Tag: biosecurity

Pandora Report 5.5.2017

by spopescu, posted in Pandora Report

Welcome to your weekly dose of all things biodefense. We hope you’ll celebrate World Hand Hygiene Day today by practicing awesome hand hygiene to help stop the spread of germs! Will Bill Gates save us from the next Ebola?

Summer Workshop Discount Extended
We’re excited to announce that the early registration deadline has been extended to June 1st for the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security! This is a great opportunity to experience a 3-day workshop led by some of the top biodefense people in the field, not to mention networking opportunities with fellow global health security gurus. Don’t miss out on this July 17-19th workshop in which you’ll learn about bioterrorism, synthetic biology, dual-use research of concern, and how experts are working to stop the next pandemic.

Three Insights from the World Bank’s Tim Evans on Global Health
“While in the previous year the U.S. was the biggest single source of development aid finance for health at $12.8 billion — 34 percent of the global total — its future position is less clear. Specifics on U.S. commitments to global health were lacking in U.S. President Donald Trump’s ‘skinny budget‘ released in March. The latest budget document released this week, meanwhile, shows proposed cuts to USAID’s global health funds.” At a recent event hosted by the Kaiser Family Foundation and the Center for Strategic and International Studies, Tim Evans, senior director of health, nutrition, and population at the World Bank Group, pointed to three important lessons. Firstly, we must catalyze domestic resource mobilization. Domestic spending impacts a country’s capacities and universal healthcare development. “Evans said the global health community needs to rethink the way it views and packages development assistance, from largely being linked to service provision to one that can strengthen countries’ domestic resource mobilization.” Second, he notes that it is crucial to build a demand for health. Policy shifts and economic strain increasingly threaten global health security efforts. He notes that there is a “very strong need to think about building demand and not to pretend that because you’re doing health and saving lives that everybody thinks that’s a great idea,”. “Actively cultivate that community, because you know if you don’t, then it doesn’t take much of a counter force — and we’ve seen this in the areas of vaccines and immunizations — to erode that base of support.” Lastly, the growing threat of disease requires that we expand beyond the “public sector-only mindset”. It’s critical to consider and utilize the private sector for public health efforts. He mentioned that “the public sector has massively important functions. But we have to look in a granular way, various ways, in which the private sector is active, will be active, and work with that in ways that are going to address burden of disease in cost effective manners,”.

Has The Deep State Hoodwinked Trump?
GMU Professor Charles P. Blair and biodefense MS student Rebecca Earnhardt are pointing to Trump’s recent military action in Syria and what really happened behind closed doors. “Though many of the administration’s more centrist supporters cheered the US missile strike on the Syrian air base, characterizing it as a bold move necessitated by the weakness of Barack Obama, other Trump supporters argued that the president had been tricked into a grand mistake. Was Trump the victim of a ruse by the ‘deep state’—a monolithic alignment of federal power centers so intent on maintaining command that it was willing to derail the new administration by encouraging it to pursue unwise military action? Or was the president misled by an even more ominous version of the deep state: one that subverts legitimate civilian leadership in a bid to recouple the United States to ‘regime change’ and similar globalist policies of militant ‘humanitarian’ interventionism?” Blair and Earnhardt look at this history of “deep state”, the rise of the “new world order”, and the growth of fringe beliefs in conspiracy and the notion of a hidden organization (think The X-Files, Men in Black, and the Matrix). “This elevated circulation of cross-pollinated conspiratorialism, now manifest in the increasingly normalized views of the fringe far right, has been facilitated not just by television and movies, as discussed above, but also by Internet platforms.” While not all associate the deep state with some totalitarian global group (which reminds me of James Bond‘s Spectre and Mission Impossible‘s Syndicate), the increasing belief in “sanitized conspiracies” has highlighted some changes how we form beliefs and what that translates to. Earnhardt and Blair also note that that while such beliefs have increased while faith in government, science, and the press have declined.

Why Are We More at Risk Than Ever for a Global Pandemic? 
GMU Biodefense PhD student, Saskia Popescu, looks at the seven reasons we’re more at risk than ever for a global pandemic. While concurring with a recent list following CNN’s pandemic documentary, she highlights two gaps within it – attitude towards infectious diseases and the role of healthcare infrastructure. “The current attitude towards infectious diseases puts us more at risk. Ebola brought the realities of borderless outbreaks to the forefront, especially with availability of faster information. Industrialized countries view diseases—emerging infectious diseases, in particular—differently than developing countries. In the United States, we relish our vaccine availability enough that we refuse it and often see emerging diseases as third world problems. Ebola showed us two things; the unfounded and irrational fear that occurred in the United States, and the lack of preparedness or acknowledgement that a disease in West Africa could venture across the pond.” She highlights the damaging implications of viewing emerging infectious diseases as “third world country problems” and what cultural shift is needed for this to change. The second missing component to the list is healthcare infrastructure and infection control efforts. “Physicians and nurses alike are desperately needed in developing countries; however, it is important to include another role that is often forgotten: infection control and prevention. Although there are fewer doctors and nurses in outbreak regions, there is also something to be said about the grossly underfunded and underutilized role of infection control as a preparedness and response tool. Whether it is in the United States or in a developing country, infection prevention and control programs are vital for both patient and employee safety, frequently understaffed, and economically strained.” Highlighting the nosocomial cases in Dallas, TX, she notes that infection control is bigger than just hospital-acquired infections and trickles down to antimicrobial resistance, communicable disease reporting, and patient isolation. “Overall, the way we look at emerging infectious diseases, our role in preventing and responding to them, and how we utilize (or fail to utilize) healthcare have created a substantial vulnerability for future public health threats. We have more than enough proof to show how vulnerable we all are to infectious diseases and how vital hospital infection control is to not only internal infections, but also preventing the spread from the community. Now is the time to truly utilize a holistic approach—including infection control programs, public education and cultural awareness, and more—to prevent the next pandemic.”

U.S. Biodefense Failures
Despite the bipartisan nature of biothreat preparedness, the U.S. struggles to to support such efforts. A recent Blue Ribbon Study Panel on Biodefense meeting highlighted yet again, the lack of leadership for U.S. biodefense efforts -whether that be an agency or person. “For at least two decades, infectious disease experts have been urging the U.S. government to do more to keep the country prepared for outbreaks of diseases such as a new strain of flu, Ebola and severe acute respiratory syndrome, or SARS. They’ve also noted that other countries have prepared biological weapons such as smallpox and anthrax and have used chemical weapons — such as Syria’s use of sarin gas against its own citizens.” Despite the constant supply of warnings from experts regarding the eventuality of a new flu pandemic, the 2014 Ebola outbreak, and concerns over dual-use research and gene editing, we just can’t seem to get it together. We know what the threat of infectious diseases, whether it be natural, intentional, or accidental, is real and will only increase as populations grow and globalizations strengthens. “The United States needs to be ready ahead of time, with stockpiles of drugs, vaccines and equipment, plans for deploying them and someone with the authority to make fast decisions, Cole and other experts said. The 2017 budget agreement worked out early Monday by Congress would provide just $57 million specifically to prepare for a new pandemic of influenza.” The truth is that U.S. response tends to be more reactive than proactive. We’ve gotten lucky so far in that the diseases weren’t highly transmissible with high fatality rates, but the truth is that our luck won’t hold forever.

Contaminated CRISPR Kits
This is quite an interesting twist in the concerns over DIY-gene editing…. While many worry about the outcomes of biohackers and garage genome editors, a recent finding of contaminated CRISPR kits sold by the company, The Odin, has added a new worrisome layer. The kits are normally sold online for $150 for those interested in doing gene engineering at home however, this recent finding by the European Centre for Disease Prevention and Control (ECDC) has resulted in a halting of all CRISPR kits imported into Germany. The kits were meant to contain harmless laboratory strains of E. coli HME63, however multiple kits were found to be contamined with several pathogens, including some that are antibiotic resistant. Klebsiella pneumoniae, Enterobacter, and Enterococcus faecalis were the microbial culprits found in the contaminated kits. The ECDC has stated that there is a low risk for users “because the manipulation of the kit does not involve percutaneous injury-prone manipulations. However, infection resulting from the contamination of broken skin or mucous membranes may occur, even though the kit recommends and provides disposable gloves. Furthermore, the kit includes lyophilised materials that need to be reconstituted, which may lead to contamination of the mucosae of the eyes, mouth and nose. Finally, the risk of infection may be increased for immunocompromised or immunosuppressed persons.” You can find the ECDC statement here, which notes that LGL, the Bavarian Health and Food Safety Authority, issued the press release in late March. There is also concern related to the potential release of drug-resistant organisms into the environment, of which the ECDC noted, “the potential contribution of the contaminated kit to the increasing burden of antimicrobial resistance in the EU/EEA is marginal, and the associated public health risk is considered very low”. They also encouraged users of the kits to appropriately dispose of their used materials to avoid releasing any drug-resistant bacteria into the environment.

Eastern Europe Antibiotic Usage Report
A new WHO report is providing information regarding antibiotic consumption and usage in 11 non-EU countries and Kosovo from 2011-2014. “The most commonly used class of antimicrobials was beta-lactams, whose share of the total ranged from 35.4% in Belarus to 65.6% in Azerbaijan, the report says. Cephalosporins accounted for between 6.1% (Azerbaijan) and 30.3% (Turkey) of total consumption, while the share for quinolones ranged from less than 0.1% in Uzbekistan to 17% in the Republic of Moldova. The report notes that cephalosporins and quinolones are broad-spectrum antibiotics and are considered second-line drugs in many prescribing guidelines. The two groups combined accounted for 10% (Azerbaijan) to 38% (Moldova) of total consumption.”

Workshop on Strategies for Identifying and Addressing Biodefense Vulnerabilities Posed by Synthetic Biology
Don’t miss this May 25th event at the National Academy of Sciences Building! This meeting will be open to the public, and will run from 8:30am until 4:30pm. The committee will hear from speakers who will discuss the current state of the science in DNA synthesis, assembly, and engineering; pathogen engineering and zoonosis; and ease of use as it relates to synthetic biology. There will be question and answer periods following each panel discussion, and members of the public will be invited to ask questions of the panelists, so we invite you to attend in person, if you are able. You can also check out the draft agenda here. It will be interesting to see if the workshop will discuss CRISPR kits and the potential for contamination.

Stories You May have Missed:

  • NIH Sets Research Cap on Funding for Scientists–  On Tuesday it was announced that for the first time, the NIH will restrict the amount of funding any individual scientists can hold at a given time via a point system. It is “part of an ongoing effort to make obtaining grants easier for early- and mid-career scientists, who face much tougher odds than their more-experienced colleagues. According to the agency, just 10% of grant recipients win 40% of the agency’s research money. Advocacy organizations and groups that advise the NIH director have been urging the agency to address this inequality for more than a decade. They are also concerned that increasing competition for grant money drives researchers to spend more time on paperwork and personnel issues associated with grants, and less time in the lab.”
  • Yellow Fever Vaccine Levels Are Dangerously Low – The CDC recently announced that the supply of yellow fever vaccine will be depleted by this summer. France is said to be able to cover the U.S. populations in need of the vaccine by the time the U.S. supply runs out, however the ongoing manufacturing problems continue to strain response efforts. “A number of vaccine doses were lost while Sanofi was transitioning vaccine production from an old site to new construction, slated to open in 2018.The United States uses 500,000 doses of yellow fever vaccine each year, distributed to travelers and military personnel who will be visiting yellow fever–endemic regions. Just 1 dose of the vaccine confers lifelong immunity, with recipients showing 80% immunity to yellow fever virus 10 days after inoculation and 99% immunity within 30 days. According to unpublished data from Sanofi, approximately 60% of these doses are distributed among about 4,000 civilian clinical sites.”
  • Attacking Antibiotic Resistance With Behavioral Approaches
    A recent Dutch study looked at antimicrobial stewardship strategies and found that by letting providers determine the root-cause of inappropriate antibiotic prescribing, they were more effective in responding to the problem. “The aim of the study was to test the effectiveness of a stewardship approach in which prescribers were asked to determine the root causes of inappropriate antimicrobial prescribing in their department, then develop one or more interventions to improve prescribing based on those root causes. The theory behind this strategy is that if you respect prescriber autonomy and allow prescribers to create their own program to improve prescribing, they will value this approach more and show more commitment to it.  Overall, there were 21,306 clinical admissions during the baseline period and 15,394 clinical admissions during the intervention period, with the appropriateness surveys including 1,121 patients and 882 patients, respectively. In the baseline period, 64.1% of antimicrobial prescriptions were considered appropriate, compared with 77.4% in the intervention period, an increase of 20.7% that equaled 4,927 improved days of therapy.”

Pandora Report 4.28.2017

by spopescu, posted in Pandora Report

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

Pandora Report 4.21.2017

by spopescu, posted in Pandora Report

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

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

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

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

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

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

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

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

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

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

Stories You May Have Missed: 

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

Pandora Report 4.7.2017

by spopescu, posted in Pandora Report

Don’t forget to tune in to CNN’s Unseen Enemy tonight at 7pm ET/PT to hear about the next potential pandemic from some of the world’s top disease experts!

Chemical Attack in Syria
On Tuesday, a chemical weapons attack killed dozens in northern Syria. While the Organization for the Prohibition of Chemical Weapons is working to collect data to determine the perpetrator, most are pointing to the Assad regime as the attacks appear to be consistent with a military-grade nerve agent. On Thursday it was announced that the autopsies performed on victims show they were subject to chemical weapons that were likely sarin nerve gas. Later last night, President Trump ordered a targeted missile strike on the Syrian Al Shayrat airfield via 59 Tomahawk cruise missiles. Some are saying the death toll from the chemical attack is between 70 and 100 and the volume of injured reported to be high. Russia is denying involvement in the latest attack that is said to have killed many children. Dr. Greg Koblentz notes that this has the implications of a sarin nerve attack, and if proven to be done by the Syrian regime, it’s one of the largest attacks. He emphasized that the U.S. will need to work to put pressure on Syria and on the Russian and Iranian allies who shouldn’t be immune to suffering the consequences from backing a regime who performs such attacks. Dr. Koblentz also recently spoke to the BBC regarding resolutions and international response towards the chemical attack, highlighting the importance of helping the victims and bringing the perpetrators to justice.

Can Bill Gates Rescue the Bioweapons Convention?
Who can save the Biological Weapons Convention? GMU biodefense graduate program director and professor Dr. Gregory Koblentz highlights the growing monetary deficits within the BWC. Dependent upon international cooperation and funding, many treaty members have been inconsistent at paying their budgetary share, which puts the implementation services unit and future meetings in jeopardy. Pointing to the challenges of acquiring funds, Koblentz draws attention to an individual who is both extremely wealthy, philanthropic, and interested in public health – Bill Gates. “Gates, ever the businessman, pointed out that this dire outcome could be avoided by spending an estimated $3.4 billion a year on pandemic preparedness. To his great credit, Gates and his foundation have already contributed vast sums to global health. Most recently, the Bill and Melinda Gates Foundation provided $100 million to help launch a public-private initiative called the Coalition for Epidemic Preparedness Innovations, with the goal of accelerating the development of new vaccines.” His recent comments at the Munich Security Conference regarding the realities of biological threats shine a harsh light the devastation a biological weapon could cause. Koblentz looks outside the box in this article, highlighting that dire times may call for unusual actions to save the BWC. “The global health community has achieved great gains over the decades, but a single bioweapon attack could reverse all that. Now more than ever, an ounce of prevention is worth a pound of cure.”

Safeguarding the Bioeconomy – Securing Life Sciences Data
Check out the latest meeting recap from the NAS workshop, which worked to assist the FBI WMD Directorate “in understanding the applications and potential security implications of emerging technologies at the interface of the life sciences and information sciences.” This workshop brought together experts from a wide range of fields to help solve the challenges of encouraging a strong bioeconomy, while preventing nefarious use and considering the implications of such data. “Advances in the life sciences are increasingly integrated with fields such as materials science, information technology, and nanotechnology to impact the global economy. Although not traditionally viewed as part of bio-technology, information technology and data science have become major components of the biological sciences as researchers move toward –omics experimental approaches.” “There is currently no government agency charged with holistically assessing the security of the bioeconomy, and the emerging importance of data (and data security) within it. These concerns will continue to grow as the world becomes more digitized and interconnected. There are a number of different types of data that can be aggregated and analyzed as part of the bioeconomy, and the collection, sharing and use of these different types of data may pose different potential concerns.” Within the workshop summary, you’ll see the division of bioconomy economy into clinical and nonclinical data, the biosecurity perspective from academia, technological advances that will further data access, data sovereignty issues, and much more.

Novel Antimicrobials – The Quest For The Grail?
The new CARB-X partnership is trying to combat the growing threat of antimicrobial resistance through innovation and supporting new research. “The CARB-X board thoroughly vetted 168 proposals and selected 11 projects that represent truly exciting early stage research. Three of them could become the first in new classes of antibiotics, and four are innovative non-traditional products. Some of the projects also take new approaches, known as mechanisms of action, to target and kill bacteria. All of the potential new medicines target Gram-negative bacteria prioritized by the U.S. Centers for Disease Control and Prevention and the World Health Organization.” BARDA is also in the race for halting the rise of the resistance bug – they’ve got a clinical-stage antibacterial program which has 13 products that are looking promising. The threat of antimicrobial resistance means that partnerships in even the most unlikely places are unfolding to help develop anything from new drugs to diagnostic tests that can determine if a lung infection is bacterial or viral. The truth is that the looming antibiotic apocalypse truly requires all hands on deck, so what’s the hold-up? At least we may have a potential cure in maple syrup…

Pandemics, Personnel, and Politics: How the Trump Administration is Leaving Us Vulnerable to the Next Outbreak
GMU Biodefense graduate program director and professor, Dr. Gregory Koblentz, and MS student Nathaniel M. Morra are looking at the increase in infectious disease outbreaks in recent years (Ebola, Zika, SARS, MERS-CoV) and how the new administration is prioritizing public health. “Despite this heightened risk of a global pandemic, the Trump Administration has dragged its feet in appointing senior officials to key Federal agencies responsible for preparing and responding to a pandemic or bioterrorist attack. These agencies are also subject to steep budget cuts under Trump’s budget for Fiscal Year 2018. The delays in installing senior leaders at these agencies and pending budget cuts puts U.S. and global health security at risk.” Interim directors, a lack of Assistant Secretary for Preparedness and Response within HHS, and a planned cut in funds are already creating vulnerabilities within U.S. health security. “If a major influenza pandemic were to occur, no wall would be high enough to stop the virus from entering the United States. The best defense against pandemics and other disease threats are Federal, state, and local health agencies and international partners with strong leadership and the necessary resources to fund vital surveillance, preparedness, response, and research activities. Mother Nature doesn’t play politics; Trump shouldn’t play politics with global health security.”

Pandemics, Bioterrorism, and Global Health Security LinkedIn Group
If you’re not already already a member, make sure to check out this LinkedIn group “dedicated to the analysis of the challenges facing the world at the nexus of health, science, and security. The group’s purpose is to serve as a unique forum for discussion and debate on critical issues in global health security.” We’re happy to announce that the group just reached 3,000 members thanks to Arthur Seward-El and Veena R. Kumar! If you’re looking for a LinkedIn group dedicated to global health security and includes members from all over the world, don’t miss out!

Center for Health Security Emerging Leaders Take on The Eight Ball
I’m a biodefense nerd – always have been and always will be, so you can imagine my excitement when part of the ELBI class of 2017 fellowship workshop involved getting to visit the Eight Ball near USAMRIID. The Eight Ball is from the days of America’s active bioweapons program and despite its history, is now a rather interesting sight stuck between two buildings and surrounded by trash dumpsters. Dr. Koblentz has provided some great trivia regarding the Eight Ball – it cost $715,468 (in 1950 dollars), is four stories high and weights 131 tons, was used to test animals ranging from mice to horses, and held its first human tests in 1955 as part of Operation Whitecoat. “This one million liter metal sphere is currently tucked away behind a service building, but at one point it was the epicenter of Operation Whitecoat, the US Cold War biodefense program. From the 1950s through the ‘70s, researchers developing treatments for biological agents released small amounts of these selected agents into the eight ball, allowed them to disperse, and then exposed volunteers to this contaminated air via specially rigged gas masks. By treating the volunteers (who signed consent forms) with their newly developed vaccines and therapies, scientists were able to develop effective methods to respond to biological warfare. Whitecoat volunteers were exposed to agents that cause diseases such as rabbit fever (tularemia), Q fever, yellow fever, and plague.”

Digital Surveillance of Emerging Infectious Disease and Outbreaks: A One Health Approach 
Don’t miss out on this Next Generation Global Health Security Network Webinar on April 7th, at 1pm EST. You can check out the webinar here to learn from Maja Carrion, Assistant Director of ProMED, about digital health surveillance in human and animal sectors.

Investing In Public Health Keeps America Great
Simply put, a nation cannot be great if it lacks health. The proposed budgetary measure that drastically cut funding for HHS point to what public health has been battling for decades – a necessary force that receives too little funding amid too many expectations. Investing in public health is the most obvious thing one could do to make a country strong and capable of growth. Whether it be extending life, eradicating disease, or even a thriving workforce, public health is a force that simply can’t be ignored. “Instead of making deep investments in public health, and thus public safety, we allocate pennies. Americans spend more per capita on health care than any other country in the world, but less than 3 percent of all health spending goes to public health. The CDC’s budget has declined slightly over the past decade, and funding cuts at the state and local levels have been ‘drastic,’ says Trust for America’s Health.” At the end of the day, we have to ask ourselves – at what price do we value our own health and that of those around us?

Dynamic Challenges & Opportunities for Global Health Security Talk
All GMU biodefense students and alum are welcome to attend Dr. Gene Olinger’s talk during Professor Nuzzo’s BIOD 710 class on Tuesday, April 11th, from 6:15-7:10pm! Dr. Olinger serves as principal science advisor for MRIGlobal Biosurveillance and Global Health Division and will be talking about global health security as a subject matter expert for multiple federal panels related to biodefense and emerging viral pathogens.

Stories You May Have Missed:

  • Two Very Different Views of Terrorism and What To Do About Them – GMU biodefense PhD alum Daniel M. Gerstein is looking at the reaction to two major events – the aviation electronics ban and the London terrorist attack. He emphasizes that risk perception and personal inconvenience plays a big role in the limitations people are willing to accept in the name of safety. “Risk perception will undoubtedly continue to be an important determinant in the types of security policies and measures that will be acceptable to governments and the public. Clear and precise communications on the various threats faced, the vulnerability to particular attacks and the potential consequences of such attacks, could help reduce inflated perceptions of risk while at the same time making people more accepting of security enhancing initiatives.”
  • Measles Takes Hold in Eastern Europe– Europe is seeing a large outbreak of measles currently as over 500 cases were reported just in January 2017. 474 cases were reported in endemic countries (France, Germany, Italy, Poland, Romania, Switzerland, and Ukraine). “The largest current measles outbreaks in Europe are taking place in Romania and Italy. Romania has reported over 3400 cases and 17 deaths since January 2016 (as of 10 March 2017). The majority of cases are concentrated in areas where immunization coverage is especially low. According to reported data, the 3 measles genotypes circulating in Romania since January 2016 were not spreading in the country before, but were reported in several other European countries and elsewhere in 2015. Comprehensive laboratory and epidemiological data are needed before the origin of infection and routes of transmission can be concluded.”
  • 10 Saudi MERS Hospital-Associated Cases– Infection prevention goes well beyond the normal hand hygiene and healthcare-associated infections. MERS-CoV is a prime example of a disease that takes advantage of poor infection prevention efforts in healthcare. “A MERS-CoV outbreak linked to a dialysis unit at a hospital in Wadi Aldwaser has sickened 10 people, 2 of them with asymptomatic infections, the World Health Organization (WHO) said yesterday in an update covering 18 recent cases in Saudi Arabia.” Two of those infected are healthcare workers.

Pandora Report 3.31.2017

by spopescu, posted in Pandora Report

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

Pandora Report 3.24.2017

by spopescu, posted in Pandora Report

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

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

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

Pandora Report 2.17.2017

by spopescu, posted in Pandora Report

screen-shot-2017-02-15-at-10-06-56-amHappy Friday! Since Tuesday was Valentine’s day, it was fitting to have a super romantic story about Ebola super-spreaders and their role in causing most of the cases. Have you ever wondered why killer viruses are on the rise or what some of these infectious disease terms mean?

ASM Biothreats 2017 Highlights 
If you missed this event or weren’t able to make some of the sessions, check out our overview! GMU sent four graduate biodefense students to ASM’s biothreats conference to not only aid in their education, but also to report back for our readers. With their unique backgrounds, we’ve got articles on the FDA’s Animal Rule, international biosecurity efforts, and more. Check out the link above and you’ll find a special edition post with all of our highlights.

A Step Closer Towards Human Embryo Editing
A new report from an international committee put together by the U.S. National Academy of Science and the National Academy of Medicine found that a clinical trial regarding DNA editing of a human embryo “might be permitted, but only following much more research” on risks and benefits, and “only for compelling reasons and under strict oversight.” Consideration would be given to couples who are both afflicted with serious genetic disease and editing is “really the last reasonable option” for them to have a healthy child. While some applaud this as a first step towards a very specific and narrow subset of DNA altering, “others see the report as lowering the bar for such experiments because it does not explicitly say they should be prohibited for now. ‘It changes the tone to an affirmative position in the absence of the broad public debate this report calls for,’ says Edward Lanphier, chairman of the DNA editing company Sangamo Therapeutics in Richmond, California.” You can read the full report here.

The Biotechnological Wild West: the Good, the Bad, and the Underknown of Synthetic Biology
GMU Biodefense PhD student and Predoc at Lawrence Livermore National Laboratory, Yong-Bee Lim, is taking on the 2017 ASM Biothreats conference and the pipette-slinging world of synthetic biology. Lim first focuses on the panel at ASM’s conference, which looked at the current state of synbio and where the future might take us. Like most things in life, there’s also a flip side to that coin – the negative aspects of this new technology. “While the benefits derived from synthetic biology are great, presenters noted that it suffers from the dual-use dilemma: the same information applied to beneficial uses could also be repurposed for nefarious purposes. Dr. Hassell noted that synthetic biology increases biologically-derived risks through three mechanisms. First, synthetic biology can be used to enhance existing microbial threats; synthetic biology allows actors to more easily manipulate the characteristics of microbes, including increasing environmental stability and introducing hypervirulence. Secondly, traditional methods of restricting access to biological select agents and toxins (BSATs) may be less effective in an age where synthetic biology can be used to construct microbes de novo. Finally, synthetic biology can be used to construct novel threats that are meant to subvert countermeasures.” Lastly, one of the most interesting components to this presentation and Lim’s article is the underknown components to synethic biology. The erosion of the knowledge and technical barriers and the rise of the do-it-yourself (DIY) practitioners all give way to a new frontier in terms of benefits and dangers.

Broad Institute Wins CRISPR Patent 
This week, the U.S. Patent Office appeal board ruled that the dispute regarding the discoveries between the University of California, Berkeley and the Broad Institute do not overlap. “The ruling is a win for the Broad Institute, which had asked for the finding of no interference. It will be able to retain its valuable patents, which cover the use of CRISPR in human and animal cells. In a statement, Berkeley said it “respects” the decision but still maintains that Berkeley biochemist Jennifer Doudna and European collaborator Emmanuel Charpentier were the first to invent the CRISPR system.” The CRISPR patent dispute has brought to light the most foundational question of who truly owns the patent rights to CRISPR work in animals and plants. This new development doesn’t mark the end of the CRISPR dispute, as many expect Berkeley to appeal the decision and the Broad Institute’s patent is facing dispute from other researchers, including the Rockefeller University. While the CRISPR patent road may have been smoothed for a bit, it will continue to remain rocky and cause ripples for business developments and the biotech industry.

Defense Civil Support: DoD, HHS, and DHS Should Use Existing Coordination Mechanisms to Improve Their Pandemic Preparedness screen-shot-2017-02-14-at-10-41-11-am
In this Government Accountability Office (GAO) report, they found that the DoD should utilize guidance developed to aid in support of civil authorities (specifically HHS and DHS). “HHS and DHS have plans to guide their response to a pandemic, but their plans do not explain how they would respond in a resource-constrained environment in which capabilities like those provided by DOD are limited. DOD coordinates with the agencies, but existing coordination mechanisms among HHS, DHS, and DOD could be used to improve preparedness. HHS’s Pandemic Influenza Plan is the departmental blueprint for its preparedness and response to an influenza pandemic.” The GAO’s goal was to assess the DoD’s plans and processes to support civil authorities during a pandemic, of which they found that the existing coordination mechanisms should be used to explore opportunities to improve preparedness if their capabilities are limited.

Global Health Security Transparency 
Global health security is a finicky creature as it requires cooperation and transparency from all countries. One weak link in the chain can cause an international public health crisis. No More Epidemics is imploring countries to publish their Joint External Evaluations (JEE) performed by the GHSA (Global Health Security Agenda). As of now, only Ethiopia, Liberia, Peru, Uganda, UK, and the U.S. have openly shared their JEE’s. “Knowledge of baseline data provided by the JEE will result in more effective programming, prevention and detection of infectious disease outbreaks and early response. The JEE and roadmap processes are critical tools for civil society to use in developing appropriate and adequate programming to help countries close health systems gaps and become IHR-compliant. Transparency and accountability are vital in addressing global health threats. No More Epidemics urges all countries carrying out their Joint External Evaluations to make the results publicly available and for these to be made available on the World Health Organization’s Strategic Partnership Portal, the online repository for tracking funding, donor profiles and country level data.” Information sharing is also a mechanism for strengthening partnerships among countries.

Webinar on Ebola’s Aftermath 
Doctors Without Borders (MSF) will be hosting this live webinar on Thursday, February 23rd at 8pm EST. Following the publication of the book, The Politics of Fear: Médecins Sans Frontières and the West African Ebola Epidemic, the MSF webinar will do a deep-dive into the 2014/2015 outbreak and the lessons learned. This event will include a panel of MSF experts, who were directly involved in the MSF response in West Africa.

Fighting Antimicrobial Resistance with Physics
The battle against antimicrobial resistance (AMR) isn’t slowing and the proposed strategies emphasize the need for increased research and development of new antimicrobial agents, which means we’re running out of options. Swinburne University is trying a new tactic though – physics. “Elena Ivanova was studying physical surfaces that could repel bacteria before they even had time to settle. In clinical settings, such as hospitals and dental practices, 80% of infections are caused by bacteria that cling to surfaces in such densities that no antibiotic can remove them. First, she tried making surfaces so smooth that bacteria would, theoretically, simply slide off. Although that was the case for some bacteria, many others—such as the common Staphococcus aureus, or staph—still managed to cling on and multiply.” This is where Greg and Jolanta Watson come in – they have amassed a huge collection of biological samples in their laboratory. Ivanova and the Watsons communicated back and forth regarding natural properties that might make bacteria incapable of sticking to and growing on surfaces. Starting with cicada wings, Ivanova found that it was able to kill one of the two main types of bacteria, which was a partial success. Next, a gecko’s skin was tested, which revealed a wealth of knowledge. “Green had added a sample of the small, rod-shaped bacterium that causes gingivitis, Porphyromonas gingivalis, to the surface. In total, he added around 10 million microbes every day for a week. What’s more, this mass of microbes was given everything that they needed for a good life: a constant temperature of 98.6˚ F, an atmosphere without oxygen, and a daily ration of food. Regardless, after the week, nearly all were punctured and torn, their cellular carcasses strewn over the gecko skin. ‘Bacteria are trying to move and settle on the surface,’ Green says. ‘And they’re just getting spiked and skewered by these long hairs’.” Looking to nature, these researchers have focused on the physics of repelling bacterial growth, which may help broaden the arsenal against resistant germs.

Stories You May Have Missed: 

  • Talking About Bioethics & Policy in the U.S. Under the Trump Administration – Dual-use research of concern, CDC’s new quarantine rule, and the Animal Rule are all topics involving bioethics and Johns Hopkins University is hoping to provide the resources needed to address these complex issues. The new administration brings with it concerns over vaccine skepticism and how they will handle these bioethical dilemmas. How will Trump address the work of biotechnology and public health crises?
  • Breaking Barriers: Women in Science Event: Don’t miss this March 8th event at 6pm at Top of the Town in Arlington, VA. The 3rd annual reception will “bring together scientific, political, and cultural leaders to celebrate the achievements of women in STEM and take a stand for the critical role women play in science and technology communities”.
  • The Cost of Biosecurity – For $1 million a year, you can buy yourself global biosecurity! A recently published list of the unit staff costs from the 2017 BWC Meeting of State Parties, gives an eye-opening revelation into the cost of biodefense. For $1.1 million a year, you can financially support the implementation unit staff of the BWC – quite a bargain, no?
  • Surprise Us, Mr. Trump – A Letter From the Global Health Community – In this editorial article from The Lancet Global Health, the authors point to the role of the U.S. in the WHO Executive Board and the future of WHO leadership. “Two legislative bills introduced in early January in the US House of Representatives and Senate are seeking to withhold funds from the UN and open a way for the USA to leave the global body, and therefore withdraw membership of WHO.” The current political and global health atmosphere is unsettled, which has many concerned about the future of U.S. involvement in global health programs.
  • CRISPR Creates TB-Resistant Cattle – Chinese researchers have created tuberculosis resistance in cattle using CRISPR/Cas9. “As the researchers reported today in Genome Biology, they used somatic nuclear transfer to get the edit into an egg cell, creating 11 cows in vitro with NRAMP1 (nine using Cas9 nickase) and demonstrating that the gene provided increased resistance to tuberculosis.Moreover, they said that while the Cas9 nickase did not completely eliminate off-target edits, it did reduce them, especially when compared to standard Cas9 which creates double-strand breaks and is much more likely to create indel mutations via the non-homologous end-joining DNA repair pathway.”

Pandora Report 1.27.2017

by spopescu, posted in Pandora Report

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

 

Pandora Report 1.6.2017

by spopescu, posted in Pandora Report

Welcome to 2017 and a whole new year of biodefense news! While you’re heading back to work, make sure to wash your hands and stay safe – the CDC has reported increasing flu activity.

The Best of Bio and Chem Weapons Coverage in 2016
The Bulletin of the Atomic Scientists has put together their “five best articles” for bio-chem weapons in 2016 and we were happy to see two familiar faces – GMU PhD alum Daniel M. Gerstein and GMU Biodefense professor, Sonia Ben Ouagrham-Gormley. Daniel Gerstein’s article, How genetic editing became a national security threat, discusses the threatening components of gene drive, like low cost and growing availability. “Armed with the proper genetic sequences, states or bioterrorists could employ genome editing to create highly virulent pathogens for use in such attacks. They could, for example, change a less dangerous, non-pathogenic strain of anthrax into a highly virulent form by altering the genome, or recreate pathogens such as the deadly smallpox virus, which was eradicated in the wild in 1980.” Sonia Ben Ouagrham-Gormley teamed up with Kathleen Vogel to discuss the good, bad, and the hype of gene drive. They emphasize the importance of understanding gene drive to really discern the benefits and risks of the technological process. Looking at all angles, their article gives a wholistic approach to better appreciate the complexities of gene drive for biodefense. “Without a clear and detailed understanding of the range of social and technical factors that cause scientists to succeed or fail in their gene-drive endeavors, threat estimates can only rely on speculation and fantasy rather than fact.”

GMU Biodefense Students – Win Registration for 2017 ASM Biothreats Conference!
Calling all GMU Biodefense students – the program will be offering free registration to four lucky students to attend this premier biodefense event at the Marriott Wardman Park in Washington, DC on February 6-8th. This year, the meeting incorporates three major tracks, “Research, Response, and Policy” to cover relevant topics in basic and applied research; public health, emergency response and preparedness; and biosecurity, government, and policy responses. The exchange between these multidisciplinary communities will shape the future of this very important field. The keynote session on February 6 will be given by Thomas M. Countryman, Acting Under Secretary for Arms Control and International Security and Assistant Secretary to the Bureau of International Security and Nonproliferation at the Department of State.  Anthony S. Fauci, M.D., Director of NIAID Director at the National Institutes of Health, will be presenting at a special session on February 7. You can find the rest of the agenda here. As an attendant for the 2016 conference, I can tell you that it’s a great experience for not only learning, but also networking. Please check your GMU email for the information Dr. Koblentz sent out. To apply: students are required to submit a 250-word essay about how attending the conference will benefit your education/professional aspirations by 5pm today (Friday, January 6th) to Dr. Koblentz. Winners will be announced the following Monday and those selected will be asked to write up summaries of at least two panels for publication in the Pandora Report.

USGS Disease Maps
screen-shot-2017-01-03-at-6-04-01-amLove maps and diseases? Or do you simply like knowing what kinds of vectored diseases are transmitted around you? Check out the USGS disease maps that also allow you to interact with them. Utilizing data from CDC’s ArboNET, you can look at transmission among humans, mosquitoes, birds, sentinel animals, and veterinary transmission. The observable diseases include West Nile Virus, St. Louis Encephalitis, Eastern Equine Encephalitis, Western Equine Encephalitis,  La Crosse Encephalitis, Powassan Virus, Dengue fever (locally acquired and imported), and Chikungunya (locally acquired and imported). The USGS disease maps allow us to not only have a better understanding of vectored disease transmission, but also landscape epidemiology.

CRISPR Off-Switch
CRISPR is going to be a hot story in 2017 and here are the seven things to look for. The burgeoning concerns regarding CRISPR technology involve the rapid pace of development and lagging DURC policies, not to mention the inability to predict future outcomes. The interest and unease over this new form of genome editing has left many searching for an “off button”, but thankfully, researchers are believed to have found one.  While the new “off switch” isn’t capable of reversing changes that were already made, it can stop the system from making additional edits. “The switch is a series of ‘anti-CRISPR’ proteins that were discovered inside viruses that attack bacteria, where they’re used to disable the gene editing tool and sneak into the bacterial DNA. ‘Just as CRISPR technology was developed from the natural anti-viral defence systems in bacteria, we can also take advantage of the anti-CRISPR proteins that viruses have sculpted to get around those bacterial defences,’ said lead researcher Benjamin Rauch. The team isolated these anti-CRISPR proteins from Listeria bacteria that had been infected by viruses. The team isolated the proteins that appeared to be involved and tested whether any of them could stop CRISPR editing from taking place in human cells. They found that two of these proteins, AcrIIA2 and AcrIIA4, worked together to inhibit the CRISPR systems commonly used by scientists.”

CDC Concludes CDP Ricin Exposure Inspection
The CDC just finished their inspection of the lab that sold the ricin toxin that was used by the Centers for Domestic Preparedness (CDP) training facility. The ongoing debate between the CDP and lab regarding the mishandling or misunderstanding points to bigger, systemic issues in regards to select agents. CDP states that the lab is to blame, noting that they ordered a less toxic version of ricin, while the lab rebutted by pointing out that the ricin was always properly labeled as the toxic version and they, in fact, never offered the less toxic version. The site visit and inspection findings are under review as the CDC determines if the lab is responsible and violated federal regulations. The conclusion of the inspection also comes at a challenging time for the CDC as the agency is taking heat for blacking out many details in reports recently released via the Freedom of Information Act. The released laboratory reports were requested by USA TODAY and only fuel the attention to lab incidents and poor biosafety practices.

NAS DURC Committee Meeting 
This week the National Academies held the Committee on Dual Use Research of Concern (DURC): Option For Future Management. You can get not only the webcast recording (check out 2:42:00 in and you’ll see GMU Biodefense director and professor, Gregory Koblentz, talk about the zero sum game in terms of regulating DURC research – to regulate or not to regulate, that is the question!), but also the full presentations. Since the 2011 H5N1 controversies, “it remains unclear as to whether there are practical mechanisms or approaches for managing such dual use research of concern (DURC) and, specifically, how to deal with situations where there is a pressing need, for public health reasons, to publish research findings while limiting, due to national security concerns, the dissemination of certain details that ordinarily would be published. This is especially true in cases where an initial assessment of proposed research does not anticipate results that would warrant such consideration.”

Zika Outbreak Updates
Scientists are currently unveiling the key proteins in the virus that made it so deadly. The first comprehensive description of the Zika genome has identified seven key proteins that are helping researchers understand the devastation the virus does to the human body. “To test the virus, Dr. Zhao used fission yeast, a species that in recent years has become a relatively common way to test how pathogens affect cells. Fission yeast was originally used to make beer, particularly in Africa, where it originated. (Its species name is Schizosaccharomyces pombe; pombe means beer in Swahili.) Over decades, fission yeast has been used by many scientists to find out mechanisms and behavior of cells. For the experiment, Dr. Zhao and his colleagues separated each of the virus’s 14 proteins and small peptides from the overall virus. He then exposed yeast cells to each of the 14 proteins, to see how the cells responded. Seven of the 14 proteins harmed or damaged the yeast cells in some way, inhibiting their growth, damaging them or killing them.” The Entomological Society of America has noted that socioeconomic factors provide protection against a large scale Zika outbreak in the U.S., but that small outbreaks are an ongoing concern. As of January 4th, the CDC reported 4,618 cases of Zika in the U.S., of which 216 were locally-acquired.

Does the CDC’s New Quarantine Rule Violate Civil Liberties?
With a new vaccine and hopeful approach to emerging infectious diseases, have we buried Ebola? Back in August, the CDC proposed a new rule regarding its powers to respond to potential outbreaks via screening, testing, and quarantining people traveling into or within the U.S. You can read the new rule here, but it focuses on “non-invasive public health prevention measures” and reporting requirements for commercial passenger flights of death or illness to CDC, etc. While this may seem pretty reasonable given health emergencies like Ebola and SARS, many ” epidemiologists, lawyers, and health organizations say that the rule, in its current form poses a serious threat to civil liberties, allowing authorities to detain and examine people with little heed to due process and informed consent.” Attempted in 2005, this rule was initially met with criticism, however the recent Ebola outbreak has changed the way we approach travel during times of infectious disease outbreaks. Public health emergencies are defined as ‘communicable disease events’ that the director believes could be high risk for death or serious illness. “It is already authorized to detain people suspected of carrying diseases like plague, Ebola, and (somewhat improbably) smallpox. But the new rule does away with a formal list. It extends the same powers to any “quarantinable communicable disease,” and uses wider range of symptoms (from a list that federal agents can update as the need arises) for defining ‘ill’ people.” While the CDC can detain travelers prior to decision to quarantine, it notes that this shouldn’t last longer than 72 hours and fails to make provisions for a lawyer if the person can’t afford one. “The rule also gives the CDC ultimate authority to carry out medical tests and treatments, stating that ‘the individual’s consent shall not be considered as a prerequisite to the exercise of any authority’.” What are your thoughts? We’d love to hear from our readership – please email or tweet @PandoraReport to give us your thoughts!

USDA ARS 4th International Biosafety & Biocontainment Symposium Registration Deadline
Don’t miss the January 13th registration deadline for this event in Baltimore, Maryland! From February 6-9, the focus of the symposium will be Global Biorisk Challenges-Agriculture and Beyond. Seven presymposium courses will address topics including unique biocontainment challenges, decontamination and inactivation, and institutional governance. Topics include biorisk management challenges in a One Health World, arthropods, HPAI, risk assessments, and more!

Stories You May Have Missed:

  • 85 People Suspected to Have Contracted Rabies– Like something out of a zombie movie, 85 people are suspected of having contracted wild rabies after being bitten by bats in Peru. “Regional director of Health of Cusco, Julio César Espinosa La Torre said that among the group of victims with a bat bite are the 15 soldiers transferred to Lima, of this group, two cases were confirmed, of which one is deceased. Espinoza la Torre said that to date, more than 912 civilians and 680 soldiers have been vaccinated in Alto and Bajo Urubamba, in the district of Megantoni, who must receive up to four doses, every 7 and 14 days.”
  • Anticipating Epidemics Using Computational Models – the White House recently released a report to strengthen the capacity for outbreak prediction. Spearheaded by the National Science and Technology Council, Toward Epidemic Prediction: Federal Efforts and Opportunities in Outbreak Modeling, looks to predictive modeling and data utilization to better understand the “processes that drive disease emergence and transmission could help to predict and prevent large-scale outbreaks. These programs range from foundational research into disease emergence and spillover, to predictive modeling contests, to the development of decision-support technologies for public health responders.”
  • Pandemic Chats – Struggling to chat to a younger generation about diseases? Check out how the Bill & Melinda Gates Foundation is talking to the next generation about the next pandemic.

Pandora Report 10.28.2016

by spopescu, posted in Pandora Report

A leaked report to the UN Security Council from the Organization for the Prohibition of Chemical Weapons, states that Syrian President Bashar al-Assad gave the order for the use of chemical weapons in 2015. The ECDC is seeing the initial cases for the 2015/2016 flu season, so make sure to get your flu shot! Science is sharing six science lessons for the next president. A new study finds that the correct antibiotics are only given half the time for common infections. Make sure to celebrate One Health Day on November 3rd!

Spillover: Ebola & Beyond Film Screening and Discussion
Don’t miss this great event at the National Museum of Natural History on Tuesday, November 15th from 6:30-8:30pm. If you loved the PBS documentary this summer, now is your chance to listen to a panel of experts discuss how they track diseases internationally and locally. “The film extends to the new frontiers of disease detection, prevention, and containment, and travels the world with virus hunters who are tracking old enemies while vigilantly looking out for new foes.” Featured speakers will include Vanessa van der Linden, Anthony Fauci, Yvonne-Marie Linton, and LaQuandra S. Nesbitt. Make sure to register before the event if you’d like to attend.

iow-zoonoses-onpgIf you enjoyed the Spillover documentary, check out this one (from the same team at the Howard Hughes Medical Institute who brought you Spillover) on Nipah virus hunters and their use of bat populations to track the disease. It’s a great film on epidemiology, One Health, and how we can study diseases in bat populations to predict outbreaks in humans. The HHMI has all sorts of wonderful disease-tracking goodies, like this one on the patterns of zoonotic diseases or an interactive on viruses. HHMI has some great interactive and fascinating learning tools for adults and children alike. Nothing like a little zoonotic disease lesson before bedtime, right?

MetaBiota Presentation for GMU Students 14875059_1343053735705798_1059784359_n
This week GMU was fortunate to hold an informational session by MetaBiota in which Dr. Kimberly Dodd discussed the organization and what life is like working on shifting emerging infectious disease response to prevention. GMU Biodefense MS student Greg Mercer was able to  listen to her experiences that range from the front lines of virus chasing to work on PREDICT and the factors that lead to zoonotic spillover. Dr. Dodd deployed to Uganda as part of the CDC’s response to the 2012 Marburg virus outbreak and to Sierra Leone during the West African Ebola outbreak. She described the challenges of trying to set up a BSL-4 equivalent laboratory in the field and the stressed of working with dangerous pathogens and noted that even in an outbreak of a high fear-factor disease like Ebola, there is often an international outpouring of volunteers. Experts are enthusiastic to help both for humanitarian reasons and the promise of cutting edge research to be done. Her experiences responding to outbreaks in the field prompted her interest in what preventative measures can be taken to forecast, identify, and mitigate outbreaks faster. She described her work on USAID’s PREDICT project, which seeks to catalogue viruses with potential to become pandemics. In its first 5 years, PREDICT sampled 56,000 animals, ran 400,000 diagnostics, and detected 984 unique viruses, 815 of which were novel. This new data was fed into Healthmap. In later pahses, PREDICT will go on to more closely examine the human-animal dynamics of spillover events.

Fears and Misperceptions of the Ebola Response System during 2014/2015 Outbreak in Sierra Leone
We’re still learning lessons from the worst Ebola outbreak in history, but will we actually apply this knowledge or continue to make the same mistakes? Public perception of public health response systems is a vastly important aspect of any outbreak response, however researchers are pointing to the severity it had on containment in 2014/2015. This study focuses on Sierra Leone and the barriers that prevented people from trusting and utilizing the Ebola response system that was established during the height of the outbreak. Researchers found that most people feared calling the national hotline for some one they believed to have Ebola as it would result in that person’s death. People tended to self medicate if they developed a fever and assumed it was not Ebola. “Fears and misperceptions, related to lack of trust in the response system, may have delayed care-seeking during the Ebola outbreak in Sierra Leone. Protocols for future outbreak responses should incorporate dynamic, qualitative research to understand and address people’s perception”

Estimating the BioTech Sector’s Contribution to the U.S. Economy screen-shot-2016-10-26-at-2-44-22-am
While the biotech sector has opened the floor for questions over dual-use, there’s no denying its growth. U.S. biotech sector revenue is estimated to have grown on average more than 10% per year over the past decade, which is faster than the rest of the economy..much faster. Data collected from various public and private sources allowed Robert Carlson to pain a much larger picture of what biotech is contributing to the U.S. economy. He found that total domestic U.S. revenue generated by biotech in 2012 reached at least $324 billion, which is the equivalent of >2% of GDP. Biotech revenue growth was >5% of annual U.S. GDP growth every year between 2007 and 2012. While the field is obviously growing, the rapid acceleration also means that there will be decreasing costs and more access to more powerful technology. “Governments around the globe are grappling with the desire to benefit from biotech-driven economic development, while simultaneously facing questions about who should have access to which technology and under what circumstances.” It’s important to not only support and monitor the technologies, but also facilitate data and reporting within the industry as these measurement deficiencies fuels biosecurity concerns. “Alongside the preexisting bioeconomy, we are building a system composed of inherently ‘dual-use’ engineering technologies that will constitute critical infrastructure for the future economy. Assuming that the revenue and growth estimates above are borne out with improved measurement and analysis, biosecurity is now clearly synonymous with economic security. The focus of biosecurity policy must shift from protecting specific targets from specific threats to securing the bioeconomy as a system that increasingly drives economic growth and employment and, ultimately, enables humans to thrive on a global scale.”

Hospitals Add Sinks to Help Fight Infections – Bad Move
Adding more easily accessible hand washing stations is one of the strategies to combating poor compliance and growing infection rates. Unfortunately, there have been some unintended consequences of upping the sink volume. Several hospitals throughout Baltimore, the Netherlands, and Shanghai have noted an increase in infections after adding more sinks (especially in patient rooms). Biofilms were a growing issue, which draws attention to the importance of facility and environmental service maintenance. I was a bit disparaged to see that the article points to the presence of non-sterile water from sinks in rooms with immunocompromised patients. Patients that are severely neutropenic are usually placed into positive pressure rooms (under protective precautions) and almost all hem-oncology units have special water filters on everything in the patient’s room (shower, sink, etc.). The concern for legionella is always an issue for those with weakened immune systems and while it’s important to cut down as much environmental exposure as possible, it’s impractical to think there should be sterile water. Another aspect of this is that patients in pre-op immune-suppression or post-op recovery will be exposed to germs – it’s a simple fact. If you’re concerned about sinks, then the patient should either be in a protective precautions room or you should not allow visitors. A sink is a small piece of the puzzle when it comes to patients that aren’t severely neutropenic. Sink design and cleaning is hugely important, which is another component to hospital infection control as anytime water is temporarily shut off, there needs to be water treatment plans in place, etc. It’s nice to see attention being brought to the environmental aspects of sinks and infection control, however one big aspect of the problem is also that people typically don’t wash their hands correctly. Yes, most people don’t spend the 15-20 seconds correctly lathering, washing all the nooks and crannies of their hands, etc. Needless to say, it takes a village to stop an infection and just one tiny moment to cause one – sinks are just one piece of the pie.

Terrorists Hamper Polio Eradication Efforts in Africa salk_headlines
Global eradication of a disease is never easy, however efforts to rid Africa of polio have encountered barriers that are allowing the disease to resurge. Nigeria has seen lingering polio as a result of “porous borders and shifting populations where travel has been blocked by terrorism.” Despite consistent work and effort to eradicate the disease from Nigeria, it was re-declared endemic in August, which leaves many concerned about it spilling over borders into neighboring countries. While Nigeria has always been a hotspot for polio, there has been increasing religious preaching that parents should not allow vaccination, specifically Muslim imams in Kano state in 2003, claiming that the vaccine had been contaminated to hurt Islamic children. Distrust compounds into lagging vaccination rates and during this time there was a spike in cases, which was coupled with terrorist activity by the Book Haram militia. “They cut off entire provinces, blocking the access needed by teams vaccinating children and epidemiologists counting cases. When the Nigerian military forced the militia out of parts of Borno state, in Nigeria’s northeast corner, the polio campaign discovered that wild polio virus had been circulating there for years.” The area around Lake Chad – Chad, Cameroon, and Niger – all pose problematic for vaccination efforts as the WHO calls the situation a “complex emergency” with more than 150,000 people fleeing across national borders. Despite these challenges, the governments of Nigeria and five nearby countries have initiated a massive emergency vaccination campaign that covers more than five million children per round, of which they’ll perform six rounds. “That may be an even more difficult task than in Afghanistan or Pakistan. In those countries, most of the areas where polio survives are remote, with little traffic in or out. Nigeria, on the other hand, is the most populous country in Africa, and a crossroads for the rest of the continent. There is no quick fix that can make the risk of onward spread go away; it requires yet more of the hard, grinding, repetitive work that eradication campaigners have been doing for almost 30 years.”

Zika Virus – What’s the Latest?
Brits are being warned not to travel to Florida after two British journalists contracted Zika during their travel to the state. The Florida state health department has released their Zika data– there are four new travel associated cases and nine non-travel associated cases. Wellcome Trust medical research charity is warning that we should expect Zika to reach India and Africa. “I think we can anticipate global spread,” said Jeremy Farrar, speaking to the Guardian alongside Sue Desmond-Hellmann, the chief executive officer of the Bill and Melinda Gates Foundation. “Given the [Aedes aegypti] mosquito’s availability across the world, I think the spread will next be across Asia and I think we really have to be prepared for it spreading in Africa. I don’t see any reason why it wouldn’t.” The WHO has released their Zika Research Agenda here, with a goal of “supporting the generation of evidence needed to strengthen essential public health guidance and actions to prevent and limit the impact of Zika virus and its complications”. Scientists are still bewildered by Zika’s path through Latin America as cases continue to grow. The CDC has reported 4,091 cases of Zika in the U.S. as of October 26th.

Stories You May Have Missed:

  • The Antibiotic Era Review – Infectious disease physician Amesh Adalja is discussing Dr. Scott Podolsky’s most recent book on antimicrobial resistance. As the realities of microbial resistance grows larger and gains more attention, it’s important to understand that this isn’t a solely modern issue. Dr. Adalja notes that the book should be required for anyone in the field as it takes great care to incorporate details that paint the larger picture of infectious diseases and antibiotics. “As Podolosky illustrates, in the post WWII era, civilization caused infectious diseases to recede in the US at the same time scores of new treatments (i.e. antibiotics) were coming to the market and experts who knew the (now rare) bug and the drugs used to treat them were valuable.” Adding it to our holiday reading list, thanks for the tip Dr. Adalja!
  • Climate & Evolutionary Drivers of Phase Shifts in Plague Epidemics of Colonial India – A recent study is looking at the climatic and evolutionary forces that impact plague epidemics. Researchers looked at the arrival of plague in colonial India through archival data and were able to identify the evolution of resistance in rats as a significant driver of the shifts within seasonal outbreaks. The findings “substantiate the rapid emergence of host heterogeneity and show how evolutionary responses can buffer host populations against environmentally forced disease dynamics.”
  • 2nd International Who’s Who in One Health Webinar – Don’t miss the One Health Commissions’ upcoming webinar on November 4th, 2016. This webinar is a great place to take part in dialogue with One Health leaders, advocates, professionals, and students The webinar is set to start at 7:45am EST and seeks to create new strategic partnerships and networks for collective, purposeful and coordinated action and educate participants about the One Health paradigm and ways of thinking towards improved health outcomes