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 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 1.6.2017

Welcome to 2017 and a whole new year of biodefense news! While you’re heading back to work, make sure to wash your hands and stay safe – the CDC has reported increasing flu activity.

The Best of Bio and Chem Weapons Coverage in 2016
The Bulletin of the Atomic Scientists has put together their “five best articles” for bio-chem weapons in 2016 and we were happy to see two familiar faces – GMU PhD alum Daniel M. Gerstein and GMU Biodefense professor, Sonia Ben Ouagrham-Gormley. Daniel Gerstein’s article, How genetic editing became a national security threat, discusses the threatening components of gene drive, like low cost and growing availability. “Armed with the proper genetic sequences, states or bioterrorists could employ genome editing to create highly virulent pathogens for use in such attacks. They could, for example, change a less dangerous, non-pathogenic strain of anthrax into a highly virulent form by altering the genome, or recreate pathogens such as the deadly smallpox virus, which was eradicated in the wild in 1980.” Sonia Ben Ouagrham-Gormley teamed up with Kathleen Vogel to discuss the good, bad, and the hype of gene drive. They emphasize the importance of understanding gene drive to really discern the benefits and risks of the technological process. Looking at all angles, their article gives a wholistic approach to better appreciate the complexities of gene drive for biodefense. “Without a clear and detailed understanding of the range of social and technical factors that cause scientists to succeed or fail in their gene-drive endeavors, threat estimates can only rely on speculation and fantasy rather than fact.”

GMU Biodefense Students – Win Registration for 2017 ASM Biothreats Conference!
Calling all GMU Biodefense students – the program will be offering free registration to four lucky students to attend this premier biodefense event at the Marriott Wardman Park in Washington, DC on February 6-8th. This year, the meeting incorporates three major tracks, “Research, Response, and Policy” to cover relevant topics in basic and applied research; public health, emergency response and preparedness; and biosecurity, government, and policy responses. The exchange between these multidisciplinary communities will shape the future of this very important field. The keynote session on February 6 will be given by Thomas M. Countryman, Acting Under Secretary for Arms Control and International Security and Assistant Secretary to the Bureau of International Security and Nonproliferation at the Department of State.  Anthony S. Fauci, M.D., Director of NIAID Director at the National Institutes of Health, will be presenting at a special session on February 7. You can find the rest of the agenda here. As an attendant for the 2016 conference, I can tell you that it’s a great experience for not only learning, but also networking. Please check your GMU email for the information Dr. Koblentz sent out. To apply: students are required to submit a 250-word essay about how attending the conference will benefit your education/professional aspirations by 5pm today (Friday, January 6th) to Dr. Koblentz. Winners will be announced the following Monday and those selected will be asked to write up summaries of at least two panels for publication in the Pandora Report.

USGS Disease Maps
screen-shot-2017-01-03-at-6-04-01-amLove maps and diseases? Or do you simply like knowing what kinds of vectored diseases are transmitted around you? Check out the USGS disease maps that also allow you to interact with them. Utilizing data from CDC’s ArboNET, you can look at transmission among humans, mosquitoes, birds, sentinel animals, and veterinary transmission. The observable diseases include West Nile Virus, St. Louis Encephalitis, Eastern Equine Encephalitis, Western Equine Encephalitis,  La Crosse Encephalitis, Powassan Virus, Dengue fever (locally acquired and imported), and Chikungunya (locally acquired and imported). The USGS disease maps allow us to not only have a better understanding of vectored disease transmission, but also landscape epidemiology.

CRISPR Off-Switch
CRISPR is going to be a hot story in 2017 and here are the seven things to look for. The burgeoning concerns regarding CRISPR technology involve the rapid pace of development and lagging DURC policies, not to mention the inability to predict future outcomes. The interest and unease over this new form of genome editing has left many searching for an “off button”, but thankfully, researchers are believed to have found one.  While the new “off switch” isn’t capable of reversing changes that were already made, it can stop the system from making additional edits. “The switch is a series of ‘anti-CRISPR’ proteins that were discovered inside viruses that attack bacteria, where they’re used to disable the gene editing tool and sneak into the bacterial DNA. ‘Just as CRISPR technology was developed from the natural anti-viral defence systems in bacteria, we can also take advantage of the anti-CRISPR proteins that viruses have sculpted to get around those bacterial defences,’ said lead researcher Benjamin Rauch. The team isolated these anti-CRISPR proteins from Listeria bacteria that had been infected by viruses. The team isolated the proteins that appeared to be involved and tested whether any of them could stop CRISPR editing from taking place in human cells. They found that two of these proteins, AcrIIA2 and AcrIIA4, worked together to inhibit the CRISPR systems commonly used by scientists.”

CDC Concludes CDP Ricin Exposure Inspection
The CDC just finished their inspection of the lab that sold the ricin toxin that was used by the Centers for Domestic Preparedness (CDP) training facility. The ongoing debate between the CDP and lab regarding the mishandling or misunderstanding points to bigger, systemic issues in regards to select agents. CDP states that the lab is to blame, noting that they ordered a less toxic version of ricin, while the lab rebutted by pointing out that the ricin was always properly labeled as the toxic version and they, in fact, never offered the less toxic version. The site visit and inspection findings are under review as the CDC determines if the lab is responsible and violated federal regulations. The conclusion of the inspection also comes at a challenging time for the CDC as the agency is taking heat for blacking out many details in reports recently released via the Freedom of Information Act. The released laboratory reports were requested by USA TODAY and only fuel the attention to lab incidents and poor biosafety practices.

NAS DURC Committee Meeting 
This week the National Academies held the Committee on Dual Use Research of Concern (DURC): Option For Future Management. You can get not only the webcast recording (check out 2:42:00 in and you’ll see GMU Biodefense director and professor, Gregory Koblentz, talk about the zero sum game in terms of regulating DURC research – to regulate or not to regulate, that is the question!), but also the full presentations. Since the 2011 H5N1 controversies, “it remains unclear as to whether there are practical mechanisms or approaches for managing such dual use research of concern (DURC) and, specifically, how to deal with situations where there is a pressing need, for public health reasons, to publish research findings while limiting, due to national security concerns, the dissemination of certain details that ordinarily would be published. This is especially true in cases where an initial assessment of proposed research does not anticipate results that would warrant such consideration.”

Zika Outbreak Updates
Scientists are currently unveiling the key proteins in the virus that made it so deadly. The first comprehensive description of the Zika genome has identified seven key proteins that are helping researchers understand the devastation the virus does to the human body. “To test the virus, Dr. Zhao used fission yeast, a species that in recent years has become a relatively common way to test how pathogens affect cells. Fission yeast was originally used to make beer, particularly in Africa, where it originated. (Its species name is Schizosaccharomyces pombe; pombe means beer in Swahili.) Over decades, fission yeast has been used by many scientists to find out mechanisms and behavior of cells. For the experiment, Dr. Zhao and his colleagues separated each of the virus’s 14 proteins and small peptides from the overall virus. He then exposed yeast cells to each of the 14 proteins, to see how the cells responded. Seven of the 14 proteins harmed or damaged the yeast cells in some way, inhibiting their growth, damaging them or killing them.” The Entomological Society of America has noted that socioeconomic factors provide protection against a large scale Zika outbreak in the U.S., but that small outbreaks are an ongoing concern. As of January 4th, the CDC reported 4,618 cases of Zika in the U.S., of which 216 were locally-acquired.

Does the CDC’s New Quarantine Rule Violate Civil Liberties?
With a new vaccine and hopeful approach to emerging infectious diseases, have we buried Ebola? Back in August, the CDC proposed a new rule regarding its powers to respond to potential outbreaks via screening, testing, and quarantining people traveling into or within the U.S. You can read the new rule here, but it focuses on “non-invasive public health prevention measures” and reporting requirements for commercial passenger flights of death or illness to CDC, etc. While this may seem pretty reasonable given health emergencies like Ebola and SARS, many ” epidemiologists, lawyers, and health organizations say that the rule, in its current form poses a serious threat to civil liberties, allowing authorities to detain and examine people with little heed to due process and informed consent.” Attempted in 2005, this rule was initially met with criticism, however the recent Ebola outbreak has changed the way we approach travel during times of infectious disease outbreaks. Public health emergencies are defined as ‘communicable disease events’ that the director believes could be high risk for death or serious illness. “It is already authorized to detain people suspected of carrying diseases like plague, Ebola, and (somewhat improbably) smallpox. But the new rule does away with a formal list. It extends the same powers to any “quarantinable communicable disease,” and uses wider range of symptoms (from a list that federal agents can update as the need arises) for defining ‘ill’ people.” While the CDC can detain travelers prior to decision to quarantine, it notes that this shouldn’t last longer than 72 hours and fails to make provisions for a lawyer if the person can’t afford one. “The rule also gives the CDC ultimate authority to carry out medical tests and treatments, stating that ‘the individual’s consent shall not be considered as a prerequisite to the exercise of any authority’.” What are your thoughts? We’d love to hear from our readership – please email or tweet @PandoraReport to give us your thoughts!

USDA ARS 4th International Biosafety & Biocontainment Symposium Registration Deadline
Don’t miss the January 13th registration deadline for this event in Baltimore, Maryland! From February 6-9, the focus of the symposium will be Global Biorisk Challenges-Agriculture and Beyond. Seven presymposium courses will address topics including unique biocontainment challenges, decontamination and inactivation, and institutional governance. Topics include biorisk management challenges in a One Health World, arthropods, HPAI, risk assessments, and more!

Stories You May Have Missed:

  • 85 People Suspected to Have Contracted Rabies– Like something out of a zombie movie, 85 people are suspected of having contracted wild rabies after being bitten by bats in Peru. “Regional director of Health of Cusco, Julio César Espinosa La Torre said that among the group of victims with a bat bite are the 15 soldiers transferred to Lima, of this group, two cases were confirmed, of which one is deceased. Espinoza la Torre said that to date, more than 912 civilians and 680 soldiers have been vaccinated in Alto and Bajo Urubamba, in the district of Megantoni, who must receive up to four doses, every 7 and 14 days.”
  • Anticipating Epidemics Using Computational Models – the White House recently released a report to strengthen the capacity for outbreak prediction. Spearheaded by the National Science and Technology Council, Toward Epidemic Prediction: Federal Efforts and Opportunities in Outbreak Modeling, looks to predictive modeling and data utilization to better understand the “processes that drive disease emergence and transmission could help to predict and prevent large-scale outbreaks. These programs range from foundational research into disease emergence and spillover, to predictive modeling contests, to the development of decision-support technologies for public health responders.”
  • Pandemic Chats – Struggling to chat to a younger generation about diseases? Check out how the Bill & Melinda Gates Foundation is talking to the next generation about the next pandemic.

Pandora Report 10.28.2016

A leaked report to the UN Security Council from the Organization for the Prohibition of Chemical Weapons, states that Syrian President Bashar al-Assad gave the order for the use of chemical weapons in 2015. The ECDC is seeing the initial cases for the 2015/2016 flu season, so make sure to get your flu shot! Science is sharing six science lessons for the next president. A new study finds that the correct antibiotics are only given half the time for common infections. Make sure to celebrate One Health Day on November 3rd!

Spillover: Ebola & Beyond Film Screening and Discussion
Don’t miss this great event at the National Museum of Natural History on Tuesday, November 15th from 6:30-8:30pm. If you loved the PBS documentary this summer, now is your chance to listen to a panel of experts discuss how they track diseases internationally and locally. “The film extends to the new frontiers of disease detection, prevention, and containment, and travels the world with virus hunters who are tracking old enemies while vigilantly looking out for new foes.” Featured speakers will include Vanessa van der Linden, Anthony Fauci, Yvonne-Marie Linton, and LaQuandra S. Nesbitt. Make sure to register before the event if you’d like to attend.

iow-zoonoses-onpgIf you enjoyed the Spillover documentary, check out this one (from the same team at the Howard Hughes Medical Institute who brought you Spillover) on Nipah virus hunters and their use of bat populations to track the disease. It’s a great film on epidemiology, One Health, and how we can study diseases in bat populations to predict outbreaks in humans. The HHMI has all sorts of wonderful disease-tracking goodies, like this one on the patterns of zoonotic diseases or an interactive on viruses. HHMI has some great interactive and fascinating learning tools for adults and children alike. Nothing like a little zoonotic disease lesson before bedtime, right?

MetaBiota Presentation for GMU Students 14875059_1343053735705798_1059784359_n
This week GMU was fortunate to hold an informational session by MetaBiota in which Dr. Kimberly Dodd discussed the organization and what life is like working on shifting emerging infectious disease response to prevention. GMU Biodefense MS student Greg Mercer was able to  listen to her experiences that range from the front lines of virus chasing to work on PREDICT and the factors that lead to zoonotic spillover. Dr. Dodd deployed to Uganda as part of the CDC’s response to the 2012 Marburg virus outbreak and to Sierra Leone during the West African Ebola outbreak. She described the challenges of trying to set up a BSL-4 equivalent laboratory in the field and the stressed of working with dangerous pathogens and noted that even in an outbreak of a high fear-factor disease like Ebola, there is often an international outpouring of volunteers. Experts are enthusiastic to help both for humanitarian reasons and the promise of cutting edge research to be done. Her experiences responding to outbreaks in the field prompted her interest in what preventative measures can be taken to forecast, identify, and mitigate outbreaks faster. She described her work on USAID’s PREDICT project, which seeks to catalogue viruses with potential to become pandemics. In its first 5 years, PREDICT sampled 56,000 animals, ran 400,000 diagnostics, and detected 984 unique viruses, 815 of which were novel. This new data was fed into Healthmap. In later pahses, PREDICT will go on to more closely examine the human-animal dynamics of spillover events.

Fears and Misperceptions of the Ebola Response System during 2014/2015 Outbreak in Sierra Leone
We’re still learning lessons from the worst Ebola outbreak in history, but will we actually apply this knowledge or continue to make the same mistakes? Public perception of public health response systems is a vastly important aspect of any outbreak response, however researchers are pointing to the severity it had on containment in 2014/2015. This study focuses on Sierra Leone and the barriers that prevented people from trusting and utilizing the Ebola response system that was established during the height of the outbreak. Researchers found that most people feared calling the national hotline for some one they believed to have Ebola as it would result in that person’s death. People tended to self medicate if they developed a fever and assumed it was not Ebola. “Fears and misperceptions, related to lack of trust in the response system, may have delayed care-seeking during the Ebola outbreak in Sierra Leone. Protocols for future outbreak responses should incorporate dynamic, qualitative research to understand and address people’s perception”

Estimating the BioTech Sector’s Contribution to the U.S. Economy screen-shot-2016-10-26-at-2-44-22-am
While the biotech sector has opened the floor for questions over dual-use, there’s no denying its growth. U.S. biotech sector revenue is estimated to have grown on average more than 10% per year over the past decade, which is faster than the rest of the economy..much faster. Data collected from various public and private sources allowed Robert Carlson to pain a much larger picture of what biotech is contributing to the U.S. economy. He found that total domestic U.S. revenue generated by biotech in 2012 reached at least $324 billion, which is the equivalent of >2% of GDP. Biotech revenue growth was >5% of annual U.S. GDP growth every year between 2007 and 2012. While the field is obviously growing, the rapid acceleration also means that there will be decreasing costs and more access to more powerful technology. “Governments around the globe are grappling with the desire to benefit from biotech-driven economic development, while simultaneously facing questions about who should have access to which technology and under what circumstances.” It’s important to not only support and monitor the technologies, but also facilitate data and reporting within the industry as these measurement deficiencies fuels biosecurity concerns. “Alongside the preexisting bioeconomy, we are building a system composed of inherently ‘dual-use’ engineering technologies that will constitute critical infrastructure for the future economy. Assuming that the revenue and growth estimates above are borne out with improved measurement and analysis, biosecurity is now clearly synonymous with economic security. The focus of biosecurity policy must shift from protecting specific targets from specific threats to securing the bioeconomy as a system that increasingly drives economic growth and employment and, ultimately, enables humans to thrive on a global scale.”

Hospitals Add Sinks to Help Fight Infections – Bad Move
Adding more easily accessible hand washing stations is one of the strategies to combating poor compliance and growing infection rates. Unfortunately, there have been some unintended consequences of upping the sink volume. Several hospitals throughout Baltimore, the Netherlands, and Shanghai have noted an increase in infections after adding more sinks (especially in patient rooms). Biofilms were a growing issue, which draws attention to the importance of facility and environmental service maintenance. I was a bit disparaged to see that the article points to the presence of non-sterile water from sinks in rooms with immunocompromised patients. Patients that are severely neutropenic are usually placed into positive pressure rooms (under protective precautions) and almost all hem-oncology units have special water filters on everything in the patient’s room (shower, sink, etc.). The concern for legionella is always an issue for those with weakened immune systems and while it’s important to cut down as much environmental exposure as possible, it’s impractical to think there should be sterile water. Another aspect of this is that patients in pre-op immune-suppression or post-op recovery will be exposed to germs – it’s a simple fact. If you’re concerned about sinks, then the patient should either be in a protective precautions room or you should not allow visitors. A sink is a small piece of the puzzle when it comes to patients that aren’t severely neutropenic. Sink design and cleaning is hugely important, which is another component to hospital infection control as anytime water is temporarily shut off, there needs to be water treatment plans in place, etc. It’s nice to see attention being brought to the environmental aspects of sinks and infection control, however one big aspect of the problem is also that people typically don’t wash their hands correctly. Yes, most people don’t spend the 15-20 seconds correctly lathering, washing all the nooks and crannies of their hands, etc. Needless to say, it takes a village to stop an infection and just one tiny moment to cause one – sinks are just one piece of the pie.

Terrorists Hamper Polio Eradication Efforts in Africa salk_headlines
Global eradication of a disease is never easy, however efforts to rid Africa of polio have encountered barriers that are allowing the disease to resurge. Nigeria has seen lingering polio as a result of “porous borders and shifting populations where travel has been blocked by terrorism.” Despite consistent work and effort to eradicate the disease from Nigeria, it was re-declared endemic in August, which leaves many concerned about it spilling over borders into neighboring countries. While Nigeria has always been a hotspot for polio, there has been increasing religious preaching that parents should not allow vaccination, specifically Muslim imams in Kano state in 2003, claiming that the vaccine had been contaminated to hurt Islamic children. Distrust compounds into lagging vaccination rates and during this time there was a spike in cases, which was coupled with terrorist activity by the Book Haram militia. “They cut off entire provinces, blocking the access needed by teams vaccinating children and epidemiologists counting cases. When the Nigerian military forced the militia out of parts of Borno state, in Nigeria’s northeast corner, the polio campaign discovered that wild polio virus had been circulating there for years.” The area around Lake Chad – Chad, Cameroon, and Niger – all pose problematic for vaccination efforts as the WHO calls the situation a “complex emergency” with more than 150,000 people fleeing across national borders. Despite these challenges, the governments of Nigeria and five nearby countries have initiated a massive emergency vaccination campaign that covers more than five million children per round, of which they’ll perform six rounds. “That may be an even more difficult task than in Afghanistan or Pakistan. In those countries, most of the areas where polio survives are remote, with little traffic in or out. Nigeria, on the other hand, is the most populous country in Africa, and a crossroads for the rest of the continent. There is no quick fix that can make the risk of onward spread go away; it requires yet more of the hard, grinding, repetitive work that eradication campaigners have been doing for almost 30 years.”

Zika Virus – What’s the Latest?
Brits are being warned not to travel to Florida after two British journalists contracted Zika during their travel to the state. The Florida state health department has released their Zika data– there are four new travel associated cases and nine non-travel associated cases. Wellcome Trust medical research charity is warning that we should expect Zika to reach India and Africa. “I think we can anticipate global spread,” said Jeremy Farrar, speaking to the Guardian alongside Sue Desmond-Hellmann, the chief executive officer of the Bill and Melinda Gates Foundation. “Given the [Aedes aegypti] mosquito’s availability across the world, I think the spread will next be across Asia and I think we really have to be prepared for it spreading in Africa. I don’t see any reason why it wouldn’t.” The WHO has released their Zika Research Agenda here, with a goal of “supporting the generation of evidence needed to strengthen essential public health guidance and actions to prevent and limit the impact of Zika virus and its complications”. Scientists are still bewildered by Zika’s path through Latin America as cases continue to grow. The CDC has reported 4,091 cases of Zika in the U.S. as of October 26th.

Stories You May Have Missed:

  • The Antibiotic Era Review – Infectious disease physician Amesh Adalja is discussing Dr. Scott Podolsky’s most recent book on antimicrobial resistance. As the realities of microbial resistance grows larger and gains more attention, it’s important to understand that this isn’t a solely modern issue. Dr. Adalja notes that the book should be required for anyone in the field as it takes great care to incorporate details that paint the larger picture of infectious diseases and antibiotics. “As Podolosky illustrates, in the post WWII era, civilization caused infectious diseases to recede in the US at the same time scores of new treatments (i.e. antibiotics) were coming to the market and experts who knew the (now rare) bug and the drugs used to treat them were valuable.” Adding it to our holiday reading list, thanks for the tip Dr. Adalja!
  • Climate & Evolutionary Drivers of Phase Shifts in Plague Epidemics of Colonial India – A recent study is looking at the climatic and evolutionary forces that impact plague epidemics. Researchers looked at the arrival of plague in colonial India through archival data and were able to identify the evolution of resistance in rats as a significant driver of the shifts within seasonal outbreaks. The findings “substantiate the rapid emergence of host heterogeneity and show how evolutionary responses can buffer host populations against environmentally forced disease dynamics.”
  • 2nd International Who’s Who in One Health Webinar – Don’t miss the One Health Commissions’ upcoming webinar on November 4th, 2016. This webinar is a great place to take part in dialogue with One Health leaders, advocates, professionals, and students The webinar is set to start at 7:45am EST and seeks to create new strategic partnerships and networks for collective, purposeful and coordinated action and educate participants about the One Health paradigm and ways of thinking towards improved health outcomes

Pandora Report: 6.3.2016

Which country do you think is the biggest consumer of antibiotics? You’ll be shocked to see the results in this infographic. The organization, No More Epidemics, has also created an infographic on pathogens and poverty, depicting the “general trajectory of infectious disease outbreaks from outbreak to epidemic, showing the potential power of interventions to interrupt the course of progression.” You may want to rethink baking this weekend as the CDC is currently working to control an E. coli outbreak related to General Mills flour. Before we start our adventure down the biodefense rabbit hole, check out this experiment showing just how far sneezes really spread (brace yourself for a “violent explosion of saliva and mucus”).

The Importance of a Resilient Health System
Sure, this may seem like a pretty obvious concept but it’s something we still struggle with. The 2014 Ebola outbreak proved it and Zika virus is just adding some salt with a side of lime juice to the wound. Between climate change, spillover, and antibiotic resistance, the need for a resilient and robust public health system has never been more dire. “The point is that resilience in the health sector is not static but rather an ongoing and evolving state of affairs. Well-performing health systems provide sustained, equitable access to essential services for all without financial hardship. They are better able to bounce back when adversity strikes; are prepared to detect and respond to emerging disease threats; are able to adapt to adverse conditions; address a wide range of health challenges; and offer innovative solutions by leveraging diverse skills and views.” USAID is working to help fix holes in the existing system through their initiatives like Fighting Ebola: A Grand Challenge for Development and the newer Combating Zika and Future Threats Grand Challenge. The world is moving at a rapid pace and with innovation and globalization, the potential for a pandemic is only a flight away. Now is the time to strengthen our public health system.

NSABB Select Agent & Gain of Function Progress
A few weeks back we discussed the National Science Advisory Board for Biosecurity’s (NSABB)’s meetings regarding Gain-of-Function (GoF) work and their risk assessment with subsequent recommendations for evaluation and oversight of proposed GoF research. Six meetings and two workshops later, NSABB approved the final proposal. The May 24th, 2016 version is similar to the earlier draft however, specific examples of “studies of concern” were provided. Seasonal flu GoF studies are not considered concerning and NSABB did modify its definition of GoF Research of Concern. “The report has new wording that is apparently aimed at critics who have argued that the HHS should not review studies it funds, because that would represent a conflict of interest. The report says the HHS review ‘should be structured to avoid real or apparent conflicts of interest,’ but doesn’t specify how that can be done.” While implementation will be challenging and require immediate initiation, it’s believed that agencies won’t have trouble adapting to the new policy. You can also check out Gryphon Scientific’s final analysis on the risks and benefits of GoF research. Enjoy Chapter 11 regarding the loss of trust in science -GMU Biodefense MS student Julia Homestead helped write it!

Ancient Plague Epidemiology F2.large
Get your Indiana Jones hat ready, we’re going back in time to look at bioarcheology and the Eyam plague outbreak of 1665-1666. Researchers used a stochastic compartmental model and Bayesian analytical models to study this outbreak that started in September 1665 in the Derbyshire village of Eyam. Updated data from parish records allowed scientists to study this specific outbreak in a more in-depth manner, leading to the discovery that both rodent-to-human and human-to-human transmission played an important role in the spread of the disease. “We also found that the force of infection was stronger for infectious individuals living in the same household compared with the rest of the village. Poverty significantly increased the risk of disease, whereas adulthood decreased the risk. These results on the Eyam outbreak contribute to the current debate on the relative importance of plague transmission routes.”

Health on the G7 Summit Agenda
Last week, international officials met for the G7 Summit and during this gathering the topic of infectious diseases and control methods came to the table. “At the G7 Ise-Shima Summit, leaders will consider issues including strengthening the response to public health emergencies, by taking into account the lessons learned from previous outbreaks, such as Ebola. In addition, they will discuss ensuring the provision of lifelong healthcare services, from maternal, newborn and child health, through to non-communicable diseases and aging, in the pursuit of universal health coverage (UHC)”. Ebola, Zika virus, and Yellow Fever are all hot topics (see what I did there…) of concern. Improving investment in pandemic response was a vital part of the G7, as well as endorsement of the Global Health Security Agenda. Hopefully, with more international awareness and investment, the practice of putting out infectious disease fires will be a thing of the past.

Zika Weekly Roundup
The WHO has released their latest global response report on the Zika virus outbreak. The report gives an overview regarding the Strategic Response Framework and Joint Operations Plan as well as current funding gaps for “critical activities until the end of June 2016, as well as the approach to setting a new strategy from July 2016 onwards.” You can also find a scoping review of the Zika literature here. 233 studies were compiled with findings that “several knowledge gaps were identified by this review with respect to ZIKV epidemiology, the importance of potential non-human primates and other hosts in the transmission cycle, the burden of disease in humans, and complications related to human infection with ZIKV.” A woman in New Jersey has given birth to a baby girl with microcephaly, making her the second Zika-related microcephaly case in the U.S. Entomologists and medical experts are participating in a Zika Symposium and you can check out some of the presentations here. President Obama commented on the need for Zika funding during his speech in Elkhart, IN, this week, noting that “we need more who are willing to work with us to lower health care costs, give us the funding we need to fight public health challenges like Zika and the opioid epidemic — Joe Donnelly is working on that diligently.” Researchers are looking at the risk factors for eye abnormalities in congenital Zika infections and scientists are now raising concern over transmission related to oral sex. Lastly, as of June 1st, 2016, the CDC has reported 618 travel-associated cases in the U.S. 

Stories You May Have Missed:

  • First Locally-Acquired Chikungunya Case in Texas–  The Texas Department of State Health Services has confirmed the first case of local transmission. ” A Cameron County resident got sick with the illness in November 2015 and was diagnosed with a lab test in January 2016. The case, however, was not reported to the local health department until last month. The investigation performed by the Cameron County Department of Health and Human Services determined the patient had not traveled, and the case was confirmed last week by testing at the US Centers for Disease Control and Prevention.”
  • Edge of the Antibiotic Abyss – There’s been a lot of talk about antibiotic resistance and the impending dangers if we don’t act soon. Here’s an overview of the concerns and recent case that is causing so much worry. While it may not get the media attention of Zika virus, this is a very real issue and recent estimates indicate that we’re teetering on the edge of the antibiotic abyss.
  • India’s HIV Blood Transfusion Transmission Reality– The National AIDS Control Organization has released their report following a petition by activist Chetan Kothari, revealing that at least 2,234 Indians have contracted HIV while receiving blood transfusions. Scarier yet, these cases occurred in the past 17 months. Kothari has pushed for investigations, citing that while it is mandatory for hospitals to screen donors, the cost of the test and limited availability of testing facilities (Mumbai has only three private hospitals with HIV testing facilities) makes this a growing threat to anyone requiring blood transfusions. India currently has around 2.09 million people living with HIV/AIDS.
  • The European Centre for Disease Prevention and Control – The ECDC has updated its rapid risk assessment for the current yellow fever outbreak that is impacting Angola, DRC, and Uganda. “In the EU/EEA, the risk of yellow fever virus being introduced is limited to unvaccinated viraemic travellers coming from areas with active local transmission.”

Pandora Report 5.20.2016

The biodefense world was pretty busy this week – between Zika funding, cloning, and debates over dual-use technologies, we’ve got a lot to recap! Check out this great infographic on mosquitoes and the diseases they spread. The “State of Innovation” report revealed a decrease in biotech patents in 2015, with many pointing to the correlation between three U.S. Supreme Court decisions that limited patentability of some biotechnologies. If you were wondering how the sale of Plum Island is going, the House has actually temporarily halted any transactions.

Congrats GMU Biodefense Graduates!IMG_3491
We’re so happy to announce the convocation of some of our phenomenal graduate students. Earning a MS in Biodefense- Julia Homstad (also awarded the Frances Harbour Award for Community Leadership), Brittany Linkous (earning the Outstanding Biodefense MS Student Award), Francisco Cruz, Mary Dougherty, Moneka Jani, Sadaf Khan, Brittany Ferris, Michael Smith, and Robert Smith. Graduating with their PhD’s – Jonathan Gines (also the recipient of the Outstanding Biodefense PhD Student award and his dissertation was: Designing Biorisk Oversight: Applying Design Science Research to Biosafety and Biosecurity, Patricia Kehn (Flu News You Can Use? An Analysis of Flu News Quality 2008-2010), and Mittie Wallace (Emergency Preparedness in Virginia, Maryland and DC: Using Exchange Theory to Identify Government-Nonprofit Incentives and Barriers to Collaboration). Congrats to all our Biodefense graduates in the hard work and dedication they’ve put forth to contribute to such a diverse and exciting field!

Evaluation of DoD Biological Safety & Security Implementation
The Inspector General of the Department of Defense (DoD) has released their report regarding the biosafety and biosecurity policies and practices within DoD laboratories working with select agents. The report also evaluated DoD oversight of these laboratories and compliance with Federal, DoD, and Service Policy, with careful consideration to recent GAO (among others) recommendations. Several findings were reported, which include: “DoD has not maintained biosafety and biosecurity program management, oversight, and inspections of its BSAT laboratories according to applicable Federal regulations. BSAT laboratories in Military Services were inspected according to different guidance, standards, and procedures, risking dangerous lapses in biosafety practices. Lack of coordinated oversight of DoD laboratories led to multiple, missing, and duplicative inspections, and, therefore, an excessive administrative burden that could interfere with scientific research performance.” The report also noted that public health and safety was put at risk due to the poor protection of these agents. Recommendations pushed for better internal and external tracking of inspections, coordination of external technical and scientific peer reviews, standardized training for inspectors, the creation of site-specific laboratory security vulnerability assessments, etc. Overall, the report addresses several key failures within select agent laboratories that have been gaining increasing attention. While these recommendations are a necessary first step, there is definitely an up-hill battle to better secure and work with select agents.

Public Health & Emerging Disease Outbreaks – The Importance of Communication 
Outbreak prevention and response isn’t a new concept…in fact it’s something we’ve been perfecting since John Snow took off the Broad Street pump handle. Sometimes, the fastest spreader isn’t the disease, but rather poor communication and fear. In every after-action report, communication tends to be the biggest failure. Not only do people fail to talk to each other enough, but information dissemination and comprehension tends to be poorly emphasized, when in fact it could save lives. “In particular, healthcare workers may benefit from knowing about newly found transmission risks or disease findings from a novel case under intensive care. Knowledge drives behavioural change that can save lives. We live in a global community. Even if the lives saved are not citizens of our country, withholding information because it is unlikely to benefit our own countrymen, or even delaying dissemination of important information until it is published in a scientific journal is a poor choice.” Dr. Ian Mackay and Katherine Arden point to communication failures regarding the zoonotic transmission of MERS-CoV and the illness of a nurse from the UK who recovered from Ebola and was later hospitalized for meningitis. Both instances involved poor communication, especially to healthcare workers. “Good communicators and reliable communications are vital. Create a dialogue with the public now to build a partnership for later, to reduce distrust when an outbreak, epidemic or pandemic occurs. In this way, communities know which voices to trust and where to turn for their information. Leaving an information void invites others to fill it and more often than not, it is those who delight in titillation, invention, make-believe and fear-mongering.”

Weekly Dose of Zika Virus
H.R. 5243 – Zika Response Appropriations Act of 2016 is the hot topic of discussion this week, as President Obama’s Administration is opposing the act. “While the Administration appreciates that the Congress is finally taking action to address the Zika virus, the funding provided in H.R. 5243 is woefully inadequate to support the response our public health experts say is needed.  Specifically, the Administration’s full request of $1.9 billion is needed to:  reduce the risk of the Zika virus, particularly in pregnant women, by better controlling the mosquitoes that spread Zika; develop new tools, including vaccines and better diagnostics to protect the Nation from the Zika virus; and conduct crucial research projects needed to better understand the impacts of the Zika virus on infants and children.On May 17th, the Senate voted to provide $1.2 billion to fight the growing outbreak. A team from the University of Texas Medical Branch at Galveston has traveled into uncharted territory – they are the first to genetically engineer a clone of the Zika virus strain.  Their work could help speed up vaccine development and research of the virus. As the Zika outbreak rages onwards, many are pointing to the need to understand how and why it mutated from Africa to Asia and then to the Americas.  “‘Like many arboviral agents, given the appropriate environmental and human conditions, new pathogens can be easily moved around the globe,’ Ann Powers said. And that’s what Zika did. The virus began to ripple across the Pacific—and as it traveled, it seemed to change.” The Olympic Games are fast approaching and the debate about the safety of the games has been spreading (see what I did there?). Last week you read about how some are saying the games should be cancelled, while others say it poses a minimal threat. You can also find a snapshot of Zika virus here. The WHO reported that the overall risk of Zika virus moving across the WHO European region is low to moderate during late spring and early summer. Rutgers is taking the lead on an IBM-sponsored project that will utilize supercomputing resources to identify “potential drug candidates to cure the Zika virus.” The Wilson Center is hosting an event, “Zika in the U.S: Can We Manage the Risk?” on Tuesday, May 24th, at 11am. Many are also wondering why humans and not mice are susceptible to the virus. Lastly, as of May 18th, the CDC has reported 544 travel-associated cases and 10 sexually transmitted cases within the U.S.

Governance Structures for Reducing Dual-Use Technology Risks
The American Academy of Arts & Sciences has published an examination of dual-use technology governance and the state of current efforts to control the spread of potentially dangerous technologies. “Governance of Dual-Use Technologies examines the similarities and differences between the strategies used for the control of nuclear technologies and those proposed for biotechnology and information technology. The publication makes clear the challenges concomitant with dual-use governance.” The report looks at the potential objectives of these measures, what they translate to in a technical format, and if these measures are even feasible.

Global Avian Influenza A H5N1 Trends
Researchers recently looked at the epidemiology of human H5N1 cases from 1997-2015. This was the first comprehensive analysis of human cases on a global scale. The number of affected countries rose between 2003 and 2008, traveling from east Asia into west Asia and Africa. “Most cases (67·2%) occurred from December to March, and the overall case-fatality risk was 483 (53·5%) of 903 cases which varied across geographical regions. Although the incidence in Egypt has increased dramatically since November, 2014, compared with the cases beforehand, there were no significant differences in the fatality risk, history of exposure to poultry, history of patient contact, and time from onset to hospital admission in the recent cases.”

Stories You May Have Missed:

  • Health Security Available – The newest volume of Health Security is now available online. The recent issue includes pieces on Zika and microcephaly, preparing for climate disruption, adapting to health impacts of climate change in the DoD, and more!
  • Secret Genome Meeting – Last week saw a meeting hosted by Harvard Medical School’s George Church, to discuss “feasibility and implementation of a project to synthesize entire large genomes in vitro.” Initially the meeting was open to the public and media however, the decision was made to keep it private (from the media) so that researchers, lawyers, entrepreneurs, and government officials could speak freely without fear of being misquoted. “Our ability to understand what to build is so far behind what we can build,” said Jeremy Minshull, chief executive of DNA synthesis company DNA2.0, told The New York Times. “I just don’t think that being able to make more and more and more and cheaper and cheaper and cheaper is going to get us the understanding we need.”
  • Four Countries Fend Off Avian Influenza- Cambodia, Ghana, and Indonesia have been battling H5N1 and Italy has just reported its second H7N7 occurrence this month. Ghana and Cambodia have reported significant bird mortalities, with the virus killing 155 of 505 susceptible birds. “In Ghana, the H5N1 virus turned up in four commercial layer and breeding farms in three of the country’s regions: two in Greater Accra and one each in Eastern and Central regions.”
  • Bavarian Nordic Smallpox Vaccine Contract – the pharmaceutical company announced that BARDA has ordered a bulk supply of their new IMVAMUNE smallpox vaccine. The $100 million supply of the non-replicating vaccine requires Bavarian Nordic to manufacture and store the bulk supply. “The freeze-dried version of IMVAMUNE is expected to reduce the life cycle management costs based on a longer shelf life and will replace the liquid-frozen version that is currently stockpiled in the U.S. Strategic National Stockpile (SNS).”
  • Early Detection Lyme Disease Test Successful – GMU researchers have proven that their early-detection urine test works to rapidly identify Lyme diseases. “The National Institutes of Health funded the research that led to Mason’s patented technology, which traps tell-tale clues (such as the Lyme bacteria protein) that a disease is present. The Mason technology, which is licensed to Ceres, works during the earliest stages of disease and finds the tiniest traces missed by most diagnostic tests.”

Pandora Report 2.12.2016

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

 

Pandora Report 12.25.2015

Happy Holidays fellow biodefense gurus! We at the Pandora Report would like to wish you and yours a lovely holiday season, filled with happiness, health, and a side of relaxation. Your favorite weekly dose of biodefense news be taking a few weeks off from reporting while I venture to the land of Oz. Rest assure, should there be a zombie outbreak, I’ll report it first hand! Since we’ll be radio silent for a couple of weeks, we’ve compiled a pretty swanky “I love biodefense and need more of it” reading list to keep you busy. Before you venture down the biodefense rabbit hole, here is fun history fact Friday: on December 24th, 1814, the war of 1812 ended and on December 24, 1936, the first radioactive isotope medicine was administered by Dr. John Lawrence

The Revolving Door of Biosafety7898_lores
GMU Biodefense Master’s student and lab guru, Scott McAlister discusses the importance of biosafety in the changing world of global health. Through his review of the 2009 report by the Trans-Federal Task Force on Optimizing Biosafety and Biocontainment Oversight and a 2015 memorandum released by the White House to enhance biosafety, he discusses the ever changing components of US biosafety. Scott breaks down and compares each report’s recommendations, language, and what these translate to within US laboratories. Moreover, given the recent failures, have US biosecurity practices and recommendations evolved over the past 6 years? Take a look into this review to see where we hope to be and if we’ve progressed since 2009.

National Action Plan for Combating Multidrug-Resistant TB
This week the White House released its national plan for combating the growing threat of multidrug resistant tuberculosis. While US rates of TB cases have dropped, the growing threat of multidrug resistant TB (MDR-TB) and extensively resistant TB (XDR-TB) requires action. This new plan is set to span over 3-5 years and has three goals that will focus on strengthening domestic capacity, improving international capacity and collaboration, and accelerating basic and applied research and development. Extensive collaboration within US agencies and international partners will be necessary to combat the evolving threat of drug resistant tuberculosis.

We’re Not Prepared for a Biological Attack
GMU Biodefense PhD alum, Dr. Daniel M. Gersteindiscusses biopreparedness and where the US stands in his work for US News  & World Report. Throughout his in-depth analysis, Dr. Gerstein emphasizes the importance of US leadership within the Biological Weapons Convention (BWC). Pointing to the disappointing Seventh and Eighth Review Conferences, Dr. Gerstein notes, “biological warfare can no longer be considered the purview of only state actors. And this democratization of biotechnology means that the world is literally one rogue microbiologist away from a potentially devastating biological attack.” Dr. Gerstein emphasizes that authorities often fail to realize that biological weapons may not act like naturally occurring diseases or outbreaks.

Holiday Biodefense Book Club
During the cold winter months it’s always nice to curl up by the fire with a good book and relax. GMU Biodefense Master’s student, Rebecca Earnhardt, and I have picked a handful of books to spark your interest. If we could have a book club with our awesome readers, we would love it, but in the mean time, here are our recommendations for a few literary works that you might enjoy!

  • Phantom Menace or Looming Danger?: A New Framework for Assessing Bioweapons Threats By Kathleen M. Vogel — Johns Hopkins Press, 2012. The military has gathered reconnaissance of a possible biological research facility, evidence of a paper trail indicating procurement of weapons delivery systems, and collection of specialized personnel to manufacture biological agents.  Do all of these pieces point to an imminent biological weapons danger?  Kathleen M. Vogel, in Phantom Menace, argues that there is more to the picture of biological weapons development than the technical and physical aspects of manufacturing.  Through examination of three case studies, Vogel highlights the shortcomings of the dominant biotech revolution frame within biological weapons assessments.  The biotech revolution frame, as described by Vogel, misses the important social and contextual factors that affect biological weapons innovation.  The alternative offered by Vogel is termed the biosocial frame.  Vogel highlights in her biosocial frame how tacit knowledge and hands-on experience is vital to biological weapons assessments.  While Vogel does not particularly focus on political influences, I enjoyed the book because of her explanation of the importance in incorporating sociological aspects into biological weapons assessments.  I think this makes Vogel’s work a key book in the field of biodefense.
  • Innovation, Dual Use, and Security: Managing the Risks of Emerging Biological and Chemical Technologies. Editor: Jonathan B. Tucker — MIT Press, 2012. The hotly debated concept of ‘dual-use’ is explored extensively through this multipart work edited by the late chemical and biological weapons expert, Jonathan B. Tucker.  This book takes on the conceptual nuances of dual-use with four parts focused on emerging technologies within the areas of directed design, acquisition of novel molecular parts, modification of biological systems, and enhanced production and packaging capabilities.  Each section, authored by leading experts in the field of biodefense research, including Filippa Lentzos and Gerald Epstein, applied Tucker’s framework of risk assessment for dual-use potential and governability.  This framework incorporates key aspects of assessing dual-use potential, including technological monitoring, technology assessments, and governability of the technology.  The strength of this framework lies in its applicability to emerging technologies, which may enable policy makers to continuously review a particular technology or an emerging area of research.  In the concluding chapter, Kirk Bansak and Jonathan Tucker redirect attention to the intervening social processes that construct relationships between the technology and its users, and how these social processes may create an environment ripe for misuse.  To me, this book is a highly valuable and informative work on the range of dual-use issues and conceptual applications.  I think this book is an important read not only because it covers a variety of dual-use issues, but also in its wide-ranging review of relatively recent biotechnology and life science innovations.  The variety of case studies makes this book an enjoyable read!
  • Spillover: Animal Infections and the next Human Pandemic by David Quammen. New York: W.W. Norton, 2012. Not only is David Quammen one of my favorites, but his overview of zoonotic diseases and the concept of spillover will both captivate and inform you. Ranging from West Nile Virus to Ebola, Quammen presents several of the zoonotic diseases you may have heard of and others that may cause you to reconsider kissing a horse anytime soon. Each chapter presents a new disease, it’s history, and a new outbreak that should raise our attention to global health security. While he doesn’t touch much on avian influenza or multi-drug resistant organisms, his points on humans infringing upon animal ecosystems and the resulting disease spillovers are harrowing. Quammen’s adventures remind me of a microbial Indiana Jones (hint hint Hollywood, that would make an excellent movie!), even with the cheeky wit. I would recommend Spillover as a gateway to understanding the role of zoonotic diseases and the emphasis we’re seeing on One Health. While his parts on Ebola aren’t as dramatic as Richard Preston, you’ll be sure to enjoy his approach to epidemiology and the impact of spillover on global health. Quammen did extend his sections on Ebola into another book that includes information related to the 2014/2015 outbreak. If you enjoy on-the-ground reporting, you’ll find this within Quammen’s book.
  • Greek Fire, Poison Arrows, and Scorpion Bombs: Biological and Chemical Warfare in the Ancient World by Adrienne Mayor. Woodstock: Overlook Duckworth, 2003. As a lover of all things biodefense and classical, I was excited when I cam across Adrienne Mayor’s book. Combining ancient history and bioweapons? Sold! Mayor’s breakdown throughout the book reveals the mythical and historical accounts of chemical and biological weapons in the ancient world. While a bit dramatic and sometimes repetitive, I found her book to be enjoyable in that few people have combined ancient history and chem/bioweapons to such an extent. Mayor makes sure to include references to mythology that heavily impact these ancient societies. While the lines of chemical and biological weapons were sometimes muddied and some generalizations related to classical history did occur, I would recommend her book to anyone who enjoys history (especially ancient history), mythology, and CBW. Realistically, with such a catchy title, how could you resist?

Stories You May Have Missed:

Pandora Report: 11.13.2015

Given the auspicious nature of Friday, the 13th, how about we start the Easy-Bake Oven version of bioreactors? (insert evil genius laugh). Our report this week is rich in biosafety, GMU Open Houses, and updates on global outbreaks. Fun History Fact Friday – this week in 1989, the Berlin Wall came down! Before we venture down the rabbit hole, don’t forget to get your flu shot before the 2015/2016 influenza season hits too hard!

DIY Bioengineering 
If you’re in search of the perfect holiday gift for your favorite biodefense/bioengineer, you can thank the creators of Amino (personally, I think calling it the Easy-Bake Oven Bioreactor is just so much more fun). The kit starts at $700 and comes with all the essentials for your “recipe” (main bacterial culture, DNA, pipettes, incubators, agar plates and various sensors for monitoring microbial growth). Did I mention it comes in a nice color-coded, pleasing-to-the-eye plywood dashboard? MIT graduate, Julie Legault, is the master genius behind Amino, and uses the “apps” (step-by-step guides) to help make even the most science adverse individual capable of making DNA products. Liz Stinson points out that “they walk users through how to insert the DNA into untransformed bacteria cells, and how to incubate, grow, and maintain the altered microorganisms”. Just make sure your new gift comes with some information on dual-use research of concern and avoids any select agents…

Master’s Open House 
Make sure to swing by our GMU Master’s Open House on Wednesday, November 18th at 6:30pm to learn about all our different programs! Good news – you can virtually attend via this link and even ask questions live! We’ll be talking biodefense and all the ways you can use our MS degree (online or in person!). Whether its fighting food safety issues, pandemic influenza, or zombies, we’re passionately trying to make the world of global health security stronger and more diverse!

Biological Research: Rethink Biosafety 
“Biology must move forward on safety and security. Let’s not reinvent the wheel, but learn from those doing safety better.” Tim Trevan’s comments echo the sentiments of many within the biosecurity field. The anthrax mishaps at Dugway and the CDC BSL-3 lab in Atlanta compound a growing concern over the handling of select agents and the lab safety practices and processes that seem to be failing. Trevan poses the question, “what are the prospects for managing the more intractable risks globally if measures to ensure the safe handling of dangerous pathogens are failing at the best-equipped facilities in the country with the most advanced biotechnology in the world?” In his words, Trevan has hit the nail on the head and summarized the realities of lab safety culture. So what’s to be done? Trevan makes the unexpected recommendation of  using nuclear security experts to advise on biosafety and biosecurity. This strategy utilizes a practice that is also common in healthcare – a culture of safety. By focussing on the prevention of failure, instead of maximizing output, safety becomes an engrained practice in all levels of an organization, transforming it into a “high-reliability organization” (HRO). By using examples within industries like offshore oil drilling, airlines, etc., Trevan points to the growing biotech capabilities that make biosecurity that much more imperative. In healthcare, I’ve seen organizations truly transform their practices by moving to a culture of safety (and utilizing “just culture” when it comes to patient safety) and while it’s not a wholly easy process, the foundations are already present in the existing teachings of patient care. Labs have the training and knowledge for safety, but as Trevan points out, it’s time to bring in those with the expertise to help move towards a culture of safety.

Screen Shot 2015-11-12 at 9.56.04 AM
Courtesy of HDOH

Dengue Fever Outbreak in Hawaii 
If you’re considering a winter retreat to Hawaii, make sure to grab some bug spray. Hawaii Island is currently experiencing a Dengue outbreak that has just reached 33 cases. Dengue is not endemic to Hawaii and while travelers have imported cases from time to time, this is marks the first big cluster of locally-acquired cases since 2011. The Hawaii Department of Health (HDOH) continues investigations and reports (as of 11/11)  25 Hawaii Island residents and 8 visitors have been laboratory confirmed with dengue fever. The HDOH has provided maps related to exposure areas to help people avoid high-risk locations or at least use preventative measures. If you’re traveling to Hawaii Island or an area where dengue is endemic, make sure to take steps to reduce the risk of mosquito bites and the potential for transmission!

Ebola Update
Guinea has reported no new cases in the last week. While they’re still on high alert after the cases surrounding a family, they are hopeful. Liberia and Sierra Leone have hit their 90-day enhanced surveillance period, meaning they have no new cases and are now working towards the WHO’s second objective (managing and responding to residual risks). Pauline Cafferkey has made a full recovery after her hospitalizations due to post-Ebola recovery complications. Researchers at Columbia University’s Mailman School of Public Health used a new statistical model to map the outbreak. Results will be published in the Journal of Royal Society Interface, which shows the development of the outbreak and role early detection and response plays.

Stories You May Have Missed: 

  • Joint Services Mask Leakage Tester (JSMLT) Contract – the DoD has announced that Air Techniques International, Inc. has been awarded a contract regarding the maintenance of the JSMLT. The JSMLT does quality control and ensures proper fitting (portably) on CBRN protective masks.
  • H7N9 Cases in China Rise– China has confirmed two more cases that occurred in October, bringing the total case count to four. Many in public health are noting that these cases bring about a fourth wave of infections (starting in October). The two new cases were a a 62-year-old woman from Shengzhou and a 51-year-old farmer from Hangzhou.
  • Boosting Biosecurity in Nigeria & Kenya– The Institute of Human Virology at the University of Maryland have announced two grants to help build biosecurity in Nigeria and Kenya. The first grant of $13 million will go to strengthen laboratory infrastructure in Kenya, and the second of $10 million will help those in Nigeria quickly detect and respond to emerging infectious diseases.

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Pandora Report 10.2

All this rain and grey weather (at least in DC) makes us want to curl up with a good book and luckily, we’ve got just the reading list! This week we’re sharing some top-notch work by our phenomenal faculty and alumni for you to enjoy. Earlier this week, straight out of a James Bond movie, Elon Musk presented Tesla’s Model X and its Bioweapon Defense Mode. Google had its 2015 Science Fair and a pretty amazing high school student took home top honors for her work on Ebola. Did I mention Kansas is prepping for the zombie apocalypse? Needless to say, there was a lot going on this week in the world of biodefense, so let’s venture down the rabbit hole….

 Zombie Preparedness Month Starts for Kansas 
I’m thinking we may need to take a class trip to Kansas since Governor, Sam Brownback, will be signing a proclamation to officially designate October as “Zombie Preparedness Month”! Brownback’s rationale is to emphasize preparedness in any form, stating, “If you’re prepared for zombies, you’re prepared for anything. Although an actual zombie apocalypse will never happen, the preparation for such an event is the same as for any disaster: make a disaster kit, have a plan, and practice it.” During Zombie Preparedness Month, state emergency management services will have activities and information for residents to help get their preparedness on. They’ll also be using social media to engage people people on these topics. The one thing we’ve learned in biodefense, Gov. Brownback, is to never say never!

Connecticut Teen Wins Google Science Award By Developing Affordable Ebola Test
High school junior, Olivia Hallisey, just took home the Google Science Fair top prize for developing an affordable and easy Ebola test in her project, “Ebola Assay Card”, which quickly (we’re talking 30 minutes quick!) detects the virus and doesn’t require refrigeration. Each test only costs $25 and picks up antigens on photo paper. Hallisey summarizes, “In this new device, that is stable and stored at room temperature, 30µl drops of water were used to dissolve silk-embedded reagents, initiating a timed-flow towards a center detection zone, where a positive (colored) result confirmed the presence of 500pg/ml Ebola(+)control antigens in 30min, at a cost of $25,” Hallisey hopes this project will encourage other girls to pursue their passions in science. Hallisey is truly an inspiration and we tip our hats to her passion for solving world problems while encouraging her peers!

Let’s Talk Dual-Use!
Come listen and chat with Dr. David R. Franz, former commander of USAMRIID, about balancing research and regulations when it comes to dual-use!
Date & Time: Monday, October 5, 2015, 4:30-6pm
Location: Hanover Hall, L-003 George Mason University, Fairfax, VA, see map

​Dr. Franz was the Chief Inspector on three United Nations Special Commission biological warfare inspection missions to Iraq and served as technical advisor on long-term monitoring.  He also served as a member of the first two US-UK teams that visited Russia in support of the Trilateral Joint Statement on Biological Weapons and as a member of the Trilateral Experts’ Committee for biological weapons negotiations.  He previously served as member of the National Science Advisory Board for Biosecurity (NSABB). Dr. Franz currently serves on several committees including the National Academy of Sciences Committee on International Security and Arms Control and the National Research Council Board on Life Sciences. Dr. Franz is a leader in the areas of cooperative threat reduction and health security and an expert in the development of U.S. regulations for biological threat reduction and biological security.  Dr. Franz will discuss the history and current debates related to U.S. and international regulations for select agents, dual use research of concern, and gain-of-function experiments.

1977 H1N1 Influenza Reemergence Reveals Gain-of-Function Hazards
Dr. Martin Furmanski discusses the gain-of-function (GoF) research hazards in relation to the 1977 H1N1 strain and it’s laboratory origins. Highlighting a previous article on the GoF debate, Dr. Furmanski notes that “separating the risks of vaccine development from those of basic GoF research is inappropriate, because GoF research seeks to discover antigenic and genomic changes that facilitate human-to-human transmission and/or augment virulence, with the aim of preemptively producing vaccines.” He also notes that while the 1977 H1N1 epidemic originated in a lab and it’s release was unintentional, the culprit laboratory matters little in the GoF debate.

Define Acceptable Cyberspace Behavior
GMU Biodefense alum, Dr. Daniel M. Gerstein, discusses the US-China cybersecurity agreement and the Friday announcement between Chinese Premier Xi Jinping and President Barack Obama. The agreement highlights the mutual desire to prevent cybertheft of business secrets. Dr. Gerstein emphasizes that while this agreement is a step in the right direction, it points to larger preparedness and response capability gaps. He notes, “So while a U.S.-China agreement is a welcome step, it also underscores the greater issues facing the United States, and indeed the international community, in this largely ungoverned space.” Dr. Gerstein highlights the necessity to define cyberspace boundaries, especially as there are delays in DHS security system deployments while US vulnerabilities continue to develop.

Implementation for the US Government Policy for Institutional Oversight of Life Sciences Dual Use Research of Concern
As of September 24, 2015, all institutions and USG funded agencies are now required to comply with the policies. Agencies now must have “a mechanisms in place to evaluate research that is potentially Dual Use Research of Concern (DURC).” Institutions must also organize an Institutional Review Entity (IRE) to review and manage compliance with these requirements.

Dr. Sonia Ben Ouagrham-Gormley’s  new book, Barriers to Bioweapons, received glowing reviews in the latest issue of Perspective on Politics. Her work, which is a staple for biodefense courses, and particularly this text, focusses on the perception of risk and lethality of bioweapons while addressing the realities of these assumptions. Ouagrham-Gormley discusses the key role of tacit versus explicit knowledge in the development and dissemination barriers for bioweapons. “The author identifies important factors internal to a weapons-development program- talented individuals and cohesive groups, corporate culture, communities of practice, organization structure- as critical nodes or ‘reservoirs’ of knowledge that must be configured to optimize the sharing of ideas and information.” The case studies of Iraqi and South African programs, as well as Aum Shinrikyo, lay the foundation for her points on the role of internal and external variables that can hinder or help a bioweapons program. Whether you’re reading  it for class (GMU Biodefense folks, I’m looking at you!) or you’re looking to brush up on nonproliferation, this book is a well-written and captivating necessity to understand bioweapon development. Did I mention how awesome the cover is?
Our very own GMU Biodefense PhD alum, Dr. Denise N. Baken, has a wonderful new book being released – let’s check it out! Al Qaeda : The Transformation of Terrorism in the Middle East and North Africa examines violence and the way it is marketed by the global terrorism industry.  Authors Denise Baken and Ioannis Mantzikos frame the violence discussion through the prism of its use by Al Qaeda, Al Qaeda in the Arabian Peninsula (AQAP) and Islamic State of Iraq and Syria (ISIS).Baken and Mantzikos look at the business parameters of violence –its cost, return on investment, efficiency, and effectiveness; They propose a new approach to that violence. One that looks at violence as a controlled commodity that evolved from Al Qaeda’s initial presentation of future possibilities, AQAP exploited those possibilities and ISIS pushed the boundaries of usability.
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