Pandora Report 3.3.2017

Welcome to March! On Tuesday, Russia cast its seventh veto and China cast its sixth veto to aid in protecting the Syrian government from UNSC actions and sanctions regarding chemical weapons attacks.

DIY Gene Editing Gets Faster, Cheaper, and More Worrisome
CRISPR/Cas-9 lab projects may not have been a possibility when I was in high school, but today’s students are getting a taste for genome editing. The technology has allowed relative amateurs to easily and cheaply learn gene editing tactics. “The question is, can we rely on individuals to conduct their experiments in an ethical and appropriately safe way?” says Maxwell Mehlman, a professor of law and bioethics at Case Western Reserve University, who is working with do-it-yourself scientists to develop DIY Crispr ethical guidelines. “The jury is out,” he says. “Crispr is too new. We have to wait and see.” GMU’s Dr. Koblentz has noted dual-use research is a wicked problem, and it seems that CRISPR/Cas-9 is one as well. Do-it-yourself (DIY) CRISPR kits can be purchased online for $150 and you can even get a handful of tutoring sessions for $400. While these products and experiments utilize harmless organisms, it’s not hard to see why so many are worried about the potential for misuse. Harvard University’s Dana Bateman visits high school classrooms for a lesson on CRISPR and during her time, she poses several ethical questions to the students. Dr. Bateman “asked a group of seventh-grade students whether Crispr should be deployed to bring extinct animals back to life. After a spirited discussion, one student asked, ‘How can we decide if we aren’t sure what will happen?’ Ms. Bateman replied that such questions will increasingly be part of public debate, and that everyone, including 12-year-olds, can benefit from learning about Crispr.” Learning the ins and outs of CRISPR isn’t so easy that it’s comparable to switching batteries in a remote, but probably closer to a complex set of IKEA instructions (ok, that’s a bit of an over simplification, but you catch my drift). Simply put, CRISPR does make DIY gene editing easier and cheaper, but foundational knowledge or instruction is still necessary. In this moment, we’re racing to catch up with the pace of innovation and understanding the risks versus rewards is proving more difficult. What are your thoughts on this hot topic?

China’s New BSL-4 Lab Plans 10729_lores
The Chinese mainland is hoping to see the construction of at least five BSL-4 labs by 2025. A laboratory in Wuhan is currently in the accreditation and clearance phase to work with the most deadly pathogens we face. While many celebrate the building  of this new lab, others are concerned about the biosafety and biosecurity risks. The increase in biodefense labs and programs has created several trade-offs for work with such high-risk pathogens.  Each new lab presents a new risk – for both biosafety failures and biosecurity failures. Biosafety failures are already plaguing U.S. labs – will this be the case with China’s labs? “The Wuhan lab cost 300 million yuan (US$44 million), and to allay safety concerns it was built far above the flood plain and with the capacity to withstand a magnitude-7 earthquake, although the area has no history of strong earthquakes. It will focus on the control of emerging diseases, store purified viruses and act as a World Health Organization ‘reference laboratory’ linked to similar labs around the world.” Skeptics have pointed to several escapes of SARS from a high-level containment facility in Beijing. Several biosafety and biosecurity experts are highlighting the need for transparency and an open and responsible culture. Addressing issues with staff at all levels and opening the floor for an honest and frank discussion regarding concerns from those working in the environment is vital to addressing the issues that may not be seen at a higher level.

WHO’s List of Superbug Super Offenders  screen-shot-2017-02-28-at-10-19-28-am
If there was an A-list for multi-drug resistant organisms, this would be it. This first-of-its-kind list, highlights the “priority pathogens” that comprise of twelve families of bacteria “that pose the greatest threat to human health”. “The list was developed in collaboration with the Division of Infectious Diseases at the University of Tübingen, Germany, using a multi-criteria decision analysis technique vetted by a group of international experts. The criteria for selecting pathogens on the list were: how deadly the infections they cause are; whether their treatment requires long hospital stays; how frequently they are resistant to existing antibiotics when people in communities catch them; how easily they spread between animals, from animals to humans, and from person to person; whether they can be prevented (e.g. through good hygiene and vaccination); how many treatment options remain; and whether new antibiotics to treat them are already in the R&D pipeline.” Not only is the publishing of this list an indicator as to the seriousness of the issue, but it signals a desperate plea for the pharmaceutical industry to develop new antibiotics. The three most critical bacteria on the list are carbapenem-resistant Acinetobacter baumannii, carbapenem-resistant Pseudomonas aeruginosa, and Enterobacteriaceae that are both carbapenem-resistant and ESBL-producing.

Kim Jong Un and the Case of the of VX Nerve Agent 
Last week saw the shocking revelation by Malaysian police that Kim Jon-nam, half-brother to North Korea’s Kim Jong-un, had been assassinated with the nerve agent, VX. The use of VX has left many wondering gif Kim Jong-un decided to use this overt form of assignation to signal his possession and willingness to use it or was this a botched assassination that was supposed to look like a natural death? Since this event has taken us into uncharted territory, many chemical and biological weapons experts are weighing in on what this means. GMU biodefense professor and graduate program director, Gregory Koblentz, pointed out that “it’s very hard to make an accurate intelligence assessment”. The dual-use nature of bio-chem weapon production facilities and materials makes intelligence gathering that much more difficult. “While Kim Jong-un is unpredictable, seasoned Korea watchers see method in what may sometimes seem like madness. And that leads them to doubt that he actually intends to use nuclear weapons — which make more sense as a bargaining chip in dealing with the US and other powers. Pyongyang’s chemical arsenal is a different prospect, however. ‘If there’s a conflict on the Korean peninsula, North Korea would probably use chemical weapons early on,’ Koblentz said.”

PHEMCE Review: Accomplishments and Future Areas of Opportunity 
GMU Biodefense PhD student and VP of Marketing at Emergent BioSolutions, Rebecca Fish, is looking at the Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) and their recent strategic implementation plan. Highlighting their four goals and sample accomplishments, Rebecca looks at their work on emerging infectious diseases (EIDs) like Ebola response and Zika. While PHEMCE has made great progress, there is still room for engagement and opportunity. Rebecca points to their plans to incentivize innovation, “while biotechnology is increasing at an exponential rate, and the opportunity for misuse (bioterrorism) is increasing, the number of companies interested in making significant investment in medical countermeasures development is decreasing. There are important MCM innovation gaps that need to be addressed.” She notes that PHEMCE activity encompasses a great deal of federal agencies, which can make work that much more challenging. “However, the PHEMCE effort still requires strong, centralized leadership and a comprehensive strategic plan with measurable outcomes against which progress can be reported. It’s impressive that so many groups are working on these challenges, but who is determining the overall strategic plan? How does it come together? Which single individual has responsibility for the entire biodefense strategic effort? Who is managing the enterprise U.S. biodefense budget? No one. No one has clear accountability for the U.S. biodefense strategy, and this puts our country at risk.”

Johns Hopkins Center for Health Security Announces 2017 Emerging Leaders in Biosecurity
The Center for Health Security at Johns Hopkins University has announced the new class of emerging leaders in biosecurity. GMU is happy to announced that one of our Biodefense PhD students, Saskia Popescu, was named among the 2017 emerging leaders. “The program’s goal is to build a multidisciplinary network of biosecurity practitioners and scholars. ELBI is supported by a grant from the Open Philanthropy Project. As part of its commitment to grow and support the field of biosecurity, the Center has selected 28 Fellows from the US, the UK, and Canada. As in previous years, this year’s Fellows have backgrounds in government, the biological sciences, medicine, national security, law enforcement, public health preparedness, and the private sector.” Congrats to the new class of emerging leaders!

Multivariate Analysis of Radiation Responsive Proteins to Predict Radiation Exposure in Total-Body Irradiation and Partial-Body Irradiation Models
GMU Biodefense PhD student, Mary Sproull, is working to strengthen medical countermeasures in the event of a radiological or nuclear attack. Advanced screening and medical management of those exposed are vital during such an event. “In such a scenario, minimally invasive biomarkers that can accurately quantify radiation exposure would be useful for triage management by first responders. In this murine study, we evaluated the efficacy of a novel combination of radiation responsive proteins, Flt3 ligand (FL), serum amyloid A (SAA), matrix metalloproteinase 9 (MMP9), fibrinogen beta (FGB) and pentraxin 3 (PTX3) to predict the received dose after whole- or partial-body irradiation.” Researchers found that the novel combination of radiation responsive biomarker proteins are an efficient and accurate tactic for predicting radiation exposure. You can read the paper here.

Stories You May Have Missed:

  • OPCW Call for Nominations For A Workshop on Policy & Diplomacy for Scientists – The OPCW Technical Secretariat is organizing a workshop, “Introduction to Responsible Research Practices in Chemical and Biochemical Sciences”, from September 12-15, 2017. “The objective of the workshop is to raise awareness among young scientists on the policy and diplomacy aspects that are related to the use of chemicals in various scientific disciplines, including chemistry, biochemistry, biotechnology, and other related fields.” Check out their link for more info on applying for admission and/or a scholarship.
  • Epidemic Tracking Tool Wins Open Science Grand Prize – A new prototype, Nextstrain, has won the new Open Science Prize. This tool analyzes and tracks genetic mutations during the Ebola and Zika outbreaks and they’re hoping to use it for other viruses. “Everyone is doing sequencing, but most people aren’t able to analyze their sequences as well or as quickly as they might want to,” Bedford said. “We’re trying to fill in this gap so that the World Health Organization or the U.S. Centers for Disease Control and Prevention — or whoever — can have better analysis tools to do what they do. We’re hoping that will get our software in the hands of a lot of people.”

Pandora Report 2.12.2016

This week we saw a lot of movement on the Zika response front – from increased funding to research teams prepping for field work, the outbreak hype is picking up traction as the horrors of Ebola are still fresh. Natural outbreaks aren’t the only thing drawing concern this week, as James Clapper, Director of US National Intelligence, added gene editing to the list of dangers posed by “weapons of mass destruction and proliferation.” The annual worldwide threat assessment report stated that, “research in genome editing conducted by countries with different regulatory or ethical standards than those of Western countries probably increases the risk of the creation of potentially harmful biological agents or products,”. Good news for hospital preparedness, the US Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response and the CDC have announced continued funding for the Hospital Preparedness Program (HPP). The HPP supports critical healthcare preparedness efforts in order to reduce the “supplemental state and federal resources during emergencies, and enables rapid recovery.” If you’re trying to work some biodefense into your Valentine’s Day, you’ve got a few options via Jane Austen-inspired zombie adventures in Pride and Prejudice and Zombies or episodes of The Walking Dead. Whichever zombie adventure you choose, just remember to avoid cuddling with any armadillos (read on to find out why). Happy Friday!

Lassa Fever Outbreak Grows
The Lassa fever outbreak that began hitting Nigeria in August 2015 has continued to spread, worrying many health officials. 101 people have already died from the infection and roughly 175 people have become infected. The Nigeria Centre for Disease Control (NCDC) stated, “As of today, 19 [including Abuja] states are currently following up contacts, or have suspected cases with laboratory results pending or laboratory confirmed cases.” Annually, Lassa fever causes 100,000-300,000 infections and 5,000 deaths in west Africa. Nigeria’s neighbor, Benin, is also seeing an increase in cases, in which seventeen have died and fifty have been infected.

Back Down the Zika Rabbit Hole
In response to the growing threat of Zika virus, the Obama administration announced on Monday that it would formally be requesting an emergency funding of $1.8 billion to combat the outbreak. The Department of Health and Human Services (including the CDC) would obtain the majority of the funds ($1.48 billion). CDC efforts will be ramped up as its emergency operations center was moved to a level 1 (the highest level) and teams are being coordinated to study the microcephaly-infection links. You can also check out the White House press release here. The WHO will be working to prioritize and fast-track research and development projects, of which Zika virus will be included. You can also find a great timeline here. According to the CDC, as of February 3, 2016, there were 35 travel-associated cases in the US. The Lancet also just released this piece discussing the labeling of Zika virus as a public health issue of concern.  On February 16, 2016, The National Academies of Sciences, Engineering, and Medicine are holding a workshop on research priorities to inform public health and medical practice for domestic Zika virus cases.

ASM-BiodefenseScreen Shot 2016-02-10 at 11.49.22 PM 
The 2016 American Society for Microbiology Biodefense and Emerging Diseases Research Meeting took place this week in Arlington, VA. For a biodefense fan, this was a pretty amazing three-day experience. Conference attendees were treated to presentations on antimicrobial resistance, applied biodefense, medical countermeasure developments, agroterrorism, and much more. Did I mention the keynote speaker was Dr. Tom Frieden, director of the CDC? I’m not even a little ashamed to admit how great it was to see Dr. Frieden emphasize that “nature is unpredictable but what is predictable is that we can be better prepared.” He also noted that “Zika is a rapidly changing situation” and the CDC would be sending a team within the next week to start a case-control study related to infection and microcephaly. Some highlights included getting to listen to Dr. Raymond Zilinskas discuss Russian biodefense efforts and how CBR training exercises increased in 2015. Dr. Jens Kuhn from the NIH wins the award for most humor during his fascinating presentation on Marburg and Ebola research within the Soviet bioweapons program. The infection preventionist in me greatly appreciated the session on antibiotic resistance and the role of medical tourism as an exposure for patients to CRE, not to mention how travel assists global clonal expansion. The Mayo Clinic’s Dr Tosh pointed out the short term (isolation of patients, hand hygiene, etc.), medium term (new microbial therapeutics, new diagnostics, etc.), and long term (specific pathogen therapy, decolonization, and immunologic therapy) response and control mechanisms for drug resistance. Last but not least, one of the biggest objectives from the applied biodefense presentations was the need for scientists to help inform policymakers about their work to drive the best policies. I would highly encourage anyone interested in the biodefense field to attend future conferences, as it was a wonderful learning experience and the poster/exhibitor sessions were an excellent way to learn about new research and network.

Lessons Learned: Using North Korea’s History to Better Understand Iran’s Nuclear Program
GMU biodefense professors, Dr. Thrall and Dr. Koblentz, discuss the use of North Korean nuclear history as a teaching tool regarding Iran’s nuclear program. By comparing and contrasting these two countries and their propensity for nuclear weapons, they look to similarities like the fact that both countries “are located in historically dangerous neighborhoods and face militarily superior adversaries. In North Korea’s case, South Korea and the United States; in Iran’s case, a Middle East full of Sunni Arabs and a nuclear-armed Israel. From a national security perspective, both countries have obvious reasons for pursuing a nuclear capability.” Given that both countries tend to be immune towards coercion, continued engagement and confrontation is vital. Using North Korea as a model for behavior, vigilant deterrence will be necessary to prevent Iran from cheating on the nuclear deal.

Managing Emerging Health Security Threats Since 9/11: The Role of Intelligence
Dr. Patrick F. Walsh, Associate Professor of Intelligence and Security Studies at Charles Sturt University in Australia, discusses the role of intelligence throughout the evolution of biosecurity since the 9/11 attacks. Dr. Walsh calls attention to the difficulties in defining biosecurity and that “cross-disciplinary focus is both a strength and weakness to understanding biosecurity threats. It is a weakness in that the presence of multiple players in the biosecurity field can result in a more fragmented understanding and operational response to various biosecurity threats. But it is also a strength in that, if intelligence systems are optimal, a multi-disciplinary approach allows a combination of expertise to assess and manage the bio-threat or risk.” Dr. Walsh presents the role of dual-use research, stolen biological agents, and the growing concern among biosecurity regulators and national security intelligence groups regarding the dwindling role of tacit knowledge and availability of equipment and technology. Dr. Walsh points out that the character of intelligence varies depending on the issue and one must account for the role of decision making. Lastly, he reminds us that “to conceptualize the role of intelligence in improving early warning of biosecurity threats is to examine how it can provide warning through various stages of the intelligence cycle, which includes the following stages—direction, collection, analysis, and dissemination.” While the role of intelligence will continue to evolve with biosecurity threats, Dr. Walsh emphasizes that strategic early warning capabilities are dependent upon the efficacy of intelligence framework. Improving these two facets of biodefense will allow critical infrastructure to not only respond to threats of bioterrorism and emerging infectious diseases, but also the growing threats of microbial resistance and dual-use research. You can also find the article here (2016 Walsh Health Security and Intelligence Jan).

Biosecurity in the Age of Big Data: A Conversation with the FBI
Advances in life science and technology can solve many health issues, but they can also pose a threat if used within the wrong context. Dual-use research of concern, CRISPR, and biotechnologies have led to some remarkable revolutionary advances, however, where do these fit within the FBI’s security concerns for bioweapons? Keith Kozminski of Molecular Biology of the Cell met with FBI Supervisory Special Agent (SSA) and head of the Biological Countermeasures Unit at their Washington, DC headquarters, Edward You, to discuss the security implications of Big Data. SSA You detailed his work with the American Association for the Advancement of Science and the United Nations Interregional Crime and Justice Research Institute to identify the security issues associated with Big Data when it comes to biology. Whether collaborating with companies like Amazon and IBM or government agencies like the CDC, SSA You has worked to identify potential vulnerabilities and how they can be addressed without halting innovation. SSA You states that “Over the last two years, we have had the issues with regard to the Centers for Disease Control and Prevention (CDC) and Department of Defense (DoD). A lot of discussion also came when the J. Craig Venter Institute synthesized that bacterial genome. There were a lot of calls and discussions about the scientific community needing more ethics training and the need to develop a greater culture of responsibility. From a law enforcement perspective those are necessary but not sufficient. What has been lacking is the scientific community being provided security awareness—something that augments how they approach the life sciences.” While there are vulnerabilities across the board, SSA You emphasized the need for partnership between biologists and WMD coordinators to not only safeguard science, but reduce threats.

UN- Protecting Humanity from Future Health Crises: Report of the High-level on the Global Response to Health Crises 
The UN has released an advanced copy of their report regarding global health safety. Highlighting the efforts and failures within the Ebola outbreak, this report emphasizes the global burden of communicable diseases and how better response and preparedness is needed. The report points out that only a third of the 196 State Parties have fully implemented the International Health Regulations (IHR, 2005) and there has been little global investment in R&D for emerging infectious diseases. 27 recommendations were made to address issues at the national, regional, and international levels, of which one of the first was for the WHO to build a new Centre for Emergency Preparedness and Response. The report also states that “all countries must meet the full obligations of the IHR” and “appropriate financing is required. Assistance should be provided to countries requiring additional support for IHR compliance, while WHO and the new Centre for Emergency Preparedness and Response must be resourced to meet global needs.” Overall, the use of the 2014 Ebola outbreak as a case study for health security recommendations echoes the sentiment that Dr. Frieden once noted– “a disease outbreak somewhere is a risk anywhere”

Stories You May Have Missed:

  • Vaccines & Therapeutic Conference– Mark your calendars for the 14th annual conference from May 17-19, 2016, in Washington DC, that covers biodefense, antimicrobial resistance, and emerging infectious diseases. Given the recent push for emergency funding for Zika virus research, this conference will be a great resource for up and coming research.
  • Quality Training for BSL-4 Biocontainment Laboratories– Interested in BSL-4 lab training? The FDA and University of Texas Medical Branch, Galveston National Medical Branch, will host training April 25-29, 2016. Held in Bethesda, MD, the course will include faculty and subject matter experts from the FDA, academia, and more.
  • Leprosy Spike in Florida– Florida has seen an increase in leprosy cases this year. Five cases have been reported in 2016 so far and 27 were reported in 2015. The spike in cases is suspected to be a result of armadillo transmission. If you find yourself traveling in Florida, you may want to avoid armadillo cuddling.