Pandora Report 11.17.2017

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

GMU Biodefense MS student Stephen Taylor

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

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

Pandora Report 11.3.2017

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

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

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

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

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

Pandora Report 10.13.2017

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

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

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

Pandora Report 10.6.2017

Welcome to your favorite weekly dose of biodefense news!

George Mason University Global Health Security Ambassador Fellowship
We’re excited to announce the selection of two GMU Biodefense students, Anthony Falzarano and Stephen Taylor, as recipients of the George Mason Global Health Security Ambassador Fellowship. As GMU Global Health Security Ambassadors, they will be attending the 4th Annual GHSA Ministerial Meeting in Kampala, Uganda as part of the Next Generation Global Health Security Network delegation. The Next Generation Network engages and facilitates contributions by emerging scholars, scientists, and professionals from government and non-governmental institutions to the Global Health Security Agenda (GHSA) and other global health security projects. The NextGen Network is led by Jamechia Hoyle, who is not only an infectious disease guru, but also an adjunct professor at GMU, teaching Global Health Security Policy. The GHSA meeting, which will take place from October 25-27, is the world’s premier meeting on global health security and will be attended by senior representatives of the Ministries of Health, Agriculture, Finance, and Security from more than 50 GHSA member states as well as implementing partners from civil society and the private sector. The theme of this year’s meeting is Health Security for All: Engaging Communities, Non-Government Actors, and the Private Sector.                                                                                                                                                       Thanks to the generous support of the Schar School, our Biodefense graduate students will be able to provide you with detailed accounts of the meeting from the front row. Following the GHSA meeting, we will be publishing their experiences and thoughts on the summit, so you’ll want to stay tuned. Anthony is a microbiologist and environmental engineer, who focuses his research on antimicrobial resistance, food and agriculture microbiology, and microbial enhanced oil recovery. Anthony also worked with Ohio State University’s Medical Center to study biofilms as a public health burden. Stephen is a biologist and Peace Corp-alum where he served in Mozambique  teaching biology, information technology, and English. Since 2015, he has worked for the U.S. Department of Agriculture at the Animal Parasitic Diseases Laboratory in Beltsville, Maryland.

Blue Ribbon Study Panel: U.S. Not Prepared to Identify Perpetrators of Biological Crimes, Terrorism, Proliferation, and Warfare
The Blue Ribbon Study Panel just released information on their recent special meeting, Biological Attribution: Challenges and Solutions, which sought to better understand the ability of the U.S. government to accurately identify pathogens and their sources, “attribute the use of biological weapons with scientific and other forms of evidence; and explore the processes used for investigative, legal, policy, and political decisions involving biological attribution.” “Effective prosecution depends on the ability to quickly and accurately attribute crimes to their perpetrators,” said Ken Wainstein, meeting chair, and former Homeland Security Advisor and United States Attorney. “In the aftermath of a biological attack, we need to find out who did it, how they did it, what disease agent they used, and where they obtained it. The biological threat is real and growing, and the Nation needs this attribution capability now.” Adds former Senate Majority Leader Tom Daschle, whose office received some of the anthrax letters in 2001, “We face some major challenges in microbial forensics and biological attribution, but we can overcome many of them. We need to do what we can to eliminate them now, before we find ourselves under attack again. We can’t afford to have another investigation drag on for years.” The Panel also addressed the impact of the President’s FY2018 budget request on biodefense efforts and how it could eliminate critical health security functions.

Fostering an International Culture of Biosafety, Biosecurity, and Responsible Conduct in the Life Sciences
GMU biodefense MS alum Kathleen Danskin and PhD student Elise Rowe are tackling the importance of biosecurity, biosafety, and responsible conduct in life sciences. Citing the lack of an internationally agreed upon definition and approach to disseminating lessons, they highlight “how these concepts are covered by relevant international treaties, international organizations, and professional organizations. While there are some efforts under way, opportunities exist to evaluate and strengthen the culture of biosafety, biosecurity, and responsible conduct in the life sciences in order to prevent the loss, theft, misuse, and diversion of biological agents, related materials, technology, or equipment, and the unintentional or intentional exposure to (or release of) biological agents.” Responding to this gap, Danskin and Rowe propose three changes: partnership between international regimes, organizations, and professional organizations to share and enhance best efforts, use of the nuclear safety and security culture as a model for creating organizational culture within life sciences, and that the international community should amplify efforts to recognize “champions of change” at the state level. “Challenges remain on how best to address the issue of operationalizing the concept of a culture of biosafety, biosecurity, and responsible conduct in order to address goals such as: (1) reducing the occurrence of laboratory-acquired infections (LAIs), incidents, and near misses, (2) ensuring that biosafety, biosecurity, and responsible conduct receive adequate attention, (3) ensuring that organizational members share the same beliefs and attitudes about risks, LAIs, and near misses, (4) increasing commitments to biosafety and biosecurity, and (5) assessing the breadth and strength of a biosafety and biosecurity program.”

Reasonable Doubts: Foreseeing Failures in WMD Security
GMU biodefense MS alum Greg Mercer is evaluating the historical failures in WMD security and what we can take away from such terrifying events. Pulling on examples from the live anthrax spores being mailed due to poor DoD lab practices to antinuclear protesters managing to get into the Oak Ridge nuclear facility, Mercer addresses serious system failures and a “culture of complacency”. Unfortunately, since the creation of nuclear weapons, there has been a colorful history of accidents and close calls. Mercer cites such examples to point out that while not spectacularly dramatic (I’m thinking of something like the film, The Rock), they nonetheless highlight significant vulnerabilities. “As a class, these organizational problems are not unique to the management of WMD. Insights into their nature, and into the sorts of practices that could help to anticipate and remedy them, may also be found further afield. Especially within the broader study of national security, a new literature has begun to emerge proposing either a new framing of the issues, or identifying tools and ideas that might be employed to guard against recurring ‘complacency’.” Mercer points to analyses, like those from Janne E. Nola, which suggest grass-roots changes that aim at fixing things at the organization level. What is to be done though? Some suggest the use of red teaming, while others point to forecasting and prediction, as a means to identifying risks and vulnerabilities. “History shows that warning signs are often ignored until disaster strikes, and that disaster is the engine of change. In the United States, the public demands change. If better institutional checks are to be placed on American nuclear and biological security, it will take a public outcry like the one that follows a disaster. The public will have to demand that the country’s nuclear- and biological-defense enterprises stop stepping out to the brink, and instead avert the disasters foreshadowed by the many uncomfortable compromises and accidents we have seen.”

Madagascar Battles Plague
The death toll has risen to twenty as government officials are banning public gatherings in the country’s capital. While plague is endemic to the country and causes roughly 400 cases a year, this spike in cases and the swift spread is concerning the WHO after already 114 cases have been reported since August. “More than half of recorded cases – 73 out of 133 – are pneumonic plague, the most virulent form, which is passed through person-to-person transmission. If it is not treated, pneumonic plague can be fatal within 24 hours. The epidemic also involves bubonic plague, which is spread by rats and kills about 50% of people it infects.” The WHO has released $300,000 in emergency funds and is asking for $1.5 to support outbreak response as the disease has quickly spread to several cities and outbreak season (September-April) is just beginning. You can read the latest WHO report on the outbreak here.

HBO VICE’s Contagion Episode
Check out the latest VICE episode regarding two interesting topics – Russian hacking and contagions. “The outbreak of an infectious disease sparks worldwide panic nearly every year. And as humans cluster themselves in denser cities and encroach closer to the wildlife harboring disease, the chances of a devastating global pandemic only intensifies. But scientists are finding that diligent surveillance of these threats could help keep the next nightmare disease at bay. VICE founder Suroosh Alvi went to Uganda to see how vulnerable humans are to a new pandemic and the options there are for staving it off.”

Bavarian Nordic Wins Up-to-$539M BARDA Contract for Smallpox Vaccine BARDA has contracted with Bavarian Nordic to ensure the U.S. Strategic National Stockpile has smallpox vaccine in the form of freeze-drived Imvamune. “The contract consists of an initial $100 million base award toward manufacturing and storage of Imvamune vaccine bulk—the third bulk contract inked between the company and BARDA. The two earlier bulk contracts total a combined $233 million. In addition, the contract includes two initial options: Up to $299 million toward the filling and freeze-drying of Imvamune produced under the three bulk awards and up to $140 million toward clinical development, regulatory commitments, and portions of the establishment and validation of fill/finish activities.” This new contract will cover roughly 13 million doses at $48 per dose.

The Risk of Adoption of Chemical and Biological Weapons by Non-State Actors in the EU                                                                                                                                             James Revill addresses growing concern over the potential for non-state groups to utilize chemical or biological terrorism within the European Union. Pulling on historical events involving CBW use by non-state actors, he addresses the current and future risks. “To achieve this, the article analyses six interlinked clusters of factors that can be seen as important in assessing the risk of whether or not to adopt such weapons. These are: the perceived relative advantage of CBW and their utilities; the complexity of such weapons; their ideological compatibility; the role of organisational structures; the visibility and ‘fashionability’ of such weapons; and the wider environmental context.” Overall, Revill finds that while there is potential for sophisticated CBWs to do great harm, they are unlikely, and the use of a “scruffy low-level chemical weapon” is much more realistic.

ABSA International 60th Annual Biological Safety Conference
October is national Biosafety Month, so don’t miss out on this conference held by the Association for Biosafety and Biosecurity on October 13-18th in Albuquerque, New Mexico. The conference will include special meetings like public health interest groups, next generation/new biosafety professionals shared interest group meetings, and great networking opportunities for biosafety and biosecurity professionals!

How the 1918 Flu Pandemic Revolutionized Public Health
As the centennial of the 1918/1919 pandemic approaches, it encourages us to really look at what has changed and what we’ve learned from such a global catastrophe. Public health itself has evolved – no longer restricted by the antiquated policies that were marked with eugenics and social stigma. At the time, influenza was not a reportable disease either, which meant that public health surveillance was shotty at best and quarantine efforts were usually too little, too late. “The lesson that health authorities took away from the catastrophe was that it was no longer reasonable to blame an individual for catching an infectious disease, nor to treat him or her in isolation. The 1920s saw many governments embracing the concept of socialized medicine—healthcare for all, delivered free at the point of delivery.” Now, disease surveillance and epidemiology are a cornerstone of public health, not to mention the development of the WHO in 1946. The 1918 flu pandemic forced us to change our approach to public health, but also taught a vital lesson – infectious disease was a global problem and not isolated to a single country, region, or group of people.

Biosafety Governance
The Federal Experts Security Advisory Panel (FESAP) just released their report on ensuring institutional compliance with biosafety, biocontainment, and laboratory biosecurity regulations and guidelines. FESAP recommendations are crucial, as they are supposed to be followed within research facilities that perform work with human, plant, and/or animal infectious agents and toxins. “The United States has a comprehensive biosafety, biocontainment, and biosecurity oversight system designed to protect laboratory workers, public health, agriculture, the environment, and national security. Biosafety and biocontainment oversight rests on a foundation of federal regulations, guidelines, and policies and is provided at multiple levels. Oversight of day to day research activities is largely a responsibility of the institutions and the investigators conducting the research with direct biosafety oversight being implemented at the local level.” In efforts to ensure compliance and build a culture of responsibility, FESAP has released guidance that aims to ensure biosafety, biosecurity, and biocontainment, while encouraging research. Some of the regulations and guidelines include: “conduct regular assessments of committees, offices, and departments with responsibilities for biosafety and biosecurity oversight to assess their function and strengthen their performance when necessary” and “promote transparency regarding institutional biosafety and biosecurity oversight.” The report also includes federal regulations and guidelines regarding research conduct, environmental regulations, dual-use research of concern oversight at the institutional level, etc.

Stories You May Have Missed:

  • BioShield Adds Ebola Vaccine To SNS & BARDA Industry Day – Project Bioshield, responsible for acquiring MCM against CBRN agents, is now adding two Ebola treatments and two vaccines to the Strategic National Stockpile (SNS). The new additions include “a single-dose vaccine licensed by Merck, a prime-boost vaccine regimen from Johnson & Johnson, and monoclonal antibody treatments from Mapp Biopharmaceutical and Regeneron Pharmaceuticals.” If you’re looking to get more information on MCM, you can also attend the 2017 BARDA Industry Day on November 7-8, at the Ronal Reagan Building. Presented by ASPR (Assistant Secretary for Preparedness and Response), the conference will give individuals the opportunity to learn about the past, present, and future of BARDA, MCM development opportunities, experiences partnering with BARDA, and more. Robert Kadlec, Assistant Secretary for Preparedness and Response, will be the keynote speaker for the event.
  • Bioweapons and Virtual Terrorism – Considering the threat of biological weapons and virtual terrorism? It was recently estimated that the cost of a bioweapon is 0.05% the cost of a convention weapon that would produce the same casualties per square kilometer. What are your thoughts on the author’s notion that biological weapons are “comparatively easy, using common technology available for the production of some antibiotics, vaccines, foods, and beverages, and delivery systems such as spray devices from an airplane, boat, or car are commonly available”?
  • History and Future of the Global HIV/AIDS Response: A Conversation with Dr. Michael Merson and Dr. Stephen Inrig– The Center for Strategic and International studies will be hosting this event on Monday, October 16th from 10-11:30am. Drs. Merson and Inrig will discuss the origins and evolution of the global HIV/AIDS response, as well as critical current and future issues affecting the fight against the disease worldwide, which were recently highlighted in papers issued by the CSIS HIV Working Group.  “This ambitious book provides a comprehensive history of the World Health Organization (WHO) Global Programme on AIDS (GPA), using it as a unique lens to trace the global response to the AIDS pandemic. The authors describe how WHO came initially to assume leadership of the global response, relate the strategies and approaches WHO employed over the years, and expound on the factors that led to the Programme’s demise and subsequent formation of the Joint United Nations Programme on HIV/AIDS (UNAIDS). The authors examine the global impact of this momentous transition, portray the current status of the global response to AIDS, and explore the precarious situation that WHO finds itself in today as a lead United Nations agency in global health. The global response – the strategies adopted, the roads taken and not taken, and the lessons learned – can provide helpful guidance to the global health community as it continues tackling the AIDS pandemic and confronts future global pandemics.” The event will be webcast live from the event page. Please register by clicking the “Register” button above and contact Sara Allinder, sallinder@csis.org, with questions.
  • MoBE 2017 Symposium to highlight research on the Microbiology of the Built Environment – October 10-12th, in Washington, D.C.  The event will highlight recent research on the Microbiome of the Built Environment and explore ways to bridge the gaps between research and applications. More specifically, The MoBE 2017 Symposium will bring together leading researchers and stakeholders to discuss MoBE findings pertinent to human health, safe drinking water, healthy built environments and urban design. Ed Yong of The Atlantic, Susan Lynch of the University of California at San Francisco and Marc Edwards of Virginia Tech will provide keynote addresses.

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

Pandora Report 9.1.2017

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.”