Pandora Report: 6.28.2019

Summer Workshop – Early Registration Discount Ends Soon
Just a few more days to get your early registration discount and we’ve only got a few spots left – make sure to grab yours! We’re excited to have top professionals and researchers in the health security field speak to the biological threats we’re facing- from securing the bioeconomy to vaccine development and pandemic preparedness, you’ll want to be there for the 3.5 days of all things pandemics, bioterrorism, and global health security.

Re-thinking Biological Arms Control for the 21st Century
Dr. Filippa Lentzos discusses the challenges of biological arms control in the face of synthetic biology and technological advances. “Innovations in biotechnology are expanding the toolbox to modify genes and organisms at a stagger- ing pace, making it easier to produce increasingly dangerous pathogens. Disease-causing organisms can now be modified to increase their virulence, expand their host range, increase their transmissibility, or enhance their resistance to therapeutic interventions. Scientific advances are also making it theoretically possible to create entirely novel biological weapons, by synthetically creating known or extinct pathogens or entirely new pathogens. Scientists could potentially enlarge the target of bioweapons from the immune system to the nervous system, genome, or microbiome, or they could weaponize ‘gene drives’ that would rapidly and cheaply spread harmful genes through animal and plant populations.” Lentos notes that “The political backdrop to these technical advances in biotechnologies and other emerging technologies is also important. There is increased worldwide militarization, with global military spending at an all-time high since the fall of the Berlin Wall. Unrestrained military procurement and modernization is creating distrust and ex- acerbating tensions. In the biological field, the proliferation of increasingly sophisticated biodefense capacities, within and among states, can lead to nations doubting one another’s intentions.”

GAO – Biodefense: The Nation Faces Long-Standing Challenges Related to Defending Against Biological Threats
The GAO testified before a House committee on their efforts to identify and strengthen U.S. biodefense and here are their overall findings in a report. Despite President Trump signing off on the Pandemic and All-Hazards Preparedness and Advancing Innovations Act (PAHPA) on Monday, there is still a lot of work to be done. “Catastrophic biological events have the potential to cause loss of life, and sustained damage to the economy, societal stability, and global security. The biodefense enterprise is the whole combination of systems at every level of government and the private sector that contribute to protecting the nation and its citizens from potentially catastrophic effects of a biological event. Since 2009, GAO has identified cross-cutting issues in federal leadership, coordination, and collaboration that arise from working across the complex interagency, intergovernmental, and intersectoral biodefense enterprise. In 2011, GAO reported that there was no broad, integrated national strategy that encompassed all stakeholders with biodefense responsibilities and called for the development of a national biodefense strategy. In September 2018, the White House released a National Biodefense Strategy. This statement discusses GAO reports issued from December 2009 through March 2019 on various biological threats and biodefense efforts, and selected updates to BioWatch recommendations made in 2015. To conduct prior work, GAO reviewed biodefense reports, relevant presidential directives, laws, regulations, policies, strategic plans; surveyed states; and interviewed federal, state, and industry officials, among others.” GAO identified several challenges in the ability for the U.S. to defend against biological threats: “Assessing enterprise-wide threats. In October 2017, GAO found there was no existing mechanism across the federal government that could leverage threat awareness information to direct resources and set budgetary priorities across all agencies for biodefense. GAO said at the time that the pending biodefense strategy may address this. Situational awareness and data integration. GAO reported in 2009 and 2015 that the Department of Homeland Security’s (DHS) National Biosurveillance Integration Center (NBIC)—created to integrate data across the federal government to enhance detection and situational awareness of biological events—has suffered from longstanding challenges related to its clarity of purpose and collaboration with other agencies. DHS implemented GAO’s 2009 recommendation to develop a strategy, but in 2015 GAO found NBIC continued to face challenges, such as limited partner participation in the center’s activities. Biodetection technologies. DHS has faced challenges in clearly justifying the need for and establishing the capabilities of the BioWatch program—a system designed to detect an aerosolized biological terrorist attack. In October 2015, GAO recommended that DHS not pursue upgrades until it takes steps to establish BioWatch’s technical capabilites. While DHS agreed and described a series of tests to establish capabilities, it continued to pursue upgrades. Biological laboratory safety and security. Since 2008, GAO has identified challenges and areas for improvement related to the safety, security, and oversight of high-containment laboratories, which, among other things, conduct research on hazardous pathogens—such as the Ebola virus. GAO recommended that agencies take actions to avoid safety and security lapses at laboratories, such as better assessing risks, coordinating inspections, and reporting inspection results. Many recommendations have been addressed, but others remain open, such as finalizing guidance on documenting the shipment of dangerous biological material.”

ABSA 1st International Biosecurity Symposium Call for Papers
“You are now able to submit papers for ABSA’s 1st International Biosecurity Symposium. The symposium will take place May 12-15, 2020 in Minneapolis, Minnesota. We anticipate having attendees from all over the world and approximately 20 commercial exhibits. The professional development courses will take place Tuesday, May 12, 2020. The symposium presentations (platform/poster) will take place Wednesday, May 13 to Friday, May 15, 2020. The Call for Platform/Posters Abstract submission deadline is July 31, 2019 at 5pm Central.”

Blue Ribbon Panel – U.S. Is Not Prepared for Biological Incidents – Testimony
June 26th- “Dr. Asha George, Executive Director of the Blue Ribbon Study Panel on Biodefense, served as an expert witness this afternoon before the House Oversight and Reform Subcommittee on National Security. Chaired by Rep. Stephen Lynch (MA), the Subcommittee is evaluating the readiness of the U.S. government and healthcare system, including hospital and emergency professionals, to respond to naturally occurring pandemics and biological attacks that could be perpetrated by state and non-state actors. The Subcommittee also is investigating the growing threat of antimicrobial-resistance, as well as the implications of this challenge for U.S. national security. ‘Our Panel has assessed and continues to assess the state of our country’s biodefense. We scrutinize the status of prevention, deterrence, preparedness, detection, response, attribution, recovery, and mitigation – the spectrum of activities necessary for biodefense,’ said Dr. George. ‘As expected, we found both strengths and weaknesses, including serious gaps that four years after the release of our Panel’s Blueprint for Biodefense in 2015 continue to make the nation vulnerable. In short, the nation is not prepared for biological outbreaks, bioterrorist attacks, biological warfare, or accidental releases with catastrophic consequences’.” This is especially relevant as many are wondering what Congress is doing to respond to health security threats.

Ebola Outbreak – Updates
As of Wednesday, the outbreak has reached 2,277 cases and security threats are increasingly making response efforts challenging. “In its weekly situation report on the outbreak, the WHO said Ebola activity continues with steady and sustained intensity, with security incidents returning to Beni—one of the outbreak’s former major hot spots—and armed group movements in Musienene and Manguredjipa impeding access to a health area next to Mabalako’s hardest-hit area. Another concern it aired is a tense security situation in neighboring Ituri province cities Bunia and Komanda in the wake of attacks in early June. Over the past few weeks, indicators show hints of easing transmission intensity in the two biggest recent epicenters, Katwa and Butembo. However, the optimism is offset by new cases in previously affected areas, including Komanda, Lubero, and Rwampara. For example, over the past week, Komanda reported its first case after going 11 days without one.”

A Dose of Inner Strength to Survive and Recover from Potentially Lethal Health Threats
“Breakthroughs in the science of programmable gene expression inspired DARPA to establish the PReemptive Expression of Protective Alleles and Response Elements (PREPARE) program with the goal of delivering powerful new defenses against public health and national security threats. DARPA has now selected five teams to develop a range of new medical interventions that temporarily and reversibly modulate the expression of protective genes to guard against acute threats from influenza and ionizing radiation, which could be encountered naturally, occupationally, or through a national security event. The program builds from the understanding that the human body has innate defenses against many types of health threats, but that the body does not always activate these defenses quickly or robustly enough to block the worst damage. To augment existing physiological responses, PREPARE technologies would provide a programmable capability to up- or down-regulate gene expression on demand, providing timely, scalable defenses that are proportional to anticipated threats. Service members and first responders could administer these interventions prior to threat exposure or therapeutically after exposure to mitigate the risk of harm or death.”

Global Community Bio Summit 3.0
From October 11-13, you can attend this community biotechnology initiative at MIT Media Lab. “The Community Biotechnology Initiative at the MIT Media Lab is organizing the third annual Global Summit on Community Biotechnology this October 11 to 13, 2019! Our goal is to provide a space for the global community of DIY biologists / community biologists / biohackers / biomakers and members of independent and community laboratories to convene, plan, build fellowship, and continue the evolution of our movement. You can learn more about last year’s Summit, including our program, here. While all are welcome, space is limited, so we are prioritizing active practitioners in the community with an emphasis on diversity across geographic, cultural, ethnic, gender, and creative backgrounds. We will add accepted participants to the directory on a rolling basis with the goal of accepting everyone interested in joining.”

Stories You May Have Missed:

  • Tackling Dirty Sinks – Did you ever think your hospital sink could be a disease reservoir? “Earlier this year, there were studies that identified sink proximity to toilets as a risk factor for contamination. Bugs like Klebsiella pneumoniae carbapenemase-producing organisms tend to be prolific in moist environments and are often pervasive in intensive care unit sinks and drains. Researchers found that sinks near toilets were 4-times more likely to host the organisms than those further from toilets. More and more, infection prevention is having to look at hospital faucets and sinks for their role in hosting microbial growth. This was also a topic of interest at last week’s annual conference of the Association for Professionals in Infection Control and Epidemiology (APIC 2019). Investigators with the University of Michigan Health System discussed how they worked to identify vulnerabilities and potential sink designs that might contribute to bioburden and biofilm in hospital faucets. Assessing 8 different designs across 4 intensive care units, the research team ultimately found that those sinks with a more shallow depth tended to allow higher rates of contamination (ie, splash of dirty water) onto equipment, surfaces, and patient care areas. In some instances, the splash of contaminated water could be found up to 4 feet from the sink.”

 

Pandora Report: 6.6.2019

Happy Thursday! That’s right – you’re getting your weekly dose of biodefense news a tad early, but don’t worry, we’ll be back to our normal schedule next week! Have you registered for the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security? From anthrax to Zika, we’ll be covering all the topics, debates, and threats related to health security.

GMU Welcomes New Faculty Member – Dr. Ashley Grant
We’re excited to announce that Dr. Ashley Grant, a lead biotechnologist at the MITRE Corporation, is joining the Biodefense Program as an Adjunct Professor to teach BIOD 620: Global Health Security Policy. Dr. Grant was previously the Senior Biological Scientist at the Government Accountability Office where she led government-wide technical performance audits focused on biosafety and biosecurity issues. Dr. Grant was an American Association for the Advancement of Science (AAAS) Science and Technology Fellow in the Chemical and Biological Defense Program Office in the Department of Defense and also worked at the National Academies of Science on the Committee on International Security and Arms Control. Her work focused on international security, nonproliferation, and medical countermeasures against chemical and biological threats. She completed the Field Epidemiology Course at the Naval Medical Research Center (NMRC) in Lima, Peru and was a Visiting Graduate Researcher at the Instituto Nacional de Enfermedades Virales Humanas J. Maitegui (INEVH) in Pergamino, Argentina. Dr. Grant received her PhD in experimental pathology and a MPH in epidemiology from the University of Texas Medical Branch at Galveston. Her graduate work focused on investigating pathogenesis and potential countermeasures for viral hemorrhagic fevers under biological safety level (BSL)-4 conditions. In addition, she received a MA in National Security Studies from the Naval War College and a BS in Chemistry and a BS in Business Economics and Management from the California Institute of Technology.

Congress Passes the Pandemic and All-Hazards Preparedness and Advancing Innovation Act
On Tuesday, June 4th, the House “passed the Pandemic and All-Hazards Preparedness and Advancing Innovation Act. The bill reauthorizes existing statute governing public health efforts at the Department of Health and Human Services. Additions made by the bill – some of which were recommended by the Blue Ribbon Study Panel on Biodefense – address biodetection, hospital preparedness, medical countermeasures and response. Many of these programs will enable HHS to better defend the nation against biological threats. Both chambers of Congress have passed the bill, and it will now go to President Trump for signature. ‘Naturally occurring diseases and biological weapons continue to endanger our nation,’ said Governor Tom Ridge, Panel Co-Chair. ‘The Panel is pleased to see that Congress addressed 15 of our recommendations in this legislation, which will help the nation better prepare for, detect, respond to, and recover from large-scale biological events, bioterrorism or other biological events’.”

National Biodefense Science Board Public Meeting
“The June 10-11, 2019 meeting of the National Biodefense Science Board will focus on early results and progress reports from four new programs that were designed to strengthen disaster health preparedness, response and recovery: the Regional Disaster Health Response System; BARDA DRIVe; ASPR’s new Incident Management Team; One Health; and the National Biodefense Strategy. As part of the evolution of the National Disaster Medical System, NBSB will discuss disaster veterinary medicine and National Veterinary Response Teams. The board will also address issues facing the medical community, including disaster medicine training for community physicians and advance practice physicians and learn about ways to develop and operationalize core competencies for disaster medicine.”

 Exploring Lessons Learned from a Century of Outbreaks
Check out the latest from the proceedings of a 2019 NAS workshop on outbreak readiness. “In November 2018, an ad hoc planning committee at the National Academies of Sciences, Engineering, and Medicine planned two sister workshops held in Washington, DC, to examine the lessons from influenza pandemics and other major outbreaks, understand the extent to which the lessons have been learned, and discuss how they could be applied further to ensure that countries are sufficiently ready for future pandemics. This publication summarizes the presentations and discussions from both workshops.” Within this document, you can access sections on global preparedness progress for the next pandemic influenza, building local and national capacities for outbreak preparedness, pandemic vaccine considerations, etc. “The participants in this workshop examined the lessons from major outbreaks and explored the extent to which they have both been learned and applied in different settings. The workshop also focused on key gaps in pandemic preparedness and explored immediate and short-term actions that exhibited potential for the greatest impact on global health security by 2030. Workshop speakers and discussants contributed perspectives from government, academic, private, and nonprofit sectors. This workshop opened with a keynote address and a plenary presentation, followed by three sessions of presentations and discussions. Additionally, panelists, forum members, and attendees were given the opportunity to assemble into small groups and asked to consider potential priority actions and strategies for systematizing and integrating outbreak and pandemic preparedness so that it is a routine activity from the local to global levels.”

Inside Britain’s Top Secret Research Laboratory 
Have you ever wanted to tour Britain’s top secret laboratory? If Porton Down has been on your wish list, here’s your chance to get a virtual tour. “The BBC was given access inside Porton Down to see what the highly secretive facility was like and, for the first time ever, entered a cleansed version of a level four laboratory. This level is where the Defence Science and Technology Laboratory team analyse some of the world’s deadliest viruses – Ebola and Marburg.”

 DRC Ebola Outbreak Updates 
The outbreak has officially reached 2,000 cases and aid groups in “the region called for pushing the reset button on the response. In its daily update yesterday, the DRC said the outbreak passed the 2,000-case bar on Jun 2. Officials said that, although the landmark is concerning, the health ministry sees some positive signs, including a slight improvement in the security situation, though the situation remains volatile and unpredictable. The ministry added that most incidents related to community resistance have been resolved by community leaders, sensitizers, and psychosocial experts.” For many, the question is still – who is attacking Ebola responders and why? “The first is that local political figures are fomenting and even organizing the attacks as a way of undermining their rivals, presumably officials of the central government or local leaders aligned with them. Many analysts hold that it was actually the national government that set the stage for the use of the Ebola crisis as a political tool, and Gressly largely echoed that account. Last December, he noted, just days before presidential elections, national electoral officials announced that voting would be suspended in the two largest cities in the outbreak zone, Beni and Butembo.” “At least one type of attack appears very much linked: Many of the incidents seem to be outbursts by members of the community who have heard the rumors and believe them. An Ebola team will arrive in a neighborhood to bury a suspected Ebola patient or vaccinate their relatives, and people will throw rocks and chase the team out. Similarly, doctors and nurses at regular health facilities have been threatened by mobs, who are angry that the health workers refer Ebola patients to treatment centers. In one case, a nurse was killed. But there has also been an increase in seemingly well-coordinated assaults by well-armed assailants. More than half-a-dozen times, gunmen have shot up Ebola treatment centers and health facilities where Ebola teams are based, including on April 19, when a group of armed men burst into a hospital where an Ebola team was meeting and killed an epidemiologist with the World Health Organization.”

African Swine Fever and China’s Pork Industry
A highly virulent virus meets a $128 billion dollar industry and we’re not sure which will win. “The virus that causes the hemorrhagic disease is highly virulent and tenacious, and spreads in multiple ways. There’s no safe and effective vaccine to prevent infection, nor anything to treat it. The widespread presence in China means it’s now being amplified across a country with 440 million pigs—half the planet’s total—with vast trading networks, permeable land borders and farms with little or no ability to stop animal diseases.” Despite 50 years of efforts, there has been no vaccine for this devastating disease and “even if China is able to stop the virus transmitting from pig to pig, two other disease vectors may frustrate eradication efforts: wild boars and Ornithodoros ticks. These are the natural hosts of African swine fever virus and are widely distributed in China, though it’s not yet known what role they are playing in spreading the disease there. Zhejiang province, south of Shanghai, has about 150,000 wild boars.”

Stories You May Have Missed:

  • U.S. Measles Cases Top 1,000 – “Federal officials yesterday said US measles cases have reached 1,001, the first time since 1992 that cases have been in quadruple figures, while experts continued to urge vaccination and underscored the safety of the vaccine. Health and Human Services (HHS) Secretary Alex Azar said in an HHS news release, ‘We cannot say this enough: Vaccines are a safe and highly effective public health tool that can prevent this disease and end the current outbreak’.”
  • Nipah Virus in Indian Man – “The Indian government today confirmed that a 23-year-old man from Kerala has a Nipah virus infection, and another 86 case contacts are being monitored for the deadly disease, according to the Deccan Chronicle. Officials said the patient, a college student, is hospitalized and in stable condition. They also said two of the case contacts have fevers, and two nurses who took care of the 23-year-old were also experiencing fevers and sore throats.”
  • GM Fungus Kills 99% of Malaria Mosquitoes – “Trials, which took place in Burkina Faso, showed mosquito populations collapsed by 99% within 45 days. The researchers say their aim is not to make the insects extinct but to help stop the spread of malaria. The disease, which is spread when female mosquitoes drink blood, kills more than 400,000 people per year. Worldwide, there are about 219 million cases of malaria each year. Conducting the study, researchers at the University of Maryland in the US – and the IRSS research institute in Burkina Faso – first identified a fungus called Metarhizium pingshaense, which naturally infects the Anopheles mosquitoes that spread malaria. The next stage was to enhance the fungus. ‘They’re very malleable, you can genetically engineer them very easily,’ Prof Raymond St Leger, from the University of Maryland, told BBC News.”

 

Pandora Report 11.16.2018

We’re back from the 5th Ministerial Meeting of the Global Health Security Agenda (GHSA)! We’ll be reporting out on this event in the coming weeks, so keep an eye out for all things GHSA. Influenza season is ramping up and you’ll want to check out the latest article on looking beyond the decade of vaccines.

Preventing Pandemics and Bioterrorism: Past, Present, and Future
We’re just weeks away from this exciting event – are you registered? Preventing Pandemics and Bioterrorism: Past, Present, and Future is a special event in celebration of the 15th anniversary of the George Mason University Biodefense Program at the Schar School of Policy and Government. We invite you to attend this exciting opportunity to hear from Dr. Kadlec of ASPR about lessons learned for pandemic preparedness since the 1918-1919 influenza pandemic, plans for implementing the new National Biodefense Strategy, and the importance of education for the future of biodefense. Following his speech and Q&A session, you are invited to an informal reception for academic and professional members of the biodefense community to socialize and network. Make sure to RSVP soon as seats are limited for this December 4th event.

Russian Disinformation & the Georgian “Lab of Death”
A recent BBC investigation has found some disturbing information regarding Russian media making false claims about a U.S.-funded lab in Georgia. “The Russian Foreign Ministry, Defence Ministry and pro-Kremlin media claimed recently that untested drugs were given to Georgian citizens at the lab, resulting in a large number of deaths. The US has accused Russia of disinformation in order to distract attention away from incidents such as the Salisbury poisonings.” This episode is part of a series the BBC is providing on disinformation and fake news.

Ebola Outbreak Updates
The Ebola virus disease outbreak in the DRC continues to grow. 15 cases were reported on Monday as well as another violent attack in Beni. “WHO Director-General Tedros Adhanom Ghebreyesus, PhD, said on Twitter that he had been briefed on a violent attack that occurred in Beni on the night of Nov 10. ‘All WHO staff safe, but my heart goes out to families who have lost loved ones in this appalling and unacceptable attack, which we condemn in the strongest terms,’ he wrote. According to a local media report translated and posted by H5N1 Blog, which focuses on infectious disease news, at least five civilians were killed and several children kidnapped in an attack by rebels with the Allied Democratic Forces (ADF) in Beni’s Mayimoya district. The report said two other people were killed in two other attacks the same day in Beni’s Runwenzori neighborhood, one linked to ADF rebels and the other by suspected Mai Mai militia members.” The latest situation report lists 333 cases and 209 deaths, with 31 new confirmed cases reported during the reporting period (Nov 5-11). Early this morning, the DRC announced three more cases and 1 death. Health officials are also reportedly planning to launch a clinical trial of three antibody treatments and an antiviral drug, within the area. These drugs are currently in utilization in the Ebola treatment centers within the area but only under compassionate use. The UK is contributing funds to help Uganda step up prevention and preparedness efforts as well. “On a recent visit to The Medical Research Council/Uganda Virus Research Institute (URVI) and the London School of Hygiene and Tropical Medicine Research Unit in Entebbe, UK Minister for Africa Harriett Baldwin announced that the UK will support Uganda’s National Task Force with up to £5.1 million ($6.6 million USD) to support Ebola preparedness and prevention efforts in Uganda. This funding will support surveillance in high-risk districts at the border with the Democratic Republic of Congo (DRC); risk reduction communication in communities; infection prevention and control measures as well as provide for improved case management.” Peter Salama, WHO Emergency Response Chief, has noted that the outbreak could last another six months – “It’s very hard to predict timeframes in an outbreak as complicated as this with so many variables that are outside our control, but certainly we’re planning on at least another six months before we can declare this outbreak over,”.

ELBI Fellowship Application Opens
The Emerging Leader for Biosecurity Initiative (ELBI) run by the Center for Health Security is now accepting applications. This is a great opportunity that several Biodefense students have been able to take advantage of for the last several years. GMU Biodefense has had several fellows – Yong-Bee Lim  is currently an ELBI fellow and Saskia Popescu, Siddha Hover, and Francisco Cruz have represented our biodefense program in previous years. If you’re a current GMU biodefense student or alumni and are interested in applying and plan to request a letter of recommendation from the Biodefense program director, please do so ASAP. Dr. Koblentz asks that applicants send a copy of their application materials (personal statement, essay, and current resume or cv) and an unofficial GMU transcript by December 5, 2018.

 One Health in the 21st Century Workshop
The One Health in the 21st Century workshop will serve as a snapshot of government, intergovernmental organization and non-governmental organization innovation as it pertains to the expanding paradigm of One Health. One Health being the umbrella term for addressing animal, human, and environmental health issues as inextricably linked, each informing the other, rather than as distinct disciplines. This snapshot, facilitated by a partnership between the Wilson Center, World Bank, and EcoHealth Alliance, aims to bridge professional silos represented at the workshop to address the current gaps and future solutions in the operationalization and institutionalization of One Health across sectors. The workshop will be held on November 26th at the Wilson Center. You can RSVP here.

USDA ARS 5th International Biosafety & Biocontainment Symposium: Biorisk and Facility Challenges in Agriculture
Registration is open for this February 11, 2019 event! The symposium will provide 2.5 days of scientific presentations and exhibits regarding agricultural biosafety and biocontainment.

WHO Report on Surveillance of Antibiotic Consumption
The WHO has just released their report on global antibiotic consumption and the surveillance methods surrounding efforts to reduce antimicrobial resistance. “Since 2016, WHO has supported capacity building in monitoring antimicrobial consumption in 57 low- and middle-income countries through workshops, trainings and technical support. At this stage, 16 of these countries were able to share their national data with WHO. Other countries are currently in the process of data collection and validation.In total, 64 countries and Kosovo1 contributed data on antibiotic consumption for this report, with the bulk of data coming from the European region and countries with pre- existing, mature surveillance systems. The consumption data showed wide intra- and interregional variation in the total amount of antibiotics and the choice of antibiotics consumed. The overall consumption of antibiotics ranged from 4.4 to 64.4 DefinedDaily Doses (DDD) per 1000 inhabitants per day.”

Stories You May Have Missed:

  • Influenza Vaccine Efficacy Among Patients with High-Risk Medical Conditions in the U.S. – Researchers utilized data from the US Influenza Vaccine Effectiveness Network from 2012-2016 to analyze vaccine effectiveness (VE) “of standard-dose inactivated vaccines against medically-attended influenza among patients aged ≥6 months with and without high-risk medical conditions. Overall, 9643 (38%) of 25,369 patients enrolled during four influenza seasons had high-risk conditions; 2213 (23%) tested positive for influenza infection.Influenza vaccination provided protection against medically-attended influenza among patients with high-risk conditions, at levels approaching those observed among patients without high-risk conditions. Results from our analysis support recommendations of annual vaccination for patients with high-risk conditions.”

 

 

Pandora Report 7.6.2018

 

We hope you had a lovely holiday this week and are ready to get back into the world of biodefense! News is still unfolding regarding the two British citizens who were hospitalized after exposure to the nerve agent, Novichok, but we’ll keep you updated as more information becomes available.

Summer Biodefense Workshop – Pandemics, Bioterrorism, and Global Health Security
In less than two weeks the summer workshop on all things health security, from anthrax to Zika, will be taking place – are you registered? This three-day workshop will cover everything biodefense from the most recent Ebola outbreak, to DIY biohackers and vaccine development, and also the challenges of defending against biothreats. Speakers include experts in the field like David R. Franz, who was the chief inspector on three United Nations Special Commission biological warfare inspection missions to Iraq and served as technical advisor on long-term monitoring. His current standing committee appointments include the Department of Health and Human Services National Science Advisory Board for Biosecurity (NSABB), the National Academy of Sciences Committee on International Security and Arms Control, the National Research Council Board on Life Sciences, and the Senior Technical Advisory Committee of the National Biodefense Countermeasures Analysis Center. Jens H. Kuhn will also be speaking on filoviruses and what it was like to be the first western scientist with permission to work in a former Soviet biological warfare facility, SRCVB “Vektor” in Siberia, Russia, within the US Department of Defense’s Cooperative Threat Reduction (CTR) Program. These are just two of our speakers who will be leading discussions over the three days – come join the conversation at our workshop from July 18-20!

All Hands on Deck – U.S. Response to Ebola in West Africa
Princeton University’s Innovations for Successful Societies has just released their report on the quality of the U.S. response to Ebola. The case study is part of a series on Liberian response to the outbreak and includes great information on coordination, political response, and the challenges of international outbreak management. “Although the deployment, which scaled up earlier assistance, took place five months after the first reported cases and required extensive adaptation of standard practices, it succeeded in helping bring the epidemic under control: the total number of people infected—28,616—was well below the potential levels predicted by the CDC’s models. This US–focused case study highlights the challenges of making an interagency process work in the context of an infectious disease outbreak in areas where health systems are weak.”

Bats and Military Defense
Sure, your first inclination might be a vampire or Batman joke, but there’s actually a significant history regarding the U.S. military and utilization of these mammals. Historically, efforts focused on employing them as bombs in Japan but a more modern plan focuses on their uncanny ability to carry deadly diseases. “‘What we are trying to do is to study bat immunology, but that turned out to be a very difficult thing to do when starting from scratch,’ said Thomas Kepler, a professor of microbiology at Boston University. It took decades to create the reactive substances necessary to study human or mouse antibodies. With bats, he explained, they were starting from zero.” Battling potential Russian bioweapons means thinking outside of the box, right? The truth is that fruit bats have a pretty amazing weapon of their own – a super immunity that might just lend itself to curing Marburg and other devastating infections. “The Marburg virus is classed as a Category A bioterrorism agent by the Centers for Disease Control and Prevention, and Kepler’s study was supported by the Defense Threat Reduction Agency, a Defense Department division established during the Manhattan Project era to combat weapons of mass destruction. If the virus is ever deployed as biological warfare, the fruit bat’s super-immunity may hold the answer to preventing its spread. But it may also go some way toward redeeming the bat in the eyes of the U.S. military — and could even make the animal an unlikely hero.”

 NASPAA Pandemic Simulation
How would you handle a pandemic? GMU’s Schar School team qualified for the final round of the Network of Schools of Public Policy, Affairs, and Administration (NASPAA) pandemic simulation, in which student teams had to respond to a constantly evolving situation and make real-time decisions regarding quarantine, trade, etc. “‘The simulation is an especially valuable experience for the biodefense students since the pandemic crisis provided students with complex problems like those that they will tackle in their professional careers,’ said director of the Schar School’s biodefense graduate program, Gregory Koblentz. ‘These exercises also test the students’ ability to bridge the gap between the science and policy-making, a key goal of the biodefense programs’.”

Gene Editing – Last Week Tonight With John Oliver and How DARPA Wants to Boost Body Defense Through Gene Editing
This week’s episode of Last Week Tonight featured one of our favorite topics – gene editing! While there’s only so much you can cover in the span of 20 minutes, it was nice to see some of the complexities, personalities, and technical hurdles, covered by John Oliver. From biohackers to germline edits, Oliver mixed humor into a discussion on the very real issues surrounding gene editing technologies like CRISPR (although his version of the acronym is much more comical – Crunchy Rectums In Sassy Pink Ray-bans). Make sure to check out the episode to get a humorous overview on this gene-editing technology. Meanwhile, DARPA (the Defense Advanced Research Projects Agency) is actually working to harness gene editing to make your body’s natural defenses that much stronger through specific gene expressions. The project is called PREPARE (PReemptive Expression of Protective Alleles and Response Elements) and works to provide temporary boots to your natural defenses. “In contrast to recent gene-editing techniques, such as CRISPR, which focus on permanently changing the genome by cutting DNA and inserting new genes, the PREPARE program will concentrate on techniques that don’t make permanent changes to DNA. These techniques target the ‘epigenome,’ or the system that controls gene expression. Genes can be turned on or off by making external modifications to DNA, which don’t change the DNA sequence, but instead affect how cells ‘read’ genes. To start, the PREPARE program will focus on four key health challenges: influenza viral infection, opioid overdose, organophosphate poisoning (from chemicals in pesticides or nerve agents) and exposure to gamma radiation, the statement said.” While there are a lot of hurdles to overcome, the overall goal is to extend the platform to known and unknown threat application.

Improving Mass Casualty Management: The Role of Radiation Biodosimetry 
How would we handle the medical response of large-scale radiological exposure? GMU Biodefense PhD student Mary Sproull presented on this very topic and the work she and her team are doing, which is aimed at making testing more efficient and effective. “Drs. Sproull and Camphausen are working to make the medical management process more efficient and effective in the event of a mass casualty radiation exposure. Specifically, they are developing a dosimetry dose prediction model to determine how radiation biodosimetry diagnostics can help physicians estimate just how much radiation exposure a patient has experienced. (Radiation biodosimetry diagnostics estimate a person’s radiation exposure by measuring changes in biological markers that include cytogenic assays like dicentric chromosome assay.)”

Everything You Need to Know About Ricin
A few weeks back a Tunisian man was arrested by German police regarding suspected plans for a bioterrorism attack with ricin. German police were searching his residence in Cologne and found enough ricin for 1,000 toxic doses. During the fervor of the news, it was reported that such a a plot could have been more devastating than 9/11 – but what’s the reality behind ricin? Check out this comprehensive review of what ricin is (a naturally occurring biological poison), its history as a biological weapon and WMD, and more. “In summary, ricin’s status as a biological weapon is quite mixed. In terms of actual potential for harm, it is more at the level of knives than bombs. Its status as a WMD is a legal one, not so much a practical one. It would be useful to the public debate and our general social assessment of risk if the media could reflect this, rather than churn out hysterical reporting.”

Stories You May Have Missed:

  • VA Study Reveals Antibiotic Prescribing Habits – “A team of researchers establishing baseline data on antibiotic use by the Veterans Administration (VA) healthcare system in Pittsburgh found that about 75% of all antibiotic prescriptions were inappropriate, meaning they were either not indicated or were used for a duration that’s not recommended. The study, which took place over 12 months, looked at prescribing information, medical records, and charts of 40,734 patients, who were written 3,880 acute antibiotic prescriptions by 76 primary care providers (PCPs). The median antibiotic index was 84 antibiotic prescriptions per 1,000 patients per year.”
  • Drone Crashes Into French Nuclear Plant – “GREENPEACE activists say they have crashed a drone into a French nuclear plant to highlight the lack of security around the facility. The drone, which was decked out to resemble a tiny Superman, slammed into the tower in Bugey, 30 kilometers (20 miles) from the eastern city of Lyon, according to a video released Tuesday by Greenpeace. The environmental group says the drone was harmless but it showed the lax nuclear security in France, which is heavily dependent on nuclear power, using it for about 75 percent of its energy needs.”

Pandora Report 6.29.2018

The month of June is nearly over, which means there’s only a few more weeks to register for the Workshop on Pandemics, Bioterrorism, and Global Health Security. Don’t miss out on the early registration discount if you sign up before July 1st!

Cost Analysis of 3 Concurrent Public Health Response Events: Financial Impact of Measles Outbreak, Super Bowl Surveillance, and Ebola Surveillance in Maricopa County
Have you ever wondered the cost of public health response for local health departments during a crisis? Imagine that within the course of six months, your county sees a measles outbreak, super bowl surveillance requirements, and Ebola surveillance. A new article is addressing the cost of this trifecta for the largest county health department in Arizona. GMU biodefense PhD student Saskia Popescu was a part of not only this response, but also aided in developing the research so that we can truly address the financial burden of public health events. “Maricopa County Department of Public Health (MCDPH) in Arizona. The nation’s third largest local public health jurisdiction, MCDPH is the only local health agency serving Maricopa’s more than 4 000 000 residents. Responses analyzed included activities related to a measles outbreak with 2 confirmed cases, enhanced surveillance activities surrounding Super Bowl XLIX, and ongoing Ebola monitoring, all between January 22, 2015, and March 4, 2015. Total MCDPH costs for measles-, Super Bowl-, and Ebola-related activities from January 22, 2015, through March 4, 2015, were $224,484 (>5800 hours). The majority was for personnel ($203,743) and the costliest response was measles ($122,626 in personnel costs). In addition, partners reported working more than 700 hours for these 3 responses during this period.” Public health is chronically underfunded, but the response efforts can be immensely expensive. Based off these events and the cost of response, perhaps it’s time we start investing more in public health.

Forget RoboCop, Meet the DNA Cops
Biotechnology is moving at a rapid pace and the ability for DIY biohacking means that frank conversations need to be had regarding the potential for someone to build a lethal biological weapon. Ginkgo Bioworks has just the team to overcome this herculean task. Remember that horsepox synthesis last year? “The study’s publication ‘crosses a red line in the field of biosecurity,’ wrote Gregory Koblentz, a professor in the biodefense department at George Mason University, in a public comment to the journal. ‘The synthesis of horsepox virus takes the world one step closer to the reemergence of smallpox as a threat to global health security’.” Hoping to get a leg up on the threat, the intelligence community is working with Ginkgo Bioworks to address the science, security, and safety. “Gingko quickly saw the potential security risks in its work. It began working with Weber, the former Obama administration official, in 2016 to get advice on how to best preserve national security.  ‘We are doing more of this genetic engineering than anybody, we think we’re going to get better at it than anybody, so we have a responsibility to be keeping our eye on both sides of that coin,’ Kelly said. ‘How do we protect and defend against that while protecting our ability to get all the positive outputs of biotechnology?’” Synthetic biology has the potential to do damage, but also the chance to counter these threats (and even emerging infectious diseases) through vaccine development. Joint efforts like those between Ginkgo Bioworks and agencies like IARPA, are critical during this time when the technology is still spreading and evolving.

Genome Editing and Security: Governance of Non-Traditional Research Communities?
GMU Biodefense doctoral student Katherine Paris has provided a detailed account of the latest National Academies webinar on gene editing and biosecurity/biosafety developments. Paris notes that “at the workshop, concerns were expressed over the extent that advancements in technology allow a greater range of people to access, and possibility misuse, genome editing technologies.  Dr. Millet and Dr. Kuiken addressed these concerns during the webinar by describing what two non-traditional research communities—the International Genetically Engineered Machine (iGEM) competition and do-it-yourself biology (DIYbio) community laboratories—are doing to foster biosafety and biosecurity.” Check out her account of this informative talk to learn more about how iGEM is demonstrating real-world application of biosecurity and biosafety practices.

The Culture of Biosafety, Biosecurity and Responsible Conduct in the Life Sciences
Curious about biosecurity, biosafety, and what it means to have a culture of responsibility in the life sciences? Look no further than this amazingly comprehensive literature review by ABSA International, which happens to include former GMU Biodefense student Kathleen Danskin and current doctoral student Elise Rowe. Identifying over four thousand unique articles published between 2001 and 2017, they reviewed 326 articles to truly evaluate the literature on ways to strengthen the biosafety/biosecurity culture. “We found that while there were discussions in the literature about specific elements of culture (management systems, leadership and/or personnel behavior, beliefs and attitudes, or principles for guiding decisions and behaviors), there was a general lack of integration of these concepts, as well as limited information about specific indicators or metrics and the effectiveness of training or similar interventions. We concluded that life scientists seeking to foster a culture of biosafety and biosecurity should learn from the substantial literature in analogous areas such as nuclear safety and security culture, high-reliability organizations, and the responsible conduct of research, among others.”

Roadmap for Implementing Biosecurity and Biodefense Policy in the U.S. 
This new report and roadmap from Gryphon Scientific, National Defense University, and Parsons, analyzes biosecurity and biodefense policy within the United States. “We developed a framework for analyzing opportunity costs of new or changing regulations (the opportunity cost analysis framework), and a framework for evaluating the successful implementation of biosecurity and biodefense policies. These analyses enabled the development of a roadmap for implementing U.S. biosecurity and biodefense policy to maximally leverage science and technology advances while simultaneously, minimizing risks. This project was funded by a generous grant from the U.S. Air Force Academy and Defense Threat Reduction Agency under their Program on Advanced Systems and Concepts for Countering Weapons of Mass Destruction.” The report includes policy and opportunity cost case studies, as well as evaluation metrics framework.

How Will Trump Lead During A Pandemic and How Well Prepared Is Your Country?
Between several science vacancies within the administration and the fundamental truth that a global epidemic is on the horizon, many are concerned about what a response would be like under Trump. “’There is a real reason for us to be scared of the idea of facing this threat with Donald Trump in the White House,’ said Ron Klain, who served as President Obama’s Ebola czar, at the Spotlight Health Festival, which is co-hosted by the Aspen Institute and The Atlantic. Klain said the ‘president is anti-science’ and ‘trades in conspiracy theories. All those things would lead to the loss of many lives in the event of an epidemic in the United States, where we need the public not to trade in conspiracy theories, not to believe that the news was fake, but to respect scientific expertise,’ said Klain, a veteran Democratic operative who served in both the Clinton and Obama administrations.” Klain underscores the importance of having pro-science leadership, which isn’t exactly something the current administration is known for. He points to several gaps within U.S. preparedness – funding, leadership, science, policy, etc. “But the biggest gap, he said, is the global gap: ‘We can’t be safe here in America when there’s a risk of pandemics around the world,’ Klain said. ‘The world’s just too small. Diseases spread too quickly … There is no wall we can build that is high enough to keep viruses and the disease threat out of the United States. We have to engage in the world’.” If you’re curious about the current state of preparedness around the globe, check out the latest site from Resolve to Save Lives, the initiative run by former CDC director Dr. Tom Frieden. Prevent Epidemics is a tool that rates countries from 0-100 on their ability to find, stop, and prevent outbreaks. “ReadyScore is calculated using data from the Joint External Evaluation (JEE), a rigorous, objective and internationally-accepted epidemic preparedness assessment developed by the World Health Organization (WHO) and other partners. The ReadyScore consolidates key information from the JEE about a country’s preparedness in the form of a simple and easy-to-understand number that makes it easy for countries to measure their preparedness gaps and fill them”

UK, Allies – Empower Chemical Arms Watchdog to Assign Blame For Attacks
The UK, US, and EU are pushing a new proposal to increase the powers of the Organization for the Prohibition of Chemical Weapons (OPCW) in efforts to strengthen the ban on chemical weapons and the ability to hold countries, like Syria, accountable for use. “‘The widespread use of chemical weapons by Syria in particular threatens to undermine the treaty and the OPCW,’ said Gregory Koblentz, a non-proliferation expert at George Mason University, in the United States. ‘Empowering the OPCW to identify perpetrators of chemical attacks is necessary to restoring the taboo against chemical weapons and the integrity of the chemical weapons disarmament regime’.”

Stories You May Have Missed:

  • Pull Incentives – A New Strategy for AMR – The World Economic Forum is supporting these initiatives to help spur the development of new antibiotics and facilitate their profitability. The financial challenges for antibiotic development can be significant hurdles – demand is unpredictable, stewardship efforts seek to decrease use which decreases sales, and clinical trials are costly. “Existing incentives for developing new antibiotics are mostly of the ‘push’ type, the report notes. Push incentives provide support for research and development, but they don’t ensure that a company can get an adequate return on a new antibiotic once it wins approval. The concept of pull incentives has attracted increasing attention in recent years. A chart in the report shows that 10 current research and development initiatives on antimicrobial resistance (AMR) involve push incentives, while no such initiatives involve pull incentives exclusively. Combinations of push and pull incentives are being used to support four existing R&D initiatives, the chart indicates, but it doesn’t give any details on those.”

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 – 5.4.2018

Happy Friday and May the Fourth Be With You!

Bill Gates Talks Universal Flu Vaccine, Pandemic Preparedness, and Bioterrorism
Bill Gates has been making the rounds this week discussing the slow progress that has been made in terms of pandemic preparedness. Gates recently spoke at the New England Journal of Medicine’s Shattuck Lecture, where he noted that “We are on the verge of eradicating polio. HIV is no longer a certain death sentence. And half the world is now malaria-free. So usually, I’m the super-optimist, pointing out that life keeps getting better for most people in the world.There is one area, though, where the world isn’t making much progress, and that’s pandemic preparedness. This should concern us all, because if history has taught us anything, it’s that there will be another deadly global pandemic. We can’t predict when. But given the continual emergence of new pathogens, the increasing risk of a bioterror attack, and how connected our world is through air travel, there is a significant probability of a large and lethal, modern-day pandemic occurring in our lifetimes.” You can find the full transcript here, but in his speech, Gates also underscores the risk of biological weapons, noting that “biological weapons of mass destruction become easier to create in the lab, there is an increasing risk of a bioterror attack. What the world needs – and what our safety, if not survival, demands – is a coordinated global approach. Specifically, we need better tools, an early detection system, and a global response system.” He also recently sat down with STAT News to discuss a new initiative he is supporting to facilitate the development of a universal flu vaccine, as well has his time in the Oval Office. “The Gates Foundation is offering $12 million in seed money for projects that would help the world develop a universal flu vaccine. Gates said he thinks that when a universal flu vaccine is developed, it will be made in one of the newer vaccine constructs attracting so much research attention these days.” Gates also noted that when meeting with President Trump, he discussed the need for a universal flu vaccine and sparked the president’s interest through the notion of inspiring American innovation. While Gates isn’t likely to take on a scientific advisor role, he continues to vocalize concerns about global health security and the gaps in preparedness/response efforts.

GMU Biodefense – Food Security 
Interested in biodefense and food security? GMU’s Biodefense graduate program is just the place, as we’re proud to announce that Philip Thomas will be teaching BIOD726 this fall. This course “analyzes threats to food security globally including those related to climate change and environmental degradation; animal and plant diseases; access to clean water; agricultural terrorism; and antimicrobial resistance. Explores the national and global health, economic, social, and ethical impacts of these disruptive forces. Examines strategies for enhancing the security of the global food production and supply systems.”

Avoiding Soviet-Era Disarmament Mistakes With North Korea’s Bioweapons Program
GMU Biodefense professor Sonia Ben Ouagrham-Gormley is trying to get the United States to avoid making the same mistakes when it comes to disarmament. Ouagrham-Gormley notes that with new talks between North Korea and the United States, it is important for the Trump administration to learn from our historical failures and previous disarmament talks. She points to the Cooperative Threat Reduction Program (CTR), which was launched in 1991 and worked to secure weapons, like nuclear and chemical, that were stored in former Soviet states. Unfortunately, the CTR program was only mildly effective in regards to biological weapons. Ouagrham-Gormley provides some “do’s and don’ts” for our bio-engagement with North Korea. Do engage as many facilities as possible. Don’t adopt a cookie-cutter approach to bio engagement – “Probably the greatest failure of the CTR program was its adoption of a one-size-fits-all approach that did not take into account the particular circumstances of the facilities and individuals engaged. For example, the CTR usually provided former Soviet facilities with biosafety equipment, which was much needed, as scientists sometimes worked with dangerous agents with no ventilation system to prevent the spread of disease should a laboratory accident occur.” She also notes that “without strategies to help scientists exit the bioweapons field and efforts to erode their expertise, a bio-engagement program in North Korea risks maintaining a bioweapons threat and possibly allowing resumption of the program in the future.”

Summer Workshop – Early Registration Discount Extended!
We’re happy to announced that the early registration discount for the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security, has been extended to June 1st. Register before then get the reduced rate for this 3-day workshop on all things health security. Join the conversation with experts regarding pandemic preparedness policy, dual-use research oversight, CRISPR, protecting the bio-economy, and more.

15 Years of Hospital Preparedness
It’s interesting to think that the Hospital Preparedness Program (HPP) has been working to strengthen U.S. healthcare preparedness for 15 years now. Check out this infographic for some interesting facts – HPP is the only source of federal funding for health care delivery system readiness and 98% of those awarded funds have said that the funding was critical to their response and preparedness efforts. From Hurricane Katrina to the bombings at the Boston Marathon, to Ebola in Dallas, and Zika virus, there is an utter need for supporting healthcare response and preparedness efforts within the United States.

Maryland Branch ASM Annual Poster Session & Student Oral Presentation
Don’t miss out on this chance to attend the Maryland ASM branch meeting on Monday, June 4th from 5:30-8:30pm. This is a great opportunity for students to present posters, meet other ASM members, and learn more about the organization.

Trends in Reported Vectorborne Disease Cases
Mosquitos and ticks are major trouble-makers in the United States.  The threat of vectorborne diseases is becoming an increasing issue within the United States, according to a new CDC report. Researchers reviewed data reported through the National Notifiable Diseases Surveillance System for 16 notifiable vectorborne diseases (West Nile virus, Rocky Mountain Spotted Fever, etc.) from 2004 to 2016. “A total 642,602 cases were reported. The number of annual reports of tickborne bacterial and protozoan diseases more than doubled during this period, from >22,000 in 2004 to >48,000 in 2016. Lyme disease accounted for 82% of all tickborne disease reports during 2004–2016.” Tickborne diseases accounted for more than 75% of reports and West Nile virus was the most commonly transmitted mosquitoborne disease. “During 2004–2016, nine vectorborne human diseases were reported for the first time from the United States and U.S. territories. The discovery or introduction of novel vectorborne agents will be a continuing threat.”

Stories You May Have Missed:

  • FDA Recommends Approval for TPOXX– The FDA Advisory Committee recently voted unanimously to recommend approval for TPOXX for the treatment of smallpox. “While TPOXX is not yet approved as safe and effective by the U.S. Food & Drug Administration, it is a novel small-molecule drug of which 2 million courses have been delivered to the Strategic National Stockpile under Project BioShield.”
  • Biodefense World Summit– Don’t miss this June 27-29 event in Bethesda, MD! “Biodefense World Summit brings together leaders from government, academia, and industry for compelling discussions and comprehensive coverage on pathogen detection, point-of-care, biosurveillance, sample prep technologies, and bio recovery. Across three days of programming, attendees can expect exceptional networking opportunities in the exhibit hall, engaging panel discussions, and shared case studies with members of the biodefense community from technology providers to policy makers. The 2017 summit saw more than 250 participants with 35% of attendees titled as scientist/technologist, 30% as executive/director, and 11% as professor.”

Pandora Report: 4.20.2018

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security: From Anthrax to Zika
The early-bird registration discount deadline is fast approaching, so make sure you’re signed up for the workshop on all things health security from July 18-20! Whether it’s the 2001 anthrax letter attacks, SARS and avian influenza, Ebola in West Africa, or dual-use research of concern, we’ll be covering it all in this three-day workshop. Where else can you mingle with some of the top minds in the field, engage with other passionate health security professionals, and learn about the latest issues in biodefense?

80,000 Hours Interview With Dr. Tom Inglesby – Careers & Policies That Can Prevent Global Catastrophic Biological Risks
If you’re not listening to the 80,000 Hours podcast, make sure to add it to your list. This is a wonderful podcast on making the right career choices and lucky us, they’re covering global health security jobs. In October, NTI’s Dr. Beth Cameron spoke about fighting pandemics and the challenge of preparing an entire country. Cameron spoke about the current state of American health security, what we’ve learned, new technologies, and more. This week, they spoke with Dr. Tom Inglesby from the Johns Hopkins Center for Health Security on how passionate health security gurus can pursue a career in the field, the top jobs, worrisome scientific breakthroughs, etc. You’ll even catch Dr. Inglesby discuss PhD programs and advisors in the field, in which he names GMU’s very own Dr. Gregory Koblentz! During his talk, Inglesby notes that “I don’t think it’s a good approach to think about it [catastrophic biological risk] as zero sum with other epidemic problems and here’s why: I think in many cases it’s gonna be similar communities that are thinking about these problems. I don’t think it’s likely, even if we really decided to get very serious as a world, I don’t think it’s likely that there will be a community solely dedicated. I don’t want to say never, because it could happen, but I don’t think it’s likely that there will be a robust enduring community of professionals that would only, solely be dedicated to global catastrophic risk, biological risks alone.”

An Afternoon with ASPR – Dr. Robert Korch and Dr. Dana Perkins
GMU Biodefense MS student Anthony Falzarano is reporting on his time at the National Academies monthly series on biological, chemical, and health security issues. “This luncheon – consisting of an open forum session with a two-member panel and a moderator – featured Dr. George W. Korch and Dr. Dana Perkins, both from the Department of Health and Human Services office of the Assistant Secretary for Preparedness and Response (ASPR). Drawing from their current roles with ASPR as well as their illustrious careers and vast experiences, two presenters made for a compelling afternoon discussing health security issues and the work being done by ASPR to prepare for and address them.” Make sure to read his report-out on this luncheon to learn Dr. Korch’s favorite priorities for ASPR!

Chemical Weapons Attack on Douma – Update
Last Saturday, 105 missiles were fired against three Syrian chemical weapons facilities in a joint effort by the U.S., UK, and France. While this is unlikely to have completely removed Assad’s chemical weapons capabilities, many are wondering how effective the airstrike truly is. “‘This is now part of their standard combat doctrine’,” said Gregory Koblentz, a chemical weapons expert at the Schar School of Policy and Government at George Mason University. The attack April 7 that triggered the U.S.-led retaliatory strikes forced the surrender of a rebel group holed up in a suburb of Damascus. ‘It changed the course of battle on the ground,’ Koblentz said.” Social media is also increasingly playing a large role in the U.S. and Russian dialogue of the attacks. “The heavy reliance of President Donald Trump’s administration on publicly available information marks a shift from his predecessor’s, which insisted on obtaining physical evidence of chemical weapons use with an established chain of custody before considering the use of force. It also highlights the difficulties Western intelligence agencies have faced in obtaining such evidence — blood, hair, or soil samples — from the Damascus suburb of Douma in the days following the April 7 chemical weapons attack that left nearly 50 dead and hundreds wounded.” The Director-General of the OPCW (Organization for the Prohibition of Chemical Weapons) recently provided an update on the fact-finding mission (FFM) in Douma, which you can find here. Challenges were found in OPCW actually getting into the site. “The United Nations Department of Safety and Security (UNDSS) has made the necessary arrangements with the Syrian authorities to escort the team to a certain point and then for the escort to be taken over by the Russian Military Police. However, the UNDSS preferred to first conduct a reconnaissance visit to the sites, which took place yesterday. FFM team members did not participate in this visit.On arrival at Site 1, a large crowd gathered and the advice provided by the UNDSS was that the reconnaissance team should withdraw. At Site 2, the team came under small arms fire and an explosive was detonated. The reconnaissance team returned to Damascus.” “The delay in the inspectors’ arrival, 10 days after the attack, will raise fresh concerns over the relevance of the OPCW investigation and possible evidence-tampering. The efforts to investigate the attack, which has been blamed on Bashar al-Assad’s government and sparked a joint operation by the US, Britain and France to bomb chemical weapons facilities near Damascus, has been repeatedly delayed despite Syria’s claim to have established full control over Douma and the surrounding region.” Koblentz notes that “Douma has been completely surrounded by the Syrian government and has been subject to intensive bombardment as part of the regime offensive since February,. The problem is that the territory is now occupied by the Syrian government and the crime scene is no longer secure. It doesn’t lend itself to a credible investigation. It’s like the criminals came back to the scene of the crime and they can do whatever they want with the evidence before the cops show up.”

CRISPR, Avengers, & Super Soldiers, Oh My! 
As we get closer to the release of Marvel’s Avengers: Infinity War, discussions about super soldiers and genome editing are growing like a mean, green, fighting machine. A frequent topic of conversation during the December 2017 Meeting of States Parties (at least among the ELBI attendees!), Matt Shearer posed the question – is Captain America a biological weapon? What about the other Avengers though – like Hawkeye, who is one of the few “normal” humans in the group? “Hawkeye’s accuracy with a bow and arrow is heavily dependent on his eyesight, which is clearly more advanced than the average human’s. As far as we know, his genome has not been intentionally altered, leading us to believe that Hawkeye has inherited his extraordinary eyesight from his parents. This theory is strengthened by the fact in the Marvel comic books, Barney Barton, Clint’s brother, is also an accomplished archer thanks to his enhanced vision. Perhaps Hawkeye’s advanced eyesight is the result of thousands of years of genetic evolution in the form of adaptation, genetic drift, or mutation of his ancestor’s DNA.” Writers at Synthego decided to look at which genes would need CRISPR modification to improve vision – like targeting specific opsin genes OPN1SW, OPN1MW, etc.

Survey – Most Americans Favor More Funding to Support Biosecurity Capabilities
A new survey by Alliance for Biosecurity has found that public confidence in US preparedness to address biosecurity has dropped. “Nationally, 73% of the 1,612 Americans surveyed say they would have a favorable reaction ‘if Congress decided to increase the budget this year for developing preventive measures for biological and chemical threats.’ How elected officials act on biosecurity issues is important enough to affect voters at the ballot box, according to the survey. A majority of Americans – 52% –  say they are more likely to support their elected representative if that representative is ‘actively engaged in promoting and supporting biosecurity.’ Similarly, 52% say they would become less likely to re-elect a representative who voted AGAINST providing additional funding to the Strategic National Stockpile (SNS) and Biomedical Advanced Research and Development Authority (BARDA). Only 20% say voting against the additional funding would make them more likely to re-elect that representative.” The survey found that only 31% of Americans are confident in our national preparedness, which is a drop from the 50% found in a March 2016 survey.

Curious 2018
Are you planning on being in Germany July 16-18? Don’t miss out on the Curious2018 Future Insight conference in Darmstadt. “The Curious2018 Future Insight conference is a world-renowned event around the future of science & technology and its application to build a better world for humanity. The best minds in science, technology, and entrepreneurship will come together to make great things happen and join forces to realize the dreams of a better tomorrow.” Topics will include healthy lives, materials & solutions, life reimagined (synthetic biology!), vibrant digital, and bright future.

Foodborne Illness Outbreaks – Romaine Lettuce and Eggs
Cobb salads may be taking a beating this week as two main ingredients are setting food epidemiologists into overtime with E.coli and Salmonella outbreaks. Three days ago, it was announced that the source of a 16-state E. coli O157:H7 outbreak, had been identified as a romaine lettuce farm in Yuma, AZ. The CDC recently announced that 53 people have been sickened and the common ingredient amongst them was chopped romaine lettuce, which was traced back to the Yuma region. If that wasn’t bad enough, over 206 million eggs have been recalled across 9 states due to a Salmonella outbreak linked back to eggs from a farm in Hyde County, N.C., and distributed by an Indiana company. “The FDA said the voluntary recall is the result of 22 illnesses reported in East Coast states, which led to extensive interviews and an inspection of the Hyde County farm. The outbreak involves the Salmonella Braenderup subtype. Federal and state officials have been investigating the outbreak since early March.”

Stories You May Have Missed:

  • Holding Russia Accountable in Salisbury– During this week, the UN Security Council and the Executive Council of the Organization for the Prohibition of Chemical Weapons (OPCW) met to discuss the most recent OPCW findings. Per the U.S. State Department – “The OPCW’s independent report, released last week, confirms the UK lab analysis regarding the identity of the chemical used in Salisbury. We applaud the OPCW’s expeditious support and technical efforts to uncover the facts. We fully support the UK and the need for today’s special meetings of the OPCW Executive Council and the UN Security Council to discuss the chemical weapons attack in Salisbury and the OPCW’s detailed independent analysis.”
  • Apartment Mice: Harborers of Disease? “In a study today in mBio, the researchers report that a genetic analysis of droppings collected from house mice in New York City detected several types of bacteria capable of causing gastrointestinal disease, including Shigella, Salmonella, Escherichia coli, and Clostridium difficile. They also found genes that confer resistance to fluoroquinolones, beta-lactam antibiotics, and methicillin. Overall, more than a third of mice carried at least one potentially pathogenic bacterium, and nearly a quarter carried at least one antibiotic resistance gene.”

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 4.13.2018

Welcome to your Friday biodefense fix! Have you registered for the summer workshop on pandemics, bioterrorism, and global health security? Don’t miss the chance to learn from the top minds in the field on everything from anthrax to Zika.

Blue Ribbon Study Panel Meeting – Transnational Biological Threats & Global Security
On April 25th, the Blue Ribbon Study Panel on Biodefense will be hosting a meeting regarding transnational biological threats. From 10am to 3pm, you can attend (or watch live!) this event. “Biological threats to the Nation increase continuously, recognizing no borders. As emerging and reemerging naturally occurring diseases continue to spread throughout the world, terrorists continue to pursue biological weapons to add to their arsenal, and nation states are establishing new and reinvigorating old offensive biological weapons programs. This meeting of the Study Panel, chaired by former Senator Joe Lieberman and Governor Tom Ridge, will provide the Study Panel with a better understanding of: Current transnational biological threats, Homeland defense and security in the global context, Global security efforts to combat these threats, International public health security efforts; and the need to elevate global health security as a national and global priority”.

Chemical Weapons Attack in Syria
This past weekend saw a horrific suspected chemical weapons attack upon the rebel-held Syrian city of Douma. Victims began seeking medical care on Saturday evening with the telling signs of chemical weapons exposure. Rough estimates are that 500 people sought medical care related to the attack and the WHO has demanded “immediate unhindered access to the area to provide care to those affected, to assess the health impacts, and to deliver a comprehensive public health response.” Healthcare workers on the ground have reported patients with symptoms, “which included frothing at the mouth, suffocation, dilated and constricted pupils, corneal burns, central cyanosis – a blue tinge to the skin – and a chlorine-like odour, were consistent with exposure to an organophosphorus compound. Sarin gas is such a chemical”. Sadly, the use of chemical weapons is becoming increasingly common in Syria, as the Assad regime has revealed an appreciation for the abhorrent tactic. “Gregory D. Koblentz, the director of George Mason University’s Biodefense Graduate Program, said the attack appeared to reflect how much the clout of U.S. policy has faded in Syria. ‘Assad is less concerned about Beltway politics, less concerned by who is in the White House. His calculation is based on whether it will help his chances in achieving gains on the ground, or punishing the rebels,’ he said.” “The possibility of western intervention against Assad was heightened on Tuesday after Russia and its western opponents, the US, UK and France, respectively vetoed duelling resolutions at the UN security council over the latest atrocity. The UN high commissioner for human rights said the world must react to the use of chemical weapons or risk dire consequences. ‘After decades when we thought we had successfully outlawed the use of chemical and biological weapons, the world is sitting idly by while their use is becoming normalised in Syria,’ said Zeid Ra’ad al-Hussein. ‘This collective shrug to yet another possible use of one of the most ghastly weapons ever devised by man is incredibly dangerous’.” What is to be done? President Trump’s recent Twitter activity points to planned use of “smart” missiles, but U.S. Defense Secretary Jim Mattis said on Wednesday that the U.S. is still assessing intelligence about the suspected chemical weapons attack. The OPCW (Organisation for the Prohibition of Chemical Weapons) is set to meet on April 16th to discuss the “alleged use of chemical weapons” in Syria. The OPCW team is also currently en-route to Syria for investigation into the suspected attack. “‘I think it looks pretty clear that a chlorine weapon was used’ on the civilians, said Charles Duelfer, former deputy head of the U.N. inspections team in Iraq, in an interview with NPR.”

Who Owns Smallpox?: The Nagoya Protocol and Smallpox Virus Retention
This week the Center for the Study of WMD held a talk on smallpox stockpiles. Spotlight speaker Michelle Rourke discussed her article regarding the convention on biological diversity and the Nagoya Protocol. If you missed the event, GMU biodefense graduate student Morasa Shaker was able to attend and has provided a detailed account of the day. “While the case can be made that endangered species pose an intrinsic value to the world’s genetic diversity, it is has proven less feasible to make the same case for a virus, specifically the variola virus—the causative agent of smallpox. Nevertheless, Michelle Rourke, a Fulbright scholar at Georgetown University’s O’Neill Institute for Domestic and Global Health Law, led an in-depth educational seminar organized by the Center for the Study of Weapons of Mass Destruction to support that very case—the smallpox virus is worthy of our conservation efforts.”

Controlling Dangerous Biological Research
Filippa Lentzos is asking a question we’ve been trying to avoid for a while – how can we control biological research that is inherently dangerous? The desire to advance technologically and in the life sciences pushes researchers and defense programs to invest in biological sciences, like synthetic biology. Just as we make gains in such research, we also worry that adversaries could use the same technologies against us. “Washington, Moscow, and other governments say they are focused only on ‘defensive’ biosecurity activities, but there is a fine line between ‘defensive’ and ‘offensive’ in this realm, and the alarming military focus on synthetic biology may cause people to wonder if there is some way to control the weaponization of biology.” Lentzos calls upon the international community to face the monster head on – let’s discuss how to address biological research that pushes the boundary of defense into offense. “To accomplish any of this, we have to be able to both characterize and evaluate biological research with high misuse potential. This is exceptionally difficult to do, and continues to elude both the international community and national policymakers.” Lentzos points to the horsepox synthesis experiment as a good example of the failures that occurred along the way and that ultimately, risk-benefit analysis is the wrong approach to biosecurity review. “Good security rests not on evaluating risks and benefits, but rather on managing uncertainty, ambiguity, and ignorance—sometimes even situations where we don’t know what we don’t know. Standard risk-benefit calculations are the wrong approach to evaluating biological research with high misuse potential.”

HHS Large-scale Exercise Moving Highly Infectious Patients
How do you transport a highly-infectious patient? The care of Ebola patients in the United States during the 2014/2015 outbreak highlighted the challenges of moving such patients to regional treatment centers. HHS sponsored a large-scale exercise that took place this week, with a hot-wash today. “The exercise focuses on moving seven people acting as patients with Ebola symptoms in different regions of the country. The patients, including one pediatric patient, first present themselves at one of the following healthcare facilities: CHI St. Luke’s Health-The Woodlands Hospital in The Woodlands, Texas; Medical University of South Carolina in Charleston, South Carolina; Norman Regional Hospital in Norman, Oklahoma; St. Alphonsus Regional Medical Center in Boise, Idaho, and St. Luke’s Regional Medical Center in Boise, Idaho.At each facility, healthcare workers will collect and ship samples for diagnostic tests to state laboratories, which in turn will practice running the necessary laboratory tests to diagnose the patients with Ebola. As part of the exercise, each patient will receive a positive diagnosis. Using appropriate isolation techniques and personal protective equipment, health care workers then must take steps to have six of the patients transported by air to designated Regional Ebola Treatment Centers. These patients will be placed into mobile biocontainment units for these flights. The pediatric patient will be placed into protective equipment and transported by ground ambulance.” The drills will also involve several airports, which include LAX, Charleston International, etc.

NASEM Bio, Chem, and Health Security Luncheon: April
Don’t miss the National Academies-hosted lunch today from noon to 1:30PM EDT. “April’s event features features George Korch, Senior Science Advisor to the Assistant Secretary for Preparedness and Response (ASPR) in the Department of Health and Human Services and Dana Perkins, Senior Science Advisor in ASPR’s Office of Policy and Planning. Dr. Korch will discuss recent developments and ASPR strategic priorities in support of the Public Health Emergency Medical Countermeasures Enterprise (PHEMCE). Dr. Perkins will talk about implementation of the recommendations arising from the Federal Experts Security Advisory Panel (FESAP) and current activities for 2018. This event is free and open to the public, but you must register to attend. This event will not be webcast, and a summary will not be provided after the fact, so please register to attend in person if you are interested! A light lunch and beverages will be provided for all attendees.”

Cyberbiosecurity – A New Way To Protect The Bioeconomy and Gene Editing for Good
How can we better ensure cybersecurity and biosecurity? Researchers are bringing forth this emerging hybrid field that we should be giving more attention to. Life sciences and biotech are heavily engrained in cyber systems. Consider 3-D printing, personalized genomics, medical labs and surgical robots, etc.  “We propose ‘Cyberbiosecurity’ as an emerging hybridized discipline at the interface of cybersecurity, cyber-physical security and biosecurity. Initially, we define this term as ‘understanding the vulnerabilities to unwanted surveillance, intrusions, and malicious and harmful activities which can occur within or at the interfaces of comingled life and medical sciences, cyber, cyber-physical, supply chain and infrastructure systems, and developing and instituting measures to prevent, protect against, mitigate, investigate and attribute such threats as it pertains to security, competitiveness and resilience’.” Promoting this field and strengthening educational strategies is key to inform people on cyberbiosecurity and ensure a trajectory that can be supported. How do we move cyberbiosecurity forward though? “Academia, industry, government or non-profits (including policy, regulatory and legal experts) need to begin to learn to communicate with and educate each other, harmoniously identify and develop priorities, opportunities and specify ‘next steps.’ A major opportunity exists right now to propose a unified structure and common vernacular. Lastly, while definition and assemblage of Cyberbiosecurity is occurring, national or international strategies should be pursued to harmonize the emerging enterprise and foster measurable value, success and sustainability.” As the talks surrounding cyberbiosecurity grow, it’s hard not to consider some of the technologies we’re discussing and their potential. Bill Gates recently wrote for Foreign Affairs regarding the good that CRISPR could do. “the next decade, gene editing could help humanity overcome some of the biggest and most persistent challenges in global health and development. The technology is making it much easier for scientists to discover better diagnostics, treatments, and other tools to fight diseases that still kill and disable millions of people every year, primarily the poor. It is also accelerating research that could help end extreme poverty by enabling millions of farmers in the developing world to grow crops and raise livestock that are more productive, more nutritious, and hardier. New technologies are often met with skepticism. But if the world is to continue the remarkable progress of the past few decades, it is vital that scientists, subject to safety and ethics guidelines, be encouraged to continue taking advantage of such promising tools as CRISPR.” Gates points to several avenues for good – feeding the world, ending malaria, etc. He also notes though that there are legitimate questions regarding the potential for misuse and risks, and that regulations for genetic engineering are decades old and need revision to remain applicable. Part of the process for truly utilizing CRISPR is also to responsibly assess risks and communicate openly.

3MT Competition 
The George Mason University 3-Minute Thesis competition took place this past weekend and we’d like to congratulate Biodefense PhD student Chris Brown on his participation in this exciting event! He was one of ten finalists who competed to explain their dissertation to a non-specialist audience in 3 minutes. Chris described his dissertation regarding protecting critical workers against emerging infectious diseases – “Many different types of workers, including those who provide essential services the rest of us frequently depend on, are at risk of exposure to emerging infectious diseases that spread through the general population. Although many factors play into these types of workers being exposed on the job, protective gear—equipment like gloves, gowns, goggles, and respirators—is an essential part of infection prevention programs aimed at keeping workers healthy. During recent outbreaks, the public health enterprise has tended toward reinventing guidelines for each new infectious disease we face. That can lead to confusion about what guidelines for worker protection should be followed, as well as delays in implementing protective measures as science works to understand the disease agent and its transmission mechanisms. Pivoting toward a system based on worker exposures associated with various job tasks instead of one built around accurately characterizing transmission routes, my research offers a guideline for protective gear that is applicable to a wide range of diseases and that can be used as soon as outbreaks begin. It serves as an off-the-shelf solution for worker protection until empirical evidence supports using disease-specific infection prevention practices.”

Stories You May Have Missed:

  • In Pictures: Decades of Navy Efforts To Combat Malaria – “Malaria is ranked by the Department of Defense as the number one infectious disease threat to military personnel deployed to areas where malaria is endemic. This includes countries spanning the tropical and subtropical regions of the world, including most of sub-Saharan Africa and larger regions of South Asia, Southeast Asia, Oceania, central Asia, the Middle East, Central and South America and the Caribbean.”

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 4.6.2018

Are You Prepared For the Next Pandemic?
Attend the GMU biodefense workshop on pandemics, bioterrorism, and global health security from July 18-20 to learn about pandemic preparedness, vaccine production, health security, and more!  From anthrax to Zika, we’re covering all things biodefense. Register before May 1stand you’ll even get an early-bird discount!  

Recounting the Anthrax Attacks
Wanting a new book for your biodefense book club? Look no further than Scott Decker’s account of the Amerithrax attacks in 2001. One of the chief scientific lead investigators, Decker provides a first hand look into the investigative process and innovative forensics that were used. “Decker provides the first inside look at how the investigation was conducted, highlighting dramatic turning points as the case progressed until its final solution. Join FBI agents as they race against terror and the ultimate insider threat—a decorated government scientist releasing powders of deadly anthrax. Walk in the steps of these dedicated officers while they pursue numerous forensic leads before more letters can be sent until finally they confront a psychotic killer.” This is a great account of one of the largest FBI investigations in the past two decades, the science behind it, and what it was like from the inside of Amerithrax.

 Russia Proposes Joint Investigation Into Salisbury Attack
As if it couldn’t get more uncomfortable…tensions are running high after a meeting of the Organization of the Prohibition of Chemical Weapons (OPCW) between London and the Kremlin. “Russia had demanded the emergency gathering of the OPCW’s top body in The Hague, after being blamed by the UK Government for the poisoning of ex-spy Sergei Skripal and his daughter Yulia.” Following this meeting, the UK delegation to the OPCW tweeted “Russia’s proposal for a joint, UK/Russian investigation into the Salisbury incident is perverse. It is a diversionary tactic, and yet more disinformation designed to evade the questions the Russian authorities must answer.” In response, Russian officials are pushing back and stating that their position is “fact-driven” and supported by 14 other nations.

GAO Report on Ebola Recovery & USAID Funds
The 2014/2015 Ebola outbreak was not only devastating, but also severely financially impacting. Response efforts alone cost billions, but what about recovery? USAID (US Agency for International Development) was given the task of supporting recovery efforts in Guinea, Liberia, and Sierra Leone however, their fiscal responsibility is being called into question. A new GAO report found that USAID was provided with $1.6 billion for Ebola recovery, of which $411.6 million was obligated for 131 recovery projects. “As of September 2017, USAID had completed 62 of its 131 planned Ebola recovery projects, had 65 projects that were ongoing, and had 4 planned projects that it had not yet started. Of the 62 completed projects, USAID had completed 39 within original time frames and budgeted costs and extended 23. Of the 65 ongoing projects, USAID expected to implement 46 within original time frames and costs, but had extended 19. USAID extended projects, in part, to complete host-government actions, hire staff, finalize project activities, and continue and expand food assistance.” The GAO report found several discrepancies in the data between USAID and its contractors. “In addition, as of December 2017 USAID has not ensured that the contractor has a complete and accurate inventory, which it said is also useful for informing and improving its ability to respond to future global health emergencies. The GAO said it looked at the contractor’s evaluation plan and found some incomplete or unclear elements, which have since been addressed by USAID and the contractor. The report also recommended that the USAID administrator ensure that a complete and accurate inventory of Ebola recovery project is compiled for ongoing evaluations.”

Enhancing Global Health Security Through Biosecurity and Engagement Programs 
The National Academics of Science, Engineering, and Medicine (NASEM) will be hosting this event April 23rd (12:30-5:30pm) and April 24th (9am-5pm) at the Keck Center of NASEM. “For over two decades, the Defense Threat Reduction Agency’s Cooperative Biological Engagement Program (CBEP) has endeavored to reduce the threat posed by especially dangerous pathogens and related materials and expertise, as well as other emerging infectious disease risks. Through collaboration with other U.S. government agencies and international partners, CBEP identifies and addresses gaps in human and animal public health systems, enhance biosafety and biosecurity standards and procedures, and strengthens the ability of human and animal public health laboratories to detect, diagnose, and report outbreaks of infectious disease. Recently, CBEP collaboration has increased with the U.S. Centers for Disease Control and Prevention (CDC) on the Global Health Security Agenda (GHSA), enabling CBEP to advance its security goals across the GHSA countries. Recognizing that it must coordinate with a host of domestic and international agencies and organizations, CBEP has requested a consensus study to be conducted by the National Academies of Sciences, Engineering, and Medicine (NAESM) to engage key partners of biological and health-security support, and to assist in articulating a vision for a coherent and harmonized set of programs that align with the larger DTRA, DOD, and USG missions. The overall objectives of the NASEM study are to help CBEP and its sister programs to be as effective as possible while ensuring that critical opportunities are not inadvertently missed.”

 ProMed April Fool’s
If you’re a subscriber to the International Society for Infectious Disease’s ProMed email alerts, you may have come across this little gem on Monday. Little did people realize, the source from the Scotland Sunday Herald was a satirical article. Regarding Anthrax Island in the UK and a possible purchase- “A group of Russian oligarchs is bidding to buy Gruinard Island off the north west coast of Scotland.” “One British source said: ‘If Gruinard had an active volcano under which they could build a lair, replete with shark tank, lasers and dozens of goons in uniform, then this move would make sense. As Gruinard is basically a contaminated hell-hole where we once bombed sheep to death with bio-weapons in the hope of doing the same to Germans, then I cannot for the life of me understand what these oligarchs would want with the place.’ A Kremlin source said: ‘Why should a group of shadowy billionaires not buy up your land of Scotch and haggis? To raise questions about this is typical of lick-spittle imperialist lackeys who see conspiracies by Russia at every turn.’ When asked how anyone could survive on an island contaminated with anthrax, the source initially said that Russia ‘had years of experience with this type of thing’, before adding: ‘You cannot report that. We didn’t say that’.” ProMed issued an alert the following day, after it was notified by readers that the Scottish Herald article was in fact, an annual April Fool’s joke. Who says we don’t have fun in biodefense?

CARB-X Specific Diagnostics Award
A novel partnership may help the battle against antimicrobial resistance. A new $1.7 million award to Specific Diagnostics will help support the company’s antibiotic susceptibility testing (AST), which would significantly help early screening and rapid diagnostics, as well as lowering costs. “CARB-X funding will support the development and testing of Specific’s product, which is designed to quickly detect the emitted volatile molecules that are the first sign of bacterial growth in the blood and to determine which antibiotic is most suited to kill the bacteria. Rapid diagnostics provide quick answers to doctors and can take the guesswork out of treatment decisions in the first critical few hours and days of illness, reducing the chance of life-threatening sepsis and other urgent complications of blood infections. Currently, it can take days of laboratory testing to diagnose a lethal bacterial infection in the bloodstream. Faster diagnosis will enable medical staff to treat the patient quickly with appropriate antibiotics.”

NextGen Happy Hour
Looking to meet other people who are passionate about global health security? Next Generation Global Health Security Network is hosting a happy hour at Penn Commons (700 6th St NW, Washington, DC 20001) on April 26th at 5pm. This is a great opportunity to meet other NextGen members, the 2018 Next Generation Global Health Security Proteges, and other health security colleagues. Please confirm your attendance by April 20th by emailing nextgenghsa@gmail.com.

CDC Makes Gains in AMR Struggle
The CDC is reporting containment of new multidrug-resistant organisms in their latest MMWR. Utilizing data from the National Healthcare Safety Network (NHSN) regarding infections, researchers calculated changes in annual proportion of specific organisms that were highly resistant (CRE and ESBL). “The percentage of ESBL phenotype Enterobacteriaceae decreased by 2% per year (risk ratio [RR] = 0.98, p<0.001); by comparison, the CRE percentage decreased by 15% per year (RR = 0.85, p<0.01). From January to September 2017, carbapenemase testing was performed for 4,442 CRE and 1,334 CRPA isolates; 32% and 1.9%, respectively, were carbapenemase producers. In response, 1,489 screening tests were performed to identify asymptomatic carriers; 171 (11%) were positive.” The new strategy the CDC is relying on (and unveiled in 2017) involves rapid detection, on-site infection control assessments, screening of exposed contacts to identify asymptomatic colonization, coordination of the response among facilities, and continuing these interventions until transmission has been controlled. “The proportion of Enterobacteriaceae infections that were CRE remained lower and decreased more over time than the proportion that were ESBL phenotype. This difference might be explained by the more directed control efforts implemented to slow transmission of CRE than those applied for ESBL-producing strains. Increased detection and aggressive early response to emerging antibiotic resistance threats have the potential to slow further spread.”

Prepare For Pandemics – Reauthorize the Preparedness Act
The CDC’s elite team of disease detectives, the Epidemic Intelligence Service (EIS), is one of our greatest tools against microbial threats, so why do we keep cutting funding? The EIS program was initially established in the 1950s, when biological weapons programs were at trending and smallpox was not yet eradicated. EIS officers are deployed to public health events, and that doesn’t just mean infectious diseases, but can include natural disasters as well. “Over the last decade, however, cuts in funding for hospital and public health programs have diminished resources and capacities to identify and contain infectious disease outbreaks. Rising costs of graduate medical education, combined with disparities between public sector and private salaries for physicians have resulted in fewer physicians applying to the EIS fellowship program. While CDC once had the authority to offer student loan repayment to EIS fellows (as the National Health Service Corps and the National Institutes of Health and do for clinicians in underserved areas and scientists), CDC’s authority expired in 2002.” This can be challenging though as EIS fellows serve two years and repayment requires three years of service. In response to these budgetary cuts, Congress could, within the reauthorization of the Pandemic and All Hazards Preparedness Act (PAHPA), “reinstate CDC’s loan repayment authority and conform the commitment to CDC employment to the term of current fellowship programs.” This would encourage and better support the development of more EIS officers, as they are vital to global health security, but also a critical component to public health after their service is completed.

Stories You May Have Missed:

  • One Health Day 2018 Promotional Launch– November 3rd is the official day we celebrate global One Health Day, and three global partners are launching promotional activities to make sure we get the word out. “Anyone, from academia to government to corporate to private individuals can plan and implement a One Health Day Event which can be organized any time of the year and does not have to fall right on 3 November (unless participating in the student events competition). The global One Health Day Events webpage and map provides an impressive account of registered One Health Day events. Online registration is free of charge and yields special benefits: promotion on the One Health Day website, free use of the One Health Day logo and other materials and –anew benefit in 2018 – the chance for a surprise visit by a renowned One Health leader at selected One Health Day events.”
  • Department of Health and Human Services FY2019 Budget Request – “This report provides information about the FY2019 budget request for the Department of Health and Human Services (HHS). The report begins by reviewing the department’s mission and structure. Next, the report offers a brief explanation of the conventions used for the FY2018 estimates and FY2019 request levels in the budget documents released by the HHS and the Office of Management and Budget (OMB). The report also discusses the concept of the HHS budget as a whole, in comparison to how funding is provided to HHS through the annual appropriations process. The report concludes with a breakdown of the HHS request by agency, along with additional HHS resources that provide further information on the request. A table of CRS key policy staff is included at the end of the report.”

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 3.23.2018

TGIF and Pandora Report day! Tomorrow is World TB Day, in which we celebrate the progress made to eradicate TB, but also recognize the work that still needs to be done. Did you know that 53 million lives were saved through effective TB diagnosis and treatment from 2000-2016? In 2016 alone, there were nearly 500,000 cases of multidrug-resistant TB around the world and it takes $2.3 billion a year to fill the resources needed for existing TB interventions. If you happen to be traveling by air anytime soon, make sure to read these tips from public health experts.

How Prepared Are You For the Next Pandemic? Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
Three days filled with global health security and all things biodefense from anthrax to Zika – what more could you want in a workshop? Learn from the top minds in the field when it comes to pandemic preparedness, vaccine development, biosecurity, etc. Between the centennial of the 1918 influenza pandemic, the recent horsepox synthesis, and the lift on the gain-of-function research moratorium, these three days will be packed with exciting topics and discussions. From July 18-20th, come get your biodefense on with us in Arlington, VA – registration prior to May 1st also gets an early bird discount!

Shining A Spotlight On Soviet Nerve Agents
A nerve agent attack in the UK has made the poison, Novichok, a household name, but also pointed a very large spotlight on Russia’s scientists and defense labs. “Few experts in the rarefied area of chemical weapons defense are willing—or able—to shed further light on them. Information about the Novichok nerve agents is classified, says one U.S. military scientist who, like other U.S. government scientists, declined to speak with Science.” Whatever the plan, this failed attempt for the quick deaths of Skripal and his daughter have left many questions about delivery of the agent and how this heavily guarded secret nerve agent found its way onto UK soil. An article from The Trench discusses the use of these nerve agents, formal accusations from the UK, and compliance of the Chemical Weapons Convention (CWC). “The OPCW experts travel to the UK under Article VIII, 38(e), which qualifies their activity as a ‘Technical Assistance Visit’ to help with the evaluation of an unscheduled chemical (the Novichock agent) is not listed in any of the three schedules in the Annex on Chemicals).  They will likely visit the sites of investigation and collect their own samples (if for no other reason than to validate any laboratory samples they may receive), take all materials and documents related to the forensic investigation back to the Netherlands where the sample will be divided up and sent to two or more designated OPCW laboratories.” On Wednesday, Russian diplomatic and military officials reportedly accused the UK of hiding evidence in the investigation of the attack. “Speaking to a lecture hall of diplomats, Vladimir Yermakov, deputy head of the ministry’s department for non-proliferation, suggested that the UK was ‘hiding facts’ about the case that may later ‘disappear’.” British diplomat Emma Nottingham noted that “Russia has offered us so far no explanation of how this agent came to be used in the United Kingdom and no explanation as to why Russia has an undeclared chemical weapons programme in contravention of international law,”.

Pandemic Preparedness
“Are we prepared for the next pandemic?” Such a question pulls at the string of a much larger web that tends to leave many feeling unsettled. The scary truth is that we’re not ready. We know there will be a pandemic – history, science, and society, all tell us this. Encroachment on nature, increasing globalization and populations, and struggles against more frequent threats like seasonal flu and even antimicrobial resistance, all reveal a severe vulnerability to infectious diseases. Lessons from HIV, Ebola, and Zika, are just the latest and on the centennial of the 1918/1919 influenza pandemic, many hope that we learned from such events and can help prevent future ones. Predictions trickle across many sectors – loss of healthcare worker lives, financial and economic struggle, etc. “Such a pandemic could cause a global stock market crash that obliterates the livelihoods and savings of millions of survivors. ‘A severe and prolonged global pandemic could … hit global GDP by as much as 5-10% in the first year,’ noted the authors of the Bank of America/Merrill Lynch 2015 Global Pandemics Primer report. Oxford Economics has suggested that the cost of a global pandemic, including spillover across industry sectors, could be as great as $3.5tn – an impact far greater than the magnitude of the great financial crisis of 2008.” With funding for the GHSA in peril, the question of preparedness becomes even more relevant…and pessimistic. The tricky thing about infectious disease threats is that we’re not sure where the next one will come from. We have hints and sometimes we’ll get a whiff of which way the wind is blowing before the storm hits, but ultimately, there is so much we can’t predict. Given these challenges, prevention efforts, like those of the GHSA, should be seen as even more critical. Infectious disease prevention strategies are always a good return on an investment. It’s also the unexpected that impacts disease control and surveillance efforts. Local news is one that doesn’t often come to mind when considering epidemiology and infectious disease forecasting. “Epidemiologists rely on all kinds of data to detect the spread of disease, including reports from local and state agencies and social media. But local newspapers are critical to identifying outbreaks and forecasting their trajectories. ‘We rely very heavily on local news. And I think what this will probably mean is that there are going to be pockets of the U.S. where we’re just not going to have a particularly good signal anymore,’ said Majumder, a Ph.D. candidate at the Massachusetts Institute of Technology.”

GMU Biodefense MS Open House & PhD Information Session
Looking to earn a Masters or PhD in a field that’s at the nexus of foreign policy and public health? GMU Biodefense is just the place for that. We’re hosting two information sessions for our biodefense graduate degrees – the MS Open House is next Wednesday at 6:30pm (Arlington Campus) and the next PhD Information Session is on Wednesday, April 18th at 7pm, in Arlington, VA. These are great opportunities to hear from faculty and students in each biodefense program about not only the application process, but also the classes and what it’s like to study what you love!

CDC Selects New Director
Dr. Robert R. Redfield was just announced as the new director for the CDC. Redfield will take over for interim director Dr. Ann Schuchat, who many were hoping would take post. The new director has a background in HIV and is said to be a dedicated researcher and physician. Unfortunately, Redfield also comes with a rather novel history for CDC directors – he has never worked for a public health department. “Critics also point to a resume marred with controversy. In the 1990s, Redfield was accused of falsifying data about an experimental HIV vaccine he worked on. He was eventually cleared of those charges, but the data had to be corrected.” On Tuesday, Sen. Patty Murray (Wash.) raised concerns regarding his appointment, noting that, “This pattern of ethically and morally questionable behavior leads me to seriously question whether Dr. Redfield is qualified to be the federal government’s chief advocate and spokesman for public health.”

Brazil Calls for Country-Wide Yellow Fever Vaccination
Brazil has been battling a yellow fever outbreak since 2017 and vaccine shortages have only fueled the challenges of outbreak response. “Brazil announced yesterday that all citizens should be vaccinated against yellow fever. The country is currently experiencing a spike in cases in what has shaped up to become the largest yellow fever outbreak to hit the country since the 1940s.The Associated Press (AP) reported that Ricardo Barros, Brazil’s health minister, said all 27 of Brazil’s states will be targeted in a vaccination campaign that will aim to reach 78 million people by 2019. Before the announcement, the vaccine was recommended in all but four Brazilian states.”

Importance of GHSA
GMU Biodefense PhD student Saskia Popescu wants clinicians to understand the importance of the GHSA and why US investment is critical. “Like many components of public health and infectious disease, the importance of prevention is often forgotten until an outbreak occurs. Hospital preparedness and infection prevention were not necessarily ‘big ticket’ items in the United States until we had Ebola in Dallas, Texas, but it only takes 1 laboratory incident to remind us of the importance of biosecurity and biosafety.”

Food Defense Conference
The Food Protection and Defense Institute will be hosting this conference on May 22 & 24th in Minneapolis, MN. “As the food system is becoming ever more global, companies need to be prepared to protect not only their products but also their reputation. The Food Protection and Defense Institute will be hosting a 2-day Food Defense Certification Training Course on May 21 & 22, 2018 that will teach food industry professionals how to navigate basic food defense principles, recognize vulnerabilities, and create a tailored food defense plans.”

Stories You May Have Missed:

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