Pandora Report 2.24.2017

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

Pandora Report 11.11.2016

The U.S. Election has concluded and whether your candidate is now our presidential elect or you’re just glad it’s all over, here’s something to celebrate – President Obama signed an executive order last week, cementing the GHSA as a national, presidential-level priority. Commitment to GHSA and fighting outbreaks on a global scale is a huge step forward to combating the health crises we’ve seen and will continue to battle in the future. Since researchers recently debunked the myth of Gaëtan Dugas as a primary source for HIV/AIDS in the U.S., check out more stories regarding the misunderstood “patient zero”.  World leaders are starting to realize that the antibiotic clock is ticking away.

Trump and the Issues Within Science
Donald Trump is the new president elect, but where does he stand on issues like Zika? Here’s a compilation of sources that cover his comments and plans for some of the top issues in science. NPR is looking at his comments on global health and humanitarian aid, while some are trying to figure out what Trump’s administration will mean for them and the need for a transition team tutorial. STAT is asking five questions regarding what the Trump administration will mean for science. Sources close to the Trump campaign have stated that two of the “best-known climate skeptics will lead his U.S. EPA transition team“.

It’s Time to Modernize the BWC 
GMU Biodefense graduate program director and professor, Gregory Koblentz teamed up with Filippa Lentzos to discuss why it’s so important for the BWC to modernize. They tackle the reality that while the convention isn’t failing, it’s definitely not flourishing. Despite its dedication to ban a whole class of weapons, the BWC is a somewhat toothless dog. “It lacks a dedicated forum to assess treaty implications of scientific advances, a robust institutional capacity, organized means of helping member nations meet their obligations, provisions for verifying compliance, and an operational role to respond in cases of a serious violations. The upcoming review conference provides a welcome opportunity to begin rectifying some of these shortcomings.” Koblentz and Lentzos point to the consistent challenges of science and technology reviews. Despite a rapidly evolving industry, the BWC hasn’t been able to keep up and maintain an international forum for the debates that are needed. Lagging behind the biotech times means the BWC is running the risk of irrelevance, not to mention the slow shift from the convention towards UNSCR 1540. In this climate, it doesn’t help that there is an even greater need for transparency. Biodefense programs have surged the last two decades, which means that transparency is increasingly important to ensure these programs aren’t biosecurity risks or being perceived as threats and becoming justifications for initiated offensive programs. The reform process is pivotal and this includes organizing a review of relevant S&T developments more systematically, renewing the mandate of an implementation unit, and setting up an Open-Ended Working Group on Providing Reassurance to encourage transparency and engagement in peer review exercises. “The Eighth Review Conference provides an opportunity to revitalize the bioweapons treaty by taking concrete actions to expand its relevance, enhance its capacity to review developments in science and technology, and strengthen the confidence of nations in the peaceful intentions of their fellow treaty members.”

RevCon began this week in Geneva and you can catch the U.S. opening statements by Thomas Countryman, Acting Under Secretary for Arms Control and International Security. You can also read Mr. Kim Won-soo’s remarks as High Representative for Disarmament Affairs. The International Committee of the Red Cross (ICRC) vice president, Christine Beerli, has also commented, noting that “States Parties should not become complacent; it remains their collective and individual responsibility to ensure that the treaty is implemented effectively. Over the past five years of annual meetings, a great deal of information has been shared and many proposals have been made on how to implement the treaty and improve its effectiveness. Disappointingly, however, there has been little collective agreement.” RevCon experts will also be focusing on new threats that may arise from technology. Guinea just became the 178th State Party to the BWC!

armas-biologicas-2NSABB Meeting on DURC and Other Hot Topics
On Friday, the National Science Advisory Board for Biosecurity (NSABB) hosted a call to review policy updates, new activities, updates from the working group on institutional oversight of the life sciences DURC policy stakeholder engagement, and updates from the Blue Ribbon panel that is currently reviewing the 2014 NIH variola incident. The conference call was fast-paced but covered substantial ground – most of it you can find on the Power Point slides. The policy updates focused on initiatives to strengthen biosafety/biosecurity stewardship. The 2016 NSABB report recommended additional, multidisciplinary evaluation prior to funding decisions and appropriate, ongoing oversight if funding were given to projects. It was noted that this is a particularly exciting time for science as we’re seeing so many advancements in human health, however the applications of these technologies are testing the oversight and policies we currently have in place to ensure science is performed safely (and securely). While they may or may not all be under the purview of the NSABB, the emergence of CRISPR and evolution of genomic sequences and gene drive techs, and abilities to create next gen of chimeras – are all examples of biotech that are evolving very rapidly and we may need to rethink how they fit our current policy and framework. NSAAB has been a part of the DURC conversation with policy focus on research responsibilities and institutional approaches. NSABB is also working on how to increase and approach stakeholder engagement in DURC polices. There were several listed strategies and topics, ranging from regional meetings at universities or panel sessions at conferences like ASM and ASV. The biggest focus was on getting dialogue and metrics across institutions, not to mention the need for feedback to evolve an objective oversight system. The Blue Ribbon panel is working on the review of the NIH variola incident but they did note that the event was handled very well and while there were obvious gaps, they were all addressed and that the interagency work between the FBI, NIH, and CDC went very smoothly.

Sverdlovsk, Three Mile Island, and Government Oversight of Biological Safety
Greg Witt is talking to us about government oversight of biological research and the lessons learned from the Three Mile Island nuclear accident (did I mention that Greg is a nuclear systems engineer?). Pointing to the biosafety failures that have happened recently (remember that time a Pasteur Institute employee improperly took MERS samples on a commercial airline???), Greg pulls together the pieces to paint a bigger mosaic of systemic failure to properly control biological agents. Pointing to similarities between these events (they even happened days apart) he notes that “both were caused, in large part, by errors in maintenance: at Sverdlovsk, technicians neglected to replace an exhaust system filter, while at TMI, staff had isolated an auxiliary feedwater pump during routine maintenance in violation of US Nuclear Regulatory Commission (NRC) rules.”

The Glamor of Bad Science02-ebola-w529-h352
Yours truly is talking about the disparaging addiction we have to dramatic science. I’m a fan of any movie that involves an outbreak, but the truth is that an overwhelming majority of these films depict infectious disease outbreaks so outrageously and dramatically, they have become anti-science. After watching the latest, Inferno, it became increasingly apparent that we’ve created a false threshold for science, specifically infectious diseases, in film. By painting the picture of diseases and outbreak response like that of Outbreak, I Am Legend, and more, we’re creating an increasingly de-sensitized culture. The result of this de-sensitization means that it takes a lot more for people to take infectious disease outbreaks seriously in real life. It’s not a genetically engineered airborne organism that will make flesh rot? Meh – not that big of a deal. Our love of bad infectious disease science in film and television could easily create a culture of poor public health support.

Ebola Was Just the Beginning…Are We Ready?
Peter Piot, Director of the London School of Hygiene and Tropical Medicine, is highlighting the realities that we simply aren’t ready for the next big virus epidemic. Piot discusses his work during the early days of Ebola in the 1970s, pointing to the challenges of attempting to figure out a novel virus while trying to put out the fires of an outbreak. Describing the 2014 outbreak as a perfect storm, he notes that the WHO response was too slow to act. The globalization of our interconnected world has made the capabilities of an outbreak much greater than 50 years ago. “Piot also believes there will be a ‘Big One’, a big influenza, similar to the likes of the Spanish Flu in World War One and we’re not quite ready for it. Yet. ‘Are we ready?’ Piot asked. ‘A little bit better than a few years ago but we’re not yet up to the job. We can’t afford to wait but we have a plan, and that’s the good news. The world has learnt from the problems of mobilisation around Ebola and we are now in a better situation; there is better technology to allow for more rapid diagnosis’.” Piot stresses the importance of investment in infrastructure, stronger global governance, and vaccine development incentives.

All Things Zika
The Florida Health Department has released their Zika updates here. PAHO has recommended that Bolivian women delay pregnancy to avoid Zika. “Fernando Leanes, PAHO representative in Bolivia, said at a press conference that it was one of several advised measures to avoid the proliferation of microcephaly cases. ‘The epidemic of Zika, from what we have seen in other countries, will have a rise and fall in Bolivia. Therefore, there are options such as delaying the decision to get pregnant in areas where Zika is spreading. This will avoid the dreaded microcephaly and the complications it represents,’ explained Leanes.” An $18 million plan was just announced to release Zika-resistant mosquitoes into urban areas of Colombia and Brazil.  “A swarm of Aedes Aegypti mosquitoes–the species that transmits dengue, yellow fever, chikungunya and Zika, have been modified to carry a bacterium called Wolbachia pipientis, which inhibits their ability to spread the viruses. Scientist released these ‘good mosquitoes’ in Brazil as part of a successful international program called ‘Eliminate Dengue’.” Many researchers are wondering why Colombia has had such few Zika-associated birth defects. They are the second largest outbreak in the world, yet have much fewer cases of microcephaly than Brazil. Researchers have noted that adult women in Puerto Rico were significantly more likely to develop Zika than men. The CDC has reported 4,175 cases of Zika in the U.S. as of November 9th, 2016.

Stories You May Have Missed:

  • How Trauma Explains Civil War– Don’t miss this event today at GMU’s Arlington campus, Founders Hall, Room 602. Eric Goepner will be discussing his research as to why “hurt people hurt people” and hypothesizing that a population’s prior traumatization predicts future civil war onset.
  • Searching for Ebola’s Hideout – The recent ebola outbreak is over, but this doesn’t mean the disease is gone. In fact, ebola is known for hiding out..so where has it gone? Leigh Cowart and other researchers are looking to stop future Ebola outbreaks by finding its hiding spot. “Such a long-term host, the quiet refuge of a pathogen, is known as a reservoir species. If a reservoir species is Ebola’s safe house, we are its luxury retirement property, a place for it to live out its last days with a bang. The trouble is that we aren’t sure where the safe house is. If we are going to be vigilant against Ebola’s re-emergence, we need to find it.”
  • The UK Forms Special Outbreak Response Team– with a five-year £20m funding, the UK is setting up a specialist team of health experts who will be able to respond to outbreaks around the world within 48 hours. “Public Health England will run the project with the London School of Hygiene and Tropical Medicine. Duncan Selbie, chief executive of Public Health England, said: ‘Speed is key in tackling infectious disease and with this new capability we can now deploy specialists anywhere in the world within 48 hours, saving and protecting lives where an outbreak starts and helping to keep the UK safe at home.'”

 

Pandora Report 10.28.2016

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