclear Security Administration, to his background in biodefense and research in synthetic biology, he’s a prime example of the diverse and passionate students we see in the GMU biodefense program. “Wiener’s PhD dissertation, ‘Penetrate, Exploit, Disrupt, Destroy: The Rise of Computer Network Operations as a Major Military Innovation,’ is groundbreaking, said Gregory Koblentz, director of Mason’s biodefense graduate program, and it has nothing to do with biodefense. Wiener connected some rather complicated dots in determining the origins of computer network exploitation and computer network attacks in the U.S. intelligence community. ‘I’ve established that computer network operations are a major military innovation, and it was developed by the U.S. intelligence community…. It’s the first time the intelligence community has developed a weapon system,’ said Wiener.” A labor of love, his work will significantly contribute to the history of cyber warfare and is a prime example of what makes GMU such a wonderful university to study.

FDA Review of 2014 Variola NIH Incident

screen-shot-2016-12-14-at-7-57-52-amThe newly released report, “FDA Review of the 2014 Discovery of Vials Labeled ‘Variola’ and Other Vials Discovered in an FDA-Occupied Building on the NIH Campus”, details the findings and corrective actions following the FDA’s internal investigation of the 2014 incident. The compilation includes several interviews, findings from reports and site visits, and a timeline of events leading to the discovery of the 327 vials on July 1, 2014. Some of the findings include: “There was no single individual responsible for the entire contents and operation of the shared cold storage area. FDA did not follow the CDC Select Agent Guidelines for the packaging and transfer of samples to a high containment facility for securing the materials.” There were six findings in the report, which included corrective actions, future actions, and compliance mechanisms. The report also includes the table regarding the disposition of the 327 vials. “It was noted that an internal, inward-looking investigation by the FDA had not formally started at the time of the hearing because both the CDC and FBI were in the midst of their own investigations of the incident.  However, FDA informally started an internal review and audit of the incident to understand the failure points to implement best policies and practices to prevent such incidents from happening in the future.”

Global Virome Project – You may remember reading  this summer about finding the next patient zero via a speaking engagement from USAID Director for Global Health Security and Development Unit, Dr. Dennis Carroll. The truth is that outbreaks like Zika and Ebola have shown us that countermeasures are invariably weak and viruses like to hide out in nature. This formidable reality has led to the development of the Global Virome Project, which looks to catalogue viruses from all over the world as a means of identifying the threats before they can identify us. “The idea has been around for a while and is supported by individual scientists and organizations including the US Agency for International Development, the nonprofit EcoHealth Alliance, HealthMap, ProMED, and the epidemic risk firm Metabiota. Now support for a global push may be picking up momentum, as scientists and health organizations find themselves repeatedly called upon whenever new threats arise.” An extension of the vision that brought about the PREDICT project, the Global Virome Project looks to make the process more efficient and effective by utilizing new methodology. While knowing the existence of a disease does not equate to preparedness, the understanding of how it interacts with humans and where it hides can help us determine risk and vaccine development. “For instance, knowing that the risk of contracting viruses carried in a species of bats is highest when their offspring are young might push ecotourism operators to avoid caves at those times. And Carroll said filling in more of the picture of the viral world will simply help scientists understand its patterns and interactions better. Right now, predictions are based on the behaviors of a few hundred known viruses, he said.”

2017-2022 Health Care Preparedness and Response Capabilities – The Office of the Assistant Secretary for Preparedness and Response has released their report outlining “the high-level objectives that the nation’s health care delivery system, including HCCs [health care coalitions] and individual health care organizations, should undertake to prepare for, respond to, and recover from emergencies.” The report further breaks down the capabilities into four sections that will, when combined and fully followed, enable full readiness. The four sections are Foundation for Health Care and Medical Readiness, Health Care and Medical Response Coordination, Continuity of Health Care Service Delivery, and Medical Surge. The report is extremely detailed and includes a wide variety of methods for identifying and coordinating resource needs during an emergency, setting up a health care EOC, implementing out-of-hospital medical surge response, and much more.

Blue Ribbon Study Panel Report on Biodefense Indicators– I remember the excitement during the Blue Ribbon Study Panel presentation on their recommendations since the Ebola outbreak. The room was packed with so many contributors to biodefense and there was a sense of fervor regarding the possibilities that could come from their 87 recommendations. Sadly, it seems that enthusiasm isn’t enough to get the work completed. It seems that an overwhelming majority haven’t been completed, according to the latest report. In fact, Tom Ridge and Joseph Lieberman have taken to TIME magazine as a means to implore the incoming administration to help protect the U.S. from bioterrorism and infectious disease threats.

Nanotherapeutics Opens Plant Near Progress Park – Nanotherapeutics opened their new $138 million 183,000-square-foot plant near Progress Park in Alachua, which was built to fulfill a DoD grant that could be worth up to $359 million. “The purpose and the capability of this facility is really fundamentally to avoid a surprise and be better prepared,” said Chris Hassell, deputy assistant secretary of defense for chemical and biological defense. “Sixty years after Pearl Harbor we were surprised again with the anthrax mailings and other events of 9/11, so this whole issue of surprise is a common area of discussion, what can we do to avoid surprise, to defend it, to respond to it more effectively and to that end this facility is very important to our capability to do that.” The DoD maintains several contracts for vaccine and treatment manufacturing, however Nanotherapeutics has tackled several of the struggles with efficiency that have plagued several other efforts. Utilizing disposable bags within stainless steel equipment allows for less clean-up and quicker transitions to help make the process more efficient and successful. The new plant follows strict NIH and military guidelines regarding waste and handling of hazardous materials, not to mention a pretty hefty security system.

czqg73pwiaacplk-png-largeUNSC 1540 Resolution – The United Nations Security Council unanimously voted on Resolution 1540 this week, which is especially prudent given the devastation in Syria and use of chemical weapons. The overwhelming adoption of the 1540 review resolution furthered the fight to keep WMD’s out of non-state actor hands. Resolution 1540 was adopted in 2004 and extended periodically through 2012 as a means of imposing binding obligations on all states to adopt legislation to prevent the proliferation of nuclear, chemical, and biological weapons. The open debate, “Preventing Catastrophe: A Global Agenda for Stopping the Proliferation of Weapons of Mass Destruction to Non-State Actors” took place on December 15th, ending the second review of 1540 implementation. “The Council is expected to adopt a resolution endorsing the review and noting the findings and recommendations contained in its report, which was agreed by the 1540 Committee last Friday”. The comprehensive review process has been somewhat challenging lately due to differences in Council member priorities and ambitions. “Russia and China made clear that they did not see the need for radical changes in the functioning or mandate of the Committee, whereas Spain, as the chair of the Committee, and other Council members, such as the UK and the US, were pushing for more substantive measures and new approaches. As a result, the discussions in the 1540 Committee on the report of the review were quite contentious, in particular with regard to its conclusions and recommendations. It took more than two months of intense negotiations after the Committee considered the first draft of the report on 27 September to reach agreement on the final document. The whole review process has taken almost two years.” We’ll make sure to keep you posted as news is released!

Avian Influenza and Global Trade Conditions– A series of avian influenza outbreaks are challenging the positive 2017 outlook for the global poultry industry. These events are especially distressing for the poultry industry as the global pork and beef production is rising. “The return of avian influenza is now shaking up global trade conditions and is especially affecting the outlook for Asia, Europe and Africa,” the report said. “It will also be a test for the U.S. industry after last year’s multiple AI outbreaks. As many European and Asian countries are exporters of meat and breeding stock, this will certainly impact the outlook for the industry and could shake up meat and breeder trade again.” The increasing protectionism and disease-related traded restrictions have caused some slowing within the poultry trade. This report comes at an auspicious time as the WHO warns of a H7N9 pandemic.

Zika Virus Updates- The most recent Florida Department of Health daily updates can be found here, which found six new travel-related cases on 12/14 and no new locally acquired cases. The CDC has issued a travel advisory for Brownsville, TX due to Zika virus. A new study has estimated the prevalence of Zika by the time a microcephaly case is detected. Saad-Roy, et al. (2016) explain, “this model gives us the probability distribution of time until detection of the first microcephaly case. Based on current field observations, our results also indicate that the percentage of infected pregnant women that results in fetal abnormalities is more likely to be on the smaller end of the 1% to 30% spectrum that is currently hypothesized. Our model predicts that for import regions with at least 250,000 people, on average 1,000 to 12,000 will have been infected by the time of the first detection of microcephaly, and on average 200 to 1,500 will be infectious at this time. Larger population sizes do not significantly change our predictions.” The CDC has reported, as of December 14th, 4,617 cases in the U.S.

Stories You May Have Missed: 

  • Biological Security Threats Situation Report – In this report from the Danish Centre for Biosecurity and Biopreparedness, you can find an assessment of current biological threats and risks. The authors note that “the overall likelihood of a major biological terrorist attack must be viewed as relatively low at the moment, but a successful attack could have grave consequences for societies.” Focusing on the capacity to respond to intentional attacks through biosecurity and biopreparedness is vital. The report looks at the risks from state, non-state terrorists, and criminals in its assessment.
  • DHS Backs Development of Livestock Disease Outbreak Readiness Program – America has a soft underbelly and it’s livestock and agriculture. The new funding for the National Agricultural Biosecurity Center (NABC) project to develop the readiness program is just over $330,000 and “will provide a clearinghouse for planning, training and knowledge products to help state, local, tribal and territorial entities prepare for transboundary livestock disease outbreaks.he program also entails extensive collaboration of academia, private industry and state governments. Faculty and staff in the Beef Cattle Institute and the College of Veterinary Medicine will provide subject matter expertise and assistance building the website, and student workers will be employed to assist with the project.”
  • ABSA International  – Don’t miss the USDA and the Agricultural Research Service’s 4th International Biosafety and Biocontainment Symposium- Gobal Biorisk challenges: Agriculture and Beyond. This symposium will take place from February 6-9th at Baltimore Convention Center. Topics will range from biorisk management challenges in one health world, arthropod containment in plant research, and much more!

Pandora Report 5.20.2016

The biodefense world was pretty busy this week – between Zika funding, cloning, and debates over dual-use technologies, we’ve got a lot to recap! Check out this great infographic on mosquitoes and the diseases they spread. The “State of Innovation” report revealed a decrease in biotech patents in 2015, with many pointing to the correlation between three U.S. Supreme Court decisions that limited patentability of some biotechnologies. If you were wondering how the sale of Plum Island is going, the House has actually temporarily halted any transactions.

Congrats GMU Biodefense Graduates!IMG_3491
We’re so happy to announce the convocation of some of our phenomenal graduate students. Earning a MS in Biodefense- Julia Homstad (also awarded the Frances Harbour Award for Community Leadership), Brittany Linkous (earning the Outstanding Biodefense MS Student Award), Francisco Cruz, Mary Dougherty, Moneka Jani, Sadaf Khan, Brittany Ferris, Michael Smith, and Robert Smith. Graduating with their PhD’s – Jonathan Gines (also the recipient of the Outstanding Biodefense PhD Student award and his dissertation was: Designing Biorisk Oversight: Applying Design Science Research to Biosafety and Biosecurity, Patricia Kehn (Flu News You Can Use? An Analysis of Flu News Quality 2008-2010), and Mittie Wallace (Emergency Preparedness in Virginia, Maryland and DC: Using Exchange Theory to Identify Government-Nonprofit Incentives and Barriers to Collaboration). Congrats to all our Biodefense graduates in the hard work and dedication they’ve put forth to contribute to such a diverse and exciting field!

Evaluation of DoD Biological Safety & Security Implementation
The Inspector General of the Department of Defense (DoD) has released their report regarding the biosafety and biosecurity policies and practices within DoD laboratories working with select agents. The report also evaluated DoD oversight of these laboratories and compliance with Federal, DoD, and Service Policy, with careful consideration to recent GAO (among others) recommendations. Several findings were reported, which include: “DoD has not maintained biosafety and biosecurity program management, oversight, and inspections of its BSAT laboratories according to applicable Federal regulations. BSAT laboratories in Military Services were inspected according to different guidance, standards, and procedures, risking dangerous lapses in biosafety practices. Lack of coordinated oversight of DoD laboratories led to multiple, missing, and duplicative inspections, and, therefore, an excessive administrative burden that could interfere with scientific research performance.” The report also noted that public health and safety was put at risk due to the poor protection of these agents. Recommendations pushed for better internal and external tracking of inspections, coordination of external technical and scientific peer reviews, standardized training for inspectors, the creation of site-specific laboratory security vulnerability assessments, etc. Overall, the report addresses several key failures within select agent laboratories that have been gaining increasing attention. While these recommendations are a necessary first step, there is definitely an up-hill battle to better secure and work with select agents.

Public Health & Emerging Disease Outbreaks – The Importance of Communication 
Outbreak prevention and response isn’t a new concept…in fact it’s something we’ve been perfecting since John Snow took off the Broad Street pump handle. Sometimes, the fastest spreader isn’t the disease, but rather poor communication and fear. In every after-action report, communication tends to be the biggest failure. Not only do people fail to talk to each other enough, but information dissemination and comprehension tends to be poorly emphasized, when in fact it could save lives. “In particular, healthcare workers may benefit from knowing about newly found transmission risks or disease findings from a novel case under intensive care. Knowledge drives behavioural change that can save lives. We live in a global community. Even if the lives saved are not citizens of our country, withholding information because it is unlikely to benefit our own countrymen, or even delaying dissemination of important information until it is published in a scientific journal is a poor choice.” Dr. Ian Mackay and Katherine Arden point to communication failures regarding the zoonotic transmission of MERS-CoV and the illness of a nurse from the UK who recovered from Ebola and was later hospitalized for meningitis. Both instances involved poor communication, especially to healthcare workers. “Good communicators and reliable communications are vital. Create a dialogue with the public now to build a partnership for later, to reduce distrust when an outbreak, epidemic or pandemic occurs. In this way, communities know which voices to trust and where to turn for their information. Leaving an information void invites others to fill it and more often than not, it is those who delight in titillation, invention, make-believe and fear-mongering.”

Weekly Dose of Zika Virus
H.R. 5243 – Zika Response Appropriations Act of 2016 is the hot topic of discussion this week, as President Obama’s Administration is opposing the act. “While the Administration appreciates that the Congress is finally taking action to address the Zika virus, the funding provided in H.R. 5243 is woefully inadequate to support the response our public health experts say is needed.  Specifically, the Administration’s full request of $1.9 billion is needed to:  reduce the risk of the Zika virus, particularly in pregnant women, by better controlling the mosquitoes that spread Zika; develop new tools, including vaccines and better diagnostics to protect the Nation from the Zika virus; and conduct crucial research projects needed to better understand the impacts of the Zika virus on infants and children.On May 17th, the Senate voted to provide $1.2 billion to fight the growing outbreak. A team from the University of Texas Medical Branch at Galveston has traveled into uncharted territory – they are the first to genetically engineer a clone of the Zika virus strain.  Their work could help speed up vaccine development and research of the virus. As the Zika outbreak rages onwards, many are pointing to the need to understand how and why it mutated from Africa to Asia and then to the Americas.  “‘Like many arboviral agents, given the appropriate environmental and human conditions, new pathogens can be easily moved around the globe,’ Ann Powers said. And that’s what Zika did. The virus began to ripple across the Pacific—and as it traveled, it seemed to change.” The Olympic Games are fast approaching and the debate about the safety of the games has been spreading (see what I did there?). Last week you read about how some are saying the games should be cancelled, while others say it poses a minimal threat. You can also find a snapshot of Zika virus here. The WHO reported that the overall risk of Zika virus moving across the WHO European region is low to moderate during late spring and early summer. Rutgers is taking the lead on an IBM-sponsored project that will utilize supercomputing resources to identify “potential drug candidates to cure the Zika virus.” The Wilson Center is hosting an event, “Zika in the U.S: Can We Manage the Risk?” on Tuesday, May 24th, at 11am. Many are also wondering why humans and not mice are susceptible to the virus. Lastly, as of May 18th, the CDC has reported 544 travel-associated cases and 10 sexually transmitted cases within the U.S.

Governance Structures for Reducing Dual-Use Technology Risks
The American Academy of Arts & Sciences has published an examination of dual-use technology governance and the state of current efforts to control the spread of potentially dangerous technologies. “Governance of Dual-Use Technologies examines the similarities and differences between the strategies used for the control of nuclear technologies and those proposed for biotechnology and information technology. The publication makes clear the challenges concomitant with dual-use governance.” The report looks at the potential objectives of these measures, what they translate to in a technical format, and if these measures are even feasible.

Global Avian Influenza A H5N1 Trends
Researchers recently looked at the epidemiology of human H5N1 cases from 1997-2015. This was the first comprehensive analysis of human cases on a global scale. The number of affected countries rose between 2003 and 2008, traveling from east Asia into west Asia and Africa. “Most cases (67·2%) occurred from December to March, and the overall case-fatality risk was 483 (53·5%) of 903 cases which varied across geographical regions. Although the incidence in Egypt has increased dramatically since November, 2014, compared with the cases beforehand, there were no significant differences in the fatality risk, history of exposure to poultry, history of patient contact, and time from onset to hospital admission in the recent cases.”

Stories You May Have Missed:

  • Health Security Available – The newest volume of Health Security is now available online. The recent issue includes pieces on Zika and microcephaly, preparing for climate disruption, adapting to health impacts of climate change in the DoD, and more!
  • Secret Genome Meeting – Last week saw a meeting hosted by Harvard Medical School’s George Church, to discuss “feasibility and implementation of a project to synthesize entire large genomes in vitro.” Initially the meeting was open to the public and media however, the decision was made to keep it private (from the media) so that researchers, lawyers, entrepreneurs, and government officials could speak freely without fear of being misquoted. “Our ability to understand what to build is so far behind what we can build,” said Jeremy Minshull, chief executive of DNA synthesis company DNA2.0, told The New York Times. “I just don’t think that being able to make more and more and more and cheaper and cheaper and cheaper is going to get us the understanding we need.”
  • Four Countries Fend Off Avian Influenza- Cambodia, Ghana, and Indonesia have been battling H5N1 and Italy has just reported its second H7N7 occurrence this month. Ghana and Cambodia have reported significant bird mortalities, with the virus killing 155 of 505 susceptible birds. “In Ghana, the H5N1 virus turned up in four commercial layer and breeding farms in three of the country’s regions: two in Greater Accra and one each in Eastern and Central regions.”
  • Bavarian Nordic Smallpox Vaccine Contract – the pharmaceutical company announced that BARDA has ordered a bulk supply of their new IMVAMUNE smallpox vaccine. The $100 million supply of the non-replicating vaccine requires Bavarian Nordic to manufacture and store the bulk supply. “The freeze-dried version of IMVAMUNE is expected to reduce the life cycle management costs based on a longer shelf life and will replace the liquid-frozen version that is currently stockpiled in the U.S. Strategic National Stockpile (SNS).”
  • Early Detection Lyme Disease Test Successful – GMU researchers have proven that their early-detection urine test works to rapidly identify Lyme diseases. “The National Institutes of Health funded the research that led to Mason’s patented technology, which traps tell-tale clues (such as the Lyme bacteria protein) that a disease is present. The Mason technology, which is licensed to Ceres, works during the earliest stages of disease and finds the tiniest traces missed by most diagnostic tests.”

Pandora Report 2.5.2016

Fear of mosquitoes continues to grow as Zika virus joins the list of burdening arbovirus infections. Perhaps the biggest surprise this week wasn’t that imported Zika cases continue to spring up across the US, but rather that the first sexually transmitted case occurred in Dallas, Texas. I’m starting to think Dallas, TX, could use a break from emerging infectious diseases… As influenza season picks up in the US, Avian influenza outbreaks are popping up in Taiwan, South Africa, and Macao. Good news- it’s safe to go back to your favorite burrito bowl! The CDC declared the Chipotle-associated E. coli outbreak over, however, their co-CEO has voiced frustration over delayed reporting. In the interview, he felt that it gave the “mistaken impression that people were still getting sick” and news was “fueled by the sort of unusual and even unorthodox way the CDC has chosen to announce cases.” Before we venture down the biodefense rabbit hole, don’t forget to stay healthy and safe this Super Bowl Sunday. Spikes in cases and flu-related deaths (in those >65 years of age) can jump by 18%  in the home regions of the two teams. Take care to avoid respiratory viruses and food-borne issues while cheering on your favorite team this weekend!

Medical Counter Measures for Children
Having worked in pediatrics, I was thrilled to see the American Academy of Pediatrics publish the updated guidelines. Throughout my work in infection prevention and collaborations with hospital emergency preparedness and local county health departments, it became increasingly evident that in many ways, this is a patient population that is easily forgotten. There is a woefully apparent gap in preparedness methodology to recognize and modify practices to meet the unique needs of children. While many may laugh at the notion that “children aren’t just little adults”, those who have worked in pediatrics can attest to these common misconceptions. Children are not only more susceptible to the devastation of disasters and CBRN attacks, the medical counter measures often do not account for pediatric dosages. The published report discussed their work over the past five years to better address and fill major gaps in preparedness efforts when it comes to medical counter measures (MCM) for children. “Moreover, until recently, there has been a relative lack of pediatric MCM development and procurement; many MCMs were initially developed for use by the military and have been evaluated and tested only in adults.” Some of the recommendations that were made from this report include: “the SNS and other federal, state, and local caches should contain MCMs appropriate for children in quantities at least in proportion to the number of children in he intended population for protection by the cache” and “federal agencies collaborating with industry, academia, and other BARDA partners, should research, develop, and procure pediatric MCMs for all public health emergency, disaster, and terrorism scenarios and report on progress made.” Perhaps one of the most interesting recommendations was that “the federal government should proactively identify anticipated uses of MCMs in children during a public health emergency and, where pediatric FDA-approved indications do not exist, establish a plan to collect sufficient data to support the issuance of a pre-event EUA that includes information such as safety and dosing information and the federal government should use existing entities with pediatric SMEs, such as the PHEMCE, PedsOB IPT, and the DHHS National Advisory Committee on Children and Disasters, and continue to collaborate with private sector partners offering pediatric expertise to provide advice and consultation on pediatric MCMs and MCM distribution planning.” Overall, these recommendations and the push for data collection and clear progress reporting are definitely a step in the right direction.

GMU Open House
Interested in a master’s degree that allows you to focus on bioweapons, global health security, and WMD’s? Check out GMU’s School of Policy, Government, and International Affairs (SPGIA) Open House on Thursday, February 25th at 6:30pm, at our Arlington Campus in Founders Hall, room 126. Representatives from our Biodefense program will be there to answer all your questions. Better yet, check out our Biodefense Course Sampler on Wednesday, March 2nd, at 7pm (Arlington Campus, Founders Hall, room 502). Dr. Gregory Koblentz,  director of the Biodefense graduate program, will be presenting “Biosecurity as a Wicked Problem”. Come check out our curriculum and get a taste of the amazing topics we get to research!

From Anthrax to Zikam6502e1f
Researchers at the University of Greenwich are finding a potential cancer-fighting strategy using the anthrax toxin. Lead scientist, Dr. Simon Richardson, is working with his team to convert the anthrax toxin into a delivery tool for medications.“This is the first time a disarmed toxin has been used to deliver gene-modulating drugs directly to a specific compartment within the cell. We’ve achieved this without the use of so called helper molecules, such as large positively charged molecules like poly(L-lysine). This is important as while these positively charged molecules, known as polycations, can condense DNA and protect it from attack by enzymes before it reaches the target, they are also known to be toxic, break cell membranes and are sent quickly to the liver to be removed from the body. In this study we demonstrate that using disarmed toxins without a polycation is effective, at a cellular level.” In the world of Zika virus….On Monday, the WHO Zika virus team met and announced that the outbreak should now be considered a public health emergency of international concern. Dr. Margaret Chan, WHO director general, stated, “I am now declaring that the recent cluster of microcephaly and other neurological abnormalities reported in Latin America following a similar cluster in French Polynesia in 2014 constitutes a public health emergency of international concern.” Given the level of uncertainty regarding the disease, many feel this was a justified classification of the outbreak. The first case of sexual transmission within the US also occurred in Dallas, Texas. The patient became sick after having sexual contact with an individual who became symptomatic upon return from Venezuela. Chile and Washington DC have just confirmed their first three cases this week. Mexico’s Health Ministry is trying to downplay the Zika impact on tourism, however as the outbreak unfolds, it will be interesting to see long-term tourism repercussions within the affected countries. The state of Florida is ramping up their mosquito elimination, control, and education efforts to combat the growing epidemic, as it is one of the mosquito-heavy states within the US. Governor Rick Scott recently declared a health emergency in four Florida counties. If you’re on the lookout for educational tools, there are several helpful CDC informational posters regarding mosquito bite prevention.

US Military and the Global Health Security Agenda
In effort to protect military members and support global public health, the DoD (specifically, the Military Health System in coordination with the Defense Health Agency’s Armed Forces Health Surveillance Branch) developed the 2014 Global Health Security Agenda (GHSA). The GHSA established a five-year plan with specific agenda items, targets, and milestones that would incorporate its 31 partner countries. The DoD’s Global Emerging Infections Surveillance and Response System (GEIS) will also support these efforts through their biosurveillance practices in over 70 countries. The international work is as varied as the challenges one might see in global biosurveillance. The Armed Forces Health Surveillance Branch (AFHSB) “leveraged existing febrile and vector-borne infection control efforts in Liberia to support the recent Ebola outbreak response. The Liberian Institute for Biomedical Research served as a central hub for Ebola diagnostic testing with the help of the Naval Medical Research Unit-3 in Cairo, Egypt and two Maryland-based facilities, the Naval Medical Research Center in Silver Spring and the U.S. Army Medical Research Institute of Infectious Diseases in Frederick.” Surveillance efforts will also look at antimicrobial resistance and the development of additional research laboratories to work in coordination with host-nations and certain regional networks. You can also read Cheryl Pellerin’s work on DoD Biosurveillance and the role it plays in maintaining global public health efforts. Pellerin reports on the duties of the GEIS and the US Army Medical Research Institute of Infectious Disease (USAMRIID) in not only global health security, but also protecting US military personnel from infections while abroad.

Norovirus Outbreak in Kansas
There are few things that will make a food-borne disease epidemiologist (or infection preventionist for that matter) as frustrated as a norovirus outbreak. It hits quickly, is highly infectious, and tends to leave you with stories from case-control interviews that will make you either laugh, cry, or need some fresh air. A Kansas City suburb is currently experiencing a 400 person outbreak of gastroenteritis associated with the New Theatre Restaurant. Initial lab reports have confirmed norovirus as the culprit. The Vice President of the restaurant said that three employees have also been confirmed as norovirus cases. To date, the almost 400 people who reported symptoms are said to have eaten at the restaurant between January 15 to present. Norovirus is a pretty unpleasant gastroenteritis (you’ve probably heard it called the “cruise ship bug”) as it has a low infectious dose (estimates put it as low as 18 viral particles, while 5 billion can be shed in each gram of feces during peak shedding). Norovirus outbreaks tend to spring up quickly and infect high volumes of people, making it difficult for public health officials to jump ahead of the outbreak. Perhaps one of the biggest components to stopping the spread of infection is good hand hygiene, environmental cleaning, and staying home when sick.

TB Transmission on Airplanes
We’ve all been there – you’re seated next to someone with a nasty cough or cold and you just know you’re going to get sick. But what happens if you’re on a plane and there’s a person a few rows away that has tuberculosis (TB)? The European Centre for Disease Prevention and Control (ECDC) reviewed evidence of TB transmission on airplanes to update their Risk Assessment Guidelines. Of all the records/studies reviewed, 7/21 showed some evidence for potential in-flight (all flights lasted more than 8 hours) TB transmission, while only one presented evidence for transmission in this environment. The interesting component is that this low transmission risk is considered only for in-flight, as they excluded transmission on the ground since the before and after flight ventilation system is not in full-function mode. The one study that did show transmission risk involved six passengers that were in the same section as the index case, of which, four were seated within two rows. After their review, they found that the risk for TB transmission on airplanes is “very low”. They noted that “the updated ECDC guidelines for TB transmission on aircraft have global implications due to inevitable need for international collaboration in contact tracing and risk assessment.”

Stories You May Have Missed:

  • Resistant HIV – A recent study published in The Lancet discusses drug resistance after virological failure with the first-line HIV medication, tenofovir-containing ART (antiretroviral  therapy). This treatment is used as both a prevention and pre-exposure prophylaxis (PrEP). Researchers found “drug resistance in a high proportion of patients after virological failure on a tenofovir-containing first-line regimen across low-income and middle-income regions”. This study highlights the growing need for surveillance of microbial drug resistance.
  • Active Monitoring of Returning Travelers – Ebola Surveillance – The CDC’s MMWR for the week of January 29, 2016, discussed NYC monitoring of returned travelers from October 2014-April 2015. Monitoring of returned travelers from Ebola-affected countries was one strategy the US employed to prevent imported cases. This report reviews the 2,407 travelers that returned from affected countries, of which no cases were detected. The NYC Department of Health and Mental Hygiene (DOHMH)’s active monitoring system proved successful, however it was very taxing on resources and reinforces the need to minimize duplication and enhanced cooperation. Speaking of Ebola, investigators from the University of Texas Medical Branch at Galveston, Vanderbilt University, the Scripps Research Institutem and Integral Molecular Inc., have performed research to establish that “antibodies in the blood of people who have survived a strain of the Ebola virus can kill various types of Ebola.” Further work will now seek to understand immune response to the virus and how we can modify treatments and potential vaccines to be more effective.
  • DoD BioChem Defense take a glimpse into the global biosurveillance and defense efforts within the DoD Chemical and Biological Defense Program (CBDP). Working within several joint programs and striving to get ahead of outbreaks and attacks with early warning systems, this program faces the challenges of monitoring biochem threats on an international scale.

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Pandora Report 7.26.15

Mason students are working through their summer courses and I’m happy to say mine is OVER! Let the summer begin (two months late)! This week we’ve got great news about Polio in Nigeria and a somber anniversary in Japan. We’ve also got other stories you may have missed.

Enjoy the rest of your weekend and have a great week!

A-Bomb Victims Remembered in Potsdam, Where Truman Ordered Nuclear Strikes

Coming up on the 70th anniversary of the atomic bombs being dropped on Hiroshima and Nagasaki, German and Japanese citizens in the city of Potsdam held a remembrance ceremony for both the victims that died in the blast and the future. Japan has become, according to the former President of the International Court of Justice, the world’s conscience against nuclear weapons and power. Why? Japan is “the only country in the world to have been the victim of both military and civilian nuclear energy, having experienced the crazy danger of the atom, both in its military applications, destruction of life and its beneficial civilian use, which has now turned into a nightmare with the serious incidents of Fukushima.”

Japan Times—“The Potsdam Conference was held between July 17 and Aug. 2 in 1945. The United States dropped an atomic bomb on Hiroshima on Aug. 6 and another bomb on Nagasaki three days later. On Aug. 15 that year, Emperor Hirohito announced to the nation that Japan had accepted the Potsdam Declaration, in which the United States, Britain and China demanded the nation’s unconditional surrender.”

Nigeria Beats Polio

Very, very, very exciting news: Nigeria has not had a case of polio in a year. A year! This makes Nigeria polio free and the last country in Africa to eliminate the disease. The achievement was possible with contributions from the Nigerian government (where elimination of the disease was a point of “national pride”), UNICEF, the WHO, the CDC, the Bill and Melinda Gates Foundation, Rotary International, and other organizations. With Nigeria’s accomplishment, there are only two other countries in the world where polio still exists—Afghanistan and Pakistan.

Voice of America—“Carol Pandek heads Rotary International’s polio program. She told VOA via Skype that a year being polio-free is a milestone for Nigeria, but noted that it is not over. “Now they need to continue to do high quality immunization campaigns for the next several years,” she said, as well as have a strong surveillance system so, should there be any new cases, they can be identified as soon as possible.”

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Image Credit: Fg2

Pandora Report 6.21.15

Changing things up this week, our lead story is a nuclear photo essay. We’ve also got Russian nuclear posturing and a bunch of other stories you may have missed.

Happy Father’s Day to all the dads out there and enjoy the rest of your weekend!

Next Exit, Armageddon: Photos of America’s Nuclear Weapons Legacy

I love a good photo essay, especially those focused on abandoned places—so this is the perfect* combination of that and nuclear history. Many times on the blog I’ve made somewhat flippant comments about visiting nuclear sites on summer vacation. However, evidently there is great public interest in this. As such, the National Park Service and the Department of Energy will establish the Manhattan Project National Historical Park that will include sites as Los Alamos, Oak Ridge and Hanford.

VICE News—“Elsewhere in the US, the ruins of the Manhattan Project and the arms race that followed remain overlooked. In North Dakota, a pyramid-like anti-missile radar that was built to detect an incoming nuclear attack from the Soviet Union pokes through the prairie grass behind an open fence. In Arizona, a satellite calibration target that was used during the Cold War to help American satellites focus their lenses before spying on the Soviet Union sits covered in weeds near a Motel 6 parking lot. And in a suburban Chicago park, where visitors jog and bird watch, nuclear waste from the world’s first reactor — developed by Italian physicist Enrico Fermi for the Manhattan Project in 1942 — sits buried beneath a sign that reads ‘Caution — Do Not Dig.’”

*Check out the photos. They’re truly extraordinary.

Putin: Russia to Boost Nuclear Arsenal with 40 Missiles

Everything old is new again, it seems. This week Vladimir Putin announced that Russia will put more than 40 new intercontinental ballistic missiles into service in 2015. It is said that the new missiles are part of a military modernization program. However, the announcement comes on the heels of a US proposal to increase its own military presence in NATO states in Eastern Europe.

BBC—“Nato Secretary-General Jens Stoltenberg said that the statement from Mr. Putin was “confirming the pattern and behaviour of Russia over a period of time; we have seen Russia is investing more in defence in general and in its nuclear capability in particular”.

He said: “This nuclear sabre-rattling of Russia is unjustified, it’s destabilising and it’s dangerous.” He added that “what Nato now does in the eastern part of the alliance is something that is proportionate, that is defensive and that is fully in line with our international commitments.’”

Stories You May Have Missed

Image Credit: Federal Government of the United States

Pandora Report 6.14.15

I’ve got brunch reservations this morning so the big story about the coming egg shortage is hitting close to home. We’ve also got a story about ISIS’ WMD and a bunch of stories you may have missed.

As a final reminder, the Early Registration Deadline for the Pandemics, Bioterrorism, and International Security is tomorrow, Monday, June 15. For more information and registration, please click here.

Enjoy the rest of your weekend!

Egg Shortage Scrambles U.S. Food Industries

The unprecedented outbreak of avian influenza in the U.S. has meant massive losses in the domestic poultry industry which has left experts warning that U.S. consumers are very likely to see an increase in egg prices. Cases of avian flu have been reported in 15 states, with Iowa and Minnesota being some of the hardest hit. “In Minnesota, the number of lost turkeys represent about 11 percent of our total turkey production…of the chickens we’ve lost that are laying eggs, 32 percent… have been affected by this” In Iowa, about 40 percent of the state’s egg-laying chickens and 11 percent of its turkeys have been affected. All these losses will mean a shortage of whole eggs and other egg-based products.

U.S. News and World Report—“Consumers haven’t felt the pinch too much just yet, but they are unlikely to emerge with their pocketbooks unscathed, [Rick] Brown [Senior VP at Urner Barry, a food commodity research and analysis firm]. He says two-thirds of all eggs produced in the U.S. remain in a shell, many of which are placed in cartons and sold in grocery stores. This stock of eggs has been hit significantly less by the avian flu outbreak than those used in the egg products industry, which Brown says encompasses “everything from mayonnaise to salad dressings to cake mixes to pasta to bread.”

Australian Official Warns of Islamic State Weapons of Mass Destruction

You may have already seen this, since this story was everywhere this week. Julie Bishop, Australia’s Minister for Foreign Affairs, said the Islamic State (ISIS) already has and is already using chemical weapons. Bishop made these comments in an address to the Australia Group—a coalition of 40 countries seeking to limit the spread of biological and chemical weapons. In a follow-up interview, Bishop also said that NATO was concerned about the theft of radioactive material and what that could mean for nuclear weapons proliferation.

The Washington Post—“‘The use of chlorine by Da’ish, and its recruitment of highly technically trained professionals, including from the West, have revealed far more seriou­s efforts in chemical weapons development,” Bishop said, using an alternate name for the Islamic State in a speech reported by the Australian. She did not specify the source of her information.  “… Da’ish is likely to have amongst its tens of thousands of recruits the technical expertise necessary to further refine precursor materials and build chemical weapons.’”

Stories You May Have Missed

 

Image Credit: Hannahdownes

Pandora Report 5.24.15

Two quick updates before we get into the weekly wrap-up.

First, the Early Registration Deadline for the Pandemics, Bioterrorism, and International Security professional education course at the GMU Arlington Campus has been extended to June 15. For more information and registration, please click here.

Second, we here at Pandora Report wanted to let you know about a new website designed to provide resources for biosecurity professionals and practitioners and key stakeholders. The International Biosecurity Prevention Forum (IBPF) brings together the world’s leading experts from the health and security communities to share expertise on key biosecurity and bioterrorism prevention issues. Registering to join IBPF is free and easy. Go to http://www.ibpforum.organd click the “Request Membership” button to request an IBPF member account. Members get access to a discussion section and projects, resources, and best practices submitted by other members. Contact the IBPF support team at IBPForum@ic.fbi.gov if you have any questions or problems.

Now, onto the news. This weekend we have stories about British nuclear submarines, anti-vaccine legislation in California, the development of bird flu vaccines, and other stories you may have missed.

Enjoy your Memorial Day weekend!!

Britain Investigates Sailor’s Disaster Warning Over Nuclear Subs

Able Seaman William McNeilly—a weapons engineer who served aboard HMS Vanguard, one of the four British submarines carrying Trident missiles—wrote a “lengthy dossier” released on the internet which says that the “Trident nuclear defense system was vulnerable both to enemies and to potentially devastating accidents because of safety failures.” McNeilly has since gone AWOL and both police and naval officials are trying to locate him.

The Japan Times—“The Royal Navy said it totally disagreed with McNeilly’s “subjective and unsubstantiated personal views,” describing him as a “very junior sailor.” But it added it was investigating both his claims and the “unauthorized release” of his dossier. “The naval service operates its submarine fleet under the most stringent safety regime and submarines do not go to sea unless they are completely safe to do so,” a spokeswoman said.”

A Blow to Anti-Vaxxers: California Approves Forced Vaccination Bill

By now, we all know that the measles outbreak that started last winter at Disneyland was a result of unvaccinated individuals. In California, the State Senate has passed a bill which limits parent’s use of the “personal belief exemption” in order to get out of getting their children vaccinated. Under the bill, parents who don’t get their children vaccinated would not be able to send their kids to state-licensed schools, nurseries, or day care centers.

State Column—“Only children who have a medical reason for why they can’t be vaccinated would still be allowed to attend schools without receiving their vaccinations under Senate Bill 277, which was sponsored by a California Sen. Dr. Richard Pan (D-Sacremento), a pediatrician, and Ben Allen (D-Santa Monica), a former school board member and the son of a survivor of polio, according to a Forbes report.”

Vaccines Developed for H5N1, H7N9 Avian Flu

Findings appearing in the Journal of Virology indicate that the U.S. Department of Homeland Security’s Center of Excellence for Emerging and Zoonotic Animal Diseases have developed a vaccine for both H5N1 and H7N9—two strains of avian influenza which can be transmitted from poultry to humans. The vaccine was developed by cloning the Newcastle disease virus and transplanting a small section of the H5N1 virus into it; the same method was used for the H7N9 vaccine.

Toronto Sun—“‘We believe this Newcastle disease virus concept works very well for poultry because you kill two birds with one stone, metaphorically speaking,” Richt said. “You use only one vector to vaccinate and protect against a selected virus strain of avian influenza.’”

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Image Credit: UK Ministry of Defence