Pandora Report 4.28.2017

If you’ve ever wondered about the 1998 story regarding the WWI anthrax sugar cube, we’ve got this gem for you.

March for Science
This past Saturday (Earth Day), cities around the world saw hoards of scientists and supporters of research marching to both celebrate science, but also push for the preservation of funded and publicly communicated research. “The March for Science is a celebration of science.  It’s not only about scientists and politicians; it is about the very real role that science plays in each of our lives and the need to respect and encourage research that gives us insight into the world.  Nevertheless, the march has generated a great deal of conversation around whether or not scientists should involve themselves in politics. In the face of an alarming trend toward discrediting scientific consensus and restricting scientific discovery, we might ask instead: can we afford not to speak out in its defense?” Cities like Chicago saw 40,000 participating in the march, armed with lab coats, pink knit brain hats, and some pretty outstanding signs. Even some furry friends got involved to celebrate science. The D.C. march battled against rainy weather and included speakers like Bill Nye on the National Mall.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
The May 1st deadline for an early registration discount is fast approaching, so don’t miss your chance to attend this educational and captivating workshop for a lower price! The three-day workshop will provide you with not only seminars from experts in the field, but also discussions with others interested in biodefense. You can check out the flyer and register for the event here. A returning participant, GMU student/alumni, or have a group of three or more? You’re eligible for an additional discount! Check out the website to get the scoop on all our expert instructors and the range of topics the workshop will be covering. From Anthrax to Zika, this is the place to be in July to get your biodefense nerdom on!

French Intelligence Brings Insight Into Syrian Chemical Weapons          A new French intelligence National Evaluation report details the direct evidence linking the April 4th chemical weapons attack in Syria to the Syrian regime. “The French report casts fresh doubts on the efficacy of what at the time was billed as a landmark U.S.-Russian chemical weapons pact, which was signed by U.S. Secretary of State John Kerry and Russian Foreign Minister Sergei Lavrov in late 2013. The pact was touted as practically eliminating Syria’s ‘declared’ chemical weapons program.” The French report is considered the most detailed evaluation of environmental analysis (among others) following the Syrian chemical weapons attacks. Not only does the April 4th sarin match that previously used by the Syrian regime, but it also points to the hexamine chemical signature found in the Syrian chemical weapons program. “The French intelligence report provides the most robust scientific evidence linking the Syrian government to the sarin attack in Khan Sheikhoun,” said Gregory Koblentz, the director of the biodefense graduate program at at George Mason University.”This scientific evidence is a direct refutation of the misinformation being peddled by Russia and Syria.”

The World Needs a DARPA-Style Project to Prevent Pandemics             We truly are not ready for a global pandemic. Across the board, all the reports, studies, and experts say the same and the latest article from Tom Ridge and Dante Disparte highlights this unpleasant reality. Zika, Ebola, SARS, and avian influenza have all shown us just how globally unprepared we are for such an event. “In public health, it is much easier to play offense than it is to play defense. Playing offense well, however, is going to require a lot more coordination – both internationally and within national borders. We believe an important first step in this effort is for the U.S. and governments around the world to develop an equivalent to the Defense Advanced Research Projects Agency (DARPA), that focuses cross-sector efforts on advancing biological and pandemic risk readiness.” No single sector can fix this problem, but rather it requires cross-sector collaboration to tackle organisms that know no borders. Ridge and Disparte insist that a a global “invest now or pay later” economic philosophy is needed to break away from stovepiping that allows biological threats to appear sector specific. “As with DARPA, the science and technology community are the unsung heroes in improving global biodefense and pandemic risk readiness. But unlike advanced military research, which is conducted under strict secrecy, the scientists working on improving our defenses to emerging threats must have a charter that encourages open collaboration and transparency. All too often research and technology investments, particularly those in the private sector, follow a zero-sum approach.”

U.S. Preparedness Index Points to Scattered and Mediocre Progress
The National Health Security Preparedness Index (NHSPI) was just released by the Robert Wood Johnson Foundation, which tracks progress at the state level regarding their capacity to respond to health emergencies. The good news is that overall, the U.S. score has increased over the past couple of years – 6.8 in 2016, up from 6.7 in 2015, and 6.4 in 2013. “Of six main dimensions—ranging from mobilizing resources after health incidents to involving stakeholders during crises—the nation as a whole improved except for one area: the ability to prevent health impacts from environmental or occupational hazards. That area is the only one showing decline from 2013”. Overall trends pointed to preparedness improvements except for those states in the Deep South and Mountain West States. Sadly, Alaska ranked lowest in the 10-point scale. “Challenges some states face include grappling with health policy uncertainties because of health insurance proposals, a situation that detracts attention and energy from other health security needs. Also, the analysis found that extreme weather events are increasing in frequency and intensity in many parts of the country, putting extra burden on food and water systems and other infrastructure areas. Though federal aid helps reduce fiscal capacity differences across states, federal preparedness funding falls far short in eliminating the health security gaps that separate affluent from poorer states, according to the report.” Policy recommendations based off their findings focus on engaging private sector, including health insurance coverage as a health security strategy, developing emerging response funding, etc.

Hospital Preparedness Program Performance Measures 
Speaking of preparedness…the 2017-2022 Hospital Preparedness Program Performance Measures Implementation Guidance was released via the Office of the Assistance Secretary for Preparedness and Response. “ASPR’s Hospital Preparedness Program (HPP) enables the health care delivery system to save lives during emergencies and disaster events that exceed the day-to-day capacity and capability of existing health and emergency response systems. HPP is the only source of federal funding for health care delivery system readiness, intended to improve patient outcomes, minimize the need for federal and supplemental state resources during emergencies, and enable rapid recovery. HPP prepares the health care delivery system to save lives through the development of health care coalitions (HCCs) that incentivize diverse and often competitive health care organizations (HCOs) with differing priorities and objectives to work together.” Within the latest guidance, you can find capabilities regarding healthcare and medical readiness, continuity of healthcare service delivery, and medical surge.

Meeting of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria
Don’t miss the upcoming meeting on the battle against the resistant bug! You can catch this in person or via webcast on May 3rd (9am-5pm ET) and May 4th (9am-3pm ET). “The Advisory Council will provide advice, information, and recommendations to the Secretary of HHS regarding programs and policies intended to support and evaluate the implementation of Executive Order 13676, including the National Strategy for Combating Antibiotic-Resistant Bacteria and the National Action Plan for Combating Antibiotic-Resistant Bacteria. The Advisory Council shall function solely for advisory purposes.” If you’re planning to attend, make sure to register ASAP as this will be a great venue to discuss new treatments, alternatives for antibiotics, and transmission prevention strategies.

Unexplained Deaths in Liberia 
The good news is that heath officials have ruled out Ebola in the nine unexplained deaths following a funeral-related event. The bad news is that we’re still not sure what caused the deaths. “The United Nations has issued a precaution to its staff in Liberia regarding an unusual number of deaths at the FJ Grante Hospital, where the patients died. The agency added that health workers in the area have been advised to don personal protective equipment, even when treating patients who aren’t suspected cases.”

Stories You May Have Missed:

  • Sandia National Labs Honored in Fight Against Ebola– The New Mexico-based laboratories are being honored for their hardworking and dedication during the Ebola outbreak. “On April 11, Dmitri Kusnezov, chief scientist and senior adviser to the secretary of energy, visited Sandia to honor nearly 60 Sandians for work to mitigate the effects of the Ebola epidemic and the work of the Technology Convergence Working Group.” The Sandia lab teams worked to cut down detection times to help reduce the risk of transmission while rule-out cases were awaiting confirmation. Their teams also aided in modeling and analyzing Liberia’s national blood sample transport system.
  • Unpasteurized Cow’s Milk and Cheese Outbreaks – If you’re a fan of unpasteurized milk, you may want to reconsider. A recent study found that unpasteurized dairy products cause 840 times more illness and 45 times more hospitalizations than their pasteurized counterparts. “We estimated outbreak-related illnesses and hospitalizations caused by the consumption of cow’s milk and cheese contaminated with Shiga toxin–producing Escherichia coliSalmonella spp., Listeria monocytogenes, and Campylobacter spp. using a model relying on publicly available outbreak data. In the United States, outbreaks associated with dairy consumption cause, on average, 760 illnesses/year and 22 hospitalizations/year, mostly from Salmonella spp. and Campylobacter spp. Unpasteurized milk, consumed by only 3.2% of the population, and cheese, consumed by only 1.6% of the population, caused 96% of illnesses caused by contaminated dairy products.”

Pandora Report 4.21.2017

If you missed the Infectious Disease Mapping Challenge webinar last week, you can catch the recording here! Ongoing reports are highlighting that the Trump administration is unprepared for a global pandemic.

How Prepared Is The U.S. For Disease Threats?
Scientific American sat down with former CDC director Tom Frieden to discuss his experiences and what he worries may be on the horizon for public health threats. When asked about immediate health issues facing the current administration, Frieden highlights the ongoing Zika outbreak, antibiotic resistance, emerging infections, and the ever-present risk of influenza. In terms of CDC preparedness, Frieden says that, “It’s a big problem that when there is an emerging threat, we are not able to surge or work as rapidly as we should, as a result of a lack of additional funding and legislative authority. When there is an earthquake, the Federal Emergency Management Agency doesn’t have to go to Congress and say, ‘Will you give us money for this?’ But the CDC does. We have made a really good start working with 70 countries to strengthen lab systems, rapid-response and field-monitoring systems, but it is going to take a while before countries around the world are adequately prepared. A blind spot anywhere puts any of us at risk.”

Bill Gates Warns of Increased Bioterrorism Threat
The entrepreneur and philanthropist has been drawing increasing attention to the threat of infectious diseases, especially in regards to bioterrorism. Speaking at the Royal United Services Institute in London (RUSI), Gates stated that, “bioterrorism is a much larger risk than a pandemic.” “All these advances in biology have made it far easier for a terrorist to recreate smallpox, which is a highly fatal pathogen, where there is essentially no immunity remaining at this point.” He goes further to point out the unique aspects of infectious disease threats that make them more deadly than nuclear bombs. “When you are thinking about things that could cause in excess of 10 million deaths, even something tragic like a nuclear weapons incident wouldn’t get to that level. So the greatest risk is from a natural epidemic or an intentionally caused infection bioterrorism events. Whether the next epidemic is unleashed by a quirk of nature or the hand of terrorist, scientists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year. So the world does need to think about this.” Gates pointed to the insufficient public health response in countries that are likely to experience emerging infections and the importance of foreign aid. Moreover, he highlights two major advancements since the 1918 pandemic – globalization and genetic editing. The DIY biohacker and potential for a single infectious person to travel around the globe in a day are all making the threat of a pandemic that much more real. Lastly, Gates emphasizes that the stability of a country and that of its health systems are vital in that an outbreak is more likely to become an epidemic in a country where both qualities are poor.

Biopreparedness – Developing Vaccines For An Eradicated Disease
Speaking of smallpox and the risk of bioterrorism…Filippa Lentzos is pointing to the smallpox vial discovery at the NIH and that despite the eradication of the disease, a biotech company, Bavarian Nordic, is still working to develop a vaccine. She notes that “possible avenues for the re-emergence of smallpox, including the impact of developments in synthetic biology, and it gives an inside view on the biodefence industry and its unusual business model.” Lentzos is an expert in the field of biodefense and focuses her work on the governance of emerging technologies like synthetic biology.

A Scope, A Resistant Germ, and Missing Data Walk into a Bar
GMU Biodefense PhD student Saskia Popescu is looking into the rise of the resistant bug and how medical equipment can pose increased risks for such infections. In 2015 several outbreaks occurred in patients following a procedure with a type of duodenoscopes made by Olympus. These scopes are “flexible medical devices that look like thin tubes and are inserted through the mouth, throat, and stomach into the small intestine—are reusable $40,000 medical devices that contain many working parts, including a camera, and are used for more than half a million procedures a year. The successful dynamics of the device also make it challenging to clean and disinfect. Just over two years ago, cases of drug-resistant infections started popping up in patients who had recently had the procedure that commonly uses duodenoscopes (endoscopic retrograde cholangiopancreatography or ERCP).” Following an outbreak of the highly resistant carbapenem-resistant Enterobacteriaceae (CRE) at UCLA Medical Center, the scopes were recalled and interim cleaning guidance was provided by the CDC. Unfortunately, there is growing concern that the issues with the scope weren’t fully remedied. “In fact, Sen. Murray highlighted a recent outbreak in Europe (location not disclosed within the US Food and Drug Administration report) tied to the modified scopes. Although, modifications made by Olympus were done in response to the previous outbreaks and meant to reduce the risk of bacteria getting into the device’s channels and preventing proper cleaning and disinfection, Sen. Murray is now questioning Olympus regarding the devices and the role they played in this most recent outbreak. The senator is specifically asking for data proving that the repaired scopes could be properly disinfected between patient use.” As the threat of antibiotic resistance rises, the role of medical devices and manufacturer accountability will become increasingly relevant.

CRISPR Breakthrough Gives Hope for Disease Diagnostics 
CRISPR technology news often comes with a bit of controversy, but research recently published in Science is pointing to exciting new diagnostic capabilities. Feng Zhang and eighteen colleagues “turned this system into an inexpensive, reliable diagnostic tool for detecting nucleic acids — molecules present in an organism’s genetic code — from disease-causing pathogens. The new tool could be widely applied to detect not only viral and bacterial diseases but also potentially for finding cancer-causing mutations.” If you’re a fan of 221b Baker Street, you’ll be pleased to hear that the new tool is named SHERLOCK – Specific High Sensitivity Enzymatic Reporter UnLOCKing. The SHERLOCK tool utilizes the viral-recognition within CRISPR to detect genetic pathogen markers in some one’s urine, blood, saliva, or other body fluids. “They report that their technique is highly portable and could cost as little as 61 cents per test in the field. Such a process would be extremely useful in remote places without reliable electricity or easy access to a modern diagnostic laboratory.” This new finding has amazing potential for public health and rapid disease detection in rural areas to improve time to treatment, isolation, and prevention efforts.

National Science Advisory Board for Biosecurity May 2017 Meeting
Don’t miss this May 11th meeting (2-4:30pm EST)! Items include presentations and discussions regarding: (1) the Blue Ribbon Panel draft report on the 2014 variola virus incident on the NIH Bethesda campus; (2) stakeholder engagement on implementation of the U.S. Government Policy for Institutional Oversight of Life Sciences Dual Use Research of Concern (DURC); and (3) other business of the Board.  A detailed agenda and other meeting material will be posted on this website as they become available. This meeting will be a conference call only; there will be no in-person meeting. To join the call as a member of the public, please use the dial-in information below. The toll-free teleconference line will be open to the public at1:30 P.M. to allow time for operator-assisted check-in.  Members of the public planning to participate in the teleconference may also pre-register online via the link provided below or by calling Palladian Partners, Inc. (Contact: Carly Sullivan at 301-318-0841).  Pre-registration will close at 12:00 p.m. Eastern on May 8, 2017. Make sure to check the website for the public conference line and passcode.

Synthetic Bioterrorism – US Developing Medical Response 
Preparedness efforts against biological threats are now expanding to include synthetic biological threats. “Dr. Arthur T. Hopkins, acting assistant secretary for Nuclear, Chemical, and Biological Defense Programs at the U.S. Department of Defense (DOD), testified that…’emerging infectious diseases, synthetic biology and engineered diseases…[is] an area where we are focusing and we have to continue to focus.’ To counter such current and emerging threats, DOD’s Chemical and Biological Defense Program is developing new strategies to more rapidly respond, especially in the area of medical countermeasures, Hopkins said.” He noted that the DoD has commissioned the National Academy of Science to lead a study on the potential for such an event and its impact on national security.

Chemical Reaction: North Korea’s Chemical Weapons Are A Big Threat- And China Needs to Help Deal With Them
GMU Biodefense PhD alum Daniel M. Gerstein is looking at the “role that China could play with respect to North Korea, in particular dissuading the use of chemical weapons. While tensions are high, the use of chemical weapons could be the “spark that could bring the region to war.” Gerstein notes that while the focus in Syria is internal, if Kim Jong Un used chemical weapons it would most likely be external- against South Korea or Japan (or even the U.S.). It is vital that there be a clear-cut response to the use of chemical weapons and action from China may just be the clear message that’s needed. “To prevent the unthinkable from occurring, the North Koreans must be dissuaded from using chemical weapons. They must be convinced that the use of chemical weapons is a red line that cannot be crossed. China should consider being the messenger for this message. China also should consider taking an active, forward-looking approach to prevent the use of chemical weapons by North Korea. When Syria deployed chemical weapons, there was speculation that Russia may have been complicit or at least aware of plans to conduct the attack.” Or perhaps some friendly games of volleyball are in order?

Wildlife Disease Biologists – An Unstoppable Force 
Neither rain nor sleet could keep APHIS wildlife disease biologists out of the field collecting samples. Animal diseases are a major source for infections coming down the pipeline for humans (i.e. spillover events) and these researchers are on the front lines trying to make sure we have a heads up. APHIS’ Wildlife Services (WS) program includes 36 wildlife disease biologists who work diligently to collect samples from wild birds for avian influenza testing (among other things). “‘By monitoring the avian influenza strains circulating in wild birds, WS and its partners are able to provide an early warning system to America’s poultry producers,’ states Dr. Tom DeLiberto, Assistant Director of WS’ National Wildlife Research Center. ‘Our experts focus their sampling on waterfowl species and locations where we are most likely to detect avian influenza. This ensures our efforts are as efficient and informative as possible’.” I think we can all appreciate the brave few who venture into frigid waters to help trap and test wild birds to help detect the spread of infectious diseases.

Stories You May Have Missed: 

  • Trends in Apocalyptic and Post-Apocalyptic Fiction – Writers frequently use an apocalyptic or post-apocalyptic backdrop for fictional stories. The Doomsday Clock is a visual representation of the general mood and often represents the fear and unease in the environment. Whether it be an environmental event or a killer virus, the end of humanity has been a frequent topic for many writers. “Often it is a fear of a naturally-evolving virus, as in Max Brooks’s World War Z: An Oral History of the Zombie War (2006) or Emily St. John Mandel’s Station Eleven (2014). Yet, with the advent of new biotechnologies, authors also considered the impact a malignant engineered virus would have on humanity, as seen in Margaret Atwood’s Maddadam trilogy (2003 onwards) and Justin Cronin’s The Passage trilogy (2010 onwards).”
  • Ebola Theme Issue – The Royal Society – Philosophical Transactions of the Royal Society B is focusing their latest biological sciences journal on the 2013-2016 Ebola outbreak in West Africa. In this edition, you can find opinion pieces discussing the contribution of engineering and social sciences, old lessons on new epidemics, and a wealth of information on outbreak evaluation and notes from the field.

Pandora Report 3.31.2017

Welcome to your weekly dose of all things biodefense! If you take heartburn medication, you may want to check out the latest research that ties it to a higher risk of recurrent Clostridium difficile infections.

Inferno
Dr. Steve Hatch is taking readers through the harrowing journey of Ebola via the eyes of an ETU physician. He traces the origins of the outbreak, the complexities of the disease, and what it was like working as a physician during this deadly outbreak in Liberia. “There, he served as a physician (and at times a nurse’s aide, a surrogate parent and even a masseur) to the droves of patients arriving in makeshift ambulances. Inferno is Hatch’s exploration of Ebola’s origins and spread throughout Africa and beyond, coupled with his personal experience caring for those infected.”

The Real Threat to National Security: Deadly Disease
As more attention is focused on Trump’s proposed budget and the impact to public health (i.e. massive drops to NIH and CDC funding, a 28% drop in the United States Agency for International Development, etc.), the glaring reality of disease vulnerability is following suit. “Those cuts will not protect American citizens. They will diminish research and vaccine development and our ability to respond to the growing threats of antibiotic resistance and new infectious diseases. Those agencies are already falling short, as we saw last year, when they couldn’t effectively respond to the Zika threat. What will they do when we face a real pandemic? With 7.4 billion people, 20 billion chickens and 400 million pigs now sharing the earth, we have created the ideal scenario for creating and spreading dangerous microbes.” Disease is a mixed bag of tricks – antibiotic resistance, vector diseases like yellow-fever, emerging infectious diseases, zoonotic bugs like Nipah, and those that we can’t even begin to imagine. That’s just touching on the natural kind, lest we forget the threat of bioweapons or potential for biosecurity/biosafety failures in labs performing dangerous or dual-use research. The truth is that public health efforts are already strained as it is. Despite the untold benefits of prevention, it’s never been as flashy to invest in public health as in military. Unfortunately, in this day and age of globalization and interconnectedness, the poor investment we make in public health is coming back to bite us. Ebola preparedness cost U.S. hospitals $360 million…mostly because they weren’t prepared to handle these kinds of things from the beginning. Imagine if we had the funds to train healthcare workers how to handle more challenging diseases from the beginning. Regrettably, these kinds of things can’t happen if we continue to cut funds to necessary public health agencies and decide that prevention isn’t worth the investment. The stark realities of global health security aren’t things that will go away, but rather will continue to grow if we ignore prevention efforts and decide that public health isn’t worth the expenditure. Ex-CDC director, Tom Frieden, recently wrote an article for TIME magazine about the historical dangers of underfunded health programs.  If you still aren’t convinced, check out the Center for Health Security’s Infectious Disease Cost Calculator here or this article on the economic disruption of infectious disease.

Antibiotic Resistance Crisis
The American Society for Microbiology (ASM) established a new initiative to support existing efforts against antimicrobial resistance (AMR) and research developments. “This new ASM initiative is a multi-stakeholder mechanism that shares information on the current state of AMR, and identifies relevant opportunities to address AMR challenges across the microbial sciences. The initiative’s subject matter experts have identified potential approaches to maximize the impact on public, animal, and environmental health, expand surveillance, promote rapid diagnostics, and implement stewardship across settings. ‘The Steering Committee is well positioned to advise the Society on interdisciplinary One Health approaches and opportunities to address critical data gaps and human resource needs to confront this multifaceted, urgent domestic and global challenge,’ said Steering Committee co-chair James Tiedje, University Distinguished Professor and director of the NSF Center for Microbial Ecology at Michigan State University.” ASM is not new to the AMR game and has been organizing and participating in working groups since the 1990’s. The hopes for this new initiative is to really hone in on the clinical and environmental issues that facilitate AMR growth. They are also looking at surveillance and how to expand these efforts to ensure we’re getting the full scope of the issue and can truly address it with the most accurate information.

Safety First with Gene Editing
The technology and developments are quickly outpacing regulatory and oversight efforts in the world of genome editing, so the question is now becoming “should we restrict their use in the face of uncertain threats, or embrace the potential they offer and hope that appropriate responses can be rallied if experiments bring serious risks to the fore?” Many would have hoped that safety mechanisms would’ve been built into the editing systems or that we weren’t racing to catch up in terms of safety. DARPA’s Safe Genes program is one such effort that anticipates starting this summer. “Safe Genes aims to accelerate the collection of data currently missing from the debate on how to apply genome editors. The initiative also aims to strengthen the scientific foundation upon which formal safety standards for genome editing applications may someday be developed and adopted.” DARPA’s new program focuses on genome editing for many reasons – the real national security implications, the rapid pace of development and DIY potential, the dramatically declining costs for genome editing toolkits, etc. Aside from the dangers of mishandled or nefarious usage, it’s important to remember there is the potential of using genome editing for a host of beneficial things like fighting diseases, etc.

Lassa Fever Outbreak in West Africa 
Lassa fever has now seared through five West African countries in the latest outbreak. Nigeria and Sierra Leone were the first countries to see cases in December 2016. Nigeria has a total of 283 cases and 56 deaths while Sierra Leone has seen 24 cases. Of the twenty-four cases in Sierra Leone, only four were laboratory confirmed, all of whom died. While the disease is endemic in West Africa and yearly peaks occur between December and February, public health officials are working to slow the spread of the disease. Benin, Togo, and Burkina Faso are also affected by the outbreak.

GHSA Roundtable With FAO Chief Veterinary Officer Dr. Juan Lubroth
Don’t miss this event on April 4th, from 10:30-11:30am (EDT)! The FAO Liaison Office for North America cordially invites members of the Global Health Security Agenda Consortium, Private Sector Roundtable, and Next Generation Network to an informal roundtable discussion with FAO Chief Veterinary Officer, Dr. Juan Lubroth on Tuesday, April 4, from 10:30 – 11:30 a.m. Dr. Lubroth has played an important role in shaping FAO’s involvement in the Global Health Security Agenda (GHSA) since its inception in February 2014 and remains a forceful and effective advocate for the GHSA’s multisectoral and One Health approach to global capacity-building to prevent, detect, and respond to infectious disease threats. Dr. Lubroth looks forward to sharing his thoughts on the GHSA from an international organization perspective and learning more about the role of non-governmental stakeholders in this important initiative. Please confirm your attendance to Mr. Gabriel Laizer, at FAOLOW-RSVP@fao.org

Meeting On The Trump Administration, Congress, and The Future of Global Health
Don’t miss this roundtable discussion on April 6th, from 5-6:30pm, hosted by the Center for Strategic & International Studies (CSIS) Global Health Policy Center. This discussion will feature Jennifer Yates (Vice President and Director of Global Health & HIV Policy Kaiser Family Foundation), Liz Schrayer (President & CEO U.S. Global Leadership Coalition), and Chris Beyrer (Director of Center for Public Health and Human Rights John Hopkins, Bloomberg School of Public Health).

Fostering an International Culture of Biosafety, Biosecurity, and Responsible Conduct in the Life Sciences
Second-year, GMU biodefense PhD candidate, and intern for the Department of Health and Human Services, Assistant Secretary for Preparedness and Response within the Office of Policy and Planning, Elise Rowe, is taking on the international role of biosafety! As part of the student internship program, all interns are required to work on an independent project and present to ASPR staff upon its completion. Elise will be presenting her project, titled “Fostering an International Culture of Biosafety, Biosecurity, and Responsible Conduct in the Life Sciences,” on Wednesday, April 5th at the Thomas P. O’Neil Jr. Federal Building from 2-3:30 pm. You can read the abstract here.

Stories You May Have Missed:

  • Beth Cameron Joins NTI To Lead Global Biological Policy and Programs– Dr. Beth Cameron is now the senior director for global biological policy and programs at the Nuclear Threat Initiative (NTI). “Among other duties, Dr. Cameron will oversee the development of a Global Health Security Index, as well as work related to national security risks associated with emerging biotechnologies. This initiative was announced by NTI earlier this month in partnership with the Open Philanthropy Project, the Robertson Foundation and the Johns Hopkins Center for Health Security. Dr. Cameron most recently served as the Senior Director for Global Health Security and Biodefense on the White House National Security Council staff, where she was instrumental in developing, launching, and implementing the Global Health Security Agenda.”
  • Georgia Reports Low-Pathogenic H7 in Commercial Breeding Flock – Agriculture officials in Georgia (GDA) reported the low-path H7 presence in a breeding operation in Chattooga Country, Georgia. “The GDA said as a precaution, the affected flock has been depopulated and officials are testing and monitoring other flocks within the surveillance area. So far no poultry at other facilities have tested positive and none has shown any clinical symptoms. Gary Black, Georgia’s agriculture commissioner, said in the statement that poultry is the top sector in agriculture, the state’s number one industry, and officials are committed to protecting the livelihoods of farm families. ‘In order to successfully do that, it is imperative that we continue our efforts of extensive biosecurity’.”
  • Hazardous Materials Research Center Live-Agent Test – Battelle will be hosting this workshop on April 17-21st for manufacturers and developers of PPE against CBRNE threats to test their PPE against live chemical agents. “Permeation test data will help accelerate research and development to enable developers to meet critical government test and evaluation requirements or be prepared for certification, ensuring materials can provide chemical agent protection against mission specific scenarios.” Have some PPE you want tested against a chemical threat? Check it out!

Pandora Report 3.24.2017

Welcome to the start of the weekend and World TB Day! The WHO estimates that just in 2015, 1/3 of people with TB missed out on quality care and 480,000 people developed multidrug-resistant TB.

Public Health Concerns in Trump’s New Budget
President Trump’s newly released proposed budget blueprint makes drastic cuts to many programs, of which, one of the hardest hit is HHS. On top of the cuts to science and public health, there is something buried within the budget that is concerning ex-CDC director, Dr. Tom Frieden. Frieden worries about the proposal to award block grants to states, which would allow them to decide how to respond to public health issues (think Ebola, Zika, etc.). “That proposal is ‘a really bad idea,’ according to Dr. Tom Frieden, who until this past January was director of the U.S. Centers for Disease Control and Prevention. Currently, the CDC experts work with state and local governments to devise evidence-based plans to respond to public health issues, such as foodborne and infectious disease outbreaks. With a block grant, states can use the federal money to replace their own spending in certain areas or spend the money unwisely, ‘and never have to report what they have done or be held accountable for it,’ Frieden said.” A withdrawal of one fifth of NIH’s budget would mean a deep slash to biomedical and science research funding.  These cuts will also impact foreign aid, which has many worried about the role of public health interventions in foreign countries. Bill Gates recently talked to TIME magazine regarding the safety implications of cutting foreign aid. “I understand why some Americans watch their tax dollars going overseas and wonder why we’re not spending them at home. Here’s my answer: These projects keep Americans safe. And by promoting health, security and economic opportunity, they stabilize vulnerable parts of the world.” Gates points to the role of overseas public health work like polio eradication, Ebola outbreak response, and America’s global HIV/AIDS effort (PEPFAR), which points to the stabilizing role that strengthening public health can have in a country.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
From Anthrax to Zika, we’ve got the place to be in July for all things biodefense. This three-day workshop will provide you with not only seminars from experts in the field, but also discussions with others interested in biodefense. You can check out the flyer and register for the event here. The best part is that we’re doing an early-bird registration discount of 10% if you sign up before May 1st. A returning participant, GMU student/alumni, or have a group of three or more? You’re eligible for an additional discount! Check out the website to get the scoop on all our expert instructors and the range of topics the workshop will be covering.

Unseen Enemy Documentary 
Mark your calendars for this upcoming infectious documentary on the lurking pandemics that worry experts. Airing on April 7th, Unseen Enemy will follow researchers looking for the early warning signs of diseases that could cause the next pandemic. The National Academy of Medicine will be hosting a special D.C. premiere of the film on April 2nd, that you can even attend.

Expert Views on Biological Threat Characterization for the U.S. Government: A Delphi Study 
Biological threat characterization (BTC) is mixed bag of risk and reward. The laboratory research involving deadly pathogens as a means for biodefense can translate to better risk assessments but also the potential for biosafety failures. To better address this issue, researchers performed a Delphi study to gather opinions from experts around the country. “Delphi participants were asked to give their opinions about the need for BTC research by the U.S. government (USG); risks of conducting this research; rules or guidelines that should be in place to ensure that the work is safe and accurate; components of an effective review and prioritization process; rules for when characterization of a pathogen can be discontinued; and recommendations about who in the USG should be responsible for BTC prioritization decisions.” Following their assessment, the researchers found that experts agree that BTC research is necessary, but there is also a need for continued oversight and review of the research to reduce as much risk as possible. “It also demonstrates the need for further discussion of what would constitute a ‘red line’ for biothreat characterization research—research that should not be performed for safety, ethical, or practical reasons—and guidelines for when there is sufficient research in a given topic area so that the research can be considered completed.”

GMU Schar School PhD Info Session
If you love global health security and have been wanting to further your education, come check out our PhD info session next Wednesday, March 29th at 7pm in Arlington. You can come learn about our biodefense PhD program from the director, Dr. Koblentz, and hear from several students about their experiences. The info session is a great way to find out what a GMU Schar PhD entails, the application process, and what current students think!

What Biosecurity and Cybersecurity Research Have In Common
Kendall Hoyt is looking at the similarities between these two research fields and how work into the unknown can often expose and create vulnerabilities. Did I mention Kendall is one of the instructors at our biodefense Summer Workshop? Hoyt provides two examples to really hone in on this point – to defend against a dangerous pathogen, we have to isolate and grow it to try and develop treatment or a vaccine and to defend against a cyberattack, we need to know how to break into the computer system. That whole dual-use dilemma creates a lot of risk-versus-reward scenarios for biosecurity and cybersecurity researchers. While the research is highly relevant and necessary, government efforts to control or maintain oversight have been challenging. Do we pull back the reigns on innovation or run the risk of a security breach or a big “whoops” moment? “Intellectual property and cybersecurity legislation—namely the Digital Millennium Copyright Act and the Computer Fraud and Abuse Act—has similarly stifled legitimate scientific and commercial activities and delayed defensive applications. In one well-known example, fear of prosecution under DMCA deterred a Princeton graduate student from reporting a problem that he discovered: Unbeknownst to users, Sony BMG music CDs were installing spyware on their laptops.” Hoyt also points out the biosecurity efforts that have begun looking not just at the pathogens and publications, but the laboratory techniques that are used for such research. Certain experiments (like gain of function work) have the capacity to increase transmissibility or host range. “For all of their similarities, key differences between biosecurity and cybersecurity risks and timelines will dictate varied regulatory strategies. For example, zero-day exploits—that is, holes in a system unknown to the software creator—can be patched in a matter of months, whereas new drugs and vaccines can take decades to develop. Digital vulnerabilities have a shorter half-life than biological threats. Measures to promote disclosures and crowd-sourced problem-solving will therefore have a larger immediate impact on cybersecurity. Still, both fields face the same basic problem: There are no true ‘choke points’ in either field. The U.S. government is not the only source of research funds and, thanks in large part to the internet itself, it is increasingly difficult to restrict sensitive information.” In the end, Hoyt notes that both fields and their regulations will need to relax the governance process and be a bit more flexible and mobile with how they control items. Both fields are constantly evolving, which means regulators need to be just as fluid.

How To Prepare For A Pandemic
NPR decided to create a “Pandemic Preparedness Kit” based off the continuous questions related to the ongoing news of increasing infectious disease threats but little info in terms of practical things people can do. While these aren’t things you can go out and buy for your home, the list hits close to home in terms of things we should be focusing our efforts and funding on. Firstly, vaccines. This is a no brainer and yet, we’ve become the habitual users of the theme “create it when we’re struggling to contain an outbreak”. Secondly, virus knowledge. “One of your best weapons during a disease outbreak is knowledge, says Dr. Jonathan Temte of the University of Wisconsin. ‘Keep up with the news and try to understand what threats might be out there,’ he says. For example, new types of influenza are one of the biggest threats right now — in terms of pandemic potential, Temte says. But if you know how to protect yourself from one type of influenza, you can protect yourself from all of them.” Lastly, and my personal favorite, is very clean hands. While every disease is different, one of the most basic and fundamental truths for infection prevention and control is hand hygiene. These three are solid ways to better prepare for future outbreaks, pandemics, emerging infectious diseases, and just about anything infectious that makes you a bit worried.

CARB-X MissionWhen I first read the name of this group, I thought it was some kind of fitness fuel, but I was pleasantly surprised to see this initiative is working to fight antibiotic resistance. CARB-X is a collaboration between NIAID and BARDA to help accelerate the development of antibacterials over the next 25 years. The goal is to help combat antimicrobial resistance through a diverse portfolio and partnership. Make sure not to miss their March 30th meeting from 11am-noon on antibiotic resistance. “CARB-X (Combating Antibiotic Resistant Bacteria Accelerator) was launched in August 2016 to accelerate pre-clinical product development in the area of antibiotic-resistant infections, one of the world’s greatest health threats. CARB-X was established by BARDA and NIAID of the U.S. Department of Health and Human Services along with Wellcome Trust, a global charitable foundation dedicated to improving health. This partnership has committed $450 million in new funds over the next five years to increase the number of antibacterial products in the drug-development pipeline.” While CARB-X may not be the latest workout supplement, it’s definitely a boost to performance in the fight against antimicrobial resistance.

New Roles and Missions Commission on DHS Is Urgently Needed
GMU biodefense PhD alum, Daniel Gerstein, is looking at DHS and pointing to the need for a Roles and Missions Commission. It’s been almost 15 years since DHS was created under rapid and urgent circumstances, which means that it’s time to look introspectively. “More generally, a roles and missions review could also examine whether the department is properly resourced for all its missions. For example, a joint requirement council was recently established for the department composed of less than 10 government civilians. Is this adequate for supporting requirements development activities for a department of over 240,000 personnel?” Gerstein looks at some of the big issues that require a comprehensive review, like centralization versus decentralization, management of R&D and engineering, and critical infrastructure issues related to national security and safety. Another component needing review is the human factors issue that impacts homeland security. How are the relationships between departments, with state and local authorities, or with the public? “The effort should not necessarily be viewed as a requirement for change, but rather an opportunity to reexamine DHS and its relations with the rest of government, the nation and its citizens, and even with our international partners across the globe. Finally, a homeland security roles and mission commission would be an ideal lead-in to a much needed update to the original 2002 authorizing legislation.”

Deadliest Enemy: Our War Against Killer Germs
Don’t miss this event on Thursday, March 30th, hosted by New America with speakers Michael T. Osterholm and Mark Olshaker. “In today’s world, it is easier than ever for people and material to move around the planet, but at the same time it is easier than ever for diseases to move as well. Outbreaks of Ebola, MERS, yellow fever, and Zika have laid bare the world’s unpreparedness to deal with the threat from infectious diseases. In Deadliest Enemy: Our War Against Killer Germs Dr. Michael Osterholm and Mark Olshaker marshal the latest medical science, case studies, and policy research to examine this critical challenge.”

Stories You May Have Missed:

  • The Feds Are Spending Millions to Help You Survive Nuclear War – North Korea’s recent firing of four ballistic missiles from Pyongyang into the ocean off Japan’s coast has brought back worries of nuclear attacks. While the days of stocking a bomb shelter are in the past, the U.S. government isn’t slowing down efforts to protect Americans. “Over the last ten years the US has poured millions of dollars into technologies and treatments it hopes to never have to use, but could, in the event of a nuclear catastrophe. From assays that measure radiation exposure to cell therapies that restore dwindling blood cells to liquid spray skin grafts, government officials are now far better equipped to deal with diagnosing and treating people if the unthinkable were to happen. And the next generation of treatments are being funded right now.” DHHS projects like BARDA and Project BioShield are just some of the sources for ongoing research to strengthen protection, whether it be a nuclear blast or reactor melt-down.
  • Disinfection and the Rise of the Superbug – GMU biodefense PhD student Saskia Popescu is addressing the growing disinfection needs as we teeter on the edge of the antibiotic abyss. Disinfection is already a challenge in healthcare however, the rise of more resistant germs means that efforts often need to be ramped up. The recent influx of Candida auris infections that we talked about last week really brings this issue to point in that this emerging infection is difficult to get rid of via traditional disinfection routes. “As new organisms are identified and existing ones become resistant to antimicrobials, the availability of strong disinfecting products has become even more pivotal.”
  • China and EU Cut Brazilian Meat Imports Amid Scandal– If you’re a fan of importing Brazilian meat, you may have to hold off for a while. A recent police anti-corruption probe is accusing inspectors of taking bribes to allow the sale of rotten and salmonella-contaminated meats from the largest exporter of beef and poultry. As the news unfolds, the Brazilian government is criticizing gate police as alarmist. “As the scandal deepened, Brazil’s Agriculture Minister Blairo Maggi said the government had suspended exports from 21 meat processing units.”
  • Study on Interferon for Treatment of Ebola Infection – The common hepatitis treatment is now being tested out on Ebola patients to help alleviate their symptoms. The pilot study was performed from March-June of 2015 and  had some interesting results. “When compared to patients who received supportive treatment only, 67 per cent of the interferon-treated patients were still alive at 21 days in contrast to 19 per cent of the former patients. Additionally, the viral blood clearance was faster in those patients treated with Interferon ß-1a. Many clinical symptoms such as abdominal pain, vomiting, nausea and diarrhea were also relieved earlier in the interferon-treated patients. A further 17 patients in other Guinean treatment centres who matched the interferon-treated patients based on age and the amount of Ebola virus in their blood were included in the analysis. These added patients, who did not receive interferon, more than doubled their risk of dying as a result of not being treated with the drug.”

Pandora Report 3.17.2017

Happy Friday! In honor of  John Snow‘s birthday (the father of epidemiology), our featured image is the Broad Street pump map he used to combat cholera in the 19th century. Don’t miss out on the early registration discount for our biodefense summer workshop!

NAS Calls for Increased Federal Regulatory Agency Preparation for Growing Biotechnology Products 
The National Academies of Science (NAS) recent press release is emphasizing the need for federal regulatory agencies to prepare for greater quantities and ranges of biotechnology products. As the biotech world constantly evolves, regulatory agencies have struggled to keep up and this latest report states that in the next five to ten years, the pace will outmatch the U.S. regulatory system. According to the report, biotechnology, like CRISPR, has a rapidly growing scale and scope, which already stresses existing staff, expertise, and resources available at agencies like the EPA, FDA, and USDA. “To respond to the expected increase and diversity of products, the agencies should develop risk-analysis approaches tailored to the familiarity of products and the complexity of their uses, the report says. For biotechnology products that are similar to products already in use, established risk-analysis methods can be applied or modified, and a more expedited process could be used. For products that have less-familiar characteristics or more complex risk pathways, new risk-analysis methods may need to be developed.  Regulatory agencies should build their capacity to rapidly determine the type of risk-analysis approaches most appropriate for new products entering the regulatory system.” Within the report, NAS notes that the federal government needs to develop a strategy to combat the current issues and strengthen their ability to scan for future biotechnology products to better prioritize.

GMU Schar School Master’s Open House 
Have you ever wanted to study topics like CRISPR, bioterrorism, global health security, and pathogens of biological weapons? Good news – we’ve got just the program for you! Come check out GMU’s biodefense MS program at our Open House on Wednesday, March 22nd at our Arlington Campus, Founders Hall (Room 126) at 6:30pm. You can talk to some of our biodefense faculty and learn about our program. Whether you’re looking to take classes in person or earn a degree online, the biodefense MS is the best for the intersection of science and policy.

DARPA Works Towards “Soldier Cell” To Fight Bioweapons 
A bio-control system to fight off invading pathogens? Sounds like something out of a science fiction movie! Well, researchers at Johns Hopkins University just received funding from DARPA to develop the capacity to “deploy single-cell fighters” that would target and eliminate the lethality of certain pathogens. “‘Once you set up this bio-control system inside a cell, it has to do its job autonomously, sort of like a self-driving car,’ said Pablo A. Iglesias, principal investigator on the project. Iglesias, a professor of electrical and computer engineering in the Whiting School, shifted his research focus from man-made to biological control systems about 15 years ago. ‘Think about how the cruise control in your car senses your speed and accelerates or slows down to stay at the pace you’ve requested,’ Iglesias said. ‘In a similar way, the bio-control systems we’re developing must be able to sense where the pathogens are, move their cells toward the bacterial targets, and then engulf them to prevent infections among people who might otherwise be exposed to the harmful microbes’.” This angle, which is being focused on bacteria outside of the body, is just one potential tool in the biodefense arsenal.

Yellow Fever Outbreak in Brazil 
Since December of 2016, Brazilian health officials have reported an ongoing outbreak of yellow fever. The CDC has moved the alert to a  Level 2 – Practice Enhanced Precautions. A report recently published in the New England Journal of Medicine looks at the outbreak and the potential for cases in U.S. territories. In Brazil, there were 234 cases and 80 deaths reported between December and February. “Although it is highly unlikely that we will see yellow fever outbreaks in the continental United States, where mosquito density is low and risk of exposure is limited, it is possible that travel-related cases of yellow fever could occur, with brief periods of local transmission in warmer regions such as the Gulf Coast states, where A. aegypti mosquitoes are prevalent.”

GMU Biodefense Represented At Biothreats Conference
If you missed out on our coverage of ASM’s 2017 Biothreats conference, here’s a spotlight on GMU biodefense students attending this captivating three-day event. GMU’s biodefense program sent four graduate students to experience and report on the conference, which addressed biothreat research, policy, and response. “The program was exciting, according to the George Mason students in attendance. Mercer and Goble recall that the conference engaged topics of specific interest to them, their degree, and their futures. ‘I attended a panel that was very closely related to disease forecasting, my graduate thesis topic,’ Mercer said. ‘I was able to hear some of the cutting-edge research in that field, which was really helpful’. ‘I didn’t really have a part I didn’t like,’ Goble said. ‘I enjoyed the niche topics that were presented in both panel discussions and poster  sessions, from emergency operations to the FDA. All of these specific topics were extremely interesting to hear about and to know they are being researched’.”

Just How Well Did the 2009 Pandemic Flu Vaccine Strategy Work?
Researchers from the University of Nottingham recently looked at the success of vaccines in terms of preventing pandemic flu and reducing hospitalizations. Their work looked at the 2009 WHO-declared pandemic of the novel A(H1N1) virus, which infected around 61 million people around the world. Vaccines against the virus were rolled out globally between September and December of 2009, with the majority being inactivated A(H1N1)pdm09 influenza virus. Their work involved reviewing 38 studies between June 2011 and April 2016 regarding the effectiveness of the inactivated vaccine, which covered around 7.6 million people. “We found that the vaccines produced against the swine flu pandemic in 2009 were very effective in both preventing influenza infection and reducing the chances of hospital admission due to flu. This is all very encouraging in case we encounter a future pandemic, perhaps one that is more severe,” noted Professor Van Tam said. “Of course, we recognize that it took five to six months for pandemic vaccines to be ready in large quantities; this was a separate problem. However, if we can speed up vaccine production times, we would have a very effective strategy to reduce the impact of a future flu pandemic.” The 2009 pandemic A(H1N1) vaccine was 73% effective against laboratory confirmed cases and 61% against preventing hospitalizations. Interestingly, when looking at the vaccines’ effectiveness in different age groups, “they were shown to be less effective in adults over 18 years than in children, and effectiveness was lowest in adults over 50 years of age. Adjuvanted vaccines were found to be particularly more effective in children than in adults against laboratory confirmed illness (88 per cent in children versus 40 per cent in adults) and hospitalization (86 per cent in children versus 48 per cent in adults).”

Deadly Fungal Infection Arrives in U.S. 
While many are asking if surveillance methods for tracking the deadly CRE bacteria are adequate, a new issue is emerging in U.S. hospitals. Despite WHO’s recent plea for increased R&D surrounding certain resistant pathogens, it seems that more and more organisms of concern are springing up in U.S. hospitals. Since last summer, roughly three dozen people have been diagnosed with a highly resistant Candida auris infection. The fungal infection has caused worry ever since it was identified in 2009 due to its capacity as an emerging and resistant organism. Candida yeast infections are pretty common and known to cause urinary tract infections however, this strain is especially concerning because it easily causes bloodstream infections, has a stronger capacity for transmission between people, and is much more hardy in terms of living on skin and environmental surfaces. “Of the first seven cases that were reported to the CDC last fall, four patients had bloodstream infections and died during the weeks to months after the pathogen was identified. Officials said they couldn’t be sure whether the deaths were caused by the infection because all the individuals had other serious medical conditions. Five patients had the fungus initially isolated from blood, one from urine, and one from the ear.”

CDC Director Warns Loss of DHHS Funds Could Weaken Infectious Disease Prevention
Acting CDC director, Anne Schuchat, recently testified before Congress to make the case for for increased funding for several programs (one being the DHHS’s Prevention and Public Health Fund). Among other things, the Prevention and Public Health Fund is responsible for 12% of the CDC’s budget. Dr. Schucat’s testimony emphasized the previous usage of these funds in terms of vaccine delivery, disease surveillance, monitoring of water supplies, and tracking hospital-acquired infections. The growth of antibiotic resistance made her testimony and plea to Congress that much more relevant and urgent. “The CDC and other government agencies have in recent years cited the numerous public health threats posed by infectious diseases in general, and have lobbied officials for increased funding for research and development of novel vaccines and treatments as well as programs to effectively distribute interventions as needed. In 2016, for example, the CDC, DHHS, and National Institutes of Health requested federal funding to combat Zika, a request that was not approved until late in the year.”

Stories You May Have Missed:

  • Science on Screen – Don’t miss this great event hosted by Lawrence Livermore National Laboratory! On March 18th, you can watch the second installment of the Science on Screen series, featuring “Lawrence Livermore scientists Monica Borucki and Jonathan Allen, who will present ‘Reconstructing a Rabies Epidemic: Byte by Byte.’ This informative and entertaining lecture will explain how biologists and computer scientists used cutting-edge, ultra-deep sequencing technology to study the dynamics of a 2009 rabies outbreak. This case study, based on a dramatic increase (more than 350 percent) in the gray fox population infected with a rabies variant for which striped skunks serve as the reservoir hosts, will be used to help illustrate the changes in the viral genome during cross-species viral transmission. This lecture is appropriately paired with the feature-length film, “Contagion” (PG-13).”
  • Clorox Gets Spot on EPA A-Team – Clorox just earned its varsity spot on the team against hospitality-acquired infections. The EPA approved two of the company’s products in killing clostridium difficile spores. C-diff is a constant battle in healthcare facilities, so having the new tool in the infection prevention and environmental disinfection toolkit, is a huge advantage for many. “In addition, the cleaners and wipes recently become EPA-registered to disinfect against other bacterial infections, such as those caused by Staphylococcus epidermidis, Candida glabrata, and Enterococcus hirae. Moreover, the products are also effective against several viral pathogens, such as Middle East Respiratory Syndrome (MERS), and Severe Acute Respiratory Syndrome (SARS), measles, and Influenza A and B, among others.”

 

Pandora Report 3.10.2017

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

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

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

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

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

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

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

Stories You May Have Missed:

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

 

Pandora Report 2.24.2017

Happy Friday and welcome to your weekly dose of all things biodefense! A preliminary report from the Malaysian police has found that VX nerve agent was most likely used to murder Kim Jong-nam.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security: From Anthrax to Zika 
Want to dabble in the world of global health security? Don’t miss out on the GMU Biodefense three-day, non-credit summer workshop on July 17-19, 2017! Participants will look at the challenges facing the world at the intersection of national security, public health, and the life sciences. Instructors for the workshop range from FBI special agents to biodefense professors and USAMRIID commanders. The workshop will look at the spectrum of biological threats – including naturally occurring disease outbreaks such as SARS, Zika, and Ebola, lapses in biosafety, dual-use research of concern, and the threat of bioterrorism. From now until May 1st, you can take advantage of the early bird registration discount!

Progress Report on BARDA & Project Bioshield 
A 10-year report card was recently published for these two efforts to defend the U.S. against biological threats. The report found 80 candidate countermeasures, 21 stockpiled countermeasures, and 6 FDA approvals supported by BARDA and Project Bioshield. “Over a decade has passed since the anthrax attacks of 2001; preparedness has increased substantially since that time, and defense against CBRN threats has become melded into national security. Both BARDA and Project Bioshield are essential elements of national security, and, especially in light of a change in presidential administration, it is important to emphasize the critical role these agencies have had in fortifying the nation against intentional CBRN threats. Larsen and Disbrow note, however, that despite the reauthorization of Project Bioshield in 2013 with annual funding at $2.8 billion (from 2014-2018), that funding is subject to annual congressional appropriations; as such, only a fraction of that funding has been appropriated.”

BWC Newsletter 
If you’re looking to keep tabs on the Biological Weapons Convention, we’ve got just the place for you. The BWC Implementation Support Unit has prepared a newsletter to better support communication among States Parties and encourage involvement in BWC-related issues and events. The first issue discusses the recent Eighth Review Conference and news like the launch of EU projects to support BWC universalization and a Confidence-Building Measures reminder letter (deadline for submission is April 15th!).

screen-shot-2017-02-21-at-2-11-26-pmCDC Lab Closure Due to Safety Concerns
The CDC has temporarily closed down its Biosafety Level-4 laboratories following the finding that their air supply hoses to researchers in protective suits were not approved for use. “‘We have no evidence that anybody has suffered ill health effects from breathing air that came through these hoses,’ Stephan Monroe, associate director for laboratory science and safety at the CDC, told Reuters. Monroe said he was confident scientists were not exposed to pathogens because the air they breathed passed through HEPA filters. The suits they wear also use positive air pressure to prevent pathogens from entering the suit.” Safety tests are currently being performed while employees are being notified and monitored. Interestingly, Monroe’s position is a newly minted one, having been established in 2015 to combat the continuous findings of major lab safety failures involving anthrax, avian influenza, and Ebola in CDC labs.

Why Bill Gates Worries About Biological Threats
Bill Gates recently spoke to Business Insider following his speech for the Munich Security Conference, in which he highlighted his real concerns for global health security. He noted that conflict areas and regions that are struggling to find stability are perhaps the most challenging in terms of outbreak containment. Gates emphasized the vulnerability for genome editing of a virus to make it more contagious, and also the advances in biotechnology that may help prevent the spread of an epidemic. “The point is, we ignore the link between health security and international security at our peril. Whether it occurs by a quirk of nature or at the hand of a terrorist, epidemiologists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year. And they say there is a reasonable probability the world will experience such an outbreak in the next 10-15 years.” Perhaps the most important thing on our “to-do” list is to invest in vaccines, drugs, and diagnostics. We have a tendency to put these priorities lower on the totem pole until a major public health crises occurs however, Gates highlights their relevance. The launch of the new Coalition for Epidemic Preparedness Innovations (CEPI) is one step closer to bridging this gap. “The really big breakthrough potential is in emerging technology platforms that leverage recent advances in genomics to dramatically reduce the time needed to develop vaccines. Basically, they create a delivery vehicle for synthetic genetic material that instructs your cells to make a vaccine inside your own body.” Gates also emphasized the importance of strengthening basic public health systems, especially in vulnerable countries – adding to that age old saying, “an outbreak anywhere is an outbreak everywhere”.

screen-shot-2017-02-23-at-7-48-50-amFinancing Pandemic Preparedness At the National Level = First Line of Defense
Pandemic preparedness funding is one of those common sense investments…right? Unfortunately, many don’t always make it a priority. Ebola alone cost billions, including a $2.27 billion allocation for response by the U.S. government. Dozens of after-action reports and papers on lessons learned have been published since the outbreak. Peter Sands noted that “all these reviews – including the one I chaired  for the US National Academy of Medicine – agreed on three key priorities: strengthening preparedness at a national level; improving coordination and capabilities at a regional and global level; and accelerating R&D in this arena.  Over the last twelve months progress has been made in implementing many of these recommendations, but big gaps and weaknesses remain. As a recent paper in the British Medical Journal put it, there has been ‘ample analysis, inadequate action’.” The highest priority though is preparedness at a national level. The International Working Group on Financing Pandemic Preparedness was created in 2016 as a means to propose ways in which national governments and partners can work to establish sustainable financing to strengthen their pandemic preparedness. Their focus “includes domestic resource mobilization, development assistance and private sector engagement. For many countries, financing preparedness through the domestic public sector budget is the best way to ensure sustained funding and seamless integration with the rest of the health system. This requires ensuring sufficient priority is attached to investing in pandemic preparedness in budget allocations. In some countries, there may also be scope to increase the fiscal envelope through improvements in tax design and collection or even hypothecated taxes.”

Insider Threats 
Get ready to add this new book to your reading list. Matthew Bunn and Scott D Sagan are looking at insider threats like nuclear material theft and Edward Snowden. “Insider Threats offers detailed case studies of insider disasters across a range of different types of institutions, from biological research laboratories, to nuclear power plants, to  the U.S. Army.” Don’t miss the chapter from Jessica Stern and Ronald Schouten, “Lessons Learned from the Anthrax Letters”. Stern and Schouten look at the investigation of the Amerithrax attacks and provide a portrait of Ivins and his troubling behavior. They also address “the combination of regulatory changes, red flags missed by Ivins’s colleagues, and the organizational and cognitive biases that contributed to the failure to identify Ivins as a potential insider”, and the current environment and new regulations.

Stories You May Have Missed:

  • Former Secretary of Defense Outlines the Future of Warfare – “Two years ago, Barack Obama appointed a new Secretary of Defense, Ashton Carter—a technocrat physicist, an arms control veteran, and a professor at Stanford—to help close this divide.” Carter recently sat down with WIRED magazine and discussed the challenges facing the White House. When asked about the impact of autonomy on warfare, Carter notes that it will change it in a fundamental way, but also points biotechnology. “I think if there is going to be something ever that rivals nuclear weapons in terms of the pure fearsomeness of their destructiveness it’s more likely to come from biotechnology than any other technology. Looking back decades from now, I do think the biological revelation could rival the atomic revolution for the fearsomeness of the potential. I think that’s one reason we need to invest in it. And although biotechnology has not been a traditional area for Defense, the new bridges that they build shold not only be to the IT tech community but also to the biotech communities in the Valley.”
  • Did Salmonella Take Down the Aztecs?– History and infectious disease? That’s surely the best way to start a weekend! Researchers recently looked at the DNA of a 500-year-old bacteria to study one of the worst epidemics in history. “In one study, researchers say they have recovered DNA of the stomach bacterium from burials in Mexico linked to a 1540s epidemic that killed up to 80% of the country’s native inhabitants. The team reports its findings in a preprint posted on the bioRxiv server on 8 February. In 1519, when forces led by Spanish conquistador Hernando Cortés arrived in Mexico, the native population was estimated at about 25 million. A century later, after a Spanish victory and a series of epidemics, numbers had plunged to around 1 million.” After extracting and sequencing the DNA from the teeth of 29 buried people buried in the highlands of southern Mexico, all but five were found to be linked to cocoliztli. “Further sequencing of short, damaged DNA fragments from the remains allowed the team to reconstruct two genomes of a Salmonella enterica strain known as Paratyphi C. Today, this bacterium causes enteric fever, a typhus-like illness, that occurs mostly in developing countries. If left untreated, it kills 10–15% of infected people.”

Pandora Report 2.3.2017

Happy Friday! Do you remember the Jurassic Park character Dr. Ian Malcolm and his famous “life finds a way” quote? Well, in this case, nature is finding its own resistance against gene drive in the wild.

Bioterrorism Preparedness & Response Position Paper 
The InterAgency Board (IAB) has released their proposed model for bioterrorism response: initial operations and characterizations. “Under this model, responder organizations that meet eligibility requirements can apply to operate through contracts as approved bioterrorism response organizations within their own jurisdictions. These teams would be trained and equipped to meet a set of national standards and would work collaboratively with the Federal Bureau of Investigation (FBI) and the Centers for Disease Control and Prevention (CDC) Laboratory Response Network (LRN) in bioterrorism incident responses.” Within the report, you can find training standards and procedures for sampling and field biodetection devices. There is also a substantial section on funding that emphasizing the necessity of implementing and sustaining the bioterrorism response model via funding. The funding plan involves “three types of expenses: annual national program costs for WMD-CST and LRN participation of $22,237,824; participating response organizations start-up costs (per team) of $353,660—developed using a notional community;27 and annual participating response organizations costs of $66,332. This model does not address costs for validating field detection equipment performance, which could be significant.” This particular section breaks down costs that range from equipment maintenance to depreciation.

GMU Biodefense Master’s Open House
Looking to study about everything from anthrax to zika while advancing your education? Check out our biodefense master’s open houses – Thursday, February 16th and Wednesday, March 22nd at 6:15pm at our Arlington Campus. These open houses are a great opportunity to learn more about the GMU biodefense program, speak to a professor, and mingle with other biodefense gurus!

2017 ASM Biothreats Conference
The meeting on biothreat research, response, and policy is just around the corner and the Pandora Report is your source for this wonderful event! Registration is still open and we’ll be having four on-the-ground biodefense graduate student reporters giving us all the great updates from this three-day event. We’ll be live tweeting during the meeting and providing a substantial overview regarding certain sessions and more.

koblentz-moonGMU Biodefense Director Talks Growing Threats and Lack of Action
Take a venture down the biodefense rabbit hole with Dr. Gregory Koblentz! A member of the Scientist Working Group on Chemical and Biological Weapons at the Center for Arms Control and Non-Proliferation, you could say that Dr. Koblentz eats, sleeps, and breathes biodefense. His most recent work has looked at the role of responsible science in biodefense programs, dual-use research of concern, and the the growing concern of biosecurity/biosafety. In a recent report, “Koblentz indicates two factors that caused a concerning increase in the number of biodefense programs worldwide. The first was the global fear of the bioterrorist threat in the aftermath of 9/11, especially after the 2001 anthrax attacks. Also, since 2003, there have been several infectious disease outbreaks with global impact that caught people by surprise: SARS, H5N1, H1N1, Ebola and Zika. ‘There’s been a growth in the number of biosafety laboratories that are safe enough to do this work on these kinds of pathogens both because they’re caused by natural causes and also because of the fear of terrorists getting a hold of them.’ The growth in the number of programs poses additional risks themselves. Even though the biodefense programs are created as a means of stopping threats, the increased number of programs means that there are more chances for something bad to happen.” Dr. Koblentz points to the changing nature of biological threats – from state bioweapon programs to non-state actors and even naturally occurring outbreaks. The most recent BWC Review Conference is also a topic of concern for Dr. Koblentz, as he notes that it was “huge missed opportunity, and will setback efforts to reduce the risks posed by biological weapons and bioterrorism. At the outset of the conference [it] looked good. But in the final days of the conference, Iran sabotaged the proceedings and blocked the consensus needed to adopt any of these measures”

U.S. Biotech Rule – A Mixed Bag of Promises and Perils  screen-shot-2017-02-01-at-8-11-00-am
Regulations and policies have been struggling to keep up with the trajectory of genetic engineering. Reviewing these regulations falls on the FDA, EPA, and USDA, which means that they’re responsible for maintaining as modern and relevant practices as possible. Gene editing tools like CRISPR challenge these often slow efforts, however a new proposal was recently released, focusing on the path to market. This pathway, while built with good intentions, is often plagued with cracks. “Earlier this month, the White House released an update to the overarching system of biotech regulation, known as the Coordinated Framework for Regulation of Biotechnology. But it’s still up to individual agencies to clarify how they intend to classify and evaluate various GE products. In an apparent effort to get plans on the table before a change of administration, USDA and FDA put out draft proposals on 18 January addressing several categories of GE products”. As we reported a few weeks back, efforts to use genetically modified mosquitos to combat Zika, were met with residential resistance, which makes these regulations all the more sensitive. The FDA is responsible for overseeing “technologies for sterilizing and controlling animal populations, but giving it responsibility for gauging the environmental impact of a mosquito raised eyebrows on both sides of the debate”. Many have noted that the FDA truly doesn’t have the capacity to review such work in a timely manner. What about genetically engineered plants? Well, the USDA’s APHIS has specific definitions for what defines GE plants, however this definition previously focused on the production process and not the end product. “The proposed rule exempts certain products from the definition of GE, including plants containing inserted DNA from a sexually compatible species, and plants with DNA changes that could also be achieved through older chemical or radiation-based methods.” While many say that this change is good, others worry that the regulations tend to focus on projects that larger companies employ, while smaller companies lack the capacity for such controversial work, meaning that these regulations could inhibit their work.

The Cost of Cooperation in Global Health 
A recent publication in The Lancet looks to the financial backing for global health cooperation via the WHO, the World Bank, the Global Fund to Fight HIV/AIDS, TB, and Malaria, and Gavi, the Vaccine Alliance. Researchers found that the current financial flow allows donors to provide funds and assistance while maintaining closer control and monitoring throughout the entire project. “We highlight three major trends in global health governance more broadly that relate to this development: towards more discretionary funding and away from core or longer-term funding; towards defined multi-stakeholder governance and away from traditional government-centred representation and decision-making; and towards narrower mandates or problem-focused vertical initiatives and away from broader systemic goals.”

Stories You May Have Missed:

  • Federal Hiring Freeze Disrupts USDA’s Food Safety Testing – The transition of the new administration and federal hiring freeze seems to be having some concerning food safety implications. While the FDA has noted that the federal freeze won’t impact the Food Safety Modernization Act, the USDA has highlighted that it is causing issues with the Food Safety Inspection Service (FSIS). “In an internal message sent to FSIS employees on Jan. 18 and obtained by Food Safety News warned that delays in lab tests are expected through at least March 3. The FSIS is responsible for ensuring the safety of meat, poultry, processed egg products and catfish. ‘Effective Jan. 18, 2017, due to a temporary decrease in staffing, results on pathology samples submitted to the FSIS laboratory system will be delayed,’ according to the email sent to all FSIS employees. ‘AMR-01 and rush cases will be given priority status; however turnaround times are expected to be delayed by at least 24 hours on these samples. This is expected to be rectified by March 3, 2017, but is dependent on staffing key vacancies. The Pathology Branch apologies for the inconvenience these delays will cause’.”
  • Is Trump Causing a Brain Drain? – Last week’s immigration executive order  has many in the science community either unable to travel/return to the U.S. or considering relocation. “The Trump White House’s decision to clamp down on communication from various federal agencies, including the Environmental Protection Agency, has left researchers frightened over political influence seeping into their work. And his executive order has left students and scientists in limbo, removed from their classrooms and work. Advocates are warning that the inhospitable environment will lead, quite quickly, to a brain drain. A young generation of thinkers, academics and researchers might simply look to other countries to conduct their work.”
  • The Rise of MCR-1 and the Importance of Understanding the DURC Debate- This week, yours truly is talking to Contagion Live in regards to two very important topics- the rise of antimicrobial resistance and why everyone should understand the DURC debate. It’s easy to get tunnel vision when it comes to science and policy, however so many of these topics are becoming increasingly relevant and in the end, global health security impacts us all.

Pandora Report 1.27.2017

The ghostbusters had proton packs and now researchers have DNA-analyzing smartphone attachments to help diagnose disease and fight antimicrobial resistance.

Doomsday Clock Moved 30 Seconds Closer to Midnight
The Bulletin of the Atomic Scientists announced that the clock setting was moved on Wednesday. This is the closest it has been to midnight since 1953 and now includes threats like climate change, cyberthreats, and biological weapons. The board has been critical of President Trump and noted that, “Over the course of 2016, the global security landscape darkened as the international community failed to come effectively to grips with humanity’s most pressing existential threats, nuclear weapons and climate change … This already-threatening world situation was the backdrop for a rise in strident nationalism worldwide in 2016, including in a U.S. presidential campaign during which the eventual victor, Donald Trump, made disturbing comments about the use and proliferation of nuclear weapons and expressed disbelief in the overwhelming scientific consensus on climate change.” You can get a better glimpse of the clock and its components here.

Possession, Use, and Transfer of Select Agents and Toxins; Biennial Review of the List of Select Agents and Toxins and Enhanced Biosafety Requirements- Final Rule
The CDC has released the final recommendations for select agent biosafety requirements in accordance with the 2002 Bioterrorism Response Act. The 2016 recommended changes included the removal of six biological agents, “add provisions to address the inactivation of select agents, add specific provisions to the section of the regulations addressing biosafety, and clarify regulatory language concerning security, training, incident response, and records.” However, as of January 19th, 2017,  HHS and USDA have published parallel amendments to the federal regulation for select agents and toxins. Following their review, HHS decided not to finalize the proposed changes to the list of select agents. They did however decide “to finalize provisions to address toxin permissible limits and the inactivation of select agents; to finalize specific provisions to the section of the regulations addressing biosafety; and to clarify regulatory language concerning security, training, incident response, and records”. The amendments are set to take effect 30 days from the date of publication.

Biodefense World Summit
Don’t miss out on the Biodefense World Summit in Alexandria, VA from June 27-28th! This will be the third summit in order to “bring together leaders from government, academia, and industry for compelling discussions and comprehensive coverage on pathogen detection, sample prep technologies, point-of-care, and biosurveillance. Across the four-track event, attendees can expect exceptional networking opportunities in the exhibit hall, across panel discussions, and shared case studies with members of the biodefense community from technology providers to policy makers.” Make sure you don’t miss out on GMU Biodefense PhD student, Mary Sproull’s presentation, “Recent Advances in Radiation Biodosimetry for Partial and Total Body Exposures” during the tools and technologies at the point-of-care session!

Missing Russian Smallpox Researcher  
This may sound like the plot of a horror movie (or Sum of All Fears), but the reality may be just as worrisome. Professor and Russian microbiologist, Ilya Drozdov has been put on Interpol’s wanted list. Having knowledge of Russia’s historical bioweapons program means that Dr. Drozdov’s disappearance has authorities worrying he may have gone abroad. Dr. Drozdov was head of Vector for five years, which means he has considerable knowledge in both the offensive program and the recent work regarding plague vaccines and HIV cures. “After quitting the institute, he returned to his native Saratov, but has now vanished. It is now confirmed that last month the 63 year old scientist – who needed top vetting clearance to lead Vector – was put on the Interpol wanted list, indicating fears he has gone abroad. He is accused by state investigators of misappropriating some 2 million roubles – then worth around $55,000, while his tenure also led to an outflow of staff unhappy at his management style. A criminal case was filed against him in 2014, and a Novosibirsk court has now approved his arrest in absentia, said Elena Chernyayeva, a regional deputy prosecutor. The microbiologist allegedly used the cash to purchase an apartment. There is no suggestion he has taken secrets abroad, but the Interpol alert indicates the Russian authorities have lost track of his whereabouts. There was criticism of him at Vector for the poor pay of its expert researchers, and ‘conflicts’.”

Bill Gates Talks Bioterrorism 
Last week we looked into the Coalition for Epidemic Preparedness Innovation (CEPI), which aims to head off worldwide outbreaks through the development and stockpiling of vaccines. CEPI has received massive financial support and one sponsor in particular is the Bill and Melinda Gates Foundation. Bill Gates recently warned, at the recent World Economic Forum, that there is a true gap in bioterrorism preparedness. “What preparedness will look like for intentionally caused things, that needs to be discussed,” he said. “It’s very hard to rate the probability of bioterrorism, but the potential damage is very, very huge. I think an epidemic, either naturally caused or intentionally caused, is the most likely thing to cause, say, 10,000 excess deaths,” Gates said. “He voiced the same concern in March during a Reddit Ask Me Anything session: ‘The problem of how we prevent a small group of terrorists using nuclear or biological means to kill millions is something I worry about,’ he wrote.” Other biotech gurus like Sam Altman noted that the 2011 H5N1 gain-of-function controversies have opened their eyes to synthetic viruses as a form of terrorism or bioerror.

Health Security Memos to the New Administration and Congress 
Despite a recent move, researchers at the Center for Health Security aren’t taking a break when it comes to global health security. They’ve recently written a series of commentaries for the new administration regarding facts and assessments that are critical for the world of health security. The memos range from healthcare preparedness to improving biosurveillance, partnering with communities to foster trust, communication of new disease threats, and much more.

FDA’s New Farm Antibiotics Policy – Is It Enough?
The new FDA Guidance for Industry (GFI) #213 is what some would consider a victory, while others are calling it a mediocre milestone at best. The new policy looks to reduce the usage of antibiotics in agriculture by requiring veterinary oversight. That’s right, prior to GFI #231, farmers could go to their local feed stores and buy penicillin and tetracycline over the counter to add to feed and water to promote growth. “Under GFI #213, which was first announced in 2013 and has taken 3 years to fully implement, pharmaceutical companies have been asked to voluntarily remove production purposes (such as growth promotion) from the labels of all medically important antibiotics used in food production. All affected companies have done so as of Jan 3, the FDA says. In addition, the guidelines require veterinary oversight for the continued use of these drugs for disease prevention and control in herds and flocks. From now on, all antibiotics used in water will require a prescription from a licensed veterinarian, and those used in feed will need a veterinary feed directive (VFD).” Sure, this is a move in the right direction, but are we ensuring the quality of veterinary oversight and truly changing the culture within farming to support responsible antibiotic usage?

Outbreak Alert: Seoul Virus in Illinois and Wisconsin Rat-Breeding Facilities
While we’ve been busy with the inauguration and Zika virus, there’s been an emerging outbreak creeping up in Illinois and Wisconsin. Eight people have been infected with Seoul virus after working in several rat-breeding facilities across the two states. While not commonly found in the U.S., this is the first known outbreak associated with pet rats. “A home-based rodent breeder in Wisconsin was hospitalized in December 2016 with fever, headache, and other symptoms. CDC tested a blood specimen and confirmed that the infection was caused by Seoul virus, a member of the Hantavirus family of rodent-borne viruses. A close family member who also worked with rodents also tested positive for Seoul virus. Both people have recovered. A follow-up investigation at several rat breeders that supplied the initial patient’s rats revealed an additional six cases of Seoul virus at two Illinois rat breeding facilities.” While related to Hantavirus, Seoul virus presents with more mild symptoms.

Stories You May Have Missed:

  • Post-Ebola reforms: ample analysis and inadequate action–  Check out a new analysis on WHO response and global reaction to the Ebola outbreak. “Given the importance of improving our ability to battle current (Zika, yellow fever, etc) and future outbreaks of infectious disease, we examined seven major reports and identified areas of consensus on action. We then assessed what progress has been made and what can be done to address the gaps. The seven reports were selected on the following criteria: scope (tackling problems beyond a single organization, country, or sector); diverse authorship (defined by country of origin, organizational affiliation, area of expertise, and gender); and public availability (excluding internal reviews).”
  • Using the lessons of economics to stop global pandemics before they start -Larry Summers is looking to economics to calculate the likely future impact of pandemics on the global economy. By combining the mortality cost and losses in income, he and fellow researchers found that “it was on the same range as that of climate change-  although at the lower end of the possible scale. A moderately severe pandemic, of the kind that occurs every few decades, would knock 4-5% off global output. The “ultra scenario”—a pandemic similar in virulence to the flu of 1918—would raise that to 12%, reducing GNI in some developing countries by more than half.”
  • How Prepared is the U.S. for Avian Influenza?– Many are pointing to an impending avian influenza outbreak and questioning how well American response measures will work. “On Jan 9, the US Department of Agriculture (USDA) confirmed that a wild mallard duck in Montana had died from H5N2, a highly pathogenic avian flu strain that in 2015 affected farms in 15 states and led to the culling of more than 43 million poultry, with an estimated $3.3 billion in economic losses. ‘This confirmed H5N2 in a wild mallard duck in Montana keeps us on high alert,’ said Donna Karlsons, a public affairs specialist with the USDA’s Animal and Plant Health Inspection Service (APHIS). ‘We know the disease is out there and serves as a great reminder for constant biosecurity vigilance. There is never a good time to ease up on biosecurity, and it remains our greatest asset to protect against avian influenza’.”

 

Pandora Report 11.4.2016

Happy Friday! We’ve got some great news – you can now watch our book launch and panel from the Biological Threats in the 21 Century event via YouTube here. Whether you missed out on attending or want a recap, you can get all the biodefense goodies there. UNMC was recently awarded $19.8 million to build an Ebola and advanced infectious disease training center. Their new center will include a training, simulation, and quarantine section, with the hope of training healthcare workers to treat patients with Ebola and other highly infectious diseases. A recent study found that limited access to Ebola diagnostic and supportive pathology assays facilitated the failure of initial 2014 outbreak control efforts, regardless if the setting was a resource-rich or resource-poor location.  Shocking news – hand hygiene is one of the biggest issues in norovirus infections.

3rd Annual Summit on Global Food Security and Health 
GMU’s Schar School of Policy and Government will be hosting this informational event on Wednesday, November 16th from 10:30am-5:30pm. Speakers include experts from organizations such as the Association of Public Land Grant UniversitiesBread for the World, the International Medical Corps and the US Agency for International Development: Academics will discuss their research on Food Security with an eye to improving access, addressing challenges and developing partnerships to improve global food security and related health outcomes. Organized with the support of the Center for Strategic and International StudiesThe Farm Journal FoundationThe Global Harvest Initiative, Policy Studies OrganizationWorld Medical & Health Policyjournal; Center for the Study of International Medical Policies and Practices (CSIMPP) in the Schar School of Policy and Government at George MasonUniversity; American Public University; and World Food Policy. The conference is free and open to the public, but registration is required. Contact Professor Bonnie Stabile bstabile@gmu.edu with any questions.

FDA Manipulation of Media
A new report from the Scientific American is drawing attention to the FDA’s arm-twisting of journalists “into relinquishing their reportorial independence”. Their investigators found that NPR and a series of other news outlets had a deal with the FDA-  get news announcements early but the FDA would dictate whom their reporters could and couldn’t interview. “This kind of deal offered by the FDA—known as a close-hold embargo—is an increasingly important tool used by scientific and government agencies to control the behavior of the science press. Or so it seems. It is impossible to tell for sure because it is happening almost entirely behind the scenes. We only know about the FDA deal because of a wayward sentence inserted by an editor at the New York Times.” The Scientific American was able to obtain supportive documents via the Freedom of Information Act, which revealed that despite their public demeanor, the FDA denies many reporters access and grows their own group of journalists that will follow their rules. Much of this is held together with the journalistic practice of embargo – a deal between source and journalist that the story won’t be published prior to a specific date/time. This is actually pretty common in the science world, but it can actually create an aura of favoritism and bias. The issue with the FDA situation is far deeper though – aside from getting early access to stories and agreeing not to publish before the agreed date/time (embargo), the other rules stated that journalists could not seek outside comment and in a nutshell, had to give up the ability to do independent reporting. In the end, this kind of control of the media and journalistic favoritism reveals things about both sides of the agreement, but also emphasizes the need for transparency and re-thinking of the embargo system.

BWC 8th Review Conference sheet-1
The eighth RevCon is fast approaching and if you’re behind as to what’s happened since the last RevCon, check out UNLOG’s (The United Nation’s Office at Geneva) Think Zone and the latest information. You’ll also find some great articles from GMU’s Biodefense faculty in there – like Dr. Koblentz’s article on dual-use and Dr. Sonia Ben Ouagrham-Gormley’s article on gene drive. Better yet, check out the BWC RevCon Series from the International Law and Policy Institute. These three papers discuss a series of issues related to the BWC and RevCon. The first, Divide and Delegate: the Future of the BWC, focuses on the pursuit of BWC aims outside RevCons and the normative strengths and operational weaknesses. LPI2, Keeping Up With the Science, looks to support enhanced science and technology review processes. LPI3, is a joint effort by GMU’s very own Biodefense Director, Gregory Koblentz, and the author of your favorite new book (Biological Threats in the 21st Century), Filippa Lentzos. The third paper, Risks, Trade-Offs & Responsible Science , looks at the security trade-off risks of the increasing volume of labs and scientists working on dangerous pathogens. They note that “the 2016 BWC Review Conference must encourage states to implement stringent national biosafety, biosecurity and dual-use research regulations; task the science advisory group to develop clear, internationally- recognized guidelines governing dual-use research of concern (DURC); establish a working group to revise the CBMs; and encourage states to participate in the CBM mechanism as well as more interactive information exchanges such as peer review and compliance assessment.”

RevCon will take place from November 7-25th in the Palais des Nations and a general agenda is available here. Gabrielle Tarini writes that this RevCon will be a “pivotal opportunity for countries to take action to ensure that the treaty remains a relevant and useful tool for preventing the development, spread, and use of biological weapons. A failure by member states to invest the necessary attention, time, and political capital in the conference could mean decreased interest and weakened multilateral engagement in a treaty that was the first to ban an entire category of weapons of mass destruction.” Moreover, the BWC should have a dedicated process, like that of the CWC, to inform and advise member states, pointing to the need for a great capacity to have expert-led meetings and continuous monitoring. Lastly, Tarini highlights that this RevCon will be an opportunity to strengthen and revise the intersessional process and framework. “The treaty should be restructured, with a stronger steering body and increased time for preparation and multilateral engagement. Adding more meetings, and limiting what gets discussed at each of those meetings, would allow the BWC to begin operating more like an international organization and would provide oversight equivalent to that for other nonproliferation treaties.” Can everyone help verify the BWC? Some are saying open source monitoring may just be that sweet spot.

Increasing Transparency in Biodefense: A 2016 Visit to a German Military Medical Biodefense Facility  screen-shot-2014-09-22-at-21-57-41
Filippa Lentzos is taking us on a journey through German biodefense practices and why transparency is so vital for these programs. Citing Germany as a prime example of countries going above and beyond their voluntary BWC efforts, she delves into the world of Germany’s biodefense activities. She notes the visitors were highly encouraged to review Germany’s most recent CBM submission and briefed on the Institute of Microbiology’s safety and health regulations. “Few restrictions were placed on us other than those related to safety and security. We were free to view rooms, lab equipment and installations. The type and scope of access was to be determined by Institute staff on a case-by-case basis. Any access denials could derive from national security, biosafety and health regulations, data privacy issues, unpublished scientific results or ongoing lab work. If access or certain information was refused, the Institute would explain the particular considerations and o er alternatives.” The Bundeswehr institute focuses on three main CBRN tasks – ensuring protection and an ability of the armed forces to act under CBRN threats, preventing vulnerability to potential CBRN threats and weapons via preventative measures, and limiting the consequences should a CBRN event ever occur. The medical biodefense responsibilities focus more on the ability to rapidly diagnose and identify pathogens, distinguishing natural outbreaks from intentional, and controlling outbreaks. The official noted on their visit that within the institute, there are 65 staff and 18 externally funded fixed-term positions over three departments (bacteria/toxins, viruses/intracellular pathogens, and medical biological reconnaissance and bioforensics). From genome sequencers to electron microscope rooms, check out Filippa’s report for a virtual tour of this amazing biodefense facility.

Assessing the Epidemic Potential of RNA and DNA Viruses  screen-shot-2016-11-02-at-7-19-56-am
Researchers from the University of Edinburgh are looking at zoonotic viruses and their transmissibility. The Ebola outbreak in 2014 highlighted the needed to better understand what kinds of pathogens, especially zoonotic, were likely to emerge as potential epidemics. Given the vast diversity and high rates of viral evolution, this was no easy task. “Of human transmissible virus, 37 species have so far been restricted to self-limiting outbreaks. These viruses are priorities for surveillance because relatively minor changes in their epidemiologies can potentially lead to major changes in the threat they pose to public health.” Researchers used the basic reproductive number, R0, as a means of answering this question. They looked at hundreds of viral species and then categorized them into 4 levels with epidemic potential in humans. They found that the taxonomic diversity is wide, but bounded and most human infective viruses are closely related to viruses of other mammals. Transmissibility within the human population is a key determinant, as well as the R0 threshold of>1. “We currently have few clues to help us predict which mammalian or avian viruses might pose a threat to humans and, especially, which might be transmissible between humans. One argument in favor of experimental studies of these traits, including controversial gain of function experiments, is that they could help guide molecular surveillance for high-risk virus lineages in nonhuman reservoirs.The first line of defense against emerging viruses is effective surveillance. A better understanding of which kinds of viruses in which circumstances pose the greatest risk to human health would enable evidence-based targeting of surveillance efforts, which would reduce costs and increase probable effectiveness of this endeavor.”

Spikes in C-diff and MDRO’s 
Halloween may be over but the rise of the resistant bugs is still going on. A recent study looked at the changing epidemiology of MDRO’s (multi-drug resistant organisms) within a specific healthcare network. While they were able to observe a significant reduction in MRSA, there was a sharp rise in other MDRO’s and C-diff (Clostridium difficile). Examining eight years of data from a Utah-based health network, researchers looked at 22 hospitals clinics to establish trends in C-diff and other MDRO’s. Of the 900,000 patient admissions, 1.4% tested positive for an MDRO and/or C-diff. MRSA was by far the most common MDRO (51% of MDRO infections) but they did see a 32% decrease in MRSA infections over the eight years. “Researchers, however, observed a 222% increase in C difficile and a 322% increase in ESBL-positive bacteria. The data also showed that 70% of all MDROs and C difficile cases originated from an ambulatory setting.” There has also been a significant rise in ESBL’s, which points to a need to refine and revise screening protocols. Overall, this points to the complexity and ever-changing habits of infection prevention and control.

Zika Updates
A recent study is showing that Zika infections have caused reduced fertility and low testosterone in male mice. The ECDC has updated their Zika epidemic rapid risk assessment, noting that “although continuing, vector-borne transmission seems to be slowing down in Central American countries and the Caribbean. The outbreak continues to evolve in Mexico and the southern part of the US, as weather conditions still favour seasonal vector activity. In addition to the Americas, cases have been reported in some Asian countries.” Researchers are working to use the Wolbachia bacteria (which naturally infect several mosquito species) against diseases like Zika and dengue. Overcoming the hurdle of infecting Aedes (a species not naturally infected with Wolbachia), they found that the bacteria was able to survive in the mosquito and then was a passed down through generations…but the best news is that those mosquitoes infected with Wolbachia weren’t able to pass dengue. When the Wolbachia-infected mosquitoes were infected with dengue, the virus couldn’t replicate and spread in the mosquito’s salivary glands (i.e. couldn’t be transmitted). This new technique shows some pretty remarkable abilities to reduce the capabilities of Aedes species to spread diseases like Zika, chikungunya, and yellow fever. The CDC has reported, as  of November 2nd, 4,128 cases in the U.S.  Interestingly 53 people in Minnesota have been found to be infected.

Stories You May Have Missed: 

  • Pandemic Simulations – The Ebola outbreak in 2014/2015 taught us a great many lessons regarding international preparedness and response to infectious disease outbreaks. As a result of this, the World Bank Group and the Bill and Melinda Gates Foundation is starting a new project to conduct the first set of pandemic simulation exercises. “President Jim Yong Kim, Bill Gates and Chancellor Angela Merkel of Germany will jointly host simulation exercises on pandemic preparedness for the Heads of State and private sector leaders during the next World Economic Forum in Davos in January 2017 and the G-20 Heads of State meeting in July 2017.  In preparation for the two major events, the World Bank will collaborate with the technical team from WHO, WEF and the German government to conduct similar exercises for G20 technical staff and and G20 Ministers of Health. Simulation exercises help make a theoretical possibility real, by allowing policymakers to role-play and map out gaps and concrete solutions to those gaps along with their peers.”
  • New Genetic Mutations in Antibiotic BW Agent– Researchers at Lawerence Livermore National Laboratory (LLNL) recently found a new genetic mutation in antibiotic-resistant tularemia (Francisella tularensis). Tularemia is a Category A Select Agent, which means it is a prime concern for bioterrorism and public safety. “This perspective allows you to see mutations that are new that we didn’t know about. If you don’t do this type of study, you’re going to miss other mechanisms that cause resistance in the bacteria. So by doing a genome-wide study, it gives you a much more complete picture about what’s going on,” said LLNL biologist and lead author Crystal Jaing. “The study found resistance-conferring mutations in a hypothetical protein, an asparagine synthase, and a sugar transamine/perosamine synthetase in addition to observing known variants.”