Pandora Report 10.13.2017

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

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

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

Pandora Report 9.29.2017

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

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

Pandora Report 9.8.2017

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

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

Pandora Report 9.1.2017

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

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

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

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

Stanford’s New Biosecurity Initiative  

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

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

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

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

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

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

Stories You May Have Missed:

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

 

Pandora Report 8.25.2017

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

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

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

Pandora Report 8.11.2017

Norovirus may be plaguing athletes in London for the World Championships, but we’re making sure to deliver the latest biodefense news to you (germ free)! Check out these WHO courses for managing public health emergencies.

CDC Invests $200 Million For Infectious Disease Preparedness
Last week the CDC announced that it awarded more than $200 million to help prevent, detect, respond to, and control biothreats posed by emerging and re-emerging infectious diseases. The funds will go through the Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) cooperative agreement and reach all fifty state health departments and several local health agencies in large metropolitan areas. The CDC announcement noted that the “CDC and states work together to improve local surveillance, laboratory diagnostic capabilities, and outbreak response. The CDC has awarded more than $200 million through the Epidemiology and ELC cooperative agreement to help states, cities, counties, and territories prevent, detect, respond to, and control the growing threats posed by emerging and re-emerging infectious diseases. State programs are the foundation of the U.S. public health system and are integral to the nation’s efforts to combat infectious disease threats. CDC and states work together to improve local surveillance, laboratory diagnostic capabilities, and outbreak response.” This also includes $77 million to help state health departments combat antibiotic resistance in their areas. The 2017 funding enhances current Antibiotic Resistance Laboratory Network (AR Lab Network) activities by increasing testing nationwide for Candida fungal threats, strengthening national TB surveillance and infrastructure, and enhancing detection of drug-resistant gonorrhea. This surge of funds, mixed with a new strategy that combines market entry rewards with population-based payments from insurers, could help bring us ahead in the battle against the resistant bug. “The proposal, dubbed the Priority Antimicrobial Value and Entry (PAVE) award, would use limited public funds to cover the majority of revenue for the first 1 to 2 years a new antibiotic is on the market, but that revenue would be phased out over 5 years and replaced by revenue from population-based contracts with health insurers. The purpose of the PAVE award, the authors said in their recent Journal of the American Medical Association paper, is to guarantee a return-on-investment for antibiotic developers by ‘de-linking’ the revenue of new antibiotics from the volume used and to promote stewardship of those drugs, so that thy remain effective and available.”

A Short History of Biological Warfare: From Pre-History to 21st Century
Don’t miss out on the latest bioweapon gem from W. Seth Carus – a history on biological warfare! “It covers what we know about the practice of BW and briefly describes the programs that developed BW weapons based on the best available research. To the extent possible, it primarily draws on the work of historians who used primary sources, relying where possible on studies specifically focused on BW. By broadening our knowledge of BW, such studies have enabled us to write about the topic with more accuracy and detail than could have been done even a few years ago.” Carus breaks BW history into three sections – prehistory to 1900, 1900-1945, and then 1945-modern day. He focuses on the agents covered by the BWC and looks at the history of state-sponsored programs, the role of scientific advances in understanding microorganisms, use of BW in warfare, and more.

What It Means To Militarize Biotechnology
Biotechnology is a fickle beast and a frequently debated topic. While many focus on the security implications of gene-editing and other biotechnologies in the hands of nefarious actors, there has been an increasing militarization of the field. Military research and investment in biotechnology can be a bag of mixed outcomes and there has been little discussion regarding the growing military interest in it. “One such issue is the risk that military investment in biotechnology will adversely affect research priorities. Another is the possibility that military investment into defensive or public health projects by one state might be misinterpreted by other states as having offensive potential. In the same vein, the scarcity of publicly available information about military research into biotechnology might fuel public distrust of valuable and well-intended work. It is clear, for example, that research into preventing, identifying, and treating infectious diseases by various militaries around the world will continue to provide broader spin-off benefits—but publics in some states might be unsure why military rather than public health institutions lead such work.” Progress in fields like synthetic biology has brought forth almost a renaissance of research and also engagement in security discussions. Brett Edwards highlights the role of the Amerithrax attacks in bringing biology into the forefront of American terrorism worries. He notes that the synbio community has been heavily engaged in the debate of misuse and its implications for innovation and regulation. Working in the synbio field inherently carries with it a forced sensitization to these issues. Edwards emphasizes that the future should include international dialogue with researchers regarding biotechnology militarization. “This sort of dialogue might allow shared principles regarding state investment in biotechnology to be identified and articulated—principles that would both guide research priorities and establish hard limits about what is permissible. Such discussions could draw upon relevant principles in international human rights, humanitarian, and arms control law—including, but not limited to, treaties specifically dealing with biological, chemical, and environmental warfare.”

Air Travel or Bug Travel?
We’ve all been on that flight with one (or more) people who are visibly and audibly ill…and there’s nothing like that ominous feeling of “I’m definitely getting sick after this flight.” A new study investigated disease transmission on airplanes and found that things like plane size and boarding method can have some pretty profound implications for disease transmission. Sure, jamming ourselves into a metal box where it’s cold and we’re in close quarters should already be a redflag for disease transmission, but there are many more variables that impact airborne disease spread. Researchers started first with how Ebola might be transmitted on a plane. “Unfortunately for current fliers, the commonly used three-section boarding technique, where passengers board by first class, middle zone and back section, is actually the worst strategy for reducing the number of infected. The reason this works so poorly is that it forces passengers to stand together in the aisle while they all wait to get to their seats, which means more time for a tightly packed group to be exposed to the contagious passenger”. They found that changing the boarding method to a two-section, random method is much more protective. Also, the speed at which we all race off the airplane once we’re landed appears to have little impact. “For plane size, you might think the bigger the plane, the smaller your odds, right? Not quite. In fact, the study found that planes with less than 150 seats are better at reducing new infections; there are fewer susceptible people present overall, fewer people within a given person’s contact radius and less time spent moving through the plane to reach assigned seats. ‘Using smaller airplanes during an outbreak, instead of completely banning flights to a specific destination, can drastically reduce the probability of introduction of infection,’ Mubayi said.” The investigative team found that if airlines stuck to their existing boarding strategies during an ebola outbreak, there would be a 67% chance of infection rates reaching 20 air-travel-related cases per month. Regardless of plane size, if airlines modified their boarding strategies, the change for infection drops to 40%. Such work gives us great insight into strategies to help slow the rate of transmission during outbreaks through the powerful vector that is international air travel.

Computer Security and DNA Sequencing
A recent article on the implications of DNA sequencing and big data highlights investigations into the “robustness of such tools if (or when) adversarial attacks manifest”. Researchers noted that DNA synthesis can provide attackers with arbitrary remote code execution and highlight the need to look at the feasibility of such attacks. Performing their own attacks on a modified down-stream sequencing utility, they found data leakage and used such lessons to evaluate security hygiene of the more common DNA processing programs. Such work is especially prudent given that biohackers recently encoded malware in a DNA strand. University of Washington researchers revealed at the USENIX Security conference this week that it’s actually possible to encode malware into DNA strands, “so that when a gene sequencer analyzes it the resulting data becomes a program that corrupts gene-sequencing software and takes control of the underlying computer. While that attack is far from practical for any real spy or criminal, it’s one the researchers argue could become more likely over time, as DNA sequencing becomes more commonplace, powerful, and performed by third-party services on sensitive computer systems.” The researchers are calling it the “the first ‘DNA-based exploit of a computer system‘.” This new finding sounds like something out of a science fiction film, but points to the unexpected threats within DNA sequencing and data processing. Thankfully, the process was pretty unreliable and the researchers had to take some significant shortcuts, which means attacks like this may be not be in the immediate future. Nonetheless, it brings forth the need to consider the security implications of information stored within DNA.

Next Generation Global Health Security Network & the Nuclear Threat Initiative Webinar 
Don’t miss out on this webinar today, at 2pm EST regarding the Next Generation for Biosecurity in GHSA Competition! This webinar will provide an overview of eligibility and submission requirements for the NTI-sponsored biosecurity competition to develop regional and global partnerships among next generation professionals. Participants will also have an opportunity ask questions about the competition. Click here to add the event to your calendar.

Bio-Labs of the Future – The Promises & Perils of the Fourth Industrial Revolution
The Wilson Center’s Science and Technology Innovation Program takes a deep-dive into the bio-labs of the future . The rise of the biotech revolution and advances in gene-editing DNA synthesis, AI, etc. are all helping laboratories grow in connectivity and intelligence. “While this may be a boon for the development of novel vaccines and therapeutics by parties that have traditionally not had access to the necessary tools, it also opens the risk of nefarious use to engineer or edit biological agents or toxins. While there have been attempts at governance to limit the avenues by which a bad actor may gain access to the pathogens or tools to create biological weapons, the ever-increasing pace of innovation has left gaps that may be exploited.” Many are calling this time a Fourth Industrial Revolution, and with technologies like portable genomics sequencers, there is a need to examine the vulnerabilities, which includes things like growing accessibility. The Wilson Center paper highlights the need to evaluate threat, potential for exploitation of gaps, and provides policy recommendations.

Combating Biological Terrorism Roundtable Discussion
Don’t miss out on this event put on by the Inter-University Center for Terrorism Studies on Thursday, August 24th, noon-2pm at the Potomac Institute for Policy Studies (901 N Stuart Street, Suit 200, Arlington, VA 22203). Roundtable speakers include Professors Rita Colwell, S. Gerald Sandler, Rashid Chotani, and Normal Kahn. “Biological security concerns are a permanent fixture of history, ranging from Mother Nature’s infectious diseases to man-made threats. Recent epidemics, such as Ebola and Zika, and the potential dangers of biological terrorism urgently need to be addressed through international partnerships to reduce the gravest health risks at home and abroad. Experts with governmental, inter-governmental, and non-governmental experience will provide an assessment of future challenges and offer recommendations for an international comprehensive biosecurity strategies.” RSVP is required (please email icts@potomacinstitute.org).

The Future of the GHSA Matters for US Clinicians
GMU Biodefense PhD student Saskia Popescu discusses the importance of the GHSA and why it should matter to U.S. clinicians. “Fundamentally, the GHSA is a crucial component to ensuring a solid and reliable global foundation exists for responding to, detecting, and preventing public health crises. Whether you are a physician in an urgent care, a nurse in a major hospital, a public health epidemiologist, or working in national policy, the importance of the GHSA and its work is apparent and a future without it will only serve to weaken US and global health security.”

CBRN Insurance Approaches
GMU biodefense MS alum Zamawang F Almemar is looking at a new actuarial approach to a CBRN insurance policy. A WMD attack against a major city would have devastating consequences but countries often struggle with the realities of costly prevention efforts. It’s important to truly analyze the threats of national security and develop countermeasure infrastructure accordingly. Drawing parallels to homeowners insurance, “investing national resources to prevent and recover from the effects of a nuclear attack is an appropriate choice for national policymakers, but what level of protection is warranted to guard against non-state actor developed and employed chemical or biological weapons, or against a radioactive attack.” The authors looked to factors that may help determine how much should be spent on WMD “insurance” and a method for evaluation. While calculating some factors, like societal fears, are challenging, there are things to consider, like economic cost of property cost damage and recovery costs, economic and societal costs of injuries, deaths, disruption, and changes to society, etc. “Factors affecting the cost of implementing a protection action include the difficulty of taking the action, the equipment needed, and the extent of the measure being taken”. Regarding policy recommendations, the authors focus on the imminent threat from terrorist organisations, noting that “it is now of utmost importance for the new administration to prioritize cWMD efforts within the national defense strategy and to ensure there is a balance in appropriations investing in these cWMD efforts.”

A Shadow Network of Science Experts
At first glance, this sounds like an elusive club of James Bond-esque scientists. In reality, the truth gives a startling look into the White House. In effort to combat several science gaps within the new administration, there are reports that an unofficial network of Obama loyalists is working to continue the Obama science agenda. “Participants have provided counsel to Democratic lawmakers and their staffs on Capitol Hill, and they have held group-wide strategy sessions much in the same fashion as they did when they worked out of a fourth-floor wing in the Eisenhower Executive Office Building, adjacent to the White House.” “In interviews, members of the new Obama group — which numbers in the dozens — said they have remained more engaged than they expected to before Trump’s victory in November. Beyond fielding policy questions from congressional offices, they have consulted with scientific societies, and advised organizers of the March for Science, among other activists — a few have even made those organizations their new professional homes. They have also assisted in analyzing the impact of White House budget proposals — which have outlined deep cuts to federal research agencies — and the impact of policies including Trump’s decision to withdraw the United States from the Paris climate accords.”

Using Vaccines to Fight Antimicrobial Resistance
While we’re working to find new antimicrobials, reducing antibiotic use, and stopping the spread of AMR, there may be another strategy – vaccines. Many are pointing to the prevention of disease via vaccines as a means of countering infections in the first place, which are frequently misdiagnosed and treated with unnecessary antibiotics. Consider pneumococcal conjugate or influenza vaccines. “A study published in the Lancet led by Ramanan Laxminarayan of the Center for Disease Dynamics, Economics, and Policy found that if every child under 5 years old in the 75 countries studied received pneumococcal conjugate vaccines, the resulting reduction of pneumonia would avert 11.4 million days of antibiotic use each year.” Vaccines can be an effective tool in reducing illness and these infections often lead to not only the missuse of antibiotics, but also hospitalizations that often result in exposure to resistant organisms. We know the benefits of vaccines against specific viral infections however, perhaps it’s time we start adding them to the arsenal against antibiotic resistance? Overcoming AMR will not be a result of a singular effort, but rather a mosaic of combined practices and changes as diverse as the reasons resistance occurred in the first place.

A Silent Anthrax Outbreak Within The Chimpanzee Population
Researchers in the Tai forest within the Ivory Coast are working to find out why chimpanzees are dying from anthrax. The anthrax strain, a new form of Bacillus cereus, known as Bcbva, has been responsible for 38% of local wildlife deaths in the forest. Anthrax in the rainforest environment is unique and this outbreak is challenging the ways we traditionally think about such infections. “In the savannah, anthrax almost always infects hoofed grazing mammals, which ingest soil laced with bacterial spores. Although it can spill over into humans, until 2001, there was no record of it afflicting wild primates. Now, we know that the Taï strain hits chimpanzees, as well as other unusual hosts like mongooses and porcupines. It even affects monkeys that spend all their time in the treetops, far away from contaminated soil. ‘We don’t know how they get infected,’ says researcher Fabian Leendertz. ‘How do the spores make it up in the trees?’” Fortunately, Bcbva isn’t active in other parts of Africa. Chimpanzees, like many great apes in this region are already fighting off disease like Ebola, so this new surge of an unsual disease is worrying researchers.

Stories You May Have Missed:

  • Hot Topics In Biodefense –  What would you consider the hottest topics? GMU’s Biodefense program has students just as diverse as the topics we face in global health security, which makes the classroom discussions pretty fantastic. One of our PhD students recently sat down and wrote about the biggest issues we face in biodefense and why this field is so crucial – check it out here.
  • Graphic Design – A New Public Health Tool?– A new exhibit at London’s Welcome Collection is drawing attention to the role of graphic design during outbreaks and epidemics. The designs range from ambulances, hospital interiors, posters, cigarette packaging, and street art. “Rebecca Wright, who has co-organised the show with graphic designer Lucienne Roberts, says that exhibits in a section about contagion are especially dramatic. An Italian ‘plague notice’ from 1681 ‘uses bold typography to give authority in time of panic,’ she says, adding that it is a beautiful object. Graphic design responding to the early spread of HIV/Aids is included, such the historic and controversial, ‘Don’t Die of Ignorance’ campaign launched by the British government in 1986. ‘It was the first time every household in the UK received a health leaflet, Wright says.”
  • China & the U.S. Battle for Biotech – Check out this latest article on FBI Supervisory Special Agent, biosecurity guru, and GMU summer workshop instructor, Ed You on the U.S.-China dispute over genetic data and its implications for biotechnology. FYI – You’ll need access to the Financial Times.

Pandora Report 8.4.2017

We all know that kitchen sponges are like little densely populated germ cities, but did you know that cleaning them could make it worse?

Only Six Nations Have Evaluated Pandemic Readiness
A new report from the World Bank is calling out how little work has been done to evaluate and prepare for pandemic readiness. The report notes that only six countries have evaluated their capacity and capabilities for responding to a pandemic. Of these countries, three are wealthy (Finland, Saudi Arabia, and the U.S.) and are were poor (Eritrea, Pakistan, and Tanzania). All six countries had gone under external evaluations and developed funding plans to rectify their inadequacies. “The annual number of disease outbreaks around the globe has more than tripled since 1980, and air travel spreads contagions across oceans far more often. To convince countries that preparedness pays, the report included estimates of the economic damage various epidemics had done. For example, the viral pneumonia SARS — which ultimately killed only 774 people — shrank China’s gross domestic product by 0.5 percent in 2003.” We’re seeing an increasing emphasis on the financial aspect of pandemics and as this report points out, knowledge is power. The report includes an entire section on incentivizing countries to prioritize allocation of funds to preparedness, assessment of economic vulnerability, sovereign credit rating, etc. It was interesting to see that antimicrobial resistance was not considered a pandemic. What would happen if a fully resistant bacteria swept the world?

We Don’t Need Another Biodefense Strategy
Al Mauroni is taking a deep dive into the history of American biodefense strategies and why Thomas Bossert’s recent comments about a new one aren’t exactly promising. White House homeland security advisor Bossert announced this during a security forum in Aspen, noting that until the development of a new plan, the U.S. lacked a comprehensive biodefense strategy. When this was announced there was a collective “um….about that..” from many within the biodefense community. Mauroni points to the three recent biodefense strategies within the last fifteen years, highlighting what we’re all thinking – this won’t be the first comprehensive strategy. First, there was the Homeland Security Presidential Directive 10 in 2005, then the National Strategy for Countering Biological Threats (Presidential Policy Directive 2) in 2009, and most recently, the National Strategy for Biosurveillance in 2012. So, if we’ve had strategies for the better part of two decades, why is there a demand for a new one? Increased outbreaks and concern for biothreats have many calling for further funding of biodefense efforts, like that of the Blue Ribbon Study Panel on Biodefense. Funding is one thing though, but a whole new strategy? “A recent article on the ‘proliferation’ of national strategies suggests that strategic guidance only adds to the confusion, allowing executive agencies to pick and choose what they want to implement.” Mauroni notes that “Going back to Bossert’s statement at the Aspen Security Forum, he referenced the 2001 anthrax-filled letters, pandemic influenza outbreaks, genetic engineering research, and the Global Health Security Agenda. He didn’t reference the protection of US military forces against adversarial use of biological warfare agents. All of these fall under the area of ‘biodefense,’ and there is no one agency that comprehensively addresses all of these threats. Because US government funding, authorities, and capabilities for biodefense reside in different agencies, it is very difficult to articulate objectives and responsibilities in one single strategy. There is no single point of authority to execute the strategy, and very often, no incentive to change given an inability to redirect resources or authorities”. Biodefense is a unique term though as it is often considered in a singular context and while the DoD plays a significant role in countering biological threats, there are other players. Biosafety and biosecurity is a large component, which rests heavily on both the private and public sectors. The DHHS leads in times of public health concerns (even if some of these efforts are duplicated by the DoD) and we can’t forget the role of public health surveillance and health security efforts like that of the GHSA. Mauroni leaves us with several points – “there cannot be one national biodefense strategy because there are at least three distinct policy areas that, while overlapping, are significantly different in execution of their policy objectives.” He notes that “I am not optimistic that the US government will consider a more diverse and complex policy process that articulates these differences. Having one national biodefense strategy offers a façade of simplicity and organization that three separate strategies will not.”

Opening Statements for ASPR Nominee
The nomination hearing for Dr. Robert Kadlec as Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health and Human Services began on August 1st. You can check out the transcript here, in which Kadlec highlights five priority issues he wishes to pursue if confirmed. His priorities include providing stable leadership and clear policy direction, creating a “national contingency health care” system, supporting the sustainment of robust and reliable public health security capabilities, re-invorgorating and advancing an innovative MCM enterprise, and working to reauthorize the Pandemic and All-Hazards Preparedness Act in 2018. You can watch the nomination hearings here. Reports are pointing to his likely confirmation as his nomination “lacks controversy“.

European Report on Drug Resistance
Is the food we eat helping antimicrobial resistance take over? A new joint report from several European public health agencies notes that “To contain antibiotic resistance we need to fight on three fronts at the same time: human, animal and the environment. This is exactly what we are trying to achieve in the EU and globally with our recently launched EU Action Plan on antimicrobial resistance. This new report confirms the link between antibiotic consumption and antibiotic resistance in both humans and food-producing animals.” The impact of consuming antimicrobial agents is increasingly becoming an area of concern. While there are many factors that contribute to the rise of antimicrobial resistance, it’s not surprising that antibiotic use in food-producing animals would become a topic of interest. “Although consumption is defined differently in humans and animals, to make the comparison as consistent as possible, the report expresses consumption in milligrams of active substance per kilogram of estimated biomass (mg/kg). Human antimicrobial consumption is typically reported as defined daily doses per 1,000 inhabitants. Overall, the report found that average antimicrobial consumption was higher in food-producing animals than in humans, although the difference was largely influenced by a handful of countries with significant animal populations.” Analysis points to a relationship between consumption and antimicrobial resistance (seen in isolates in certain species of bacteria). This latest report underscores the complexity of antimicrobial resistance and the challenges in truly addressing this hydra-like problem. Perhaps we are what we eat?

Australian Raid Finds Chemical Weapon Attempts
The Sydney police raids across four properties, which resulted in four arrests, found components for improvised explosive devices (IEDs) and construction on an “improvised chemical dispersion device”. Two men were ultimately charged with building the military-grade device and were reportedly supported by ISIS operatives but their attack plans were foiled. “Police will allege that components for an improvised explosive device (IED) were sent to Australia in air cargo from Turkey via Isis operatives in Syria. Two men, who remained in custody after facing court on Friday, then allegedly assembled the devices with instruction from ‘a senior Isis operative’, according to the Australian federal police deputy commissioner Mike Phelan.” In response to the attempt, intelligence and law enforcement agencies are working to improve screening. Fortunately, the chemical weapon was in the early stages of development.

Biothreat Worries Over Cancer Research
At last week’s DEF CON hacking conference in Las Vegas, Intel’s chief medical officer John Sotos brought forth a somewhat surprising topic – bioweapons. Building on his discussion of the cancer moonshot, Sotos discussed the same technology (DNA manipulation) having the potential for misuse and development into biological weapons. “’The reason you haven’t heard much about bioweapons is that they’ve been held back by a pretty severe limitation, which is the potential for blowback’,” Sotos said. It is hard for any attacker to use weaponised diseases because they spread beyond their initial distribution range: destroy your neighbouring nation and you destroy your own as well. Sotos noted, ‘the cancer moonshot is going to really drive new technologies to manipulate DNA because cancer is a disease of DNA. [And] the same exquisite targeting that allows it to attack only your cancer cells also overcomes the blowback potential for bioweapons’.” While this level of precision medicine isn’t available yet, it draws parallels to gene-editing tools like CRISPR, in which targeted application is becoming more real. Soto hones in on the fear that such genetic engineering capabilities will not only be possible, but used for nefarious purposes like stealing genetic codes or rewriting DNA to tamper with fertility. Soto’s points are valid and it is important to consider the full spectrum of use for biotech developments in the future however, we must not lose sight of the consistent and growing threat that is natural disease.

Stories You May Have Missed:

  • Saliva Secretions & Zika Transmission – A recent study found that rhesus monkeys, when infected with high levels of the virus, could theoretically transmit via saliva. When compared to rhesus monkeys with more common viral loads, it was possible, although extremely unlikely, that the highly infected monkey could spread via saliva “All three monkeys who were exposed to high doses of Zika virus (20-fold higher than that typically found in saliva) applied directly on their tonsils developed the disease. Another group of 7 monkeys were exposed to the virus via the saliva of monkeys who had received subcutaneous infections, representing a typical virus count. None of the monkeys exposed to doses typically found in saliva contracted the disease when their tonsils (5 animals), conjunctivae (1), or nasal passages (1) were exposed. ‘We tried to simulate sneezing, sharing utensils, and other mucosal exposures,’ said Friedrich. ‘But the amount of virus typically founding saliva was not enough to infect a monkey or suggest any seroconversion [development of detectable antibodies]’.”
  • Biodefense World Summit Coverage – Get the latest overview of the Biodefense World Summit here, with a focus on biosurveillance! Topics range from DHS work to enhancing situational awareness for global disease surveillance.

Pandora Report 7.21

Beat the heat and cool down with your weekly report on all things biodefense! Have you ever wondered how researchers become bug-chasers? Check out this story on what turned a wildlife biologist into a plague-chaser in the Southwest.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
Thanks to our amazing faculty and attendees for a successful (and fun) summer workshop this week. We heard from Ed You on safeguarding the bio economy, Dave Franz explained the dual-use dilemma in life sciences, Sonia Ben Ouagrham-Gormley discussed barriers to bioweapons, Andy Kilianski explained the ins and outs of biosurveillance, Kendall Hoyt discussed the role of innovation and MCM, Sandy Weiner highlighted the social and cultural disease amplifiers, and so much more! Did I mention that Greg Koblentz brought the house down by discussing why biosecurity is a wicked problem? You can check out the Twitter stream here to see some amazing photos and dialogue during the three-day event. Participants from all over the globe, with backgrounds in everything from infectious diseases to defense and academia, participated in talks that truly ranged from anthrax to Zika, with pit stops on influenza and Ebola. With the 1918/1919 pan-flu centennial anniversary next year, we’re already starting to put together a great workshop for the summer of 2018, so keep on the look-out for more info in the future.

The Future of the GHSA and American Biodefense
Next week in Seoul, a meeting will be held for the Steering Group of the Global Health Security Agenda (GHSA) to discuss what exactly the future entails for the group. While its five-year run will expire in 2019, many are pushing for the GHSA to be extended as it is a highly valuable piece to global health security and IHR compliance. “Recognizing that the GHSA’s work has never been more vital and would be impossible to replace, more than 100 health and health security organizations and companies operating in over 150 countries, including the Nuclear Threat Initiative (NTI), this week banded together to urge GHSA’s extension for at least another five years.” The NTI signed on for several reasons – the world is still not prepared to handle a pandemic of a lethal/easily transmittable disease and frankly, the GHSA provides measurement, accountability, and transparency, which are all desperately needed in global health security efforts. The NTI recently released a statement regarding their support for extending the GHSA beyond 2019, highlighting its irreplaceability and proven ability to help measure and support change in countries working to strengthen their prevention and response to biothreats. Next week’s meeting with be the first since President Trump took office, which makes its outcome that much more important. NTI cites several GHSA successes in efforts to highlight the desperate need we have for it – commitment of more than 75 countries, developing and implementing the first agreed set of global metrics for national health security, mobilizing the private sector to engage in pandemic preparedness and response, etc. Discussions regarding the future of the GHSA comes at a poignant time as the House Appropriations Subcommittee approved FY 2018 State and Foreign Operations (SFOPs) and Health and Human Services (HHS) Appropriations Bills. The approval supports efforts to maintain global health funding. The bill includes funding for the State Department and USAID through the Global Health Program (the bulk of global health assistance) and despite President Trump’s FY2018 request (which would have cut it by $1.8 billion, or 28%), it’s providing $3.8 billion, which is roughly 5% less than FY 2017. Also within the bill – “funding provided to CDC for global health matched the FY 2017 enacted level ($435.1 million) and was $85.1 million (24%) above the President’s FY 2018 request. Funding for the Fogarty International Center (FIC) at the National Institutes of Health (NIH) totaled $73.4 million, a slight increase above the FY 2017 enacted levels ($72.5 million); FIC was eliminated in the FY18 Request.” Despite the cuts that are suggested in his proposed FY 2018 request, the Trump administration is reportedly developing the first comprehensive strategy on biosecurity. A top White House homeland security official reportedly said that such efforts are underway and involve retired Admiral Tim Ziemer. “We have not had as a country a comprehensive bio-defense strategy ever,” White House homeland security adviser Thomas Bossert told the annual Aspen Security Forum, in Aspen, Colorado. “It’s high time we had a bio-defense strategy.” While Bossert points to the need for a biodefense strategy, it is crucial to remember that the U.S. has already gone through two biodefense strategies – the 2004 Homeland Security Presidential Directive 10 (Biodefense for the 21st Century) and 2009’s National Strategy for Countering Biological Threats. This news comes on the heals of Trump’s nominee for a key biosecurity position. Guy B. Roberts of Virginia was just nominated to be an Assistant Security, Nuclear, Chemical, and Biological Defense Programs within the DoD. “Mr. Roberts is currently president of GBR Consulting, a national security consulting firm. In that capacity, Mr. Roberts has provided subject matter expertise on arms control, non-proliferation, international legal issues and strategies to combat terrorism to over 30 international and domestic organizations and institutions. In addition, he is a senior associate with the Center for Strategic and International Studies and an adjunct professor teaching courses on homeland security, international terrorism, non-proliferation, and arms control at Mary Washington University and Virginia Commonwealth University. Mr. Roberts previously served as the Deputy Assistant Secretary General for Weapons of Mass Destruction Policy and Director of Nuclear Policy for the North Atlantic Treaty Organization.” You can catch some of his talks via C-SPAN here, and while there’s not a lot on his work in biodefense, you can read this paper within the USAF Institute for National Security Studies, entitled, “Arms Control Without Arms Control: The Failure of the Biological Weapons Convention Protocol and a New Paradigm for Fighting the Threat of Biological Weapons“. His paper notes that despite the 2001 U.S. rejection of the BWC protocol for more stringent compliance mechanisms, there was still substantial focus on biological weapons and potential threats (especially after the 2001 Anthrax attacks). Roberts notes that “The time for ‘better-than-nothing’ proposals is over. A united world, acting in concert across a broad front of areas utilizing the full panoply of financial, diplomatic, economic, and military resources at our disposal, with the firm determination to rid the world of these weapons of terror, is our best hope for success.” In all, with talks next week on the GHSA, presidential hopes of cutting health funding, and a supposed biosecurity plan in the works, the future of health security is seemingly in the air.

The Case of the Reconstituted Horsepox and Other Dual-Use Adventures 
Last week we, like so many others, were engrossed in the news that a Canadian research team had reconstituted horespox with $100,000 worth of supplies and mail-ordered DNA. The news of this unpublished study has raised a lot of red flags for those in the dual-use research community, as well as the debate on the remaining smallpox stockpiles. What’s most concerning about the project, led by virologist David Evans as the University of Alberta, is that it wasn’t stopped earlier on for DURC concerns and risk reviews. Gregory Koblentz, biodefense guru and director of the GMU graduate program, “says the work should never have been done. His worry isn’t so much that terrorists will cook up smallpox anytime soon. ‘My concern is that we have opened up the door to the idea that it is perfectly acceptable to synthesize [such] viruses without any oversight,’ Koblenz says. And if the necessary technology and expertise spread, it will become “that much easier at some point for those capabilities to be turned from peaceful uses to hostile uses’.” This project and the resulting discussions will surely play a pivotal role in the future of DURC and oversight, so we’ll make sure to keep you updated!

North Korea’s Bioweapons Program
GMU Biodefense professor Sonia Ben Ouagrham-Gormley is taking a deep dive into the realities of North Korea’s potential bioweapons program. Working backwards from the 2015 photo tour with Kim Jun-un at a pesticide facility that certainly had dual-use potential and was a seemingly obvious attempt to send a message to the U.S.,  Ouagrham-Gormley highlights the sordid history that is North Korean bioweapons. While South Korea has repeatedly claimed North Korean maintains an active program, there have been inconsistent reports elsewhere and Ouagrham-Gormley hones in on realities about this well-publicized dual-use equipment and facility. She notes critical aspects that would be missing from an active bioweapons program (even if you have all the shiny equipment), like consistent electricity, economic stability, and an effective laboratory/research management. While there are gaps in intelligence regarding the conditions that would truly facilitate an active (and successful) bioweapons program, “analyses of past state and terrorist bioweapons programs indicate that the continuity and stability of scientific and production work must be ensured over a long period of time to allow scientists and technicians to accumulate the knowledge necessary for development of a working bioweapon.” While many suspect that a North Korean bioweapons program was launched in the 1960s and then new infrastructure was built in the 1970s, there are a lot of questions regarding the continuity of such efforts. Were there breaks in between? Changing research teams and inconsistent management/organization all severely impact the efficacy of such secretive work. Perhaps one of Ouagrham-Gormley’s most critical points (and why you should check out her book, Barriers to Bioweapons), is that to truly assess the alleged bioweapons program, one has to understand the state of natural and medical science in North Korea. “Without a solid foundation in natural and medical sciences, a bioweapons program cannot succeed. When Soviet authorities issued a decree to expand the country’s bioweapons program in the early 1970s, they had to face the reality that Soviet science had fallen behind and needed modernization. Years of Stalin’s purges, along with the policy of Lysenkoism—which negated the role of genetics in science—had resulted in the elimination of a whole generation of competent scientists. Decades of economic sanctions, and the desperate state of North Korea’s economy and society, have undoubtedly had an effect on the scientific sector.” With these notions, Ouagrham-Gormley questions if the North Korean bioweapons program is more of a Potemkin village. While there is limited information on the organized scientific research in North Korea or real potential for such a program to exist, more information is needed, which would be a great task for a BWC verification regime.

Center for Biosecurity ELBI Research and Policy Symposium 
This week the Johns Hopkins Center for Health Security held their first research symposium for the Emerging Leaders in Biosecurity Initiative (ELBI). The current ELBI class and several alumni presented on research and projects they’re working on. The topics ranged from dual-use research to risk assessments, biosecurity, and more. During this time they also toured the Johns Hopkins Medical Center’s Biocontainment Unit. Two GMU biodefense students attended – Francisco Cruz (MS alumni and ELBI class of 2016) and Saskia Popescu (PhD student and ELBI class of 2017), who presented on the role of infection prevention in biodefense efforts.

Tackling the Next Epidemic With Big Technology
In an age of globalization and increasing spillover, the threat of naturally occurring outbreaks spreading from one corner of the globe to the other is a real fear. Fortunately, we also live in a time of great technological advances and a wealth of data. A recent article from B.Next highlights the availability of data technologies and how such big data can be woven into the fabric of public health prevention and intervention. Outbreaks and pandemics threaten global security and perhaps one of the biggest hurdles is matching the data needs with the limited supplies on the ground. Data gaps and lags are a massive problem when responding to an outbreak, especially in terms of specialized personnel and resource constraints. There are several technologies though, that could be applied to response efforts – novel data or means of collection, crowdsourcing methods, data cleansing, analytics, and visualization. “Improving response times for activities that have proven to be effective (i.e, non-pharamceutical interventions) need to be prioritized. The full potential of surveillance and advanced analytics for improving outbreak management has not yet been realized and, unfortunately, is not yet adequate to the task. We need a fundamental reconsideration of how to use combinations of data technologies for effective response management. Accomplishing this reconsideration and implementing it effectively will allow for faster, better, stronger responses. Past outbreaks have threatened national security, but they do not need to be as significant a threat in the future. Current and emerging data technologies can help tackle the next epidemic.”

Stories You May Have Missed:

  • USDA Test Finds Atypical BSE In Alabama Cow – A recent announcement from the USDA reported the finding of atypical bovine spongiform encephalopathy (BSE) in an 11-year-old cow in Alabama. This would be the 5th case in the U.S. since 2012 and the cow did in fact have symptoms of the disease, which was picked up by routine surveillance. “The animal never entered the slaughtering process and has not posed a threat to the food supply or to human health. The Alabama Department of Agriculture and Industries (ADAI) said in a press release yesterday that cow died after it was delivered to the livestock market and that routine tissue samples were taken and sent for testing. Tony Frazier, DVM, Alabama’s state veterinarian, said ‘This instance proves to us that our on-going surveillance program is working effectively’.”
  • Three Antibiotics Discovery Projects You Should Know About: With the threat of antimicrobial resistance only growing bigger, BARDA, CARB-X, and big pharma are bringing out the big guns with the Superbugs & Superdrugs USA this November. “Understanding the translational link between animals and humans; navigating the pitfalls of early drug discovery; and evaluating the potential of immunotherapies will be a major focus, as will hearing from a selection of biotech and pharma companies currently undertaking clinical research. This will include case studies from Pfizer, MedImmune, Merck, Visterra and ContraFect. Event highlights will include a keynote presentation by Tim Opperman, Senior Research Scientist from Microbiotix. The talk will discuss advances in the three-prong approach taken by Microbiotix to address the problem of MDR Gram-negative pathogens. It is claimed that all three discovery projects have demonstrated efficacy in murine models of infection.”
  • Stanford Hospital – A Canary In A Coal Mine: Stanford Healthcare is coming under increasing public scrutiny as a battle between members of an affiliated union have highlighted hospital infection rates as evidence for unsafe working conditions and patient safety. GMU biodefense PhD student Saskia Popescu takes a deeper dive into this situation and what it really means for healthcare infections and patient safety. “The healthcare industry is always in a battle against cutting costs, keeping patients safe, and maintaining high patient satisfaction; all while following federal regulations and requirements. Despite the alarmist nature that comes across in the media coverage on the Stanford case, we need to realize that this is only a glimpse through the window that is healthcare infection control and the struggle to follow best practices while working in an increasingly stressful environment. In this case, Stanford Health Care is the canary in the coal mine, alerting us that there’s a problem. They just happened to get the media scrutiny that comes with being pulled into a union debate involving the safety of employees.”

Pandora Report 7.14.2017

Welcome to your weekly dose of all things biodefense! We’ve got a lot of global health security goodies for you this week, so grab a coffee and let’s get our biodefense on!

Canadian Researchers Reconstitute Horsepox With Online DNA Order
Friday was an exciting day in the world of dual-use research of concern (DURC) and biosecurity efforts. News of a Canadian research team and their successful experiment in reconstituting horsepox, brought to light several concerns and gaps within DURC oversight. Led by virologist David Evans, the team was able to synthesize horsepox, a relative of smallpox, which is no longer found in nature. What is really concerning so many about this experiment is that Evans and his team were able to do this with little specialized knowledge, $100,000, and using mail-order DNA fragments. While the study hasn’t been published, it is drawing a lot of attention, not only for the potential that such a process could be applied to smallpox, but also that it failed to trigger more reviews at an institutional level for DURC risks. While the U.S. DURC oversight only applies to federally funded research with fifteen select agents, the Canadian processes cover such research that could disseminate knowledge, regardless of what organism is being used. GMU’s Dr. Gregory Koblentz spoke to Science and discussed DURC oversight, noting, “That should have captured the horsepox synthesis,”. “But as far as I understand, they did not engage in a systematic review of the broader dual-use implications of synthesizing an orthopox virus,” says Koblentz. “I don’t think this experiment should have been done.” Researchers and biosecurity experts around the world are weighing in on this study, especially since its publication is immiment. Tom Inglesby of the Center for Health Security pointed to three serious questions and concerns that this work raises – whether experimental work should be performed for the purpose of demonstrating that a dangerous or destructive  outcome could be created by using biology, how much new detail will be provided in the forthcoming publication regarding the processes for constructing an orthopox virus, and the international biosecurity and biosafety implications regarding the approval process for such experimental work. Perhaps one of the most startling aspects of all the commentary and reports on the horsepox experiment has been Evans own opinion on it all – “Have I increased the risk by showing how to do this? I don’t know,” he says. “Maybe yes. But the reality is that the risk was always there.” Where ever you might stand on the topic of dual-use research, bioethicist Nicholas Evans of the University of Massachusetts (of no relation to David Evans), said it best regarding this debated experiment – “an important milestone, a proof of concept of what can be done with viral synthesis. Aside from the oversight and life science research questions that this experiment brings to light, it also stirs the embers of the fiery debate regarding the destruction of the remaining smallpox stockpiles. The most recent blue ribbon panel review regarding the 2014 NIH variola incident sheds some light on the biosecurity and biosafety challenges of maintaining the stockpiles. You can check out the report of the Blue Ribbon Panel to Review the 2014 Smallpox Virus Incident on the NIH Campus  here. The report goes through the event itself, as well as their findings on the incident, response to the incident, and policy changes. Some of the contributing factors they identified included lack of responsibility for infectious materials in shared space, failure to find all variola samples in the 1980s, lack of complete and regular inventory of potentially hazardous biological materials, lack of policy for abandoned materials, history of NIH lapses following implementation of the Select Agent Regulations, etc.

Summer Workshop – Last Chance to Register!
Our Summer Workshop on Pandemics, Bioterrorism, and Global Health Security starts on Monday, July 17th, which means you still have time to register! Don’t miss out on this wonderful opportunity to discuss everything from Ebola to the concerns surrounding the horsepox dual-use dilemma. This three-day workshop will feature experts across the field of biodefense and will provide participants with a wonderful opportunity for networking and brainstorming!

The Pentagon Weighs the Threat of Synthetic Bioweapons 
While the topic of synbio and DURC is still fresh in our minds, how is the Pentagon considering gene-editing as a potential threat? Sure, we prepare for natural outbreaks and acts of bioterrorism, but how does CRISPR come into the mix? “Pentagon planners are starting to wonder what happens if the next deadly flu bug or hemorrhagic fever doesn’t come from a mosquito-infested jungle or bat-crowded cave. With new gene editing tools like Crispr-Cas9, state enemies could, theoretically, create unique organisms by mixing-and-matching bits of genetic information.” In response to these questions and potential scenarios, deputy assistant secretary of defense for chemical and biological defense, Christian Hassell, is working to get some answers. Hassell and other Pentagon colleages funded a year-long review by the National Academies of Sciences to evaluate the health security threats of synbio. While the review is still going on, a preliminary report is undergoing “classified review” before it can be publicly released. This review will be vital to consider the future of gain-of-function research and other dual-use research of concern in the context of biodefense. “Scientists at the meeting expressed a range of ideas about how the military could best defend against biological threats. Sriram Kosuri runs a synthetic biology lab at UCLA that has developed libraries of DNA sequences that can be developed into new kinds of organisms. While he understands the possibility of a lab-engineered threat, he believes the Pentagon and federal health officials should focus on responding to emerging public health menaces rather than monitoring academic labs that use genetic manipulation tools. ‘There’s a legitimate threat of emerging viruses and we need to be prepared for those things,’ Kosuri said during a break in the meeting. ‘The tiny threat of engineered viruses is miniscule compared to that’.” The challenging part in all of this is that there’s no precedent – this is a new field of threat and risk analysis where historical examples are lacking. Hypothetical situations and response scenarios are the best we can offer, but some of the most valuable tools are the ones we already have, like surveillance or early-stage review processes.

Trump Appoints A Key Bioterrorism Position But Still Leaves Dozens Open
Biological threats aren’t just acts of bioterrorism, but also natural outbreaks or laboratory accidents. If the latest horsepox experiment hasn’t convinced you already, we live in a time of quite unique and diverse biothreats. The spectrum of threats requires an array of agencies and personnel with the skills and resources to prevent and respond to such an event. Unfortunately, we’re currently at a national disadvantage in terms of biodefense. If we look at just one small facet of biothreats (bioterrorism), the U.S. has twenty-six (now twenty-five with the nomination of Kadlec) major and vital roles that are vacant and have not been filled by the Trump administration. While some are awaiting confirmation, there are vacancies without even a nominee like the White House position of Director, Office of Science and Technology Policy. The Department of Health and Human Services is missing a surgeon general and assistant secretary for health (awaiting confirmation), while the U.S. Agency For International Development lacks a nominee for the assistant administrator for global health. There are just a few of the vital positions we rely upon for preventing and responding to acts of bioterrorism. In the wider context of all biological threats, it may not seem like much, but the truth is that these vacancies leave the U.S. in a dangerously vulnerable position. Fortunately, President Trump announced on Monday his plans to nominate Robert P. Kadlec of New York to be the Assistant Secretary of Health and Human Services for Preparedness and Response. “Currently, Dr. Kadlec is the Deputy Staff Director for the Senate Select Committee on Intelligence. Previously, he served as a Special Assistant to the President for Biodefense Policy for President George W. Bush. Dr. Kadlec holds a B.S. from the U.S. Air Force Academy; a M.D. from the Uniformed Services University of the Health Sciences, and a M.A. in National Security Studies, Georgetown University.” He was also the Director for the Biodefense Preparedness on the Homeland Security Council and aided in drafting the Pandemic and All-Hazard Preparedness Act, as well as conducting the biodefense end-to-end assessment (culminating in the National Biodefense Policy for the 21st Century). You can even watch Dr. Kadlec speak on C-SPAN at the Bipartisan Policy Center & Kansas State University forum on biodefense in October of 2016. Dr. Kadlec also directed the Blue Ribbon Study Panel on Biodefense during their efforts to establish guidance during critical biothreats.

Public Health Preparedness and Response National Snapshot 2017
The CDC just released their 2017 snapshot regarding U.S. public health preparedness and response, noting that “this year has shown us, once again, that we can’t predict the next disaster. But it has also shown us clearly how being prepared protects health and saves lives. Emergencies can devastate a single area, as we saw with Hurricane Matthew, or span the globe, like Zika virus. Disasters from 9/11 to Ebola have demonstrated that we absolutely must have people, strategies, and resources in place before an emergency happens.” Within the snapshot, there are four main sections- Prepare, Respond, Connect, and Looking Forward. Within these sections, you can look at Zika, laboratories as the front lines of America’s health, global training programs, delivering results through partnership, etc. I found the section on Health Security: How Is The U.S. Doing, quite interesting. They note that “as part of the Global Health Security Agenda, teams of international experts travel to countries to report on how well public health systems are working to prevent, detect, and respond to outbreaks. This process is known as the Joint External Evaluation.” The CDC and Office of the Assistant Secretary for Preparedness and Response (ASPR) work together to establish evaluators , etc. Thankfully, this position is in the process of being filled so that these efforts can move forward. While this snapshot captures the range of issues that must be covered in public health preparedness, it also draws attention to how vital the roles in each agency are, which makes the vacancies that much more impacting.

Summary of Key Recommendations – Meeting to Solicit Stakeholder Input on Forthcoming 2017 National Biodefense Strategy
The Johns Hopkins Center for Health Security, supported by the Open Philanthropy Project, recently held a meeting to discuss and consider the landscape of biological threats to the United States and what response measures, programs, and policies are in place, etc. Featuring members from across academia, industry, and government, these subject matter experts weighed in on this honest and frank discussion about U.S. biodefense strengths and weaknesses. There were several recommendations and topics that were discussed but some of the highlights include improving biosurveillance capabilities and laboratory network, performing risk assessments and characterizing threats, strengthening emergency response capabilities including decontamination efforts, prevention-related efforts, building global capacities for bio-threat preparedness and response, etc. They noted several components to improving U.S. biodefense – “internationally, laboratory and surveillance systems for early detection of new outbreaks will be most effective when they serve the needs of countries where they are housed. It will not work for the US to create systems to gather and export data that the US needs from countries if those countries do not get the information themselves and find it to be valuable.” In regards to healthcare system response and strengthening the workforce, the group pointed out that “national and international preparedness for biological threats requires a strong workforce, including public health experts and animal and plant disease scientists. To some degree, success at controlling infectious diseases in the US may have inadvertently resulted in workforce attrition in these fields. Federal support for developing the workforce in these fields is important”.

Strategies for Effective Biological Detection Systems: A Workshop
Don’t miss this workshop put on by the National Academies of Sciences on Monday, September 18th – Tuesday, September 19th. “The National Academies of Sciences, Engineering, and Medicine will host a two-day public workshop on strategies for effectively updating biological detection systems. The workshop will explore alternative effective systems that would meet requirements for the Department of Homeland Security’s BioWatch Program as a biological detection system for aerosolized agents. There will be a focus on systems or strategies that could be deployed by 2027, and enable indoor surveillance and dual-use with day-to-day environmental surveillance that would be of value to the public health and medical communities. There will also be a focus on the integration of improvements and new technologies into the existing biological detection architecture.”

MRSA Screening – Healthcare Prevention Methods for Resistant Germs & Swabbing Our Way To A Solution for Antibiotic Resistance
Antibiotic resistance is a growing global issue and one of the hotspots for transmission of resistant germs is in hospitals. Given that MRSA (Methicillin-resistant Staphylococcus aureus) is now a common bacteria in the community and healthcare world, hospitals are working to screen patients to ensure those with MRSA are isolated appropriately and they can stop the spread of infection. GMU biodefense PhD student and infection preventionist Saskia Popescu looks at MRSA screening practices within hospital intensive care units (ICUs) and the cost analysis that can make or break a program. Most hospitals utilize one of two approaches – preemptive universal precautions (isolate all ICU patients until microbiology labs can prove they are negative for MRSA) or targeted isolation (wait until labs come back and then isolate). Each tactic has benefits and weaknesses. Delays in isolation can translate to further spread of MRSA, while longer periods in isolation mean additional costs associated with isolation. A recent study evaluated these very two strategies and the “researchers found that the total cost of preemptive isolation ‘was minimized when a PCR screen was used ($82.51 per patient). Costs were $207.60 more per patient when a conventional culture was used due to the longer turnaround time.’ For ICUs that used targeted isolation, the researchers found that costs would be lowest when chromogenic agar 24-testing was used and not PCR.” What this study highlights is that there is inherently no best practice and that depending on laboratory capability, hospitals may have to plan their MRSA screening and isolation protocols off their microbiology department and cost centers. While hospitals are working to screen patients as a means of responding to microbial resistance, researchers are working against the clock to find solutions. Dr. Adam Roberts is one such innovative microbiologist in the UK who is using an old-school approach to respond to a new problem. Popescu was able to interview him regarding his Swab and Send program, which utilizes citizen scientists from around the world to collect samples that may help produce new antimicrobials from the environment. Roberts is working to utilize environmental samples that hold microorganisms which produce compounds that can help build new antibiotics. “The initiative also helps create a microbial database. For £30, Dr. Roberts’ team will send anyone a handful of sample tubes, a mailing envelope, and directions for what to swab (for example: a nutritious area bacteria would likely grow, likely something unsanitary). After you send back your swabs, you can check out Swab and Send’s Facebook page and see what microbes grew from the samples.” Check out Dr. Roberts’ comments on trends he’s seeing and how even GMU biodefense students are getting in on the swabbing!

Naval Research Lab Find High Prevalence of Antibiotic Resistance in Kenya
Microbial resistance has a way of popping up in even the most unexpected places and projects. The U.S. Navy Research Laboratory (NRL), U.S. Army Medical Research Directorate-Kenya (USAMRD-K), Kenya Medical Research Institute (KEMRI), and University of Washington, led a joint effort to evaluate intestinal tract bacteria and its resistance in patients across Kenya. The NRL-developed microarray they used is capable of detecting over 200 difference antimicrobial resistant genes. “These results suggest that there is selective pressure for the establishment and maintenance of resistant strains,” said Dr. Chris Taitt, research biologist, NRL Center for Bio/Molecular Science and Engineering. “This is potentially due to agriculture and prophylactic use of antibiotics and further suggests the need for more effective public health policies and infection control measures than those currently implemented.” “Specific to Kenya, widespread use of tetracycline in livestock production, use of trimethoprim/sulfamethoxazole (SXT) and chloramphenicol as first line therapeutics for typhoid, and prophylactic use of SXT in persons exposed to or infected with human immunodeficiency virus (HIV) might have contributed to the high prevalence of resistance.” Surveillance of antimicrobial resistance has been a struggle on an international level however, joint efforts like this are vital to not only establishing global standards and processes, but also highlighting the importance it has for military personnel abroad.

Stories You May Have Missed:

  • Agroterrorism Bill – a new bill was recently introduced by U.S. Rep. David Young (R-IA) and Sen. Pat Roberts (R-KS) regarding the preparedness of the U.S. agriculture, food, and veterinary systems. “The Securing Our Agriculture and Food Act requires the DHS Secretary, through the Assistant Secretary for Health Affairs, to ensure food, agriculture, animal, and human health sectors receive appropriate attention and are also integrated into the DHS’s domestic preparedness policy initiatives. The legislation specifically addresses issues seen after the 2015 avian influenza outbreak, which killed millions of turkeys, backyard flocks, and layer hens. It was the deadliest outbreak of avian influenza in Iowa’s history.”
  • What The G-20 Needs To Do To Fight The Next Ebola– The G-20 summit occurred last week in Hamburg and many were hoping for a renewed passion surrounding biological threats. While much attention was focused on climate change, there is also a call for efforts to prevent the next outbreak that will produce a pandemic. “Ultimately, strong health systems depend on communities, health workers, managers, researchers and other local stakeholders being empowered to respond to the inevitable, future waves of change we all face. At Health Systems Global, our members represent these multiple groups. Strengthening everyday resilience demands that we all — governments, donors, researchers, communities, health professionals — work with the resources that health systems already have — their people and relationships. This must be done as we take wider action to confront inequality at all levels. If we do not do that, then efforts to safeguard disease outbreaks will be meaningless.”

Pandora Report 6.30.2017

Happy Friday to all our amazing readers – we hope you have a lovey holiday weekend! Don’t miss the July 1st deadline for an early registration discount to the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security.

Preventing Pandemics and the Necessity of Funding Prevention
Next January will mark the centenary of the 1918-1919 pandemic influenza, but what have we really learned since then? The looming threat of antimicrobial resistance is slowly surrounding us, as is the increasing biothreat of zoonotic disease. Globalization, encroachment into animal habitats, and recent models that predict a 60-day global spread for a virulent strain of airborne flu virus, all paint a rather gloomy reality for the future of health security. So what are we doing? Not enough. That’s usually the answer in public health- a field of which you can comfortably say society likes to contribute the bare minimum. A highly pathogenic influenza virus that could engulf the globe in a pandemic isn’t the storyline for a horror movie, but rather something that even UN panels note is “not an unlikely scenario”. “Pathogens are not only terrifying, they’re expensive. The 2003 SARS epidemic cost $30 billion in only four months. A flu pandemic of a severity that occurs every few decades could contract the global economy by 5 percent — some $4 trillion”. Here’s where the economics of preventative public health come into play – vaccines are expensive to make and there’s little incentive when we’re not in the eye of a disease storm. Moreover, global health security is challenging. Politics makes disease response and preparedness a sensitive topic, especially during an outbreak. The key lesson to remember though, is that an outbreak anywhere is really an outbreak everywhere. So what preparedness tactics can we start utilizing? “The project is called CEPI — the Center for Epidemic Preparedness Innovations. After the world’s failure to control Ebola quickly in 2014 and 2015 cost 11,000 lives and at least $6 billion, three global experts proposed a vaccine development organization with $2 billion in start-up funding. Harvard, the National Academy of Medicine and the United Nations all created commissions that proposed ways to avoid another catastrophe. Among other steps, all endorsed vaccine development.” CEPI aims, in the next five years, to develop vaccine candidates for Lassa fever, Nipah, and MERS. “Creating vaccines is not the same as guaranteeing that people who need them can get them. CEPI will require its awardees to sell vaccines to the poorest and lower-middle-income countries (more likely, to donors who will buy vaccine for them) at the lowest possible price.” Perhaps one of the most poignant comments from this article was that the threat to this goal is not scientific, but rather political, highlighted by short attention spans. The World Bank has initiated it’s “pandemic bond” to aid in outbreak response should there be a public health crisis like that of Ebola in 2014. “The catastrophe bond, which will pay out depending on the size of the outbreak, its growth rate and the number of countries affected, is the first of its kind for epidemics. It should mean money is disbursed much faster than during West Africa’s Ebola crisis.” The Pandemic Emergency Fund (PEF) will offer coverage to those countries eligible for financing from the IDA (International Development Agency), which is dedicated to helping the poorest countries. Head of derivatives and structured finance at the World Bank’s capital markets department, Michael Bennett, noted that “if a trigger event occurs, instead of repaying the bond in full, some or all of the principal is transferred to the PEF trust fund. So essentially the investors are acting like insurance companies. The objective of offering the risk in both forms is that the bonds and swaps appeal to different types of investors, and therefore … we are creating the broadest possible investor pool for this risk,”. The PEF would provide more than $500 million in coverage over the next five years. Efforts to provide financial support to outbreaks before they reach pandemic potential are vital. It is estimated that had the PEF been available during the 2014 Ebola outbreak, $100 million could have been mobilized as early as July 2014, which may have prevented the outbreak spreading so rapidly and costing $2.8 billion. “The annual global cost of moderately severe to severe pandemics is estimated at roughly $570 billion, or 0.7 percent of global income, the World Bank said.”

Ebola Burial Teams 
The 2014/2015 Ebola outbreak in West Africa was not only the worst in history, but taught us a great many lessons about outbreak control. One of the most extraordinary lessons learned was just how valuable burial teams could be. Funerals became a significant source for disease exposure and transmission, especially for loved ones of the deceased, as washing and handling the body was customary. In effort to combat this high-risk activity, public health responders established burial teams comprised of paid volunteers, who would collect the bodies from homes and aid in their burial. The teams would don PPE and work with families to ensure they avoided exposure. Dignified burial through these teams helped ease much of the concern for families regarding the treatment of their loved one. A recent study published in the PLOS Neglected Tropical Disease Journal evaluated the impact of these burial teams using modeling and data from 45 unsafe community burials and 310 people who were identified as having contact with the infected bodies. Researchers found that those who cared for the Ebola patient just before their death were at greatest risk, meaning that caring for an infected loved one at home was far riskier than bringing them to a healthcare facility. The study estimates that the safe and dignified burials performed by Red Cross volunteers (the burial teams) prevented between 1,411 and 10,452 cases of Ebola. “Hundreds of paid volunteers took on the grim task of collecting bodies from people’s homes in full personal protective gear, while also having to manage the grieving families and communities. They were ordinary West Africans, such as teachers and college students. Many carried out the relentless and dangerous work for months. Some were stigmatised in their communities, because people became scared they might bring the virus home with them. In reality, they were helping to stem world’s worst ever Ebola outbreak.” In the end, the Red Cross burial teams managed over 47,000 burials, carried out more than 50% of all burials during the outbreak, and consisted of 1,500 volunteers.

Instructor Spotlight – Workshop on Pandemics, Bioterrorism, & Global Health Security
We’re nearing the last few weeks before our workshop and your opportunity to get the early registration discount, so don’t miss out! This week we’re happy to show off not only the director of this workshop, but also of our GMU biodefense graduate program – Dr. Gregory Koblentz. If there was a biodefense Jeopardy, Dr. Koblentz would not only be the reigning champion, but would also have Alex Trebek doubled over in laughter. Gregory Koblentz, PhD, MPP, is an Associate Professor in the Schar School of Policy and Government and Director of the Biodefense Graduate Program at George Mason University. During 2012-2013, he was a Stanton Nuclear Security Fellow at the Council on Foreign Relations. Dr. Koblentz is also a member of the Scientist Working Group on Chemical and Biological Weapons at the Center for Arms Control and Non-Proliferation in Washington. He previously worked at Georgetown University, the Executive Session for Domestic Preparedness at Harvard University, and the Carnegie Endowment for International Peace. He is the author of Strategic Stability in the Second Nuclear Age (Council on Foreign Relations, 2014), Living Weapons: Biological Warfare and International Security (Cornell University Press, 2009) and co-author of Tracking Nuclear Proliferation (Carnegie Endowment for International Peace, 1998). He serves on the editorial boards of Nonproliferation Review, World Medical and Health Policy, and Global Health Governance. His teaching and research interests focus on international security, weapons of mass destruction, terrorism, and homeland security. He received his PhD from the Massachusetts Institute of Technology, his Master in Public Policy from the John F. Kennedy School of Government, and his BA from Brown University. For more information, see https://schar.gmu.edu/about/faculty-directory/gregory-koblentz. Don’t miss your chance to not only learn from Dr. Koblentz, but also chat with him and other experts in the field at our workshop July 17-19th!

Can CRISPR Tackle Zika?
GMU Biodefense PhD student Saskia Popescu is looking at CRISPR and its application as a vector-borne disease prevention tool. “Whether it be the latest announcement that CRISPR reversed Huntington’s Disease in mice or that it could provide rapid diagnostic improvements, the technology is being considered a breakthrough for many diseases and conditions, including vector-borne diseases.” Drawing on a recent TED Talk by famed molecular biologist, Dr. Nina Federoff, she highlights the potential for GMO mosquitoes to be used as a biological control tool. Federoff points to the public perception issues that come with GMO products, which was seen in Key Haven, Florida when GMO mosquitoes were to be trialed as a means to prevent dengue and Zika cases. “Concluding her talk with a plea to the audience, Dr Federoff emphasized the need to dig past misinformation and hype to truly look at the science of this work and the substantial benefits that can come from biological control efforts and the science of genetic modification.”

The Case of the Missing Sarin
Dugway Proving Ground is under the spotlight again for mishandling of dangerous substances. The same Army lab was responsible for mishandling Anthrax in 2015, during which they sent 575 shipments of live samples across the U.S. Unfortunately, the latest reports are looking to Dugway as the source for potentially losing a small amount of sarin. The inspector general for the DoD released a report highlighting the findings that a contractor used by the facility was not maintaining inventory properly. “Dugway stored its sarin in a two-container system. The sarin was stored in a primary container, which is then stored inside a secondary container. But officials only checked the secondary containers when doing inventory, and did not check inside the primary container, so they did not know if all the sarin was still in the containers, the inspector general found. ‘Therefore, custodians cannot identify and account for leaks, evaporation, or theft that may have occurred,’ the inspector general found. ‘Furthermore, Dugway officials did not immediately notify the chemical materials accountability officer of a 1.5-milliliter shortage of … sarin identified during an April 19, 2016, inventory nor did they properly document the results of that inventory,’.” The report found that the contractor and Dugway used varying methods for container sealing but that the amount missing is relatively small. Fortunately, sarin evaporates and degrades very quickly. Overall the report highlights the operations and procedures for handling the chemical agent put workers at an increased risk and encouraged the Army to evaluate and improve practices immediately.

The Moral Question of Bioengineering
The financial and technical hurdles for biotechnology and gene-editing have been decreasing over the years and Stanford is taking a unique approach to their budding bioengineers – asking moral questions. During their final exams for the university’s Intro to Bioengineering course, the students are asked several questions – at what point will the cost of printing DNA to create human life equal the cost of teaching a student at Stanford?  If you and your partner are planning to have kids, would you start saving for college tuition, or for printing the genome of your offspring? These questions represent much of the debate and concern regarding gene editing – the rapid decrease in cost and the morality of just how far the technology can and will take researchers. Many note that just because we can, doesn’t mean we should. Stanford professor Drew Endy emphasizes the decrease in costs, which was initially prohibitive when the technology was developing. Regarding the last question, “about 60 percent say that printing a genome is wrong, and flies against what it means to be a parent. They prize the special nature of education and would opt to save for the tuition. But around 40 percent of the class will say that the value of education may change in the future, and if genetic technology becomes mature, and allows them to secure advantages for them and their lineage, they might as well do that. There is clearly no right answer to the second question, and students are graded on their reasoning rather than their conclusion. But when both questions are considered together, they suggest, Endy says, that ‘in the order of a human generation, we’ll have to face possibilities that are much stranger than what we’re prepared for’.”

Stories You May Have Missed:

  • John Oliver Takes on Anti-Vaxxers – If you’re a fan of the HBO host, make sure to check out his recent episode of  “Last Week Tonight” in which he points out just how dangerous the anti-vaccine movement really is. “Some have even developed an ‘alternative vaccine schedule’ in which the inoculations can be delivered less frequently and over a longer period of time. ‘That sounds like a decent compromise because it’s the middle-ground position, right?”’Oliver said on ‘Last Week Tonight’ on Sunday. ‘The problem is, it’s the middle ground between sense and nonsense. It’s like saying, ’It would be crazy to eat that entire bar of soap, so I’ll just eat half of it’.”
  • Yemen’s Growing Cholera Outbreak– Yemen is currently experiencing the worst international outbreak of cholera, with 200,000 suspected cases and an average of 5,000 new cases reported daily. The WHO and UNICEF have gotten involved as there have already been 1,300 deaths in the past two months. “By calling the outbreak the “world’s worst” UNICEF and WHO hope to speed international aid efforts to the war-torn country. “This deadly cholera outbreak is the direct consequence of two years of heavy conflict,” said a press statement from UNICEF. ‘Collapsing health, water and sanitation systems have cut off 14.5 million people from regular access to clean water and sanitation, increasing the ability of the disease to spread.’ In addition to a lack of public health infrastructure, UNICEF estimated that 30,000 dedicated local health workers who play the largest role in ending this outbreak have not been paid their salaries for nearly 10 months.”