Pandora Report 2.16.2018

 

 White House Budget Hits Public Health
The White House has released their new plan, “Efficient, Effective, Accountable: An American Budget”, which sees an increase in military spending, funds for a U.S.-Mexico border wall, and a 10%  increase in spending from 2017. “The plan also calls for major cuts to Medicare, Medicaid, food stamps and other social programs — reductions that conservatives have long sought. But even with these reductions, which add up to more than $3 trillion in cuts over 10 years, the proposal would not bring the budget into balance because of the lost tax revenue and higher spending on other programs.” The 2019 budget proposal also includes $9.2 billion added after Congress lifted mandatory spending caps. “But the 2019 budget might not be as steady as it seems, because the White House is calling for the creation of three new institutes within the NIH. They include a National Institute for Research on Safety and Quality, which would replace the $324-million Agency for Healthcare Research and Quality within the Department of Health and Human Services (HHS). The Trump plan would also transfer the National Institute of Disability, Independent Living, and Rehabilitation Research from the HHS’s Administration for Community Living, and the National Institute of Occupational Safety and Health (NIOSH) to the NIH from the US Centers for Disease Control and Prevention (CDC).” The plan also includes a cap for how much salary a scientist can draw from an NIH grant (90%), gives NIH an additional $750 million for research towards the opioid crisis ($400 million of which must “be spent on public-private partnerships to develop new treatments”). Unfortunately, this proposed budget significantly weakens public health preparedness and response plans with a 43% reduction in the CDC’s Public Health Preparedness and Response Program. Furthermore, it includes hitting the CDC hard with a 12% reduction and plans to move the strategic national stockpile (SNS) to ASPR. Such plans severely impact global health security as funding for the GHSA is expected to drop. You can read a further overview on the health security outlook by the Johns Hopkins Center for Health Security here. There has also been increasing concern regarding the lack of a nominee for the head of the Office of Science and Technology Policy, especially since the de facto advisor is a 31-year-old political science major from Princeton

GMU Schar School MS Open House
Don’t miss out on our information session next week. This is a great chance to chat with faculty about the GMU Biodefense MS program (both online and in person). “The session will provide an overview of our master’s degree programs, an introduction to our world-class faculty and research, and highlights of the many ways we position our students for success in the classroom and beyond. Our admissions and student services staff will be on hand to answer your questions.” FYI – GMU biodefense students are making headlines for their dedication and passion for health security, come join the nerdom!

Next Generation Global Health Security Mentorship Program
Interested in becoming a mentor  or protege in health security? The NextGen Global Health Security Mentorship Program is a great way to build partnerships and collaborations for those passionate about health security. “The NextGen Global Health Security (NGGHS) Mentorship Program is an annual program aimed at connecting early to mid-career professional and students interested in global health security with experts in the field to enhance professional development. Mentors and Protégés are free to establish a program that suits them best. Meetings can be based on current events, suggested topics and/or other common areas of interest. The pair will maintain correspondence either in person, over the phone or by email, as often as they have decided feasible.” If you’re a GMU biodefense alum, also make sure to update your information in Stay Connected so you’ll get the latest in biodefense program news and opportunities!

The Anniversary of Kim Jong Nam’s VX Assassination
February 13th marked the one-year anniversary of the assassination of Kim Jong Un’s half brother at the Kuala Lumpur airport. Kim Jong Nam was attacked by two women who smeared VX nerve agent on his face. “The women claim they were tricked into believing they were part of a reality show, but the U.S. and South Korea say the murder was orchestrated by Pyongyang. The brazen killing came as North Korea was starting to accelerate its missile tests and countries around the world came under mounting pressure to enforce ever-tightening U.N. sanctions against Pyongyang.” In the wake of the attack, Malaysia is working to distance itself from its previously close relationship with Pyongyang. The murder trial, which started in October of 2017, is set to end in March of this year, with the two women maintaining their innocence. 

Biosafety Failures in UK Lab
The Health and Safety Executive (HSE) released findings from their investigations into more than 40 “mishaps” at specialist labs from 2015-2017. The labs were run by hospitals, private companies, and Public Health England (PHE), which reveals an unfortunate trend across many sectors. “One scientist at a PHE laboratory became sick after contracting Shigella, a highly contagious bacterial infection that causes most cases of dysentery in Britain. The incident led the HSE to send the agency an enforcement letter to improve its health and safety practices.” Incidents range from failure to communicate safety requirements for mailing samples to airflow failures and lab workers acquiring illnesses from lab safety mishaps.

Antimicrobial Resistance: Forging A New Strategy Against An Old Threat
GMU Biodefense students love all things health security and that includes antimicrobial resistance. PhD student Saskia Popescu is tackling the woefully insufficient response we’ve had over the years to this growing threat. Pointing to current challenges, initiatives, and research strategies, Popescu discusses current trends and hopeful plans to combat AMR. “What is to be done? There are several initiatives, like the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator (CARB-X), that seek to infuse life into the research and development of new drugs. There is also a push on health care providers and agriculture to reduce the use of antimicrobials. But these are all long-term solutions that may take years or decades to implement. Although long-term plans are critical, if you were hospitalized today with a highly resistant infection, what would be the short-term plan of action your heath care providers would take?”

ABSA Risk Group Database App
Check out the latest Risk Group Database resource (and app!) from the Association for Biosafety and Biosecurity (ABSA) International. “In many countries, including the United States, infectious agents are categorized in risk groups based on their relative risk. Depending on the country and/or organization, this classification system might take the following factors into consideration: pathogenicity of the organism, mode of transmission and host range, availability of effective preventive measures (e.g., vaccines), availability of effective treatment (e.g., antibiotics), and other factors.”

Blue Ribbon Study Panel on Biodefense Receives Grant to Advance Leadership and Reduce Catastrophic Risk
“The Blue Ribbon Study Panel on Biodefense announced today a $2.5 million grant from the Open Philanthropy Project. The grant allows the Panel to continue its leadership role in assessing our nation’s biodefense, issuing recommendations and advocating for their implementation, and identifying viable avenues for needed change to policy. The grant comes amidst heightened global tensions as North Korea and other regimes seek to develop biological weapons. It also arrives on the 100th anniversary of a catastrophic influenza pandemic that took the lives of millions around the world, a stark reminder of the dangers of biological events.”

Stories You May Have Missed:

  • DHS Announces Finalists in $300k Biothreat Prize Competition –  “The Department of Homeland Security (DHS) Science and Technology Directorate (S&T), in collaboration with the Office of Health Affairs National Biosurveillance Integration Center (NBIC), today announced five finalists for Stage 1 of the Hidden Signals Challenge. The challenge calls for the design of an early warning system that uses existing data to uncover emerging biothreats. The announcement was made at the American Society for Microbiology’s 2018 ASM Biothreats meeting.”
  • Seoul Virus Transmission – Have a pet rat at home? Make sure to practice safe rodent handling and hand hygiene as physicians are seeing cases of rodent-to-human transmission of Seoul virus. “After confirming Seoul virus infection in the Wisconsin patients, the CDC and the Wisconsin Department of Health Services investigated the source of the disease. ‘The outbreak spread from sales or trade of infected pet rats between people’s homes or between ratteries’ – places where rats are bred – ‘in 11 states,’ said Kerins, who coauthored the report.”

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

Pandora Report 2.9.2018

Happy Friday fellow biodefense enthusiasts! The Winter Olympics are already starting off with a bang as Korean health officials have confirmed 128 cases of norovirus among security personnel, police officers, and Olympic workers.

WHO Releases List of Blueprint Priority Diseases
The WHO has just released their annual review of the Blueprint list of priority diseases, which includes a special tool for “determining which diseases and pathogens to prioritize for research and development in public health emergency contexts”. While the list includes diseases like Ebola, MERS and SARS, Nipah, and Zika, it is the inclusion of Disease X that highlights the unknowns of infectious diseases in the future.  “Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease, and so the R&D Blueprint explicitly seeks to enable cross-cutting R&D preparedness that is also relevant for an unknown ‘Disease X’ as far as possible.”

BioWatch Documents Left Behind on Flight
Biowatch officials are doing a bit of a damage control at the moment as multiple copies of an official DHS document regarding performances during a bioterrorism simulation were left behind on an airplane prior to the Super Bowl. The errant document offered a critique of how officials performed during a simulated release of the infectious disease anthrax in Minneapolis on the day of the Super Bowl. Other sensitive material was also found, CNN said, without further description.” Ironically, it was a CNN employee who discovered the forgotten papers in the seat-back pocket of a commercial plane. “The reports were accompanied by the travel itinerary and boarding pass of the government scientist in charge of BioWatch, the DHS program that conducted the anthrax drills in preparation for Super Bowl LII in Minneapolis. The reports were based on exercises designed to evaluate the ability of public health, law enforcement and emergency management officials to engage in a coordinated response were a biological attack to be carried out in Minneapolis on Super Bowl Sunday.” CNN waited to publish the incident until after Sunday’s game, but the papers revealed significant areas for response improvement during a bioterrorism incident. While not surprising, the identification of such gaps is critical for improvement however, it is the concerning nature of which they were left behind. Vulnerabilities are always present, but that doesn’t mean we want them being aired in the open for nefarious actors to utilize.

 GMU Biodefense PhD Student Selected As ELBI Fellow 
The Biodefense Graduate Program in the Schar School of Policy and Government at George Mason University is proud to announce that PhD student Yong-Bee Lim has been selected for the prestigious Emerging Leaders in Biosecurity Fellowship (ELBI) program within the Johns Hopkins Center for Health Security. Selected from a group of over 120 international applicants, the 2018 ELBI class includes professionals and scholars with a passion for health security and biosecurity. This year-long fellowship will deepen the biosecurity expertise and broaden the network of those passionate about furthering the field. Yong-Bee was also the recipient of an internship with the Center for Global Security Research at Lawrence Livermore National Laboratory and the SB7.0 Fellowship, which supported his attendance of an international synthetic biology conference in Singapore. His selection also marks the third consecutive year that the Schar School’s Biodefense program has had graduate students named ELBI fellows. Congrats Yong-Bee!

Smallpox Signalling
It’s been a couple of weeks since PLOS One published the horsepox synthesis paper and the truth is that many are still in awe that not only such work was done, but that it was published. Where were broader discussions regarding the merits of this research? Conversations about need to publish it? Moreover, what about the importance of oversight in the private biotech arena and not just those with federal funding? One thing is for certain though, this is a critical moment for life sciences and DURC oversight. “A vaccine against smallpox already exists. The research was carried out unilaterally, without a broader discussion of the merits beforehand. There are apparently few oversight mechanisms when experiments are done with private funding. The restrictions that now cover dual-use research funded by U.S. government — which include an independent review process, and a weighing of the risks and benefits, as well as the ethics — should be expanded to private-sector research.”

Topics of Interest at the DHS Meeting on Sequences of Interest
Synthetic biology has led to the creation of new products, markets, companies, and industries. At the same time, this technology poses potential risks to biosafety and biosecurity, as recently demonstrated by the synthesis of horsepox virus, a cousin of variola, the virus that causes smallpox.  On January 29-30, 2018, the Department of Homeland Security (DHS) Science and Technology Directorate sponsored a workshop to discuss the evolving role of databases that contain genetic sequences of pathogens and toxins that pose safety or security concerns, termed “sequences of interest.” The workshop brought together stakeholders from government, industry, and academia to discuss the need for such databases, review current databases and those under development, explore potential applications and users of these types of databases, and consider the potential risks that they pose due to malicious or inadvertent misuse. The workshop provided a valuable opportunity to explore the scientific and technical aspects of constructing such databases, maintenance and sustainability challenges, and the trade-offs involving functionality, accessibility, affordability, confidentiality, and security. While the workshop did not produce a consensus on the best path forward, it played an important role in educating the participants on the most critical issues and facilitating a dialogue among a diverse range of stakeholders on this important topic.  The workshop also came at a propitious time as stakeholders grapple with the changing landscape of the biotech industry and advances in DNA synthesis technology.  For instance, the International Gene Synthesis Consortium, a group of the leading DNA synthesis companies that have adopted customer and sequence screening protocols to prevent the misuse of their products, has expanded in size and geographic scope and recently updated its biosecurity protocols. The U.S. government is also reviewing the customer and sequence screening guidance it issued in 2010 and is considering whether, and how, to update it.  Should a decision be made to proceed, stakeholder engagement would be a significant part of the review, just as it was a significant part of the guidance’s original development.

The US Can’t Afford to Reduce Public Health Funding
GMU biodefense PhD alum Daniel M. Gerstein is evaluating the decision to reduce funding for global epidemic prevention activities and just how dangerous that would be for the United States. “Recent reporting suggests that the Trump administration is preparing to downsize the Centers for Disease Control’s (CDC) global epidemic prevention activities in 39 of 49 countries starting in 2019 when funding first authorized by Congress in 2014 expires. Such a move is potentially dangerous and could place the U.S. at significant risk.” Gerstein points to the notion of shared responsibility in global health security and how important efforts like the GHSA are for global public health. He also notes that the last decade alone has revealed just how undeniable public health is as a national security issue. “Without renewed funding, the long-term outlook could include weakened global disease surveillance and response systems, less capable partner nations and an increased likelihood of global disease outbreaks that would undoubtedly threaten the U.S.” Wanting more information regarding the implications of CDC cutting back on their global health security funding? Check out this article regarding the funding cliff the CDC is about to fall off.

Biosecurity in Putin’s Russia
The latest book from Raymond A. Zilinskas and Philippe Mauger delves into the biodefense world of Putin’s Russia. “In March 2012, at a meeting convened by the recently reelected Russian president Vladimir Putin, Minister of Defense Serdyukov informed Mr. Putin that a plan was being prepared for ‘the development of weapons based on new physical principles: radiation, geophysical wave, genetic, psychophysical, etc.’ Subsequently, in response to concerns expressed both in Russia and abroad, the Russian government deleted the statement from the public transcript of the meeting. But the question remains: Is Russia developing an offensive biological warfare program?”

Global Monitoring of Disease Outbreak Preparedness
The Harvard Global Health Institute has released their new report that is “a step towards developing a shared framework and monitoring mechanism” for outbreak response and preparedness. “This report is primarily intended for the community of policymakers and researchers concerned about the rising risks of domestic, regional, and global infectious disease epidemics, and the collective failure to take the coordinated actions required to reduce such risks. These risks include the expected health, economic, and societal costs that are borne by countries, regions, and even all nations in the case of pandemics (which are worldwide epidemics). These risks also include the consequences of increasing antimicrobial resistance (AMR) and its spread within regions and globally.” The report focuses on strengthening public health capacity as a foundation, improving S&T, reinforcing risk analysis and incentives for action, strengthening global mechanisms, and revised shared monitoring framework and next steps.

 The Fearsome Future of Flu
This year has been rough for seasonal flu and while it has been a cold dose of reality in terms of hospital response, are we really learning our lesson or just running from fire to fire? 2018 marks the centennial of the 1918/1919 influenza pandemic and with a larger, more connected population, have we made ourselves safer? The next flu virus with pandemic potential will either enhance our response capabilities or exploit our most damning weaknesses. “And influenza viruses excel at the element of surprise. Few would have guessed Mexico as the origin of that 2009 H1N1 pandemic, for example, notes Fukuda. That outbreak was recognized in San Diego—never considered a hotspot—when a little girl happened to seek treatment at a clinic participating in a study focused on diagnosis, Adalja explains. That’s why he believes it is important to build up the diagnostic capacity for frontline clinicians, and not be satisfied with non-specific diagnoses—failing to pin down the specific microbial cause.” Unfortunately, we are still practicing the methods of frenzied response, delayed information sharing, and dangerous hysteria that can spread even faster through social media. These concerns highlight yet another reason why we need a universal flu vaccine.

Johns Hopkins Center for Health Security Event: Healthcare Disaster Resilience
Don’t miss this event at the National Press Club Holeman Lounge on Thursday, February 22nd from 8:30-10am EST. The Johns Hopkins Center for Health Security will release new policy recommendations for building a more effective disaster health system in the United States. Speakers include Dr. Luciana Borio from the White House National Security Council staff, Sally Phillips of HHS, Linda Langston from the National Association of Counties, as well as Drs.Tom Inglesby, Eric Toner, Monica Schoch-Spana from the Center for Health Security.

 Genetic Sequencing and the Dangers of DIY Genome Editing
Nebula Genomics will sequence your genome for just under $1,000 and you can even share it using a blockchain.  “Nebula is the brainchild of geneticist George Church, PhD student Dennis Grishin, and graduate Kamal Obbad, all from Harvard. Mirza Cifric, CEO of Veritas Genetics, which offers a genome-sequencing service for $999, is a founding advisor. When you pay to take a DNA test—through 23andMe, Helix, or Ancestry.com, for example—the company that does the testing owns your genetic data. Nebula wants to sequence people’s entire genomes and let them own it, allowing them to earn digital money by sharing it.” While professionals may be providing your genomic data through these companies, many are looking to actually learn to experiment with genes themselves. DIY gene therapy is becoming increasingly accessible, which has many worried and the FDA issuing a warning to the public. The FDA, on “November 21 cautioned against do-it-yourself (DIY) gene therapies. But even as the agency’s statement also warned that selling gene editing kits aimed at homemade therapeutics is illegal, CRISPR–Cas9 kits are available to buy online, and the number of providers is growing, raising concerns that DIY gene therapy enthusiasts could be putting themselves and others at risk.”

Biodefense Policy Landscape Analysis Tool
B-PLAT is a new tool from Pacific Northwest National Laboratory scientists Rachel Bartholomew and Kristin Omberg that aims to help coordinate national biodefense preparedness. It “captures and presents a slew of information about U.S. efforts to protect its citizens and others around the world from threats as diverse as the flu, diseases like Ebola, threats from terrorists, potential risks to water and food supplies, and myriad other concerns. The tool is freely available. In 2017, PNNL chartered an internally funded working group, the Policy Wranglers, to capture relevant biodefense policy directives, public laws, and corresponding sections of the U.S. Code, in a format conducive to visualization. The resulting tool can be utilized to better understand the current state of the U.S. biodefense enterprise.” A presentation on B-LAT will also be made at ASM’s Biothreats next week as part of a town hall on Tuesday.

Stories You May Have Missed:

  • US Battles IV Bag Shortage During Record-Setting Severe Flu Season – GMU biodefense PhD student Saskia Popescu is looking at the impacts of this IV bag shortage during the severe flu season. “Even prior to Hurricane Maria, the United States was already battling challenges with meeting the demand for IV fluids; however, the storm crippled Puerto Rico-based manufacturing sites for materials. In a news release on January 16, the FDA reported that they were taking additional steps to combat the shortages, such as ‘asking companies to submit data to extend expiration dates for these products.’ They noted that, ‘if expiration dates can be safety extended [for these products], it would allow some near-expiry product that remains at the hospital level to be used’.”
  • DARPA Program to Track Genetic Markers for Past WMD Material Exposure – “The program is being called Epigenetic Characterization and Observation (ECHO), and its endgame is the creation of a field-deployable system that could analyze someone’s epigenome and identify markers of whether or not–in that person’s entire lifetime–been exposed to WMD-associated materials. DARPA officials are billing it as worlds quicker than sending to a lab to test for biological or chemical agents in clothing or hair.”

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

Pandora Report 1.26.2018

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

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

Pandora Report 1.19.2018

Happy Friday and welcome to your favorite source for all things biodefense! We hope you’re able to avoid the onslaught of respiratory viruses that are circulating right now, but on the off chance that you’re battling a bug, here’s some infectious disease new that won’t get you sick.

Fighting Influenza
Whether you’re fighting the flu or watching the mayhem unfold in the news, you can’t escape influenza right now. We’re getting hit hard with flu season in the United States and the CDC has reported that activity is still rising and we’re not out of the woods yet. You can find the latest flu data here, but what is worrying so many is the hit that hospitals are taking across the country. It’s not just that we’re facing an IV bag shortage due to the devastation Hurricane Maria wreaked upon Puerto Rico, but that hospitals are being overrun with an onslaught of ILI (influenza like illness) patients. Wait times are through the roof, staff are stretched thin, patients are being admitted into overflow areas, hospitals are having to divert patients because they’re so full, triage areas have been set up in parking lots and emergency areas, and hospitals are even struggling to ensure they have enough PPE and influenza tests. This year marks the centennial of the 1918/1919 influenza pandemic, and it seems like what’s going on is out of a history book instead of down the street. As an infection preventionist and infectious disease epidemiologist, it is not surprising or unexpected that we’re running into these issues. It’s easy for people to point to the current situation and use it as an example of why we’re not ready for a flu pandemic – and they’re right, but it shouldn’t take what’s going on to see that. These are not new issues. Infection control and hospital preparedness has been struggling for a long time and it doesn’t take a pandemic to prove it. Even after the surge of funding and focus on hospital preparedness post-Ebola, we still struggle with these issues, but throw in budget cuts and an administration that is set to pull funding away from public health…well, the outlook is dismal.

With so much attention on influenza, pandemic preparedness, and how we’re just not ready for the next great flu pandemic, what kind of household interventions can we apply in our own little ecosystems? Researchers looked at a HPAI H5N1 outbreak and estimated the reduction in primary attack rates for household-based interventions. “We show that, for lower transmissibility strains, the combination of household-based quarantine, isolation of cases outside the household, and targeted prophylactic use of anti-virals will be highly effective and likely feasible across a range of plausible transmission scenarios. For example, for a basic reproductive number (the average number of people infected by a typically infectious individual in an otherwise susceptible population) of 1.8, assuming only 50% compliance, this combination could reduce the infection (symptomatic) attack rate from 74% (49%) to 40% (27%), requiring peak quarantine and isolation levels of 6.2% and 0.8% of the population, respectively, and an overall anti-viral stockpile of 3.9 doses per member of the population.” While we all may not access to anti-virals, the use of quarantine and isolation are all effective strategies. From an infection control standpoint, it can be tough to maintain such efforts in a household where one or two people are sick. When in doubt, wash your hands, cover your cough, and clean those high-touch surfaces/objects!

GMU Biodefense MS Open House
Mark your calendars for the February 21st Master’s Open House at GMU’s Arlington campus! If you’ve been thinking about getting a MS in biodefense (who wouldn’t want to take classes on biosurveillance, historical bioweapons programs, and more?!), this is a great chance to talk to faculty and learn about the admissions process. GMU has biodefense MS programs in person and online, so even if you’re not in the DC-area, you can get your biodefense on.

Smallpox, Horsepox, And The Trouble With Poxviruses
It seems only a few months ago that news broke of a Canadian research team’s de novo synthesis of horsepox. Since then, there has been considerable discussion surrounding not only the biosafety and biosecurity behind research involving an orthopoxvirus, but also the implications of normalizing orthopoxvirus synthesis, and again, if the remaining smallpox stockpiles should be destroyed. The latest report from researchers at the University of Alberta points to the potential smallpox vaccine developments that synthetic viruses could bring. “Virologist David Evans and his research associate Ryan Noyce produced an infectious horsepox virus, which they synthetically reconstructed using a published genome sequence and DNA fragments manufactured entirely by chemical methods. The team went on to show that the synthetic horsepox virus could provide vaccine protection in a mouse model of poxvirus infection.” Unfortunately, the implications of synthesizing an orthopoxvirus aren’t so simple. GMU biodefense professor and program director Dr. Gregory Koblentz evaluated the implications of such synthesis for biosecurity and what would be needed to prevent a reemergence of smallpox. “The synthesis of horsepox virus takes the world one step closer to the reemergence of smallpox as a threat to global health security. That threat has been held at bay for the past 40 years by the extreme difficulty of obtaining variola virus and the availability of effective medical countermeasures. The techniques demonstrated by the synthesis of horsepox have the potential to erase both of these barriers. The primary risk posed by this research is that it will open the door to the routine and widespread synthesis of other orthopoxviruses, such as vaccinia, for use in research, public health, and medicine.” Koblentz notes that while there are potentially legitimate uses for synthesizing orthopoxviruses (safer smallpox vaccine development), it also means that such labs have the potential to produce smallpox from synthetic DNA and emphasized that action is needed now to avoid the misuse of synthetic biology by nefarious actors. “Unfortunately, the current legal and technical safeguards against the synthesis of smallpox virus are weak and fragmented. There is no clear international legal or regulatory framework to prevent the synthesis of smallpox virus. The WHO has a policy banning the synthesis of the smallpox and regulating who can produce and possess large fragments of smallpox DNA, but it hasn’t been widely adopted by states. Furthermore, there is no mechanism—at either the national or international level—for detecting or punishing violations of this policy.” GMU biodefense PhD student Saskia Popescu cited the importance of medical providers understanding the dual-use research of concern debate and that ultimately, biosecurity impacts us all. “From the healthcare perspective, it may not seem like something we should worry about, but the direction of gene editing and dual-use research of concern is something that is intrinsically linked to public health. Nefarious outcomes of such experiments, regardless of the origin or intent, will inevitably make their way into an emergency department, urgent care, or worse, the community. Although we may not be seeing the implications today, as medical providers and healthcare workers, we must keep our ears to the ground, listening for these biotech advancements, and then thinking through what they mean for us tomorrow.”

Blue Ribbon SLTT Ability to Respond to Large Scale Biological Events: Challenges and Solutions
If you missed the Wednesday meeting, here’s a recording to catch up on all things biodefense. “State, Local, Tribal, and Territorial Ability to Respond to Large-Scale Biological Events: Challenges and Solutions government officials, federal and academic representatives, and subject matter experts will discuss their perspectives, experiences, challenges, and recommended solutions with regard to SLTT response to large-scale biological events.”

Gene Therapy Hits a Wall With Microbial Resistance
Can gene editing trigger an immune reaction in humans? A new study is suggesting that it may be a risk. “The CRISPR-Cas9 system, which functions as a genetic scissors and tape for editing DNA, is generally derived from either Staphyloccoccus aureus or Streptococcus pyogenes bacteria.” Most of us though, have been exposed to these organisms throughout our lives. “This prior exposure could potentially render the gene editing ineffective, with the body quickly eliminating all the CRISPR–Cas9 proteins. Or worse, it could trigger the kind of immune storm that killed a young gene therapy patient named Jesse Gelsinger in 1999, derailing the field for more than a decade. ‘We share everyone’s excitement about doing Cas9 genome editing, but we want to make sure we have learned from what happened in the gene therapy world and not ignore the possibility that this could become a problem,’ Porteus says. ‘As we’re all thinking about developing Cas9-based therapeutics, we should think carefully about this potential problem’.”

Pediatric Rabies Death
A 6-year-old boy in Florida has died from rabies he contracted after being scratched by an infected bat. The boy’s father reports that he found the sick bat, put it in a bucket, and told him not to touch it however, he did and was scratched. In response, the father had the boy wash his hands thoroughly based off what he read online and opted not to take him to the hospital because the boy didn’t want to get shots. Unfortunately, within a week, the boy became ill and even after attempts at treatment, passed away. Rabies is almost always fatal once symptoms appear, which highlights the importance of seeking care immediately after exposure.

Stories You May Have Missed:

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

Pandora Report 1.12.2018

 The Bright Side of Synthetic Biology and Crispr
GMU biodefense professor Sonia Ben Ouagrham-Gormley and Phd alum Shannon Fye-Marnien are looking at the realities of synthetic biology and fears of bioterrorism. Biological advances have inspired questions regarding the safety and potential for nefarious use, but are such technologies guilty until proven innocent or innocent until proven guilty? “As with previous advances in biology, Crispr is sometimes characterized as a blueprint for bioweapons development or bioterrorism, and it has elicited calls for increased control and regulation of science. But while it is important to examine the potential dangers of emerging technologies, reaching a balanced assessment of risks and benefits requires that technologies’ potential to improve human life be appreciated as well. Synthetic biology and Crispr offer a potentially enormous package of benefits, spanning from medicine to energy to agriculture and beyond. Discussions about the security and safety of synthetic biology and Crispr should not obscure these technologies’ potential to address a wide variety of complex and pressing problems.”

The United States Battles Influenza
Flu season is hitting hard in the United States as 46 states report widespread activity. 80% of cases are of the H3N2 strain, which is associated with severe symptoms and hospitalizations. “The flu is now widespread across the country and the peak of transmission probably occurred during the Christmas-New Year’s holiday week, just as many people were crowded into planes, buses and cars or in large family gatherings, said Dr. Daniel B. Jernigan, director of the influenza division of the Centers for Disease Control and Prevention. ‘H3N2 is a bad virus,’ Dr. Jernigan said. ‘We hate H3N2’.” 26 states (and New York City) are reporting high influenza-like illness (ILI) activity. The CDC has reported that “Influenza-like illness (ILI) went from 4.9% to 5.8%. ‎These indicators are similar to what was seen at the peak of the 2014-2015 season, which was the most severe season in recent years.” This tough influenza season is a helpful reminder that it could always get worse, especially in the context of the 1918/1919 influenza pandemic, which marks its centennial this year. Michael T. Osterholm and Mark Olshaker recently wrote an OpEd regarding the dismal truth – we’re not ready for a flu pandemic. Pointing to not only massive growth in population, but also challenges of supply shortages, and an outdated approach to vaccine research, they highlight the need to find a universal vaccine that can do battle against all influenza A strains with a longer immunity. “But there is no apparent effort to make these vaccines a priority in the current administration. Its national security strategy published last month cites Ebola and SARS as potential bioterrorism and pandemic threats, yet makes no mention of the risk of pandemic influenza nor any aspect of critical vaccine research and development. The next few weeks will highlight how ill prepared we are for even ‘ordinary’ flu. A worldwide influenza pandemic is literally the worst-case scenario in public health — yet far from an unthinkable occurrence. Unless we make changes, the question is not if but when it will come.”

GMU Biodefense Professor – Robert House
We’d like to welcome back professor Dr. Robert House to GMU biodefense, who will be teaching BioD766: Development of Vaccines and Therapeutics. Dr. House holds a PhD in medical parasitology and is a senior VP for government contracts at Ology Bioservices (previously Nanotherapeutics). The world faces a growing threat from microbiological agents in the form of terrorist weapons, pandemics (particularly influenza) and emerging/re-emerging diseases. Characteristics such as high pathogenicity/toxicity and lack of appropriate animal models, as well as lack of a viable commercial market, make it difficult to develop effective medical countermeasures for these agents. In his course, students will explore how the US Government is developing medical countermeasures (MCM) against these threats and will explore the various threat agents, the context of regulatory considerations, and the specifics of how MCMs are developed.

Infectious Disease Mapping Challenge Launched!
Do you love infectious diseases and maps? The goal of the challenge is to promote the use of geospatial mapping to address the objectives of the GHSA. The NextGen Network has partnered with the U.S. Department of State’s Virtual Student Foreign Service program to launch the 2018 challenge. You can find out more information from this engaging and informative webinar or at the page here. The deadline for signing up for the challenge is January 19, 2018. This is a great way to contribute to the GHSA goal of creating a world safe and secure from the threat of infectious diseases.

Biodefense Alum – Stay Connected! 
Are you a GMU Biodefense alum? If so, please make sure to keep your information updated in our Schar Stay Connected site. We have a strong alum community and would love to keep you up to date on future events and give shout outs for the amazing work our biodefense students accomplish.

Biopreparedness Needs to Start At the Frontlines of Disease Control
GMU biodefense PhD student and infection preventionist Saskia Popescu evaluates the attention to biopreparedness and how our focus on bioterrorism fails to address the major gaps within disease control in the United States. “The Blue Ribbon Panel report and the CNN article both highlight the bureaucratic challenges with coordination at a national level across many agencies and sectors. The crux of it all is that from a grass-roots level, we’re struggling to better prepare and respond for a host of reasons. Public health funding is always in a chronic state of too little too late and often, we don’t push out resources until we’re already in the throes of a major incident (Ebola, Zika, etc.). Preparing for biothreats, regardless of origin, requires that we strengthen the most basic surveillance and response systems within public health and health care. During the 2014–2015 Ebola outbreak, for example, there was a lot of attention on enhanced precautions. Although this was beneficial and brought attention to several gaps infection control and prevention measures, I found myself reminding staff that we can’t truly prepare and respond to rare events if we can’t get our daily practices down. The shear challenges of ensuring staff practice appropriate hand hygiene and isolation precautions in health care are indicators that we are struggling on the frontlines of disease preparedness.”

Lessons from A 2016 CRE Outbreak in A Kentucky Hospital
Hospital outbreaks are tough. The shear volume of people that go into a single patient’s room is considerable (healthcare workers, visitors, ancillary staff, etc.) and enough to spread germs throughout an entire hospital. Now imagine that the organism is a highly resistant one, such as carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE). A hospital in Kentucky experienced this very thing in 2016 and a recent CDC MMWR revealed just how difficult it can be to conquer an outbreak involving one of the worst resistant organisms you can imagine. “Over the next 4 months, scientists identified an additional 21 CRE isolates from patients at the hospital via screening and clinical cultures. The investigators believe organisms were imported into the facility and then spread among patients.” Epidemiological investigation found that five of the thirteen interviewed patients had received healthcare outside the local area and that three of the patients may have brought CP-CRE into the facility. “The authors of the report say their investigation highlights the potential role of cleaning equipment, which frequently moves between patient rooms, in CP-CRE spread. In addition, they note that although there is a low prevalence of CP-CRE in rural areas, rural hospitals should be aware that patients who’ve also accessed healthcare in areas with higher CP-CRE prevalence—primarily urban areas—can introduce these organisms into their facilities.”

Stories You May Have Missed:

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

Pandora Report 12.29.2017

This will be our last Pandora Report of 2017 and we’d like to take a moment and thank our wonderful readers for a great year of biodefense news! We hope you have a marvelous and safe New Years celebration. We’re starting the festivities early with some memories of infectious disease research from 2017.

Agroterrorism – A Threat To America’s Food Supply
Food vulnerability is not something people tend to think about very often and even less in the context of terrorism. There have been many experts noting that food safety is America’s soft underbelly for years, but just how vulnerable are we? “Agroterrorists have access to animal based bio-agents, which are easy to transport and simple to conceal. Just as ramming a speeding truck into a crowd is low-tech, an attack via the food chain has a low barrier to entry and little skill needed to execute. Weaponizing livestock is as simple as tending the flock or feeding the cattle. There is little expertise or special equipment required and given most animal borne pathogens are not communicable to humans, the logistics are easy. It really is farm to table pathogen delivery.” Increasing automation within food processing and rapid delivery from farm to table has the potential to be used as a weakness. Not only are these systems inherently weak against terrorist attacks, but one would severely damage the U.S. economy. A 2013 study found that outbreaks in FMD-free countries/zones could cause losses of more than $1.5 billion a year.

Biological Weapons Threat In The Spotlight – UN News
Check out this great podcast of UN news in which Dr. Tom Inglesby from the Johns Hopkins Center for Health Security discusses the BWC Meeting of States Parties and the importance of global cooperation to address biothreats. “He told Daniel Johnson that because most biological research now takes place ‘far outside the control of government’, a key objective should be to ensure that an information-sharing mechanism exists between industry and Member States.

Meeting of the Blue Ribbon Study Panel on Biodefense: SLTT Ability to Respond to Large-Scale Biological Events: Challenges and Solutions
Don’t miss this event on January 17th, 2018 in Miami, Florida! “The Nation continues to confront infectious disease events and the threat of biological terrorism. This meeting of the Study Panel, chaired by former Secretary of Health and Human Services Donna Shalala and former Representative James Greenwood, will provide the Study Panel with a better understanding of the ability of state, local, tribal, and territorial (SLTT) governments to: respond to large-scale biological events, identify and utilize SLTT assets and resources for immediate response (prior to a declaration of a SLTT biological emergency or disaster), operate before federal assistance arrives and after federal resources are exhausted, and shift to population management when a biological event overcomes pre-hospital and hospital response protocols.”

Analyzing the Detection and Response Aspects of Global Health Security
GMU biodefense PhD student Saskia Popescu is taking a trip down the detection and response rabbit hole of health security. Evaluating research on laboratory response networks, public health coordination, frontline epidemiology training, and more, she highlights the vulnerability we all share if even one country has a weak public health and healthcare infrastructure. “Response efforts often point to gaps within our plans, like the need to train staff on enhanced use of personal protective equipment during the Ebola outbreak, or cultural dynamics that challenge public health education efforts. Public health response is an evolving process and with each new challenge, lessons are learned and we hope that we can appropriately apply them in the future. The most important lesson is the global aspect of health security—an outbreak anywhere is an outbreak anywhere. Strengthening national prevention, detection, and response efforts will only serve to protect us all.”

WHO Priority List of Antibiotic-resistant Bacteria and Tuberculosis
The WHO has released a list of priority pathogens to help encourage the development of new antibiotics. “Detailing its findings in The Lancet Infectious Diseases yesterday, the WHO Pathogens Priority List Working Group used a multicriteria decision analysis method to select 20 antimicrobial-resistant bacteria. The experts then applied 10 criteria to assess priority: mortality, healthcare burden, community burden, prevalence of resistance, 10-year resistance trends, transmissibility, preventability in the community, preventability in healthcare settings, treatability, and drug pipeline.” The list of 20 bacterial species highlights three categories (critical, high, and medium priority), which includes “carbapenem-resistant Acinetobacter baumannii andPseudomonas aeruginosa, and carbapenem-resistant and third-generation cephalosporin-resistant Enterobacteriaceae. The highest ranked Gram-positive bacteria (high priority) were vancomycin-resistantEnterococcus faecium and meticillin-resistant Staphylococcus aureus. Of the bacteria typically responsible for community-acquired infections, clarithromycin-resistant Helicobacter pylori, and fluoroquinolone-resistantCampylobacter spp, Neisseria gonorrhoeae, and Salmonella typhi were included in the high-priority tier.”

 Drug Discovery, Development and Deployment
Speaking of the importance of drug R&D…the NIH has released their Drug Discovery, Development and Deployment Maps (4DM) to help engage and support this complicated process. There are two maps – one for small molecules and one for biologics, using monoclonal antibodies as the representative therapeutic. “The maps provide a common framework for discussing the therapeutic development process and serve as an education tool for those who are new to it. A common language and collective knowledge base for therapeutic development is essential to enable systemwide improvements that will benefit patients. The 4DM can help facilitate dialogue among those interested or participating in drug development to explore innovative solutions to existing bottlenecks and potential collaborative action to overcome those barriers and accelerate new medicine discovery.”

Bird Flu in South Korea
Avian influenza is wreaking havoc in South Korea. Officials have reported the culling of 201,000 birds in efforts to prevent the spread of H5N6 after it was found in four duck farms. “Last year, South Korea slaughtered more than 30 million birds to contain the worst outbreak of bird flu in the country‘s history.” Such efforts are especially important as the country prepares to host the Winter Olympics, which begin on February 9, 2018.

ASM Supports NIH Decision To Lift Funding Pause on GoF Research
Last week saw a surge of news regarding the official lift on the funding moratorium on GoF research. The news released an onslaught of over-the-top headlines and debates, but nonetheless the existence of GoF research will likely remain one that sparks concerns on both ends of the spectrum. The American Society for Microbiology (ASM) has come out in support of the lift on the funding pause though, noting that they are “in complete support of the National Institutes of Health lifting the funding pause on gain-of-function (GoF) experiments involving influenza, SARS, and MERS viruses. GoF research studies ways nature might make some viruses more virulent or transmissible. This is important in helping identify and develop strategies and effective countermeasures against rapidly evolving pathogens that pose a threat to public health, as well as to prepare for pandemics. ASM also applauds the review framework released by the Department of Health and Human Services. This process will ensure that any proposal that passes scientific peer review and fits the Potential Pandemic Pathogen (PPP) definition will undergo a multidisciplinary review process before funding is received. The review panel will provide oversight and facilitate safe and responsible conduct of this type of research.”

Stories You May Have Missed:

  • United States Flu Season Update– This flu season is already shaping up to be rough, so where are we? “Influenza A viruses have been most commonly identified, with influenza A(H3N2) viruses predominating. Several influenza activity indicators were higher than is typically seen for this time of year. The majority of influenza viruses characterized during this period were genetically or antigenically similar to the 2017–18 Northern Hemisphere cell-grown vaccine reference viruses. These data indicate that currently circulating viruses have not undergone significant antigenic drift; however, circulating A(H3N2) viruses are antigenically less similar to egg-grown A(H3N2) viruses used for producing the majority of influenza vaccines in the United States.” Outpatient visits have spiked with patients seeking care for influenza-like illness (ILI) across the U.S. The national average is 2.2% and last week saw 2.7% however, this week is now 3.5%, which points to a growing influenza season.

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

Pandora Report 12.22.2017

Happy Holidays from your friends at the Pandora Report! We hope you have a lovely holiday weekend and enjoy this warm cup o’biodefense. If you’re still looking for the perfect gift for a microbe-loving person in your life, check out the latest holiday pack here.

International Criminal Court Adds Use of Biological Weapons to Rome Statute
Last week, during the Assembly of States Parties to the ICC, it was decided that three new crimes would be now be classified as war crimes within the Rome Statute. “The new war crimes added to the Rome Statute are, respectively, the use of biological and toxin weapons, the use of weapons causing injuries by fragments which in the human body escape detection by X-rays and the use of laser weapons causing permanent blindness. These weapons kill without discrimination or inflict very severe suffering. Their elevation to the rank of war crimes strengthens international law. The use of these weapons during armed conflicts will become even more difficult. The inscription of these new crimes in the Statute of Rome ensures also legal certainty to the victims and gives a specific recognition to their pain.” The Belgium Ministry of Foreign Affairs has come forward noting that “It was Belgium that had proposed these amendments to the Statute, the founding treaty of the ICC, as early as 2009. Belgium has tirelessly mobilized, through its diplomatic network and the voices of its foreign ministers, its ministers of justice and even its prime ministers to promote the adoption of these amendments.”

2017 National Security Strategy – Biodefense
Just in the nick of time, the National Security Strategy was released – and with a biodefense gem hidden on page 9! Pillar 1 (of 4) within the NSS includes a section on securing U.S. borders and territories, in which the “combat biothreats and pandemics” section is buried. Citing biological threats, whether it be natural outbreaks like Ebola, bioterrorism, or advancements in life sciences that have the potential to be mis-used, the NSS includes several priority actions. The three priority actions to combat biological threats are: “detect and contain biothreats at their source, support biomedical innovation, and improve emergency response. ”

Trump’s Biodefense Strategy – Naught, Nice, or MIA?
GMU biodefense MS student Janet Marroquin is taking a look at the Trump administration’s biodefense strategy and what the past year has shown us in terms of what we can expect. With the release of the NSS this past week, some direction is being given, but just how far have we come in terms of a true strategy? Marroquin delves into the nitty gritty and also gives us a holiday wish list for what we’d like to see on a biodefense strategy. She notes that “An important reform present in the proposed FY 2018 Federal budget is the call to dismantle the Academic Centers for Public Health Preparedness under the CDC and the distribution of its funds among state governments to support state-led public health preparedness.  Interestingly, this action seems to contradict expert recommendations to the federal government for the development of a centralized approach to health security.” In response to the release of the NSS, the Blue Ribbon Study Panel has released a statement and highlights, like Marroquin, the importance of a comprehensive approach.

Congrats to GMU’s Biodefense December Graduates!
We’re excited to announce the graduation of several GMU Biodefense students this winter. Congrats to our students graduating with a MS: Zamawang Almemar, Alexander Rowe, and Stephanie Smith – and congrats to those graduating with a Certificate in Biodefense: Mi Chung and Mary Oberlies. We can’t wait to see where the future takes you and the amazing biodefense adventures you’ll have!

Federal Funding Resumes for Gain-of-Function Research
On Tuesday, it was announced that DHHS has ended the funding pause on GoF research. Suspended since the 2014 moratorium, guidance was released in January of this year by the White House Office of Science and Technology Policy (OSTP) for individual agencies reviewing research. While the OSTP P3C0 recommendations provided guidance for agencies looking to conduct, support, or planning to conduct such research, its sole purpose was “to recommend consistent and appropriate Federal agency review and reporting processes for the enhanced oversight of Federally funded research that is anticipated to create, transfer, or use enhanced pathogens with pandemic potential.” In fact, once agencies adopted a review process and satisfied such requirements, they could lift their moratorium on GoF research. It is this week’s NIH announcement however, that fully lifted the moratorium and provided framework for guiding funding decisions about such research (FYI – you won’t find many differences between the framework and the OSTP P3C0).  “The framework, condensed into a 6-page document, spells out a multidisciplinary review process that involved the funding agency and a department-level review group that considers the merits and possible research benefits and the potential to create, transfer, or use an enhanced potential pandemic pathogen (PPP).” Funding for GoF research on potential pandemic pathogens, like SARS, MERS, and avian influenza, was resumed jointly with the DHHS framework that seeks to guide funding of proposed research that would involve enhancing such pathogens. “The HHS P3CO Framework is responsive to and in accordance with the ‘Recommended Policy Guidance for Departmental Development of Review Mechanisms for Potential Pandemic Pathogen Care and Oversight’ issued on January 9, 2017  and supersedes the previous ‘Framework for Guiding U.S. Department of Health and Human Services Funding Decisions about Research Proposals with the Potential for Generating Highly Pathogenic Avian Influenza H5N1 Viruses that are Transmissible among Mammals by Respiratory Droplets’.” The new framework includes 8 criteria for department-level review, which includes “An assessment of the overall potential risks and benefits associated with the research determines that the potential risks as compared to the potential benefits to society are justified” and “The research will be supported through funding mechanisms that allow for appropriate management of risks and ongoing Federal and institutional oversight of all aspects of the research throughout the course of the research”.

GMU Biodefense Student Tackles USPS Safety
Speaking of awesome things GMU biodefense graduates are doing…Stephanie Smith is using her forensic chemistry background and new biodefense degree to tackle safety in the USPS. “I’m a forensic chemist by training, that’s what I’ve done my entire career,” she said. “I came to Mason to study the ‘bio-side’ of this complex advisor position, but I realized I was also expanding my knowledge beyond science and into the policy side.” Having studied a range of different topics like agroterrorism and biosurveillance during her time at GMU, Smith’s capstone project “was based on her idea that the method of detecting bioagents in the mail could be improved.” While she was working on her studies at GMU, she was also working at the USPS within the Security and Crime Prevention Group and was tasked with writing the job description for a new permanent scientific advisor position. “Once Smith wrote the job description for the new position of ‘Scientific and Technical Advisor, Dangerous Mail Investigations’ for the Postal Inspection Service, it was determined there was only one person qualified to fill a job that required knowledge of chemistry, biodefense, security and public policy. That would be Stephanie Smith. She got the job.”

2017-2018 PHEMCE Strategy and Implementation Plan
The latest Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) SIP has been released, which highlights some of the priorities that the Department of Health and Human Services will focus on over the next five years. Within the SIP, you can find a summary of the major accomplishments, new activities, updates to the 2016 SIP activities, and specific information required annually under the Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA). The latest SIP includes accomplishments from 2016 that include regulatory science management, Zika and Ebola response, international collaboration on MCMs, etc. Some of the new projects include Ebola response, bacterial threat projects like CARB-X, etc. You can also read the PHEMCE multi-year budget for fiscal years 2016-2020 here.

GMU Biodefense Students Visit DARPA
If you’ve ever wondered what it’s like to go inside the walls of the Defense Advanced Research Projects Agency (DARPA), this article is just for you! GMU biodefense professor Andrew Kilianski took students from one of his classes to visit DARPA and gain a better understanding of their biodefense efforts. Dr. Kilianski is currently a biological scientist at the DoD and his work focuses on combating current and future threats from weapons of mass destruction in addition to teaching classes on biosurveillance and virology in the GMU Biodefense graduate program. In this segment, biodefense MS student Janet Marroquin takes us on a tour of DARPA and some of the fascinating projects they work on. “These projects range from surveillance tools to diagnostics and therapeutics, using futuristic mechanisms such as a dialysis-like purification of pathogen-infected blood or unobtrusive nanoplatforms that continuously monitor the physiological state of the patient for the detection of infectious disease. ”

Preventing An “Outbreak Anywhere” From Becoming An “Outbreak Everywhere”
GMU Biodefense PhD student Saskia Popescu is addressing the trifecta of efforts within global health security – prevention, detection, and response. Drawing on the special edition Emerging Infectious Disease journal, she highlights the importance of prevention and the obstacles that are often met. “Prevention is the first component to health security, but in many ways, it is also the most difficult. Biological threats can come from anywhere: a naturally occurring outbreak, a laboratory accident, or even an act of biological terrorism. How do we prevent biothreats when they come from so many directions? Zoonotic diseases are one place to start as more than 60% of known diseases spread from animals and roughly 75% of new or emerging diseases in humans spread from animals.”

Is Captain America A Biological Weapon?
Attending the Biological Weapons Convention will make you ponder such things and Matt Shearer from the Johns Hopkins Center for Health Security is venturing down that rabbit hole. Article I of the BWC states that each state party will not develop, produce, stockpile, or otherwise acquire or retain “microbial or other biological agents, or toxins whatever their origin or method of production, of types and in quantities that have no justification for prophylactic, protective or other peaceful purposes;” and “weapons, equipment or means of delivery designed to use such agents or toxins for hostile purposes or in armed conflict.” Shearer poses a unique question about what constitutes a biological agent – what if there is no infection but rather a human who has been enhanced? “But normal humans, animals, and plants do not seem to count as “other biological agents” in the context of the BWC, but what about enhanced or modified versions like Captain America or, perish the thought, the accidentally enhanced Teenage Mutant Ninja Turtles? Have we been unwittingly cheering for bioweapons this whole time?”

Stories You May Have Missed: 

  • Cadavers in the Ballroom – Shockingly, this not the title of a zombie wedding movie, but rather a reality of medical conferences. This recent article found that some medical conferences, operating in grand ballrooms, utilize cadavers and body parts for teaching at their lectures. “When the deceased are cut open, there’s an increased risk of a disease being transmitted to others, said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. ‘I will be the first to acknowledge there have been no big outbreaks or situations that have occurred yet from a dead body,’ Osterholm said. ‘But I am absolutely convinced it’s just a matter of time’.”
  • Building A National Capability to Monitor and Assess Medical Countermeasures Use During A Public Health Emergency – Don’t miss the latest NAS report on MCM use. “During public health emergencies (PHEs) involving chemical, biological, radiological, or nuclear threats or emerging infectious diseases, medical countermeasures (MCMs) (e.g., drugs, vaccines, devices) may need to be dispensed or administered to affected populations to help mitigate the human health impact of the threat. The optimal MCMs determined for use during an emergency might be U.S. Food and Drug Administration (FDA) approved but used in unapproved ways (e.g., in a new age group or against a new agent); FDA approved using animal models because human efficacy testing is not ethical or feasible; or not yet FDA approved for any indication.”

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

Pandora Report 12.15.2017

Welcome back to your weekly dose of all things biodefense! We’ve got a packed newsletter for you, so buckle up. Curious about CRISPR and how it works? Check out the best and worst analogies here.

Read Out On The GHSA Ministerial Meeting in Kampala
If you missed our Read-Out on the GHSA meeting in Kampala, we’ve got a great overview with attachments. The NextGen Global Health Security Network Reflections can be found here and Coordinator Jamechia Hoyle was kind enough to provide her powerpoint from the Read-Out, which you can access here. The Read-Out involved presentations and discussions from not only NextGen GHSA Coordinator Hoyle, but also Jennifer Nuzzo from the Center from Health Security, and two GMU Biodefense MS students – Anthony Falzarano and Stephen Taylor. In fact, Anthony and Stephen provided several great photos from the Kampala summit, which you can see here. “While they discussed that the dialogue was driven by high level members of government. The overall consensus was the need to bring in non-governmental and academic voices. The panel members emphasized this by showcasing the work with Next Generation Global Health Security Leaders and the continued efforts to bring young professionals and students into these working groups. From the discussion, it is evident that GHSA’s efforts are being felt in many nations. The Response Center in Uganda, while small, had the hallmarks of the CDC and other organizational support.” Dr. Nuzzo brought her talk to a close with a poignant quote from the summit – “it is much cheaper to spend on preparedness than it is to spend on response.” Attendee and biodefense MS student Janet Marroquin noted that “the containment of the Marburg virus in Uganda during the conference perfectly illustrated the benefits of improved health security measures, but it is easy to overlook this success when good health is expected as a guarantee. In addition to bringing attention to current deficiencies in global health security, the GHSA is needed to look to the future and anticipate and prevent roadblocks in implementation.”

Biological Weapons Convention Meeting of States Parties – Recap
Last week, GMU biodefense PhD student Saskia Popescu attended the Biological Weapons Convention Meeting of States Parties (MSP) with the Johns Hopkins Center for Health Security ELBI program. This MSP started on somewhat of a bated breath as last year’s Review Conference was, as described by many, an epic failure. Having endorsed the Joint NGO Statement, Popescu noted that “the role of the NGOs felt even more important in such a disjointed climate where the future of the BWC was in many ways, up in the air. The importance of support and pushing for future cohesion regarding not only the intersessional process (ISP), but also S&T developments, was a significant point within the NGO statement.” As you can find in many of the live-tweeting that was occurring (#MSP2017), the MSP started off with a bang as Iran noted that they were not convinced further ISP work would be productive and if the BWC isn’t legally binding, it can’t truly be universal. Chairman Gill started the MSP with a quote from Rumi and worked tirelessly to maintain focus and forward momentum. Thankfully, despite several days of closed-door discussion, consensus was reached and the ISP was established to include 4 days of meetings of the MSP and 5 meetings of experts, which would focus on cooperation and assistance, development S&T, strengthening national implementation, assistance for preparedness and response, and the institutional strength of the BWC.  You can also find detailed overviews of each day here. A few of Popescu’s favorite moments from attending: “Sweden’s inclusion of antimicrobial resistance in their opening statement, Australia’s comments on the need for a more diverse attendance in the future and the growing presence of women within the BWC. It was also surprising how shockingly low the states costs for BWC inclusion are…and how some are delinquent by a few hundred dollars. Lastly and perhaps the most important part of the trip was getting to attend a pivotal event in biodefense history with such an amazing group of people who were all as excited and enthusiastic as I was. As we took a break to visit the WHO and peered upon the famous smallpox statue, I think it all hit us how vital this work is on a global level.”

Jurassic Ticks?
Paleontologists have recently announced the finding of a 99-million-year-old tick that not only was holding on for dear life within the feathers of a dinosaur, but provides evidence that these blood-suckers fed on dinosaurs. While this tick came from the Cretaceous period, it feels eerily similar to how Jurassic Park began. “This study provides the most compelling evidence to date for ticks feeding on feathered animals in the Cretaceous,” said Ryan C. McKellar, a paleontologist at the Royal Saskatchewan Museum in Canada who was not involved in the study. “It demonstrates just how much detail can be obtained from a few pieces of amber in the hands of the right researchers.” Imagine the kind of dino-arboviruses we might come across with this finding! It’s hard not to chuckle at the timing of the announcement since the latest Jurassic World movie trailer was released just last week.

Podcast “Syria(s) Problem: Chemical Weapons & International Norms from Power Problems
Don’t miss this episode of the bi-weekly podcast Power Problems from the Cato Institute hosted by Emma Ashford and GMU biodefense professor Trevor Thrall. In this episode on the use of chemical weapons in Syria, GMU biodefense professor and graduate program director Gregory Koblentz discusses how the use of such weapons calls into question the utility of international norms. Some of the show notes also include the discussion of taboos against chemical weapons, and antibiotic resistance as a biological threat.

Is North Korea’s Bioweapons Threat Growing With Increasing Biotech Expertise?
Are the technical hurdles to biological weapons eroding in North Korea? Advances in the life sciences have brought forth a wealth of new capabilities, like manipulating DNA, but are we also lowering the bar for bioweapons development? There’s been increasing talk regarding the potential for North Korea to develop and deploy biological weapons. While there certainly has been a lowering of technical hurdles in some aspects of bioweapons development, has North Korea truly developed a functioning program? “The gains have alarmed U.S. analysts, who say North Korea — which has doggedly pursued weapons of mass destruction of every other variety — could quickly surge into industrial-scale production of biological pathogens if it chooses to do so. Such a move could give the regime yet another fearsome weapon with which to threaten neighbors or U.S. troops in a future conflict, officials and analysts say. Current and former U.S. officials with access to classified files say they have seen no hard evidence so far that Kim has ordered production of actual weapons, beyond samples and prototypes. And they can only speculate about the reasons.” Many note that their possession of biological agents is known but that the unknown is just how far along a bioweapons program might be. The development of a high-functioning and successful bioweapons program requires significant funding, human resources, and tacit knowledge. Dr. Sonia Ben Ouagrham-Gormley recently broke down just how realistic these concerns are (hint: she’s a GMU biodefense professor and guru on tacit knowledge). In response to this week’s increased attention on a potential program in North Korea, Dr. Ben Ouagrham-Gormley was also interviewed regarding the cost of a biological weapons program and just how much it would take to truly develop and maintain one. “The cost of maintaining an active biological weapons program is high, according to Sonia Ben Ouagrham-Gormley, associate professor in the Schar School of Policy and Government at George Mason University. She said the Soviet Union spent ‘several billion dollars’ on its program, while terrorist group Aum Shinrikyo spent about $10 million, though the latter ‘failed at every step.’ The United States spent about $700 million on its program, which was active over the course of roughly 27 years. ‘The challenge is in acquiring the expertise to handle and manipulate living organisms that are fragile and unpredictable: that requires time and a work organization that ensure continuity and stability of work,’ Ben Ouagrham-Gormley said. ‘These are conditions that are difficult to maintain in a covert program. That’s why most covert bioweapons programs have failed thus far’.”

Global Health Security and the US Export Economy
It’s easy for many to think that outbreaks only impacts public health, but the truth is that the effects of health security threats are felt across many sectors and industries. The export economy is not immune to disruption should there be a public health emergency. A recent study reviewed economic vulnerability to the US export economy that would be impacted by disruptions in 49 countries. These 49 countries are currently being targeted by the CDC and partners to improve capabilities to prevent/respond to public health infectious disease threats throughout laboratories, workforce, surveillance, and response systems. Enhancing global health security by strengthening the country capacity is the goal for these 49 countries. “US exports to the 49 countries exceeded $308 billion and supported more than 1.6 million jobs across all US states in agriculture, manufacturing, mining, oil and gas, services, and other sectors. These exports represented 13.7% of all US export revenue worldwide and 14.3% of all US jobs supported by all US exports. The economic linkages between the United States and these global health security priority countries illustrate the importance of ensuring that countries have the public health capacities needed to control outbreaks at their source before they become pandemics.” The numbers are startling, especially if you consider that the 2002-2003 SARS epidemic was estimated to have a global economic impact of almost $40 billion USD. The total value of US material goods/services exported to all countries was estimated to be $2.3 trillion in 2015. The findings of this study point to the significant economic disruption that would occur if a health security event occurred in one of these 49 countries. Global health security is truly an investment that provides a return, as we know that an outbreak anywhere is an outbreak everywhere.

CyberbiosecurityDNA Has Gone Digital – What Could Possibly Go Wrong?
As biotechnology and biology go full-steam ahead, there is increasing use of technology and informatics databases to support such innovation. Where does that leave us in terms of cybersecurity? Coined as “cyberbiosecurity”, many in the field, like Colorado State University’s Jean Peccoud, are drawing attention to the risk this new frontier has for researchers, industry, and the government. Peccoud and his colleagues point to the potential for accidental or intentional breaches, noting that “In the past, most biosecurity and biosafety policies were based on sample containment,” Peccoud says. “Now, it’s so easy to read DNA sequences, for example, or to make DNA molecules out of sequences publicly available from bioinformatics databases. Most projects have a cyber dimension, and that introduces a new category of risk.” Traditional biosecurity efforts focus on containment of the organism from accidental or nefarious use, but that doesn’t really focus on the computational aspect of new biotech, like synthetic biology. “The authors recommend employee training, systematic analyses to examine potential exposure to cyberbiosecurity risks, and the development of new policies for preventing and detecting security incidents. ‘Once individuals in a community are aware of cyberbiosecurity risks, they can begin to implement safeguards within their own work environments, and work with regulators to develop policies to prevent cyberbiosecurity breaches,’ they write.” Peccoud also pointed to the potential for computer viruses to impact the physical world. Citing the 2010 computer virus that caused equipment failure at an Iranian nuclear plant, such malware could result in biological outcomes that could be dangerous. It doesn’t take much of a venture down the rabbit hole to think about the automated processes that are used in laboratories, especially high-containment labs, and how they could be damaging if commandeered for nefarious purposes. So what can be done? The first step is truly recognizing the threat – “The threats are bidirectional. And not all cyberbiosecurity threats are premeditated or criminal. Unintentional errors that occur while translating between a physical DNA molecule and its digital reference are common. These errors might not compromise national security, but they could cause costly delays or product recalls.” Synthetic biology and biotech have taken us to places we would’ve never dreamed of, but it’s critical that the ability to manipulate DNA be protected through proper measures and we protect the digital components as well. The growing attention to cyberbiosecurity also comes at a time when the FDA has issued a warning on DIY gene therapy, noting that “the sale of these products is against the law. FDA is concnered about the safety risks involved.” “Last month, Josiah Zayner, CEO of The Odin, which sells DIY biology kits and supplies through its website, posted a video in which he injected himself with the gene-editing tool CRISPR during a biohacker conference in California. That video has been viewed more than 58,000 times on YouTube. In its statement, which FDA Commissioner Scott Gottlieb tweeted on November 21, the same day it was posted to the agency’s website, the regulator took aim directly at companies selling CRISPR supplies intended for self-administration.”

Biodosimetry: A Future Tool for Medical Management of Radiological Emergencies                                                                                                                          How can we better manage patients in radiological emergencies? GMU biodefense PhD student Mary Sproull and professor/graduate program director Gregory Koblentz are looking at biodosimetry as a medical management tool for this very predicament. “The field of radiation biodosimetry has advanced far beyond its original objectives to identify new methodologies to quantitate unknown levels of radiation exposure that may be applied in a mass screening setting. New research in the areas of genomics, proteomics, metabolomics, transcriptomics, and electron paramagnetic resonance (EPR) applications have identified novel biological indicators of radiation injury from a diverse array of biological sample materials, and studies continue to develop more advanced models of radiation exposure and injury. In this article, we identify the urgent need for new biodosimetry assessment technologies, describe how biodosimetry diagnostics work in the context of a broad range of radiation exposure types and scenarios, review the current state of the science, and assess how well integrated biodosimetry resources are in the national radiological emergency response framework.”

Fellowship in Grand Strategy, Security, and Statecraft
The International Security Program of Harvard Kennedy School’s Belfer Center for Science and International Affairs and the MIT Security Studies Program at the Center for International Studies in the School of Humanities, Arts, and Social Sciences are launching a collaborative program to mentor the next generation of foreign policy scholars. The Project on Grand Strategy, Security, and Statecraft is made possible with support from the Charles Koch Foundation: a $1,846,200 grant to MIT and one for $1,853,900 to Harvard Kennedy School (HKS). Those interested in this fellowship should apply to the International Security Program Fellowship when the Belfer Center’s online application system becomes available on December 15, 2017.  Those desiring to apply before then may apply through MIT’s application system. For more information, click here.

National Academies Publication – Combating Antibiotic Resistance
The National Academies has released their latest report on a one health approach to the global threat that is antimicrobial resistance. “As of 2017, the emergence and spread of antimicrobial resistance continues unabated around the world, leaving devastating health and economic outcomes in its wake. Those consequences will multiply if collaborative global action is not taken to address the spread of resistance. Major drivers of antimicrobial resistance in humans have been accelerated by inappropriate antimicrobial prescribing in health care practices; the inappropriate use of antimicrobials in livestock; and the promulgation of antibiotic resistance genes in the environment.” The report focuses on the global momentum to counter AMR, microbial movements across the one health domain, utilization of social and behavioral sciences to combat AMR, R&D, and strengthening partnerships and international cooperation. AMR is a multi-sectoral, international problem that requires a One Health approach to combat it – reports like these are a critical step towards combatting AMR

Boston University’s Needle Gets the Greenlight
After years of controversy and $200 million in federal funds spent on a BSL 4 high-containment lab, the Boston University Lab “The Needle” is finally opening. Located in the heart of the city, local citizens raised substantial opposition over biosafety concerns for the neighboring areas. It’s taken nearly a decade to get to this point, but the Boston Public Health Commission gave the official greenlight for the lab to open. “The commission’s OK was the final step allowing the study of Biosafety Level 4 pathogens — those that have no treatment or vaccine, such as Ebola. Level 4 research could begin in a month or two at the facility, called the National Emerging Infectious Disease Laboratories. Facing fierce opposition from neighbors and others concerned that dangerous germs would escape, the biolab underwent more than a dozen years of risk assessments, public hearings, and failed lawsuits. It received more than 50 permits and approvals from federal, state, and city agencies, most recently passing muster a year ago with the US Centers for Disease Control and Prevention.”

Doreen and Jim McElvany Nonproliferation Challenge
To advance this goal, the Doreen and Jim McElvany Nonproliferation Challenge will recognize the most outstanding new ideas and policy proposals published in Volume 25 (2018) of the Nonproliferation Review. The Challenge will award a grand prize of $5,000, a $3,000 runner’s-up prize, and a $1,000 honorable mention prize. The deadline to submit is 11:59 pm/EST, July 6, 2018. However, due to the limited number of pages that we can publish in a single volume, eligible articles will be accepted for publication on a rolling basis. We therefore encourage interested authors to submit early. Decisions on the winners of the scholarly award will be announced in early 2019

Stories You May Have Missed:

  • Most Americans Think A Zombie Pandemic Is Likely – We recently stumbled across this survey and were surprised to find that while a surprisingly high number of Americans think a zombie plague is going to happen, few are prepared for it. “Only 9% of respondents considered it likely that undead zombies might ever walk the earth. Nearly three times that many respondents (28%) consider it likely that a worldwide epidemic of a neurological disease that makes people more aggressive and likely to lose control of their thoughts and motor functions.”

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

Pandora Report 12.1.2017

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

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

Pandora Report 11.17.2017

Happy Friday – we hope you had a wonderful time celebrating Antibiotic Awareness Week! As Canada reports rising antibiotic resistance despite decreasing use of antibiotics in humans and animals, it’s important we recognize the importance of stewardship and infection control. November 13-19 marks Antibiotic Awareness week, in which we observe the importance of proper antibiotic use and prescribing practices. In the United States alone, 23,000 people die a year due to an infection that was resistant to antimicrobials. Help stop antimicrobial resistance through antibiotic stewardship.

GMU Biodefense MS student Stephen Taylor

Reflections from the GHSA Ministerial Meeting in Kampala, Uganda
The recent GHSA Ministerial Meeting was not only a success, but also reaffirmed the importance of the agenda and those dedicated to combatting health security threats. We’re excited to provide you with a series of on-the-ground reflections from those who participated through the George Mason Global Health Security Ambassador Fellowship and the Next Generation Global Health Security Network. Within these reflections, you’ll get to hear from Next Generation Coordinator Jamechia D. Hoyle and a wonderful array of international students and professionals. Hoyle notes that “the meeting was called to order during a time where health security professionals were addressing a plague outbreak in Madagascar and a local Marburg outbreak in the host country, Uganda.  This alone was a vivid reminder that health security must remain a priority.” The reflections present unique outlooks on the meeting and range from detailed descriptions of the sessions to visiting the Uganda Virus Research Institute, and more. Make sure you catch reflections from GMU biodefense MS students Anthony Falzarano and Stephen Taylor!

Did Russia Accidentally Provide the Best Evidence of the Syrian Government’s Involvement in Sarin Attacks?
Russia has been trying to downplay the Syrian government’s role in chemical weapons attacks, but their latest press conference may have just backfired on them. The November 2nd press conference in which Russian officials responded to the Organization for the Prohibition of Chemical Weapons – UN Join Mission, included a presentation that revealed a bit more than anticipated. “The presentation included a series of slides, which included diagrams of two types of chemical bombs, designated the MYM6000 and M4000. Remarkably, the Russian presentation appears to be the first-time images of these munitions have been made public, and before the press conference, no other references to MYM6000 or M4000 bombs appear online.” GMU Biodefense Graduate Program Director and Professor Dr. Gregory Koblentz noted that “‘these designations match bombs declared by Syria to the OPCW’, although there appears to be no open source material that provides specifics about the types of bombs declared to the OPCW. In the press conference the source of the diagrams are described as being provided ‘by certain organisations’, but no more specifics are given.” The Russian presentation diagrams provide some pretty clear matches between munitions found during investigations into the attacks. “The only way for the Russian or Syrian governments to now deny the M4000 bomb was used is to produce detailed photographs of the M4000 bomb, showing the same parts indicated above, or, if the Syrians still claim all these bombs were destroyed after 2013, declassify and publish further information about the bomb.”

The Center for Global Security Research – Student Internship                     The Center for Global Security Research, Lawrence Livermore National Laboratory is now accepting applications for Spring 2018 student internships! “The Center for Global Security Research (CGSR) was established at Lawrence Livermore National Laboratory (LLNL) in 1996 to bring together experts from the science, technology, and policy communities to address pressing national security challenges. For more than 20 years, CGSR has engaged diverse perspectives on topics important to national security, deterrence, diplomacy, dual-use technology, arms control, nonproliferation, peacekeeping, cyber defense and energy security.”

A Field Test of CRISPR
Researchers are getting to test, for the first time, treatment of a genetic disorder with gene-editing tools infused into the patient’s blood. The 44-year-old man suffers from Hunter syndrome, which is a metabolic disorder. “The company (Sangamo Therapeutics) inserts a replacement copy of the gene, using gene editing to snip the DNA helix of liver cells in a specific place near the promotor, or on-off switch, for the gene for a protein called albumin. The cells fix the damage by inserting the DNA for the new gene, supplied by the researchers along with the gene editor’s DNA scissors, and the gene’s activity is then controlled by the powerful albumin promotor. The idea is to turn these modified liver cells into a factory for making the enzyme missing in Hunter syndrome.” This is an exciting step forward for gene-editing technologies and their ability to treat chronic diseases. Curious what CRISPR looks like in action? Check out this video here.

Call for Papers- Women’s Health in Global Perspective
World Medical & Health Policy’s call for papers on Women’s Health in Global Perspective seeks to contribute to understanding and improve policy on women’s health and wellbeing around the world. Manuscripts on all factors that influence health outcomes for women will be considered, including social determinants such as education, nutrition, poverty, violence, access to health care, job opportunities and personal freedom.  The 2018 Workshop on Women’s Health in Global Perspective will follow a successful 2016 workshop by the same name (see video at http://www.ipsonet.org/conferences/whgp/2016-womens-health-in-global-perspective-videos), which resulted in a special issue http://onlinelibrary.wiley.com/wol1/doi/10.1002/wmh3.212/full and an ongoing series of articles in WMHP highlighting global women’s health issues and their implications for economic, political and social development. Abstract submission deadline (250 words): December 15, 2017. Contact: Bonnie Stabile, Co-Editor, bstabile@gmu.edu

Three Decades of Responding to Infectious Disease Threats
NIAID Director Anthony Fauci has been fighting infectious diseases in his role since 1984. After 30+ years of work, Dr. Fauci undoubtedly has some fascinating stories, whether it be from the beginning of the HIV pandemic or SARS. “Initial responses to a newly recognized disease, now known as HIV/AIDS, in the early 1980s were criticized as being too slow, the essay notes. ‘The insidious emergence of HIV/AIDS and the lack of due attention by policymakers illustrate how some outbreaks that start subtly can grow to global proportions if they are not aggressively addressed early on,’ Dr. Fauci writes. Between the early 1980s and the early 1990s, federal funding for HIV/AIDS research increased markedly, reaching $1 billion by the end of 1992. The accelerated government response supported both research and research infrastructure, and yielded advances in countering the HIV/AIDS pandemic domestically and internationally. Ultimately, notes Dr. Fauci, sustained support for scientific research coupled with political and community engagement helped transform HIV/AIDS from a nearly universally fatal disease to a condition that can be managed with appropriate treatment.”

The One Health Commission’s Call to Action for Social Scientists
“The One Health Commission, a 501(c)(3) global non-profit organization based in the U.S., stresses recognition of human, animal, and ecosystems interconnections and facilitates collaboration of all professions required to achieve global and planetary health. The One Health Social Sciences Team invites social scientists of all disciplines to become involved in the One Health community. By forging new and innovative partnerships, collaborations across human, animal, plant and ecosystem health communities will collectively enable betterment of health and well-being for all.” To learn more and get involved please contact the One Health and Social Sciences Working Group at ohss@onehealthcommission.org.

What Should The US National Biodefense Strategy Look Like?                                                                                                     The complex nature and painful lessons of biological threats, regardless of source, have challenged U.S. biodefense efforts for decades. As the Blue Ribbon Study Panel on Biodefense pointed out in their report, there is a general lack of clear leadership and coordination. The 2016 National Defense Authorization Act required that the DoD, DHHS, DHS, and USDA, all develop a national biodefense strategy and plan for implantation. Laura H. Kahn has provided a handful of critical strategies that are necessary. “First, human-intelligence-based monitoring of rogue nations and militant groups that use bioweapons is critical. Second, a national strategy must include a plan for disease surveillance of humans and animals, with a view to predicting the next naturally occurring epidemic. This kind of work is difficult, because there are so many viruses that could spill over from other mammals or birds into humans.” Kahn also highlights laboratory security and the importance of high-containment lab biosecurity, review of the Federal Select Agent Program, investigation of large-scale wildlife die-offs, and recognizing the importance of One Health. “Threat to one component in this triad threatens them all. For that reason, animal and environmental health must be taken just as seriously as human health—which requires devoting personnel and resources to monitoring them, which requires sufficient funding for entities like the EPA and the Fish and Wildlife Service.” Kahn also draws attention to the recent GAO report on biological threat awareness and the need to share information and resources. “Most distressingly, the current administration appears willfully ignorant of scientific issues, while at the same time disinclined to fund critical scientific efforts. The White House Office of Science and Technology Policy, which is intimately involved with biodefense issues, remains leaderless and understaffed.” Overall, a national biodefense strategy will not be easy, but it must be as comprehensive and wholistic as the biological threats we face.

The World’s Deadliest Diseases: How Is Biotech Fighting Them?
Biotech has an increasingly important role of health security and infectious disease response. As we saw with CRISPR this week, it has the capacity to help treat chronic conditions, but what about infectious diseases? Rapid diagnostics and development of medical countermeasures are critical during outbreaks and can determine if an epidemic will turn into a pandemic. Ute Boronowsky, pulling on Robert Herriman’s list of the five deadliest diseases, is looking to the biotech approaches for such biothreats. Whether it be plague or amebic meningoencephalitis, biotech advances are providing new avenues for treatment and response. Naegleria fowleri (the amoeba that causes the fatal meningoencephalitis) can be difficult to track within water sources and treatment is even trickier. “In 2015, investigational breast cancer and anti-leishmania drug miltefosine was used successfully on a 12-year-old girl at the Arkansas Children’s Hospital. However, when the same drug was used on two other patients, one of them died, and the other suffered from major neurological damage. This year saw a new therapeutic approach when scientists at the Virginia Commonwealth University found evidence that Naegleria relies on matrix metalloproteases to degrade the host extracellular matrix during infection, identifying these enzymes as potential therapeutic targets.” Other biotech advances, like prion disease therapy kinase inhibitors on the unfolded protein response, or the latest Ebola vaccine, all highlight the importance of biotech advances in combatting infectious diseases.

Stories You May Have Missed:

  • Legionella in Disneyland – GMU biodefense PhD student Saskia Popescu is looking at the latest outbreak of Legionnaires’ disease and how it highlights the challenges of prevention. “There are many factors that may attribute an outbreak, such as warming climates, a large aging population, and increased attention on the disease, which all lead to a better chance of infections being reported. The recent outbreak in Disneyland is a good reminder of the inherent challenges with disinfection efforts and continued vigilance that is needed to ward off this bacterial infection. It is also a reminder that outbreaks can happen anywhere there is a water source, even Disneyland, or other areas that somehow seem to be untouchable.”
  • Bulgaria and South Africa Battle HPAI – The two countries are dealing with outbreaks related to highly virulent strains of avian influenza. “A US vaccine company announced that the US Department of Agriculture (USDA) has conditionally approved the first DNA avian flu vaccine for chickens. Also, the United Nations Food and Agriculture Organization (FAO) provided a snapshot of current highly pathogenic H5 observations and what could play out in the upcoming season, and Chinese researchers reported new findings on airborne spread of avian flu based on sampling in a live-poultry market.”

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