Pandora Report 11.17.2017

Happy Friday – we hope you had a wonderful time celebrating Antibiotic Awareness Week! As Canada reports rising antibiotic resistance despite decreasing use of antibiotics in humans and animals, it’s important we recognize the importance of stewardship and infection control. November 13-19 marks Antibiotic Awareness week, in which we observe the importance of proper antibiotic use and prescribing practices. In the United States alone, 23,000 people die a year due to an infection that was resistant to antimicrobials. Help stop antimicrobial resistance through antibiotic stewardship.

GMU Biodefense MS student Stephen Taylor

Reflections from the GHSA Ministerial Meeting in Kampala, Uganda
The recent GHSA Ministerial Meeting was not only a success, but also reaffirmed the importance of the agenda and those dedicated to combatting health security threats. We’re excited to provide you with a series of on-the-ground reflections from those who participated through the George Mason Global Health Security Ambassador Fellowship and the Next Generation Global Health Security Network. Within these reflections, you’ll get to hear from Next Generation Coordinator Jamechia D. Hoyle and a wonderful array of international students and professionals. Hoyle notes that “the meeting was called to order during a time where health security professionals were addressing a plague outbreak in Madagascar and a local Marburg outbreak in the host country, Uganda.  This alone was a vivid reminder that health security must remain a priority.” The reflections present unique outlooks on the meeting and range from detailed descriptions of the sessions to visiting the Uganda Virus Research Institute, and more. Make sure you catch reflections from GMU biodefense MS students Anthony Falzarano and Stephen Taylor!

Did Russia Accidentally Provide the Best Evidence of the Syrian Government’s Involvement in Sarin Attacks?
Russia has been trying to downplay the Syrian government’s role in chemical weapons attacks, but their latest press conference may have just backfired on them. The November 2nd press conference in which Russian officials responded to the Organization for the Prohibition of Chemical Weapons – UN Join Mission, included a presentation that revealed a bit more than anticipated. “The presentation included a series of slides, which included diagrams of two types of chemical bombs, designated the MYM6000 and M4000. Remarkably, the Russian presentation appears to be the first-time images of these munitions have been made public, and before the press conference, no other references to MYM6000 or M4000 bombs appear online.” GMU Biodefense Graduate Program Director and Professor Dr. Gregory Koblentz noted that “‘these designations match bombs declared by Syria to the OPCW’, although there appears to be no open source material that provides specifics about the types of bombs declared to the OPCW. In the press conference the source of the diagrams are described as being provided ‘by certain organisations’, but no more specifics are given.” The Russian presentation diagrams provide some pretty clear matches between munitions found during investigations into the attacks. “The only way for the Russian or Syrian governments to now deny the M4000 bomb was used is to produce detailed photographs of the M4000 bomb, showing the same parts indicated above, or, if the Syrians still claim all these bombs were destroyed after 2013, declassify and publish further information about the bomb.”

The Center for Global Security Research – Student Internship                     The Center for Global Security Research, Lawrence Livermore National Laboratory is now accepting applications for Spring 2018 student internships! “The Center for Global Security Research (CGSR) was established at Lawrence Livermore National Laboratory (LLNL) in 1996 to bring together experts from the science, technology, and policy communities to address pressing national security challenges. For more than 20 years, CGSR has engaged diverse perspectives on topics important to national security, deterrence, diplomacy, dual-use technology, arms control, nonproliferation, peacekeeping, cyber defense and energy security.”

A Field Test of CRISPR
Researchers are getting to test, for the first time, treatment of a genetic disorder with gene-editing tools infused into the patient’s blood. The 44-year-old man suffers from Hunter syndrome, which is a metabolic disorder. “The company (Sangamo Therapeutics) inserts a replacement copy of the gene, using gene editing to snip the DNA helix of liver cells in a specific place near the promotor, or on-off switch, for the gene for a protein called albumin. The cells fix the damage by inserting the DNA for the new gene, supplied by the researchers along with the gene editor’s DNA scissors, and the gene’s activity is then controlled by the powerful albumin promotor. The idea is to turn these modified liver cells into a factory for making the enzyme missing in Hunter syndrome.” This is an exciting step forward for gene-editing technologies and their ability to treat chronic diseases. Curious what CRISPR looks like in action? Check out this video here.

Call for Papers- Women’s Health in Global Perspective
World Medical & Health Policy’s call for papers on Women’s Health in Global Perspective seeks to contribute to understanding and improve policy on women’s health and wellbeing around the world. Manuscripts on all factors that influence health outcomes for women will be considered, including social determinants such as education, nutrition, poverty, violence, access to health care, job opportunities and personal freedom.  The 2018 Workshop on Women’s Health in Global Perspective will follow a successful 2016 workshop by the same name (see video at http://www.ipsonet.org/conferences/whgp/2016-womens-health-in-global-perspective-videos), which resulted in a special issue http://onlinelibrary.wiley.com/wol1/doi/10.1002/wmh3.212/full and an ongoing series of articles in WMHP highlighting global women’s health issues and their implications for economic, political and social development. Abstract submission deadline (250 words): December 15, 2017. Contact: Bonnie Stabile, Co-Editor, bstabile@gmu.edu

Three Decades of Responding to Infectious Disease Threats
NIAID Director Anthony Fauci has been fighting infectious diseases in his role since 1984. After 30+ years of work, Dr. Fauci undoubtedly has some fascinating stories, whether it be from the beginning of the HIV pandemic or SARS. “Initial responses to a newly recognized disease, now known as HIV/AIDS, in the early 1980s were criticized as being too slow, the essay notes. ‘The insidious emergence of HIV/AIDS and the lack of due attention by policymakers illustrate how some outbreaks that start subtly can grow to global proportions if they are not aggressively addressed early on,’ Dr. Fauci writes. Between the early 1980s and the early 1990s, federal funding for HIV/AIDS research increased markedly, reaching $1 billion by the end of 1992. The accelerated government response supported both research and research infrastructure, and yielded advances in countering the HIV/AIDS pandemic domestically and internationally. Ultimately, notes Dr. Fauci, sustained support for scientific research coupled with political and community engagement helped transform HIV/AIDS from a nearly universally fatal disease to a condition that can be managed with appropriate treatment.”

The One Health Commission’s Call to Action for Social Scientists
“The One Health Commission, a 501(c)(3) global non-profit organization based in the U.S., stresses recognition of human, animal, and ecosystems interconnections and facilitates collaboration of all professions required to achieve global and planetary health. The One Health Social Sciences Team invites social scientists of all disciplines to become involved in the One Health community. By forging new and innovative partnerships, collaborations across human, animal, plant and ecosystem health communities will collectively enable betterment of health and well-being for all.” To learn more and get involved please contact the One Health and Social Sciences Working Group at ohss@onehealthcommission.org.

What Should The US National Biodefense Strategy Look Like?                                                                                                     The complex nature and painful lessons of biological threats, regardless of source, have challenged U.S. biodefense efforts for decades. As the Blue Ribbon Study Panel on Biodefense pointed out in their report, there is a general lack of clear leadership and coordination. The 2016 National Defense Authorization Act required that the DoD, DHHS, DHS, and USDA, all develop a national biodefense strategy and plan for implantation. Laura H. Kahn has provided a handful of critical strategies that are necessary. “First, human-intelligence-based monitoring of rogue nations and militant groups that use bioweapons is critical. Second, a national strategy must include a plan for disease surveillance of humans and animals, with a view to predicting the next naturally occurring epidemic. This kind of work is difficult, because there are so many viruses that could spill over from other mammals or birds into humans.” Kahn also highlights laboratory security and the importance of high-containment lab biosecurity, review of the Federal Select Agent Program, investigation of large-scale wildlife die-offs, and recognizing the importance of One Health. “Threat to one component in this triad threatens them all. For that reason, animal and environmental health must be taken just as seriously as human health—which requires devoting personnel and resources to monitoring them, which requires sufficient funding for entities like the EPA and the Fish and Wildlife Service.” Kahn also draws attention to the recent GAO report on biological threat awareness and the need to share information and resources. “Most distressingly, the current administration appears willfully ignorant of scientific issues, while at the same time disinclined to fund critical scientific efforts. The White House Office of Science and Technology Policy, which is intimately involved with biodefense issues, remains leaderless and understaffed.” Overall, a national biodefense strategy will not be easy, but it must be as comprehensive and wholistic as the biological threats we face.

The World’s Deadliest Diseases: How Is Biotech Fighting Them?
Biotech has an increasingly important role of health security and infectious disease response. As we saw with CRISPR this week, it has the capacity to help treat chronic conditions, but what about infectious diseases? Rapid diagnostics and development of medical countermeasures are critical during outbreaks and can determine if an epidemic will turn into a pandemic. Ute Boronowsky, pulling on Robert Herriman’s list of the five deadliest diseases, is looking to the biotech approaches for such biothreats. Whether it be plague or amebic meningoencephalitis, biotech advances are providing new avenues for treatment and response. Naegleria fowleri (the amoeba that causes the fatal meningoencephalitis) can be difficult to track within water sources and treatment is even trickier. “In 2015, investigational breast cancer and anti-leishmania drug miltefosine was used successfully on a 12-year-old girl at the Arkansas Children’s Hospital. However, when the same drug was used on two other patients, one of them died, and the other suffered from major neurological damage. This year saw a new therapeutic approach when scientists at the Virginia Commonwealth University found evidence that Naegleria relies on matrix metalloproteases to degrade the host extracellular matrix during infection, identifying these enzymes as potential therapeutic targets.” Other biotech advances, like prion disease therapy kinase inhibitors on the unfolded protein response, or the latest Ebola vaccine, all highlight the importance of biotech advances in combatting infectious diseases.

Stories You May Have Missed:

  • Legionella in Disneyland – GMU biodefense PhD student Saskia Popescu is looking at the latest outbreak of Legionnaires’ disease and how it highlights the challenges of prevention. “There are many factors that may attribute an outbreak, such as warming climates, a large aging population, and increased attention on the disease, which all lead to a better chance of infections being reported. The recent outbreak in Disneyland is a good reminder of the inherent challenges with disinfection efforts and continued vigilance that is needed to ward off this bacterial infection. It is also a reminder that outbreaks can happen anywhere there is a water source, even Disneyland, or other areas that somehow seem to be untouchable.”
  • Bulgaria and South Africa Battle HPAI – The two countries are dealing with outbreaks related to highly virulent strains of avian influenza. “A US vaccine company announced that the US Department of Agriculture (USDA) has conditionally approved the first DNA avian flu vaccine for chickens. Also, the United Nations Food and Agriculture Organization (FAO) provided a snapshot of current highly pathogenic H5 observations and what could play out in the upcoming season, and Chinese researchers reported new findings on airborne spread of avian flu based on sampling in a live-poultry market.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 11.3.2017

Welcome to your weekly dose of all things biodefense. Today we get to celebrate Global One Health Day, in which the goal “is to build the cultural will necessary for a sea change in how planetary health challenges are assessed and addressed.”

High-Containment Laboratories: Coordinated Actions Needed to Enhance the Select Agent Program’s Oversight of Hazardous Pathogens
The latest U.S. Government Accountability Office (GAO) report is focusing on high-containment labs and how we can enhance the Select Agent Program’s oversight of hazardous pathogens. “Safety lapses continue to occur at some of the 276 laboratories in the United States that conduct research on select agents—such as Ebola virus or anthrax bacteria—that may cause serious or lethal infection in humans, animals, or plants, raising concerns about whether oversight is effective. GAO was asked to review the federal oversight approach for select agents and approaches from other countries or regulatory sectors. This report (1) evaluates the extent to which the Select Agent Program has elements of effective oversight and strategic planning documents to guide it, and (2) identifies approaches selected countries and regulatory sectors have used to promote effective oversight.” The Select Agent Program is managed through a partnership between DHHS and USDA, which oversees how labs handle these deadly pathogens. The biosecurity and biosafety failures that have occurred in recent years highlights the challenges of not only performing such work, but also oversight. The GAO report found that the Select Agent Program hasn’t assessed the risks of its current structure, has reviews that may not target the highest-risk activities, continues to have significant workforce and training gaps, etc. Eleven recommendations were made, which range from “To improve transparency, the CDC director of the Select Agent Program should work with APHIS to determine what additional information about laboratories’ use of select agents, incidents, and violations of the select agent regulations is appropriate for the program to share with registered laboratories” to “improve independence, the Administrator of APHIS should formally document the reporting structure for the APHIS component of the Select Agent Program from the APHIS director of the program to the Administrator of APHIS”. You can read the full report here or get the highlights here.

GHSA Ministerial Meeting
Last week’s Ministerial Meeting at Kampala was a success and a great time to reflect on GHSA accomplishments from member countries. You can get all the information here regarding the success stories across GHSA members. We will also be reporting on stories from those attendees who were able to join NextGeneration GHSA for the meeting, so don’t miss out on some great deep-dives from GMU biodefense students and their stories from Kampala!

COMMENTARY: Pandemic preparedness and missed opportunities             CIDRAP Director Dr. Michael T. Osterholm is honing in on a dogma for so many within public health – we need pandemic preparedness and we’re just not prepared. Unfortunately, sometimes our efforts to change this can result in a backfire. “Last week PATH issued a report titled, Healthier World, Safer America: A US Government Roadmap for International Action to Prevent the Next Pandemic. PATH, a leading international nonprofit organization, is widely recognized for its work to save lives and improve health, especially among women and children.” “The PATH report, if it commented only on epidemic preparedness, would be a home run. But by stating that the recommendations in the report will stem the risk of the next pandemic, the report ends up contributing to the ongoing mischaracterization about what pandemic preparedness truly means and what is needed to reduce any impact of a future pandemic. Understanding the difference between a pandemic and epidemic is absolutely necessary for consequential preparedness and response planning and action to be accomplished.  Let me illustrate the difference between the two and why it matters.” Osterholm points to this very vital misstep that can easily add confusion when working towards preparedness. He highlights the substantial difference between pandemics and epidemics and that ultimately, before we can truly address preparedness and response, we need to sincerely understand the discrepancies. Osterholm also highlights the biothreats we should be worried about for potential pandemics – influenza and antimicrobial resistance. Osterholm points to these two pandemic concerns while highlighting the importance of the GHSA, the vital role of early and effective detection to epidemic diseases, and that pandemic clocks are ticking. “The influenza and antimicrobial pandemic clocks are ticking; we just don’t know what time it is. Misunderstanding and misrepresenting what we need to do to be better prepared takes an understanding of what a pandemic is and what it isn’t. To date we are not doing a very good job of understanding that point and responding accordingly. The PATH report is a clear reminder.”

Early Insights from Madagascar’s Plague Outbreak: Lessons Learned from Ebola?
Have we really learned some of those difficult lessons from Ebola? Joshua Hutton, Doctoral Candidate at the University of Sussex is evaluating the current plague outbreak in Madagascar under the lens of Ebola. Hutton looks at the epidemiology and cultural impact of these diseases, their similarities and differences, and what lessons can be learned. Hutton looks at the health systems within Madagscar and the Ebola-affected West African countries, noting that Madagascar has 1 doctor per 100,000, while Liberia has 0.1 and Sierra Leone has 0.2 per 100,000. “Furthermore, both Ebola and plague elicit very strong emotional reactions. Ebola has been sensationalized by popular books and major motion pictures (such as Outbreak). Its haemorrhagic symptoms, exaggerated in popular culture, instil fear and remain memorable as an object of cultural anxiety.” “Despite these similarities, there are some obvious differences that affect the public health responses to these outbreaks. The first is that plague is a very different pathogen from Ebola. While Ebola is a virus, Y. pestis is a well-characterised bacterium. One important implication of this difference is that while treatments for Ebola remain elusive, antimicrobials to combat plague do exist. Plague is curable when caught early enough. This not only helps the response, but also reduces the heavy emotional burden placed on healthcare workers who felt helpless caring for Ebola patients without a treatment.” Hutton also notes the differences between public health responses, especially by the WHO – highlighting the lessons learned from the Ebola outbreak. “The early response to this anomalous outbreak of pneumonic plague in Madagascar seems to suggest that lessons are being learned from the Ebola outbreak. While there are distinct differences between the two outbreaks – not the least the availability of rapid diagnostics to identify infected individuals and the availability of antibiotics to treat them – the broader context, the rapid response, and the engaging of local communities produce a cautious optimism for the future.

US-Malaysia Workshop on BWC
The November 30-December 1st workshop at the Council Chamber, Palais des Nations, will focus on BWC-relevant developments by international experts. This workshop will feature expert presentations about global activities during the past year that strengthen the BWC. The purpose of the workshop is to inform States Parties about recent developments relating to national implementation, cooperation and assistance, preparedness and response, and science and technology; and to exchange ideas about their relevance to the Convention.

 My Time As An Emerging Leader in Biosecurity Initiative Fellow                         Take a journey down the biosecurity rabbit hole with GMU biodefense PhD student Saskia Popescu and her experience as a fellow at the Johns Hopkins Center for Health Security. “The Johns Hopkins Center for Health Security has maintained a fellowship since 2012 that seeks to provide opportunities for biosecurity professionals and helps to broaden their careers through contacts and experiences. The Emerging Leader in Biosecurity Initiative (ELBI) program is something I’ve been striving to join for years. I’ll admit it – it wasn’t my first time applying and while this is a highly competitive group, I was definitely disappointed when I didn’t get that acceptance email. Fortunately, 2017 was my year and I was selected as an ELBI fellow and that’s where this adventure begins.” Popescu describes her experiences at the three workshops, the engagement with some of the top minds in the field, and just how much fun it can be to geek out with fellow biosecurity nerds.

Fourth Annual Summit on Global Food Security and Health
Don’t miss this great opportunity to focus on the interrelationship between Food Security and National Security! Held at GMU’s Schar School of Policy and Government on Wednesday, November 15th, you’ll want to make sure you register for this full-day summit! “The conference is co-sponsored by the Stimson Center, RTI International, and The Policy Studies Organization. Our focus this year is on the interrelationship between food security and national security, progress and challenges under Feed The Future (FTF) and the Global Food Security Act, and the growing importance of food security private-public partnerships, resilience, critical indigenous food security challenges, nutrition and health issues. Summit speakers will represent a wide array of government, international organization, NGO, private sector, and academic experts. Our Summit follows the issuance of a recent USAID Feed The Future 2017 Progress Report, the enactment of the July 2016 Global Food Security Act, the related completion of new USAID global food security and food aid strategies, and the issuance of USAID’s December 2016 Feed The Future Global Performance Evaluation. The Summit will follow the World Food Prize Conference in Des Moines, Iowa , October 18 – 20 which addresses opportunities for innovative agriculture to eliminate the scourge of global hunger and poverty. Our GMU Summit takes place during a particularly important period marked by protracted uncertainty about U.S. support for International food aid, global food security, and foreign aid.”

Preppers: On the Frontline of U.S. Preparedness
Are you prepared for an apocalyptic event? GMU Biodefense PhD student and VP of marketing at Emergent BioSolutions student Rebecca Fish is taking us on a deep-dive into the world of preppers. “In 2015, Emergent BioSolutions undertook a multi-phase research project to better understand the prepper movement.  A random sample of 1,022 people aged 18-65 was surveyed to explore prepping behavior.  Findings suggested that the average prepper is not as extreme as many television programs would have you believe.  Rather, your average prepper is an ordinary person trying to do his/ her best for his/her family by preparing for emergency events.  The defining characteristic of a prepper is a belief in self-sufficiency and a desire to be prepared for whatever life throws at you.” This study found some interesting data on preppers – 67% are married and 43% earn over $100,000 per year, while 45% hold a college or advanced graduate degree. The volume and commitment of preppers is also indicative of a market for MCM product and other CBRNe products. “After the 2011 Fukushima Daiiche nuclear disaster in Japan, potassium iodide tablets stocked out everywhere due to overwhelming demand. Similarly, during the Ebola crisis, CBNBC reported that sales of one type of full-body protective suit increased 131,000 percent on Amazon. Gas masks and Ebola survival guides shot up the rankings as well.” As a further example, twenty four percent of preppers in our research own a gas mask.  These data suggest that preppers have demonstrated interest in CBRNe supplies and represent a market for some preparedness supplies.” Fish not only provides new insight into the Prepper community, but also encourages us to start learning more about this group and their interests in preparedness.

BARDA Industry Day
Don’t miss out on BARDA Industry Day next week, from November 7-8th, at the Ronald Reagan Building. “BARDA remains committed to engaging with our industry and government partners to fulfill our mission, saving lives and protecting America through the research and development of medical countermeasures against serious threats. The theme of BARDA Industry Day 2017 is: Innovation in products and partnerships for flexible, dynamic response capabilities.” The keynote speakers will be Robert Kadlec, Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services, and Senator Tom Daschle, Founder and CEO of the Daschle Group.

 New Biosecurity Threats Appear in Less Familiar Forms                                    Following the anthrax attacks in 2001, focus within biodefense and biosecurity fell upon bioterrorism and the potential attack that could impact millions of Americans. Since then, health security has evolved to include a wider range of potential issues and threats – natural, manmade, and accidental. GMU biodefense PhD student Saskia Popescu highlights some of these newer threats and that while they may be less familiar to health professionals, it is vital we involve them in the narrative of hospital preparedness. Discussing the gaps within U.S. biodefense efforts, genetic engineering, and how dual-use research impacts bio-vulnerability, Popescu implores infectious disease practitioners to soak in this knowledge. “How can we, as infectious disease practitioners, prepare or respond? First, knowledge is key. It is crucial to understand the threats, whether they are a natural outbreak, a lab breach you read about, or even just a review of the signs and symptoms of organisms we tend to worry about but may not see in the United States (such as severe acute respiratory syndrome, Middle East respiratory syndrome, anthrax, etc). Researchers should also consider the implications of their work and take the necessary review processes to ensure the proper biosecurity measures are taken.”

Should FEMA Be a Stand Alone Agency?                                                                            GMU Biodefense PhD alum Daniel M. Gerstein is at it again – evaluating DHS and the potential for major realignments in the Department. “As Congress considers reauthorizing the Department of Homeland Security, principles guiding any major realignments could include assessing whether the organization would be performing operational or staff management functions. Additionally, those principles could examine whether mission effectiveness would be improved through those major realignments and whether implemented changes would introduce new points of friction or inefficiency.” Gertstein notes several major realignments under consideration – replace the National Protection and Programs Directorate at DHS with a new Cybersecurity and Infrastructure Security Agency, remove FEMA from the DHS and make it a stand-alone department, and standing up a counter WMD organization. “As part of comprehensive department legislation, these realignments should be considered with an eye towards increasing operational effectiveness and efficiency while minimizing organizational friction in the transformed organizations and avoiding loss of key support relationships.”

Stories You May Have Missed:

  • The Unforgiving Math That Stops Pandemics– Another prime example of herd immunity and the importance of vaccination – “When talking about vaccination and disease control, health authorities often invoke “herd immunity.” This term refers to the level of immunity in a population that’s needed to prevent an outbreak from happening. Low levels of herd immunity are often associated with epidemics, such as the measles outbreak in 2014-2015 that was traced to exposures at Disneyland in California. A study investigating cases from that outbreak demonstrated that measles vaccination rates in the exposed population may have been as low as 50 percent. This number was far below the threshold needed for herd immunity to measles, and it put the population at risk of disease.”
  • Biosecurity Implications for the Synthesis of Horsepox, an Orthopoxvirus– Gigi Gronvall evaluates the biosecurity and biodefense implications of the recent horsepox synthesis. “The ability to recreate horsepox, or smallpox, will remain no matter what policy controls are put into place. It will be impossible to close off all avenues for nefarious misuse of gene synthesis, or misuse of biological materials more broadly. As a result, we advocate for the implementation of policy, regulations, and guidance that will make illicit recreation harder, more burdensome, more detectable, and, thus, more preventable without having sweeping negative consequences for the research enterprise. As part of our biosecurity efforts, we must also encourage and enable scientists to participate actively and to do all they can to safeguard their technical fields from irresponsible or illicit actions.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 10.27.2017

TGIF and Pandora Report day! Buckle up because we’ve got an abundance of biodefense news that covers GHSA, chemical weapons, synbio, and more.

 Global Health Security – WHO & PATH Reports and GHSA Ministerial Meeting
As the Global Health Security Agenda Ministerial meeting in Kampala, Uganda takes place this week, several reports were released highlighting the deficiencies in global biosecurity and biosafety efforts, as well as the importance of investing in global health security. Fortunately, on the eve of the GHSA Kampala summit, the Trump administration endorsed the future of the GHSA. Don’t forget to stay tuned to our weekly reports as two GMU Biodefense graduate students are participating (as recipients of the George Mason Global Health Security Ambassador Fellowship) in the Ministerial meeting alongside NextGen GHSA and they’ll be reporting on their experiences in the coming weeks. The first report this week is from NTI, which called on countries to improve biosecurity after WHO demonstrated that there are substantial biosecurity/biosafety gaps worldwide. NTI analyzed 39 Joint External Evaluation (JEE) peer reviews and mapped the related biosecurity and biosafety related scores. Here are their findings: “74% of the assessed countries demonstrated limited or no capacity for a whole-of-government national biosafety and biosecurity system. 64% of the assessed countries demonstrated limited or no capacity for biosafety and biosecurity training and practices. 41% of the assessed countries demonstrated limited or no capacity for linking their public health and security authorities during a suspected or confirmed biological event.” The map they’ve created is also a great visualization for how truly weak biosecurity and biosafety efforts are on a global scale. NTI also used this information to track commitments and biosecurity assistance and partners. The next report comes from PATH, which just released their work: Healthier World, Safer America: A US government Roadmap for International Action to Prevent the Next Pandemic The latest PATH analysis focuses on global health security and global efforts to respond to threats. “This paper aims to examine the benefits of investments in pandemic preparedness, as well as recommends the US Administration and Congress come together behind a comprehensive US strategy, robust investments, and continued vigilance both at home and abroad. The recommendations focus on global leadership, a US plan for international action, and research and development; underpinned by the risks of unsustainable funding, with special focus given to the Ebola supplemental funding sunset set to occur in FY2019.”

Reauthorizing & Improving The Department of Homeland Security
Don’t miss the recent National Interest series by GMU Biodefense PhD alum Daniel Gerstein  on the DHS reauthorization bill. This three-part series starts with a focus on why it’s time to improve the Department of Homeland Security. Gerstein notes that “reauthorization of the Department of Homeland Security is vital to clarifying responsibilities and setting expectations for the continued evolution of the department.” The second part in the series highlights methods for fixing the fractured department. “The question is not whether reauthorization of DHS is necessary. It  most definitely is. However, we should also ask whether the bill goes far enough and what other issues should a comprehensive DHS bill encompass? This second commentary considers whether the DHS structure with  relatively weak central authorities should be reevaluated. Interestingly, each successive secretary has sought to consolidate power and authorities at the department level. Is it time to legislate this outcome? ” Lastly, Gerstein addresses why updating the DHS Acquisition System matters. “This third commentary considers how to better align the department’s requirements, research, development and acquisition processes. Currently, the processes are not synchronized and should be harmonized to better align these critical departmental systems.”

Global Health Security Forum 2017 
Don’t miss out on this November 7th event hosted by the Center for Strategic & International Studies. The all-day event will be held at the CSIS headquarters and will even include an entire session on “Hurtling Toward a Genomic 9/11”! Don’t miss out on the “CSIS’s annual flagship conference on the top challenges facing U.S. and global security. This year’s Forum will focus on national security priorities ten months into the Trump Administration and one year prior to U.S. midterm elections.”

 The Collision Of Civil War And Threat Of Global Pandemics
Infectious disease outbreaks can be challenging for even the most stable country and those experiencing civil war are even more impacted by such biological events. Currently, there are 30 civil wars going on around the world – between cholera in Yemen, polio in Syria, and yellow fever in the DRC, countries that have experienced civil war also tend to experience infectious disease outbreaks. “The Daedalus issue, “Civil War & Global Disorder: Threats and Opportunity,” explores the factors and influences of contemporary civil wars. The 12 essays look at the connection of intrastate strife and transnational terrorism, the limited ambitions of intervening powers, and the many direct and indirect consequences associated with weak states and civil wars. Barry and Wise believe there is significant technical capacity to ensure that local infectious outbreaks are not transformed into global pandemics. But those outbreaks require some level of organized and effective governance—and political will. Prevention, detection, and response are the keys to controlling the risk of a pandemic. Yet it’s almost impossible for these to coincide in areas of conflict.” Civil war impacts not only communication, but access to health resources and can challenge early detection and response of outbreaks. Moreover, the traditional hotspots for emerging infectious diseases (tropical and subtropical areas where spillover is likely) are also areas continually “plagued by civil conflict and political instability.”

Chemical Weapons and Syria
On Tuesday, Russia vetoed a vote at the United Nations Security Council that would “renew a mandate to continue an investigation into who was responsible for the use of chemical weapons during Syria’s civil war.” The Joint Investigative Mechanism (JIM) was initially set up in 2015 to help identify those responsible for chemical attacks and is currently reviewing the April nerve agent attack in Khan Sheikhoun. “But Russia could not get enough support and instead used its veto to block adoption. Russia, along with the UK, China, France and the US, have veto powers at the Security Council. It is the ninth time Russia has blocked action against its ally Syria, something rights group Amnesty called ‘a green light for war crimes’.” The United States has already released a statement through the State Department – “We are disappointed, we are very disappointed that Russia put what it considered to be political considerations over the Syrian people who were so brutally murdered,”.

The Good, The Bad, and The Ugly of Pandemic PredictionPreparation, and Medical Countermeasure Communication 
Pandemic preparedness often feels like a teetering game of picking your poison. Will we see an avian influenza like H7N9 or will it be a novel disease? The CDC “evaluates every potentially dangerous strain, and gives them two scores out of 10—one reflecting how likely they are to trigger a pandemic, and another that measures how bad that pandemic would be. At the top of the list, with scores of 6.5 for emergence and 7.5 for impact, is H7N9.” While there isn’t strong transmission capacity between humans with the H5 and H7 viruses, the H7 strains are more worrisome in that they require fewer mutations to get to that point. Our efforts against avian influenza pandemics go beyond surveillance, and also focus on vaccine responses. “In the meantime, vaccines are being developed to match the viruses seen in the fifth and current epidemic. Other control measures have waxed and waned. When the first of the epidemics struck, Chinese health ministries closed markets and slaughtered birds. But as Helen Branswell reports in STAT, some of those containment efforts became more lax in 2015 and 2016.” Preparedness and response exercises can also gives great insight into problems that may arise when dealing with a pandemic. A recent pandemic simulation was held during the World Bank’s annual meeting in Washington D.C., in which participants addressed everything from hospital closures to mass quarantine. “For the World Bank simulation, organizers looked at the impact on travel and tourism of an outbreak of a mysterious respiratory virus in a hypothetical country. Discussions during the 90-minute session were off the record. But in interviews after the event, organizers said the step-by-step scenario made the theoretical possibility seem very real for participants. In particular, it drove home the need for speedy, accurate information-sharing and strong coordination within and across governments and institutions.” These kinds of exercises are crucial to not only address gaps, but bring together a variety of people that will be critical to pandemic response and recovery. The Johns Hopkins Center for Health Security also just released their self-guided exercise scenario that focuses on communication dilemmas that occur during development of medical countermeasures. The exercise is aimed at public health communicator and risk communications researchers, and revolves around a novel coronavirus outbreak in 2025. “Over a 3-year period, the virus spreads to every US state and more than 40 countries, where case fatality rates vary depending on the capabilities of local health systems. In the United States, an existing drug is repurposed to treat SPARS symptoms while federal regulators work with a pharmaceutical company to fast-track the production of a SPARS vaccine. The response differs in other nations. What follows is a nationwide vaccination effort and lingering strains on the US healthcare sector from a steady stream of patients seeking treatment for serious post-SPARS complications.”

Security Implications of Genome Editing – Meeting of Experts in Hanover
Earlier this month, a meeting of scientists and experts on policy and security gathered to discuss the potential implications of genome editing technologies like CRISPR. GMU Biodefense professor Dr. Sonia Ben Ouagrham-Gormley attended, noting that “Over 100 CRISPR scientists form all over the world (China, India, U.S., Europe, Africa), and policy and security experts gathered in Hannover, Germany,  to discuss the security implication of the new gene-editing technique CRISPR.The group reviewed various threat scenarios and discussed potential policy responses. The meeting was particularly successful as both the scientists and security experts engaged in a productive dialogue about the importance of ensuring security without hampering the use of this new technology to promote progress in medicine and agriculture among other things.” The conference focused on establishing proactive international dialogue about genome editing and incorporating experts that range from ethics and philosophy to economics and political science. “Many workshop participants emphasised that it is vital to support and sustain a culture of responsibility and integrity in research and innovation and to engage with stakeholders. Moreover, researchers and policy makers must commit to continuing an open and inclusive dialogue that builds trust. As with other new and emerging technologies, a lack of communication about any uncertainties may undermine public confidence in science. Scientists and security experts should listen to concerns or fears regarding the misuse of genome editing, and provide their expertise on what is and is not likely.”

Synthesizing Biological Threats—A Small Leap From Horsepox to Smallpox
GMU biodefense PhD student Saskia Popescu discussed dual-use research concerns with GMU professor and graduate program director Dr. Gregory Koblentz and how these relate to healthcare and infectious disease professionals. Drawing on the recent horsepox synthesis, Dr. Koblentz emphasized how this opens Pandora’s box even wider for potential smallpox synthesis and misuse of synbio. Popescu highlighted these concerns and how important it is for healthcare workers to be aware of such events and vulnerabilities. “From the healthcare perspective, it may not seem like something we should worry about, but the direction of gene editing and dual-use research of concern is something that is intrinsically linked to public health. Nefarious outcomes of such experiments, regardless of the origin or intent, will inevitably make their way into an emergency department, urgent care, or worse, the community. Although we may not be seeing the implications today, as medical providers and healthcare workers, we must keep our ears to the ground, listening for these biotech advancements, and then thinking through what they mean for us tomorrow.”

Step Away From The Backyard Poultry
Do you keep poultry in your backyard? If so, you may want to rethink it as the number of Salmonella infections related to contact with backyard poultry has quadrupled since 2015. “This year, nearly every state has been pecked by outbreak strains; only Alaska and Delaware can crow about dodging them. The Centers for Disease Control and Prevention has confirmed 1,120 cases. Nearly 250 of those involved hospitalization, and one person died.But that is likely just scratching the surface of the real numbers, according to CDC veterinarian Megin Nichols. ‘For one Salmonella case we know of in an outbreak, there are up to 30 others that we don’t know about,’ she told the AP.” The issue is that chickens and other fowl can carry organisms without having symptoms and shed them in their feces. While some hatcheries will test prior to selling their birds, it’s important that owners be aware of the risks for such infections.

The Schar School of Policy & Government Presents: Strategic Trade and International Security: Policy and Practice
This Brown Bag Seminar Presentation by Dr. Andrea Viski is the place to be on Thursday, November 2nd, from noon to 1:30pm. “Dr. Andrea Viski is the founder and director of the Strategic Trade Research Institute, an independent organization dedicated to providing authoritative research on issues at the nexus of global security and economic trade. She is also the editor-in-chief of the Strategic Trade Review, a peer reviewed journal dedicated to sanctions, export controls, and compliance. She previously worked for Project Alpha at King’s College London and for the Stockholm International Peace Research Institute (SIPRI). She has published numerous articles and book chapters in the areas of strategic trade controls, nuclear non-proliferation, and international law. Dr. Viski received her Ph.D. from the European University Institute, her M.A from Georgetown University’s Institute for Law, Science and Global Security, and her B.A in International Politics from Georgetown University’s School of Foreign Service.” The seminar will be at Founders Hall 602, 3351 Fairfax Drive, Arlington, VA 22201.

Stories You May Have Missed:

  • Uganda’s Marburg Outbreak – Uganda has just confirmed the death of a 50-year-old woman as a result of the hemorrhagic fever, Marburg. “The victim, a 50-year old woman, died on October 11 at a hospital in eastern Uganda after “she presented with signs and symptoms suggestive of viral hemorrhagic fevers”, the minister said. The woman had nursed her 42-year old brother who died on September 25 with similar signs and symptoms and also participated in cultural preparation of the body for burial, she added.”
  • Big Chicken – Are you reading the latest book by Mary McKenna on antibiotic misuse in the poultry industry? “In Big Chicken, McKenna lays out in extensive detail the unintended consequences that resulted from experiments performed at Lederle Laboratories in December 1948 when scientist Thomas Jukes began adding trace amounts of the antibiotic aureomycin (later to be known as chlortetracycline) to chicken feed. The discovery that the drug could quickly fuel growth in chicks raised in confinement revolutionized the poultry industry, turning chicken into America’s favorite protein.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 10.20.2017

Happy Friday and welcome to our weekly rundown of all things health security!

Smallpox Could Again Be A Serious Threat
GMU Biodefense professor, graduate program director, and all around health security grand master, Dr. Gregory Koblentz, is working to make sure we’re not ignoring the threat of smallpox due to synthetic biology. The problem isn’t just within the amazing capabilities of synbio, but its dual-use nature, meaning that it has the potential to be misused by nefarious actors. This concern has become even greater with the horsepox recreated by Canadian researchers who demonstrated not only capability, but also the low cost of such work. It’s not a far jump from horsepox to smallpox, especially when we have mail-order DNA fragments available at prices that continue to lower. Koblentz notes just how much of a disaster a re-emergence of smallpox would be on a global level, especially since it’s highly contagious and routine immunization has long been gone. “If resurrecting horsepox virus provides a roadmap to synthesizing smallpox virus, then why would anyone try to synthesize it? Because there are potentially legitimate uses for. Tonix claims that the horsepox virus is a good candidate for developing a new, safer smallpox vaccine. Unfortunately, the current legal and technical safeguards against the synthesis of smallpox virus are weak and fragmented. There is no clear international legal or regulatory framework to prevent the synthesis of smallpox virus. The WHO has a policy banning the synthesis of the smallpox and regulating who can produce and possess large fragments of smallpox DNA, but it hasn’t been widely adopted by states. Furthermore, there is no mechanism—at either the national or international level—for detecting or punishing violations of this policy.” Aside from some substantial gaps in regulations, there are some voluntary industry screening processes however, these are pretty limited and tend to be minimal at best. Koblentz points out that there is still time to get ahead of the pox in this case – specifically by rallying international organizations, national governments, the DNA synthesis industry, and the synbio community. Check out his recommendations and comments in the article here!

Global Health Security Supplement – CDC’s EID Journal
Don’t miss out on this ahead-of-print alert for the December edition of the CDC’s Emerging Infectious Disease journal. Volume 23 will include a section on global health security, with articles on the contributions made by the CDC and other partners, establishment of the CDC Global Rapid Response Team, and Joint External Evaluations. There’s also a great commentary by Dr. Michael T. Osterholm on the unfinished journey of global health security. “All countries need to have the laboratory, trained workforce, surveillance, and emergency operations capabilities to prevent, detect, and respond to disease threats. Only when these accomplishments are realized can we truly be on the road to global health security for infectious diseases. Until then, the goal of global health security remains an unfinished journey.”

GMU Biodefense PhD Info Session – October 26th!
Don’t miss your last chance to catch our biodefense PhD info session before applications are due! On Thursday, October 26th at 7pm at our Fairfax campus, we’ll be hosting this session where you can meet with professors, current students, and find out how much fun getting a PhD can be. Where else can you study everything from synbio to Ebola and even how to stop biological threats? GMU Schar School’s Biodefense program is just the place for all things health security.

The Worrying State of Epidemic Preparedness & Global Spread of Hemorrhagic Fever Viruses: Predicting Pandemics
University of London professor Sanjeev Krishna studies neglected infectious diseases and like so many, wasn’t surprised at the 2014/2015 Ebola outbreak. He notes that globally, we could’ve been better prepared to handle the outbreak and that vaccine development, among other things, is critical. “At the start of this year an organisation was launched to lead the way, the Coalition for Epidemic Preparedness Innovations (CEPI). Its mission is to bring politicians, academics, drug firms and philanthropists together to help prepare for the next epidemic. It was launched at the World Economic Forum in Davos in January, and is backed with $620m (£466m) from the governments of Norway, Germany, Japan, Canada, Belgium and Australia and the world’s two largest health charities the Wellcome Trust and the Bill and Melinda Gates Foundation. It is working to establish the lab and distribution infrastructure and access to funds needed to rapidly develop vaccines in a crisis.” CEPI Chief Executive Richard Hatchett has continually emphasized the importance of recognizing warning signs and investing in prevention efforts. Hatchett points out that the biggest lesson from Ebola, like so many outbreaks, is that we simply can’t be complacent about diseases with epidemic potential. Vaccine development can take a while and is costly (some say it’s about $1 billion per vaccine) and it’s taken groups like the Bill and Melinda Gates Foundation and Wellcome Trust to really support some of these efforts when government investments have been lacking. These gaps in preparedness and funding are worrisome in the event of a pandemic flu. “Sir John Bell, scientist at Oxford University and author of the UK’s life sciences industrial strategy, agrees on the threat posed by flu, noting that the last flu pandemic in 1918 killed 50m to 100m people, around 3-5pc of the world’s population at the time. ‘The experience of the epidemic in 1919 should give ample cause for concern about the impact of such an event globally,’ he says.” The truth is that we’re still working to prepare and respond to these biological events, but the real question is – will we learn from our mistakes? You can also read Dr. Alaa Murabit’s comments on the challenges of securitizing health and how this UN High-Level Commissioner is tackling global health issues. Epidemics usually occur when health systems are unprepared.” These words ring especially true this week, during International Infection Prevention week (read below). Hemorrhagic viruses and hantavirus have shown an uncanny ability for epidemic expansion, whether it be through people or rodents across significant geographical areas. “The ultimate goal is to develop a resilient global health infrastructure. Besides acquiring treatments, vaccines, and other preventive medicine, bio-surveillance is critical to preventing disease emergence and to counteracting its spread. So far, only the western hemisphere has a large and established monitoring system; however, diseases continue to emerge sporadically, in particular in Southeast Asia and South America, illuminating the imperfections of our surveillance. Epidemics destabilize fragile governments, ravage the most vulnerable populations, and threaten the global community.” The truth is that we so frequently follow the pattern of poorly prepared health systems responding to epidemics and governments re-alligning preparedness efforts only after the event. The current world is in a state of flux to fix these health issues despite constant external stressors like conflict, growing populations, migration, climate change. Despite these challenges, it is vital we strengthen our health systems to more effectively and efficiently identify biological threats, prevent them, and respond to them.

Measuring Radiation Doses in Mass-Casualty Emergencies                 We’re getting a double-dose of GMU biodefense in this fascinating article on radiation measurement. GMU biodefense professor and graduate program director Dr. Gregory Koblentz and doctoral candidate Mary Sproull (who is also a radiation guru at the Radiation Oncology Branch of the National Cancer Institute at the National Institutes of Health) are teaming up to address diagnostic challenges and technologies in the event of a nuclear attack. This article is especially relevant with tensions rising between the United States and North Korea in the wake of nuclear tests. In the event of something this horrific, one of the challenges is to appropriately and accurately diagnosis and treat radiation-related injuries. “Fortunately, new types of diagnostics to address this critical need are being developed in the field of radiation biodosimetry. Radiation biodosimetry is the estimation, through observation of biological variables, of received dose from previous radiation exposure; the new diagnostics use changes in various biological markers to estimate the severity of radiation doses.” Koblentz and Sproull highlight several gaps within U.S. preparedness related to biodosimetry, especially in terms of surge capacity and how such diagnostic capabilities may be challenged in a large-scale event. They also point to research into new assays, like those using newly identified radiation biomarkers. Lastly, Koblentz and Sproull focus on recommendations to better integrate biodosimetry, whether it be integrating medical management of radiation injuries into healthcare provider education or equipping federal response teams with deployable point-of-care biodosimetry diagnostic capability.

Meeting of the Blue Ribbon Study Panel on Biodefense – National Biodefense Strategy: Implementation and Implications
Don’t miss this event at the Hudson Institute on Thursday, November 2nd from 10:30am to 2pm. “This meeting of the Study Panel will address implementation of the National Biodefense Strategy and its implications for the Office of Management and Budget, congressional authorization and appropriation, leadership, coordination, collaboration, and innovation. Thought leaders will draw upon current and previous experiences with implementing national strategies and high-level policy directives. These speakers will also share their thoughts on: (1) the biological threat, the priority they place on biodefense, and efforts to address their concerns; (2) what the Administration should consider as it goes about populating the Implementation Plan for the National Biodefense Strategy; and (3) how Congress should use the Strategy and its Implementation Plan to inform its biodefense oversight and legislative activities.” Make sure to RSVP here by October 30th if you’re attending in person – the event will also be webcast.

Doreen and Jim McElvany Nonproliferation Challenge
Don’t miss out on this wonderful opportunity through the James Martin Center for Nonproliferation Studies (CNS) to encourage innovative thinking and help address nonproliferation. “The James Martin Center for Nonproliferation Studies (CNS) and its journal, the Nonproliferation Review, aim to spur new thinking about nonproliferation and disarmament.To advance this goal, the Doreen and Jim McElvany Nonproliferation Challenge will recognize the most outstanding new ideas and policy proposals published in Volume 25 (2018) of the Nonproliferation Review. The Challenge will award a grand prize of $5,000, a $3,000 runner’s-up prize, and a $1,000 honorable mention prize.”

The Evolution of the Islamic State’s Chemical Weapons Efforts               The Islamic State has grown increasingly comfortable with using chemical weapons and Columb Strack is taking us through the evolution of their practices. While their use of chemical weapons seems to have been abandoned since the loss of Mosul in June 2017, intelligence sources have suggested that a new chemical weapons cell has been established within the Euphrates River Valley. “The Islamic State’s use of chemical agents in Iraq and Syria is characterized by three phases. During the initial phase, which encompasses the first year of the caliphate’s existence (between June 2014 and June 2015), chemical attacks drew on tried and tested techniques, adapted to include widely available industrial chemicals—mainly chlorine and phosphine—from stockpiles captured as part of the group’s territorial expansion. These attacks were carried out using crude delivery mechanisms, in most cases adding canisters of chemicals to roadside or vehicle-borne improvised explosive devices (IEDs). The second phase, from July 2015 to January 2017, represents the enhanced capability the group had achieved by combining the production of sulfur mustard agent with the means to deliver it using projectiles, such as mortar bombs and improvised rockets. During this period, chemical attacks were carried out simultaneously across the caliphate, from Syria’s Aleppo province in the west to Iraq’s Kirkuk province in the east, indicating the existence of multiple operational units with the required expertise. Attacks peaked in April 2016, with eight separate recorded chemical attacks in one month. The third phase began with the last recorded chemical attack in Syria on January 8, 2017, and ended with the Islamic State’s apparent abandonment of its CW production following the loss of Mosul in July 2017.” Strack traces the history of intent and methodology development from two decades of experimentation by other militant groups. Strack also discusses experiments and sources for the weapons, including the seizure of military sites where chemical weapons could have been stored. Lastly, he discusses the slow degradation of capability that occurred following airstrikes against facilities and individuals, but that ultimately, the Islamic State has “the capability not only to transfer the know-how to produce toxic chemicals via secure online communications to operatives already living in target countries, but also to ship materials, including explosives, undetected.”

Blue Ribbon Study Panel on Biodefense- Animal Agriculture Vulnerabilities
Diseases that impact animals and have the potential to cross over to humans, let alone impact the agriculture industry, can be devastating. The Blue Ribbon Study Panel on Biodefense has just released their report evaluating the threats to animal agriculture and how this can not only impact human health, but also the U.S. economy. “In December 2014, a highly pathogenic strain of avian influenza entered the United States via migrating wild birds. The ensuing outbreak resulted in the largest animal health disaster ever experienced by the United States. Federal and state governments spent $879 million on outbreak response. The outbreak impacted 21 states, lasted until the middle of 2015, and led to the depopulation of more than 50 million birds on 232 farms. Subsequent trade bans impacted as many as 233,770 farms. The total cost to the U.S. economy was estimated at $3.3 billion. In 2015, the agriculture, food, and related industries contributed $992 billion (5.5%) to U.S. gross domestic product (GDP), making it one of the largest sectors of the U.S. economy. Given its critical importance to food safety and availability in the United States and around the world, protecting this sector is a matter of national security.” The report covers the threat to food and agriculture, zoonoses, how federal response is organized, collaborative efforts like biosurveillance, and the innovative work within next-generation medical countermeasures.

Why You Should Be Celebrating International Infection Prevention Week                                                                                                                                         Are you celebrating infection control this week? GMU Biodefense PhD student Saskia Popescu is pointing out how vast the role of infection prevention is across healthcare and why we should all be celebrating it. “October 15-21, 2017 marks International Infection Prevention Week and while this may seem like a week where we rally around hand hygiene, it’s much bigger than that. Infection prevention goes beyond the nuances of hand hygiene and expands to almost every corner of medical care and healthcare. Whether it be a dental clinic, operating room, or even an outpatient treatment center, infection prevention plays a vital role in keeping patients and healthcare workers safe. Not convinced? On any given day, the Centers for Disease Control and Prevention estimates that roughly 25 people in the United States will acquire a healthcare-associated infection (HAI). In a given year, it’s estimated that 722,000 HAIs occur, of which 25,000 of those patients die due to the infection. Realistically, it’s believed that the annual number of HAIs within the United States is closer to 2 million, which is astounding.”

Monkeypox in Nigeria
Nigeria is currently experiencing an outbreak of monkeypox after confirming three cases. “Since Sep 22, there have been 60 reports of suspected monkeypox cases from across Nigeria. The laboratory analysis showed that 12 suspected cases from the Bayelsa state were not positive for monkeypox. The NCDC said that all patients with suspected and confirmed monkeypox are currently receiving supportive medical care and improving. The NCDC offered no further details on the confirmed cases, besides noting that they were from Bayelsa state. The agency said the likely source of infection is through primary zoonotic transmission, and cautioned Nigerians to avoid contact with squirrels, rats, and any animals that appear sick.” Samples are currently being analyzed at the WHO regional office in Dakar, Senegal.

Stories You May Have Missed:

  • Did Disease Impact the Fall of Rome?– We know that disease can have devastating consequences on societies and even ancient Rome experienced several outbreaks of smallpox and plague, but just how impacting were these biological events? “Rome was far from the only advanced society shaken to its core by the explosive force of infectious diseases. The medieval Black Death sent some leading-edge polities (like the communities of Italy) backward, while opening the space for the ascent of others, such as England. The lethal role of pathogen exchange in the European conquest of the New World is relatively famous, if still imperfectly understood.”
  • Supportive Care Recommendations for Ebola Patients– Treatment for patients afflicted with Ebola can be tricky and there’s often little time to get the right mixture. “The study, by a team of international experts, was published yesterday in The Lancet. The authors write that at the beginning of the outbreak in 2013, case-fatality rates were 70%, but that number was lowered significantly (to 40%) as supportive care practices improved over the course of the outbreak. Using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, the authors present evidence-based recommendations for patient care during the next Ebola outbreak. Oral hydration and intravenous hydration had the strongest recommendation. When administered properly, the measure carries no risk of transmission to healthcare workers, the experts say. and making sure patients, especially the very young, are adequately hydrated is a necessary supportive measure.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 10.13.2017

What could be spookier than a Friday, 13th, in October? Actually, a few things – antimicrobial resistance, biological weapons, plague in Madagascar…..

The Trump Administration’s Misaligned Approach to National Biodefense
This recent publication from Reid Kirby is casting light upon the calamitous state of current and future U.S. biodefense efforts. Kirby points to several factors that will ultimately impact the new administration’s ability to create a new national biodefense strategy – the dysfunction rampant throughout the White House, the anti-science culture that continues to bubble up, a general inability to appoint fill key positions in a timely manner, and the disparage between the Trump administration’s ability to strategize and execute effective actions. “Again, how is the Trump administration doing so far in national biodefense? To answer this question, it is helpful to think in terms of ways, means, and ends – where the “ends” amount to security itself, the “ways” are formation of strategy, and the “means” are execution of strategy. What is concerning about the Trump administration is that the ways and means through which it pursues biodefense policy are fundamentally mismatched with the execution of meaningful biodefense ends.” Kirby highlights these failures through several examples, like the administration’s continued disrespect for science, whether it be climate change or nuclear energy. The administration’s resistance against government-sponsored research (and science in general), is in direct opposition to what a new biodefense strategy will need. “The Trump administration’s worldview, and its inability to distinguish between defense and security, may well be incompatible with a biodefense strategy. Biodefense is a scientific and technological endeavor.” Kirby states that “the administration has expressed a desire to formulate a comprehensive biodefense strategy, but the ways and means it is marshalling are not in alignment with achieving that goal. The future of US biodefense is at significant risk.

North Korea’s Biological Weapons Program – The Known and Unknown
The Harvard Kennedy School’s Belfer Center has just released a new report on North Korea’s biological weapons program. There’s been significant attention recently on their nuclear program however, there is still speculation regarding the real capacity for a biological weapons program. Bioweapon programs are always challenging to determine from the outside – so much of the equipment has dual-use capacity that makes external monitoring inaccurate at best. The new report utilizes publicly available information and interviews with experts to investigate the knowns and unknowns of North Korea’s BW program. Researchers “examine where policy on North Korea’s BW stands. We focus our analysis on the policies of South Korea and the United States, rather than at an international level, as North Korea has had limited participation in the Biological Weapons Convention (BWC).” The report also provides recommendations on how to improve assessment and surveillance efforts, not to mention current policies regarding North Korea’s BW program. Within this report, you’ll also find sections regarding means of delivery, strategic and tactical usage, gaps in current policies, how to improve nonproliferation policy, etc.

GMU Biodefense MS Open House – October 19th
Next week, GMU’s Schar School will be hosting a Masters Open house for prospective students, which means you get another chance to learn about our engaging and exciting Biodefense MS programs! You’ll be able to speak to faculty, learn about admissions, and how you can study biodefense on campus or remotely, at 6:30pm on Thursday, October 19th at our Arlington campus.

Biodefense: Federal Efforts to Develop Biological Threat Awareness
The most recent report from the U.S. Government Accountability Office (GAO) is drawing attention to biothreat awareness and how key agencies, like the DHS, DoD, USDA, HHS, and EPA, work to develop such awareness, regardless of the origin of the threat. The report highlighted three categories of efforts – intelligence gathering, scientific research, and analysis activities. “Federal agencies with key roles in biodefense share biological threat information through many different mechanisms designed to facilitate collaboration among government partners, including working groups and interagency agreements. For example, agency officials reported using collaborative mechanisms to coordinate activities and avoid duplication and overlap. However, as GAO and others have noted, opportunities exist to better leverage shared resources and inform budgetary tradeoffs. Recent legislation requires key biodefense agencies to create a national biodefense strategy that has the potential to help address these issues, by, among other things, supporting shared threat awareness. Until the strategy is developed, the extent to which it will meet this need is unknown.” Due to the variety of sources that biological threats can originate from, this report was established to review how federal agencies not only develop, but also share threat information and how this impacts future biodefense efforts. GAO utilized policies, directives, and strategies that were all related to biodefense to appropriately assess processes and the main agencies that would have critical roles within biodefense efforts.

NASA Backs Research on Evolution of Viruses in Extreme Environments Understanding how viruses adapt and infect hosts is a critical component to predicting movement and hopefully, prevention. NASA has recently funded Portland State biologist Ken Stedman to study viral evolution and how hybrid viruses work. “The study stems from a bizarre virus Stedman discovered in a hot spring at Lassen Volcanic National Park five years ago. The virus’s genetic code is derived from both DNA and its evolutionary predecessor, RNA. The vast majority of life on Earth switched its genetic code from RNA to DNA about four billion years ago, so the fact that this virus has both is highly unusual, according to Stedman.” The NASA grant will allow Stedman and his research team to study hybrid viruses, who they infect, and how they were able to adapt to such extreme environments.

Pandora Report Twitter
Feeling like you need a little extra biodefense information and humor in your life outside of our weekly reports? Check out our Twitter account (@PandoraReport) for a pretty constant stream of not only informative headlines, but also a taste of the hysterical biodefense community. The hidden world of biosecurity/biodefense twitter nerdom is pretty outstanding and probably the best thing on twitter (well, we may be a bit biased, but find out for yourself!).

Seychelles Identifies A Case of Plague
As Madagascar is struggling against a severe outbreak of plague, a nearby chain of islands, Seychelles, has just identified its first imported case. Seychelles is currently working to prophylactically treat fifteen people who were in close contact with the 34-year-old man who fell ill after returning from Madagascar. This is the first case that has spread beyond Madagascar, so officials are working diligently to avoid secondary cases. The WHO is currently sending 1.2 million antibiotics to Madagascar to fight the plague outbreak that is rapidly spreading, especially since many of the cases are pneumonic. Currently, there have been 50 deaths and 500 cases in Madagascar since the outbreak began in August.

Backing the Global Health Security Agenda
After months of speculation and concern regarding the Trump administration’s support for the future of the GHSA, Secretary of State Rex Tillerson brought forth a wave of relief. In a recent keynote speech, Tillerson “voiced support for US collaboration on global infectious disease issues, including ongoing efforts to battle threats such as HIV and malaria. He also signaled US support for extending to 2024 the Global Health Security Agenda (GHSA), a partnership of 50 nations, international organizations, and nongovernmental organizations geared toward building countries’ capacity to prevent and respond to infectious disease threats.” While discussing the importance of the President’s Emergency Plan for AIDS Relief (PEPFAR), he also highlighted that HIV/AIDS is not the only biological threat that needs addressing, commenting that the GHSA was a useful framework. Tillerson noted that “While we’ve made tremendous progress since GHSA was launched in 2014, considerable work remains. That is why the United States advocates extending the Global Health Security Agenda until the year 2024. the United States commitment to working in multi-sectoral partnerships to counter infectious diseases through the Global Health Security Agenda will remain constant,”.

Strategies Against Antimicrobial Resistance
We’ve been waging war on antimicrobial resistance (AMR) for decades now, but the truth is that future strategies may require thinking outside the box. Here are some of the potential avenues for helping to stop the global burden of microbial resistance – utilizing the human micro biome to help develop new antimicrobials and deploying tiny semiconductors – “A minuscule amount of drug with some light can treat some of the worst superbug infections we tested in clinical strains acquired from a Colorado hospital,” Nagpal says. “Of course, more work and extensive studies in preclinical and clinical trials need to be done before we can administer these quantum dots to patients. However, this initial study shows a lot of promising features.” Efforts also includes infection killing polymers, changing the culture of research to move away from siloing and towards efforts across multiple channels, making existing antibiotics stronger, etc. In fact, if you want to see how AMR spreads around the world, check out this graphic from Pew Charitable Trusts.

Stories You May Have Missed:

  • Puerto Rico’s Post-Hurricane Infectious Disease Woes – Following the destruction of Hurricane Maria, Puerto Rico is now working against the clock of infectious diseases. “Four deaths in Hurricane Maria’s aftermath are being investigated as possible cases of a disease spread by animals’ urine, Puerto Rico’s governor said Wednesday amid concerns about islanders’ exposure to contaminated water. A total of 10 people have come down with suspected cases of leptospirosis, Gov. Ricardo Rossello said at a news conference.”
  • The Interesting Case of the World’s First Vaccine– a recent report on a 115-year-old smallpox vaccine vile is shedding light onto the ingredients of this revolutionary medical countermeasure. “With the evolution of science and the advanced tools now used to conduct it, it has become clear that vaccinia — the virus used in modern smallpox vaccines — is neither cowpox nor horsepox. Whether it is a virus that formerly infected some species of animals — rodents, maybe — or is something that evolved in laboratories through the deliberate mingling of pox viruses isn’t clear.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 9.29.2017

 Homeland Security Struggles to Fund ChemBio Defense & The Invisible Threat Looming budget cuts within DHS are doing little to qualm concern that state and local infrastructure is simply unprepared to handle a biological or chemical attack. “In terms of bsecurity, ‘we are much better prepared than we were’ post-9/11, said Tom Inglesby, director of the Center for Health Security at the Johns Hopkins School of Public Health in Baltimore, Maryland. ‘But we are not where we need to be, and the progress is, in some cases, somewhat fragile’.” Internationally, the use of chemical weapons in Syria and growing tensions with North Korea are continual reminders that preparedness is vital. “The department’s science and technology directorate took a 28 percent budget cut when the omnibus bill for fiscal year 2017 was signed in May, and the chemical biological defense division is ‘taking a cut much more significant than that’ in fiscal year 2018, said John Fischer, division director. The directorate in May released a budget overview for congressional justification, which stated over $58 million would be put toward chemical, biological and explosive defense research and development for 2017, assuming a continuing resolution would remain in effect for the rest of the fiscal year. Less than $53 million was requested for 2018, according to the document. DHS did not respond to requests for an interview.” 2018 will be a year of harsh budget reductions for biosurveillance and chemical detection programs, as border security will be headlining in terms of priority. The surge of biodefense funding that was seen post-Amerithrax has certainly waned, but there is also concern for complacency and a tendency to go from fire to fire instead of working to establish robust and effective prevention and response mechanisms. Overall, this fiscal tightening will surely have an impact on prevention, identification, and response strategies for biological and chemical threats, leaving many people holding their breath that the blowback won’t be severe.

 Now more than ever, it is important we change the narrative of lackluster efforts to defend against biological threats. Budgetary slashing, lowering of barriers, and an era of increasing globalization and rapid international travel – these are all the things that should remind us that biological threats are not a figment of science fiction. “What was unthinkable back in the day is now quite common and easy,” Inglesby said. “Genetic engineering is now possible with kits from boxes at younger and younger ages with less and less training.” The dual-use nature of biological research not only has the capacity to lower the barriers to bioweapon development, but can also muddy the waters when determining if research is  offensive or defense. “That’s not the only challenge facing those sounding the alarm about biothreats. Government scientists worry that there aren’t enough biologists working on this problem. “We have relatively few biologists working in national security,” Matheny told FP. “This is one area where we’re just starting to catch up to the fact.” While the future of NBACC is still not set, such uncertainty has rippling effects when it comes to staffing. While we consider biological threats a multi-faceted enemy – natural, intentional, or accidental, it is now biodefense efforts that are facing attacks at multiple fronts. The recent de novo synthesis of smallpox has brought many of these concerns to fruition. Whether it be through the advancement of life sciences that poses dual-use risk, severe budgetary cuts, or a shifting focus onto border walls, we cannot afford to allow this threat to be invisible much longer.

 GMU Schar School MS Open House – October 19th
Have you ever wanted to study what you love to further your career? GMU’s MS in Biodefense is just that chance and we’ve got an open house coming up so you can get all the information on it. On Thursday, October 19th at 6:30pm at our Arlington campus, we’ll be hosting an information session about our in-person and online biodefense MS program. From anthrax to Zika, GMU is the place for all things biodefense!

Navigating Our Way Out of the Jungle: Modernizing Meat Inspection
It’s been over 111 years since the famous Meat Inspection Act of 1906 and we’re still struggling to keep food safety efforts at a pace that can beat risks from farm to table. “What triggered such a shift after decades of poor industry practice? The year prior, in 1905, a book by Upton Sinclair was published in a series, which would then be published in entirety in early 1906. The Jungle brought forth the unsavory and grotesque underbelly of the American meat system. Although this may not have been the focus of his book, readers took away from it that their trusted source for meat was corrupt and lacked safety mechanisms. Within the year, the Federal Meat Inspection Act was established.” Pew Charitable Trusts is working to help evaluate and strengthen the meat and poultry industry and to help reduce the impact that contamination has within the U.S. population (2 million are sickened annually due to contamination). “A June 2017 report from Pew and Cargill, an American privately held global corporation based in Minnetonka, Minnesota, highlighted some of these concerns and established an open dialogue to develop recommendations. They addressed the need to establish a risk-based oversight system, which would incorporate data from across the food-safety system. The guidance also included better risk communication, a modernized approach to slaughter inspection that would include current technology and pathogen-specific appropriate levels of protection, among other components.” Food safety and security is truly the soft underbelly of American and it’s vital that we modernize such efforts.

BBC Pandemic
If you’re one of our readers in the UK, make sure to take advantage of this new outbreak tool through the BBC. The BBC Pandemic app can be downloaded onto your phone and may just help us understand how future outbreaks spread. “Through the app, BBC Pandemic will be conducting two experiments: the National Outbreak, which is open to anyone in the UK from 27th September 2017; and the Haslemere Outbreak, a closed local study that is only open to people in the town of Haslemere, Surrey, and runs for 72 hours starting on Thursday 19th October 2017. In the National Outbreak, the app will track your approximate movement at regular intervals over a 24 hour period. (Don’t worry, it won’t know exactly where, or who you are.) It will also ask some questions about your journeys and the people you spent time with during those 24 hours. All data collected will be grouped to ensure your anonymity, and a research team from the University of Cambridge and the London School of Hygiene and Tropical Medicine will use it to predict how a flu pandemic might spread across the country – and determine what can be done to stop it.” If you’re still not sold on it, here’s another reason why apps like this can truly help future pandemic response – data modeling. Despite our best efforts, epidemiological models are only as good as the data we have available. Simulation efforts help response efforts coordinate resources and plan accordingly however, if our modeling isn’t a decent representation of the population due to limited data, it won’t be that effective. Getting information from a broad range of people helps strengthen such efforts.

Recommendations for Incentivizing the Development of Therapeutics, Diagnostics, and Vaccines to Combat Antibiotic-Resistance 
The Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB) has been working since 2015 to curb the threat of resistant germs. The group has found that current economic efforts are insufficient and through three working groups on incentives (for vaccines, diagnostics, and therapeutics), they have released a new report. Identifying 46 critical issues that are preventing the development of new/improved products and providing 64 recommendations to address them, this new report is a robust 42 pages worth the read. For example, regarding human health and incentives for vaccine use, the group found that “federal and nonfederal stakeholders lack a common understanding about the current and potential economic value and societal impact of vaccines that can reduce AMR.” Their recommendation for this issue: “Analyses on the cost and societal impacts associated with new vaccine development and administration in the AMR arena developed via a multi-agency process that involves at least CDC, the Centers for Medicare and Medicaid Services (CMS), and the Treasury Department, in partnership with industry and public health stakeholders.” Within each section, you can find issues and recommendations categorized by economic, R&D, regulatory, and behavioral. The United Nations Foundation and the Wellcome Trust has also released a new report regarding the global efforts that have been sustained to fight AMR. “The report, published a year to the day that the United Nations (UN) General Assembly agreed to address the root causes of AMR and take action to tackle the problem, shows that many nations are following up on their pledge to encourage more responsible use of antimicrobials in human medicine and agriculture. Out of 151 countries recently surveyed, 85% say they are developing or have developed national action plans on AMR and 52% have a fully developed plan that addresses the One Health spectrum of human, animal, and environmental sectors.”

 Chemical & Biological Attacks: Underground Transport Restoration Project
After four years, this DHS-sponsored project is finally wrapping up their work studying the methods for chem-bio agent dispersion in subways. “Sandia National Laboratories’ engineer Bob Knowlton has worked on this challenge for a dozen years. His team has developed scientific sampling methods to determine the extent and nature of the contamination. Sampling also is essential to confirm the decontamination was effective and the site is safe to re-enter. Sandia researchers and their collaborators at other national laboratories and local, state and federal agencies have looked at everything from how to clean subway stations and grimy tunnels to where a surrogate for anthrax would go when released inside the New York City subway system and the best way to decontaminate a subway car.” Check out their findings on this project and from the 2016 large-scale testing they did in a mock subway system.

Little Island of Horrors – Vozrozhdeniya 
During height of the Soviet offensive bioweapons program, an ideal island, like Vozrozhdeniya, was the perfect place to test cutting-edge biological weapons. Present day, the island is a sad reminder of one of the largest state-sponsored bioweapons programs. “The island’s secrets have endured, partly because it isn’t the kind of place where you can just turn up. Since Vozrozhdeniya was abandoned in the 1990s, there have only been a handful of expeditions. Nick Middleton, a journalist and geographer from Oxford University, filmed a documentary there back in 2005. ‘I was aware of what went on, so we got hold of a guy who used to work for the British military and he came to give the crew a briefing about the sorts of things we might find,’ he says. ‘He scared the pants off me, to be honest’. Aerial photographs taken by the CIA in 1962 revealed that while other islands had piers and fish-packing huts, this one had a rifle range, barracks and parade ground. But that wasn’t even the half of it. There were also research buildings, animal pens and an open-air testing site. The island had been turned into a military base of the most dangerous kind: it was a bioweapons testing facility.” An isolated secret, this island was the testing ground for some of the worst pathogens. It was also chosen as a holding place for “the largest anthrax stockpile in human history” and while the cache’s location was never disclosed, the pits were visible from space, which meant that the U.S. pledge $6 million towards a clean-up project. Sadly, this isn’t a resolution as the open-air testing done on the island has surely left residual microbial burden, not to mention the burial pits of infected animals. Make sure to read about Dave Butler’s journey to this island and how even now, it still instills fear.

Stories You May Have Missed:

  • China to Open BSL-4– The first certified BSL-4 lab in China will be opening this year. The research institute, located in Wuhan, represents a partnership with the Chinese Academy of Sciences and the Wuhan government. “The lab is part of a 10-year-plan by the Ministry of Science and Technology that proposes to build five to seven BSL-4 laboratories by 2025 as well as one BSL-3 lab in every province. It was built with technology and equipment imported from France, and some of its future research staff have visited France for BSL-4 training. Although construction was finished in 2015, the lab has since undergone multiple assessments, Yuan Zhiming, director of the Wuhan branch of CAS, told the Science and Technology Daily. ‘The lab will become a public platform for Chinese scientists to conduct research into dangerous viruses,’ Yuan said.”
  • Signature Science-led Team awarded $2.9M contract to develop advanced genomic computational technologies in support of IARPA’s Functional Genomic and Computational Assessment of Threats Program – “The Intelligence Advanced Research Projects Activity (IARPA) awarded Signature Science, LLC a $2.9M contract for the development of new computational tools to screen DNA sequences to detect biological threats that may manifest from synthetic microbial manipulation. The challenge is to overcome the speed and precision limitations of contemporary synthetic DNA screening practices to rapidly detect and isolate a prospective threat within a segment of DNA. The research team will re-tool bio-threat detection methods, and focus detection efforts on functional genetic elements to increase analytic speed and precision, thereby dramatically improving predictive capacity to isolate the toxic gene that constitutes the threat.”
  • Medieval Plague Gives Insight Into Human Pollution History – “A recent study indicates that much less lead occurs naturally in the air than we thought—in fact, there should be almost none. Scientists measured lead trapped in an ice core from the Swiss-Italian Alps. They found that lead levels dropped dramatically only once in the past 2,000 years, during a time that coincided with the Black Death pandemic. This means that in Europe, lead levels in the air have been elevated for thousands of years. Most people think about air pollution as a problem that began with the Industrial Revolution, but we’ve been spoiling the quality of our air for a very long time. It has harmed our health throughout history, from Medieval Europe to the Roman Empire to Ancient Egypt and Peru, and continues to do so today.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 9.15.2017

Global Health and the Future Role of the United States
The latest report from the National Academies of Science Engineering, and Medicine, is now available! “Growing forces for globalization have increased the interconnectedness of the world and our interdependency on other countries, economies, and cultures. Monumental growth in international travel and trade have brought improved access to goods and services for many, but also carry ongoing and ever-present threats of zoonotic spillover and infectious disease outbreaks that threaten all.” The report includes chapters on investing in global health for America and how such investments protect U.S. interests, the effects of globalization, and looking into the future. There are individual chapters on infectious diseases like pandemic influenza and global health security as national security, TB, and how we can enhance productivity and economic growth. “By investing in global health over the next 20 years, there is a chance to save the lives of millions of children and adults. Beyond these health benefits to individuals, global health is directly linked to economic productivity and growth worldwide. According to the Lancet  Commission on Investing in Health, the return on investments in global health can be substantial—as the benefits can exceed the costs by a factor between 9 and 20, for low-income and lower middle-income countries, respectively. Worldwide, investing in core capacities to prevent, detect, and respond to infectious disease outbreaks through the development of multidisciplinary ‘One Health’ systems focused on the interface of human and animal health can result in an estimated savings of $15 billion annually from the prevention of outbreaks alone.” The report emphasizes the importance of continued commitment to global health and that ultimately, aid is truly an investment in global health, which benefits us all. Disease knows no borders and an outbreak anywhere is an outbreak everywhere. Melinda Gates also recently discussed the importance of foreign aid, noting that “If we don’t make these investments in global health, my argument to people is, you’re going to see a lot more things like Ebola in our own country, and we’ll be dealing with them in our own health clinics because borders are porous,”.

GMU Biodefense Graduate Program Information Sessions 
Don’t miss out on the chance to learn about our PhD program on September 21st! You can join the info session at 7pm at the GMU Arlington Campus. The GMU Schar School PhD info session will also include a panel of current PhD students to discuss their experiences and answer questions. This is also a great chance to chat with faculty and learn about admissions. Where else can you study a range of topics that include biosurveillance, select agents, global health security, and policy with such an engaged group of faculty and students?

Tom Frieden Launches New Global Health Initiative
Former CDC director Dr. Tom Frieden is launching a new program to combat not only global cardiovascular disease, but also infectious diseases. The new initiative Resolve to Save Lives, will be located in New York City, and “will prevent heart attacks, strokes, and epidemics with the goal of saving 100 million lives and making the world safer from epidemics.” The initiative has $225 million in backing over the next five years by major funders including the Chan Zuckerberg Initiative, Bloomberg Philanthropies, and the Bill and Melinda Gates Foundations. Frieden hopes to work with major players like the WHO and CDC “to persuade more countries to ban trans fats and lower the salt content in foods and shore up defenses against disease outbreaks”.

Johns Hopkins Center for Health Security ELBI Workshop
The Johns Hopkins Center for Health Security Emerging Leaders in Biosecurity Initiative (ELBI) recently hosted their last event for the 2017 class. The 2017 group capped off their fellowships with a day of engaging lectures and discussions including talks from FBI SSA Ed You, STAT reporter Helen Branswell, MIT’s Peter Carr, and more. The group was able to tour the Ginkgo Bioworks and George Church labs while chatting with Andy Weber, George Church, Patrick Boyle, Tom Knight, and Devin Leake about the future of synbio and biotechnology. Last but not least, the fellows participated in a viral storm exercise, which challenged them through a real-world scenario that required policy, security, public health, and science responses on a global scale. GMU biodefense PhD student Saskia Popescu attended as a member of the class, noting that “one of my favorite parts from this workshop was getting to hear from Tom Inglesby and several analysts from the CHS regarding their research and initiatives they’ve worked on. Learning about projects like Outbreak Observatory, data-driven outbreak response (outbreak science), and healthcare capacities during natural disasters, was fascinating and really opened my eyes to the range of topics the CHS is involved in.”

Biological Engagement Programs: Reducing Threats and Strengthening Global Health Security Through Scientific Collaboration
Don’t miss out on this latest eBook addressing biological engagement programs and the health security perspective. “Biological engagement programs are a set of projects or activities between partner countries that strengthen global health security to achieve mutually beneficial outcomes. Engagement programs are an effective way to work collaboratively towards a common threat reduction goal, usually with a strong focus on strengthening health systems and making the world a safer place. Cooperative programs are built upon trust and sharing of information and resources to increase the capacity and capabilities of partner countries.” You can download the PDF here – make sure not to miss the chapter “Strengthening Biosecurity in Iraq: Development of a National Biorisk Management System”, co-authored by GMU biodefense professor and graduate program director, Dr. Gregory Koblentz.

NAS Symposium on Cooperative Threat Reduction (CTR) for the Next Ten Years and Beyond
The National Academy of Science will be hosting this symposium on September 18-19 at the Keck Center in Washington, D.C. “In 2009 the National Academy of Sciences (NAS) report Global Security Engagement: A New Model for Cooperative Threat Reduction concluded that expanding and updating U.S. Government Cooperative Threat Reduction (CTR) programs in both form and function would enhance U.S. national security and global stability. The NAS Committee on International Security and Arms Control (CISAC) is convening a symposium to examine how CTR has evolved since that time and to consider new approaches for CTR programs and related WMD elimination efforts to increase their ability to enhance U.S. security. The symposium is sponsored by the Project on Advanced Systems and Concepts for Countering Weapons of Mass Destruction (PASCC) in the Naval Postgraduate School and will be open to the public. A ‘meeting in brief’ document will be issued by NAS after the symposium. For detailed information on this event and a draft agenda please visit:  www.nas.edu/cisac.”

Stories You May Have Missed:

  • GAO Report on Medical Devices for Infectious Disease Rapid Diagnosis – The latest GAO report is looking to the capabilities and challenges of technologies that allow for the rapid diagnosis of infectious diseases. Diagnosis of bio-threats is a crucial component to prevention and control, which makes the efficacy of these technologies critical. “Some stakeholders GAO spoke to identified the need for more clinical studies to establish the benefits of these technologies. Implementation challenges included reluctance by medical users to adopt these technologies, due to factors such as (1) lack of familiarity with such technologies, (2) costs and resources to use them, and (3) reluctance to order, and pay for, all of the tests for a given multiplex assay. Further, in some situations, positive test results for rare diseases are more likely to be false positives; thus systematic testing for such diseases may result in wasted resources to address all patients who test positive.”
  • CSIS Event: The New Barbarianism- don’t miss out on this event organized by the CSIS Global Health Policy Center on Monday, September 18th, from 6:30-9pm at the Newseum. “This hour-long film explores the recent surge of violence we’ve witnessed against the health sector across multiple wars, both new and old, and the accompanying shredding of international humanitarian norms”. Make sure to register here.

Pandora Report 9.8.2017

Happy Friday and welcome to your weekly source for all things biodefense. Got plague? Good news – if you have some live chickens hanging around, you can try this medieval treatment.

Defense Against Biological Attacks
Biological threats come in all shapes and sizes – whether it’s an outbreak of Ebola, a biological weapon, a laboratory mishap, or even the potential for biosafety breaches following  a hurricane. Preparedness and response efforts need to be just as diverse. As Texas begins the process of rebuilding and the threat of nuclear weapons has been fresh in everyone’s mind, it is crucial we don’t forget about the importance of health security. Disease knows no borders and it’s easy to diminish the threat of it however, Laura Holgate and Elizabeth Cameron are drawing attention to the need for President Trump to prevent the next biological attack before it happens. “As Congress and the Trump administration mull a new biodefense strategy, we urge them to use this time — the time in between biological crises — to get ahead of the curve before the next major biological event inevitably comes our way.” They point to several different strategies that should to be followed – watch out for emerging threats in unstable regions, fund and renew the Global Health Security Agenda, replenish the budget to maintain global biosecurity, keep laboratory assets for attributing biological attacks, and use biosurveillance to stop outbreaks before they start. We need to take the National Bioforensics Analysis Center off the chopping block, stop slashing the biosecurity budget as programs like the Cooperative Biological Engagement Program are vital, and truly, the GHSA renewal is a no-brainer. These efforts not only defend against current threats, but work to address the next generation of bioweapons and biothreats.  Holgate and Cameron note that “We know that biological threats must remain at the top of the national security agenda, and leaders must recognize that stopping outbreaks at the source requires strong global and domestic capacity to prevent, detect and rapidly respond to naturally occurring outbreaks and biological attacks”

Health Security – Call for Papers
The Health Security journal is currently looking for papers on communication and health security: improving public health communication in response to large-scale health threats. Manuscript deadlines are October 20, 2017. “Effective communication is an essential tool in establishing an appropriate response to any large-scale health threat or disaster, such as a newly emerging infectious disease, terrorism, environmental catastrophe, or accident. Yet, public health communication is occurring in an increasingly complex world with competing messages, new platforms, and limited trust.A special feature in Health Security will be devoted to analysis of the current communication environment and efforts to effectively communicate during outbreaks of infectious diseases and other health threats. The journal seeks papers that address the wide range of policy, practice, and research issues relevant to communication in large-scale health events.” Topics might include exploration of the communication environment during recent infectious disease events or public health disasters, investigation of the role of social media and other emerging or recently emerging communication platforms, etc. Submission information can be found here.

GMU Biodefense MS – Open House on September 14th
Don’t miss out on the Master’s Open House next week for the GMU Biodefense MS program!  From 6:30-8:30pm next Thursday, September 14th, at the GMU Arlington campus, you can speak to faculty, learn about admissions, and why biodefense students have a blast while getting their graduate degrees. This is a great chance to learn about the MS program (for both online or in-person) and chat with faculty about the exciting classes and activities GMU biodefense students get to enjoy.

The Biological Weapons Convention At A Crossroad
As Robert Frost once said, “Two roads diverged in a wood, and I- I took the one less traveled by, and that has made all the difference.” Which direction will the BWC take? Bonnie Jenkins investigates the uncertain future of the BWC, its current challenges, which direction it might take, and the direction it should take. Despite its relevance and capacity to endure decades of challenges, the latest RevCon was considered a monumental disappointment and left many in a state of disagreement. “Some of the major issues that were discussed at previous meetings—but at this point have no platform for discussion at the BWC—include advances in science and technology, disease outbreak preparedness and response, and national BWC implementation. Previously-held mid-year experts’ meetings have also been dropped, so there is now no chance for the exchanges with experts from relevant international organizations, including input from the World Health Organization that has been so useful in the past. These are all steps backward.” Despite a lack of Meeting of States Parties in August, there is hope that the December meeting with work towards developing an inter-sessional work program. On top of these barriers, the BWC has funding challenges, which severely impacts the Implementation Support Unit (ISU). Against these odds, the BWC ISU continues to promote universal membership and treaty implementation. Global initiatives are also beneficial to promotion of health security and prevention of biological weapons. “When global initiatives interconnect like this, it reinforces all of the initiatives. The Global Health Security Agenda, for instance, brings over 55 countries together to strengthen countries’ capacities to prevent, detect, and respond to infectious disease threats, whether natural, deliberate, or accidental.” These efforts seek to strengthen the BWC through global health security, but there is still work to be done. Jenkins suggests three tasks are crucial to maintain BWC relevancy and sustainability: “1) Sufficient and sustained funding by states parties, to include payments now in arrears; 2) Strong leadership and a successful December MSP that reaffirms the importance of the treaty to the international community and that also develops an inter-sessional work program; and 3) A vision for developing the role of the BWC as part of a larger interconnected global security architecture.”

Using Ebola Data to Fight Future Outbreaks
Learning from past outbreaks to avoid future failures is always a tough aspect of public health however, a new strategy is using data to help stop the next outbreak of Ebola. Researchers have developed a new platform to help organize and share Ebola data that was previously scattered and unable to be utilized. This was a significant issue on the ground during the 2014/2015 outbreak, which makes this project all the more important. “The information system is coordinated by the Infectious Diseases Data Observatory (IDDO), an international research network based at the University of Oxford, UK, and is expected to launch by the end of the year. At a meeting to discuss Ebola on 7–9 September in Conakry, Guinea, the team heading the platform will seek input from West African scientists, health officials and advocacy groups.” One of the most vital components to the system is the emphasis of partnership and involvement of African collaborators. Not only will this focus encourage the use of historical data, but will also allow utilization during future outbreaks. Control of the data has also been a challenging hurdle to overcome, as there are many cooks in the kitchen. “Amuasi says that he would have liked the database to be hosted and curated in Africa, rather than in Oxford, because training and paying African researchers to manage the platform would teach them how to use the information and improve their ability to respond to future outbreaks in the region. But he adds that this seems unlikely, because it would raise the cost of the project, and the infrastructure already exists at Oxford. Merson says that a copy of the database will be maintained in West Africa, although its exact location has yet to be determined. She adds that an African committee may be in charge of deciding who gets access to the data. And she says that fellowships are likely to be made available for West African students who want to work on the database.”

The Global Health Security Agenda: Public & Private Partnerships
The Global Health Security Agenda Consortium and EcoHealth Alliance will be hosting this meeting on Thursday, September 14th at 12pm. Held at the ONE UN New York Hotel in NYC, you can catch this event with speakers like Dr. Beth Cameron from the Nuclear Threat Initiative and Admiral Tim Ziemer from the US National Security Council. Make sure to RSVP here.

Launch of International Health Regulations Costing Tool
Georgetown University Center for Global Health Science & Security is launching their new open-access IHR costing tool. “In 2016, the World Health Organization adopted the Joint External Evaluation tool (JEE) to measure country-specific progress in developing the capacities needed to prevent, detect, and respond to public health threats, as mandated under the 2007 International Health Regulations (IHR). However, national governments and development partners have struggled to accurately define the costs of strengthening and maintaining critical health security systems that often depend on multi-sectoral coordination. This poses a serious dilemma for global health security and presents a compelling opportunity to improve the drafting and implementation of practical health security policies.” A joint effort with Talus Analytics, this new tool was developed to help estimate the cost to build capacity under the IHR. You can access the tool here (you may want to use Google Chrome).

IDSA Slams Budget Cuts to AMR
Biodefense budgets aren’t the only ones to be taking a beating… The president’s FY2018 budget released in May would cut the CDC’s Antibiotic Resistance Solutions Initiate (ARSI) by 14%, as well as 23% from the NIH and NIAID, which funds research on AMR. Leaders from Infectious Disease Society of America (IDSA) are rallying to oppose such efforts. “In a letter published yesterday in Annals of Internal Medicine, IDSA treasurer Helen Boucher, MD, past president Barbara Murray, MD, and current president William Powderly, MD, argue that the budget cuts for public health and research proposed by the Trump administration will not only diminish the nation’s surveillance capacity and its efforts to reduce infections and promote appropriate antibiotic use, but also undercut US leadership in global efforts to tackle the AMR threat, which is responsible for more than 700,000 deaths each year globally.” The letter emphasizes that such cut would severely impact AMR efforts, which is highly worrisome and dangerous given the severity of the global AMR threat. You can read the letter here.

An Integrated Approach to Forensic Investigation of Threat Agents
In the wake of a chemical or biological event, threat analysis is a high-stakes operation that has little room for error. Determining the substance, origin, and components all make for a stressful situation that requires effective analytical methods. “Traditional analytical methods are good at confirming the presence or absence of a particular agent or substance. If a sample is believed to contain Bacillus anthracis, standard biological analysis will quickly determine whether or not this is the case. But it will not provide insight into its virulence, origin or how it might have been manipulated. And if the sample turns out to be something other than B. anthracis, it will not tell you what it actually is. An integrated approach to CB forensics provides investigators with richer information. Integrated forensics combines advanced forensic science technologies to provide more comprehensive and timely technical intelligence.” Some of these strategies include advanced genomic analysis like massively parallel sequencing and advanced chemical analysis like gas chromatography and high resolution mass spectrometry. Currently, the extraction methods for biological analysis can render the sample unusable for chemical analysis, which make analysis problematic. A new strategy from Battelle is looking to combat these discrepancies, which involves a new process to “systematically triage samples and integrate biological and chemical forensics, as well as developing and testing new technologies to help investigators more quickly identify and characterize biological agents, including new, emerging and synthetic agents, to glean more forensic information from the samples.”

Stories You May Have Missed:

  • Zika Vaccine Efforts Slow– Sanofi recently announced they are halting work on a candidate Zika vaccine. The vaccine was a joint effort with Walter Reed Army Institute of Research however, budgetary cuts and federal efforts to scale back put the project in jeopardy. “In its Sep 1 statement, Sanofi said BARDA informed the company on Aug 17 that the agency reassessed its Zika-related projects and have decided to focus on a more limited set of goals and deliverable, and that BARDA has decided to “de-scope” its contract with Sanofi for the manufacture and clinical development of an inactivated Zika vaccine. BARDA said it would limit its funding to a case definition and surveillance study, as well as any activities needed to pause work on the vaccine until an epidemic re-emerges. As a result, Sanofi said it doesn’t intend to continue developing or seek a license from WRAIR for the Zika vaccine candidate.”
  • Australia Battles Influenza – As Australia experiences a particularly harsh flu season, many are wondering what this will mean for Europe and North America.”In general, we get in our season what the Southern Hemisphere got in the season immediately preceding us,” Fauci said. An “intelligent guess,” therefore, is that the north will probably have a bad flu season. “With influenza, it is never 100%,” he said. “So when you talk about influenza, almost nothing is absolutely precision,” Fauci said. “In general, one can say we usually see here what they see there in their season.” Schaffner agrees: “There’s not a one-to-one correlation.” Still, hearing about Australia’s high number of flu cases, he said, “I started to tighten my belt.”

Pandora Report 9.1.2017

Craving some satyrical genome editing? Check out the Onion’s pros and cons list on this biotechnology.

The De Novo Synthesis of Horsepox Virus: Implications for Biosecurity and Recommendations for Preventing the Reemergence of Smallpox 

The recent de novo synthesis of horsepox by Canadian researchers has raised concern and spurred serious conversations about the future of orthopoxviruses, like smallpox, and the dual-use research that could bring them back. GMU biodefense associate professor and graduate program director Dr. Gregory Koblentz evaluates this horsepox experiment and what it means for biosecurity and efforts to prevent the reemergence of smallpox. Koblentz notes that this experiment represents a significant crossroads within the field of biosecurity and that the techniques for synthesis of such viruses are increasingly reducing barriers to potential misuse. Unleashing smallpox back into the world would be a global disaster as most of the world is no longer immune. Koblentz points out that “The threat of smallpox has been held at bay for the past 40 years by 2 conditions: the extreme difficulty of acquiring the virus and the availability of effective medical countermeasures. Synthetic biology is on the brink of erasing both of these formidable barriers to the reemergence of smallpox as a global health threat.” He highlights the limited and rather lackluster legal and technical safeguards against smallpox synthesis and that the increasing normalization and globalization of it will likely create a boom of researchers performing such experiments. Think of the gold rush, but rather the orthopoxvirus syntehesis rush. As orthopoxviruses, are being used to develop new vaccines and oncolytic medical treatments, its popularity and wider range of applications carries with it inherent risks that should be considered. “The combination of rising demand and increasing supply could lead to the global diffusion of the capability and expertise to create orthopoxviruses de novo as well as modify these synthetic viruses. With this diffusion will come an increased risk that scientists, acting on their own volition or on behalf of a terrorist group, might misuse their know-how to create variola virus, or that governments could use civilian biomedical research with synthetic orthopoxviruses as a cover for offensive applications. The release of the smallpox virus— whether due to a biosafety failure, a breach in biosecurity, or an act of biological warfare—would be a global health disaster.” Koblentz draws attention to the challenges that the normalization and globalization of orthopoxvirus synthesis poses to national and international systems working to ensure life sciences research is safely conducted. He points out that there is no clear international legal framework to prevent the synthesis of the variola virus, few comphresensive legal safeguards, and that the private DNA industry (the main supplier of large synthetic DNA fragments) has inconsistent regulatory interventions. With these concerns, Koblentz suggests several recommendations to prevent the return of smallpox, ranging from the WHO’s World Health Assembly (WHA) passing a resolution to enshrine the WHO’s Advisory Committee on Variola Research (ACVVR) recommendations on the handling and synthesis of variola virus DNA into international law, to efforts within the DNA synthesis industry to declare a temporary moratorium on the synthesis of orthopoxvirus DNA fragments until effective WHO oversight can be established. Overall, Koblentz points to the importance of this experiment in terms of how such work is performed and the lack of informed debate surrounding the dual-use nature prior to the start of research. He emphasizes  “the risks posed by the routine and widespread synthesis of orthopoxviruses that could lead to the creation of a widely distributed network of laboratories and scientists capable of producing infectious variola virus from synthetic DNA.”

GMU Biodefense Master’s Open House – September 14th
We’re two weeks away from the first Master’s Open House and you won’t want to miss the chance to learn about GMU’s biodefense MS program. From 6:30-8:30pm on Thursday, September 14th, at the GMU Arlington campus, you can speak to faculty, learn about admissions, and why biodefense students have a blast while getting their graduate degrees. From Anthrax to Zika, we’ve got the place for all things biodefense.

Stanford’s New Biosecurity Initiative  

Stanford University’s Freeman Spogli Institute for International Studies (FSI) just announced their new biosecurity initiative, the Stanford Biosecurity Initiative, which will be led by David Relman and Megan Palmer. “Relman said the biosecurity initiative will seek to advance the beneficial applications of the life sciences while reducing the risks of misuse by promoting research, education and policy outreach in biological security. His CISAC leadership gives him the know-how to lead such a wide-ranging effort across diverse disciplines and communities,”. Palmer is a senior research scholar at Center for International Security and Cooperation (CISAC) and leads research on risk governance in emerging technology development and is an all around biotechnology guru. The biosecurity initiative also includes key Stanford partnerships and expertise within the fields of life sciences, engineering, law, and policy. Palmer noted that, “Stanford has an opportunity and imperative to advance security strategies for biological science and technology in a global age. Our faculty bring together expertise in areas including technology, policy, and ethics, and are deeply engaged in shaping future of biotechnology policy and practices.” We look forward to seeing the amazing work this new initiative will accomplish!                                                                                         

NAS Symposium on Cooperative Threat Reduction (CTR) for the Next Ten Years and Beyond
Don’t miss out on this September 18-19 event at the Keck Center. “In 2009 the National Academy of Sciences (NAS) report Global Security Engagement: A New Model for Cooperative Threat Reduction concluded that expanding and updating U.S. Government Cooperative Threat Reduction (CTR) programs in both form and function would enhance U.S. national security and global stability. The NAS Committee on International Security and Arms Control (CISAC) is convening a symposium to examine how CTR has evolved since that time and to consider new approaches for CTR programs and related WMD elimination efforts to increase their ability to enhance U.S. security. Speakers will include Amb. Laura Holgate, former U.S. Representative to the Vienna Office of the UN and IAEA, Amb. Ronald Lehman, Counselor to the Director of LLNL, William Tobey, former Deputy Administrator for Defense Nuclear Nonproliferation at NNSA, Andrew Weber, former Assistant Secretary of Defense for Nuclear, Chemical, and Biological Defense Programs, and other key thinkers and practitioners from CTR programs as well as experts from outside of CTR implementing agencies who have experience addressing complex international security problems. The symposium is sponsored by the Project on Advanced Systems and Concepts for Countering Weapons of Mass Destruction (PASCC) in the Naval Postgraduate School and will be open to the public. A ‘meeting in brief’ document will be issued by NAS after the symposium.”

International Biosecurity Fellows Reflect on SB7.0
The Johns Hopkins Center for Health Security recently partnered with Stanford’s Drew Endy to bring 32 emerging biosecurity leaders together for a fellowship program to attend the 7th International Meeting on Synthetic Biology (SB7.0) in Singapore. “In addition to attending the conference, fellows had the opportunity to engage with practicing experts and to discuss—with peers and senior scientists and government officials—biosecurity as it relates to synthetic biology. The fellows represented 19 countries on 6 continents and professions in the public and private sectors, the nonprofit space, and academia. The fellowship program was sponsored by the Open Philanthropy Project, hosted by Endy, and coordinated by the Center, BioBricks Foundation, and SynBioBeta. Center staffers Crystal Watson, DrPH, MPH, senior associate, and Matt Watson, senior analyst, organized the fellowship discussions and events and joined the fellows in Singapore for the 4-day experience. Gigi Kwik Gronvall, PhD, a senior associate at the Center and author of Synthetic Biology: Safety, Security, and Promise, spoke at SB7.0 and helped lead the fellowship’s panel discussions along with Watson and Watson.” Don’t miss out on GMU Biodefense PhD student Yong-Bee Lim’s reflection on page 39. Lim comments on the unique insight that comes from researchers with a non-technical background who still focus on the biosecurity, biosafety, and governance of emerging biotechnologies. “However, the enthusiasm of the technical conference attendees and fellows that I met about the advancements in synthetic biology was infectious. Whether Christina Smolke was talking about leveraging yeast to produce opioids to address medical access inequities, Kate Adamala was discussing synthetic cells as an alternative for research purposes, or Dorothee Krafft explained how her lab was seeking to synthesize a simple cell with alternate building blocks, their passion for their work came through. This allowed me the rare opportunity to enjoy the possibilities of these new avenues of innovation.” Don’t miss out on his tales of confiscated beef jerky and how there’s often a disparage between the science and security communities.

Building Airborne Isolation Units During Emergent Times  & Why the CDC Quarantined Potentially Defective Equipment
GMU biodefense PhD student Saskia Popescu is taking a deep-dive into faulty PPE and hospital preparedness efforts that might just save us during an airborne outbreak. Popescu first looks at the recent CDC actions to pull defective PPE from the SNS. “The special focused on personal protective equipment (PPE) that was being stockpiled by the CDC for use against future outbreaks or public health emergencies, such as treating an influx of Ebola patients during an outbreak. The 60 Minutes investigative team filed a Freedom of Information Act request to obtain documents regarding MicroCool gowns that are part of the US Strategic National Stockpile (SNS). The filing of the Freedom of Information Act request is especially prudent as a group of hospitals were recently awarded $454 million in damages from PPE manufacturers Kimberly-Clark and Halyard Health (formerly a division of Kimberly-Clark) after a jury found they were liable for fraud and defects within the MicroCool gowns.” While these gowns were advertised as meeting standards for the highest level of impermeability, their efficacy is clearly in question. Many are concerned about the existing stockpiles hospitals have been holding onto since the Ebola outbreak in 2014 and if such PPE is still effective. Popescu also takes a look into a recent study that evaluated the potential for hospitals to readily and cheaply convert entire wings into negative-pressure, airborne isolation units. Such a measure would be necessary if there was an influx of infectious patients with SARS, MERS, or another disease that requires airborne isolation, as most hospitals have limited amounts of negative-pressure rooms. “Following their analysis, the team found that they were able to maintain negative pressure that was actually higher than the CDC recommendations for airborne isolation and there was no pressure reversal during the entering and exiting of the ward by medical staff. They did find that ‘pressures within the ward changed, with some rooms becoming neutrally or slightly positively pressured’, which means that healthcare staff would need to wear proper personal protective equipment (PPE) at all times in the unit and not just while in the patient rooms.” While this isn’t a permanent response measure, it does show proof of concept that would allow safer hospitalization for infectious patients during an airborne outbreak.

Stem Cells, Smallpox Vaccines, and FDA Crackdowns 
Earlier this week, the FDA announced it was taking action to shut down clinics that were advertising and performing unproven stem cell therapies. Clinics in California and Florida have received warning letters and the StemImmune Inc, clinic in San Diego, CA, received a visit from U.S. Marshals, who seized five vials of smallpox vaccine. “The FDA says it learned that StemImmune was using the vaccines as well as stem cells from body fat to create an unapproved stem cell therapy. On its website, StemImmune says ‘The patient’s own (autologous, adult) stem cells, armed with potent anti-cancer payloads, function like a ‘Trojan Horse,’ homing to tumors and cancer cells, undetected by the immune system’.” These clinics have been using stem cell treatments for patients suffering from Parkinson’s, ALS, COPD, heart disease, and pulmonary fibrosis. “Action by the FDA on clinics promoting unproven stem cell therapies is ‘a long time coming,’ says Sean Morrison, former president of the International Society for Stem Cell Research (ISSCR) and d irector of the Children’s Research Institute at UT Southwestern.”

Hurricane Harvey – Harbinger of Infectious Disease?
As hospitals are forced to evacuate patients and medical centers become overwhelmed, the George R. Brown Convention Center has become the city’s largest emergency shelter. It’s always challenging though, meeting the medical demands of so many people in an emergent environment. As providers work to meet basic medical needs there is another concern that bubbles up with an influx of people into a small environment…disease. Floodwater injuries are of course a concern, but we also worry about infectious diseases associated with overrun sewage systems, lack of potable water and safe food, and the existence of mega-shelters that are ripe for transmission of respiratory and diarrheal illness. That’s not even considering the potential for nasty resistant infections like MRSA, VRE, etc. Did I mention mosquitoes? “Based on experience following Hurricane Katrina, there will be several competing effects on the population of mosquitoes and the prevalence of arboviruses, such as Zika, dengue and West Nile, that they transmit. Mosquitoes need stagnant water to lay eggs. Winds and floods will wash away containers that would have been breeding pools, said Hayden, who studies weather and vector-borne disease. In the immediate future, both Hayden and Hotez anticipate that local mosquito populations will decline. But once the floodwaters recede, mosquitoes will recover. In 2006, a year after Katrina, Tulane University public-health experts reported that cases of West Nile infection increased more than twofold in communities that had been in that hurricane’s path. The study authors suggested that increased exposure was the culprit. Fleeing partially submerged buildings, people spent days outside waiting for rescue.” Sadly, it will take years to recover and rebuilding Houston after Harvey, and there are lessons we can apply from not only Harvey, but also Hurricane Sandy, towards future preparedness and response efforts. Matt Watson and Eric Toner from the Center for Health Security are drawing attention to the need for Congress to start gearing up for the health impacts following Harvey.  “Stepping back from the operational response, it’s important to recognize that Congress has a vital role to play in both preparing for and enabling recovery following large scale disasters. On the recovery front, it will be important for lawmakers to pass an emergency appropriation that provides emergency funding. It is critical that Congress reverse that trend and continue to support annual appropriations for hospital and public health preparedness so that the nation is able to respond to increasingly frequent natural disasters and other large-scale emergencies.”

Stories You May Have Missed:

  • Distinguishing Virulent from Harmless Bacteria to Improve Biosurveillance- “Researchers at Los Alamos National Laboratory are working to eliminate false positives in detection of Francisella bacteria, a few species of which include highly virulent human and animal pathogens. The effort contributes to more efficient and effective biological surveillance, such as that conducted by the US Department of Homeland Security and the Department of Defense, which provides early warning of infectious disease outbreaks, hazardous environmental exposures, or possible bioterrorist attacks by spotting trends of public health importance.”
  • Deadly Strain of Klebsiella pneumoniae Found In China– Chinese researchers are reporting a highly virulent, resistant, and deadly strain of the bacteria in five patients at a hospital in Hangzhou, China. “All five patients—who were admitted to the ICU between late February and April of 2016—had undergone surgery for multiple trauma followed by ventilation and subsequently developed carbapenem-resistant K pneumoniae infections and severe pneumonia that responded poorly to all available antibiotics. All five patients died of severe lung infection, multi-organ failure, or septic shock.”

 

Pandora Report 8.25.2017

Happy Friday and welcome to your weekly dose of all things biodefense. Have you ever wanted to take a tour of Dugway Proving Ground? Here’s your chance at a virtual tour through some amazing photography.

GMU Biodefense Graduate Programs & Information Sessions
Classes are just starting up and if you’ve ever wanted to take classes on synthetic biology and biosecurity, global health security policy, nonproliferation and arms control, biosurveillance, or emerging infectious diseases, we’ve got just the program for you! GMU offers both Masters and PhD programs in biodefense and has several informational sessions coming soon. Our program provides the perfect intersection of policy and science with courses taught by a range experts. If your time is limited or distance is a problem, we also offer an online MS program, which means you can study biodefense from anywhere!

Revisiting NIH Biosafety Guidelines
It’s been forty years since NIH established the Guidelines for Research Involving Recombinant or Synthetic Nucleic Acid Molecules to assess the risks of genome editing. Now more than ever, with the speed of biotech development, it is relevant to take a moment and look back at the significance of such guidelines. “Responsibilities include setting up Institutional Biosafety Committees (IBCs) to assess risks and potential hazards through standards for containment and laboratory practices. Noncompliance on any project, whatever the funding source, can result in loss of all such NIH funding. In his address to the workshop.” Since its inception, there have been several advances in the field, like DIY gene editing and CRISPR, which may require changes to the existing guidelines. “And conventional risk management practices that focus on listed pathogens may underestimate risks of new, unlisted organisms. The informality of voluntary guidelines has enabled prompt responses by funders and researchers to emerging evidence on benefits and risks of technologies. But what has worked with those receiving NIH funding with IBCs may not work with the wider range of actors who now have access to these technologies.” How can the NIH meet these challenges with a forty-year-old set of rules? A few things might help it maintain relevancy- participation in international forums, facilitating researchers/publishers/insurers to set common benchmarks on researcher conduct, engage more with institutional biosafety officials, and working to ensure there are more IBCs. Overall, there is a need to modernize the guidelines to better meet and serve the expanding plain of the life sciences.

Revisiting Compliance in the Biological Weapons Convention                                                                       Have you noticed a trend this week? Revisiting is the name of the game and that’s just what the latest occasional paper from the Middlebury Institute of International Studies at Monterey is doing. The latest RevCon was a dud and the future of the BWC and its relevance is being tested. James Revill is looking at compliance and an incremental approach within the BWC. Revill notes that “compliance with the BWC is more than a simple binary choice to sign a commitment not to develop or produce biological weapons. It requires the adherence to all the obligations, both negative and positive, undertaken by BWC states parties in signing and ratifying the convention. In the BWC context, this is complicated by the ambiguity surrounding certain obligations, changes in science and security, and the limited resource capacity of some states to fulfill their obligations. Under such circumstances, without episodically revisiting compliance, there remains the risk that BWC will become ever more fragmented, outmoded and poorly implemented.” He emphasizes that despite many pushing for multilaterally negotiated, legally binding verification protocols, this is an unlikely outcome. An incremental approach to revisiting compliance, Revill suggests, could incorporate several activities – review relevant science and technology, enhance the collection and analysis of compliance indicators, develop the consultative mechanism, building the provision of assistance in the event of a violation of the BWC, explore voluntary visits, enhance the United Nations Secretary-General’s Mechanism, and remedy the institutional deficient. Overall, he points to the wavering nature of norms against bioweapons and that “without revisiting compliance and tending the convention, there is a risk that the regime will be left to fester and fragment, in time potentially diminishing the norms against biological weapons.”

Meeting on the Attribution of Biological Crime, Terrorism, and Warfare
The Blue Ribbon Study Panel on Biodefense will be hosting this October 3rd meeting in Washington D.C. “Effective prosecution and decisions regarding U.S. response depend on accurate attribution of biological attacks. Despite ongoing biological crimes and suspected development of biological weapons for the purpose of attacking the Nation, the United States has yet to establish this capability fully. The Study Panel will host a special focus meeting entitled Biological Attribution: Challenges and Solutions. This meeting of the Study Panel, chaired by former Homeland Security Advisor Ken Wainstein and former Senate Majority Leader Tom Daschle, will provide federal government, industry, and academic representatives with the opportunity to discuss their perspectives, experiences, challenges, and recommended solutions with regard to biological attribution.” Stay tuned for more details!

SynBio Salmagundi: Proposed Framework for Identifying Potential Biodefense Vulnerabilities Posed by Synthetic Biology – Report, SB7.0 & Options for Synthetic DNA Screening 
It’s a good day to get your synbio nerdom on with this potpourri of news! If you missed the webinar on Tuesday, you can now access the latest NAS interim report regarding the biodefense implications of synthetic biology. “Synthetic biology and related biotechnologies hold great promise for addressing challenges in human health, agriculture, and other realms. At the same time, synthetic biology raises concerns about possible malicious uses that might threaten human health or national security. This interim report is the first phase of a study by the National Academies of Sciences Engineering and Medicine to assess potential vulnerabilities. The report proposes a strategic framework that can be used to identify and prioritize potential areas of concern.” Within the report you can find definitions and study scope regarding synthetic biology in the context of biodefense, factors to assess capability for malicious use, technologies and applications to assess, and framework approach (parameters to consider, use and limitations, etc.). Check out this latest article regarding the screening processes of for synthetic DNA ordering. Sure, there are current screening processes (providers affiliated with the International Gene Synthesis Consortium voluntarily screen double-stranded DNA synthesis orders over 200bp to check for regulated pathogens and additional customer screening), but truly, the processes isn’t that easy…or cheap. Researchers, like Gigi Kwik Gronvall, pointed out actions that could help “preserve the effectiveness of DNA order screening as a security tool and develop additional mechanisms to increase the safety and security of DNA synthesis technologies.” Highlighting the DHHS screening guidance as quickly becoming obsolete, they emphasized options like including direct financial support to companies for screening, especially as we look to the future costs and responsibilities of the U.S. government. “The screening of dsDNA orders is not a panacea for biosecurity concerns: it is possible for nefarious actors to work around the screening. However, we believe that screening dsDNA orders still raises barriers to the development of biological weapons and may offer some protection against biosafety concerns.” The future of synthetic DNA ordering will surely be debated as experiments, like the recent horsepox reconstitution, bring to light new gaps. One such focus onto the realm of biosecurity and synthetic biology comes from Dr. Eric van der Helm, who participated at the latest SB7.0 synthetic biology conference. Van der Helm attended as part of the SB7.0 biosecurity fellowship and has highlighted some of the biorisks we worry about. He also points to the latest horsepox experiment which brought about so much attention to the biosecurity implications of reconstituting an extinct virus. “Synthetic biology has only been recently recognized as a mature subject in the context of biological risk assessment — and the core focus has been infectious diseases. The main idea, to build resilience and a readiness to respond, was reiterated by several speakers at the SB7.0 conference.  In the case of biosecurity, we’re already dependent on biology [with respect to food, health etc.] but we still have an opportunity to develop biosecurity strategies before synthetic biology is ubiquitous.  There is still an opportunity to act now and put norms and practices in place because the community is still relatively small.” Van der Helm emphasizes the need to have these conversations regarding biosecurity measures and synbio, like those at SB7.0, more frequently and openly.

North Korea’s Bioweapon Program: What do we actually know?
If you haven’t gotten enough on discussions regarding North Korea’s bioweapons program, check out GMU biodefense professor Sonia Ben Ouagrham-Gormley‘s latest interview in which she discusses what we know and what we might be missing. What a perfect way to enjoy the morning commute or a lunch break!

Post-Ebola Recovery – An Upside to an Epidemic
A recent mudslide in Sierra Leone is revealing a positive outcome from the 2014/2015 Ebola outbreak – sustained disaster response. Shortly after the mudslide, emergency response crews were already working alongside volunteers to help rescue victims. Sidi Tunis chatted with Buzzfeed, noting that “During Ebola we had a lot of community engagement, so they knew how to be first responders. They knew how to do search and rescues, they knew how to convey corpses safely to the morgue.” Many of the young men digging through rubble were already experienced, having helped with Ebola burial teams and the ambulance system was better equipped and supported as a result of the outbreak. “There was a lesson learnt from Ebola that instead of creating parallel system of NGOs, let’s take leadership from the start,” she said. “So this time it’s been led by the government from the onset, and having them take that ownership is more of a sustainable system.” “Still, NGOs playing a critical role are in a better position than they might typically have been. Three days after the mudslide, unclaimed bodies piling up in Freetown’s main mortuary posed another health risk. There were so many that they began to decompose in the tropical heat, prompting the government to order mass burials over the following two days. Workers from UNICEF were among those who helped scrub out the morgue during a massive clean-up operation that followed. ‘That needed a lot of infection prevention equipment – gloves, boots, aprons,’ James said. ‘UNICEF had emergency stock ready to go from Ebola’.”

Meeting of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria
Don’t miss out on this September 13th and 14th meeting in which the “Advisory Council will provide advice, information, and recommendations to the Secretary regarding programs and policies intended to preserve the effectiveness of antibiotics by optimizing their use; advance research to develop improved methods for combating antibiotic resistance and conducting antibiotic stewardship; strengthen surveillance of antibiotic-resistant bacterial infections; prevent the transmission of antibiotic-resistant bacterial infections; advance the development of rapid point-of-care and agricultural diagnostics; further research Start Printed Page 38913on new treatments for bacterial infections; develop alternatives to antibiotics for agricultural purposes; maximize the dissemination of up-to-date information on the appropriate and proper use of antibiotics to the general public and human and animal healthcare providers; and improve international coordination of efforts to combat antibiotic resistance.” The meeting will be held at the DHHS Hubert Humphrey Building or you can attend online here.

Pandemic Readiness (Hint: We’re Not There Yet)
Despite funding for the Hospital Preparedness Program (HPP) and an increase in funding to the Public Health Emergency Preparedness Program (PHEP), many are pointing out that these programs are chronically underfunded to begin with. “This House bill also does little to create a realistic public health emergency response fund, a standing pot of money to meet the immediate needs of a public health crisis. We saw how long it took to get emergency funds to respond to Zika, Ebola and Hurricane Sandy, with each event taking longer and longer to help these communities respond to devastating disasters.” You can also check out this latest meeting with Judy Woodruff and Liberian-born Dr. Raj Panjabi at Spotlight Health. Dr. Panjabi discusses the seriousness of infectious disease threats and the challenges of pandemic prevention.

Forecasting Outbreaks One Image at a Time
Tracking infectious diseases is a tough job and requires a lot of boots on the ground (shout out to gumshoe epidemiologists who go door to door doing contact tracing). Researchers at Los Alamos National Laboratory have been using computer modeling for a while to track disease movement, but a new partnership with Descartes Labs, is bringing high-resolution satellite imagery into the arsenal. “By mapping where high-moisture areas intersect with those social media signals and clinical surveillance data, we can help identify areas at risk for disease emergence and subsequently predict its potential path. Descartes Labs collects data daily from public and commercial imagery providers, aggregating the images into a single database. Our team at Los Alamos will use the Descartes Labs Platform to correlate satellite imagery with multiyear clinical surveillance data from approximately 5,500 Brazilian municipalities for mosquito-borne diseases such as dengue, chikungunya, and Zika in order to better understand how they spread.” This new imagery will allow Los Alamos Lab researchers to focus on specific neighborhoods and other small geographical areas. By using retrospective analysis via historical data, they’ll make sure the mathematical models are accurate and ensure that future models are truly capable of prediction.

Stories You May Have Missed:

  • Munich Re Signs Strategic Agreement With Metabiota to Enhance Insurability Against Epidemic Losses – The risk analytics firm Metabiota has announced a strategic agreement with Munich Re, one of the world’s leading reinsurers, to better establish insurability “by protecting companies and local economies from the financial loss related to epidemics. This really is the next frontier for the insurance industry – given the high risk of infectious disease outbreaks, it is imperative that we find new ways to manage and finance these risks for our customers.” Metabiota’s newest platform is a modeling method for estimating epidemic preparedness and risk, as well as the cost and severity of outbreaks by using historical data and disease scenarios and analytics.
  • Ebola Survivors Plagued With Long-term Disabilities – Imagine becoming infected with one of the most deadly viruses on the planet. Now, imagine by some stroke of luck and medical marvel, you’re able to survive. After the long, miserable road that is Ebola infection, survivors have been finding themselves with chronic conditions and high rates of disabilities. A new study found that Ebola survivors have seven times the disability rate compared to their close contacts. “In the first study, researchers followed 27 Ebola survivors in Sierra Leone for 1 year after diagnosis and found they were seven times more likely than their close contacts to report a disability. Almost 80% of the survivors (77.8%) reported a disability 1 year post-infection, compared with 11.1% of their close contacts. Disabilities included major limitations in vision, mobility, and cognition. ‘This study has demonstrated that a year following acute disease, survivors of the recent EVD outbreak have higher odds of persisting disability in mobility, vision, and cognition,’ the authors concluded. ‘Mental health issues such as anxiety and depression persist in EVD survivors and must not be neglected’.”
  • Minnesota Measles Woes & Anti-vaxxers– The benefits of vaccines have been under fire from anti-vaccine activists, despite the overwhelming good they’ve done for the world. While Minnesota continues to battle their worst outbreak of measles in decades, the antivaxxers are becoming energized in their efforts. “In Facebook group discussions, local activists have asked about holding ‘measles parties’ to expose unvaccinated children to others infected with the virus so they can contract the disease and acquire immunity.” The initial cases of this outbreak were in the Somali American community, which are believed to be the result of anti-vaccine activists speaking to community members and instilling fears and concerns. “Despite the anti-vaccine drumbeat, Minnesota’s Somali American community has begun to push back, according to some health-care providers. As part of an unprecedented collaboration clinicians and public health officials launched this summer, ­Somali American imams are urging families to protect their children by getting the measles-mumps-rubella (MMR) vaccine.”