Pandora Report 11.16.2018

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

 

 

Pandora Report 9.28.2018

Happy Friday biodefense gurus! October is right around the corner, which means the flu vaccine will be available soon. Make sure to get vaccinated this season, as the CDC just announced that 80,000 people died of the flu during the 2017/2018 season, which is the highest death toll in 40 years.

GMU Global Health Security Ambassador
We’re excited to announce that two graduate students from the Schar biodefense program will be attending the 5th GHSA Ministerial Meeting in Bali, Indonesia. The two students, Annette Prieto and Saskia Popescu, will observe the Global Health Security Agenda in action and the the GHSA 2024 planning. Following their attendance in early November, we’ll be providing a report out on the events. Meet our two GMU Global Health Security Ambassadors – Annette Prieto has a background in Microbiology and Immunology and is currently a Biodefense student in the Master’s Program here at George Mason University. Before coming to George Mason, Annette focused on medical Microbiology at the University of Miami before moving into the laboratory and becoming a Teacher’s Assistant. From there, Annette became an Adjunct Instructor at Daytona State College and taught for a year before entering the Biodefense Program. Annette is also a part of the Next Generation Global Health Security Network. Saskia Popescu is a biodefense doctoral candidate at GMU and infection preventionist. She worked as an infection preventionist during the Dallas Ebola cluster, a 2015 measles outbreak, and is an external expert for the ECDC. She is a 2017 ELBI fellow and trained infectious disease epidemiologist. Saskia’s research focuses on the utilization of infection control in the U.S. healthcare system and it’s impact on biodefense. Make sure to check back in the weeks following their trip to learn about their experiences at the ministerial meeting.

Why Poor Pandemic Preparedness is Deadly
Ebola response efforts in the DRC are struggling and were suspended earlier this week, after violence between rebels and armed forces. While outbreak response in Beni have resumed, events like these are a prime example of why outbreaks can quickly spread beyond control and ultimately emphasize the need for pandemic preparedness. Drs. Tom Inglesby and Eric Toner from the Johns Hopkins Center for Health Security recently discussed the importance of investing in biopreparedness and how their Clade-X tabletop revealed many of the existing weaknesses. “Could a natural or man-made pandemic happen today? Yes. New lethal viruses are emerging from nature, and dizzying developments in biotechnology mean that biological weapons no longer are the sole province of a few state-sponsored programs — a manufactured pandemic could be unleashed by a rogue regime or by terrorists utilizing one of the thousands of laboratories around the world capable of making a dangerous pathogen. If the worst-case scenario unfolds, strong pandemic preparedness planning would save millions of lives. But progress is possible only with effective leadership.”

Rebuilding Health Security in the Wake of Ebola
GMU Biodefense graduate student Stephen Taylor discusses the latest talk from Georgetown University on global health security following the 2013-2016 Ebola outbreak. “In the midst of this disaster, the U.S. Centers for Disease Control turned to health security experts at the Georgetown Center for Global Health Science and Security to support the expansion and augmentation of the Guinean public health infrastructure.  Dr. Alpha Barry, Dr. Erin Sorrell, Dr. Claire Standley, and Ms. Aurelia Attal-Juncqua supported on-the-ground efforts to develop and implement improved health security policy that would make Guinea more resilient against future infectious disease outbreaks.  The Guinean government’s priorities for capacity and capability building were to prevent further outbreaks of zoonotic diseases, improve the capacity of surveillance laboratories and capabilities of the healthcare workforce to identify outbreaks, and to better respond to outbreaks by streamlining and coordinating emergency response operations.  On September 14th, 2018, as part of its Global Health Security Seminar Series, Georgetown University hosted a panel discussion of Dr Sorrell, Dr. Standley, and Ms. Attal-Juncqua on their efforts in Guinea.”

 The AMR Challenge
The United Nations (UN) General Assembly was held this week and one particular topic captured our attention – antimicrobial stewardship and a new initiative to combat resistance. “The AMR Challenge is a way for governments, private industries, and non-governmental organizations worldwide to make formal commitments that further the progress against antimicrobial resistance. The challenge encourages a One Health approach, recognizing that the health of people is connected to the health and animals and the environment. The AMR Challenge launches at the United Nations (UN) General Assembly in September 2018. Organizations can make commitments beginning September 25, 2018 until September 2019. CDC will feature commitments throughout the year. At the 2019 UN General Assembly, antimicrobial resistance will continue to be a priority topic for world leaders.” Within the Challenge, there are commitments to tracking and sharing data, reducing the spread of resistant germs through infection prevention and control, improving antibiotic use, decreasing antibiotics and resistance in the environment, and investing in vaccines, therapeutics, and diagnostics.

NASEM – Review & Assessment of Planetary Protection Policy Development Processes
How do we protect the Earth from contamination following space exploration? How can we avoid bringing microorganisms from Earth to other planets and solar system bodies? The latest NASEM report discusses how scientists tackle these issues and implement such policies. As you read the text, you’ll also see one of the Center for Health Security’s ELBI fellows in there – Betsy Pugel of NASA. “For decades, the scientific, political, and economic conditions of space exploration converged in ways that contributed to effective development and implementation of planetary protection policies at national and international levels. However, the future of space exploration faces serious challenges to the development and implementation of planetary protection policy. The most disruptive changes are associated with (1) sample return from, and human missions to, Mars; and (2) missions to those bodies in the outer solar system possessing water oceans beneath their icy surfaces.” This gives new insight into a field we may not be considering in health security – what about interstellar health security?

The Spanish Flu, Epidemics, and the Turn to Biomedical Responses
We already discussed the impact of poor pandemic preparedness, but what about biomedical efforts? A recent article from AJPH discusses the role of the 1918/1919 pandemic in bringing biomedical approaches to the forefront of outbreak response. “A century ago, nonpharmaceutical interventions such as school closings, restrictions on large gatherings, and isolation and quarantine were the centerpiece of the response to the Spanish Flu. Yet, even though its cause was unknown and the science of vaccine development was in its infancy, considerable enthusiasm also existed for using vaccines to prevent its spread. This desire far exceeded the scientific knowledge and technological capabilities of the time. Beginning in the early 1930s, however, advances in virology and influenza vaccine development reshaped the relative priority given to biomedical approaches in epidemic response over traditional public health activities. Today, the large-scale implementation of nonpharmaceutical interventions akin to the response to the Spanish Flu would face enormous legal, ethical, and political challenges, but the enthusiasm for vaccines and other biomedical interventions that was emerging in 1918 has flourished.”

HHS Sponsors TPOXX
Speaking of biomedical measures…the Department of Health and Human Services (HHS) just announced its sponsorship of a new formulation of the world’s first approved smallpox treatment – TPOXX. This purchase will be used for the Strategic National Stockpile and will work with Siga Technologies to develop an IV formulation of the drug. “Purchase of TPOXX in pill form and development of an IV formulation will be completed under a contract between Siga Technologies and the Biomedical Advanced Research and Development Authority (BARDA), part of the HHS Office of the Assistant Secretary for Preparedness and Response. BARDA will use funding from the Project BioShield Special Reserve Fund. The contract can be extended for up to 10 years and $629 million if necessary to complete development of the IV formulation.”

NASEM – Engaging the Private-Sector Health Care System in Building Capacity to Respond to Threats to the Public’s Health and National Security
Don’t miss the latest NASEM report on the intersection of preparedness and healthcare. From Ebola patients to natural disasters, and even terrorism, the private-sector healthcare system plays a critical role in response. “As a result, disasters often require responses from multiple levels of government and multiple organizations in the public and private sectors. This means that public and private organizations that normally operate independently must work together to mount an effective disaster response. To identify and understand approaches to aligning health care system incentives with the American public’s need for a health care system that is prepared to manage acutely ill and injured patients during a disaster, public health emergency, or other mass casualty event, the National Academies of Sciences, Engineering, and Medicine hosted a 2-day public workshop on March 20 and 21, 2018. This publication summarizes the presentations and discussions from the workshop.”

USDA ARS 5th International Biosafety & Biocontainment Symposium
ABSA has just announced this event being held on February 11-14, 2019 in Baltimore, Maryland. “The focus of the symposium will be Biorisk and Facility Challenges in Agriculture. Seven professional development courses will address topics including life science security, facility maintenance and operational issues, agricultural risk assessment, emergency response and preparedness for livestock disease outbreaks, waste management, and strategic leadership. Courses will be held on Monday, February 11. There will be 2 1/2 days of scientific presentations covering various topics including; governance updates, design methodologies, deferred maintenance, rabies, occ health laboratory to the field, gene editing, risk management and communication, and many others. The poster and networking reception will be held on Wednesday, February 13, attendees will have the opportunity to meet with presenters and discuss their presentations. Exhibits showcasing the latest biosafety, biosecurity, and biocontainment products and services will be open February 12-13.”

Next Generation Biosecurity Webinar 
Don’t miss this webinar today, Friday 9.28, at 11am (CDT, Mexico City). Hosted by Next Generation GHSA, this webinar will be with Luis Alberto Ochoa Carrera, Coordinator of Biosafety and Biochemistry of the GHSN and Coordinator of the Biosafety Laboratory Level 3 of the National Reference Laboratory (InDRE) of Mexico.

Stories You May Have Missed:

  • Airplanes and Airports – Hubs for Germs: GMU biodefense doctoral candidate Saskia Popescu discusses the latest on germ transmission during air travel. “Most people have a general sense that air travel tends to involve exposure to germs. Whether it’s through the thousands of people we will come into contact with, the sick person next to us on the plane, or the dirty surfaces, many of us get a sense of unease knowing there is a real chance we may arrive at our destination with a microscopic companion.”

 

Pandora Report 8.17.2018

Happy Friday fellow biodefense nerds! Welcome to your weekly roundup of all things global health security. If you’re finding yourself a food source for mosquitoes and ticks this summer, just a friendly heads up – the associated diseases are on the rise (hint: climate change may be a big reason).

The Lingering Scare of Smallpox
The recent FDA approval of TPOXX to treat smallpox, a disease eradicated since 1980, has many wondering, especially those of us born in a time where the vaccine was not necessary, why so much attention is being raised. It’s an easy thing to forget – the peril of a disease long since eradicated, but the threat of smallpox is very much still a concern in biodefense. Between the concerns of a laboratory biosecurity/biosafety incident at the two remaining stockpile locations or the chance that a frozen corpse (aka corpsicle) who died of smallpox could defrost as the Arctic permafrost melts. Did I mention the risk of a de novo synthesis like the horsepox one in Canada? These are the reasons we haven’t been able to shake the nightmare that is smallpox. “The greatest threat is advances in synthetic biology, which could permit a rogue lab to re-engineer a smallpox virus. In 2016, researchers in Canada announced that they had created horsepox using pieces of DNA ordered from companies. A synthetic smallpox virus could be even more dangerous than the original, because it could be designed to spread more easily or with ways to survive new therapies.” While we eradicated smallpox and proved that such a feat was possible, there is the painful reality that such efforts left an unvaccinated and inherently vulnerable population.

Biological Events, Critical Infrastructure, and the Economy: An Unholy Trinity
Biodefense graduate student Stephen Taylor is reporting on the latest Blue Ribbon Study Panel. “At its recent meeting about resilience, the Blue Ribbon Study Panel on Biodefense explored the potential impacts of a biological event on critical infrastructure in the United States, as well as the best way to approach risk mitigation.  Ann Beauchesne, former Senior Vice President of the National Security and Emergency Preparedness Department at the U.S. Chamber of Commerce, summed up critical infrastructure as ‘the critical services for our society and the backbone our economy.’  Projected increases in global travel, trade, and development all rely on critical infrastructure, magnifying the potential impact of insults to infrastructure systems.  Concurrently, biological threats are also on the rise. As the world warms and urbanizes, natural infectious disease outbreaks manifest in unexpected places.”

Ebola, Healthcare Workers, and the Pandemic Potential in Vulnerable Countries 
Every day brings news of the Ebola virus disease outbreak along the eastern border of the DRC. On Thursday, cases jumped by seven – one of whom is a healthcare worker. The outbreak is up to 73 cases, 46 of which are confirmed and 27 are probable. 43 deaths have been reported. Nearly a thousand people are under surveillance as contacts of cases and healthcare workers are again, experiencing increased risk of transmission. On Tuesday, it was reported- “that health worker Ebola infections could amplify the current outbreak in the Democratic Republic of Congo (DRC), the country’s health ministry today reported five more confirmed cases, including four involving health workers at a health center in Mangina. The other is a patient recently treated at that facility.” The hope is that the new vaccine can help put an end to the outbreak and curb the risk for healthcare workers. The recent outbreak draws attention yet again, to the inherent danger that infectious disease outbreaks pose in vulnerable countries. We’ve seen how fast and unexpectedly such outbreaks can spread beyond international borders (SARS, MERS, Ebola, etc.), which means that these are global health security issues. The 2013-2016 Ebola outbreak taught us a “great deal about how to respond in a fragile state setting. Traditional leaders and faith leaders played an important role in communicating necessary information and behavior change requirements to isolated groups who did not necessarily trust the government or health care workers.” Preventative measures like stronger public health and healthcare infrastructure can make a world of difference. “Preventative investments can mean the difference between life and death for people in those countries and the difference between an outbreak being contained or becoming an epidemic. As we face repeated outbreaks of infectious diseases, including new pathogens, it is essential that U.S. policy-makers continue funding the operations that make containment possible.”

BWC Meeting of Experts
Don’t miss out on the daily reports from Richard Guthrie on the latest MX. You’ll definitely want to check out days six and seven, where national implementation and preparedness were discussed. How would countries respond to a potential act of bioterrorism? Guthrie notes that “Concerns were raised about whether bodies such as the World Health Organization should be engaged with any assessment of the cause of an outbreak if there were indications it was deliberate in case this brought the health body into the security realm with potential negative consequences for other health work. A number of contributions to the discussion noted that health officials would have different roles to officials looking to attribute the cause of an attack and there was a need to ensure that effective ways of operating together were established. An example of the challenges was given in WP.10 from the USA in the section on ‘preservation of evidence’.” The response and preparedness measures for each country can be complex and challenging when considering the global context of the BWC. For example, Saudi Arabia discussed its own preparedness measures for natural events during times when influxes of people were expected (pilgrimages).

 The Economic Burden of Antimicrobial Resistance and the Drive For Intervention
A recent study enumerated the economic cost of antimicrobial resistance per antibiotic consumed to inform the evaluation of interventions affecting their use. Their model utilized three components – correlation coefficient between human antibiotic consumption and resulting resistance, economic burden of AMR for five key pathogens, and the consumption data for antibiotic classes driving resistance in these organisms. “The total economic cost of AMR due to resistance in these five pathogens was $0.5 billion and $2.9 billion in Thailand and the US, respectively. The cost of AMR associated with the consumption of one standard unit (SU) of antibiotics ranged from $0.1 for macrolides to $0.7 for quinolones, cephalosporins and broad-spectrum penicillins in the Thai context. In the US context, the cost of AMR per SU of antibiotic consumed ranged from $0.1 for carbapenems to $0.6 for quinolones, cephalosporins and broad spectrum penicillins.” Ultimately, they found that the cost of AMR per antibiotic frequently exceeded the purchase cost, which should encourage policy and consumption changes.

NASEM Report: Cooperative Threat Reduction Programs for the Next Ten Years and Beyond
The latest report from the National Academies is now available regarding the Cooperative Threat Reduction (CTR) Program. “The Cooperative Threat Reduction (CTR) Program was created by the United States after the dissolution of the Soviet Union to provide financial assistance and technical expertise to secure or eliminate nuclear weapons delivery systems; warheads, chemical weapons materials, biological weapons facilities, and nuclear, biological, and chemical weapons technology and expertise from the vast Soviet military complex. In a 2009 report, Global Security Engagement: A New Model for Cooperative Threat Reduction, the National Academy of Sciences (NAS) recommended adoption of a modified approach to thinking about CTR, including the expansion of CTR to other countries and specific modifications to CTR programs to better address the changing international security environment.” The report has insight from some of the time minds in the field of biological threats – Elizabeth Cameron, David Franz, James Le Duc, etc.

Stores You May Have Missed:

  • Key Global Health Positions and Officials in the USG – Have you ever wondered who is in charge for global health programs throughout the government? Look no further than this comprehensive list by the Kaiser Family Foundation.
  • CEPI Collaborative for Lassa Fever Vaccine“In a deal worth up to $36 million to advance the development of a vaccine against Lassa fever, the Coalition for Epidemic Preparedness Innovations (CEPI) today announced a new partnership with Profectus BioSciences and Emergent BioSolutions.”

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 6.22.2018

 US Military Asks – What Would A SynBio Weapon Look Like?
A new study ordered by the DoD seeks to evaluate the potential for synthetic biology to be a biodefense threat. The report, Biodefense in the Age of Synthetic Biology, was issued by the National Academies of Sciences, and provides an actual ranking of national security threats that genetic engineering technology, like CRISPR, pose. “’Synthetic biology does expand the risk. That is not a good-news story,’ says Gigi Gronvall, a public health researcher at Johns Hopkins and one of the report’s 13 authors. ‘This report provides a framework to systematically evaluate the threat of misuse’.” The report includes a framework for assessing synbio capabilities as well as concerns related to the production of chemicals or biochemicals, bioweapons that alter the human host, pathogens, etc. The report also includes a section on related developments that impact the ability to effect an attack using a synthetic biology-enabled weapon, where the authors note several mitigation challenges posed by synbio. Some of the challenges to deterrence and prevention include accessibility of biotechnology, pointing to DIY biohackers, the iGEM competition, and traditional pathways like academic laboratories. Regarding the challenges in recognizing and attributing an attack, they note that “synthetic biology could also confound the ability to identify the causative agent in a biological attack. Despite the breadth and depth of available repository resources, there would not always be a reference specimen to use as comparator, particularly if the agent is markedly different from natural pathogens or toxins.” “According to the report, the US must now also track ‘enabling developments’ including methods, widely pursued by industry, to synthesize DNA strands and develop so-called chassis’ organisms designed to accept genetic payloads.” Consider the recent de novo synthesis of the horsepox virus by researchers in Canada that has opened up Pandora’s box regarding synbio and biosecurity. GMU Biodefense professor and graduate program director Gregory Koblentz noted that “Synthetic biology has provided the tools necessary to recreate the smallpox virus,” and “Safeguards against the misuse of those tools are weak and fragmented.”  “The US government should pay close attention to this rapidly progressing field, just as it did to advances in chemistry and physics during the Cold War era,” says Michael Imperiale, a microbiologist at the University of Michigan. The recent tabletop hosted by the Center for Health Security (Clade-X) even presented some real-world scenarios and gaps for dealing with a bioterrorism event that involved an engineered organism.

Gene Drives and Frank Discussions With CRISPR Scientists
Speaking of gene editing…GMU Biodefense professor Sonia Ben Ouagrham-Gormley recently sat down with Vox to discuss the good and bad side of gene drives in the context of genetically modified mosquitos and their place in the fight against malaria. Malaria kills hundreds of thousands a year and despite eradication efforts, it’s still a monumental task for public health. “We have eliminated malaria from the rich world; it used to be endemic to France just as it is to Mali today. And now, with CRISPR gene drives, we have the potential to wipe it out globally and save millions of lives. Gene drives allow humans to change the genetic makeup of a species by changing the DNA of a few individuals that then spread the modification throughout an entire population. In the case of malaria, the idea is to change the three species of mosquito most responsible for its transmission — Anopheles gambiae, Anopheles coluzzii, and Anopheles arabiensis — so that all their offspring would be male, effectively leading to the species’ extinction.” The debate though is that if gene drive was used poorly, it could cause irreversible changes in the ecosystem. Many worry about the potential for weaponization of gene drives or nefarious actors using it, but several biosecurity experts have pointed to the limitations of gene drive when it comes to making diseases more potent. “The biosecurity experts I talked to are deeply skeptical of those nightmare scenarios. Sonia Ben Ouagrham-Gormley, a professor in the biodefense program at George Mason University, says she doubts gene drives will be militarily effective in targeting rival countries’ harvests. ‘Animals and plants that are raised for food are generally monitored, and a gene drive can be easily detected in the genome of the animal,’ she explained. ‘Because of that regular monitoring, I don’t think gene drives would be a good tool for affecting a country via agriculture.’ Biosecurity experts like Ben Ouagrham-Gormley and Filippa Lentzos have concerns that are more social. “What happens if one of the few thousand fruit fly biologists around the world decides to act unilaterally and throws international talks on the matter into chaos? What if a grad student creates a gene drive that can’t reliably hurt people but can reliably terrify them?” If she wasn’t busy enough, Sonia Ben Ouagrham-Gormley recently returned from a research trip to China where she met with several CRISPR scientists and toured their laboratories. She discussed CRISPR developments in China and gave a talk at the University of the Chinese Academy of Sciences in Beijing (UCAS) on the technological, regulatory and technical challenges of CRISPR.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
We’re less than a month away from the workshop on all things health security, are you registered? Since we’re on the topic of biotechnology and biosecurity, our workshop is a great chance to hear from Supervisory Special Agent Edward You of the FBI’s WMD Directorate, Biological Countermeasures Unit. “Mr. You is responsible for creating programs and activities to coordinate and improve FBI and interagency efforts to identify, assess, and respond to biological threats or incidents. These efforts include expanding FBI outreach to the Life Sciences community to address biosecurity. Before being promoted to the Weapons of Mass Destruction Directorate, Mr. You was a member of the FBI Los Angeles Field Office Joint Terrorism Task Force and served on the FBI Hazardous Evidence Response Team.” Don’t miss Mr. You’s talk on the bioeconomy and biosecurity threats during this three-day workshop on all things biodefense!

WHO Releases New International Classification of Disease (ICD11)
The World Health Organization (WHO) released the latest ICD-11, which includes 55,000 codes for specific injuries, diseases, and causes of death. “The ICD is also used by health insurers whose reimbursements depend on ICD coding; national health programme managers; data collection specialists; and others who track progress in global health and determine the allocation of health resources. The new ICD-11 also reflects progress in medicine and advances in scientific understanding. For example, the codes relating to antimicrobial resistance are more closely in line with the Global Antimicrobial Resistance Surveillance System (GLASS). ICD-11 is also able to better capture data regarding safety in healthcare, which means that unnecessary events that may harm health – such as unsafe workflows in hospitals – can be identified and reduced.”

Ebola Virus Disease Outbreak Updates
The DRC has reported 5 more suspected cases in the Iboko health zone, which brings the total to 60 cases, included 28 deaths (38 confirmed, 14 probable, and 8 suspected) as of June 19th. The case fatality rate for this outbreak is at 47% and “‘The number of contacts requiring follow-up is progressively decreasing, with a total 1,417 completing the mandatory 21-day follow-up period,’ the WHO said. As of Jun 17, a total of 289 contacts were still being monitored.” WHO Director General Tedros Adhanom Ghebreyesus recently tweeted “Just over a month into the response in , further spread has largely been contained. In spite of progress, there should be no room for laxity and complacency until it’s finally over. This is a collaborative effort led by

 MERS Trends in Saudi Arabia – Hospitals and Households
Since January of this year, the WHO has reported 75 laboratory confirmed MERS-CoV cases and 23 deaths in Saudi Arabia. 21 of these cases were involved in four clusters (2 household and 2 healthcare) – “Cluster 1: From 2 through 4 February, a private hospital in Hafer Albatin Region reported a cluster of three (3) health care workers in addition to the suspected index case (four [4] cases in total). Cluster 2: From 25 February through 7 March, a hospital in Riyadh reported six (6) cases, including the suspected index. No health care workers were infected. Cluster 3: From 8 through 24 March, a household cluster of 3 cases (index case and 2 secondary cases) was reported in Jeddah. No health care workers were infected. Cluster 4: From 23 through 31 May, a household cluster was reported from Najran region with eight cases including the suspected index case. This cluster is still under investigation at the time of writing. As of 31 May, no health care workers have been infected and the source of infection is believed to be camels at the initial patient’s home.” The total number of MERS cases since 2012 is now 2,220. These clusters underscore the role of hospitals as amplifiers for MERS transmission during outbreaks and the importance of infection prevention efforts.

Infection Prevention Gaps Found Across Critical Access Hospitals
GMU Biodefense doctoral student Saskia Popescu addresses infection prevention failures and gaps within the United States and specifically in critical access hospitals. “These findings are not novel as staffing issues are problematic across the country in all types of hospital systems. The importance of having IPs within health care and ensuring they have access to training and the ability to focus on infection control activities—not just reporting tied to CMS reimbursement—is critical. IPs need time for activities such as education, rounding, antibiotic stewardship, and more. This study supports the notion that not only should hospitals be ensuring proper staffing and support for infection prevention programs, but that significant gaps exist across CAHs. In the areas where CAHs are the only health care patients may access, it is vital that infection prevention processes be supported and followed”

How Ready Is the United States For The Next Anthrax Attack?
This week the CDC reviewed their recommendations for mass vaccination in the event of an anthrax attack. “The way that people think about [nuclear weapons] is on a much, much grander scale than biological weapons, and I think that’s a misperception,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “If you use a contagious infectious disease, you really could create havoc on a different scale.” The Amerithrax attack was in 2001 and since then we’ve seen SARS, MERS, and Ebola as potential infectious disease threats that reveal a rather large spectrum of avenues for microbial events. “But there’s still a long way to go in terms of preparedness, Redlener said, adding that no city is fully prepared. Questions remain about what dosage of the vaccine to use for children, the safety of the vaccine for the general public, delivery and distribution of the vaccine and medications. ‘I think a vaccination program would be a nightmare. Who would administer it? Who would pay for it? Who would manufacture it? The cost of complications that may occur. I don’t think it would be practical,’ Redlener said.”

Stories You May Have Missed:

  • Gene-edited Farm Animals – “The team edited the animals’ DNA to make them resist the deadly respiratory disease known as PRRS – a move that could prevent billions of pounds in losses each year. However, consumers have traditionally been reluctant to eat genetically altered animals and crops. This poses a significant barrier to farmers owning gene-edited pigs. And because genome, or gene, editing (GE) is relatively new, the absence of regulation currently prevents their sale anyway.”
  • FDA Releases New Food Defense Guidance – “Today the US Food and Drug Administration (FDA) released the first of three installments of draft guidance on the intentional adulteration (IA) rule, part of the Food Safety and Modernization Act (FSMA). The rule is meant to guide the food industry on reducing the risk of exposing food facilities to IA, such as acts of terrorism. Unlike other FSMA rules that address specific foods or hazards, IA will require preventive measures for reducing vulnerabilities at all domestic and foreign companies that are required to register with the FDA as food facilities.”

Pandora Report 6.15.2018

Welcome back to your favorite weekly dose of all things biodefense! We’ve got a lot of health security news to cover this week as microbes just don’t seem to take a break.

Outbreak Updates
The latest data from the DRC has reported four more suspected Ebola cases, which would bring the overall outbreak total to 59 cases (38 confirmed, 14 probable, and 7 suspected), and 28 deaths. You can find the timeline of Ebola response for the DRC outbreak here, that was released by the WHO. In the latest WHO statement on the outbreak, Director-General Dr. Tedros Adhanom Ghebreyesus noted that “’It’s far too early to declare victory, but the signals are positive and we are cautiously optimistic,’. ‘We have new weapons and together with the government and our partners, we have acted with urgency to save lives. We will remain vigilant until this outbreak is over’.” You can also read the latest WHO situation report here. As the DRC works to contain the Ebola outbreak, the Nipah virus outbreak in India is ongoing, as 17 cases have been identified. Kenya is also currently facing a Rift Valley fever outbreak as 10 people were found to be sick and 5 have died. “The disease primarily strikes livestock by the mosquito-borne route. Though humans can be infected by mosquitoes, the virus is more commonly passed by contact with blood or organs of infected animals or drinking milk from sick ones. The disease is usually mild, but some patients experience a severe form.”

 Workshop on Pandemics, Bioterrorism, and Global Health Security
Are you registered for the summer workshop on all things health security? From Anthrax to Zika, we’re talking vaccine development, bioterrorism, the Ebola outbreak, and more. Don’t miss the chance to attend this July 18-20 workshop in Arlington, where you’ll learn from the top minds in the field and chat with others passionate about global health security. Make sure to register before July 1st for an early registration discount. If you’re a GMU student or alum, returning workshop attendee, or large group, you can even get an additional discount!

Clade-X Policy Recommendations
Following the Clade-X pandemic tabletop last month, the Johns Hopkins Center for Health Security has released their policy recommendations. If you missed the chance to observe the tabletop, make sure to check it out on YouTube or read through the resources here. The policy recommendations focus on a strong and sustainable global health security system, a robust, highly capable national public health system that can manage the challenges of pandemic response, etc. The Washington Post noted of the tabletop, “Even though many players in the scenario had decades of experience in health security and national and global policy and law, ‘there were still so many unanswered questions and capability gaps,’ said Beth Cameron, formerly senior director for global health security and biodefense at the National Security Council under President Barack Obama. Cameron, who was in the audience, is vice president for global biological policy at the Nuclear Threat Initiative.”

FEMA Wants Local Governments to Step Up
GMU Biodefense PhD alum Daniel M. Gerstein is pulling back the curtain on FEMA’s new strategic plan and the reality that its capacity doesn’t grow when there are high volumes of natural disasters. Gerstein notes of the FEMA Administrator Brock Long- “Long’s language signals that FEMA’s disaster policy, upon which so many communities may depend, is changing. FEMA’s recently released strategic plan reveals several important shifts in federal disaster relief policy. FEMA is streamlining its mission to focus on coordination with state and local stakeholders before disasters even strike in order to shorten disaster recovery times. Why the changes? 2017 was particularly full of disasters – there were 16 events that exceeded $1 billion in total damage. An estimated $306 billion in losses made 2017 the most expensive year ever for natural disasters. Three hurricanes in succession in August and September combined with the Western wildfires greatly stressed FEMA’s capacity to support these response and recovery operations.” Moreover, Gerstein underscores that this approach is central to getting the message across that FEMA is not a first-responder agency, but rather offers coordination and resourcing for catastrophic disasters.

Characteristics of a Pandemic- The Devil Is In The Details
GMU Biodefense doctoral student Saskia Popescu reviewed the Center for Health Security publication regarding the characteristics of microorganisms that are more likely to cause a global catastrophic biological risk. “The CHS findings pose critical questions as to how we handle global health security and pandemic preparedness, as well as what inherently makes a microorganism likely to cause a pandemic. Moreover, the report speaks to medical providers and those working on the frontline, which is a breath of fresh air for so many of us who are all too often given non-specific guidance that fails to meet the true demands of preparing for pandemics. ”

Book Reviews
Still in need for that book to read during a summer vacation? Here are reviews of two books for anyone interested in antibiotic resistance. First, a review of Superbugs: An Arms Race Against Bacteria, in which Jerome Groopman discusses the importance of understanding this growing threat and the origin of AMR. Groopman notes that “Fleming’s advice to use the antibiotic properly was widely disregarded, not by “the ignorant man” but by “negligent” medical professionals. Prescriptions of penicillin in suboptimal dosages led to the emergence of bacteria resistant to it.” Next, GMU biodefense doctoral student Saskia Popescu reviews Maryn McKenna’s book, Big Chicken, which reveals the truth about antibiotic usage in poultry. Popescu notes that “Showcasing the complexity of this microbial threat and the role of poultry, McKenna chronicles the efforts across the United States and Europe to understand novel outbreaks of common bacterial infections that began springing up in the 1950s and left medical providers struggling to find treatments, but also the scientific work done to provide proof of the problem.”

NTI Presentation – Biosecurity By Design: Getting Ahead of Risk in the World of Designer Operations
GMU Biodefense doctoral student Carlos Alvarado is reporting on the NTI event this week regarding the rapid advances in biotechnology and what that means for biosecurity. Alvarado notes that Dr. Reshma Shetty, co-founder of Ginkgo Bioworks, began with posing a unique scenario for the audience – she “explained how technology and biology are very similar in the fact they’re both made form unique core codes. One of the slides within her presentation contained a photo of a desk with a plant, cell phone, tablet, computer, and other technological devices. She then asked the audience what is the most technological item in this picture,  to which she stated the answer was the plant because the plant was self-replicating, self-cleaning, and self-sensing. She explained that with bio synthesis and bioengineering, Ginkgo Bioworks is working on developing these codes for specific bio synthesized organisms.” Overall, while the presentation mostly focused on the work of Ginkgo Bioworks, it did provide insight into the industry perspective for biosecurity and what such advances might mean for the future.

 Medical Benefits Now Available for Vets Subjected to Chem-Bio Tests
Operation Whitecoat is an infamous example of American soldiers – conscientious objectors, who became the human guinea pigs for biological weapons, and now those soldiers are able to receive medical care. “About 6,000 of the soldiers that the U.S. Army tested potential chemical and biological substances on are still living and may be eligible for medical care. A recent class action lawsuit filed by the Vietnam Veterans of America required the U.S. Army to provide medical care to veterans who volunteered to contribute to the advancement of the U.S. biological and chemical programs.”

ISDS Presentation: Outbreak Observatory
Don’t miss out on the chance to learn about Outbreak Observatory at this presentation held by the International Society for Disease Surveillance (ISDS) on Wednesday, June 27th from 11am-noon EST. “During this presentation, researchers will discuss how Outbreak Observatory, a pilot project initiated by the Johns Hopkins Center for Health Security, will facilitate the conduct of real-time operational research during outbreak responses, helping to improve outbreak preparedness and response capabilities.”

Preventing Pandemics – Spend on Surveillance
Where do we put the funds for pandemic prevention? Despite the inherent importance of these efforts, financial support for prevention is often problematic. Researchers are emphasizing that funding should be put towards surveillance, not prediction, as such efforts can easily be a double-edged sword in terms of public trust. Credibility issues arise for the public when predictions are wrong (H1N1 or Ebola). “In short, there aren’t enough data on virus outbreaks for researchers to be able to accurately predict the next outbreak strain. Nor is there a good enough understanding of what drives viruses to jump hosts, making it difficult to construct predictive models.” Fundamentally, the researchers argue, it is in the surveillance of human populations that is the most effective and realistic approach to fighting outbreaks. Efforts should focus on the vulnerable countries and locations, strengthen detailed screening of those symptomatic, etc. “This will best be achieved through an established global network of highly trained local researchers, such as the WHO Global Outbreak Alert and Response Network (GOARN). Real-time tools for reconstructing and tracking outbreaks at the genomic level, such as portable sequencing devices, are improving fast. Information gathered during recent outbreaks has quickly had tangible impacts on public-health decisions, largely owing to data generation and analysis by many research teams within days of people being infected.” More and more, researchers are also underscoring the importance of including veterinarians in pandemic prevention, in fact, many say to follow the bats when looking for the next Ebola outbreak.

Stories You May Have Missed:

  • Salmonella Outbreak Tied to Pre-Cut Melons – The CDC has announced that the culprit of this multi-state outbreak is pre-cut melon. “As of June 8, 2018, 60 cases of Salmonella Adelaide have been reported spanning 5 states; a little more than half (31) of these individuals have required hospitalization for their infections. To date, no deaths have been reported. The infected individuals range from 1 to 97 years in age, with a median age of 67, according to the CDC. Available data indicate that 65% of those who have fallen ill are female. The reported dates of illness range from April 30 to May 28; however, according to the CDC, Salmonella can take up to 2 to 4 weeks to diagnose and report. As such, any illnesses that have occurred after May 28 may not have been reported yet.”

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

Pandora Report 3.2.2018

Happy Friday! We’ve got a full plate of biodefense news this week, so we hope you’re hungry for everything from ASM Biothreats 2018 coverage to Gain of Function research, and a side of pandemic budgeting.

ASM Biothreats 2018 – GMU Biodefense Coverage
We’re excited to present our annual coverage of the ASM Biothreats conference from some of GMU’s very own biodefense graduate students. Our overview is a great way to catch up on some of the hot topics and captivating breakout sessions from the conference. You can find a landing page for all the reviews here, which will have links and a brief synopsis for each section the students wrote. GMU biodefense graduate students covered a variety of sessions – from artificial intelligence in biosecurity to the GHSA, future DoD programs in biodefense policy, and BARDA/DARPA projects- we’re reporting it all!

New Pathogen Research Rules: Gain of Function, Loss of Clarity
GMU Biodefense professor and graduate program director Gregory Koblentz is teaming up with Lynn Klotz (co-managing director of Bridging BioScience and BioBusiness LLC), to evaluate the December 2017 release of the latest Gain of Function (GoF) research rules. The DHHS release finally lifted the funding moratorium on GoF research following the controversial projects involving H5N1 in 2011. While the DHHS policy (or “Framework for guiding funding decisions about proposed research involving enhanced potential pandemic pathogens”) is similar to the Office of Science and Technology Policy guidance that was released in January 2017 (the “P3C0 Framework”), it came with the bonus of restoring funding for such research. Unfortunately, there are still considerable concerns with how GoF research is evaluated and if these frameworks have really addressed the gaps. “We, the authors, harbor concerns about adequate oversight of potentially dangerous research, and the framework incorporates several elements that address those concerns. The framework is thorough. It does a good job of laying out the principles and processes through which the Health and Human Services Department will make funding decisions regarding research that involves enhanced potential pandemic pathogens. The framework’s approach to dual-use research of concern is not based on lists of experiments or on specific pathogens, but instead takes a risk-based approach that focuses on the attributes of modified organisms. While the identity of starting organisms is central to existing oversight policy for dual-use research of concern, the framework emphasizes the importance of organisms’ properties once the experiment is over. This more comprehensive approach to dual-use research is a welcome change. Some elements of the new framework, however, remain worrisome.” Koblentz and Klotz point to several limitations of the new framework – it’s too narrow and not broad enough in that it only applies to research funded by DHHS, the terminology and definitions are lacking (especially in the definition of a potential pandemic pathogen), and the review process that was created is a limited. The framework also has new criteria for risks and benefits, which is “inherently problematic” and agreement is often never achieved. “The criteria used to judge which experiments involving enhanced potential pandemic pathogens warrant review by the Health and Human Services Department—and how the risks, benefits, and ethical aspects of such experiments are measured and weighed—are ambiguous enough to provide departmental reviewers wide latitude in their funding decisions. The process and outcomes must be transparent in order to demonstrate that the process is conducted in good faith and that policy is implemented appropriately. The framework, though it recognizes the importance of transparency for maintaining public trust in science, does not go far enough in actually providing the requisite level of transparency.” Lastly, Koblentz and Klotz point to the international considerations as a considerable weakness within the new framework. Sadly, it only applies to research done within the United States and the truth is that this is an international issue and needs global consideration and collaboration.

 2018 NASPAA Student Simulation – Global Health Security
How did you spend your Saturday? Battling a virtual pandemic? We were fortunate to participate as judges at an international collaboration and simulation to test students on their response during a pandemic. The NASPAA-Batten simulation (Network of Schools of Public Policy, Affairs, and Administration) involved a total of 563 students in 117 teams, from 159 universities across 27 countries. Teams represented approximately 336 million fictitious people in 4 fictitious countries per 1 fictitious world and were battling 1 seriously tough outbreak. GMU’s Schar School and the biodefense program were represented in both participants and judges. Professor and graduate program director Gregory Koblentz and PhD student Saskia Popescu were judges while six Schar students participated (four of which were biodefense students!) at the Carnegie Mellon University site in DC – Alexandra Williams (Biodefense MS), Annette Prietto (Biodefense MS), Stephen Taylor (Biodefense MS), Justin Hurt (Biodefense PhD), Fleciah Mburu (MPA), and Ryan Kennedy (MPP). The two finalist teams from the CMU site included biodefense MS students Alexandra and Justin, which means they’ll now move on to the global round where they are competing for the $10,000 prize. GMU biodefense students know how to battle a pandemic – whether it’s simulated or real! From a judge’s perspective, this was a great experience to not only observe how people respond to the complexities of a global outbreak, but also pose questions that help them see all the moving pieces in response.

Blue Panel Study Panel on Biodefense Calls For Strategic Budgeting Tied to New National Biodefense Strategy
The Blue Ribbon Study Panel has released a statement on the desperate need for decision-makers to commit to biodefense funding and recognize it as an imperative component to national security.  “We would do well to remind ourselves that we are really just as vulnerable now as we were then. In addition to the enormous potential toll on human health that intentional or natural outbreaks can inflict, the cost of the relentless rise of outbreaks is also entirely unsustainable based on current funding approaches. Emergency appropriations reach into the billions in direct outlays to the U.S. government. Economic impacts of a catastrophic outbreak could reach into the trillions.” You can also read the OpEd by Sen. Joe Lieberman and Former Gov. Tom Ridge, stating that American lives are worth budgeting for biodefense. “We call upon the president to release the National Biodefense Strategy soon and ensure that his next budget request to Congress conforms to the priorities in this strategy, showing how money requested for biodefense programs support the National Strategy’s goals and objectives.”

CDC Plans for New High Containment Lab
The CDC is asking congress for $350 million to start building the high containment continuity laboratory on their main campus to replace the existing one that has been used since 2005, but requires replacement by 2023. “The existing facility contains a number of BSL4 labs and labs that are one step down the biosafety and biosecurity ladder, BSL 3 enhanced. That’s where research on dangerous avian influenza viruses like H5N1 and H7N9 is conducted. Buildings that house these types of labs simply require a lot of maintenance, explained Dr. Dan Jernigan, head of the CDC’s influenza branch. ‘We’re just faced with the realities of what it takes to maintain something as complex as the high containment lab,’ he said.” The complex design of high containment labs makes them both expensive to build and maintain.

Battelle Takes On Biological Threats With New Software
Between naturally occurring outbreaks, bio-error, and bio-terror, there are a lot of ways infectious diseases can pose a threat to human life and safety. Battelle is seeking to change this through a new software for the U.S. government that “would screen small bits of DNA and assess whether they belong to potentially dangerous genetic sequences.The local research institution is one of six groups awarded an $8.7 million, two-and-a-half-year grant by the Intelligence Advanced Research Projects Activity (IARPA), an organization within the Office of the Director of National Intelligence.” The growing application of CRISPR and other genome editing technologies has underlined the gaps in DNA sequence screening for biosecurity concerns, especially when one considers the recent horsepox synthesis. “In the absence of national or international policy that would monitor bioengineering activity — and the technological gap for keeping an eye on never-before-encountered organisms — Battelle and the other groups awarded the federal contract are trying to figure out how to stay a step ahead. ‘At first I thought it would be too big of a lift for us,’ Dickens said. At the end of January, Battelle researchers completed a first version of the software, which they are now testing and optimizing. It can, for example, analyze a small fraction of an influenza virus’ genetic code and identify or predict whether it has the potential to make people, animals or the environment sick. The tool then assigns the genetic scrap a threat level: dangerous, potentially hazardous or safe. The tool is artificially intelligent enough to detect whether the sample is related to any known specimens, such as botulism or anthrax, and predict the function of never-seen-before DNA sequences.”

Workshop on Women’s Health In Global Perspective
GMU Schar School is hosting this free workshop on March 7-8th in Arlington,VA – don’t miss out! “The Workshop on Women’s Health in Global Perspective seeks to contribute to understanding and improve policy on women’s health and wellbeing around the world. The program includes panels on Communicable and Non-Communicable Disease; Health and Wellbeing; Maternal Health; and Reproductive Technology and Family Planning. It will cover topics such as HPV Vaccine Awareness, Maternal Mortality, and Cross-border Reproductive Care.”

GMU Biodefense Alum Leads NEIC Laboratory 
We love getting to brag about the amazing things that GMU Biodefense students and alum do with their passion for health security. Biodefense MS alum Francisco Cruz was recently named the Chief of the EPA’s National Enforcement Investigations Center (NEIC) Laboratory Branch! “The branch’s primary responsibility is conducting forensics analysis on environmental samples related to criminal and civil cases. The lab is a fully accredited forensics laboratory staffed by 21 chemists who can not only conduct the lab analysis, but also testify in court regarding the science behind the analysis. Additionally, the lab is capable of developing novel analytical methods for rare and difficult matrices that most labs cannot analyze. The lab supports EPA and other federal law enforcement partners with either lab analysis or technical consultation on how to process a sample.” Biodefense alums – don’t forget to stay connected so we can recognize you for all the amazing biodefense work you do!

DARPA Names Pandemic Prevention Platform Researchers
Launched in 2017, the P3 program from DARPA hopes to stop the spread of an outbreak before it becomes a pandemic. “In contrast with state-of-the-art medical countermeasures, which typically take many months or even years to develop, produce, distribute, and administer, the envisioned P3 platform would cut response time to weeks and stay within the window of relevance for containing an outbreak.” DARPA recently announced the institutions that are contracted for the program and will hopefully make progress in the fight against pandemics – MedImmune, Abcellera Biologics Inc., Duke University, and Vanderbilt University.

 The WHO – What Went Wrong from Swine Flu to Ebola?
The WHO has struggled to find its strong foot since 2009’s H1N1 influenza pandemic and then the 2014/2015 Ebola outbreak. With new leadership, many are hoping the WHO’s abilities can be strengthened and some faith restored in their capacity to prevent and respond to international health events. One particular evaluation of this can be found in a chapter of Political Mistakes and Policy Failures in International Relations. “This chapter examines a series of mistakes and the structural, cultural, political and epidemiological factors that contributed to the WHO’s mishandling of the first pandemic of the twenty-first century and the world’s largest ever outbreak of Ebola. The chapter then concludes by examining the reforms currently being implemented to strengthen the WHO’s global health security capabilities and what these signify for the future.”

Stories You May Have Missed:

  • CDC Epidemiologist Missing – “Police investigators are bewildered as they work through the “extremely unusual” circumstances surrounding the missing-person case of Timothy Cunningham, a researcher who vanished Feb. 12, shortly after hearing why he had been passed over for a promotion at the Centers for Disease Control and Prevention (CDC). Cunningham, 35, told colleagues he was not feeling well and left work at CDC headquarters in Atlanta, not long after speaking with his supervisor about why he had not been promoted, Atlanta Police Maj. Michael O’Connor told reporters. Cunningham works in the chronic disease unit at the CDC, not in the part of the CDC that deals with infectious disease, according to authorities.”
  • Iraqi, Dutch, Vietnamese Officials Report Avian Flu Outbreaks – Several countries reported new avian flu outbreaks, including two more H5N8 events at commercial poultry farms in Iraq, an H5 outbreak at a poultry farm in the Netherlands, and the first known H5N6 detection of the year in Vietnam. In Iraq, which has reported ongoing H5N8 activity since early January, authorities reported new outbreaks in Diyala and Baghdad province that began on Feb 13 and Feb 14, respectively, according to a report yesterday from the World Organization for Animal Health (OIE). The investigation said the source of the virus was contact with wild species.”
  • 11 Fall Ill After Suspicious Letter Arrives At Military Base– “Eleven people fell ill after a suspicious letter was opened in an administrative building at Joint Base Fort Myer-Henderson Hall in Arlington, Virginia, on Tuesday, according to the Arlington County Fire Department. A law enforcement official said field tests for the letter all came back negative for any harmful substance, but the FBI is transporting it tonight to its lab in Quantico for further analysis. The law enforcement official said the text of the letter contained derogatory, at time unintelligible and ranting language, and was addressed to a commanding officer at the base. Investigators are still determining what relationship, if any, the sender had with the base. A corporal, gunnery sergeant and a colonel all exhibited symptoms of a burning sensation on their hands and face, according to Specialist Nicholas Hodges who spoke to CNN from the base.”

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 2.2.2018

The world of health security has been busy this week as news of CDC leadership changes and ongoing flu troubles have caused ripples. A new mouse study is also hinting that West Nile virus may cause Zika-like birth defects. Check out Maryn McKenna’s latest article on changing the market for flu shots and the desperate need for innovation.

 CDC’s Plans to Scale Back Global Health Security Activity 
A recent article brought attention to CDC plans that would reduce efforts to prevent and respond to outbreaks on a global scale through the global health security agenda (GHSA). “In an email to U.S. and overseas leaders in its global health center, the CDC said it anticipates that if its funding situation remains the same, it will have to narrow activities to 10 ‘priority countries’ starting in October 2019. The email was reviewed by The Wall Street Journal.” The 10 countries include Vietnam, India, Nigeria, etc. “Reductions now would halt critical work midstream and result in a loss of newly trained local experts, said Tom Frieden, the former CDC director who led the effort until a year ago and is now president and chief executive of Resolve to Save Lives, an initiative working on strengthening epidemic preparedness.” In response to this alarming plan, the Global Health Security Agenda Consortium, Global Health Council, Next Generation Global Health Security Network, and Global Health Technologies Coalition, have drafted a letter to newly appointed HHS Secretary Alex Azar, regarding the serious implications of such actions. Sent to HHS, CDC, OMB, State and NSC leadership, they underline the funding ramifications of scaling back on CDC’s efforts regarding the GHSA. “US investments in global health security and deployed CDC personnel are making America safer today. For example, US investments in surveillance capacity in Cameroon have decreased the disease outbreak response time from 8 weeks to just 24 hours.” The letter highlights the recent Ebola and Marburg outbreaks as prime examples of work within the GHSA, but also what occurs when global efforts are not available or lacking. “As the United States and the world begin to reap the benefits of our investments in better disease preparedness, now is not the time to step back. The ongoing danger that biological threats pose to American health, economic, and national security interests demands dedicated and steady funding for global health security. Congress and the Administration must invest in our deployed global biodefense capability.” Nothing short of serendipitous, the National Academies have also released their report from a workshop on Exploring Partnership Governance in Global Health. “In global health, collaboration frequently occurs through public–private partnerships (PPPs), with public and private parties sharing risks, responsibilities, and decision-making processes with the objective of collectively and more effectively addressing a common goal. PPPs include government and industry as well as partners from a range of other sectors. The workshop examined what role governance assumes in global health PPPs through presentations and discussion on transparency and accountability, operational challenges, legal considerations, barriers and strategies for engagement, examples of governance structures and lessons learned, and measurement. This publication briefly summarizes the presentations and discussions from the workshop”

Antimicrobial Resistance Surveillance Efforts and Needs
While the outcome is not surprising, this first release of the WHO’s surveillance data on AMR isn’t pretty. Surveillance data is revealing high levels of antibiotic resistance are in fact, found worldwide. “WHO’s new Global Antimicrobial Surveillance System (GLASS) reveals widespread occurrence of antibiotic resistance among 500 000 people with suspected bacterial infections across 22 countries. The most commonly reported resistant bacteria were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Streptococcus pneumoniae, followed by Salmonella spp. The system does not include data on resistance of Mycobacterium tuberculosis, which causes tuberculosis (TB), as WHO has been tracking it since 1994 and providing annual updates in the Global tuberculosis report.” The GLASS program includes 52 countries (25 high-income, 20 middle-income, and 7 low-income countries) and was launched in 2015 as a way to better track and understand the complexities of AMR. Wellcome Trust has also just announced a new strategy to combat AMR on an international scale. SEDRIC (Surveillance and Epidemiology of Drug-Resistant Infections Consortium) will work to strengthen country capacity for AMR surveillance and detection. “We need to better understand where patients acquire bacteria that cause infections – are they acquiring bacteria from other patients, from healthcare settings, water or food or the general environment? Drug-resistant infections are, like us, international travellers. We need to track which borders they cross, and how quickly. Without detailed and up-to-date information we cannot effectively intervene.” SEDRIC will work to fix surveillance gaps across countries by focusing on improving global coordination, identifying critical gaps and barriers, and helping countries to adopt sustainable best practice and strategies. These surveillance efforts and strategies are desperately needed to understand the AMR problem at a global level, especially as it was reported that India’s farmed chickens are dosed with colistin (the antibiotic of last resort). 

CDC Director Steps Down
Dr. Brenda Fitzgerald has stepped down from her role as director of the CDC due to conflicts of interest. “Politico reported on Tuesday that Fitzgerald, a physician and former commissioner of the Georgia Department of Public Health, bought shares in a tobacco company a month into her leadership of CDC, an agency charged with safeguarding public health, including reducing rates of smoking. She took over leadership at CDC in July. After advising the HHS secretary of the status of her financial interests and the way in which it limited her ability to do her job, Azar accepted her resignation, HHS said in a statement.” Dr. Fitzgerald began her role in July and is the second of top health positions appointed by the Trump Administration to resign. Dr. Anne Schuchat is now the Acting Director for the CDC. 

GMU Master’s Open House – February 21st
We’re just a few weeks out from the GMU Schar School MS Open House on February 21st and you won’t want to miss this opportunity to talk to faculty about our biodefense graduate degrees. Whether you’re looking to attend in person or online, this is a great opportunity to discuss the application process, curriculum, and how students are supported in their academic and career goals.

 Hawaii’s False Missile Alert and The Woeful State of US Preparedness
For 38 minutes, residents of Hawaii were alerted that a ballistic missile was approaching the island. A deep-dive of this mishap has found that the “emergency worker who sent a false public safety alert on Jan. 13 warning of an imminent  ballistic missile attack on Hawaii believed that a ballistic missile was truly bound for the state after mishearing a recorded message as part of an unscheduled drill,”. A mix-up in communication between shift supervisors regarding when the drill would run led to a trickle-down of confusion as the day-shift workers were notified of a missile threat (as part of the drill). “Following standard procedures, the night-shift supervisor posing as Pacific Command played a recorded message to the emergency workers warning them of the fake threat. The message included the phrase ‘Exercise, exercise, exercise.’ But the message inaccurately included the phrase ‘This is not a drill.’ The worker who then sent the emergency alert failed to hear the ‘exercise’ portion of the message and acted upon the ‘This is not a drill’ part of the message that should not have been included, according to the report.” Furthermore, the computer systems in place that should’ve been a stop-gap did not detect the difference between test alerts and actual alerts. This event is a prime example of the traditional failure in emergency preparedness exercises (and real events) – communication. Such an event, while frustrating, should be utilized as a teaching tool to truly fix the communication gaps. Sometimes it’s the “did that seriously just happen?” events that teach us the most about the fissures in our preparedness.

Flu Wreaking Havoc on Hospitals, Infection Control Practices Struggling
GMU Biodefense PhD student and infection preventionist Saskia Popescu is looking at the current flu situation from the perspective of infection control and healthcare response. “Hospitals are being hit hard by a rapid influx of individuals who are requiring isolation, treatment, and manpower during a time where health care institutions are already suffering from an intravenous (IV) bag shortage. I’ve seen some hospitals go on diversion because they are so inundated with patients that they are unable to accept any more. Hospitals are experiencing shortages of influenza testing kits, conference rooms and outside tents are being set up as triage/waiting areas, personal protective equipment (PPE) stores are being strained. Furthermore, infection prevention and control practices are being stressed against the influx of patients and staff calling in sick. All the while, clinicians are trying to maintain proper isolation precautions. To add insult to injury, a recent study on the transmissibility of aerosols and the role they play in spreading influenza has uncovered some disheartening results.”

Tests Link Syrian Government Stockpile to Largest Sarin Attack
Laboratories performing analysis for the Organisation for the Prohibition of Chemical Weapons (OCPW) have confirmed linkage between the Syrian government’s chemical weapons stockpile and the largest sarin attack of the civil war. “The tests found ‘markers’ in samples taken at Ghouta and at the sites of two other nerve agent attacks, in the towns of Khan Sheikhoun in Idlib governorate on April 4, 2017 and Khan al-Assal, Aleppo, in March 2013, two people involved in the process said. ‘We compared Khan Sheikhoun, Khan al-Assal, Ghouta,’ said one source who asked not to be named because of the sensitivity of the findings. ‘There were signatures in all three of them that matched’.” The test results further reinforce the widespread belief that the Assad regime has not destroyed their chemical weapons supply (and continues to use them), which would violate not only the Chemical Weapons Convention, but also several UNSC resolutions. Russia continues to maintain that the Syrian government has not carried out such attacks and that the OCPW inquiries aren’t reliable, but inspectors continue to find evidence of chemical weapons in Syria. “Independent experts, however, said the findings are the strongest scientific evidence to date that the Syrian government was behind Ghouta, the deadliest chemical weapons attack since the Halabja massacres of 1988 during the Iran-Iraq war.” “A match of samples from the 2013 Ghouta attacks to tests of chemicals in the Syrian stockpile is the equivalent of DNA evidence: definitive proof,” said Amy Smithson, a U.S. nonproliferation expert. “The hexamine finding ‘is a particularly significant match,’ Smithson said, because it is a chemical identified as a unique hallmark of the Syrian military’s process to make sarin. ‘This match adds to the mountain of physical evidence that points conclusively, without a shadow of doubt, to the Syrian government,’ she said.” Furthermore, experts are dispelling the notion that the attacks could have been carried out by rebels, noting that it would be impossible for them to achieve such a coordinated, large-scale attack.

Stories You May Have Missed:

  • South Korea Works to Eradicate Avian Flu Before Olympics – “With the PyeongChang Winter Olympics set to begin on Feb. 9, the South Korean Ministry of Agriculture, Food and Rural Affairs announced Monday that it had confirmed the presence of a highly pathogenic strain of the H5N6 avian influenza virus at two chicken farms south of Seoul, Korea JoongAng Daily reportsThe two farms both are approximately 80 miles to the west of PyeongChang. The government has culled 190,000 chickens at the farm in Hwaseong and another 144,000 at the farm in Pyeongtaek. It also has ordered that 430,000 chickens on farms in a 500-meter radius of the Pyeongtaek farm be slaughtered and has destroyed nearly 500,000 eggs at the Hwaseong farm as a precautionary measure. The government also will inspect and disinfect other farms in the area.”
  • Yellow Fever in Brazil – Cases of yellow fever have jumped in Brazil, based upon data from the Ministry of Health data. “In 1 week, the number of recorded deaths from yellow fever rose from 20 to 53, reported cases rose from 470 to 601, while confirmed cases jumped from 35 to 130, O Globo reported yesterday. All deaths have occurred in Minas Gerais, Sao Paulo, and Rio de Janeiro states. Ministry of Health data lag behind data from state officials, Brazilian media reported. The state health data for Minas Gerais notes 24 deaths (1 more than the federal government count), and Rio de Janeiro recorded 8 deaths (also 1 more than the federal total for that state.)  All reports indicate that Sao Paulo has 21 deaths.”

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 11.17.2017

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 11.10.2017

Looking for a great podcast? Check out the American Society for Microbiology’s Meet the Microbiologist – especially the latest episode on biopreparedness and biosecurity with Gigi Kwik Gronvall. From island emergency preparedness to antimicrobial resistance and monkeypox, we’ve got you covered for all things biodefense this week.

Top 5 Challenges in Emergency Preparedness: An Island Perspective
Imagine dealing with a natural disaster or health security threat like a major outbreak, but instead of being on mainland where you can rapidly get aid, you’re on an island. GMU Biodefense MS student Tara Hines provides unique insight into emergency preparedness for islands and how these efforts must overcome unusual challenges. From the health security perspective, there are always challenges, but what would be the biggest ones if you were on an island, like Bermuda? “The great part about biodefense is that it integrates public health, public safety, and basic science to provide health security. This interdisciplinary approach lets us tap into all of these areas to identify potential problems and suggest possible solutions, before a disaster strikes. Plus, biodefense work can be done anywhere and is crucial everywhere!” Tara addresses the challenges of not only collaboration and communication, but also military history and capacity, and several other factors that come into play. Make sure to read about her take on these response efforts and what it has been like responding to such events from an island.

Center for Health Security – ELBI Fellowship Application Now Open
If you’re looking to become an EBLI fellow with the Center for Health Security, good news – applications are now open! “The Emerging Leaders in Biosecurity Fellowship is an opportunity for talented career professionals to deepen their expertise, expand their network, and build their leadership skills through a series of sponsored events coordinated by the Johns Hopkins Center for Health Security.” The GMU Biodefense program is proud to have seen four students selected for this prestigious fellowship. For more insights into the ELBI fellowship, check out 2017 fellow and current GMU biodefense PhD student Saskia Popescu’s take on her ELBI experience. If you are a GMU biodefense student or alum looking to apply and hoping to get a golden ticket (aka letter of recommendation) from Dr. Koblentz – make sure to email him ASAP and make sure to send him your CV/resume/statement letter prior to December 4th.

Summit on Global Food Security and Health: “Integrating Global Food Security and National Security: Problems, Progress, and Challenges”
We’re excited to see this amazing summit on food security and national security is right around the corner. Don’t miss your chance to attend this November 15th event at the Schar School of Policy and Government, Founders Hall Auditorium. “The Fourth Annual Summit on Global Food Security and Health will take place George Mason University’s Schar School of Policy and Government on Wednesday, November 15, 2017 at our Arlington Campus from 9:00 am to 5:00 pm in the Founders Hall Auditorium at 3351 Fairfax Drive, Arlington, Va. 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.” The event is free, but make sure you RSVP!

Antimicrobial Resistance, WHO Agriculture Recommendations, & USDA’s Not-So-Subtle Shade
AMR is slowly becoming the “I told you so” of infectious disease threats. Even Alexander Fleming warned of a day when antibiotics would no longer be effective. “Back in 2013, the UK’s chief medical officer Dame Sally Davies started warning the world that antibiotic resistance posed a deadly threat to humanity. But, she believes, that her lack of hard data meant few people took her seriously. ‘One crucial thing that got the whole world to take climate change seriously was the Stern Review on the Economics of Climate Change back in 2006’ she explains. ‘So we launched our own Stern Review – and found superbugs will kill us before climate change does’.” Reports since then have also highlighted the millions that will die every year due to AMR, but we’re still struggling with incentives for drug discovery and development. “Superbugs are a classic example of market failure – Dame Sally gave a timeline and a point of no return that we have to solve or we’re FUBAR. Government is too linear, industry sees no profit, VC’s don’t see any capital, labs have other problems and NGOs struggle to innovate.” While efforts to invigorate industry are underway, the WHO’s new recommendations are addressing AMR from the agriculture angle. The latest report is calling for a reduction in antimicrobial use across the board in food-producing animals and the halting of use in healthy animals for growth. “The formal guidelines issued by the WHO further recommended that when animals are diagnosed with a bacterial infection, antibiotics that are considered critically important for human medicine should not be used for treatment or to prevent the spread of the infection within a herd or flock, unless tests indicate those drugs are the only treatment option. Instead, antibiotics used for the treatment of sick animals should be chosen from those the WHO considers least important to human health.” Responding to these new recommendations, the USDA has thrown some not-so-subtle shade in their recent press release. The USDA Acting Chief Scientist, Dr. Chavonda Jacobs-Yong, has stated that the WHO recommendations are “not in alignment with U.S. policy and are not supported by sound science. The recommendations erroneously conflate disease prevention with growth promotion in animals.” Fighting AMR is a like fighting a chimeric hydra – a multi-headed, regenerating beast made of different animals – all dangerous and different. What herculean effort will be required for us to win the battle of the superbug?

Schar School Master’s Open House – Biodefense MS
It’s the last MS Open House of the season and you won’t want to miss this opportunity to learn about our biodefense graduate programs and talk to faculty. Next Wednesday, November 15th at 6:30pm at GMU’s Arlington campus, you can get the scoop on earning your master’s degree in biodefense on campus or remotely – don’t miss out!

Panel Discussion: Security in the New Era of Targeted Sanctions
Don’t miss the Fall 2017 Symposium hosted by the National Security Law Journal on November 13th at 11:30am! Hosted at GMU’s Founders Hall Auditorium, you can hear from a distinguished panel of attorneys and policy experts specializing in foreign policy, economics, and current events for this event, two of whom are George Mason professors. Dr. Gregory Koblentz, Dr. Mark Katz, and Dr. Adam Smith, will be panelists on this great symposium – infact, Dr. Koblentz will be speaking on the role of sanctions in responding to Syria’s use of chemical weapons. Mark sure to RSVP by emailing symposium@nslj.org

Chasing a Killer – Hunting Monkeypox
While we talk of pandemic flu and synthetic biology, it’s easy to forget some of the more mysterious, and yet, equally sinister natural outbreaks that are occurring. The Congo Republic is currently battling a surprising outbreak of monkeypox, which is a cousin of smallpox. “Over the past year, reports of monkeypox have flared alarmingly across Africa, one of several animal-borne diseases that have raised anxiety around the globe. The Congolese government invited CDC researchers here to track the disease and train local scientists. Understanding the virus and how it spreads during an outbreak is key to stopping it and protecting people from the deadly disease.” In fact, the U.S. has experienced its own monkeypox outbreak – in 2003 due to an exotic pet that was imported (sounds like the beginning of that movie Outbreak…). Zoonotic spillover is normally how these outbreaks begin and while monkeypox is not as deadly as smallpox or ebola (a mortality rate of around 10%), researchers are working to understand the ecology of monkeypox hosts and reservoirs. Take a minute to check out this article as there are some wonderful photos and maps that will take you along for this on-the-ground virus hunting expedition.

CBFP Biosciences Fellowship Program
CBFP welcomes applications from early to mid-career biological scientists working in government ministries, government-operated biological science laboratories, and/or research and diagnostic facilities with experience in laboratory operations, research, and diagnostics from Jordan, Lebanon, and Turkey. Only applications from these three countries will be considered. Selected fellows will conduct a science exchange fellowship of up to six months in duration to engage in research at a host institution including, but not limited to, the United States, Europe, and the Middle East beginning no earlier than September 2018. Applications are due December 17th, so make sure to apply here!

Canada To Prioritize Biothreat Reduction During G7 Presidency        In 2018, Canada will assume the G7 presidency role and Global Affairs Associate Deputy Minister Mark Gwozdecky has made it known that the country will prioritize biological threat reduction. “Infectious diseases have plagued mankind since the dawn of time. They’ve proven to be ruthless, persistent and all too adaptive and have been responsible for unparalleled death, suffering and economic loss,” Gwozdecky said.” He pointed to the recent outbreak of bubonic plague in Madagascar, which has infected more than 1,300 people, as an example of the ongoing challenges facing public health officials.” Efforts will also focus on the growing issue of antimicrobial resistance and the threat of biological weapons. Canada has continued to prioritize the full spectrum of biological threats and importance of biosecurity and biosafety within labs through its BSL4Znet network, which is a global information and resource sharing program to protect against biothreats. “While these threats, both natural and intentional are formidable, they are not beyond our means to overcome,” he said. “Key to this, however, will be enhanced cooperation, collaboration and collective effort.” “We look forward to engaging all of our partners to identify new ways, means and opportunities to strengthen global biological security,” Gwozdecky added.

The U.S. Government and Global Health Security
The Henry J. Kaiser Family Foundation’s latest issue brief focuses on the roe of the U.S. government and global health security. Ranging from a number of threats like Ebola, HIV, and SARS, global health security efforts are vital and must be as diverse and adaptable as the infectious diseases they thwart. “U.S. funding for its primary global health security programs –activities primarily carried out by the U.S. Agency for International Development (USAID), Centers for Disease Control and Prevention (CDC), and Department of Defense (DoD) – has remained relatively flat from FY 2006 ($390 million) through FY 2017 ($402 million), with episodic funding spikes through supplemental funding mechanisms reflecting specific outbreak events, including Ebola in FY 2015 ($1 billion) and Zika in FY 2016 ($145.5 million). The Administration has proposed reduced global health security funding for FY 2018 ($353 million).” This comprehensive report addresses the current global situation of infectious disease outbreaks and reviews U.S. government efforts and funding.

Stories You May Have Missed:

  • Financial Misappropriations, Ebola, and The Red Cross – The Red Cross organization recently confirmed that nearly $6 million in donated funds were misappropriated during the 2014 Ebola outbreak. “The organisation’s own investigations uncovered evidence of fraud, with more than $2.1m (£1.6m) lost in Sierra Leone, probably stolen by staff in collusion with local bank officials, according to a statement. In Guinea, a mixture of fake and inflated customs bills cost it $1m.” Investigations found the prices of relief goods and payrolls were inflated and while this isn’t the first time corruption has been associated with humanitarian relief, the Red Cross has yet to issue an apology.
  • Minnesota’s Drug-Resistant TB Outbreak– Minnesota’s Ramsey County is battling a deadly multi-drug resistant tuberculosis (MDR-TB) outbreak. “Six of the 17 have died, with three of those deaths being directly attributed to tuberculosis, said Kris Ehresmann, director for Infectious Disease at the Minnesota Department of Health, on Monday. Of the 17 cases, 14 were in the Hmong community and 10 are associated with individuals who participate in activities at a senior center, Ehresmann said.”

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 9.22.2017

Happy Friday! Are you a fan of antibiotics and their ability to fight off microbial threats? So are we, which makes the recent WHO report that much scarier. Since this latest report points to the dire situation of antibiotic development, we’re super-sizing the focus on the antimicrobial resistance and super bugs this week.

Fifteen Years of Public Health Emergency Preparedness  & AJPH Special Edition
Make sure not to miss the special edition of the American Journal of Public Health (AJPH), focusing on public health emergency preparedness. Within this edition there are great articles on science in emergency response at the CDC, children’s health in emergency preparedness, evolution of the field, funding, etc. One of the best parts was the Editor’s Choice – From Anthrax to Zika: Fifteen Years of Public Health Emergency Preparedness. This article discusses public health threats, regardless of origin, and how they can lead to national emergencies. “Our current frame of reference is shaped by the events of September 11, 2001. In response to the terrorist attack, the US Congress set up appropriations to support state, local, tribal, and territorial public health departments nationwide; these funds are administered through a cooperative agreement from the Centers for Disease Control and Prevention (CDC) to fortify national security. The Public Health Emergency Preparedness (PHEP) cooperative agreement helps health departments strengthen their abilities to effectively respond to a range of public health threats, including infectious diseases; natural disasters; and biological, chemical, nuclear, and radiological events. As a result, the CDC and the PHEP community have played critical roles over the past 15 years in preventing, responding to, and rapidly recovering from public health threats ranging from anthrax (2001) to Zika (ongoing currently as of publication). Responses to these public health threats highlight the need for preparedness efforts to protect people and support communities when disaster strikes.” The authors discuss the impact of the 2001 Amerithrax attacks on public health countermeasures and response, and then the 2009 pandemic of H1N1 during the school year. They also touch on food safety and biosurveillance, which caught the 2015 E. coli and meningitis B outbreaks in Oregon, not to mention the recent impact of Zika and Ebola. “These are just a few examples of public health preparedness capabilities that the CDC identified in its 2011 guidance document issued to aid in the development of successful public health preparedness programs. The articles in this issue of AJPH provide detailed accounts of preparedness in action, showcasing competencies in biosurveillance, incident management, community resilience, information management, countermeasures and mitigation, and surge management. These articles demonstrate how and why public health agencies, health care systems, and communities play a vital role in protecting and securing the nation’s public health.”

CARB-X: Fighting AMR through Public-Private Partnerships
GMU biodefense MS alum Nick Guerin is taking us through the journey of fighting resistant organisms and the importance of antimicrobial stewardship partnerships. Guerin looks to the new CARB-X strategy at curbing the impending threat of antimicrobial resistance (AMR). “One possible protection against AMR is the development of new medical countermeasures (MCMs). The strategies to find the best MCMs crisscross multiple organizations and functions, namely through either public or private initiatives. However, such divided efforts create limitations that might best be overcome through comprehensive public-private collaborative efforts.” Not only does Guerin highlight the details of CARB-X and other partnerships, but he also addresses past approaches and failures in fighting AMR. “AMR’s threat demands expedient solutions; the decade’s long wait for new antibiotics cannot continue. AMR poses one of the most difficult development requirements for these new MCMs, one that public and private sectors haven’t overcome on their own.”  

Global Health 2030 Symposium  
The second annual Global Health 2030 Symposium will be held on October 4th at the United Institute of Peace in Washington, D.C. “Experts, academics, and practitioners will be exploring the Science of Health: Bridging Epidemics and Technology. Join us as we convene the community to prepare for the growing health challenges at home and abroad. Learn about the latest technology and global health innovations combating widespread epidemics and improving disaster response. The keynote address, ‘The Persistence of Epidemics and Our Response’ will be given by Dr. Michael Cowan, Executive Director, Association of Military Surgeons of the United States.”

Space – The Next Microbial Frontier?
How do bacteria act in space? Sure, we know the microgravity can permanently alter bacteria and make them even better at reproducing, but we need to really understand why this happens and how it might impact our health during space exploration. “In an experiment planned by researchers at the University of Colorado at Boulder and carried out on the ISS, cultures of Escherichia coli bacteria were doused with the antibiotic gentamicin sulphate, which usually kills off E. coli quite easily. Out in space, it was a totally different story. ‘We knew bacteria behave differently in space and that it takes higher concentrations of antibiotics to kill them,’ says one of the researchers, Luis Zea. ‘What’s new is that we conducted a systematic analysis of the changing physical appearance of the bacteria during the experiments’.” Their experiment found that E. coli reacted with a 13-fold increase in cell numbers and reduced their cell volume by almost 75%. This reduction in size can make treatment with antimicrobials tricky as there is a smaller surface area for them to interact with. Researchers also found that the bacteria increased cell envelope thickness and outer membrane vesicles. “The bacteria threw up extra shields by thickening their cell walls and outer membranes, and growing in clumps so a shell of outer cells could protect the inner ones from getting exposed. ‘Both the increase in cell envelope thickness and in the outer membrane vesicles may be indicative of drug resistance mechanisms being activated in the spaceflight samples,’ says Zea. ‘And this experiment and others like it give us the opportunity to better understand how bacteria become resistant to antibiotics here on Earth’.” While more research is needed, perhaps this environment will be the new proving ground for novel antimicrobials and tougher processes. If nothing else, this just gives me a lot of appreciation for how tough space disinfection is.

How China’s AMR Outbreak Revealed the Changing Landscape of Infection Control                                       The news that a Chinese hospital lost five patients to a severe strain of drug-resistant Klebsiella pneumoniae left many concerned about the growing threat of antibiotic resistance. The strain of K. pneumoniae was not only highly resistant, but also hypervirulent and highly transmissible, which is just about everyone’s worst nightmare when it comes to antimicrobial resistance. GMU biodefense PhD student and infection preventionist Saskia Popescu takes a look at this outbreak and how it reveals the changing landscape of infection control. “The recent report from the Chinese ICU outbreak points to the increasing threat of microbial resistance and the desperate need to address prevention efforts in terms of both stewardship and infection control. As the landscape changes for both medical care and biothreats, it is important that infection prevention and control efforts be a part of this evolution. We must consider these practices and hospital programs when modernizing healthcare and public health. These infectious disease events can, and should, teach us about the diverse range of issues hospitals face and how we can better prevent the spread of infection through active, instead of passive, efforts. “

Attribution of Biological Crime, Terrorism, and Warfare: Challenges and Solutions                                                                                                                                         The latest Blue Ribbon Study Panel on Biodefense event, highlighting biocrimes and biowarfare, will be on October 3rd from 10am-1pm. “Effective prosecution and decisions regarding U.S. response depend on accurate attribution of biological attacks. Despite ongoing biological crimes and suspected development of biological weapons for the purpose of attacking the Nation, the United States has yet to establish this capability fully. The Study Panel will host a special focus meeting entitled Attribution of Biological Crime, Terrorism, and Warfare: Challenges and Solutions. This meeting of the Study Panel, chaired by former Homeland Security Advisor Ken Wainstein and former Senate Majority Leader Tom Daschle, will address the current states of science, investigations, and intelligence for biological attribution and the extent to which they inform strategic, operational, and tactical decisions; and provide a better understanding of the ability of the United States to identify pathogens and their sources correctly, attribute biological crimes, terrorism, proliferation, and warfare to their perpetrators, using scientific and other forms of evidence and information, and explore the processes used for investigative, legal, policy, and political decisions involving biological attribution.”

Cryptology History Symposium
GMU biodefense PhD alum Craig Wiener will be presenting his dissertation research at the October Center for Cryptology History Symposium. His research, “Penetrate, Exploit, Disrupt, Destroy: The Rise of Computer Network Operations as a Major Military Innovation”. Don’t miss out on this opportunity to listen to Craig discuss his research “determining the origins of computer network exploitation and computer network attacks in the U.S. intelligence community.”

Health Security Call for Papers – Extended Deadline
The call for papers on communication and health security deadline has been extended to December 31st, 2017. “A special feature in Health Security will be devoted to analysis of the current communication environment and efforts to effectively communicate during outbreaks of infectious diseases and other health threats. The journal seeks papers that address the wide range of policy, practice, and research issues relevant to communication in large-scale health events. The special Journal section devoted to communication and health security will be published in the March/April 2018 issue of Health Security. Scholarly and review articles, descriptions of practice, and opinion and commentary pieces are welcome. Manuscripts can be up to 5,000 words exclusive of the abstract, tables, figures, and references. Please consult the journal website for specific submission instructions.”

Stories You May Have Missed:

  • Biosecurity Luncheon – NAS– Don’t miss the September 27th luncheon and “informal discussion on Global Catastrophic Biological Risks (GCBRs), led by the Director of the Johns Hopkins Center for Health Security, Dr. Thomas Inglesby. Dr. Inglesby will review the Center’s recent attention on GCBRs, and how the synthesis of horsepox by a Canadian researcher has moved the needle on the necessity of discussing these potential future events. This meeting is the second in a series of biological, chemical, and health security discussions to address compelling topics and to provide a forum for engagement among the DC-based community interested in biosecurity issues. The lunch will take place at the Keck Center of the National Academies of Sciences, Engineering, and Medicine (located at 500 Fifth Street NW, Washington, DC). The event is free and lunch will be provided, but space is limited, so you must register to attend this event.” Make sure to register here!
  • CDC & Its Partners’ Contributions to Global Health Security– A new report from Emerging Infectious Diseases is highlighting the challenges many countries face when attempting to comply with the WHO’s IHR. “The US Centers for Disease Control and Prevention (CDC) works with countries and partners to build and strengthen global health security preparedness so they can quickly respond to public health crises. This report highlights selected CDC global health protection platform accomplishments that help mitigate global health threats and build core, cross-cutting capacity to identify and contain disease outbreaks at their source. CDC contributions support country efforts to achieve IHR 2005 compliance, contribute to the international framework for countering infectious disease crises, and enhance health security for Americans and populations around the world.”
  • San Diego Battles Hepatitis A – San Diego is battling a deadly hepatitis A outbreak, in which sixteen people have died. Shortly after announcing it had become a public health emergency in San Diego, Los Angeles reported cases and has declared an outbreak. Sanitary conditions, especially in public bathrooms, have been considered one source of transmission and many cases have been within the homeless population. The outbreak has “infected 421 since November, ravaging San Diego’s large homeless and illicit drug-using population. It could eventually cost the county health department up to a million dollars, a local health official estimated.” While there hasn’t been a point source identified, efforts are being taken within homeless shelters and even bleaching of streets are underway. Many are pointing to the lack of affordable housing in San Diego as a catalyst for homelessness and the certain laws and practices that push homeless people into smaller areas, which can facilitate the spread of disease. “It was a wake-up call that this is killing people,” Norris said. “It’s killing people we know. It’s killing our neighbors.” “We’re not a third world country,” added McConnell, the community advocate. “We should quit acting like we are.”

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