Tag: Biodefense Policy Seminar

Pandora Report: 6.28.2019

by spopescu, posted in Pandora Report

Summer Workshop – Early Registration Discount Ends Soon
Just a few more days to get your early registration discount and we’ve only got a few spots left – make sure to grab yours! We’re excited to have top professionals and researchers in the health security field speak to the biological threats we’re facing- from securing the bioeconomy to vaccine development and pandemic preparedness, you’ll want to be there for the 3.5 days of all things pandemics, bioterrorism, and global health security.

Re-thinking Biological Arms Control for the 21st Century
Dr. Filippa Lentzos discusses the challenges of biological arms control in the face of synthetic biology and technological advances. “Innovations in biotechnology are expanding the toolbox to modify genes and organisms at a stagger- ing pace, making it easier to produce increasingly dangerous pathogens. Disease-causing organisms can now be modified to increase their virulence, expand their host range, increase their transmissibility, or enhance their resistance to therapeutic interventions. Scientific advances are also making it theoretically possible to create entirely novel biological weapons, by synthetically creating known or extinct pathogens or entirely new pathogens. Scientists could potentially enlarge the target of bioweapons from the immune system to the nervous system, genome, or microbiome, or they could weaponize ‘gene drives’ that would rapidly and cheaply spread harmful genes through animal and plant populations.” Lentos notes that “The political backdrop to these technical advances in biotechnologies and other emerging technologies is also important. There is increased worldwide militarization, with global military spending at an all-time high since the fall of the Berlin Wall. Unrestrained military procurement and modernization is creating distrust and ex- acerbating tensions. In the biological field, the proliferation of increasingly sophisticated biodefense capacities, within and among states, can lead to nations doubting one another’s intentions.”

GAO – Biodefense: The Nation Faces Long-Standing Challenges Related to Defending Against Biological Threats
The GAO testified before a House committee on their efforts to identify and strengthen U.S. biodefense and here are their overall findings in a report. Despite President Trump signing off on the Pandemic and All-Hazards Preparedness and Advancing Innovations Act (PAHPA) on Monday, there is still a lot of work to be done. “Catastrophic biological events have the potential to cause loss of life, and sustained damage to the economy, societal stability, and global security. The biodefense enterprise is the whole combination of systems at every level of government and the private sector that contribute to protecting the nation and its citizens from potentially catastrophic effects of a biological event. Since 2009, GAO has identified cross-cutting issues in federal leadership, coordination, and collaboration that arise from working across the complex interagency, intergovernmental, and intersectoral biodefense enterprise. In 2011, GAO reported that there was no broad, integrated national strategy that encompassed all stakeholders with biodefense responsibilities and called for the development of a national biodefense strategy. In September 2018, the White House released a National Biodefense Strategy. This statement discusses GAO reports issued from December 2009 through March 2019 on various biological threats and biodefense efforts, and selected updates to BioWatch recommendations made in 2015. To conduct prior work, GAO reviewed biodefense reports, relevant presidential directives, laws, regulations, policies, strategic plans; surveyed states; and interviewed federal, state, and industry officials, among others.” GAO identified several challenges in the ability for the U.S. to defend against biological threats: “Assessing enterprise-wide threats. In October 2017, GAO found there was no existing mechanism across the federal government that could leverage threat awareness information to direct resources and set budgetary priorities across all agencies for biodefense. GAO said at the time that the pending biodefense strategy may address this. Situational awareness and data integration. GAO reported in 2009 and 2015 that the Department of Homeland Security’s (DHS) National Biosurveillance Integration Center (NBIC)—created to integrate data across the federal government to enhance detection and situational awareness of biological events—has suffered from longstanding challenges related to its clarity of purpose and collaboration with other agencies. DHS implemented GAO’s 2009 recommendation to develop a strategy, but in 2015 GAO found NBIC continued to face challenges, such as limited partner participation in the center’s activities. Biodetection technologies. DHS has faced challenges in clearly justifying the need for and establishing the capabilities of the BioWatch program—a system designed to detect an aerosolized biological terrorist attack. In October 2015, GAO recommended that DHS not pursue upgrades until it takes steps to establish BioWatch’s technical capabilites. While DHS agreed and described a series of tests to establish capabilities, it continued to pursue upgrades. Biological laboratory safety and security. Since 2008, GAO has identified challenges and areas for improvement related to the safety, security, and oversight of high-containment laboratories, which, among other things, conduct research on hazardous pathogens—such as the Ebola virus. GAO recommended that agencies take actions to avoid safety and security lapses at laboratories, such as better assessing risks, coordinating inspections, and reporting inspection results. Many recommendations have been addressed, but others remain open, such as finalizing guidance on documenting the shipment of dangerous biological material.”

ABSA 1st International Biosecurity Symposium Call for Papers
“You are now able to submit papers for ABSA’s 1st International Biosecurity Symposium. The symposium will take place May 12-15, 2020 in Minneapolis, Minnesota. We anticipate having attendees from all over the world and approximately 20 commercial exhibits. The professional development courses will take place Tuesday, May 12, 2020. The symposium presentations (platform/poster) will take place Wednesday, May 13 to Friday, May 15, 2020. The Call for Platform/Posters Abstract submission deadline is July 31, 2019 at 5pm Central.”

Blue Ribbon Panel – U.S. Is Not Prepared for Biological Incidents – Testimony
June 26th- “Dr. Asha George, Executive Director of the Blue Ribbon Study Panel on Biodefense, served as an expert witness this afternoon before the House Oversight and Reform Subcommittee on National Security. Chaired by Rep. Stephen Lynch (MA), the Subcommittee is evaluating the readiness of the U.S. government and healthcare system, including hospital and emergency professionals, to respond to naturally occurring pandemics and biological attacks that could be perpetrated by state and non-state actors. The Subcommittee also is investigating the growing threat of antimicrobial-resistance, as well as the implications of this challenge for U.S. national security. ‘Our Panel has assessed and continues to assess the state of our country’s biodefense. We scrutinize the status of prevention, deterrence, preparedness, detection, response, attribution, recovery, and mitigation – the spectrum of activities necessary for biodefense,’ said Dr. George. ‘As expected, we found both strengths and weaknesses, including serious gaps that four years after the release of our Panel’s Blueprint for Biodefense in 2015 continue to make the nation vulnerable. In short, the nation is not prepared for biological outbreaks, bioterrorist attacks, biological warfare, or accidental releases with catastrophic consequences’.” This is especially relevant as many are wondering what Congress is doing to respond to health security threats.

Ebola Outbreak – Updates
As of Wednesday, the outbreak has reached 2,277 cases and security threats are increasingly making response efforts challenging. “In its weekly situation report on the outbreak, the WHO said Ebola activity continues with steady and sustained intensity, with security incidents returning to Beni—one of the outbreak’s former major hot spots—and armed group movements in Musienene and Manguredjipa impeding access to a health area next to Mabalako’s hardest-hit area. Another concern it aired is a tense security situation in neighboring Ituri province cities Bunia and Komanda in the wake of attacks in early June. Over the past few weeks, indicators show hints of easing transmission intensity in the two biggest recent epicenters, Katwa and Butembo. However, the optimism is offset by new cases in previously affected areas, including Komanda, Lubero, and Rwampara. For example, over the past week, Komanda reported its first case after going 11 days without one.”

A Dose of Inner Strength to Survive and Recover from Potentially Lethal Health Threats
“Breakthroughs in the science of programmable gene expression inspired DARPA to establish the PReemptive Expression of Protective Alleles and Response Elements (PREPARE) program with the goal of delivering powerful new defenses against public health and national security threats. DARPA has now selected five teams to develop a range of new medical interventions that temporarily and reversibly modulate the expression of protective genes to guard against acute threats from influenza and ionizing radiation, which could be encountered naturally, occupationally, or through a national security event. The program builds from the understanding that the human body has innate defenses against many types of health threats, but that the body does not always activate these defenses quickly or robustly enough to block the worst damage. To augment existing physiological responses, PREPARE technologies would provide a programmable capability to up- or down-regulate gene expression on demand, providing timely, scalable defenses that are proportional to anticipated threats. Service members and first responders could administer these interventions prior to threat exposure or therapeutically after exposure to mitigate the risk of harm or death.”

Global Community Bio Summit 3.0
From October 11-13, you can attend this community biotechnology initiative at MIT Media Lab. “The Community Biotechnology Initiative at the MIT Media Lab is organizing the third annual Global Summit on Community Biotechnology this October 11 to 13, 2019! Our goal is to provide a space for the global community of DIY biologists / community biologists / biohackers / biomakers and members of independent and community laboratories to convene, plan, build fellowship, and continue the evolution of our movement. You can learn more about last year’s Summit, including our program, here. While all are welcome, space is limited, so we are prioritizing active practitioners in the community with an emphasis on diversity across geographic, cultural, ethnic, gender, and creative backgrounds. We will add accepted participants to the directory on a rolling basis with the goal of accepting everyone interested in joining.”

Stories You May Have Missed:

  • Tackling Dirty Sinks – Did you ever think your hospital sink could be a disease reservoir? “Earlier this year, there were studies that identified sink proximity to toilets as a risk factor for contamination. Bugs like Klebsiella pneumoniae carbapenemase-producing organisms tend to be prolific in moist environments and are often pervasive in intensive care unit sinks and drains. Researchers found that sinks near toilets were 4-times more likely to host the organisms than those further from toilets. More and more, infection prevention is having to look at hospital faucets and sinks for their role in hosting microbial growth. This was also a topic of interest at last week’s annual conference of the Association for Professionals in Infection Control and Epidemiology (APIC 2019). Investigators with the University of Michigan Health System discussed how they worked to identify vulnerabilities and potential sink designs that might contribute to bioburden and biofilm in hospital faucets. Assessing 8 different designs across 4 intensive care units, the research team ultimately found that those sinks with a more shallow depth tended to allow higher rates of contamination (ie, splash of dirty water) onto equipment, surfaces, and patient care areas. In some instances, the splash of contaminated water could be found up to 4 feet from the sink.”

 

Pandora Report: 4.5.2019

by spopescu, posted in Pandora Report

Good news- spring is in full effect and flu transmission is starting to slow. With summer around the corner, have you registered for our workshop on all things biodefense, from anthrax to Zika?

The Plague Years – How the Rise of Right-Wing Nationalism is Jeopardizing the World’s Health
Maryn McKenna is calling out a very real issue – politics, vaccines, and the reality that “As nativist appeals undermine public health systems and cooperation among countries degrades, the potential for catastrophe increases. We are always at risk of a new disease breaking out, or a previously controlled one surging back. What’s different now is that the rejection of scientific expertise and the refusal to support government agencies leave us without defenses that could keep a fast-moving infection at bay. Pathogens pay no respect to politics or to borders. Nationalist rhetoric seeks to persuade us that restricting visas and constructing walls will protect us. They will not. ‘Nationalism, xenophobia, the new right-wing populism in Europe and the United States, are raising our risk,’ said Ronald Klain, who was the White House Ebola response coordinator for President Barack Obama and now teaches at Harvard Law School. ‘There’s a focus not so much on stopping infectious diseases as much as there is on preventing the movement of people to prevent the transmission of diseases. And that’s not possible, because no matter what you do about immigrants, we live in a connected world’.” Moreover, that belief system can be seen in the White House, as President Trump tweeted during the 2014 Ebola outbreak – “Keep them out of here,” he tweeted about American missionaries who fell ill in West Africa. “Stop the Ebola patients from entering the U.S.” and “The U.S. cannot allow Ebola infected people back.” As McKenna notes “This is the perverse legacy of nationalism in power: By stigmatizing immigrants and segregating them, xenophobia can turn the lie of the ‘dirty foreigner’ into truth.
”

 Hospital-Associated Conditions Penalties: What They Really Mean
Just how good is your local hospital at preventing infections in patients? GMU biodefense doctoral student and infection preventionist Saskia Popescu is breaking down what these quality metrics really mean and how hospitals are scoring. “In 2014, CMS established another rule tying health care quality of care and reimbursement—the HAC Reduction Program. Although this started with reporting of certain conditions, such as central-line associated bloodstream infections, these pay-for-performance programs were expanded over time. The program links hospital performance in certain categories with reimbursement. That’s right, if a hospital performs poorly, they can be hit where it hurts—the bank. Scores are determined by a hospital’s performance in 2 domains—1 includes indicators like pressure ulcers and in-hospital falls with injury, while the second domain focuses on health care-associated infections that include central-line associated bloodstream infections, catheter-associated urinary tract infections, certain surgical-site infections, methicillin-resistant Staphylococcus aureus bacteremia, and Clostridium difficile (C diff) infections. Considering there are 500,000 cases and 15,000 deaths a year related to C diff in the United States, it’s not surprising that CMS would want to crack down on those cases associated with hospitalization.” “There are just over 5000 US community hospitals that will likely receive CMS reimbursement in FY2019, and 800 (16%) of these institutions experienced financial penalties related to poor performance. That’s a pretty substantial amount, but the painful truth is that this number is likely higher considering there have been concerns for hospitals failing to report HACs and a general lack of CMS data validation.”

Ebola Continues to Hit the DRC
We’ve surpassed 1,000 cases and are now beyond the point where the WHO called a PHEIC in the 2014-2016. On Tuesday, the “World Health Organization (WHO) today reiterated that the outbreak in the Democratic Republic of the Congo (DRC) will be defeated only with local communities at the helm of response efforts. The message came from Ibrahima-Soce Fall, MD, WHO assistant director-general for emergency response, who held a brief teleconference this morning from Butembo. With 72 Ebola cases reported last week and 56 in the previous week, March was a low point for responders, as activity spiked and the outbreak topped the 1,000-case milestone.” On Thursday, it was reported that 7 new cases were identified, including a healthcare worker. “The healthcare worker in Musienene brings the total number of health workers infected during the outbreak to 82 (7.4% of all confirmed or probable cases), and 29 of them have died, the DRC said. In an update released late yesterday, the DRC recorded 8 new confirmed cases, and 7 deaths, including 5 community deaths. Butembo and Katwa each had a community death, and Mandima recorded 3. Community deaths have been a compounding factory of this outbreak, as they enable the virus to spread more easily among family members and funeral attendees.” Based off the latest case counts, three main areas have been the hotspots for the outbreak – Katwa, Vuhovi, and Mandima.

Next Generation Biosecurity Online Course
“An open online course exploring biosecurity and biological threats begins this week on FutureLearn. This course is for professionals working in public and global health, international security, politics and international relations. It may be of particular use to biosafety officers in academia, industry or government, and early-career science scholars in the life sciences.” You can access the course here.

 Why the Scientific Debate Over a UW Bird Flu Study Isn’t Going Away
“A University of Wisconsin-Madison laboratory is set to resume experiments that could build the foundation of an early warning system for flu pandemics. The research is based on altering a deadly type of the influenza virus in a way that could make it more dangerous, though, and critics say its approval lacked transparency and creates unnecessary risks. Yoshihiro Kawaoka is a virologist and professor at the UW School of Veterinary Medicine and the University of Tokyo who has figured prominently in Wisconsin’s long-term central role in flu research. Kawaoka’s work has been the focus of fierce debate among epidemiologists ever since he announced in 2011 that his lab had successfully altered the H5N1 subtype of the influenza A virus to be transmittable through the air among ferrets. These small mammals are a common laboratory stand-in for studying human flu transmission.” “That debate has lingered since 2011 and intensified in early 2019 after the federal government approved funding for Kawaoka to continue his research. Marc Lipsitch is a professor of epidemiology and director of the Center for Communicable Disease Dynamics at Harvard T.H. Chan School of Public Health. He’s a longtime critic of research that modifies flu viruses to be more dangerous in humans. ‘What worries me and my colleagues is the effort to modify viruses that are novel to humans and therefore to which there’s no immunity in the population, and where a laboratory accident wouldn’t just threaten the person who got infected … but potentially could be the spark that leads to a whole pandemic of infectious disease,’ Lipsitch told WisContext.”

New Plant Breeding Tech for Food Safety
Tackling the issue of food safety is up there with a universal flu vaccine – something we all want, but a task requiring a Herculean effort. A new insight to this problem has come forward though and the authors “argue that with careful deployment and scientifically informed regulation, new plant breeding technologies (NPBTs) such as genome editing will be able to contribute substantially to global food security. Previously, conventional plant breeding through cross- and self-pollination strategies played a major role in improving agricultural productivity. Moreover, the adoption of genetically modified (GM) crops by smallholder farmers has led to higher yields, lower pesticide use, poverty reduction, and improved nutrition. Nevertheless, so far only a few developing and emerging economies—such as China, India, Pakistan, Bangladesh, and South Africa—have embraced GM crops. Even though three decades of research show that GM crops are no more risky than conventional crops, many countries in Africa and Asia are hesitant to promote the use of GM crops, largely because of erroneously perceived risks and fears of losing export markets to Europe.”

Stories You May Have Missed:

  • Opioid Epidemic Increases Some Infectious Disease Rates – “The United States faces a converging public health crisis as the nation’s opioid epidemic fuels growing rates of certain infectious diseases, including HIV/AIDS, hepatitis, heart infections, and skin and soft tissue infections. Infectious disease and substance use disorder professionals must work together to stem the mounting public health threat, according to a new commentary in the Journal of Infectious Diseases. The article was co-authored by officials from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and the Institute of Human Virology at the University of Maryland School of Medicine in Baltimore. Since 1999, nearly 400,000 people in the United States have fatally overdosed on opioid-containing drugs, with 47,600 deaths in 2017 alone. Many people with opioid use disorder (OUD), who initially were prescribed oral drugs to treat pain, now inject prescribed or illegal opioids. High-risk injection practices such as needle-sharing are causing a surge in infectious diseases. Additionally, risky sexual behaviors associated with injection drug use have contributed to the spread of sexually transmitted infections.”
  • US Army Develops Fast-acting Spray for CW Decon– “Chemical and biological weapons experts earned the U.S. Army a patent on Tuesday for their groundbreaking work on rapid decontamination. Gregory Peterson, Joseph Myers, George Wagner, Matthew Shue, John Davies, Jr., and Joseph Rossin were listed as the inventors on U.S. Patent 10,245,456, “Process for Decontamination and Detoxification with Zirconium Hydroxide-Based Slurry.” (The patent is linked below). The research team works at the Army’s Chemical Biological Centerin Maryland, and has significantly reduced decontamination time down to less than 30 minutes and the amount of water needed to treat large amounts of equipment coated in deadly toxins.”

 

Pandora Report: 3.15.2019

by spopescu, posted in Pandora Report

TGIF or beware the Ides of March? Either way, we’ve got some health security news for you, so grab your Caesar salad and enjoy this weekly dose of all things biodefense.

Summer Workshop – Are You Registered?
We’re offering an early-bird discount for registration prior to May 1st – have you signed up? Threats to global health security continue to evolve due to the changing nature of conflict, advances in science and technology, globalization, and the growing threat posed by emerging infectious diseases and pandemics. Pandemics, Bioterrorism and Global Health Security: From Anthrax to Zika is a three and a half-day workshop, non-credit summer workshop designed to introduce participants to the challenges facing the world at the intersection of national security, public health, and the life sciences. The workshop faculty are internationally recognized experts from the government, private sector, and academia who have been extensively involved with research and policy-making on public health, biodefense, and national security issues. Don’t miss out on an additional discount if you’re a returning attendee, GMU employee/student, or are registering with a large group.

Germline Gene-Editing – Do We Need a Moratorium?
In the wake of He Jiankui’s gene-edited babies, many are calling for a moratorium on germline gene-editing. In fact, the Chinese health ministry released draft guidelines at stopping rogue efforts with unapproved biotech. This topic is so important that Nature published a call for a moratorium by several top ethicists and researchers. “Whether or not a moratorium receives more widespread support, several things need to be done to ensure that germline gene-editing studies, done for the purposes of research only, are on a safe and sensible path. As a starting point, proposals for all ethically vetted and approved basic research studies that use gene-editing tools in human embryos and gametes, including those aimed at assessing efficacy and safety, should be deposited in an open registry. Second, researchers need to develop a system that allows early recognition of any research that risks overstepping predefined boundaries. A useful model to follow could be the WHO guidance for regulating research with a potential biosecurity risk. The system should include a mechanism — perhaps affiliated with the open registry — that allows researchers to flag up potentially dangerous research. Analysing whether He’s work could have been prevented will help. It’s important to hammer out whether, how and to whom scientists and ethicists who became aware of the project could have voiced their concerns — and how they could do so more easily in future. Raising the alarm would require a change of practice for researchers who, for the sake of scientific independence, often do not intervene in the choice of research projects undertaken by their peers.” In the joint statement, the researchers noted that “By ‘global moratorium’, we do not mean a permanent ban. Rather, we call for the establishment of an international framework in which nations, while retaining the right to make their own decisions, voluntarily commit to not approve any use of clinical germline editing unless certain conditions are met.”

Taking A Step Back in Staph
This common skin bug is becoming increasingly resistant to not only intervention efforts, but also antimicrobials. Saskia Popescu, GMU biodefense doctoral student and infection preventionist, discusses the latest CDC report on the concerning state of Staphylococcus aureus infections, including MRSA. “Staph infections can either be methicillin-resistant or methicillin-sensitive (MSSA) but, overall, staph is the leading cause of infections in US hospitals. Infection preventionists have been zeroing in on MRSA for decades in the health care industry, working tirelessly to stop the spread. Unfortunately, according to the CDC, progress in curbing MRSA has slowed, and findings indicate that MSSA rates are also not declining. One theory is that the opioid crisis may be connected, as 9% of all serious staph infections in 2016 occurred in patients who used injection drugs, a statistic that represented an increase from 4% in 2011. Consider this—right now, nearly 1 in 10 staph infections that occur are in people who use intravenous drugs.”

 MERS-CoV Outbreak
Speaking of healthcare-associated infections…Saudi Arabia’s Ministry of Health reported two more cases in an ongoing outbreak in Wadi ad-Dawasir. Unfortunately, most of these cases are linked to healthcare exposures and a handful are related to contact with camels. One particular study assessed camel infections, noting that “The investigators focused on 53 studies published from 2013 to December 2018, of which 33 were from the Middle East, 13 from Africa, and 7 from Spain, Australia, Japan, Bangladesh, and Pakistan. The team reported its findings yesterday in the preprint server bioRxiv. The team said another group unknowingly carried out a similar review, which covered studies published from 2013 to April 2018 and was published Feb 21 in Epidemiology and Infection by a team from Qatar and the Netherlands. The authors of the bioRxiv said their study confirms and updates the findings of the other study.The authors of the new review found that MERS-CoV seroprevalence in camels increases with age, up to 80% to 100% in adult dromedaries, which the team says suggests that the virus is widely endemic in camels on the Arabian Peninsula and in African countries that export dromedaries. However, they note variable patterns within some countries. Also, the experts found a high prevalence of active infection in juvenile animals and at sites where the animals mix, such as livestock markets and slaughterhouses. Other findings from the longitudinal studies they examined include reinfection despite high MERS-CoV antibody titers.”

Improving Global Health Security Through One Health Platforms
Don’t miss out on this March 21st even at the National Press Club, hosted by the USAID -funded Preparedness and Response project. “Over the past four and a half years, the USAID-funded Preparedness & Response project has worked across 16 countries to spread the vision of a multisectoral One Health approach — where human, animal, and environmental health assets join forces — becoming the standard way to prevent, detect, and respond to emerging pandemic threats. As the project approaches the end of its tenure, please join us as we bring together the One Health community of practice to share key learning, demonstrate successful approaches to country ownership, and discuss the future of multisectoral coordination for preparedness and response.”

Biodefense MS and PhD Open Houses
Looking to improve your biodefense knowledge while obtaining a graduate degree? The Schar school Biodefense program is the place for it – from anthrax to Zika, we’ve got you covered. We’ve got two events coming up that you won’t want to miss if you’re looking to invest in your education. On Wednesday, March 20th you can attend a Master’s in Biodefense Webinar (online) at 12pm EST and at 7pm there will be a PhD Open House at the Arlington campus. These are great opportunities to hear about the biodefense programs, meet faculty and students, and learn how you can become a biodefense guru through our in-person and online programs.

Ebola Outbreak Updates and An Epidemic of Suspicion 
On Tuesday, two new cases were reported, as well as two new deaths, bringing the case counts to 925, including 584 deaths. Vinh-Kim Nguyen recently wrote in NEJM regarding the violence and turmoil surrounding outbreak response efforts in the DRC. “As a medical team leader for Médecins sans Frontières (MSF), I work halfway between Butembo and Goma, North Kivu’s capital city and a transport hub. In late January, five Ebola cases were identified in Kayna and Kanyabayonga; MSF opened a center in Kayna to isolate patients with suspected cases and test them for Ebola virus disease (EVD). I soon suspected that most patients would turn out to have diseases other than EVD. The standard “isolate and test” model often leads to expectant management for such patients — the tendency is to “cover” patients with antimalarials and broad-spectrum antibiotics, wait for EVD test results, and then discharge patients without Ebola. We instead took a more active approach, treating severe cerebral malaria, typhoid, sepsis, and even cholera. I have witnessed how such active clinical management for all patients, along with MSF’s long-term presence in North Kivu, has contributed to the community’s acceptance of our Ebola unit. Having patients emerge from isolation in improved health is powerful evidence that we aim to make everyone better, not just to stop Ebola’s spread.” Nguyen further discusses the labeling of attacks as “resistance” are fundamentally wrong and how they are actually a bigger issue – persons against prevention activities aimed at them and those orchestrated, armed attacks against symbols of the international response. “The mistrust of authority in the DRC also reflects a growing global mistrust of experts and science. Vaccine refusals are a growing problem worldwide, and they have already resulted in measles epidemics in the United States and France and in outbreaks elsewhere. Mistrust of public health authorities may thus be the new norm, and smoldering epidemics merely a symptom.”

 Ambitious American AIDS Initiatives & Cutting Foreign Aid Programs
In the February State of the Union, President Trump pledged to end the HIV epidemic by 2030. This re-invigoration of HIV efforts was shocking, but exciting. The official pledge of $291 million to help end transmission of HIV within the United States will hopefully bring us closer to that goal through initiatives that increase access to pre-exposure prophylaxis (PrEP). While Congress still needs to approve the 2019 budget, there is a concerning proposal within it. Beyond the cuts to Medicare and Medicaid ($845 billion and $241 billion respectively) which are deeply worrisome, the budget seeks to drop US contribution to the Global Fund to Fight AIDS, Tuberculosis, and Malaria by one billion. “The US will contribute $3.3bn between 2020 and 2023, a reduction on its previous contribution of $4.3bn. In a statement the global fund said: ‘The United States is the leading supporter of the Global Fund, and we are confident that the U.S. Congress will continue the strong funding that is urgently needed to improve global health security by ending epidemics. Various proposals are being considered and we look forward to final budget decisions taken by Congress in the coming months.’ The fund is looking for at least $14bn for the next year and, as the US donates around a third of the total, its contribution will mark a significant reduction on previous years. Mr Trump also proposes a $12.3bn cut to the State Department and USAID, marking a 23 per cent cut from the previous year. USAID, through the President’s Emergency Programme for Aids Relief, is a key player in the United Nations programme to eliminate HIV around the world.”

WHO Launches New Global Influenza Strategy
Influenza continues to be not only an annual issue, but the lack of preparedness for severe seasons and potentially pandemic strains is also an international issue. The WHO released their Global Influenza Strategy for 2019-2030. “The threat of pandemic influenza is ever-present.” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “The on-going risk of a new influenza virus transmitting from animals to humans and potentially causing a pandemic is real.   The question is not if we will have another pandemic, but when.  We must be vigilant and prepared – the cost of a major influenza outbreak will far outweigh the price of prevention.” This new strategies “is the most comprehensive and far-reaching that WHO has ever developed for influenza.  It outlines a path to protect populations every year and helps prepare for a pandemic through strengthening routine programmes. It has two overarching goals: 1. Build stronger country capacities for disease surveillance and response, prevention and control, and preparedness. To achieve this, it calls for every country to have a tailored influenza programme that contributes to national and global preparedness and health security. 2. Develop better tools to prevent, detect, control and treat influenza, such as more effective vaccines, antivirals and treatments, with the goal of making these accessible for all countries.”

How Africa Can Quell the Next Disease Outbreaks
How can African nations enable public health institutions (NPHIs) to help stop emerging and re-emerging infectious diseases from springing up and causing large outbreaks? Beyond waiting for outside intervention and emergency help from the West, John N. Nkengasong, head of the Africa Centre for Disease Control and Prevention, calls “on all 55 member states to establish or strengthen NPHIs. And I urge the private sector in Africa and worldwide, and bodies everywhere, to invest in these efforts. According to the World Bank, Africa needs between US$2 billion and $3.5 billion a year for epidemic preparedness; in 2015, 8 African nations received from various donors about $700 million for this cause.” Furthermore, he notes that “NPHIs should prioritize four broad areas. First, providing basic functions such as disease surveillance and coordinating emergency operations, even in remote areas. Second, creating lab networks that can quickly diagnose, track and pinpoint the origin of emerging infections. Third, developing a workforce to collect, assess, share and act on quality data, including advanced technologies such as genetic sequencing and informatics. Fourth, developing a strong capacity for social scientists to engage with communities and change behaviours. Sociologists and anthropologists were crucial in ending the Ebola outbreak in West Africa by, for example, promoting safe burials — which meant modifying long-standing traditions, such as washing the corpse of a loved one.”

Measles and the Threat of the Anti-vaccination Movement
From measles to polio, the threat of vaccine-preventable diseases is a real one that we’re slowly losing our headway in. “The anti-vaccination movement threatens to undo years of progress made against a range of preventable diseases. Mass immunization campaigns helped slash the number of measles deaths worldwide by 80 percent between 2000 and 2017, but that headway may now be stalling. Today, only 85 percent of the world’s infants receive the first dose of the treatment, and even fewer get the second dose. This is well short of the 95 percent vaccination rate that the WHO says is needed to prevent outbreaks. If the anti-vaccination movement continues to gain momentum, there could be more outbreaks in places such as the United States, where measles has been considered eliminated for nearly two decades. With more cases, there will be greater potential for measles to spread across borders. Until governments turn the tide of the anti-vaccination movement, health workers will face the dual challenge of containing measles in both countries where the disease is still endemic and those where it was thought long gone.”

Infectious Diseases Spike Amid Venezuela’s Political Turmoil
The crisis in Venezuela is leaving millions without clean water, access to hospitals,  safe food, and more. Unfortunately, it is also causing a spike in infectious diseases as public health and healthcare efforts have been all but decimated. “These so-called vector-borne diseases—transmitted by mosquitoes or other organisms—have increased by as much as 400 percent in Venezuela in the last decade, according to a review study published in The Lancet in February. Spiraling economic and political turmoil have worsened the situation, as has the government’s apparent hostility toward researchers who publish epidemiological data—with reports of pro-government paramilitary groups smashing labs and even stealing experimental mice. “’Last year we had more than 600,000 cases [of malaria] reported by the government,’ says study co-author Maria Eugenia Grillet, a tropical disease ecologist at Central University of Venezuela in Caracas. She and her co-authors estimated there were actually around 1.2 million cases, taking into account underreporting and disease relapses, Grillet notes. (Relapses occur when a patient has recovered but still carries the malaria-causing parasite and later suffers a recurrence of symptoms.) She blames the increase on a lack of antimalarial surveillance, treatment and control, partly due to funding cuts. ‘Research in our universities and laboratories is almost completely paralyzed because there are no financing programs that allow us to cover the basic needs to carry out our experiments or fieldwork,’ she says.”

Stories You May Have Missed:

  • New Vaccine Manufacturing Innovation Centre Bolsters Pandemic Preparedness – “The first dedicated Vaccines Manufacturing Innovation Centre (VMIC) is coming to the UK in 2022, addressing gaps in late-stage vaccine manufacturing for clinical trials and emergency preparedness for epidemic and pandemic threats. Led by the the University of Oxford’s Jenner Institute, the new centre has been awarded funding by UK Research and Innovation of £66 million ($86 million USD) through the UK Government’s Industrial Strategy Challenge Fund (ISCF) Medicines Manufacturing challenge. ‘This is an exceptional opportunity for the UK to lead in the provision of vaccines against a wide range of outbreak pathogens which threaten to cause major epidemics,’ said Adrian Hill, Jenner Institute Director. ‘The lack of commercial incentive to develop these has now led to this exceptional partnership of major academic and industrial players in the vaccine field, to accelerate a range of vaccines towards large-scale manufacture and stockpile provision for vulnerable populations. In parallel, the Centre will develop innovative manufacturing technologies with UK companies and Universities to support the next generation of life-saving preventive and therapeutic vaccines’.”

Pandora Report 3.2.2018

by spopescu, posted in Pandora Report

Happy Friday! We’ve got a full plate of biodefense news this week, so we hope you’re hungry for everything from ASM Biothreats 2018 coverage to Gain of Function research, and a side of pandemic budgeting.

ASM Biothreats 2018 – GMU Biodefense Coverage
We’re excited to present our annual coverage of the ASM Biothreats conference from some of GMU’s very own biodefense graduate students. Our overview is a great way to catch up on some of the hot topics and captivating breakout sessions from the conference. You can find a landing page for all the reviews here, which will have links and a brief synopsis for each section the students wrote. GMU biodefense graduate students covered a variety of sessions – from artificial intelligence in biosecurity to the GHSA, future DoD programs in biodefense policy, and BARDA/DARPA projects- we’re reporting it all!

New Pathogen Research Rules: Gain of Function, Loss of Clarity
GMU Biodefense professor and graduate program director Gregory Koblentz is teaming up with Lynn Klotz (co-managing director of Bridging BioScience and BioBusiness LLC), to evaluate the December 2017 release of the latest Gain of Function (GoF) research rules. The DHHS release finally lifted the funding moratorium on GoF research following the controversial projects involving H5N1 in 2011. While the DHHS policy (or “Framework for guiding funding decisions about proposed research involving enhanced potential pandemic pathogens”) is similar to the Office of Science and Technology Policy guidance that was released in January 2017 (the “P3C0 Framework”), it came with the bonus of restoring funding for such research. Unfortunately, there are still considerable concerns with how GoF research is evaluated and if these frameworks have really addressed the gaps. “We, the authors, harbor concerns about adequate oversight of potentially dangerous research, and the framework incorporates several elements that address those concerns. The framework is thorough. It does a good job of laying out the principles and processes through which the Health and Human Services Department will make funding decisions regarding research that involves enhanced potential pandemic pathogens. The framework’s approach to dual-use research of concern is not based on lists of experiments or on specific pathogens, but instead takes a risk-based approach that focuses on the attributes of modified organisms. While the identity of starting organisms is central to existing oversight policy for dual-use research of concern, the framework emphasizes the importance of organisms’ properties once the experiment is over. This more comprehensive approach to dual-use research is a welcome change. Some elements of the new framework, however, remain worrisome.” Koblentz and Klotz point to several limitations of the new framework – it’s too narrow and not broad enough in that it only applies to research funded by DHHS, the terminology and definitions are lacking (especially in the definition of a potential pandemic pathogen), and the review process that was created is a limited. The framework also has new criteria for risks and benefits, which is “inherently problematic” and agreement is often never achieved. “The criteria used to judge which experiments involving enhanced potential pandemic pathogens warrant review by the Health and Human Services Department—and how the risks, benefits, and ethical aspects of such experiments are measured and weighed—are ambiguous enough to provide departmental reviewers wide latitude in their funding decisions. The process and outcomes must be transparent in order to demonstrate that the process is conducted in good faith and that policy is implemented appropriately. The framework, though it recognizes the importance of transparency for maintaining public trust in science, does not go far enough in actually providing the requisite level of transparency.” Lastly, Koblentz and Klotz point to the international considerations as a considerable weakness within the new framework. Sadly, it only applies to research done within the United States and the truth is that this is an international issue and needs global consideration and collaboration.

 2018 NASPAA Student Simulation – Global Health Security
How did you spend your Saturday? Battling a virtual pandemic? We were fortunate to participate as judges at an international collaboration and simulation to test students on their response during a pandemic. The NASPAA-Batten simulation (Network of Schools of Public Policy, Affairs, and Administration) involved a total of 563 students in 117 teams, from 159 universities across 27 countries. Teams represented approximately 336 million fictitious people in 4 fictitious countries per 1 fictitious world and were battling 1 seriously tough outbreak. GMU’s Schar School and the biodefense program were represented in both participants and judges. Professor and graduate program director Gregory Koblentz and PhD student Saskia Popescu were judges while six Schar students participated (four of which were biodefense students!) at the Carnegie Mellon University site in DC – Alexandra Williams (Biodefense MS), Annette Prietto (Biodefense MS), Stephen Taylor (Biodefense MS), Justin Hurt (Biodefense PhD), Fleciah Mburu (MPA), and Ryan Kennedy (MPP). The two finalist teams from the CMU site included biodefense MS students Alexandra and Justin, which means they’ll now move on to the global round where they are competing for the $10,000 prize. GMU biodefense students know how to battle a pandemic – whether it’s simulated or real! From a judge’s perspective, this was a great experience to not only observe how people respond to the complexities of a global outbreak, but also pose questions that help them see all the moving pieces in response.

Blue Panel Study Panel on Biodefense Calls For Strategic Budgeting Tied to New National Biodefense Strategy
The Blue Ribbon Study Panel has released a statement on the desperate need for decision-makers to commit to biodefense funding and recognize it as an imperative component to national security.  “We would do well to remind ourselves that we are really just as vulnerable now as we were then. In addition to the enormous potential toll on human health that intentional or natural outbreaks can inflict, the cost of the relentless rise of outbreaks is also entirely unsustainable based on current funding approaches. Emergency appropriations reach into the billions in direct outlays to the U.S. government. Economic impacts of a catastrophic outbreak could reach into the trillions.” You can also read the OpEd by Sen. Joe Lieberman and Former Gov. Tom Ridge, stating that American lives are worth budgeting for biodefense. “We call upon the president to release the National Biodefense Strategy soon and ensure that his next budget request to Congress conforms to the priorities in this strategy, showing how money requested for biodefense programs support the National Strategy’s goals and objectives.”

CDC Plans for New High Containment Lab
The CDC is asking congress for $350 million to start building the high containment continuity laboratory on their main campus to replace the existing one that has been used since 2005, but requires replacement by 2023. “The existing facility contains a number of BSL4 labs and labs that are one step down the biosafety and biosecurity ladder, BSL 3 enhanced. That’s where research on dangerous avian influenza viruses like H5N1 and H7N9 is conducted. Buildings that house these types of labs simply require a lot of maintenance, explained Dr. Dan Jernigan, head of the CDC’s influenza branch. ‘We’re just faced with the realities of what it takes to maintain something as complex as the high containment lab,’ he said.” The complex design of high containment labs makes them both expensive to build and maintain.

Battelle Takes On Biological Threats With New Software
Between naturally occurring outbreaks, bio-error, and bio-terror, there are a lot of ways infectious diseases can pose a threat to human life and safety. Battelle is seeking to change this through a new software for the U.S. government that “would screen small bits of DNA and assess whether they belong to potentially dangerous genetic sequences.The local research institution is one of six groups awarded an $8.7 million, two-and-a-half-year grant by the Intelligence Advanced Research Projects Activity (IARPA), an organization within the Office of the Director of National Intelligence.” The growing application of CRISPR and other genome editing technologies has underlined the gaps in DNA sequence screening for biosecurity concerns, especially when one considers the recent horsepox synthesis. “In the absence of national or international policy that would monitor bioengineering activity — and the technological gap for keeping an eye on never-before-encountered organisms — Battelle and the other groups awarded the federal contract are trying to figure out how to stay a step ahead. ‘At first I thought it would be too big of a lift for us,’ Dickens said. At the end of January, Battelle researchers completed a first version of the software, which they are now testing and optimizing. It can, for example, analyze a small fraction of an influenza virus’ genetic code and identify or predict whether it has the potential to make people, animals or the environment sick. The tool then assigns the genetic scrap a threat level: dangerous, potentially hazardous or safe. The tool is artificially intelligent enough to detect whether the sample is related to any known specimens, such as botulism or anthrax, and predict the function of never-seen-before DNA sequences.”

Workshop on Women’s Health In Global Perspective
GMU Schar School is hosting this free workshop on March 7-8th in Arlington,VA – don’t miss out! “The Workshop on Women’s Health in Global Perspective seeks to contribute to understanding and improve policy on women’s health and wellbeing around the world. The program includes panels on Communicable and Non-Communicable Disease; Health and Wellbeing; Maternal Health; and Reproductive Technology and Family Planning. It will cover topics such as HPV Vaccine Awareness, Maternal Mortality, and Cross-border Reproductive Care.”

GMU Biodefense Alum Leads NEIC Laboratory 
We love getting to brag about the amazing things that GMU Biodefense students and alum do with their passion for health security. Biodefense MS alum Francisco Cruz was recently named the Chief of the EPA’s National Enforcement Investigations Center (NEIC) Laboratory Branch! “The branch’s primary responsibility is conducting forensics analysis on environmental samples related to criminal and civil cases. The lab is a fully accredited forensics laboratory staffed by 21 chemists who can not only conduct the lab analysis, but also testify in court regarding the science behind the analysis. Additionally, the lab is capable of developing novel analytical methods for rare and difficult matrices that most labs cannot analyze. The lab supports EPA and other federal law enforcement partners with either lab analysis or technical consultation on how to process a sample.” Biodefense alums – don’t forget to stay connected so we can recognize you for all the amazing biodefense work you do!

DARPA Names Pandemic Prevention Platform Researchers
Launched in 2017, the P3 program from DARPA hopes to stop the spread of an outbreak before it becomes a pandemic. “In contrast with state-of-the-art medical countermeasures, which typically take many months or even years to develop, produce, distribute, and administer, the envisioned P3 platform would cut response time to weeks and stay within the window of relevance for containing an outbreak.” DARPA recently announced the institutions that are contracted for the program and will hopefully make progress in the fight against pandemics – MedImmune, Abcellera Biologics Inc., Duke University, and Vanderbilt University.

 The WHO – What Went Wrong from Swine Flu to Ebola?
The WHO has struggled to find its strong foot since 2009’s H1N1 influenza pandemic and then the 2014/2015 Ebola outbreak. With new leadership, many are hoping the WHO’s abilities can be strengthened and some faith restored in their capacity to prevent and respond to international health events. One particular evaluation of this can be found in a chapter of Political Mistakes and Policy Failures in International Relations. “This chapter examines a series of mistakes and the structural, cultural, political and epidemiological factors that contributed to the WHO’s mishandling of the first pandemic of the twenty-first century and the world’s largest ever outbreak of Ebola. The chapter then concludes by examining the reforms currently being implemented to strengthen the WHO’s global health security capabilities and what these signify for the future.”

Stories You May Have Missed:

  • CDC Epidemiologist Missing – “Police investigators are bewildered as they work through the “extremely unusual” circumstances surrounding the missing-person case of Timothy Cunningham, a researcher who vanished Feb. 12, shortly after hearing why he had been passed over for a promotion at the Centers for Disease Control and Prevention (CDC). Cunningham, 35, told colleagues he was not feeling well and left work at CDC headquarters in Atlanta, not long after speaking with his supervisor about why he had not been promoted, Atlanta Police Maj. Michael O’Connor told reporters. Cunningham works in the chronic disease unit at the CDC, not in the part of the CDC that deals with infectious disease, according to authorities.”
  • Iraqi, Dutch, Vietnamese Officials Report Avian Flu Outbreaks – “Several countries reported new avian flu outbreaks, including two more H5N8 events at commercial poultry farms in Iraq, an H5 outbreak at a poultry farm in the Netherlands, and the first known H5N6 detection of the year in Vietnam. In Iraq, which has reported ongoing H5N8 activity since early January, authorities reported new outbreaks in Diyala and Baghdad province that began on Feb 13 and Feb 14, respectively, according to a report yesterday from the World Organization for Animal Health (OIE). The investigation said the source of the virus was contact with wild species.”
  • 11 Fall Ill After Suspicious Letter Arrives At Military Base– “Eleven people fell ill after a suspicious letter was opened in an administrative building at Joint Base Fort Myer-Henderson Hall in Arlington, Virginia, on Tuesday, according to the Arlington County Fire Department. A law enforcement official said field tests for the letter all came back negative for any harmful substance, but the FBI is transporting it tonight to its lab in Quantico for further analysis. The law enforcement official said the text of the letter contained derogatory, at time unintelligible and ranting language, and was addressed to a commanding officer at the base. Investigators are still determining what relationship, if any, the sender had with the base. A corporal, gunnery sergeant and a colonel all exhibited symptoms of a burning sensation on their hands and face, according to Specialist Nicholas Hodges who spoke to CNN from the base.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 1.26.2018

by spopescu, posted in Pandora Report

In this week’s Pandora Report we’re taking a trip down the horsepox synthesis rabbit hole, looking at influenza transmission, and so much more. But first..the Bulletin of the Atomic Scientists just announced that the Doomsday Clock has been moved and is now two minutes to midnight. You can also read the full testimony from Dr. Tom Inglesby, director of the Johns Hopkins Center for Health Security, during the US Senate Committee hearing on the reauthorization of the Pandemic and All-Hazards Preparedness Act. The Senate has also just confirmed Alex Azar as the new head of Health and Human Services.

The Perilous Road of Horsepox Synthesis 
Unless you were in a state of flu-induced delirium, last Friday was a rather big day in with world of dual-use research of concern (DURC) news. The controversial publication of Dr. Evans’ synthesis of horsepox has brought about a flurry of discussion and debate regarding the implications of not only such research, but also the publication of it. Kai Kupferschmidt provided an overview of the history of this paper and what its publication means, so if you’re needing a refresher, I’d start there. As many within the biodefense and biosecurity industry read the paper, it sparked a renewed concern for how such research has exhumed a gap within DURC oversight and publication review. GMU’s biodefense guru and graduate program director Gregory Koblentz expanded upon his thoughts regarding these oversight failures. Pointing to not only the utter disaster that a smallpox re-emergence would be, he also evaluates the PLOS editorial statement and review of DURC work. “Given the serious potential risks that this research could be used to recreate variola virus, the blanket assertion by the PLOS Dual-Use Research Committee that the benefits of this research outweighs the risks is woefully insufficient. The committee dramatically understates the risks and overestimates the benefits this research presents. The U.S. government has outlined a number of factors to consider and questions to ask about dual-use research when weighing the risks and benefits of conducting and publishing such research. Although this research did not fall under current U.S. regulations on dual-use research of concern, the authors and publisher were well aware of the risks that I and others had raised and they had an ethical responsibility to carefully consider those risks before publishing the article.” NTI’s Dr. Elizabeth Cameron, VP of Global Biological Policy and Programs, weighed in on the publication and how it underlines the need for dialogue at a global level to reduce biological risks. Cameron notes that these hurdles aren’t getting smaller and the incremental approach just isn’t getting us where we need to be. “Moving forward, it’s clear that the capability to create and modify biological agents is outpacing governmental oversight and public debate. Now more than ever, scientific stakeholders, private sector actors, and biotechnology leaders should develop and take specific actions to mitigate risk and accelerate biosecurity innovation.” Dr. Tom Inglesby, director of the Johns Hopkins Center for Health Security, has also put forth commentary on the horsepox synthesis, pointing to the lack of clear-cut benefits and and that ultimately, it created a new risk. Inglesby notes that “The most important locus of control should be whether specific research is approved and funded in the first place. When scientists are considering the pursuit of research that has the potential to increase highly consequential national population-level risks, national authorities and leading technical experts on those issues should be part of the approval process. When there are highly consequential international population-level implications, international public health leaders should also be involved. When researchers put forth claims about potential benefits of this work to justify extraordinary risks, those claims ought not be accepted without discussion; those claims should instead be examined by disinterested experts with the expertise to validate or refute them.” GMU biodefense PhD student and infection preventionist Saskia Popescu also discussed the importance of this publication and why medical providers and researchers should be paying attention to the DURC debate.

ASM Biothreats
The American Society for Microbiology will be hosting their annual conference on biological threats from February 12-14 in Baltimore, MD. If you’re not able to attend, we’ve got you covered with in-depth reporting and analysis by some of GMU’s finest biodefense graduate students. Following the conference, we’ll be providing this report-out as we did with the 2017 conference, so make sure to check back for the scoop on all things ASM Biothreats.

Chemical Weapons – No Impunity
The International Partnership Against the Impunity for the Use of Chemical Weapons has just been launched! “Ringing together around 30 countries and international organizations, its purpose is to supplement the international mechanisms to combat the proliferation of chemical weapons. This intergovernmental initiative deals exclusively with the issue of impunity for the perpetrators of chemical attacks worldwide, and is a forum for cooperation in which the participating States have made several commitments that include gathering, compiling, and retaining all available information on those who use chemical weapons, etc.” Efforts like this are increasingly needed as the use of chemical weapons in Syria has been met with little adverse outcome for those at fault. GMU’s Dr. Gregory Koblentz highlighted Syria’s CW killchain, noting that “Bringing these criminals to justice, however, will be a long, slow, and difficult process. Many individuals who comprise Syria’s chemical weapons kill chain were listed in a U.N. Security Council resolution that was vetoed by Russia and China on Feb. 28.” Koblentz also points out that “So far, the only concrete steps to hold these individuals accountable for their actions are financial sanctions and travel bans imposed by the U.S. and European governments. Although the sanctions themselves are largely symbolic, by identifying these individuals and specifying their role in the chemical attacks, the United States and its European allies are laying the groundwork for future prosecutions once Assad is no longer in power.”

Germ Transmission While Flying
Dr. Nereyda Sevilla, George Mason Biodefense PhD 2017 alum, presented the results of her dissertation at the Transportation Research Board (TRB) 97th Annual Meeting held January 7–11, 2018, at the Walter E. Washington Convention Center, Washington, D.C. The information-packed program attracted more than 13,000 transportation professionals from around the world. Nereyda’s poster entitled “Germs on a Plane:  The Transmission and Risks of Airplane-Borne Diseases” was part of the Young Professional’s Research in Aviation Session.  Her research explored the role of air travel in the spread of infectious diseases, specifically Severe Acute Respiratory Syndrome (SARS), H1N1, Ebola, and pneumonic plague. She concluded that modeling showed that the spread of Ebola and pneumonic plague is minimal and should not be a major air travel concern if an individual becomes infected. On the other hand, H1N1 and SARS have higher infectious rates and air travel will facilitate disease spread across the country.

Schar School Career Fair
Schar School students and employers looking for talented graduate students – on Wednesday, February 14th from 2-5pm, GMU’s Schar School will be hosting a Career Fair at the Arlington campus. “The Schar School of Policy and Government at George Mason University, in conjunction with the School for Conflict Analysis and Resolution, will host our annual career and internship fair that attracts more than one hundred employers from federal, business, and non-profit organizations who are eager to meet our outstanding students.” For our readership – this is also a great place to recruit biodefense students who are passionate about health security!

Nonproliferation Review Call For Papers
Calling all writers of the nuclear, chemical, and biological weapons persuasion – the Nonproliferation Review is accepting manuscripts for publication in 2018! “All submitted manuscripts that are accepted for publication in Volume 25 are eligible to win the Doreen and Jim McElvany prize of $5,000, a $3,000 runner’s-up prize, or a $1,000 honorable mention prize. The deadline to submit is July 6, 2018; however, due to the limited number of pages that we can publish in a single volume, eligible articles will be accepted for publication on a rolling basis. It is therefore in authors’ interest to submit early to ensure consideration for the prize. Submissions must contribute new ideas and insights to the nonproliferation field. The Review’s editors welcome submissions on any topic related to weapons proliferation, including but not limited to chemical, biological, radiological, nuclear, and conventional weapons. Example topics include: activities and developments in international nonproliferation regimes; social, political, and economic dynamics of specific countries and regions with regard to weapons development and/or proliferation; new information on policies or weapons programs of specific countries; the spread of knowledge, materials, or technologies with potential destructive applications; the proliferation of new technologies impinging on international security; measures, either existing or proposed, to control proliferation; the causes of proliferation or nonproliferation; the consequences of proliferation, including its influence on strategic stability and its economic or environmental effects; and the relevant activities of non-state actors, such as nongovernmental organizations or terrorists.”

 Influenza Aerosols
A new study has found that influenza aerosol-spread is more common than previously thought, especially in relation to coughing and sneezing. “To measure transmission, each participant sat in a chamber for 30 minutes with his or her face in a large metal cone, part of a ‘Gesundheit machine’ that captures and measures influenza virus in exhaled breath. Patients were also asked to cough, sneeze, and say the alphabet three times. Altogether, researchers collected 218 nasopharyngeal samples and 218 breathing sample sessions. When the team analyzed the samples, they found that a significant number of patients routinely shed infectious virus—not just RNA particles—into particles small enough for airborne transmission. They were surprised to find that 11 (48%) of the 23 fine aerosol samples acquired when patients weren’t coughing had detectable viral RNA, and of those 8 contained infectious virus, suggesting that coughing isn’t a prerequisite for generating fine aerosol droplets.” The latest news points to not only the importance of staying home when sick, but also the ease of transmission of influenza viruses. While many thought transmission was limited to droplets (i.e. heavier particles that were sneezed/coughed out about three feet), this latest analysis may change the dynamics of isolation.

Stories You May Have Missed:

  • Addressing AMR in Lower-Income Countries – Fighting antimicrobial resistance (AMR) is a global challenge, but we need to ensure that our strategies account for a range of countries and the unique barriers they face. “Although traditional efforts to reduce the spread of antibiotic resistance in these countries have focused on antibiotic use in individuals, LMICs must also address the increasing roles of animal and environmental exposures in this public health crisis, write Maya Nadimpalli, PhD, University of Versailles Saint-Quentin-en-Yvelines, France, and colleagues. ‘In particular, current strategies do not prioritize the impacts of increased antibiotic use for terrestrial food-animal and aquaculture production, inadequate food safety, and widespread environmental pollution,’ the authors stress.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 12.1.2017

by spopescu, posted in Pandora Report

Are you registered for the Read-Out on the GHSA Summit in Kampala? Just a friendly reminder – we’ll be on hiatus next week as we attend the Biological Weapons Convention Meeting of States Parties. Make sure to look out for a packed newsletter on 12.15 as we’ll be covering both the Read-Out on the GHSA Summit and the BWC meeting! If you’d like real-time updates, check out our Twitter account @PandoraReport.

 Read-Out on the GHSA Summit in Kampala
Global health security on your lunch break? Only at the Read-Out on the GHSA Summit will you get lunch and an in-depth recap of this international health security event. Don’t miss this exciting opportunity to hear from global health practioners and young professionals who attended the 4th annual Global Health Security Agenda (GHSA) Ministerial Meeting in Kampala, Uganda in October. You’ll want to register ASAP for this exciting opportunity on December 4th, from 12-1:30pm at the George Mason University Founders Halls in Arlington. The GHSA meeting, Health Security for All: Engaging Communities, Non-governmental Organizations, and the Private Sector, was a multi-sectoral collaboration between governments, civil society, and industry dedicated to the strengthening of globaly capacity to prevent, detect, and respond to infectious disease threats. Attended by the ministers of health, finance, and agriculture and other senior officialfs from more than 50 nations, this was the first Ministerial GHSA Meeting held on the African continent. The meeting was held in late October at the same time as an unprecedented outbreak of pneumonnic plague in Madagascar and a rare outbreak of Marburg in Uganda itself. These outbreaks were timely, but unfortunate reminders, that global health security is still very much a work in progress. Our panel will include four participants who were on the ground in Kampala and actively engaged in this historical step forward for global health security. Attendees will have the opportunity to engage and hear the perspectives of esteemed public health practitioners and rising health security professionals. Lunch will also be provided. This event is free and open to the public.

Mason, Stanford Researchers Join Forces To Study The Science, Benefits And Dangers Of Genome Editing
GMU Biodefense researchers are teaming up with Stanford University to better address the complexities of genome editing and what it means for science, security, and governance. “The study is the only unclassified, independent academic project of its kind, said Gregory Koblentz, director of George Mason’s Schar School of Policy and Government biodefense graduate program and co-principal investigator. The Mason and Stanford researchers will examine scientific advances in the field of genome editing that can have benefits for human health and the bioeconomy, as well as the security aspects of preventing the misuse of this technology. They expect to deliver a suite of policy recommendations based on their research in summer 2018.” Genome editing has not been without controversy, as the technology allows the deletion and replacement of DNA within living organisms and many are concerned about the dual-use nature of such work. While there is potential to eradicate disease and strengthen agriculture, there is also worry that such technology will be misused for nefarious purposes or even poorly handled and result in negative outcomes. This collaborative effort is a huge step to ensuring we’re aware of the risks, benefits, and oversight needed for this exciting new technology.

Maintaining U.S. Investment in Global Health Security
Progress must continue on the global health security front and industrialized countries like the United States have a critical role in sustaining forward movement. “However, the work of the GHSA, including motivating and assisting countries to improve their capacities to prevent epidemics like Ebola from reoccurring, is now at a crossroad. Even though senior officials in the Trump administration have voiced support for the GHSA, and at a recent GHSA ministerial meeting in Uganda signed onto the Kampala Declaration to extend the GHSA for at least another 5 years, US funding for the initiative is ending and no commitment for future financial support has been made. Without additional funding, prospects for the next phase of the GHSA will be endangered. It is important for the United States to commit to support the GHSA to help protect the nation and the rest of the world from epidemic disease.” U.S. financial support encourages other countries to pledge funds but if our efforts waver, it may cause a domino effect. Not only does U.S. engagement encourage others to support the GHSA, but it also supports our own national security. “If vulnerable countries do not have the capacity to quickly cope with disease outbreaks, those outbreaks are more likely to spread internationally, including to the United States.” You can hear more about the importance of the GHSA from Jennifer Nuzzo (one of the authors of this paper) at the Read-Out on the GHSA Summit in Kampala event on December 4th!

Failure to Diagnose Monkeypox Highlights Nigeria’s Poor Health Infrastructure
Like most outbreaks, Nigeria’s monkeypox cases have exposed weaknesses in the country’s ability to rapidly identify and test potential patients. These inadequacies highlight gaps within their International Health Regulations compliance as there were no national labs that could test patients for the disease. “Consequently, for more than two weeks after the outbreak (from the September 22 to October 13), there was no conclusive confirmation that the suspected case was actually that of monkeypox. According to experts, the implication of this is that the country may be dealing with a dangerous outbreak, but unsure of what it is dealing with on time, thereby giving room for a lot of things to go wrong during the waiting period. For instance, during the waiting period for the monkeypox confirmation, different statistics on the actual number of cases were being bandied, even as the large number of suspected cases (94 cases) and the manifestation of the disease had already caused fright and panic.” Laboratory delays can be devastating to outbreak control as it can delay treatment, isolation, quarantine, and data collection. Public health laboratories are the early warning system in many ways. Many are drawing attention to these gaps as a way to reinforce the need to strengthen country-level laboratory infrastructure and capacity. The National Centre for Disease Control (NCDC) was established in 2011, but still is struggling to find the capacity to respond to health threats due to funding and personnel issues. As 14 more cases of monkeypox were reported in Nigeria, this services as a reminder of  why the GHSA is so vital!

The WHO Reports on Fake Drugs
This week the WHO released a report on medical products  that shed light upon the startling realities of patient safety and public health in low and middle income countries. The report, “Global Surveillance and Monitoring System for Substandard and Falsified Medical Products”, found that 1 in 10 products circulating in such countries are either substandard or fake. The findings of this report are extremely worrying as it means that people are taking medications intended to treat life-threatening ailments and they are either fake or not effective. In many cases, the individual is paying a considerable amount of money for such medications and can have severe medical complications from contaminated or expired products. “Substandard and falsified medicines particularly affect the most vulnerable communities,” says Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Imagine a mother who gives up food or other basic needs to pay for her child’s treatment, unaware that the medicines are substandard or falsified, and then that treatment causes her child to die. This is unacceptable. Countries have agreed on measures at the global level – it is time to translate them into tangible action.” You can read the report here. The report also cites some of the work being done around this endemic issue – 17 WHO training workshops, 126 Member States and more than 400 regulatory personnel trained, 1500 product reports, etc.

How Will We Handle Contamination On An Airplane?
What would happen if you were on a plane with a patient who had a highly infectious disease like SARS or Ebola? What’s our national plan to deal with such issues? Hint: we don’t have a plan. How do flight attendants or pilots relay to ground control that a patient or entire plane needs to be quarantined? These are all the sorts of questions that need to be considered when planning and responding to such events. How would we quarantine an entire plane? On February 7, 2011, such an event occurred – a pilot issued a public health emergency to the air traffic control tower in Milwaukee, WI, for 3 (of 115) passengers with flu-like symptoms. “Airport officials soon learned something interesting about Flight 703 that could point to the presence of a communicable disease. The plane included at least 12 people who had returned from Cozumel, Mexico, on a cruise in which many of the passengers had fallen ill with flu-like symptoms. The incident revealed gaps in America’s emergency planning for communicable diseases aboard planes — gaps that were still present four years later when the U.S. Government Accountability Office investigated. ‘The United States lacks a comprehensive national aviation-preparedness plan aimed at preventing and containing the spread of diseases through air travel,’ the GAO found.” Sadly, it seems as if there’s still no plan. The creation of such a plan would require collaboration between the CDC and U.S. Department of Transportation, and while meetings have occurred, it is reported that no one has taken the lead. So, how are airports currently handling infectious disease incidents? “The lack of uniformity in dealing with communicable diseases during air travel was evident when the National Academy of Sciences asked 50 different airports in the U.S. and Canada how they expect to learn of an incident aboard a plane. They found 15 different notification procedures.” Report after report has found a gap within these response efforts and with the holiday season upon us and airline travel to be busy, it seems that should a public health emergency arise, we may be flying by the seat of our pants.

 Flu Season is Upon Us!
Flu season is starting to hit the United States as the CDC reports an up-tick is influenza positive tests. A majority of the positive specimens have been Influenza A (78% are H3, 13% have been H1N1). “Three southeastern states are reporting high or widespread flu activity, and the CDC said it received reports of five more pediatric flu deaths. In its report, which covers the week ending Nov 18, the CDC also reported one more novel flu infection, an H1N1 variant (H1N1v).Globally, flu activity in the Northern Hemisphere is rising, with H3N2 and influenza B the most frequently detected strains, the World Health Organization (WHO) said yesterday in an update.” Flu season and vaccination compliance is increasingly becoming an issue even in healthcare – in fact, many hospitals are terminating employees who don’t get their flu shot. Remember – get your flu vaccine, stay home when sick, wash your hands, and cover your cough!

Stories You May Have Missed:

  • Exclusive Interviews: Tackling Regulatory and Economic Challenges of Antimicrobial Resistance – “It is imperative for medical experts and drug discovery specialists to stay on top of the latest clinical advancements, developments and industry initiatives related to antimicrobial resistance. SMi Group will gather industry experts and government bodies to share their insights at the 20th annual conference on Superbugs and Superdrugs taking place on 19-20 March 2018 in London, UK. SMi Group recently had the opportunity to sit down with three of the event’s featured speakers to discuss some of the challenges they face in the industry and their strategies for overcoming them.”
  • Raw Flour and E. coli – this whole time we thought it was the eggs in the cookie dough that were doing it, but it seems that flour may also be a culprit for foodborne illness! “Research published today in the New England Journal of Medicine describes how raw flour, an unlikely suspect, caused an Escherichia coli outbreak in 2016. Because of its low-moisture properties, flour was not thought to be a conduit of E coli bacteria, but a multistate team of investigators discovered that flour processed in one facility was linked to the outbreak.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 9.8.2017

by spopescu, posted in Pandora Report

Happy Friday and welcome to your weekly source for all things biodefense. Got plague? Good news – if you have some live chickens hanging around, you can try this medieval treatment.

Defense Against Biological Attacks
Biological threats come in all shapes and sizes – whether it’s an outbreak of Ebola, a biological weapon, a laboratory mishap, or even the potential for biosafety breaches following  a hurricane. Preparedness and response efforts need to be just as diverse. As Texas begins the process of rebuilding and the threat of nuclear weapons has been fresh in everyone’s mind, it is crucial we don’t forget about the importance of health security. Disease knows no borders and it’s easy to diminish the threat of it however, Laura Holgate and Elizabeth Cameron are drawing attention to the need for President Trump to prevent the next biological attack before it happens. “As Congress and the Trump administration mull a new biodefense strategy, we urge them to use this time — the time in between biological crises — to get ahead of the curve before the next major biological event inevitably comes our way.” They point to several different strategies that should to be followed – watch out for emerging threats in unstable regions, fund and renew the Global Health Security Agenda, replenish the budget to maintain global biosecurity, keep laboratory assets for attributing biological attacks, and use biosurveillance to stop outbreaks before they start. We need to take the National Bioforensics Analysis Center off the chopping block, stop slashing the biosecurity budget as programs like the Cooperative Biological Engagement Program are vital, and truly, the GHSA renewal is a no-brainer. These efforts not only defend against current threats, but work to address the next generation of bioweapons and biothreats.  Holgate and Cameron note that “We know that biological threats must remain at the top of the national security agenda, and leaders must recognize that stopping outbreaks at the source requires strong global and domestic capacity to prevent, detect and rapidly respond to naturally occurring outbreaks and biological attacks”

Health Security – Call for Papers
The Health Security journal is currently looking for papers on communication and health security: improving public health communication in response to large-scale health threats. Manuscript deadlines are October 20, 2017. “Effective communication is an essential tool in establishing an appropriate response to any large-scale health threat or disaster, such as a newly emerging infectious disease, terrorism, environmental catastrophe, or accident. Yet, public health communication is occurring in an increasingly complex world with competing messages, new platforms, and limited trust.A special feature in Health Security will be devoted to analysis of the current communication environment and efforts to effectively communicate during outbreaks of infectious diseases and other health threats. The journal seeks papers that address the wide range of policy, practice, and research issues relevant to communication in large-scale health events.” Topics might include exploration of the communication environment during recent infectious disease events or public health disasters, investigation of the role of social media and other emerging or recently emerging communication platforms, etc. Submission information can be found here.

GMU Biodefense MS – Open House on September 14th
Don’t miss out on the Master’s Open House next week for the GMU Biodefense MS program!  From 6:30-8:30pm next Thursday, September 14th, at the GMU Arlington campus, you can speak to faculty, learn about admissions, and why biodefense students have a blast while getting their graduate degrees. This is a great chance to learn about the MS program (for both online or in-person) and chat with faculty about the exciting classes and activities GMU biodefense students get to enjoy.

The Biological Weapons Convention At A Crossroad
As Robert Frost once said, “Two roads diverged in a wood, and I- I took the one less traveled by, and that has made all the difference.” Which direction will the BWC take? Bonnie Jenkins investigates the uncertain future of the BWC, its current challenges, which direction it might take, and the direction it should take. Despite its relevance and capacity to endure decades of challenges, the latest RevCon was considered a monumental disappointment and left many in a state of disagreement. “Some of the major issues that were discussed at previous meetings—but at this point have no platform for discussion at the BWC—include advances in science and technology, disease outbreak preparedness and response, and national BWC implementation. Previously-held mid-year experts’ meetings have also been dropped, so there is now no chance for the exchanges with experts from relevant international organizations, including input from the World Health Organization that has been so useful in the past. These are all steps backward.” Despite a lack of Meeting of States Parties in August, there is hope that the December meeting with work towards developing an inter-sessional work program. On top of these barriers, the BWC has funding challenges, which severely impacts the Implementation Support Unit (ISU). Against these odds, the BWC ISU continues to promote universal membership and treaty implementation. Global initiatives are also beneficial to promotion of health security and prevention of biological weapons. “When global initiatives interconnect like this, it reinforces all of the initiatives. The Global Health Security Agenda, for instance, brings over 55 countries together to strengthen countries’ capacities to prevent, detect, and respond to infectious disease threats, whether natural, deliberate, or accidental.” These efforts seek to strengthen the BWC through global health security, but there is still work to be done. Jenkins suggests three tasks are crucial to maintain BWC relevancy and sustainability: “1) Sufficient and sustained funding by states parties, to include payments now in arrears; 2) Strong leadership and a successful December MSP that reaffirms the importance of the treaty to the international community and that also develops an inter-sessional work program; and 3) A vision for developing the role of the BWC as part of a larger interconnected global security architecture.”

Using Ebola Data to Fight Future Outbreaks
Learning from past outbreaks to avoid future failures is always a tough aspect of public health however, a new strategy is using data to help stop the next outbreak of Ebola. Researchers have developed a new platform to help organize and share Ebola data that was previously scattered and unable to be utilized. This was a significant issue on the ground during the 2014/2015 outbreak, which makes this project all the more important. “The information system is coordinated by the Infectious Diseases Data Observatory (IDDO), an international research network based at the University of Oxford, UK, and is expected to launch by the end of the year. At a meeting to discuss Ebola on 7–9 September in Conakry, Guinea, the team heading the platform will seek input from West African scientists, health officials and advocacy groups.” One of the most vital components to the system is the emphasis of partnership and involvement of African collaborators. Not only will this focus encourage the use of historical data, but will also allow utilization during future outbreaks. Control of the data has also been a challenging hurdle to overcome, as there are many cooks in the kitchen. “Amuasi says that he would have liked the database to be hosted and curated in Africa, rather than in Oxford, because training and paying African researchers to manage the platform would teach them how to use the information and improve their ability to respond to future outbreaks in the region. But he adds that this seems unlikely, because it would raise the cost of the project, and the infrastructure already exists at Oxford. Merson says that a copy of the database will be maintained in West Africa, although its exact location has yet to be determined. She adds that an African committee may be in charge of deciding who gets access to the data. And she says that fellowships are likely to be made available for West African students who want to work on the database.”

The Global Health Security Agenda: Public & Private Partnerships
The Global Health Security Agenda Consortium and EcoHealth Alliance will be hosting this meeting on Thursday, September 14th at 12pm. Held at the ONE UN New York Hotel in NYC, you can catch this event with speakers like Dr. Beth Cameron from the Nuclear Threat Initiative and Admiral Tim Ziemer from the US National Security Council. Make sure to RSVP here.

Launch of International Health Regulations Costing Tool
Georgetown University Center for Global Health Science & Security is launching their new open-access IHR costing tool. “In 2016, the World Health Organization adopted the Joint External Evaluation tool (JEE) to measure country-specific progress in developing the capacities needed to prevent, detect, and respond to public health threats, as mandated under the 2007 International Health Regulations (IHR). However, national governments and development partners have struggled to accurately define the costs of strengthening and maintaining critical health security systems that often depend on multi-sectoral coordination. This poses a serious dilemma for global health security and presents a compelling opportunity to improve the drafting and implementation of practical health security policies.” A joint effort with Talus Analytics, this new tool was developed to help estimate the cost to build capacity under the IHR. You can access the tool here (you may want to use Google Chrome).

IDSA Slams Budget Cuts to AMR
Biodefense budgets aren’t the only ones to be taking a beating… The president’s FY2018 budget released in May would cut the CDC’s Antibiotic Resistance Solutions Initiate (ARSI) by 14%, as well as 23% from the NIH and NIAID, which funds research on AMR. Leaders from Infectious Disease Society of America (IDSA) are rallying to oppose such efforts. “In a letter published yesterday in Annals of Internal Medicine, IDSA treasurer Helen Boucher, MD, past president Barbara Murray, MD, and current president William Powderly, MD, argue that the budget cuts for public health and research proposed by the Trump administration will not only diminish the nation’s surveillance capacity and its efforts to reduce infections and promote appropriate antibiotic use, but also undercut US leadership in global efforts to tackle the AMR threat, which is responsible for more than 700,000 deaths each year globally.” The letter emphasizes that such cut would severely impact AMR efforts, which is highly worrisome and dangerous given the severity of the global AMR threat. You can read the letter here.

An Integrated Approach to Forensic Investigation of Threat Agents
In the wake of a chemical or biological event, threat analysis is a high-stakes operation that has little room for error. Determining the substance, origin, and components all make for a stressful situation that requires effective analytical methods. “Traditional analytical methods are good at confirming the presence or absence of a particular agent or substance. If a sample is believed to contain Bacillus anthracis, standard biological analysis will quickly determine whether or not this is the case. But it will not provide insight into its virulence, origin or how it might have been manipulated. And if the sample turns out to be something other than B. anthracis, it will not tell you what it actually is. An integrated approach to CB forensics provides investigators with richer information. Integrated forensics combines advanced forensic science technologies to provide more comprehensive and timely technical intelligence.” Some of these strategies include advanced genomic analysis like massively parallel sequencing and advanced chemical analysis like gas chromatography and high resolution mass spectrometry. Currently, the extraction methods for biological analysis can render the sample unusable for chemical analysis, which make analysis problematic. A new strategy from Battelle is looking to combat these discrepancies, which involves a new process to “systematically triage samples and integrate biological and chemical forensics, as well as developing and testing new technologies to help investigators more quickly identify and characterize biological agents, including new, emerging and synthetic agents, to glean more forensic information from the samples.”

Stories You May Have Missed:

  • Zika Vaccine Efforts Slow– Sanofi recently announced they are halting work on a candidate Zika vaccine. The vaccine was a joint effort with Walter Reed Army Institute of Research however, budgetary cuts and federal efforts to scale back put the project in jeopardy. “In its Sep 1 statement, Sanofi said BARDA informed the company on Aug 17 that the agency reassessed its Zika-related projects and have decided to focus on a more limited set of goals and deliverable, and that BARDA has decided to “de-scope” its contract with Sanofi for the manufacture and clinical development of an inactivated Zika vaccine. BARDA said it would limit its funding to a case definition and surveillance study, as well as any activities needed to pause work on the vaccine until an epidemic re-emerges. As a result, Sanofi said it doesn’t intend to continue developing or seek a license from WRAIR for the Zika vaccine candidate.”
  • Australia Battles Influenza – As Australia experiences a particularly harsh flu season, many are wondering what this will mean for Europe and North America.”In general, we get in our season what the Southern Hemisphere got in the season immediately preceding us,” Fauci said. An “intelligent guess,” therefore, is that the north will probably have a bad flu season. “With influenza, it is never 100%,” he said. “So when you talk about influenza, almost nothing is absolutely precision,” Fauci said. “In general, one can say we usually see here what they see there in their season.” Schaffner agrees: “There’s not a one-to-one correlation.” Still, hearing about Australia’s high number of flu cases, he said, “I started to tighten my belt.”

Pandora Report 8.4.2017

by spopescu, posted in Pandora Report

We all know that kitchen sponges are like little densely populated germ cities, but did you know that cleaning them could make it worse?

Only Six Nations Have Evaluated Pandemic Readiness
A new report from the World Bank is calling out how little work has been done to evaluate and prepare for pandemic readiness. The report notes that only six countries have evaluated their capacity and capabilities for responding to a pandemic. Of these countries, three are wealthy (Finland, Saudi Arabia, and the U.S.) and are were poor (Eritrea, Pakistan, and Tanzania). All six countries had gone under external evaluations and developed funding plans to rectify their inadequacies. “The annual number of disease outbreaks around the globe has more than tripled since 1980, and air travel spreads contagions across oceans far more often. To convince countries that preparedness pays, the report included estimates of the economic damage various epidemics had done. For example, the viral pneumonia SARS — which ultimately killed only 774 people — shrank China’s gross domestic product by 0.5 percent in 2003.” We’re seeing an increasing emphasis on the financial aspect of pandemics and as this report points out, knowledge is power. The report includes an entire section on incentivizing countries to prioritize allocation of funds to preparedness, assessment of economic vulnerability, sovereign credit rating, etc. It was interesting to see that antimicrobial resistance was not considered a pandemic. What would happen if a fully resistant bacteria swept the world?

We Don’t Need Another Biodefense Strategy
Al Mauroni is taking a deep dive into the history of American biodefense strategies and why Thomas Bossert’s recent comments about a new one aren’t exactly promising. White House homeland security advisor Bossert announced this during a security forum in Aspen, noting that until the development of a new plan, the U.S. lacked a comprehensive biodefense strategy. When this was announced there was a collective “um….about that..” from many within the biodefense community. Mauroni points to the three recent biodefense strategies within the last fifteen years, highlighting what we’re all thinking – this won’t be the first comprehensive strategy. First, there was the Homeland Security Presidential Directive 10 in 2005, then the National Strategy for Countering Biological Threats (Presidential Policy Directive 2) in 2009, and most recently, the National Strategy for Biosurveillance in 2012. So, if we’ve had strategies for the better part of two decades, why is there a demand for a new one? Increased outbreaks and concern for biothreats have many calling for further funding of biodefense efforts, like that of the Blue Ribbon Study Panel on Biodefense. Funding is one thing though, but a whole new strategy? “A recent article on the ‘proliferation’ of national strategies suggests that strategic guidance only adds to the confusion, allowing executive agencies to pick and choose what they want to implement.” Mauroni notes that “Going back to Bossert’s statement at the Aspen Security Forum, he referenced the 2001 anthrax-filled letters, pandemic influenza outbreaks, genetic engineering research, and the Global Health Security Agenda. He didn’t reference the protection of US military forces against adversarial use of biological warfare agents. All of these fall under the area of ‘biodefense,’ and there is no one agency that comprehensively addresses all of these threats. Because US government funding, authorities, and capabilities for biodefense reside in different agencies, it is very difficult to articulate objectives and responsibilities in one single strategy. There is no single point of authority to execute the strategy, and very often, no incentive to change given an inability to redirect resources or authorities”. Biodefense is a unique term though as it is often considered in a singular context and while the DoD plays a significant role in countering biological threats, there are other players. Biosafety and biosecurity is a large component, which rests heavily on both the private and public sectors. The DHHS leads in times of public health concerns (even if some of these efforts are duplicated by the DoD) and we can’t forget the role of public health surveillance and health security efforts like that of the GHSA. Mauroni leaves us with several points – “there cannot be one national biodefense strategy because there are at least three distinct policy areas that, while overlapping, are significantly different in execution of their policy objectives.” He notes that “I am not optimistic that the US government will consider a more diverse and complex policy process that articulates these differences. Having one national biodefense strategy offers a façade of simplicity and organization that three separate strategies will not.”

Opening Statements for ASPR Nominee
The nomination hearing for Dr. Robert Kadlec as Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health and Human Services began on August 1st. You can check out the transcript here, in which Kadlec highlights five priority issues he wishes to pursue if confirmed. His priorities include providing stable leadership and clear policy direction, creating a “national contingency health care” system, supporting the sustainment of robust and reliable public health security capabilities, re-invorgorating and advancing an innovative MCM enterprise, and working to reauthorize the Pandemic and All-Hazards Preparedness Act in 2018. You can watch the nomination hearings here. Reports are pointing to his likely confirmation as his nomination “lacks controversy“.

European Report on Drug Resistance
Is the food we eat helping antimicrobial resistance take over? A new joint report from several European public health agencies notes that “To contain antibiotic resistance we need to fight on three fronts at the same time: human, animal and the environment. This is exactly what we are trying to achieve in the EU and globally with our recently launched EU Action Plan on antimicrobial resistance. This new report confirms the link between antibiotic consumption and antibiotic resistance in both humans and food-producing animals.” The impact of consuming antimicrobial agents is increasingly becoming an area of concern. While there are many factors that contribute to the rise of antimicrobial resistance, it’s not surprising that antibiotic use in food-producing animals would become a topic of interest. “Although consumption is defined differently in humans and animals, to make the comparison as consistent as possible, the report expresses consumption in milligrams of active substance per kilogram of estimated biomass (mg/kg). Human antimicrobial consumption is typically reported as defined daily doses per 1,000 inhabitants. Overall, the report found that average antimicrobial consumption was higher in food-producing animals than in humans, although the difference was largely influenced by a handful of countries with significant animal populations.” Analysis points to a relationship between consumption and antimicrobial resistance (seen in isolates in certain species of bacteria). This latest report underscores the complexity of antimicrobial resistance and the challenges in truly addressing this hydra-like problem. Perhaps we are what we eat?

Australian Raid Finds Chemical Weapon Attempts
The Sydney police raids across four properties, which resulted in four arrests, found components for improvised explosive devices (IEDs) and construction on an “improvised chemical dispersion device”. Two men were ultimately charged with building the military-grade device and were reportedly supported by ISIS operatives but their attack plans were foiled. “Police will allege that components for an improvised explosive device (IED) were sent to Australia in air cargo from Turkey via Isis operatives in Syria. Two men, who remained in custody after facing court on Friday, then allegedly assembled the devices with instruction from ‘a senior Isis operative’, according to the Australian federal police deputy commissioner Mike Phelan.” In response to the attempt, intelligence and law enforcement agencies are working to improve screening. Fortunately, the chemical weapon was in the early stages of development.

Biothreat Worries Over Cancer Research
At last week’s DEF CON hacking conference in Las Vegas, Intel’s chief medical officer John Sotos brought forth a somewhat surprising topic – bioweapons. Building on his discussion of the cancer moonshot, Sotos discussed the same technology (DNA manipulation) having the potential for misuse and development into biological weapons. “’The reason you haven’t heard much about bioweapons is that they’ve been held back by a pretty severe limitation, which is the potential for blowback’,” Sotos said. It is hard for any attacker to use weaponised diseases because they spread beyond their initial distribution range: destroy your neighbouring nation and you destroy your own as well. Sotos noted, ‘the cancer moonshot is going to really drive new technologies to manipulate DNA because cancer is a disease of DNA. [And] the same exquisite targeting that allows it to attack only your cancer cells also overcomes the blowback potential for bioweapons’.” While this level of precision medicine isn’t available yet, it draws parallels to gene-editing tools like CRISPR, in which targeted application is becoming more real. Soto hones in on the fear that such genetic engineering capabilities will not only be possible, but used for nefarious purposes like stealing genetic codes or rewriting DNA to tamper with fertility. Soto’s points are valid and it is important to consider the full spectrum of use for biotech developments in the future however, we must not lose sight of the consistent and growing threat that is natural disease.

Stories You May Have Missed:

  • Saliva Secretions & Zika Transmission – A recent study found that rhesus monkeys, when infected with high levels of the virus, could theoretically transmit via saliva. When compared to rhesus monkeys with more common viral loads, it was possible, although extremely unlikely, that the highly infected monkey could spread via saliva “All three monkeys who were exposed to high doses of Zika virus (20-fold higher than that typically found in saliva) applied directly on their tonsils developed the disease. Another group of 7 monkeys were exposed to the virus via the saliva of monkeys who had received subcutaneous infections, representing a typical virus count. None of the monkeys exposed to doses typically found in saliva contracted the disease when their tonsils (5 animals), conjunctivae (1), or nasal passages (1) were exposed. ‘We tried to simulate sneezing, sharing utensils, and other mucosal exposures,’ said Friedrich. ‘But the amount of virus typically founding saliva was not enough to infect a monkey or suggest any seroconversion [development of detectable antibodies]’.”
  • Biodefense World Summit Coverage – Get the latest overview of the Biodefense World Summit here, with a focus on biosurveillance! Topics range from DHS work to enhancing situational awareness for global disease surveillance.

Pandora Report 7.21

by spopescu, posted in Pandora Report

Beat the heat and cool down with your weekly report on all things biodefense! Have you ever wondered how researchers become bug-chasers? Check out this story on what turned a wildlife biologist into a plague-chaser in the Southwest.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
Thanks to our amazing faculty and attendees for a successful (and fun) summer workshop this week. We heard from Ed You on safeguarding the bio economy, Dave Franz explained the dual-use dilemma in life sciences, Sonia Ben Ouagrham-Gormley discussed barriers to bioweapons, Andy Kilianski explained the ins and outs of biosurveillance, Kendall Hoyt discussed the role of innovation and MCM, Sandy Weiner highlighted the social and cultural disease amplifiers, and so much more! Did I mention that Greg Koblentz brought the house down by discussing why biosecurity is a wicked problem? You can check out the Twitter stream here to see some amazing photos and dialogue during the three-day event. Participants from all over the globe, with backgrounds in everything from infectious diseases to defense and academia, participated in talks that truly ranged from anthrax to Zika, with pit stops on influenza and Ebola. With the 1918/1919 pan-flu centennial anniversary next year, we’re already starting to put together a great workshop for the summer of 2018, so keep on the look-out for more info in the future.

The Future of the GHSA and American Biodefense
Next week in Seoul, a meeting will be held for the Steering Group of the Global Health Security Agenda (GHSA) to discuss what exactly the future entails for the group. While its five-year run will expire in 2019, many are pushing for the GHSA to be extended as it is a highly valuable piece to global health security and IHR compliance. “Recognizing that the GHSA’s work has never been more vital and would be impossible to replace, more than 100 health and health security organizations and companies operating in over 150 countries, including the Nuclear Threat Initiative (NTI), this week banded together to urge GHSA’s extension for at least another five years.” The NTI signed on for several reasons – the world is still not prepared to handle a pandemic of a lethal/easily transmittable disease and frankly, the GHSA provides measurement, accountability, and transparency, which are all desperately needed in global health security efforts. The NTI recently released a statement regarding their support for extending the GHSA beyond 2019, highlighting its irreplaceability and proven ability to help measure and support change in countries working to strengthen their prevention and response to biothreats. Next week’s meeting with be the first since President Trump took office, which makes its outcome that much more important. NTI cites several GHSA successes in efforts to highlight the desperate need we have for it – commitment of more than 75 countries, developing and implementing the first agreed set of global metrics for national health security, mobilizing the private sector to engage in pandemic preparedness and response, etc. Discussions regarding the future of the GHSA comes at a poignant time as the House Appropriations Subcommittee approved FY 2018 State and Foreign Operations (SFOPs) and Health and Human Services (HHS) Appropriations Bills. The approval supports efforts to maintain global health funding. The bill includes funding for the State Department and USAID through the Global Health Program (the bulk of global health assistance) and despite President Trump’s FY2018 request (which would have cut it by $1.8 billion, or 28%), it’s providing $3.8 billion, which is roughly 5% less than FY 2017. Also within the bill – “funding provided to CDC for global health matched the FY 2017 enacted level ($435.1 million) and was $85.1 million (24%) above the President’s FY 2018 request. Funding for the Fogarty International Center (FIC) at the National Institutes of Health (NIH) totaled $73.4 million, a slight increase above the FY 2017 enacted levels ($72.5 million); FIC was eliminated in the FY18 Request.” Despite the cuts that are suggested in his proposed FY 2018 request, the Trump administration is reportedly developing the first comprehensive strategy on biosecurity. A top White House homeland security official reportedly said that such efforts are underway and involve retired Admiral Tim Ziemer. “We have not had as a country a comprehensive bio-defense strategy ever,” White House homeland security adviser Thomas Bossert told the annual Aspen Security Forum, in Aspen, Colorado. “It’s high time we had a bio-defense strategy.” While Bossert points to the need for a biodefense strategy, it is crucial to remember that the U.S. has already gone through two biodefense strategies – the 2004 Homeland Security Presidential Directive 10 (Biodefense for the 21st Century) and 2009’s National Strategy for Countering Biological Threats. This news comes on the heals of Trump’s nominee for a key biosecurity position. Guy B. Roberts of Virginia was just nominated to be an Assistant Security, Nuclear, Chemical, and Biological Defense Programs within the DoD. “Mr. Roberts is currently president of GBR Consulting, a national security consulting firm. In that capacity, Mr. Roberts has provided subject matter expertise on arms control, non-proliferation, international legal issues and strategies to combat terrorism to over 30 international and domestic organizations and institutions. In addition, he is a senior associate with the Center for Strategic and International Studies and an adjunct professor teaching courses on homeland security, international terrorism, non-proliferation, and arms control at Mary Washington University and Virginia Commonwealth University. Mr. Roberts previously served as the Deputy Assistant Secretary General for Weapons of Mass Destruction Policy and Director of Nuclear Policy for the North Atlantic Treaty Organization.” You can catch some of his talks via C-SPAN here, and while there’s not a lot on his work in biodefense, you can read this paper within the USAF Institute for National Security Studies, entitled, “Arms Control Without Arms Control: The Failure of the Biological Weapons Convention Protocol and a New Paradigm for Fighting the Threat of Biological Weapons“. His paper notes that despite the 2001 U.S. rejection of the BWC protocol for more stringent compliance mechanisms, there was still substantial focus on biological weapons and potential threats (especially after the 2001 Anthrax attacks). Roberts notes that “The time for ‘better-than-nothing’ proposals is over. A united world, acting in concert across a broad front of areas utilizing the full panoply of financial, diplomatic, economic, and military resources at our disposal, with the firm determination to rid the world of these weapons of terror, is our best hope for success.” In all, with talks next week on the GHSA, presidential hopes of cutting health funding, and a supposed biosecurity plan in the works, the future of health security is seemingly in the air.

The Case of the Reconstituted Horsepox and Other Dual-Use Adventures 
Last week we, like so many others, were engrossed in the news that a Canadian research team had reconstituted horespox with $100,000 worth of supplies and mail-ordered DNA. The news of this unpublished study has raised a lot of red flags for those in the dual-use research community, as well as the debate on the remaining smallpox stockpiles. What’s most concerning about the project, led by virologist David Evans as the University of Alberta, is that it wasn’t stopped earlier on for DURC concerns and risk reviews. Gregory Koblentz, biodefense guru and director of the GMU graduate program, “says the work should never have been done. His worry isn’t so much that terrorists will cook up smallpox anytime soon. ‘My concern is that we have opened up the door to the idea that it is perfectly acceptable to synthesize [such] viruses without any oversight,’ Koblenz says. And if the necessary technology and expertise spread, it will become “that much easier at some point for those capabilities to be turned from peaceful uses to hostile uses’.” This project and the resulting discussions will surely play a pivotal role in the future of DURC and oversight, so we’ll make sure to keep you updated!

North Korea’s Bioweapons Program
GMU Biodefense professor Sonia Ben Ouagrham-Gormley is taking a deep dive into the realities of North Korea’s potential bioweapons program. Working backwards from the 2015 photo tour with Kim Jun-un at a pesticide facility that certainly had dual-use potential and was a seemingly obvious attempt to send a message to the U.S.,  Ouagrham-Gormley highlights the sordid history that is North Korean bioweapons. While South Korea has repeatedly claimed North Korean maintains an active program, there have been inconsistent reports elsewhere and Ouagrham-Gormley hones in on realities about this well-publicized dual-use equipment and facility. She notes critical aspects that would be missing from an active bioweapons program (even if you have all the shiny equipment), like consistent electricity, economic stability, and an effective laboratory/research management. While there are gaps in intelligence regarding the conditions that would truly facilitate an active (and successful) bioweapons program, “analyses of past state and terrorist bioweapons programs indicate that the continuity and stability of scientific and production work must be ensured over a long period of time to allow scientists and technicians to accumulate the knowledge necessary for development of a working bioweapon.” While many suspect that a North Korean bioweapons program was launched in the 1960s and then new infrastructure was built in the 1970s, there are a lot of questions regarding the continuity of such efforts. Were there breaks in between? Changing research teams and inconsistent management/organization all severely impact the efficacy of such secretive work. Perhaps one of Ouagrham-Gormley’s most critical points (and why you should check out her book, Barriers to Bioweapons), is that to truly assess the alleged bioweapons program, one has to understand the state of natural and medical science in North Korea. “Without a solid foundation in natural and medical sciences, a bioweapons program cannot succeed. When Soviet authorities issued a decree to expand the country’s bioweapons program in the early 1970s, they had to face the reality that Soviet science had fallen behind and needed modernization. Years of Stalin’s purges, along with the policy of Lysenkoism—which negated the role of genetics in science—had resulted in the elimination of a whole generation of competent scientists. Decades of economic sanctions, and the desperate state of North Korea’s economy and society, have undoubtedly had an effect on the scientific sector.” With these notions, Ouagrham-Gormley questions if the North Korean bioweapons program is more of a Potemkin village. While there is limited information on the organized scientific research in North Korea or real potential for such a program to exist, more information is needed, which would be a great task for a BWC verification regime.

Center for Biosecurity ELBI Research and Policy Symposium 
This week the Johns Hopkins Center for Health Security held their first research symposium for the Emerging Leaders in Biosecurity Initiative (ELBI). The current ELBI class and several alumni presented on research and projects they’re working on. The topics ranged from dual-use research to risk assessments, biosecurity, and more. During this time they also toured the Johns Hopkins Medical Center’s Biocontainment Unit. Two GMU biodefense students attended – Francisco Cruz (MS alumni and ELBI class of 2016) and Saskia Popescu (PhD student and ELBI class of 2017), who presented on the role of infection prevention in biodefense efforts.

Tackling the Next Epidemic With Big Technology
In an age of globalization and increasing spillover, the threat of naturally occurring outbreaks spreading from one corner of the globe to the other is a real fear. Fortunately, we also live in a time of great technological advances and a wealth of data. A recent article from B.Next highlights the availability of data technologies and how such big data can be woven into the fabric of public health prevention and intervention. Outbreaks and pandemics threaten global security and perhaps one of the biggest hurdles is matching the data needs with the limited supplies on the ground. Data gaps and lags are a massive problem when responding to an outbreak, especially in terms of specialized personnel and resource constraints. There are several technologies though, that could be applied to response efforts – novel data or means of collection, crowdsourcing methods, data cleansing, analytics, and visualization. “Improving response times for activities that have proven to be effective (i.e, non-pharamceutical interventions) need to be prioritized. The full potential of surveillance and advanced analytics for improving outbreak management has not yet been realized and, unfortunately, is not yet adequate to the task. We need a fundamental reconsideration of how to use combinations of data technologies for effective response management. Accomplishing this reconsideration and implementing it effectively will allow for faster, better, stronger responses. Past outbreaks have threatened national security, but they do not need to be as significant a threat in the future. Current and emerging data technologies can help tackle the next epidemic.”

Stories You May Have Missed:

  • USDA Test Finds Atypical BSE In Alabama Cow – A recent announcement from the USDA reported the finding of atypical bovine spongiform encephalopathy (BSE) in an 11-year-old cow in Alabama. This would be the 5th case in the U.S. since 2012 and the cow did in fact have symptoms of the disease, which was picked up by routine surveillance. “The animal never entered the slaughtering process and has not posed a threat to the food supply or to human health. The Alabama Department of Agriculture and Industries (ADAI) said in a press release yesterday that cow died after it was delivered to the livestock market and that routine tissue samples were taken and sent for testing. Tony Frazier, DVM, Alabama’s state veterinarian, said ‘This instance proves to us that our on-going surveillance program is working effectively’.”
  • Three Antibiotics Discovery Projects You Should Know About: With the threat of antimicrobial resistance only growing bigger, BARDA, CARB-X, and big pharma are bringing out the big guns with the Superbugs & Superdrugs USA this November. “Understanding the translational link between animals and humans; navigating the pitfalls of early drug discovery; and evaluating the potential of immunotherapies will be a major focus, as will hearing from a selection of biotech and pharma companies currently undertaking clinical research. This will include case studies from Pfizer, MedImmune, Merck, Visterra and ContraFect. Event highlights will include a keynote presentation by Tim Opperman, Senior Research Scientist from Microbiotix. The talk will discuss advances in the three-prong approach taken by Microbiotix to address the problem of MDR Gram-negative pathogens. It is claimed that all three discovery projects have demonstrated efficacy in murine models of infection.”
  • Stanford Hospital – A Canary In A Coal Mine: Stanford Healthcare is coming under increasing public scrutiny as a battle between members of an affiliated union have highlighted hospital infection rates as evidence for unsafe working conditions and patient safety. GMU biodefense PhD student Saskia Popescu takes a deeper dive into this situation and what it really means for healthcare infections and patient safety. “The healthcare industry is always in a battle against cutting costs, keeping patients safe, and maintaining high patient satisfaction; all while following federal regulations and requirements. Despite the alarmist nature that comes across in the media coverage on the Stanford case, we need to realize that this is only a glimpse through the window that is healthcare infection control and the struggle to follow best practices while working in an increasingly stressful environment. In this case, Stanford Health Care is the canary in the coal mine, alerting us that there’s a problem. They just happened to get the media scrutiny that comes with being pulled into a union debate involving the safety of employees.”

Pandora Report 6.23.2017

by spopescu, posted in Pandora Report

TGIF! Before we begin our weekly dose of all things biodefense, have you ever wondered the traits that predict animal or host spillover?

What Does A Post-Polio World Look Like?
Decades of battling diseases in eradication efforts has been a struggle throughout public health history, but what happens when you finally reach the finish line? Donors around the world have worked to eliminate polio and in the final stretch and last ditch efforts, many are asking what will happen when polio is eradicated and the donors are gone? The truth is that many polio eradication programs (which include vaccination and surveillance campaigns) actually form the foundation of public health for many countries and rural areas. These programs have been the backbone of establishing some semblance of public health for areas that many not receive it otherwise. “If and when polio is gone, however, much of the transition may fall to national governments. International funding stands to shrink dramatically. About 27 percent of WHO’s $587 million in spending in 2016 went to polio eradication efforts. The African region would also be particularly hard hit. Forty-four percent of WHO spending there went to polio efforts, and about 90 percent of all immunization staff and infrastructure on the continent are funded through the WHO’s Global Polio Eradication Initiative.” We haven’t really considered what it means to eradicate a disease like polio and how the withdrawing of funds and personnel might impact countries. Moreover, many of the polio eradication programs are closely tied to other vaccination programs (measles, tetanus, pertussis, etc.) and if funds are lost because polio is eradicated, these other vaccination programs could take a hit. Aside from vaccination initiatives, if stable public health programs are not established prior to eradicating polio, there is also a risk for loss of disease surveillance. Current polio eradication programs highlight the role of surveillance, which is also used to facilitate laboratory development, all of which could impact pandemic preparedness and global health security. It is vital that efforts to eradicate polio are also met with work from political leadership to ensure a transition occurs that maintains public health efforts. “The transition as polio is eradicated will be complex, and needs to be carefully managed, country specific and country led. Polio surveillance systems can provide an important foundation, and are tremendous assets to health care systems, said Irene Koek, the deputy assistant administrator of global health at the United States Agency for International Development. Civil society organizations will have a role to play in advocating to keep local governments and ministries on target, said John Lange, the United Nations Foundation‘s senior fellow for global health diplomacy.”

Instructor Spotlight – Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
We’re getting closer to the July 17th start date for our workshop (and the July 1st early registration discount expiration!) and this week we’re excited to show off one of our very own GMU Biodefense professors, Dr. Sonia Ben Ouagrham-Gormley. An economics and defense expert, biodefense guru, and world traveler, Dr. Ouagrham-Gormley is the kind of professor whose class you spend the entire time on the edge of your seat. Sonia Ben Ouagrham-Gormley, PhD, is an Associate Professor in the Schar School of Policy and Government at George Mason University. She holds affiliations with GMU’s Biodefense Program, Center for Global Studies, and the Department of History and Art History’s Master of Arts in Interdisciplinary Studies (MAIS) program. Prior to joining the faculty at George Mason in 2008, Professor Ben Ouagrham-Gormley was a Senior Research Associate with the Monterey Institute of International Studies’ James Martin Center for Nonproliferation Studies (CNS). While at CNS, she spent two years at the CNS Almaty office in Kazakhstan, where she served as Director of Research. She also was the founding Editor-in-Chief of the International Export Control Observer, a monthly publication focusing on proliferation developments and export controls around the globe. From 2004 to 2008, she was an adjunct professor at Johns Hopkins’ School of Advanced International Studies in Washington, D.C. She is the author of Barriers to Bioweapons: The Challenges of Expertise and Organization for Weapons Development (Cornell University Press, 2014). She received her PhD in Development Economics from the Ecoles des Hautes Etudes en Sciences Sociales (EHESS) in Paris; a graduate degree in Strategy and Defense Policy from the Ecoles des Hautes Etudes Internationales in Paris; a master’s degree in Applied Foreign Languages (triple major in economics, law, and foreign languages —Russian, and English) from the University of Paris X-Nanterre, and a dual undergraduate degree in Applied Foreign Languages and English Literature from the University of Paris X-Nanterre. She is fluent in French, English, Russian, and spoken Arabic, and possesses beginner competence in Kazakh. For more information, visit https://schar.gmu.edu/about/faculty-directory/sonia-ben-ouagrham-gormley

President’s Budget Would Leave U.S. Vulnerable to Global Health Security Threats and Why We Need An Emergency Fund For Future Outbreaks
Cuts to public health, health research, and international aid have some pretty far-reaching implications and faculty from the Johns Hopkins Center for Health Security are pointing to the inherent vulnerability that would come from Trump’s proposed budget. Health security incorporates several programs and the reality is that an epidemic anywhere means an epidemic everywhere – simply put, the outbreaks that could pose a threat to the U.S. commonly begin abroad. “The proposed budget would cut $76 million from CDC’s Global Health programs, including cuts to Global Disease Detection and other programs that train and prepare countries to diagnose and respond to emerging diseases, and to the Global Immunization Program. It would reduce by $65 million CDC’s Emerging and Zoonotic Infectious Diseases programs, which aim to prevent and control outbreaks of diseases such as Zika. It cuts by $136 million the CDC Preparedness and Response Capability budget, which includes the funding for CDC’s Emergency Operations Center and the deployment of its people abroad to emergencies such as the Ebola epidemic in West Africa.” The CDC, among other agencies with biodefense positions, has a significant volume of vacancies that haven’t been filled.  More over, the authors point to the gap within the president’s budget regarding the future work of the GHSA, which is a vital multi-lateral effort to strengthen global health security. The budget has many worried because together, these cuts paint a bleak future for health security efforts – impacting surveillance, preparedness, and response efforts across the board. Global health security is simply not an investment we can afford to ignore. Did I mention that co-author Jennifer Nuzzo is also an adjunct professor at GMU’s biodefense program? Even if you’re not worried about the impact of the budget on health security, Ebola and Zika revealed just how necessary an emergency fund for outbreaks really is. “Creating a similar ‘rainy day’ fund—and providing the Centers for Disease Control and Prevention with permission to use it in advance—could save lives and money, both at home and overseas. The idea behind an emergency fund is not to displace efforts to combat infectious disease but to ramp them up to meet a crushing temporary need. During an outbreak the CDC can call on many doctors and nurses to work without pay, but the costs of transportation, medical supplies and protective equipment still have to be covered.” While the president’s 2018 budget includes such a fund, it fails to give a specific dollar figure and is already cutting into public health funding, which may be counterintuitive. “Lawmakers need to follow through by approving one or both of the proposed measures for the president to sign to ensure that the money will be there when the next public health emergency strikes.”

North Korea & A Sea of Sarin
The threat of nuclear-armed ballistic missiles from North Korea is a growing concern and while many focus on their nuclear and ballistic missile ambition, Reid Kirby is examining North Korean chemical weapons. Looking at the Terminal High Altitude Area Defense (THAAD) missile system and South Korean capital of Seoul, which houses more than 10 million people, many worry about North Korea’s ongoing vague threats. “Proponents of preemptive military action against North Korea’s nuclear program, along the lines of Israel’s 1981 Operation Opera against Iraq’s nuclear program, typically ignore North Korea’s history of asymmetrical responses. But North Korea’s capacity to inflict mass chemical casualties on the Seoul area in a ‘sea of sarin’ attack rivals its capacity for nuclear destruction.” In 2010, it was estimated that North Korea possessed 2,500-5,000 tons of chemical weapons (mostly sarin and VX) and maintains roughly eight manufacturing facilities, which could ramp up production to 12,000 tons. Kirby addresses estimates of rounds per minute and calculations of how much sarin Seoul might receive in such an attack, noting that “a heuristic approach to estimating the total quantity of sarin required to inflict 25 percent casualties on a city such as Seoul under the specified conditions simplifies the problem into a box model of 600 square kilometers, with casualty rates integrated by area to find the necessary quantity. Using this approach, a ‘sea of sarin’ attack on Seoul would require about 400 kilograms of sarin per square kilometer”. He highlights the consequences of a 240-ton sarin attack on Seoul, noting that it would kill around 6.5% (higher lethal dosage) or potentially 25% of the population (if lower lethal dosage assumed). “If publicly stated intelligence estimates are to be believed, North Korea’s chemical arsenal represents a credible and present threat. How North Korea could apply this threat as a deterrent is speculative. But the destructive potential of the threat should give reasonable cause to hesitate regarding preemptive military options against North Korea’s nuclear weapons ambitions.”

Pandemic Flu Plan – A New Approach
The US Department of Health and Human Services (DHHS) just released their updates to pandemic flu plans. “The original plan was geared toward a more severe scenario and set a goal of delivering pandemic vaccine within 6 months of a pandemic declaration. The new document incorporates lessons learned from the 2009 H1N1 pandemic, which resulted in a less severe event. It also spells out the goal of having the first vaccine doses ready within 3 months of pandemic strain emergence, along with approved broad-spectrum antivirals.” Within the plan there are now seven domains of focus, which include objectives, goals, and key steps. The domains are: surveillance, epidemiology, and lab activities, community mitigation measures, medical countermeasures, healthcare system preparedness and response, communications and public outreach, scientific infrastructure and preparedness, domestic and international response policy, incident response, and global partnerships. You can read the plan here, in which HHS notes that they are exploring several innovative approaches to pandemic flu preparedness like re-conceptualizing respiratory protection, accelerating vaccine and antiviral development, building on emerging technologies for innovative diagnostic and diagnostic testing, etc. “Taken together, the updated domains reflect an end-to-end systems approach to improving the way preparedness and response are integrated across sectors and disciplines, while remaining flexible for the conditions surrounding a specific pandemic. This more-nuanced and contemporary approach recognizes the interdependence of domain areas, which should lead to a better understanding of how the system functions as a whole.” The updated HHS pandemic plan emphasizes that while the nature of influenza and pandemics may change, the importance of planning and strengthening critical infrastructure will always be necessary.

DoD Tick-Borne Disease Research Program
There’s been increasing attention to the threat of tick-borne diseases and the DoD is ramping up research efforts. Their Tick-Borne Disease Research Program (TBDRP) looks to help increase not only treatment efforts, but also diagnostic capacity. Created in 2016, the TBDRP works to fill the gaps within tick-borne disease research through programs like the Idea Award which encourages and supports investigators in the early stages of their career. The New Investigator aspect of this award aims at those postdoctoral fellows working to develop independent research and in the early stages of faculty appointments. “There are currently at least 16 known tick-borne illnesses, with emerging diseases being discovered all the time. In the United States, the yearly cases of Lyme disease and other tick-borne diseases, including spotted fever rickettsiosis, anaplasmosis, and ehrlichiosis, have been increasing steadily for years, currently totaling tens of thousands of people diagnosed annually, with more likely undiagnosed. Globally, the US Military prioritizes tick-borne Crimean-Congo hemorrhagic fever as an operational threat abroad. The FY17 TBDRP intends to support conceptually innovative, high-risk/potentially high-reward research in the early stages of development that could lead to critical discoveries or major advancements that will accelerate progress in improving outcomes for individuals affected by Lyme disease and/or other tick-borne illnesses.”

Health Sector Resilience Checklist for High- Consequence Infectious Diseases
Johns Hopkins Center for Health Security and the CDC jointed together to take the lessons learned from Ebola and build a checklist to strengthen the U.S. in the event of such high-consequence outbreaks. This checklist focused on high-consequence infectious diseases (HCIDs), which are novel, moderate to highly contagious, moderate to highly lethal, not easily controllable by MCM or non-pharmaceutical intervention, and cause exception public concern (think Ebola, MERS, H5N1, etc.). “The principal aim of this project was to develop evidence-based recommendations to enable communities to build health sector resilience to events involving HCIDs based on the domestic response to confirmed cases of EVD in the United States.” Aside from the checklist, their findings highlight issues with governance and coordination, communication, public health issues, health-care specific issues, EMS, and laboratories.  The general checklist itself includes sections on preparedness, leadership, creative flexibility, command structure, public trust, managing uncertainty, and crisis and emergency risk communication. There are also checklists for public health, healthcare, EMS, and elected officials, which includes things like a collaborative relationship with partners at other healthcare facilities and awareness of resources related to public health law expertise.

Stories You May Have Missed:

  • Anthrax: DoD Develops Biological Select Agents & Toxins Surrogate Solution – “The Defense Biological Product Assurance Office (DBPAO), a component of the Joint Program Executive Office for Chemical and Biological Defense, has announced the development of a Biological Select Agents and Toxins (BSAT) surrogate solution that will mitigate the risks associated with shipment and use of Bacillus anthracis. In addition to risk mitigation for Department of Defense (DoD) stakeholders and the community at large, this product demonstrates DBPAO’s commitment to providing quality reagents to the DoD and to the biodefense community. To accomplish this task, the DBPAO developed a Bacillus anthracis surrogate strain named Recombinant Bacillus anthracis with Assay Targets (rBaSwAT) using a recombinant DNA approach to create a BSL-2-level genetically modified organism that will allow continuation of operations with reduced risk. The strain is built in a novel, non-virulent Bacillus anthracis background and carries a comprehensive complement of anthrax specific molecular and immunological markers.”
  • Bioviolence- Matt Watson from Johns Hopkins Center for Health Security, is taking us through the history of bioviolence aka using infectious diseases for violent purposes. While not everyone truly sees the immediate threat of biological agents, Watson highlights the newer threats like synbio and biotechnologis that have growing potential for misuse. He also takes care to highlight the history of bioweapons to truly show the range of their application. “Of all the scourges of mankind, plagues and warfare are almost certainly the most dreaded and dangerous. Several times throughout history—and more frequently than most people are aware of—there have been attempts by individuals, organizations, and nation-states to harness the former in service of the latter.” If you want a brief overview of historical biological weapons and to truly understand the future of biothreats, don’t miss out on this great op-ed.
  • New York City Legionnares’ Cluster – Health officials are scrambling to investigate the source of a NYC Legionnaires’ cluster in Manhattan. “In a Jun 16 statement, the New York City Department of Health and Mental Hygiene (DOHMH) said seven illnesses have been confirmed over the past 11 days. Four people are recovering in the hospital, two have been discharged, and one person in his or her 90s with underlying health conditions has died. Authorities are sampling and testing all cooling tower systems within a half-kilometer radius of the affected area of Lennox Hill. The health department is urging New Yorkers who have respiratory symptoms such as fever, cough, and chills to promptly seek medical care. In a typical year, about 200 to 400 Legionnaires’ cases are reported in New York City.” Legionnaires’ can be deadly for immunocompromised patients and is often a result of water treatment issues or poor disinfecting processes with spas, hot tubs, humidifiers, condensers, etc.