Pandora Report 5.26.2017

Summer is in full swing and that means the mosquitoes are out in force. Before you make those pesky bugs your biggest enemy, don’t forget about the threat of antibiotic resistance and the current MCR-1 Klebsiella outbreak in China!

Congrats GMU Biodefense Graduates 
Last week we saw several MS and PhD students graduate from GMU’s biodefense program and we couldn’t be more excited to show off their hard work! Earning their MS in biodefense, we’d like to celebrate Kathryn Ake, Rebecca Earnhardt, Nicholas Guerin, Andrew Joyce, Ryan Lockhart, Patrick Lucey, Alison Mann, Jonathon Marioneaux, Scott McAlister, Greg Mercer, Katheryn Payton, Dana Saft, Colleen Tangney, and Anupama Varma. Earning their PhD in biodefense, we’re celebrating Keith W. Ludwick (Dissertation title: The Legend of the Lone Wolf: Categorizing Singular and Small Group Terrorism), Nereyda Sevilla (Germs on a Plane: The Transmission and Risks of Airplane-Borne Diseases), and Craig Wiener (Penetrate, Exploit, Disrupt, Destroy: The Rise of Computer Network Operations as a Major Military Innovation). Congrats to our biodefense graduates – we can’t wait to see what wonderful things you’ll accomplish in global health security!

U.S. Investment in Global Health Security  – The Good and The Bad
Whether it be an intentional, accidental, or natural biological event, infectious diseases can devastate local economies and populations. “Catastrophic” is a term commonly used for such events. Disease knows no borders or boundaries, which means that our global health security is only as strong as the weakest link. To aid in the stability of global health security, the State Department funds projects around the world to help improve biosafety and biosecurity. The philosophy is that if we can train local trainers to establish expertise and biorisk programs, it would lay the foundation for biosecurity/biosafety for the future. “The State Department carefully evaluates and selects the most impactful projects for each region, pairing local needs with appropriate subject matter expertise. One source of such expertise is Sandia National Laboratories (SNL), which has received State Department funding to implement numerous health security projects. Just this April, Lora Grainger, working at the Labs’ International Biological and Chemical Threat Reduction (IBCTR), travelled to Algeria to train Algerian trainers on a project funded by the State Department. Participants included scientists working in Algeria’s national network of laboratories managed by the Ministry of Agriculture, the Institut National de Médecine Véterinaire (INMV).” This partnership is just one of many and involves education that is tailored to the skills and needs of those being trained. Global health security is bigger than any one country and it’s vital to not only strengthen our own practices, but also facilitate its development in countries that might not have all the resources needed. Speaking of U.S. health security efforts, don’t forget to catch the Operation Whitecoat documentary on the June 1st.                                                                                                                                                              

While these are great efforts the U.S. is putting forward, there is also an internal struggle to maintain public health during a hiring freeze. The freeze was imposed by President Trump’s executive order in late January, which covers currently open positions, blocks transfers, and prevents new positions from being created. It was recently reporting that nearly 700 positions within the CDC are vacant due to the ongoing hiring freeze. “Like HHS, the State Department and the Environmental Protection Agency have maintained the freeze as a way of reducing their workforces and reshaping organizational structures after a directive last month from the Office of Management and Budget that said all federal agencies must submit a plan by June 30 to shrink their civilian workforces. HHS, State and EPA also face significant cuts in the Trump administration’s budget proposal for the fiscal year starting Oct. 1. The administration, which unveiled a ‘skinny budget‘ for fiscal 2018 in March, is scheduled to release its full budget next week. A senior CDC official said unfilled positions include dozens of budget analysts and public health policy analysts, scientists and advisers who provide key administrative support.” A new CDC document notes that at least 125 job categories have been blocked from being filled, which includes positions in the Office of Public Health Preparedness and Response.

Ebola in the DRC – Updates
While we’re honoring researchers and workers for their efforts during the 2014/2015 West Africa outbreak, Ebola continues to rage through the DRC. You can find daily situation reports here from the WHO, as the numbers of reported cases are constantly changing. The WHO is reportedly optimistic that it can contain the outbreak and many are curious to see how the new director general will handle such challenges. The latest situation report from the WHO is pointing to six more cases of Ebola, bringing the total suspected cases to 43. 365 people are currently under monitoring in the DRC. Researchers have also made substantial progress towards understanding how Ebola disables the immune system so effectively. In response to this latest outbreak, the WHO is requesting funding to ensure adequate response to the DRC outbreak.

Pandemics, BT, & Global Health Security Workshop – Instructor Spotlight
We’re excited to announce that Kendall Hoyt is our instructor spotlight this week! Dr. Hoyt is an Assistant Professor at the Geisel School of Medicine at Dartmouth where she studies U.S. biodefense policy and biomedical R&D strategy. She is also a lecturer at the Thayer School of Engineering at Dartmouth College where she teaches a course on technology and biosecurity. She is the author of Long Shot: Vaccines for National Defense, Harvard University Press, 2012. She serves on the National Academy of Sciences Committee on the Department of Defense’s Programs to Counter Biological Threats and on the advisory board of the Vaccine and Immunotherapy Center at Massachusetts General Hospital. Kendall Hoyt received her Ph.D. in the History and Social Study of Science and Technology at the Massachusetts Institute of Technology in 2002 and was a Fellow in the International Security Program at the Belfer Center for Science and International Affairs at the Harvard Kennedy School of Government from 2002-2004. Prior to obtaining her degree, she worked in the International Security and International Affairs division of the White House Office of Science and Technology Policy, the Washington DC office of McKinsey and Company, and the Center for the Management of Innovation and Technology at the National University of Singapore. Did I mention that she’s also done work on Ebola and has written extensively about medical countermeasures for the disease? Dr. Hoyt is not only an expert on biosecurity and the impact of technology, but will take students through the journey of medical countermeasures and security.

The Finish Line in Ending Pandemics and The Future of the WHO
The recent election of a new WHO director-general highlights the current global shift in priorities, and yet the reality is that we’re still fighting an uphill battle against infectious disease and the threat of a pandemic. Recent decades have shown that outbreaks have been increasingly common, taking advantage of globalization, growing populations, and spillover. Avian influenza has been knocking at the door for a while…while bursts of Ebola and SARS have shaken global health security to its core. MERS has also triggered such events in hospitals, leaving no environment safe from emerging infectious diseases. The list of worrying viral diseases has also grown and taught us a rather painful truth – pandora’s box is already open and every time we think we’ve closed it…we realize the seal just isn’t that tight. “Dynamic, rapidly evolving viral threats emerge with increasing frequency, exploiting new pathways in endless pursuit of their biologic imperative. These viruses are the paradigm of adaptive learning. Pushing and probing at our defenses, they shift to new hosts, opportunistically hijack transmission routes, and acquire capacities to evade immune detection. They are subject to no rules of engagement, and their viral intelligence is anything but artificial”. Our new strategy is now to strengthen our detection efforts and to build up response processes. Many have highlighted that what we’ve seen is just a small percentage of what’s out there, but that doesn’t mean we have to keep our heads buried in the sand forever. The future of international disease response will change with the appointment of the new WHO director-general, especially for poor countries dependent upon resources. On Tuesday, it was announced that Ethiopia’s Dr. Tedros Adhanom Ghebreyesus was voted director-general. Dr. Ghebreyesus is the first ever African director-general and brings to the position a long history of health stewardship as a former health minister in Ethiopia. Not only is this election particularly significant as the future of the WHO will be heavily weighed against its failures in recent years, but recent accusations against the newly elected director-general have created further doubts as to the stability of the organization.

Double-edged Sword Research
A new report from the Swiss Academies of Art & Sciences is drawing attention to the need for continued conversation and engagement about the potential for misuse in life sciences. As a result of the workshop, a report was developed highlighting “six issues that should be considered when designing, conducting, and communicating research projects. Each issue is illustrated with examples from actual research projects.” In fact, CRISPR inventor, Jennifer Doudna, is drawing attention to the promises and perils of the gene-editing technology. She points to the worries of creating designer embryos while contrasting the promises of reducing mosquito-transmitted diseases. In fact, recent work has shown some promise in using CRISPR to fight HIV. “Part of the problem is HIV’s ability to squirrel itself away inside a cell’s DNA – including the DNA of the immune cells that are supposed to be killing it. The same ability, though, could be HIV’s undoing. ast week, a group of biologists published research detailing how they hid an anti-HIV CRISPR system inside another type of virus capable of sneaking past a host’s immune system. What’s more, the virus replicated and snipped HIV from infected cells along the way.” While this work has only been done in mice and rats, the concept is promising. Overall, these advances bring about exciting future possibilities, but it’s important to remember that there are dangers too – whether it be tampering with human evolution, contaminated CRISPR kits, nefarious actors using them for terrorism, etc. The complexities of CRISPR and genetic engineering are only growing, which makes the 2018 arrival of the peer-reviewed publication, The CRISPR Journal, even more relevant.

Stories You May Have Missed:

  • Model Systems and the Need For Curiosity-Driven Science– GMU Biodefense PhD student, Saskia Popescu, is looking at the importance of model systems and picking the brain of a top researcher in the field, Dr. Julie Pfeiffer. “Poliovirus is great to use to create model systems because not only does it grow easily, but it is also relatively safe due to vaccination for lab workers, not to mention that we have a pretty solid understanding of the virus based off a century of working with it. ‘We know a lot about poliovirus and we have great tools in our toolbox. If you’re going to tackle a tough problem, it helps to have a great toolbox. For other fields, the ideal toolbox may be fruit flies, worms, or yeast. Collectively, these model systems have illuminated biology and have led to major advancements in human health.’ stated Dr. Pfeiffer in her recent PLOS Pathogens article on the importance of model systems.” “Firstly, I asked if she thought there were other eradicated or ‘almost’ eradicated diseases that could make decent models. She replied, ‘No. We use poliovirus as a model system because of its great tractability, safety, and ease of use (not because it’s nearly eradicated). [Other eradicated diseases such as] smallpox and rinderpest would not be good model systems because they have been completely eradicated from circulation, making biosafety and tractability major issues. [That being said,] if the poliovirus eradication campaign is successful, the idea is to stop vaccination. If this happens, poliovirus will likely become a BSL3/4 agent and I will no longer work with it’.”
  • Is Your Daycare Prepared For a Pandemic?– Daycare centers may not be your first thought when it comes to pandemic preparedness, however a recent survey found that fewer than one in ten U.S. centers have taken steps to prepare for a pandemic flu event. “Researchers surveyed directors of licensed childcare centers in 2008 and again in 2016, to assess flu prevention measures before and after the 2009 pandemic outbreak of a new strain of H1N1 influenza. Among other things, they looked at flu prevention activities like daily health checks for kids, infection control training for staff, communicating with parents about illness and immunization requirements for children and staff.” Children are great sources for disease transmission and when guardians are needed at work, childcare capacity will be extremely important if a pandemic flu occurs.

 

Pandora Report 5.12.2017

TGIF and welcome to your favorite weekly dose of all things biodefense! Check out this film from PBS Digital Studios Brain Craft exploring the technical and ethical questions about CRISPR and genetic engineering.

The Growing Threat of Pandemics: Enhancing Domestic and International Biosecurity
The Bush School of Government and Public Service at Texas A&M University just released their new white paper on biosecurity measures. The paper highlights the increased threat of pandemics due to globalization and ease of transportation. In their review they found nine priority areas that will help address the current biodefense problem. Their priority areas/action items are leadership, international response, the anti-vaccine movement, animal and human health, uniform health screening, public health and healthcare infrastructure, effective outbreak response, cultural competency, and academic collaborations. The white paper notes that “there should be uniform health screenings for individuals seeking permanent or extended temporary residence in the United States. Currently, there are discrepancies between the vaccination requirements for immigrants and the vaccination requirements for refugees.” The inclusion of the anti-vaccination movement was particularly interesting as few reports truly capture this in regards to biodefense efforts. “The increasing influence of the anti-vaccine movement in the United States is another growing threat. Leaders of the movement spread misinformation to parents with questions or anxiety over the safety of vaccines. Many within the anti-vaccine movement incorrectly believe that vaccines cause autism and the number of individuals seeking nonmedical exemptions to the vaccination requirements of schools is on the rise.”

Pandemic Summer Workshop Sneak Peek 
We’re getting closer to the July 17-19 workshop on pandemics, bioterrorism, and global health security, which means that starting next week, we’ll be highlighting some of the amazing faculty teaching the courses. Make sure to look for our spotlight on Dr. Andy Kilianski in next week’s Pandora Report as we’ll be looking at his work on biosurveillance and its role within U.S. biodefense efforts! Make sure to take advantage of the early registration discount before June 1st!

2017 Infectious Disease Mapping Challenge
Don’t miss this wonderful chance to show off your infectious disease mapping skills! The Next Generation Global Health Security Network and DigitalGlobe Foundation are “seeking undergraduate and graduate students, in a team or individually, to generate up to three maps (one map is perfectly acceptable) that illustrate a research question related to any of the categories detailed below. Maps can be analytic (examining relationships between multiple domains, phenomena, or data sources) or descriptive (depicting a single phenomenon or data source). While analytic projects are ideal, descriptive projects will be accepted as long as students/teams describe why their map depicts a notable phenomenon. Similarly, while international maps are preferred, domestic maps will be accepted if the student/team can provide justification as to why a map focusing on the U.S. is necessary (e.g., U.S. data sets on a given topic are the most comprehensive).”

Scientists Take On HIV By Using CRISPR
Researchers have just made headway in the battle against HIV/AIDS by using the genome editing technology, CRISPR-Cas9. Current treatment for HIV involves anti-retrovirals, which are pretty harsh on the body and come with several nasty side effects. In their fight against HIV, the research team used the CRISPR technology like a pair of scissors to get rid of the HIV-1 DNA in the body of mice. “If you cut out the DNA, you stop the virus from being able to make copies of itself. The team is the first to show HIV can be completely annihilated from the body using CRISPR. And with impressive effect. After just one treatment, scientists were able to show the technique had successfully removed all traces of the infection within mouse organs and tissue.”

Public Interest Report – Chemical Weapons
Don’t miss the latest publication from the Federation of American Scientists, which includes several articles on chemical weapons. The Public Interest Report (PIR) is a great source for articles on human rights, counterterrorism, and more. The most recent edition includes articles on the threat of toxic chemicals, investigations regarding the chemical attacks in Syria, the value of scientific analysis of chemical weapons attacks, and more. The president of the Federation of American Scientists, Charles D. Ferguson, also wrote a special message regarding the value of scientific analysis, specifically in regards to chemical weapons attacks. He highlights several articles regarding chemical weapons attacks over the years, one of which includes an analysis of symptoms and potential agents used. This specific work includes analysis from GMU professor, Keith Ward, and highlights the use of chemical weapons in Darfur and Sudan and the limitations of NGO documentation of chemical warfare agents. The article points to the specific symptoms following chemical weapons attacks and notes that “NGOs find themselves at considerable disadvantage compared to national governments when faced with evaluating evidence of alleged attacks using chemical weapons.”

Could Saving Animals Prevent the Next Pandemic?
70% of emerging infectious diseases are zoonotic, meaning that some type of a spillover event had to occur. Ebola, HIV/AIDS, H1N1, and avian influenza are all examples of spillover that has resulted in human morbidity and mortality. The USAID PREDICT program is working to combat this growing threat of zoonotic diseases. PREDICT works to establish a global surveillance system for infectious diseases that can spillover into humans. PREDICT is a collaborative effort between the University of California at Davis’s One Health Institute and the School of Veterinary Medicine, as well as the Wildlife Conservation Society, Metabiota, EcoHealth Alliance, and the Smithsonian Institute’s Global Health Program. “In its first five years, PREDICT trained 2,500 government and medical personnel in 20 countries on things like the identification of zoonotic diseases and implementing effective reporting systems. They collected samples from 56,340 wild animals, using innovative techniques like leaving chew ropes for monkeys then collecting saliva afterwards. They also detected 815 novel viruses—more than all the viruses previously recognized in mammals by the International Committee on Taxonomy of Viruses.” One of the tools PREDICT uses for surveillance is to monitor animal health and diseases that are circulating in them. “When you disrupt an ecosystem by removing a species through culling, you have a less healthy ecosystem and higher risk of disease,” says Megan Vodzak, a research specialist for Smithsonian’s Global Health Program. “Sometimes you increase the level of the virus within the population because you eliminate some but not all of the animals, and they’re still circulating it.” This brings about a humbling notion – conservation and human health might go hand in hand. Some researchers note that by protecting wildlife, we can help prevent spillover events and outbreaks. This concept however, is a bit more complex and has many on the fence regarding the actual role of conservation in human diseases. Some work has found that increases in biodiversity have no impact on human health, emphasizing the murky water of those trying to sell conservation as a tool for fighting pandemics. “When researchers do embark on conservation projects, she cautions that they should also consider other possible outcomes besides the protective benefit humans get from healthy wildlife and ecosystems. ‘We have to recognize that conservation could provide benefits for public health and it could endanger public health,’.”

The Battle of the Resistant Bug
We often think of an infectious disease threat emerging from some hidden jungle or quiet spillover event. While these are are true scenarios, I offer one more – the moment a bacteria becomes resistant to antimicrobials. Whether it be related to over-use in farming or over prescribing in healthcare, this is often a forgotten battleground. We’ve become accustomed to the ease and availability of antibiotics, which has translated to increased and improper use. Antibiotic resistant has frequently been overshadowed by the flashier of infectious disease threats however, this is to our detriment. Antimicrobial resistance (AMR) has proven time and time again to not only be a devious adversary, but one that gets little attention. Research and development into new antibiotics has lagged in recent years, which has only compounded the issue. One of the issues is also the lack of coordinated international surveillance and response strategies. Interestingly, Russian scientists recently developed an interactive world map, which shows human gut microbiota and their potential for resistance. The ResistoMap (pretty outstanding name, right?) makes it easier to track national resistance trends and potentially create an international response plan. “Using the ResistoMap, it is possible to estimate the global variation of the resistance to different groups of antibiotics and explore the associations between specific drugs and clinical factors or other metadata. For instance, the Danish gut metagenomes tend to demonstrate the lowest resistome among the European groups, whereas the French samples have the highest levels, particularly of the fluoroquinolones, a group of broad-spectrum anti-bacterial drugs.” While the rise of an emerging infectious disease should not be ignored, it is important that we remember the slower burn of antimicrobial resistance. Even Alexander Fleming saw the future involving a world without effective antibiotics, as he noted just following his acceptance of the 1945 Nobel Prize, “The thoughtless person playing with penicillin treatment is morally responsible for the death of the man who succumbs to infection with the penicillin-resistant organism.”

Regional Action Needed to Prevent Syrian Chemical Weapons Attacks
GMU biodefense PhD alum, Daniel M. Gerstein, is focusing on the role regional actors could play with respect to Syria, especially in terms of dissuading the use of chemical weapons. Despite the horrific attack in early April, global response has been surprisingly tepid and Russian support is ongoing, but Gerstein also highlights the “deafening silence” on the issue by countries within the region. Pressure could be applied from surrounding countries to indicate a strong message that the use of such weapons will not be tolerated. “Borders with Syria could be sealed to prevent any of the re­maining stocks from leaving the country. This would likely require a mix of military, law enforcement and border police to ensure that any illicit crossings are immediate­ly halted. In the event that chemi­cal weapons do breach the Syrian border, response forces should be prepared to stop suspect ship­ments, conduct searches of cargo and have appropriate protection to avoid becoming casualties them­selves.” Gerstein also notes that regional leaders could direct efforts towards Assad specifically, making it clear that Syria’s future will not include him, by calling for the International Criminal Court to indict him for war crimes.”Over the past 15 years, the norms against the use of chemical weap­ons have continued to be threat­ened, with increasing state and non-state actor use. Most of these attacks have occurred in the Middle East. This trend cannot be allowed to continue.”

The Chemical Attack in Syria – Sorting Truth from Propaganda
Rod Barton takes us through the April chemical weapons attack in Syria and argues against those who claim it was a “false flag” operation, staged by rebels to draw the U.S. into further intervention efforts. The most notable proponents of this argument have been former MIT professor Theodore Postol and Sydney University professor, Tim Anderson. In efforts to help break the cycle of a false narrative, the U.S. has released intelligence reports however, those who support the “false flag” narrative continue to point to misinformation and confusion about the April 4th attack as evidence. Barton argues against the “false flag” narrative by highlighting several points as evidence for the attack – victims seeking medical care following a Syrian air strike with classic symptoms of nerve agent poisoning, analysis samples that confirmed sarin, and the air raid crater found in the road north of the town, which tested positive for sarin and hexamine. Postol, on the other hand, while continuing to claim that the U.S. intelligence reports fail to prove definitively that the attack was done by the Assad regime, does not argue that it was sarin that killed the people in Khan Sheikhoun. “His case is largely based on the nature of distortion of the metal fragment in the crater – he claims this proves that it was not dropped from an aircraft, as stated by US intelligence. His theory is that a sarin-filled tube, possibly a 122mm artillery rocket body, was placed on the road by individuals on the ground and overlaid with a small explosive charge to disperse the agent.” Barton argues against Postol’s comments for several reasons – Postol fails to explain the origin of the sarin in the tubes, how the rebel groups managed to coordinate the detonation of their device with that of a Syrian government air raid, and that Postol fails to account for the evidence of a second chemical round that detonated around 300m from the road crater. Barton notes that “Postol was an eminent scientist and his views cannot simply be ignored. However, on this occasion the evidence to support his argument is not there – he has got it wrong. His writings on this subject have nevertheless been useful in that they have forced analysts to question the evidence closely to determine their degree of certainty in their assessments. But while the particulars are difficult to ascertain, there is still sufficient evidence to state beyond reasonable doubt that the Syrian military is responsible for the attack. In other words, the jury should convict – sadly, in today’s world, the reality may be different.”

Stories You May Have Missed:

  • 3-D Structures vs. Infectious Diseases– Northwestern University Feinberg School of Medicine is leading a team of international researchers to determine the 3-D atomic structure of more than 1,000 proteins to help develop treatments and vaccines against infectious diseases. “Almost 50 percent of the structures that we have deposited in the Protein Data Bank are proteins that were requested by scientific investigators from around the world,” said Wayne Anderson, PhD, professor of Biochemistry and Molecular Genetics at Feinberg, and director of the project. “The NIH has also requested us to work on proteins for potential drug targets or vaccine candidates for many diseases, such as the Ebola virus, the Zika virus and antibiotic-resistant bacteria. We have determined several key structures from these priority organisms and published the results in high-impact journals such as Nature and Cell.”
  • The Million Dollar Minnesota Measles Outbreak – the growing measles outbreak in Minnesota is projected to cost the state $1 million and is quickly growing. “When it began last month, public health officials knew this outbreak could be large and ongoing, because many Somali-Americans have been refusing the measles, mumps, and rubella (MMR) vaccine for years over unfounded rumors that the childhood immunization, whose first dose is routinely given to babies at 12 to 15 months, causes autism.” Sadly, the vaccination declinations in the Somali-Americans in Minnesota are considered to have been a result of targeting from anti-vaccine groups.

Pandora Report 5.5.2017

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

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

Pandora Report 4.21.2017

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

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

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

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

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

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

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

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

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

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

Stories You May Have Missed: 

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

Pandora Report 4.7.2017

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

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 3.17.2017

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

 

Pandora Report 2.24.2017

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

Pandora Report 2.3.2017

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

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

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

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

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

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

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

Stories You May Have Missed:

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