Pandora Report 9.23.2016

Welcome to the first few days of Fall 2016! We need to really ramp up our investment in vaccines – an ounce of prevention is worth a pound of cure. Doctors in Saskatchewan are imploring the province to declare a medical state of emergency over a surge of HIV/AIDS cases. Johns Hopkins University is currently working on a study to assess why healthcare workers catch the flu – what’re your thoughts? Poor PPE use, isolation precautions, and/or hand hygiene is my guess. New research from the World Bank shows that antibiotic resistance is likely to increase poverty and by 2050, could cause global economic damage on par with the 2008 financial crisis. The Blue Ribbon Study Panel on Biodefense has received a $1.3 million grant to continue work on assessing American biodefense systems, informing policymakers, etc. Before we start with the latest in global health security, you can now access (for free!) the Global Health Impacts of Vector-Borne Diseases workshop summary here.

The Uncertain Future of Plum Island 
Established in 1945, Plum Island Animal Disease Center (PIADC) (Orient Point, NY), “has served as the nation’s premier defense against accidental or intentional introduction of transboundary animal diseases (a.k.a. foreign animal diseases) including foot-and-mouth disease (FMD). PIADC is the only laboratory in the nation that can work on live FMD virus (FMDV). The lab and its staff of nearly 400 employees provide a host of high-impact, indispensable preparedness and response capabilities, including vaccine R&D, diagnostics, training, and bioforensics among others.” Not immune to controversy or a theme in horror movies, Plum Island is a research facility that hosts BSL-2, BSL-3 Enhanced, and Animal Biosafety Level 3 and Biosafety Level 3 Agriculture laboratories and animal research facilities that maintain highly restricted access and trained security professionals. The nostalgia of Plum Island is fast approaching as the research center is set to be closed within the next decade. The research campus will move to Kansas and the 840-acre island is up for sale. “Located 100 miles east of New York City, with sweeping water views, the island has already drawn unsurprising interest from local real estate agents and developers, including, yes, Donald J. Trump. Many people in the area, however, want the island preserved as a nature sanctuary or perhaps a park. In July, a coalition of environmental groups and activists filed a federal lawsuit to stop the sale, and there is a similar legislative push in Congress.” Since its inception and through its new ownership in 2003, (when DHS took it over) the biggest concern of Plum Island has always been containment as the infectious livestock samples and animals could introduce diseases, like food-and-mouth disease, to a susceptible population. The facility takes great care to mitigate any risk through “stringent security clearances and background checks, the boiling of all water discarded from the lab and the requirement that anyone who works within the biocontainment lab must shower twice before leaving. As for the cattle, pigs and other animals used for vaccine and other kinds of testing, they are kept in indoor, secured living quarters, said Dr. Luis L. Rodriguez, who leads research at the center’s laboratories.” In the event a deer should swim onto the island, it’s killed and immolated. Aside from the “Island of Dr. Moreau” vibe that is often felt when discussing the island, it has water views and sandy beaches that are met with a green terrain. While the future of the island is up in the air, the zoning stipulates that it must be reconstructed for similar use (i.e. research). Any takers?

Don’t Miss the Biological Threats in the 21st Century Book Launch!
screen-shot-2016-09-12-at-8-00-42-pm
On October 14th, join us in celebrating the book launch of Biological Threats in the 21st Century! Biological Threats in the 21st Century introduces readers to the politics, people, science and historical roots of contemporary biological threats through rigorous and accessible chapters written by leading scholars and supplemented by expert point-of-view contributions and interviews. The book launch will feature a panel discussion on the threat of biological weapons and the role of scientists in bioweapons non-proliferation and disarmament. The event is free and open to the public. Lunch will be available beginning at 11:45 AM so please RSVP. Attendants will also be able to pick up the book at a 15% discount.

Screen Shot 2016-04-21 at 1.28.57 PMGMU Biodefense Graduate Program Informational Videos
Curious about a graduate degree in biodefense but unable to attend an information session? We’re happy to show off our new informational videos on both our MS and PhD biodefense programs at GMU. Check out what students are saying about our MS programs (we have both an online and an in-person tract) and our PhD program. You’ll also get to hear from biodefense guru and graduate program director, Dr. Koblentz, throughout the videos!

Bioresearch Labs and Inactivation of Dangerous Pathogens Hearing                                   

The Committee on Energy and Commerce, Subcommittee on Oversight and Investigations will be holding a hearing today at 9am regarding bioresearch labs and the inactivation of dangerous pathogens. While witnesses are by invitation only, the hearing webcast will be available here – don’t miss it! You can also read a recent GAO report on high-containment laboratories: improved oversight of dangerous pathogens needed to mitigate risk. 

The Global Implications of Antibiotic Resistance
I love a good zombie movie like the next person, but where are the horror movies about antibiotic resistance? Show me a film that depicts the global threat of losing all effective antibiotics – that is a real horror movie. The UN General Assembly held a high level meeting on Wednesday about the growing threat of antimicrobial resistance (AMR). Despite increasing surveillance and high-level attention to the rise of the resistant bugs, it will take more than the efforts of a few countries. We’ve passed the golden age of antibiotic development and the “pipeline of new antibiotics has been running dry”. Colistin-resistant bacteria continue to sporadically pop up, highlighting that once again, germs know no borders and are skilled in the art of travel. Hopefully, with the recent UN General Assembly meeting, it will send a clear message that the threat of antibiotic resistance is being taken seriously and for more world leaders to really hone in their efforts for surveillance and prevention through the GHSA. Sadly, a recent study found that antibiotic usage hasn’t changed in hospitals, despite the growing threat of AMR. Researchers looked at patient discharge records in over 300 US hospitals between 2006 and 2012 and “found that 55.1% of patients discharged received at least one antibiotic during their stay, with little change in that proportion between 2006 and 2012. The overall rate of antibiotic use for all study years was 755 days of therapy per 1,000 patient-days, a rate that also saw little change over the period of the study. But the study also showed significant increases in the use of carbapenem antibiotics, third- and fourth-generation cephalosporins, beta-lactam/beta-lactamase inhibitor combination antibiotics, tetracyclines, and vancomycin.”

Next Generation Global Health Security Network Webinar – Our Antimicrobial Anthropocene: UNiting against Pan-Epidemic AMR
As you know, a key component of responding to (and preparing for) outbreaks is the ability to treat them. But how can we make sure that the drugs we have to treat diseases will work? How can we combat the growing trend of antimicrobial resistance? In line with the recent high-level meetings by the Presidential Advisory Committee (see here) and the UN, the Next Generation Global Health Security Network is pleased to present the first of an ongoing series of webinars, this one focused on Antimicrobial Resistance (AMR). These webinars are intended to provide unique learning opportunities for global health security professionals through educational sessions about important GHS topics and situate emerging issues for a global health audience.  Please join the event on Tuesday, September 27 from 6:00-7:00pm EST as the Next Generation Global Health Security Leaders Network and CRDF Global host a webinar by Dr. Dan Lucey titled “Our Antimicrobial Anthropocene: UNiting against Pan-Epidemic AMR”.  There will also be limited in-person space for those in the DC metro area who wish to attend.  If you wish to attend in person, please RSVP by email (nextgenghsa@gmail.com)

Your Weekly Dose of Zika News
The Zika virus outbreak has pointed out several international challenges when it comes to infectious disease outbreaks – funding, vector control, long-term health effects, and international events. Sandro Galea points to the poet John Keats as a potential role model for how we should approach such events. Trained as a surgeon, Keats had a solid background in the scientific method, however the quality he “emphasized was not the scientist’s finely tuned analytic instrument, but the ability to exist comfortably amidst uncertainty and doubt.” Galea notes that the Zika outbreak is a prime example of how scientists should start thinking more like poets, living in the space of inevitable ambiguity and the new norm of the grey area. Here is the ECDC’s epidemiological update on Zika. The CDC is ramping up testing support in Florida to aid in rapid diagnostics. A recent study published in the Lancet points to a low risk of sexual transmission and questions the sustainability of Zika transmission without the presence of a vector. The CDC is reporting 3,358 cases of Zika virus in the US as of September 21st. Of these cases, 43 are locally acquired related to mosquitoes.

Stories You May Have Missed:

  • Are We Prepared For Another Ebola Outbreak? In response to last week’s Ebola and Zika: Cautionary Tales article, John LaMattina is digging into the realities of R&D. “Actually, a check of clinicaltrials.gov lists 71 studies ongoing in Ebola, the majority of which involve studying novel vaccines or drugs in humans. Furthest along appears to be Merck with planned regulatory filings for its vaccine in 2017.” He notes that while Ebola may not be making headlines, that shouldn’t be translated into a total lack of preparedness for another outbreak. You can also read the latest article in NaturePublic Health: Beating Ebola.
  • Glory in the Guts- If you’re a fan of Mary Roach’s books (Stiff, Spook, etc.), you’ll love hearing what GMU Biodefense MS student, Greg Mercer, thinks of her latest book, Grunt. Roach’s latest book looks at the life of soldiers and how the military keeps them alive. “The only gun that interests her is the one that fires chicken carcasses at military aircraft to test their birdstrike resilience. Roach isn’t squeamish, though. She participated in a training simulation as a victim of smoke inhalation burns, experienced a live-fire demonstration of the importance of hearing protection, and endured a treadmill trip in the 104-degree “cook box” to witness just how easy it is to become dehydrated while lugging 80 pounds of gear.”
  • Global Capacity for EID Detection – In the most recent CDC Emerging Infectious Disease online report, researchers are evaluating the global improvements of disease detection and communication during 1996-2014. “Improvement since 1996 was greatest in the Eastern Mediterranean and Western Pacific regions and in countries in the middle HDI quartiles. However, little progress has occurred since 2010. Further improvements in surveillance will likely require additional international collaboration with a focus on regions of low or unstable HDI.”

Pandora Report 9.16.2016

Is it time to outsource key tasks out of the WHO and into more capable agencies? On Monday, the U.S. carried out a massive airstrike on a suspected ISIS chemical weapons facility in Mosul, Iraq. Sri Lanka has made history by being declared malaria-free after three years since its last case. Sri Lanka had previously tried to eradicate malaria over fifty years ago, but the effort was met with failure and is frequently cited by malaria experts. Do you subscribe to the “five-second rule” when it comes to your food? You may want to give it a second thought as Rutgers researchers have recently disproven the notion – sadly, cross-contamination can’t be avoided in most cases. The CDC has added Bacillus cereus Biovar anthraces to the list of Tier 1 Select Agents.

GMU Biodefense Graduate Info Sessions
In case you missed last night’s MS Open House in Arlington, we’ve got plenty more graduate program information sessions. GMU will be hosting several more events this Fall, so make sure not to miss one! The next MS information session (for both in-person and online programs) is on Wednesday October 19th, 6:30pm in Founders Hall, room 126. If you’re looking at a PhD in biodefense, come to our information session on Wednesday, October 12th, from 7-8:30pm, at the Johnson Center in the Fairfax Campus, room 334. From Anthrax to Zika, we cover all the biodefense topics and applications in our information sessions.

Biological Threats in the 21st Century Book Launch!  
On October 14th, join us in celebrating the book launch of Biological Threats in the 21st Century! Biological Threats in the 21st Century introduces readers to the politics, people, science and historical roots of contemporary biological threats through rigorous and accessible chapters written by leading scholars and supplemented by expert point-of-view contributions and interviews. The book launch will feature a panel discussion on the threat of biological weapons and the role of scientists in bioweapons non-proliferation and disarmament. The event is free and open to the public. Lunch will be available beginning at 11:45 AM so please RSVP. Attendants will also be able to pick up the book at a 15% discount.

Identifying Future Disease Hot Spots
Check out the latest RAND report in which researchers are asking which countries might be particularly vulnerable to infectious disease outbreaks and how the U.S. can help support these countries to better prepare and respond to public health events. Pulling from a wide variety of literature and data, “authors created an index for identifying potentially vulnerable countries and then ranked countries by overall vulnerability score.” Researchers looked at the 25 most-vulnerable countries, which include the “disease belt” in the Sahel region of Africa. Of the 25 noted countries, 22 are in Africa, and the remaining are Afghanistan, Yemen, and Haiti. “Conflict or recent conflict is present among more-vulnerable countries. Seven of the ten most-vulnerable countries are current conflict zones. Of the 30 most-vulnerable countries, 24 form a solid, near-contiguous belt from the edge of West Africa to the Horn of Africa in Somalia — a disease hot spot belt. Were a communicable disease to emerge within this chain of countries, it could easily spread across borders in all directions.” The 25 least-vulnerable countries were found to be in Europe, North America, and Asia-Pacific. The least-vulnerable countries were found to have larger medical systems and expenditures, better health indicators, less corrupt and more stable governments, better human rights, and often technological sophistication.

Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB) 
You can join (in listen-only) this teleconference and webcast on Monday, September 19th, to gain further insight into the battle of microbial stewardship. “With participation of Member States, non-governmental organizations, civil society, the private sector and academic institutions, the primary objective of this pubic meeting is to summon and maintain strong national, regional and international political commitment in addressing antimicrobial resistance comprehensively and multi-sectorally, and to increase and improve awareness of antimicrobial resistance.”

Ebola & Zika: Cautionary Tales 20988_lores
In the latest issue of Science, Michael T. Osterholm discusses the challenges of combating infectious disease outbreaks and the struggles to respond with vaccine development. Osterholm points to the need to drive development and funding mechanisms in coordination with surveillance of emerging infectious diseases (EID). Upon the indication that an EID is bubbling up, it would be prudent to have vaccines (even if they’re not licensed yet), ready for large trials. Moreover, the looming threat of EID’s should be the best motivator for developing candidate vaccines. “The handwriting is on the wall regarding the current Zika outbreak in the Americas. High human infection rates in the major impact regions, caused by virus-carrying mosquitoes and human sexual transmission, will continue for several more years. Eventually, the number of cases will drop as more of the community develops immunity. Zika vaccine trials in the Americas may be too late to be tested on the current high number of cases.” Pointing to the Coalition for Epidemic Preparedness Innovations (CEPI), he emphasizes the need to fill the vaccine preparedness hole. Current practices are slow and on an “as-needed” basis, but the truth is that we already have the incentives and EID presence to make the push towards correcting the insufficient process.

Weapons of Mass Destruction: A Dialogue with Students
The UN Security Council 1540 Committee and the UN Office of Disarmament Affairs collaborated with the Stimson Center to create an international essay contest for students. On September 30th, from 10:30am-4pm, they will be hosting an on-the-record discussion regarding the proliferation of WMD’s and honoring the winners of the essay contest.  The winners will be announced and some will even be presenting their ideas at this event. “The goals of the competition were to involve the younger generation in understanding and addressing the important issue of proliferation of Weapons of Mass Destruction (WMDs), i.e., chemical, biological and nuclear weapons, and to solicit innovative student approaches to implementing U.N. Security Council Resolution 1540 (2004) to support the Council’s Comprehensive Review of the resolution this year.” Panel discussions will include speakers such as Dana Perkins (Senior Science Advisor, U.S. Department of Health and Human Services, former 1540 Expert), Will Tobey (Senior Fellow, Belfer Center for Science and International Affairs, Harvard University), Craig Finkelstein (Coordinator for the Working Group of the 1540 Committee on Transparency and Outreach), and more! The event will be at Harvard University’s Tubman Building in Cambridge, MA. You can RSVP for all or part of the event here.

Latest Zika News
As more outbreaks occur, the question is quickly becoming – should government officials “allocate resources to support the advancement of traditional drugs and vaccines or emerging broad-spectrum therapies?” If you’re a Miami Beach resident, free Zika testing is now being offered at the Miami Beach Police Department. Utah is keeping public health investigators on their toes with a mystery Zika case.  CDC officials are investigating a man who contracted Zika but was not exposed via a mosquito or sexual contact. Recently published in the CDC’s MMWR, “Patient A was known to have had close contact (i.e., kissing and hugging) with the index patient while the index patient’s viral load was found to be very high,” CDC researchers said in the report. “Although it is not certain that these types of close contact were the source of transmission, family contacts should be aware that blood and body fluids of severely ill patients might be infectious.” If you need a laugh, the Daily Show’s Trevor Noah addressed Zika in a recent episode. Singapore is quickly becoming a Zika hot spot, leaving many researchers stumped about the strain. Experts are suspecting a significant mutation that ramped up the virus’s capability to spread. “What is most intriguing is the question as to whether some mutation has occurred in the Zika virus to make it more transmissible by the Aedes albopictus mosquito—this would be analogous to what happened with chikungunya,” said Paul Anantharajah Tambyah, the secretary-general of the Asia Pacific Society of Clinical Microbiology and Infection. The CDC has reported, as of September 14th, 3,176 cases of Zika virus in the U.S.

Stories You May Have Missed:

  • Biodefense in the Age of Synthetic Biology – the National Academy of Sciences (NAS) has a new contract with the U.S. DoD’s Office of the Deputy Assistant Security of Defense, Chemical, and Biological Defense (NCB/CBD) to assess the nature of biothreats given the innovations within synthetic biology. “NAS will appoint an ad hoc committee to study the manipulation of biological functions, systems, or microorganisms resulting in the production of a disease-causing agents or toxins. The study will start with development of a strategic framework to guide an assessment of the potential security vulnerabilities related to advances in biology and biotechnology, with a particular emphasis on synthetic biology.”
  • Evidence of Airborne H5N2 Found in Distant Barns – a recent study found H5N2 highly pathogenic avian influenza in air samples collected “inside, immediately outside, and up to 70 meters from affected barns during the 2015 outbreak in the Midwest”. The researchers also found H5N2 RNA in air samples collected 1 kilometer from the infected barns. “A total of 26 of 37 (67%) sampling events collected inside and 18 of 40 (45%) collected at 5 meters were positive for H5N2. Sampling at distances from 70 meters to 1 kilometer resulted in about 2% positives and 58% suspected findings. The researchers found HPAI H5N2 viruses in particles up to 2.1 micrometer in diameter.”
  • History of the War on Superbugs – The war on antibiotic resistance may seem new, but it’s actually been waging on for over 60 years. Even Alexander Flemming knew the potential for antibiotic misuse and resistance, noting that “There is the danger that the ignorant man may easily undergoes himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.” Sadly, even the identification of penicillin-resistant germs didn’t scare people, simply because it was a time of antibiotic renaissance – developments were happening all around us and that calmed the fear that should have been brewing.