Tag: ebola

Pandora Report 12.16.2016

by spopescu, posted in Pandora Report

Sick to your stomach? Make sure to tweet about it! Seriously – the UK Food Standards Agency is using social media to track stomach bugs like norovirus. Before we venture down the biodefense rabbit hole, have you ever wondered what would happen if college students tried to hack a gene drive?

GMU Biodefense PhD Writes ‘Groundbreaking’ Thesis on Cyber Warfare– GMU Biodefense PhD graduate, Craig Wiener, is talking about his PhD experience and the amazing work he did on his dissertation. Craig’s story is pretty unique – between the commute from his position at the Department of Energy’s National Nuclear Security Administration, to his background in biodefense and research in synthetic biology, he’s a prime example of the diverse and passionate students we see in the GMU biodefense program. “Wiener’s PhD dissertation, ‘Penetrate, Exploit, Disrupt, Destroy: The Rise of Computer Network Operations as a Major Military Innovation,’ is groundbreaking, said Gregory Koblentz, director of Mason’s biodefense graduate program, and it has nothing to do with biodefense. Wiener connected some rather complicated dots in determining the origins of computer network exploitation and computer network attacks in the U.S. intelligence community. ‘I’ve established that computer network operations are a major military innovation, and it was developed by the U.S. intelligence community…. It’s the first time the intelligence community has developed a weapon system,’ said Wiener.” A labor of love, his work will significantly contribute to the history of cyber warfare and is a prime example of what makes GMU such a wonderful university to study.

FDA Review of 2014 Variola NIH Incident

screen-shot-2016-12-14-at-7-57-52-amThe newly released report, “FDA Review of the 2014 Discovery of Vials Labeled ‘Variola’ and Other Vials Discovered in an FDA-Occupied Building on the NIH Campus”, details the findings and corrective actions following the FDA’s internal investigation of the 2014 incident. The compilation includes several interviews, findings from reports and site visits, and a timeline of events leading to the discovery of the 327 vials on July 1, 2014. Some of the findings include: “There was no single individual responsible for the entire contents and operation of the shared cold storage area. FDA did not follow the CDC Select Agent Guidelines for the packaging and transfer of samples to a high containment facility for securing the materials.” There were six findings in the report, which included corrective actions, future actions, and compliance mechanisms. The report also includes the table regarding the disposition of the 327 vials. “It was noted that an internal, inward-looking investigation by the FDA had not formally started at the time of the hearing because both the CDC and FBI were in the midst of their own investigations of the incident.  However, FDA informally started an internal review and audit of the incident to understand the failure points to implement best policies and practices to prevent such incidents from happening in the future.”

Global Virome Project – You may remember reading  this summer about finding the next patient zero via a speaking engagement from USAID Director for Global Health Security and Development Unit, Dr. Dennis Carroll. The truth is that outbreaks like Zika and Ebola have shown us that countermeasures are invariably weak and viruses like to hide out in nature. This formidable reality has led to the development of the Global Virome Project, which looks to catalogue viruses from all over the world as a means of identifying the threats before they can identify us. “The idea has been around for a while and is supported by individual scientists and organizations including the US Agency for International Development, the nonprofit EcoHealth Alliance, HealthMap, ProMED, and the epidemic risk firm Metabiota. Now support for a global push may be picking up momentum, as scientists and health organizations find themselves repeatedly called upon whenever new threats arise.” An extension of the vision that brought about the PREDICT project, the Global Virome Project looks to make the process more efficient and effective by utilizing new methodology. While knowing the existence of a disease does not equate to preparedness, the understanding of how it interacts with humans and where it hides can help us determine risk and vaccine development. “For instance, knowing that the risk of contracting viruses carried in a species of bats is highest when their offspring are young might push ecotourism operators to avoid caves at those times. And Carroll said filling in more of the picture of the viral world will simply help scientists understand its patterns and interactions better. Right now, predictions are based on the behaviors of a few hundred known viruses, he said.”

2017-2022 Health Care Preparedness and Response Capabilities – The Office of the Assistant Secretary for Preparedness and Response has released their report outlining “the high-level objectives that the nation’s health care delivery system, including HCCs [health care coalitions] and individual health care organizations, should undertake to prepare for, respond to, and recover from emergencies.” The report further breaks down the capabilities into four sections that will, when combined and fully followed, enable full readiness. The four sections are Foundation for Health Care and Medical Readiness, Health Care and Medical Response Coordination, Continuity of Health Care Service Delivery, and Medical Surge. The report is extremely detailed and includes a wide variety of methods for identifying and coordinating resource needs during an emergency, setting up a health care EOC, implementing out-of-hospital medical surge response, and much more.

Blue Ribbon Study Panel Report on Biodefense Indicators– I remember the excitement during the Blue Ribbon Study Panel presentation on their recommendations since the Ebola outbreak. The room was packed with so many contributors to biodefense and there was a sense of fervor regarding the possibilities that could come from their 87 recommendations. Sadly, it seems that enthusiasm isn’t enough to get the work completed. It seems that an overwhelming majority haven’t been completed, according to the latest report. In fact, Tom Ridge and Joseph Lieberman have taken to TIME magazine as a means to implore the incoming administration to help protect the U.S. from bioterrorism and infectious disease threats.

Nanotherapeutics Opens Plant Near Progress Park – Nanotherapeutics opened their new $138 million 183,000-square-foot plant near Progress Park in Alachua, which was built to fulfill a DoD grant that could be worth up to $359 million. “The purpose and the capability of this facility is really fundamentally to avoid a surprise and be better prepared,” said Chris Hassell, deputy assistant secretary of defense for chemical and biological defense. “Sixty years after Pearl Harbor we were surprised again with the anthrax mailings and other events of 9/11, so this whole issue of surprise is a common area of discussion, what can we do to avoid surprise, to defend it, to respond to it more effectively and to that end this facility is very important to our capability to do that.” The DoD maintains several contracts for vaccine and treatment manufacturing, however Nanotherapeutics has tackled several of the struggles with efficiency that have plagued several other efforts. Utilizing disposable bags within stainless steel equipment allows for less clean-up and quicker transitions to help make the process more efficient and successful. The new plant follows strict NIH and military guidelines regarding waste and handling of hazardous materials, not to mention a pretty hefty security system.

czqg73pwiaacplk-png-largeUNSC 1540 Resolution – The United Nations Security Council unanimously voted on Resolution 1540 this week, which is especially prudent given the devastation in Syria and use of chemical weapons. The overwhelming adoption of the 1540 review resolution furthered the fight to keep WMD’s out of non-state actor hands. Resolution 1540 was adopted in 2004 and extended periodically through 2012 as a means of imposing binding obligations on all states to adopt legislation to prevent the proliferation of nuclear, chemical, and biological weapons. The open debate, “Preventing Catastrophe: A Global Agenda for Stopping the Proliferation of Weapons of Mass Destruction to Non-State Actors” took place on December 15th, ending the second review of 1540 implementation. “The Council is expected to adopt a resolution endorsing the review and noting the findings and recommendations contained in its report, which was agreed by the 1540 Committee last Friday”. The comprehensive review process has been somewhat challenging lately due to differences in Council member priorities and ambitions. “Russia and China made clear that they did not see the need for radical changes in the functioning or mandate of the Committee, whereas Spain, as the chair of the Committee, and other Council members, such as the UK and the US, were pushing for more substantive measures and new approaches. As a result, the discussions in the 1540 Committee on the report of the review were quite contentious, in particular with regard to its conclusions and recommendations. It took more than two months of intense negotiations after the Committee considered the first draft of the report on 27 September to reach agreement on the final document. The whole review process has taken almost two years.” We’ll make sure to keep you posted as news is released!

Avian Influenza and Global Trade Conditions– A series of avian influenza outbreaks are challenging the positive 2017 outlook for the global poultry industry. These events are especially distressing for the poultry industry as the global pork and beef production is rising. “The return of avian influenza is now shaking up global trade conditions and is especially affecting the outlook for Asia, Europe and Africa,” the report said. “It will also be a test for the U.S. industry after last year’s multiple AI outbreaks. As many European and Asian countries are exporters of meat and breeding stock, this will certainly impact the outlook for the industry and could shake up meat and breeder trade again.” The increasing protectionism and disease-related traded restrictions have caused some slowing within the poultry trade. This report comes at an auspicious time as the WHO warns of a H7N9 pandemic.

Zika Virus Updates- The most recent Florida Department of Health daily updates can be found here, which found six new travel-related cases on 12/14 and no new locally acquired cases. The CDC has issued a travel advisory for Brownsville, TX due to Zika virus. A new study has estimated the prevalence of Zika by the time a microcephaly case is detected. Saad-Roy, et al. (2016) explain, “this model gives us the probability distribution of time until detection of the first microcephaly case. Based on current field observations, our results also indicate that the percentage of infected pregnant women that results in fetal abnormalities is more likely to be on the smaller end of the 1% to 30% spectrum that is currently hypothesized. Our model predicts that for import regions with at least 250,000 people, on average 1,000 to 12,000 will have been infected by the time of the first detection of microcephaly, and on average 200 to 1,500 will be infectious at this time. Larger population sizes do not significantly change our predictions.” The CDC has reported, as of December 14th, 4,617 cases in the U.S.

Stories You May Have Missed: 

  • Biological Security Threats Situation Report – In this report from the Danish Centre for Biosecurity and Biopreparedness, you can find an assessment of current biological threats and risks. The authors note that “the overall likelihood of a major biological terrorist attack must be viewed as relatively low at the moment, but a successful attack could have grave consequences for societies.” Focusing on the capacity to respond to intentional attacks through biosecurity and biopreparedness is vital. The report looks at the risks from state, non-state terrorists, and criminals in its assessment.
  • DHS Backs Development of Livestock Disease Outbreak Readiness Program – America has a soft underbelly and it’s livestock and agriculture. The new funding for the National Agricultural Biosecurity Center (NABC) project to develop the readiness program is just over $330,000 and “will provide a clearinghouse for planning, training and knowledge products to help state, local, tribal and territorial entities prepare for transboundary livestock disease outbreaks.he program also entails extensive collaboration of academia, private industry and state governments. Faculty and staff in the Beef Cattle Institute and the College of Veterinary Medicine will provide subject matter expertise and assistance building the website, and student workers will be employed to assist with the project.”
  • ABSA International  – Don’t miss the USDA and the Agricultural Research Service’s 4th International Biosafety and Biocontainment Symposium- Gobal Biorisk challenges: Agriculture and Beyond. This symposium will take place from February 6-9th at Baltimore Convention Center. Topics will range from biorisk management challenges in one health world, arthropod containment in plant research, and much more!

Pandora Report 12.9.2016

by spopescu, posted in Pandora Report

Happy Friday and welcome to your weekly source for all things biodefense! Can you guess the 37 viral species that may have epidemic potential? Like something out of a horror movie, a team of researchers found the oldest  known smallpox virus sample in a naturally mummified child in Lithuania.

Learning From Ebola – Workshop Proceedings from NAS & Laboratory Battles
17649_phil_who_on_site_ebola_outbreak_2014This week was rich with information from the 2014/2015 Ebola outbreak and the lessons we’re still extracting from it. The National Academies of Science released their 136 pages proceedings from a workshop on the Ebola epidemic in West Africa. This is an extremely in-depth review of the situation, the failures, and what we’re doing to prevent it from happening again. If you don’t have time to read the full 136 page (too bad they don’t have it as a book on tape, right?), they’ve broken it down into sections- the outbreak, global preparedness and response, current and future research, etc. The actual body of the paper is about 65 pages but there are some gems in the appendixes – EVD preparedness in Germany, the view from the national institute of allergy and infectious diseases, and more. I found the outbreak section particularly interesting as it discussed the differences with previous outbreaks. This section noted the weakening of the affected countries through ongoing civil unrest and relative inexperience when dealing with ebola. Another great resource this week comes from the African Journal of Laboratory Medicine. They’ve just released a special edition that focuses on global health security during the Ebola outbreak. You can find articles on building laboratory capacity to combat diseases in Africa, the lab health system and its response to the EVD outbreak in Liberia, Sierra Leone’s lab system now and in the future, etc. The article on building lab capacity points to issues with Ebola, but also notes the challenge that several countries have in meeting the GHSA as their national disease programs are fragmented and have not yet joined the national lab networks, surveillance systems, and health research institutes. Interestingly, the focus then turns to antibiotic resistance and emphasizes the critical role of labs in detection and containment of AMR’s, which is a serious deficiency in Africa.

Since we’re already talking about Ebola, the CDC just released an article in their Emerging Infectious Diseases journal, regarding media messages and the perception of risk for ebola in the U.S. I think many of us can appreciate the significance of this article as media representation and messaging of risk during this outbreak was just another in a long list of mis-information and avoidable hysteria. The researchers reviewed U.S.-focused news about Ebola from July1-November 30, 2014 and found an abundance of risk-elevating messages. “Overall, 96% of print and television news stories that covered EVD in the context of the United States included >1 risk-elevating messages, 55% of stories contained >1 risk-minimizing messages, and 53% contained both message types. The most common risk-elevating messages (72%) concerned foreigners or travelers bringing Ebola virus to the United States. The most frequent risk-minimizing messages (32%) described scientific knowledge about EVD (Table).” When it comes to responding to ebola and other emerging infectious diseases, aside from the change in media habits, there’s a lot we still need to learn. Some of the more high-priority recommendations DHHS is trying to focus on include the role of the U.S. in aiding countries with limited surveillance and response capabilities (GHSA!), forming a pot of discretionary funds, capacity to call on the necessary public health experts, and clear guidelines for when the U.S. will send medical personnel to other countries.

antimcrresukreview2Farm Animals Are Now Resistant to Antibiotic of Last Resort
Is this the start of the antibiotic apocalypse? A recent study found the presence of carbapenem-resistant (carbapenems are antibiotics that are last-line drugs for severe bacterial infections) bacteria in agricultural settings. Firstly, it’s important to note that because there is concern over this issue, carbapenems are not supposed to be used in agriculture. The samples that revealed the presence of the resistant microbes were taken during a study of a pig farm over the course of five months, and were collected from the floors, walls, fecal samples etc. The good news – none of the resistant bacteria were found in pigs, however it was found in sows and piglets. Dr. Wittum, chair of veterinary preventive medicine at Ohio State University, noted that “farms do not use carbapenem antibiotics not only because doing so is illegal, but that it’s also very expensive. ‘How the [resistant bacteria] got onto the farm we really don’t know,’ said Wittum in an email exchange with TIME. ‘But probably it was introduced from the outside from movements of wildlife, people, equipment, etc.’ He says it’s possible that other legal antibiotics used on the farm could be contributing to the maintenance and spread of the bacteria, but more research needs to be done.”

CRISPR Mortal Combat 
Before we get into the battle that is the CRISPR patent world, Cold Spring Harbor Laboratory (CSHL) just announced the creation of a new molecular tool to change the genomes of plants that will strengthen harvest yields and expand their geographical range. CSHL researchers established a process to make two kinds of tomato plants flower and produce ripe fruit two weeks faster than what is currently possible. “The impact of this discovery cannot be overstated, as the potential impact could mean more plantings per growing season and thus higher yield. Moreover, it also means that the plant can be grown in latitudes more northerly than currently possible. Attributes that are extremely important as the earth’s climate warms and population continue to burgeon.” On to the battle of CRISPR patents! Things have been getting nasty in these hearings and Tuesday morning saw the first and only oral arguments over a patent. “The nasty dispute pits the University of California against the Broad Institute of Harvard and MIT for rights to key patents on CRISPR genome-editing. Since April 2014, the Broad has received 13 CRISPR patents, based on work led by its bioengineer Feng Zhang, but UC believes it deserves some of the most foundational ones, reflecting earlier work by its biochemist Jennifer Doudna and her collaborator Emmanuelle Charpentier.” STAT highlighted three very crucial questions that are being asked by so many as we sit in the audience of this gladiator-like spectacle- should we even be here, what are we arguing about, and why hasn’t there been a settlement? While there are potentially billions of dollars at stake, this could also change the nature of the exclusive and non-exclusive licenses to CRISPR technology. The patent dispute also comes at an interesting time for patent laws. “On March 16, 2013, the U.S. patent system switched the way patents are awarded: Previously, a patent was granted to the very first party to invent something; now, a patent simply goes to whoever files a patent application for an invention first. As it happened, Berkeley filed its initial patent just one day before the March 16 switchover. So here we are trying to figure out who invented CRISPR first.”

Enhancing BioWatch Capabilities Through Tech & Collaboration
The latest National Academies of Science publication looks to BioWatch and how we can improve it. In response to the 2015 Government Accountability Office (GAO) report Biosurveillance: DHS Should Not Pursue BioWatch Upgrades or Enhancements Until System Capabilities Are Established, a NAS workshop was requested by DHS to further explore the findings and impact they may have on the future of BioWatch. The report reviews the recommendations from GAO and the DHS response, and then discusses the BioWatch collaborative planning process. One particularly interesting section focused on future opportunities for state and local collaboration. Several participants noted their state and local health departments deemed homeland security as a top issue and were open to participate on special projects but often met barriers when working with security and the Secret Service. The publication is definitely worth the read in terms of the issues encountered with BioWatch and what future goals might be. It’s also a breath of fresh air to hear accounts from local public health sources regarding their experiences.

Spanish Minister of Foreign Affairs Chairs High Level Security Council WMD Debate 
On December 15th, the Spanish Minister for Foreign Affairs, H.E. Mr. Alfonso Dastis, will be chairing a high level open debate of the Security Council on the topic of “Preventing catastrophe: A global agenda for stopping the proliferation of weapons of mass destruction by non-state actors”.  The debate will focus on the process to strengthen a preventative system to avoid humanitarian, political, and economic catastrophe that the use of WMD’s by non-state actors would entail. “The debate will take into account the conclusions of the report of the Comprehensive Review of Resolution 1540 (2004), which will be sent to the Security Council by end November and sets the basis of a global agenda to achieve full implementation of resolution 1540 (2004) by 2021, when the current institutional arrangements adopted by the Security Council in this field will expire. Particularly, the debate aims at reflecting on the practical measures that the Security Council and the UN System, Members States, international organisations and relevant sectors of civil society can adopt to prevent non-State from accessing or using WMD. The debate will have a practical and action-oriented approach that connects the discussion with real life, thus creating momentum for an improvement of the effectiveness of the preventive system in the fight against the proliferation of WMD, perhaps the biggest threat the world faces presently. Participants in the open debate are also encouraged to announce specific commitments for implementing the main recommendations of the Comprehensive Review, including financial support for those with the capacity to do it, to push forward the global non-proliferation agenda and directly contribute to a safer world.” The best part? The debate will be open to the public and broadcast over the internet!

Zika Virus Updates
The CDC has reported 4,575 case in the U.S. as of December 7th. The daily Florida Department of Health counts can be found here, in which you’ll see three new travel-associated cases and five new locally acquired cases reported on December 8th. The CDC has released a new article in their EID journal regarding the characteristics of US travelers to Zika-virus affected countries in the Americas from March 2015-October 2016.  They found that 3/4 of the travelers were men or women of reproductive age. The New York City department of health just announced that a 5th baby has been born with Zika-linked brain developmental issues. This makes five babies since July to be born with neurological development symptoms, like microcephaly, related to maternal infection. Arthur Caplan is talking to Forbes about how the Zika outbreak foretold Trump’s win.

Stories You May Have Missed:

  • Big Data & Analytics for Infectious Disease Research, Operations, and Policy – You can now download this NAS workshop document for free! Get the latest news on how big data is a tipping point for global health and surveillance systems. The book includes information on utilizing big data, combating antimicrobial resistance with it, and some great case studies. It points to the range of opportunities for use, however there are several challenges to really access the full potential – like usage, access, interoperability, analysis, validation, liability, security, etc.
  • Responding To The Next Ebola – Will Your Smartphone Play A Role?– Just when you thought we were done talking about Ebola…one of the greatest strengths technology has given us is speed. Coincidentally, that’s something we desperately need when fighting an infectious disease in an area with constantly moving people. Researchers tested this out by logging the number of calls from individual cell towers and then mapping the movement of people throughout the country. “Already, we’re getting immensely valuable insights about what happens during epidemics, and where we need to target our treatment efforts. For example, mobile mapping has confirmed that, in the wake of an epidemic or natural disaster, people head home to their families. So if you’re planning for worst-case scenarios, you can make a surprisingly good forecast by loading up migration data from national holidays such as Chinese New Year, Christmas or Diwali.”
  • Re-emergence of Syphilis Traced to Pandemic Strain Cluster– the past few decades have seen a growth in syphilis cases globally. Researchers led by the University of Zurich analyzed low levels of DNA to delve into the history of syphilis strains. They found that all strains from modern patients share a common ancestor from the 1700s. In fact, the dominating strains of today originated from a pandemic cluster following the 1950s. The concerning aspect of these strains is their ability to fight off the second-line antibiotic, azithromycin.

 

Pandora Report 11.11.2016

by spopescu, posted in Pandora Report

The U.S. Election has concluded and whether your candidate is now our presidential elect or you’re just glad it’s all over, here’s something to celebrate – President Obama signed an executive order last week, cementing the GHSA as a national, presidential-level priority. Commitment to GHSA and fighting outbreaks on a global scale is a huge step forward to combating the health crises we’ve seen and will continue to battle in the future. Since researchers recently debunked the myth of Gaëtan Dugas as a primary source for HIV/AIDS in the U.S., check out more stories regarding the misunderstood “patient zero”.  World leaders are starting to realize that the antibiotic clock is ticking away.

Trump and the Issues Within Science
Donald Trump is the new president elect, but where does he stand on issues like Zika? Here’s a compilation of sources that cover his comments and plans for some of the top issues in science. NPR is looking at his comments on global health and humanitarian aid, while some are trying to figure out what Trump’s administration will mean for them and the need for a transition team tutorial. STAT is asking five questions regarding what the Trump administration will mean for science. Sources close to the Trump campaign have stated that two of the “best-known climate skeptics will lead his U.S. EPA transition team“.

It’s Time to Modernize the BWC 
GMU Biodefense graduate program director and professor, Gregory Koblentz teamed up with Filippa Lentzos to discuss why it’s so important for the BWC to modernize. They tackle the reality that while the convention isn’t failing, it’s definitely not flourishing. Despite its dedication to ban a whole class of weapons, the BWC is a somewhat toothless dog. “It lacks a dedicated forum to assess treaty implications of scientific advances, a robust institutional capacity, organized means of helping member nations meet their obligations, provisions for verifying compliance, and an operational role to respond in cases of a serious violations. The upcoming review conference provides a welcome opportunity to begin rectifying some of these shortcomings.” Koblentz and Lentzos point to the consistent challenges of science and technology reviews. Despite a rapidly evolving industry, the BWC hasn’t been able to keep up and maintain an international forum for the debates that are needed. Lagging behind the biotech times means the BWC is running the risk of irrelevance, not to mention the slow shift from the convention towards UNSCR 1540. In this climate, it doesn’t help that there is an even greater need for transparency. Biodefense programs have surged the last two decades, which means that transparency is increasingly important to ensure these programs aren’t biosecurity risks or being perceived as threats and becoming justifications for initiated offensive programs. The reform process is pivotal and this includes organizing a review of relevant S&T developments more systematically, renewing the mandate of an implementation unit, and setting up an Open-Ended Working Group on Providing Reassurance to encourage transparency and engagement in peer review exercises. “The Eighth Review Conference provides an opportunity to revitalize the bioweapons treaty by taking concrete actions to expand its relevance, enhance its capacity to review developments in science and technology, and strengthen the confidence of nations in the peaceful intentions of their fellow treaty members.”

RevCon began this week in Geneva and you can catch the U.S. opening statements by Thomas Countryman, Acting Under Secretary for Arms Control and International Security. You can also read Mr. Kim Won-soo’s remarks as High Representative for Disarmament Affairs. The International Committee of the Red Cross (ICRC) vice president, Christine Beerli, has also commented, noting that “States Parties should not become complacent; it remains their collective and individual responsibility to ensure that the treaty is implemented effectively. Over the past five years of annual meetings, a great deal of information has been shared and many proposals have been made on how to implement the treaty and improve its effectiveness. Disappointingly, however, there has been little collective agreement.” RevCon experts will also be focusing on new threats that may arise from technology. Guinea just became the 178th State Party to the BWC!

armas-biologicas-2NSABB Meeting on DURC and Other Hot Topics
On Friday, the National Science Advisory Board for Biosecurity (NSABB) hosted a call to review policy updates, new activities, updates from the working group on institutional oversight of the life sciences DURC policy stakeholder engagement, and updates from the Blue Ribbon panel that is currently reviewing the 2014 NIH variola incident. The conference call was fast-paced but covered substantial ground – most of it you can find on the Power Point slides. The policy updates focused on initiatives to strengthen biosafety/biosecurity stewardship. The 2016 NSABB report recommended additional, multidisciplinary evaluation prior to funding decisions and appropriate, ongoing oversight if funding were given to projects. It was noted that this is a particularly exciting time for science as we’re seeing so many advancements in human health, however the applications of these technologies are testing the oversight and policies we currently have in place to ensure science is performed safely (and securely). While they may or may not all be under the purview of the NSABB, the emergence of CRISPR and evolution of genomic sequences and gene drive techs, and abilities to create next gen of chimeras – are all examples of biotech that are evolving very rapidly and we may need to rethink how they fit our current policy and framework. NSAAB has been a part of the DURC conversation with policy focus on research responsibilities and institutional approaches. NSABB is also working on how to increase and approach stakeholder engagement in DURC polices. There were several listed strategies and topics, ranging from regional meetings at universities or panel sessions at conferences like ASM and ASV. The biggest focus was on getting dialogue and metrics across institutions, not to mention the need for feedback to evolve an objective oversight system. The Blue Ribbon panel is working on the review of the NIH variola incident but they did note that the event was handled very well and while there were obvious gaps, they were all addressed and that the interagency work between the FBI, NIH, and CDC went very smoothly.

Sverdlovsk, Three Mile Island, and Government Oversight of Biological Safety
Greg Witt is talking to us about government oversight of biological research and the lessons learned from the Three Mile Island nuclear accident (did I mention that Greg is a nuclear systems engineer?). Pointing to the biosafety failures that have happened recently (remember that time a Pasteur Institute employee improperly took MERS samples on a commercial airline???), Greg pulls together the pieces to paint a bigger mosaic of systemic failure to properly control biological agents. Pointing to similarities between these events (they even happened days apart) he notes that “both were caused, in large part, by errors in maintenance: at Sverdlovsk, technicians neglected to replace an exhaust system filter, while at TMI, staff had isolated an auxiliary feedwater pump during routine maintenance in violation of US Nuclear Regulatory Commission (NRC) rules.”

The Glamor of Bad Science02-ebola-w529-h352
Yours truly is talking about the disparaging addiction we have to dramatic science. I’m a fan of any movie that involves an outbreak, but the truth is that an overwhelming majority of these films depict infectious disease outbreaks so outrageously and dramatically, they have become anti-science. After watching the latest, Inferno, it became increasingly apparent that we’ve created a false threshold for science, specifically infectious diseases, in film. By painting the picture of diseases and outbreak response like that of Outbreak, I Am Legend, and more, we’re creating an increasingly de-sensitized culture. The result of this de-sensitization means that it takes a lot more for people to take infectious disease outbreaks seriously in real life. It’s not a genetically engineered airborne organism that will make flesh rot? Meh – not that big of a deal. Our love of bad infectious disease science in film and television could easily create a culture of poor public health support.

Ebola Was Just the Beginning…Are We Ready?
Peter Piot, Director of the London School of Hygiene and Tropical Medicine, is highlighting the realities that we simply aren’t ready for the next big virus epidemic. Piot discusses his work during the early days of Ebola in the 1970s, pointing to the challenges of attempting to figure out a novel virus while trying to put out the fires of an outbreak. Describing the 2014 outbreak as a perfect storm, he notes that the WHO response was too slow to act. The globalization of our interconnected world has made the capabilities of an outbreak much greater than 50 years ago. “Piot also believes there will be a ‘Big One’, a big influenza, similar to the likes of the Spanish Flu in World War One and we’re not quite ready for it. Yet. ‘Are we ready?’ Piot asked. ‘A little bit better than a few years ago but we’re not yet up to the job. We can’t afford to wait but we have a plan, and that’s the good news. The world has learnt from the problems of mobilisation around Ebola and we are now in a better situation; there is better technology to allow for more rapid diagnosis’.” Piot stresses the importance of investment in infrastructure, stronger global governance, and vaccine development incentives.

All Things Zika
The Florida Health Department has released their Zika updates here. PAHO has recommended that Bolivian women delay pregnancy to avoid Zika. “Fernando Leanes, PAHO representative in Bolivia, said at a press conference that it was one of several advised measures to avoid the proliferation of microcephaly cases. ‘The epidemic of Zika, from what we have seen in other countries, will have a rise and fall in Bolivia. Therefore, there are options such as delaying the decision to get pregnant in areas where Zika is spreading. This will avoid the dreaded microcephaly and the complications it represents,’ explained Leanes.” An $18 million plan was just announced to release Zika-resistant mosquitoes into urban areas of Colombia and Brazil.  “A swarm of Aedes Aegypti mosquitoes–the species that transmits dengue, yellow fever, chikungunya and Zika, have been modified to carry a bacterium called Wolbachia pipientis, which inhibits their ability to spread the viruses. Scientist released these ‘good mosquitoes’ in Brazil as part of a successful international program called ‘Eliminate Dengue’.” Many researchers are wondering why Colombia has had such few Zika-associated birth defects. They are the second largest outbreak in the world, yet have much fewer cases of microcephaly than Brazil. Researchers have noted that adult women in Puerto Rico were significantly more likely to develop Zika than men. The CDC has reported 4,175 cases of Zika in the U.S. as of November 9th, 2016.

Stories You May Have Missed:

  • How Trauma Explains Civil War– Don’t miss this event today at GMU’s Arlington campus, Founders Hall, Room 602. Eric Goepner will be discussing his research as to why “hurt people hurt people” and hypothesizing that a population’s prior traumatization predicts future civil war onset.
  • Searching for Ebola’s Hideout – The recent ebola outbreak is over, but this doesn’t mean the disease is gone. In fact, ebola is known for hiding out..so where has it gone? Leigh Cowart and other researchers are looking to stop future Ebola outbreaks by finding its hiding spot. “Such a long-term host, the quiet refuge of a pathogen, is known as a reservoir species. If a reservoir species is Ebola’s safe house, we are its luxury retirement property, a place for it to live out its last days with a bang. The trouble is that we aren’t sure where the safe house is. If we are going to be vigilant against Ebola’s re-emergence, we need to find it.”
  • The UK Forms Special Outbreak Response Team– with a five-year £20m funding, the UK is setting up a specialist team of health experts who will be able to respond to outbreaks around the world within 48 hours. “Public Health England will run the project with the London School of Hygiene and Tropical Medicine. Duncan Selbie, chief executive of Public Health England, said: ‘Speed is key in tackling infectious disease and with this new capability we can now deploy specialists anywhere in the world within 48 hours, saving and protecting lives where an outbreak starts and helping to keep the UK safe at home.'”

 

Pandora Report 10.28.2016

by spopescu, posted in Pandora Report

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

Pandora Report 10.21.2016

by spopescu, posted in Pandora Report

TGIF! It looks like biodefense and genetic engineering are the new hot topics in Hollywood. Inferno will be opening in theaters next week, but it was also reported that Jennifer Lopez will be starring in a new bioterror TV drama, “C.R.I.S.P.R.“, that takes on topics like genetic assassination. That’s right, JLo will be a CDC scientist exploring “the next generation of terror”. You can get an epidemiological update on the cholera situation in the Americas here. A new Ebola vaccine will be tested by researchers in Canada next month.

Biological Threats in the 21st Century Book Launchimg_0359
Last Friday we celebrated the book launch of Biological Threats in the 21st Century. For those who attended, thank you and we hope you enjoyed it as much as we did! For those unable to attend, don’t fret – we’ll have the recording up ASAP, but in the meant time, here’s a brief recap… We were fortunate to have Dr. Koblentz MC’ing the event, with Andrew C. Weber discussing the threats we face in the 21st century and that the topic is really the orphan of the bunch as nuclear weapons tend to get all the bandwidth. Weber noted that we learned the wrong lesson from Amerithrax and need to remember that one person did it all by himself and despite a very primitive delivery mechanism, it took us eight years to find him. He emphasized the lessons learned from 9/11 and the use of imagination in regards to potential attacks, specifically that we should all challenge ourselves to think about these things and be imaginative. Filippa Lentzos, the editor of the book, took us through her journey to bring together the politics, people, and science of biological warfare. Her goal was to create a one-stop shop for issues regarding bioweapons and socio-politics. Incorporating narratives from people that are both advocates and negotiators of biological disarmament, she highlighted the importance of scientists in building the agenda and biological risk management. Perhaps one of the highlights of the event was the expert panel comprised of Jo Husbands, GMU’s Sonia Ben Ougrham-Gormley, GiGi Gronvall, and Nancy Connell. The panel took questions from the audience and each expert discussed a range of topics – the role of scientists in DURC, GoF experiments and governance efforts, talking to US and Soviet bioweapons specialists from the days of offensive programs, and the efforts to engage scientists and make them part of the solution. Overall, the event was a wonderful mixture of experts, students, and industry people who are all passionate about the world of biodefense.

How Do You Know Your Flu Shot is Working?
GMU Biodefense MS student Greg Mercer is tackling the topic of flu shot performance. Despite the challenges of antigenic drift and forecasting, there has to be a way to check how well the vaccine is performing..right? “The Centers for Disease Control and Prevention (CDC) offers a guide to how they assess flu vaccine effectiveness and efficacy in the United States. These are two slightly different measurements. Efficacy is measured with randomized controlled trials. This is a classic, high rigorous scientific setup designed to eliminate research biases. Effectiveness is measured with observational studies. These are more reflective of real world conditions, since they rely on self-identifying subjects seeking care.”

On Patrol with a Bioterror Cop
For biodefense students, Edward You is pretty much our crime-fighting role model. Supervisory special agent in the WMD directorate in the FBI’s DC headquarters, You monitors the growth of lab tech to help prevent bioterrorism. Trying to find the gaps within the detection chain is no easy feat, but You helps to improve FBI and interagency efforts to identify, assess, and respond to biological threats. What makes his approach so unique is that prior to the FBI, he worked for six years in graduate research focusing on retrovirology and human gene therapy at USC. Simply put, You knows the science, tech, and culture that make biocrimes and emerging biotechnologies worrisome. You’s background and perspective has helped shift FBI credibility within the science community after incidents like the detainment of Buffalo bio-artist, Steve Kurtz. The FBI is now helping to sponsor events like the International Genetically Engineered Machine Competition, and is helping build a network where scientists share concerns. “You is often the first to hear about scientists’ darkest worries. Lately some of these have been connected to the gene-editing method CRISPR, which can be used to create self-spreading gene alterations in insects or DNA-slashing viruses.” You notes that “a threat implies intent, and we haven’t seen that yet,” he says. “But as things become more widely available, more widely distributed, the bar gets lower, and the possibility of an incident gets higher.”

Infection Prevention & Control Week  screen-shot-2016-10-18-at-10-32-54-am
Hand hygiene, PPE, and vaccines, oh my! Infection prevention doesn’t take breaks, so this week we’re celebrating the importance of reducing the spread of infections, specifically in healthcare. The Ebola outbreak lifted back the curtain as to just how impacting minor breaches in infection control can be, but as the threat of antibiotic resistance grows, we need to invest more into this field. Here are a few things you can do to help fight the battle of the bug in healthcare – need to wear PPE? Make sure you’re donning and doffing correctly. Wash your hands! Know about infection preventionists, follow rules of isolation if visiting a sick friend (or you’re sick!), get your annual flu shot and stay up to date on vaccines, make sure to follow directions and finish antibiotics appropriately if you’re taking them, and keep your work environment clean.

Public Health: Biosecurity and the GHSA Distance Learning Opportunity 
Don’t miss out on this great opportunity for a 2-hour webinar session on Wednesday, December 7th, 2016 at 11am CST. The U.S. has taken the lead on a global campaign to fortify both public health and international security. The Public Health: Biosecurity and the Global Health Security Agenda webinar will review the nexus between public health and biosecurity, through the context of the developing Global Health Security Agenda (GHSA). We will learn how modern threat management concepts can be efficiently employed by the GHSA to augment both public health response and preparedness in the event of a natural outbreak, or from the perspective of an intentional attack. The webinar will be presented by Ryan N. Burnette, PhD, Director, International Biosecurity & Biosafety Programs, At Risk International. Upon completion of this webinar, participants will be able to:

  • Define the methods and goals of the GHSA
  • Paraphrase how threat management techniques can be applied at a macro level to augment global security in the context of epidemics and bioterrorism
  • Describe how biosecurity plays a vital role in public and global health

Gene Drives – the Good, the Bad, and the Hype
GMU Biodefense professor, Sonia Ben Ouagrham-Gormley, and Kathleen Vogel are discussing the advances in life sciences and what these new gene-editing techniques could mean for biodefense. “The absence of clear safety guidelines, coupled with ambiguous government regulations, has nurtured fears of an accidental or voluntary release of a gene drive in nature that could cause irreparable damage. On the security front, the presumed simplicity and accessibility of Crispr raise the possibility that states, terrorists, or rogue scientists might use the technology to modify genomes to develop malicious gene drives and create novel bioweapons that could spread more quickly, cheaply, and globally than traditional bioweapons agents.” Caution is always a good strategy, but Ouagrham-Gormley and Vogel emphasize the importance of approaching these new technologies with a realistic approach grounded in empirical findings, rather than the hype of a shiny new toy. Understanding gene drive and the capabilities of CRISPR are necessary to not only proceed with advancements, but also fully assess the risks versus rewards. Gene drive does have some potential benefits, especially in terms of vectors and pest-control, in trying to impact the population of disease-transmitting mosquitoes and invasive mouse species that wreak agricultural havoc. There is also potential for gene drives to aid in endangered species and environmental conservation work as “gene-drive rodent control on islands can mitigate the environmental impact of invasive species, which disrupt island ecosystems by bringing in invasive plants, or eating plants and insects essential for other species’ survival.” Like anything, there is a potential for mis-use or neglect. In the wake of any new exciting innovation, the spread of CRISPR and gene drive technology has amplified concerns over lab safety and establishing a fundamentally better understanding of the technology before such rapid innovative leaps. Concerns over adverse effects on target species and damage to non-target species is crucial and regulators are racing to keep up with this constantly evolving technology. “These two cases show that Crispr-induced alterations have outpaced and continue to defy current regulations, leaving governments around the world to play catch-up. In this context, fears that an altered organism might escape the laboratory to potentially eradicate a whole species, or unexpectedly jump into another population and cause unpredictable economic and environmental damage, do not seem far-fetched.” Lastly, from the viewpoint of a bioweapons threat, the authors note that the perceived low cost, easy availability, and self-propagating nature of gene drives make it appealing to would-be bioterrorists. There are significant technical challenges that do form substantial roadblocks, not to mention that gene drives only work with organisms that produce sexually (in other words, they’re unable to alter a virus or bacteria). “However, to accurately evaluate their potential misuse, one needs to rigorously assess the state of the technology and consider its limitations. Current fears (and hopes) related to gene drives are based on projections of what gene drives could in theory do if they spread in nature. At the moment, these are still anecdotal, speculative claims and are not based on in-depth empirical research and analysis. One needs to keep in mind that the techniques under debate are still in their infancy, and in spite of their apparent progress, they may not prove to be as dangerous or promising as expected.” In the end, it is important to identify the risks when it comes to a lack of Cas enzyme control, capabilities of potentially a state-level gene-editing technology based bioweapons program, and slow regulatory catch-up. Threat estimates are speculative and the authors point to problematic historical security assessments of emerging biotech. Overall, it’s important to have a better understating of the complex and unique factors that push state and non-state actors to develop biological weapons and in the wake of this uncertainty, the authors “are engaged in a project that aims to understand the social and technical factors for how Crispr scientists around the world actually work in the lab.”

A Threat to the U.S. Food System
Food safety is often a forgotten component of biodefense when Anthrax and Ebola tend to steal the spotlight. Sadly, this is America’s soft underbelly as a threat to U.S. food production and security could have devastating economic ramifications. While the Blue Ribbon Study Panel on Biodefense report in 2015 did mention the vulnerability of the agriculture system, it’s easy to forget just how damaging such an event could be. “The agriculture sector in the U.S. is a $1 trillion business and employs approximately 9.2 percent of American workers. In 2012, domestic animal agriculture – livestock and poultry production – generated approximately 1.8 million jobs, $346 billion in total economic output and $60 billion in household income.” Consider even a disease that impacts crops – wheat and rice account for 39% of the world’s total calorie consumption. It’s important to consider the devastation that crop or livestock attacks could have on not only the U.S. system, but also on an international level.

Zika Virus Weekly Updates
Venezuela is struggling to respond to and support cases of Zika-related microcephaly as the government refuses to acknowledge a single case. “Some doctors accuse Venezuela’s unpopular government of hiding the Zika problem amid a deep recession that has everything from flour and rice to antibiotics and chemotherapy medicines running short and spurred fierce criticism of Maduro. They also say government inaction means kids are missing out on targeted state-sponsored therapy programs that would help to stimulate them”. HHS recently announced how the Zika funds will be allocated among players.  “According to Caitlyn Miller, director of the division of discretionary programs for HHS, $394 million will go to the Centers for Disease Control and Prevention (CDC), $152 million to the National Institutes of Health (NIH), and $387 million toward the public health and social services emergency fund. Within that $387 million, $75 million will be used to reimburse healthcare providers who treat uninsured Zika patients, $40 million will be used to expand Zika resources in US territories, and $20 million will go to regional and national projects, such as creating microcephaly registries.” Public health officials have created a color-coded map of Zika zones in Florida. As of October 19th, the CDC has reported 5,016 cases of Zika in the U.S.

Stories You May Have Missed

  • EU Reports Animal Antibiotic Use Is Up– Despite a drop in overall sales, a recent report from the European Medicines Agency (EMA) has revealed the worrisome reality that there has been an increase in the use of medically important antibiotics. While there was a 2.4% drop from 2011-2014 in sales of veterinary antibiotics, there was a sharp increase in “critically important” antibiotic usage. The usage of “fluoroquinolones, macrolides, and polymyxins sold for use in food-producing animals rose significantly—14%, 13%, and 19%, respectively.” The report does note that responsible-use campaigns in some countries could be effective in countering antibiotic resistance, however the increase in usage is raising many red flags.
  • Global Civil Society Coalition for the Biological Weapons Convention – last week Kathryn Millet, on behalf of the Global Civil Society Coalition for Biological Weapons, delivered a statement to the UN General Assembly First Committee. The statement points to the importance of the BWC but also the challenges and necessity of avoiding complacency. The coalition statement emphasizes the importance of recognizing the evolving threat posed by malign use of the life sciences since the last Review Conference and the need for more systematic advice for BWC State Parties on S&T. Further recommendations include the need for States to ensure that the interval between Review Conferences is used more effectively, reexamination and improvement on dealing with compliance with the BWC, and the application of more resources to support work that is necessary to fulfill the BWC’s objectives.

Pandora Report: 8.12.2016

by spopescu, posted in Pandora Report

In the event you find a skunk with an ice cream cup stuck on its head, you can use Ebola PPE like this Southern Ontario paramedic. The yellow fever outbreak is surging and yet again, the WHO is being called out for poor leadership and outbreak response. “An internal draft document sent from WHO’s Africa office to its Geneva headquarters in June cited a lack of senior leadership at WHO. It said the emergency outbreak response manager and team in Angola ‘are unable to lead or positively influence the operational direction and scale of containment efforts.” Science and technology issues truly impact voters, so are 20 questions many science organizations feel Presidential candidates should have to answer.

Medical Countermeasures Dispensing Summit: National Capitol Region
On-site attendance is full, but you can still enjoy the August 16-17 summit virtually. Organized by the U.S. Department of Health and Human Services Assistant Secretary for Preparedness and Response, the regional summit allows people “direct access to local best practices and MCM subject matter experts, as well as to create collaborative environments to address nationally identified target areas and hear directly from stakeholders at all levels of response planning.” The Washington, DC summit will have a dual-track agenda and allow each attendant to base their participation on topics they find most relevant.

Are Exotic Pets a New Biothreat?
Dr. Laura Kahn is making us second guess exotic pets and invasive species in the biodefense paradigm. While not the normal “go-to” when thinking of bioweapons, she notes that a handful of security experts are raising concerns over their ability to impact ecosystems and the agriculture sector. Pointing to a recent paper in Biosafety, Kahn draws attention to the potential biological attack using non-native species to infiltrate, impact natural resources, injure soldiers, transmit disease, etc. While this threat may seem unlikely, the truth is much more startling – we’re already under attack by non-native wild animals via the exotic animal market. “Invasive species—which can take the form of anything from microscopic organisms to plants, fish, and mammals—are those inhabiting a region where they are not native, and where they are causing harm. They displace native species by either eating them or eating their food. In part because they often have no natural predators in their new location, they can disrupt ecosystems, delicate webs of plants and animals that evolved to exist in balanced harmony. This can wreak havoc on environmental, animal, and human health.” A prime example would be Australia in the 18th century, which endured a rabbit invasion by way of European settlers. As a result of these furry invaders, Australia is reported to lose more than $87 USD per year. Delicate ecosystems and dangerous animals have a role in this compounding threat and it’s not just related to the illegal trade of animals. Dr. Khan notes that the legal importation of animals is a substantial source for risk – between 2005 and 2008, the U.S. imported more than one billion live animals. The regulatory agencies involved in oversight of these processes are spread across the Department of Agriculture’s Animal and Plant Health Inspection Service, the Department of the Interior’s Fish and Wildlife Service, the Department of Health and Human Services’ Centers for Disease Control and Prevention (CDC), and the Department of Homeland Security’s Customs and Border Protection. Aside from the obvious challenges of legal importation, wildlife trafficking still occurs and when coupled with the exotic pet market, the volume of threats is far greater than we might consider. “It appears that exotic pets fall through the regulatory cracks much to the peril of our nation’s ecosystems and agriculture. In fact, they should be considered potential biological threats, and the regulation loopholes allowing their unfettered importation should be closed.”

Colistin-Resistance, Where Is It Now?
The Olympics may have taken over Brazil, but colistin-resistant bacteria are the latest arrival in the South American country. Making its debut, the MCR-1 gene that allows bacteria like E. coli to become resistant to the antibiotic of last resort (colistin), was found in the infected foot wound of a diabetic patient. “In earlier research, these investigators showed that E. coli harboring the mcr-1 gene had been present in food-producing livestock in Brazil since at least 2012. ‘In spite of this, we had previously recovered no isolates from humans that were positive for mcr-1,’ said coauthor Nilton Lincopan, PhD, Assistant Professor in the Department of Microbiology, Institute of Biomedical Sciences, Universidade de São Paulo, Brazil.” This news comes at an especially relevant time as the concerns over water quality and aquatic events are being voiced daily. The growing reports of MCR-1 genes are pushing for more global surveillance on antibiotic resistance. In the U.S., Minnesota is making strides to combat the rise of antibiotic resistance. Utilizing a One Health approach to antibiotic stewardship, their 5-year plan will incorporate “Minnesota’s departments of health and agriculture, along with the Board of Animal Health and the Minnesota Pollution Control Agency (MPCA), to work together to promote the judicious use of antibiotics in humans and animals and get a better sense of how antibiotic use is affecting environmental health.”

Aerosol Stability of Ebola Strains
Do you ever find yourself pondering the aerosol transmission capability of certain Ebola strains? Researchers are doing just that in the latest Journal of Infectious Diseases. During the 2014/2015 outbreak, there was a lot of concern over the potential for aerosol transmission, especially in the healthcare environment (invasive procedures, suctioning, etc.). Despite there being little epidemiological evidence to support this transmission route, there were substantial reports and media speculation to push researchers to go back to the drawing board regarding Ebola transmission. Looking at two Ebola strains (1976 and 2014 strains), researchers found that there was “no difference in virus stability between the 2 strains and that viable virus can be recovered from an aerosol 180 minutes after it is generated.”

The Latest on Zika
Screen Shot 2016-08-11 at 4.24.44 PM The U.S. Department of Health and Human Services has awarded $4.1 million to Hologic, Inc. for the advancement of a Zika blood screening test. To aid in the fight against the growing outbreak, federal employees are deploying to help stop the outbreak. With Congress and the White House at an impasse, hundreds of employees from DHHS, the Defense Department, and the State Department are all deploying to help combat the outbreak. Florida has reported more infections, bringing their total local transmission cases to 25, while a Texas newborn has died from Zika complications. Texas has reported 99 cases, including two infants. You can read about the investigations into the local transmission cases here. USAID has announced their investment of over $15 million to accelerate development and deployment of 21 innovations to combat Zika. “The award nominees range from deployment of mosquitoes infected with Wolbachia, a naturally-occurring bacteria that prevents the spread of disease to humans; to low-cost, insecticide-treated sandals; to a cell phone app that measures wing-beat frequency to not only distinguish different types of mosquitoes but potentially identify whether they are carrying disease.” In a letter to Congress, DHHS Secretary Sylvia Burwell pointed to the lack of federal support, resulting in $81 million having to be transferred to Zika from other programs. As of August 10th, the CDC has reported 1,962 cases of Zika in the U.S.

Stories You May Have Missed:

  • Impaired Growth & Campylobacter Infections – a recent study reviewed the impact of Campylobacter infections in children in eight low-resource settings. Addressing the role of enteropathogen infections on enteric dysfunction and impaired growth in children, researchers performed a multi-site cohort to look at Campylobacter infections in the first two years of life. Following their analysis, they found a high prevalence of the infection within the first year and that a high burden of Campylobacter was associated with a lower length-for-age Z (LAZ) score. Campylobacter infections were also found to bear an “association with increased intestinal permeability and intestinal and systemic inflammation.”
  • High School Student Awarded For Work on Ebola Proteins in Bats-While many of us were attending sporting events or getting into trouble with friends, Rachel Neff was contacting pathology professors and working on a project that would later translate to several awards. Neff’s project focuses “on a protein called VP35 that is found in both the Ebola virus and the bat genome. The Ebola version of VP35 suppresses the immune response in infected animals, allowing the virus to multiply. Bats are thought to carry the Ebola virus — and transmit it to humans — but are not sickened by it themselves. Scientists are exploring whether VP35 in bats may interfere with Ebola VP35, protecting the bats from disease.”

 

Pandora Report: 7.15.2016

by spopescu, posted in Pandora Report

Happy Friday! Don’t forget to read that Federal Select Agent Program report we revealed last week, as many are shocked to find the 199 lab mishaps that occurred. Check out these One Health researchers who are trying to predict and prevent the next disease that will run rampant like Ebola. You can also listen to Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, talk about how superbugs are beating us. Have we reached the end of the Golden Age of antibiotics? 

International Security & Foreign Policy Implications of Overseas Disease Outbreaks Screen Shot 2016-07-12 at 8.40.13 AM
A recent report by the International Security Advisory Board (a Federal  Advisory Committee) has been released regarding the security implications of infectious disease outbreaks and the efforts of the WHO, the Biological and Toxin Weapons Convention (BWC), international academies, etc. Within the report there is a heavy focus on how the Department of State should prepare for such global health challenges and a series of structural solutions, capacity issues, and opportunities that can be taken. The National Bureau of Economic Research recently found that a global pandemic would cost $570 billion per year. “The links between disease and security have become clearer as more disease threats have emerged and global interconnectedness makes a threat anywhere, a threat everywhere. There are few threats to the United States and its global interests that match the potential scale and scope of the threat to life and security and economic interests than those from infectious disease outbreaks, whether naturally occurring or intentionally caused.” Some of the recommendations emphasized the strengthening of U.S. government coordination through the development of plans for responding to such public health emergencies in areas out of control of a central government and/or hostile to U.S. government involvement. Additional recommendations included strengthening by fully integrating public health emergencies and the associated challenges into the national security agenda by “providing resources, developing organizational leadership within the U.S. and internationally, and developing and exercising appropriate plans for preparing for, preventing, and responding to threats.” Whether they are natural, deliberate, or accidental, globalization makes the threat of these outbreaks that much more dangerous.”Public health is now a national security challenge and must be treated as such in terms of planning, resources, and organizational support. It is essential to refocus the U.S. approach to this threat, and to invest in the appropriate level of ‘insurance’ just as we do for traditional defense related needs.”

The National Biodefense Strategy Act of 2016
Introduced in May by Sen. Ron Johnson, the bill amends the Homeland Security Act of 2002 “to require the President to establish a Biodefense Coordination Council to develop a national strategy to help the federal government prevent and respond to major biological incidents.” The bill defines biodefense as “any involvement in mitigating the risks of major biological incidents and public health emergencies to the United States, including with respect to- threat awareness, prevention and protection, surveillance and detection, response and recovery, and attribution of an intentional biological incident.” Within the bill, the President must establish a Biodefense Coordination Council and develop a National Biodefense Strategy in which there must be status updates to Congress every 180 days. The strategy must be updated at least every five years and the bill also requires that an annual report with detailed expenditures and their relevance to the strategy is submitted. The Congressional Budget Office (CBO) recently released its summary on the costs of S. 2967 – “CBO estimates that enacting S. 2967 would cost less than $500,000 annually and about $2 million over the 2017-2021 period; any such spending would be subject to the availability of appropriated funds.”

The Growing Cost of the Next Flu Pandemic
A recent study from researchers at the Society for Risk Analysis (SRA) utilized advanced methodology to calculate the total cost of an influenza outbreak. SRA’s work concluded that if the public used flu vaccines during the pandemic, the U.S. GDP loss would be $34.4 billion. In the event that flu vaccines weren’t used, the cost would rise to $45.3 billion. This particular study is unique in that it addresses public, government, and business responses to an epidemic. Conducted as part of a project by the the Department of Homeland Security’s National Biosurveillance Integration Center (NBIC), the study estimates “the relative prominence of the various economic consequence types,’ as well as complicating factors, many of them not addressed in any prior study. These complicating factors include different types of avoidance behavior, such as the already noted avoidance of public events and facilities.”

A New Case of Super Resistant E. Coli 
A second patient in the U.S. has been found to carry the colistin-resistant E. coli that raised concern in late May when it was also found in Pennsylvanian woman. Colistin resistance means that the antibiotic of last resort, colistin, is no longer effective at killing the organism. The most recent was reported to have had surgery in a New York hospital last year, which begs the question – is this where it was acquired? Were post-operative antibiotics not discontinued properly? The second case is fueling public health fear over the spread of this resistant gene, especially in regards to bacteria that are currently only susceptible to colistin. In the wake of these findings, many are pushing for increased surveillance and focus on antibiotic resistance. “The CDC is planning to establish seven regional laboratories this fall that will have the capacity to do better and faster testing for a broad range of antimicrobial resistance.”

One Health & Antimicrobial Resistance 
On Wednesday, the One Health Commission held a webinar on antimicrobial resistance in the environment. Led by Dr. Laura Kahn, the presentation focussed on the challenges of feeding billions, the growth of antibiotic use in meat, and the reality that antibiotic resistance is an integral part of 21st century challenges. In general, people are eating more meat, with China shouldering a 147% growth in meat consumption, while the U.S. has remained unchanged. Antibiotic usage in meat is not the only concerning source as sewage sludge can easily be a source of antibiotic exposure for animals. Dr. Kahn also discussed that from 2000-2010, global human antibiotic consumption has grown 37% and the top antibiotic consumers are India, China, and the U.S. Interestingly, India and Pakistan have some of the most resistance microbes in the world. A Dutch study looking at archived soil from 1942-2008 found that there were increasing concentrations of resistant genes as time progressed. Expanding human population and demand for animal proteins, rising human and animal waste production, poor sanitation, indiscriminate antibiotic usage, and land/water contamination are all fueling the rise of antibiotic resistance and altering the “global resistome”. So what can be done? Dr. Kahn noted the potential role of bacteriophages as a means of fighting bacteria and the growing threat of microbial resistance. Overall, we need to understand the microbial world better, decrease antimicrobial usage, and tap into the bacteriophage resource.

Weekly Zika News
As more Zika cases are found within the U.S., many are wondering why Congress is holding up funding. Here’s a map of California and where you can expect to find mosquitoes that have the potential to transmit Zika. The CDC has a national map you can also reference with estimated range of the Aedes mosquitoes. Infectious disease and mosquito control expert, Duane Gubler, notes that spraying may not be successful against the Aedes mosquito.  The difficultly lies in that the Aedes mosquitoes tend to live in harder-to-reach areas (garbage, closets, indoors, etc.) and spraying is most effective against mosquitoes living in floodwater. Olympic risk for Zika is considered low following a CDC analysis, which concluded that the visitors expected at the games represent less than 0.25% of the total travel volume to Zika-affected countries. “Estimated travel to the U.S. from Rio for the Games is 0.11% of all 2015 U.S. travel from countries where Zika is now spreading, the CDC said.” You can read the official MMWR release here. Colombia’s low volume of microcephaly and birth defects following Zika infection during pregnancy offer some home that the outbreak may not be as bad as early estimates suggested. A new study published in the Lancet looks to women as possible modes of sexual transmission for Zika. “Our findings raise the threat of a woman potentially becoming a chronic Zika virus carrier, with the female genital tract persistently expressing the virus RNA. Additional studies are underway to answer those essential questions and to assess what would then be the consequences for women of child-bearing age”. CDC Director, Dr. Tom Frieden, writes about the lessons we can learn from the fading Ebola epidemic and how we can apply these to Zika.  Researchers have also recently written that the epidemic in Latin America is “likely to run its course within the next 18 months” – you can read their article in Science here. The CDC has reported 1,306 cases of Zika virus in the U.S as of July 13, 2016. 

Stories You May Have Missed:

  • Malaria and the Duration of Civil War – The Journal of Conflict Resolution recently published an article regarding the prolonging of civil war in relation to malaria. Just as geographical factors can impact the duration of civil war, researchers note that malaria can inflict costs and can “indirectly prolong civil war by helping to maintain a socio-geographic environment that is conducive to insurgency”. The rotation of government forces also means they’re likely to have exposures to malaria.
  • The Current State of Our Immunity – Infectious disease physician Dr. Amesh Adalja discusses 21st century immunity to disease. Drawing from points made in Taylor Antrim’s Immunity (set in a post-pandemic world following the 4% loss of global life due to a genetic recombinant of influenza and Lassa Fever), Dr. Adalja relates many of the lessons from his experiences during the West Africa Ebola outbreak and the impact of poverty on resilience. “Today, worldwide extreme poverty — in real terms — is at its lowest. Smallpox has been vanquished with polio and guinea worm about to follow suit. Even Ebola, because of major advances that have occurred in the basic understanding of the clinical illness as well as in vaccine technology since the last outbreak, has been substantially defanged.”
  • The Growing Misuse of Toxic Weapons: Attend the seminar on Monday, July 18th (3:30-5pm) at the James Martin Center for Nonproliferation Studies (1400 K St. NW, Suite 1225, Washington, DC). “We are witnessing today a global threat of toxic chemicals as a means of warfare or terror.  The recent use of chemical weapons and dual-use toxic chemicals in both Syria and Iraq, and possible terrorist attacks against chemical infrastructure, are visible confirmations of a growing threat of misuse of chemicals. This seminar, organized by Green Cross International and the Center for Nonproliferation Studies, will present the results of Chemss2016, an April conference in Poland, including its Summit Declaration which addressed challenges, goals, guidelines, and principles of global cooperation against chemical threats today.”

 

Pandora Report 7.8.2016

by spopescu, posted in Pandora Report

We hope you had a lovely Fourth of July holiday and are ready to get your feet wet with the latest news in global health security! Global health advocates are pointing to the impending reality of blurring between national security interests and global health agendas. Researchers in Belgium have discovered E. coli samples from cows and pigs that contain a novel gene, MCR-2, that is colistin-resistant. Colistin-resistant bacteria are particularly concerning as colistin is the antibiotic of last resort. This week has been busy with three major reports on lessons learned from the 2014 Ebola outbreak.

Panel Urges Reform After HHS Ebola Response Failures 
The plain and simple truth of the 2014/2015 West Africa Ebola outbreak is that the U.S. was not prepared to handle it – we struggled internationally and seriously failed domestically. In the wake of this sobering reality, an independent review of the Department of Health and Human Services (HHS) efforts found serious flaws within their response to the outbreak. You can read the report here, which stresses that the lessons from HHS’s response to Ebola can be applied to future outbreaks, including Zika virus. There were thirteen findings from the panel ranging from “lack of strong leadership and response coordination from WHO hindering HHS and international response efforts” to “HHS did not apply existing pandemic plans and coordination mechanisms during the Ebola response” and “HHS is not configured or funded to respond to a prolonged public health or medical emergency overseas or at home”. Key recommendations focussed on coordination with the National Security Council and federal partners to finalize a government framework for multi-agency response, clarification on strategy for communicating risk-related information to the public, Congress, and other key stakeholders during public health crises, etc. Communication and consistent messaging was definitely a huge issue during this outbreak and just from my experience in healthcare during the outbreak, the dissemination of information was muddy at best and only served to add fuel to an already chaotic fire. “Four thousand HHS personnel were unable to travel to West Africa, the panel said, because of untested regulations outlined in the Affordable Care Act (ACA). Additionally, US government workers who wanted to work more than 30 days overseas had to complete a training course before traveling to an outbreak country. The course had only limited availability, making it difficult to deploy staff quickly”. The report is definitely worth the read and includes some great explanations for each finding and excellent timelines throughout the outbreak.

U.S. Department of Health and Human Services Ebola Response Improvement PlanScreen Shot 2016-07-05 at 6.53.46 PM
Following the aforementioned report and lessons learned, HHS released their Ebola Response Improvement Plan. The plan breaks down priorities and actions into six main categories: global health security and coordination with international partners, incident management and operation coordination, public health and healthcare response, risk communication, medical countermeasures, and response funding. Aside from supporting the Global Health Security Agenda (GHSA), the improvement plan discusses codifying infectious disease emergency management under the National Response Framework (NRF) via the Biological Incident Annex and better defining roles during such events. I found the healthcare side particularly interesting as plans included the pre-identifiction of healthcare facilities that can be used for quarantine, isolation, and treatment, strengthening waste management interagency concept of operations, refining personal protective equipment (PPE) guidance and developing a mechanism to coordinate the purchase of PPE by federal partners, etc. Regarding risk communication, HHS will “Identify and train a cadre of personnel from across HHS that have public health expertise and a thorough understanding of, and fluency in, health crisis and risk communications to serve as spokespersons during domestic or international public health and medical emergencies. This training can draw upon a body of work developed since the 9/11 terrorist attacks”. Overall, the report addresses several key categories, vulnerabilities, and makes correlations to the independent panel report.

Safeguarding Deadly Pathogens and Poisons and U.S. Progress on Global Health Security Screen Shot 2016-07-05 at 7.07.37 PM
The term “select agents” gets thrown around a lot, but what really does it mean and why is it so important? The CDC recently published two new segments in their “Public Health Matters Blog” that gives the basics on select agents, why work involving them is so important, and how the U.S. is doing in terms of global health security. “While it might be easier to avoid handling deadly pathogens and poisons in the first place, scientists have to work with them in order to better understand how to protect people from their effects. Research leads to discoveries that save lives – for example, when we create vaccines to protect from exposure to smallpox or when we’re able to track mutations of killer diseases like Ebola.” The blog discusses the role of the Federal Select Agent Program and lab safety, specifically the response practices in the event of a “whoops” moment. They also reference the findings from the recently published 2015 Annual Report of the Federal Select Agent Program and the continuous commitment to both safety and increased transparency. While this may seem like the tourist’s brochure to select agents and concerns over lab safety, it’s a nice strategy to better educate the public on the work surrounding these agents and the safety mechanisms in place. They also have a pretty fantastic infographic accompanying the post. The next Public Health Matters blog talks about how the U.S. is handling global health security. Centering around a photo that includes colleagues from the HHS and USDA, the blog discusses the Joint External Evaluation Team. The team, which is part of GHSA, works to assess how well the U.S. is prepared to prevent, detect, and respond to major public health threats. The best part about this team is that its work is independent and unbiased. The group spent five days in May assessing federal response capabilities, the CDC’s work and technical practices, etc. Aside from finding excellent reporting mechanisms within the CDC and other federal agencies, they also found that we could improve in a few areas: “communicating risks quickly and consistently with communities across the country, combining and utilizing data from multiple surveillance systems, including systems that monitor human, animal, environmental, and plant heart, and conducting triage and long-term medical follow-up during major radiological disasters”.

Drug Resistant Bacteria in Rio Waters
Jaws made you wonder if it was safe to go back into the water, but multi-drug resistant organisms (MDRO’s) are the growing threat for aquatic events at the approaching Rio de Janeiro Olympic Games. Researcher Renata Picao believes that the resistant bacteria made their way into the waters from sewage that local hospitals have been dumping. The research team tested water samples from 2013 to 2014 for MDRO’s and found carbapenem-resistant Enterobacteriaceae, or CRE. Sadly, the team doesn’t believe these levels have changed and with reports of athlete infections and irritations due to water contact, that’s likely an accurate prognosis. CRE is easily one of the nastiest MDRO’s and is extremely difficult to treat, with a report citing 50% mortality rates. The concerns over Zika and drug-resistant organisms are just two in a laundry list of trouble that has followed Brazil’s Olympic bid – athlete mugging, financial issues, and unfinished buildings. While the acting governor of Rio has expressed concerns, he says that the city will be ready for the games, but also encouraged visitors to moderate their expectations. While some athletes have quit the games due to concerns over Zika, it’s interesting that the concern for drug resistant organisms in the water haven’t raised the same fears.

Is the Biological Weapons Convention Falling Behind?
While the Eighth Review Conference of the Biological Weapons Convention (BWC) won’t be until November, the Preparatory Committee for the Review Conference is next month. One can only imagine the scientific and technological advancements since the BWC was initiated in 1972. Despite some countries struggling to develop effective national biosecurity programs, the growing capabilities of CRISPR and other biotech breakthroughs have moved full-steam ahead. Many are pointing to the U.S. challenges to merely agree on an oversight system for gain of function research. “The discussions of science at the experts’ meetings should be split off into a separate dedicated parallel track. This is the best way to create the necessary time. Even then, it will be impractical to cover all relevant ground across the sciences, so each year a specific topic — CRISPR editing, say — should be considered. Researchers and scientific bodies should present the facts, and then discuss the implications with government officials at the experts’ meeting.” Between dual-use technologies of concern and CRISPR-Cas9, the BWC must adapt to the rapid pace of the biotech industry and the growth of biosecurity developments.

What Direction is the Zika Storm Blowing?
The ECDC has released their sixth Zika update, which discusses several uncertainties that prove difficult when developing response options. Some of these uncertainties include: “all the currently reported sexual transmission events are linked to symptomatic index cases. There is no evidence of transmission by asymptomatic sexual partners” and “there is growing evidence that Zika virus infection during the first and second trimester is associated with increased risk for central nervous system malformation of the foetus. The risk associated with infection during the third trimester is unknown. Therefore, Zika virus infection should be considered as a risk throughout the entire duration of pregnancy.” Fort Benning is trapping and freezing mosquitoes in effort to help the military combat the virus and quickly identify any positive Aedes mosquitos. National Institute of Health supported researchers will be monitoring Zika virus exposure in a group of U.S. athletes, coaches, and Olympic Committee staff attending the games in Brazil. A recent news poll found that most Americans aren’t worried about Zika, in fact they were more worried about Ebola than they currently are about Zika. When asked what they’re doing to limit exposure to Zika, 67% of respondents said they’re waiting to see if it is necessary. The CDC has reported 1,133 cases of Zika virus in the U.S. as of July 6th, 2016. You can also find the full transcript of President Obama’s remarks on Zika on July 1st, following an update from his public health team.

Zika Funding – The Disease Slush Fund
GMU Biodefense MS student Greg Mercer talks about the funding issues related to Zika virus in this week’s commentary. Greg’s overview of the funding struggles reveals a deeper issue when it comes to public health funding and emergency outbreaks. While the U.S. likes to paint itself as a global force for epidemic response, the truth is that we’ve struggled to combat government dysfunction and partisanship. “Government agencies might be funded by the fiscal year, but there’s no telling what the CDC, NIH, and others will have to fight next, not how big that fight will be.”

National Biosafety Systems – Case Studies 
Researchers from the UPMC Center for Health Security released their report on case studies to analyze current biosafety approaches and regulations for Brazil, China, India, Israel, Pakistan, Kenya, Russia, Singapore, the United Kingdom, and the U.S. “In previous research, we found that there is a lack of international norms governing biosafety precautions for dangerous or especially contagious; by describing a variety of biosafety governance approaches in these nations, we hoped to find areas of commonality which could be further developed into international norms.” Five trends were identified during comparison of the ten nations – biosafety regulation exists in all ten nations, information availability was extremely variable, making comparisons difficult, the incentives behind biosafety regulation are varied, ranging from agricultural development to infectious disease control to biotechnology investments, advanced or synthetic biology is not consistently addressed by national-level biosafety policy, and funding information for biosafety was generally available. Aside from evaluating each nation, the case studies will aid in future evaluations by establishing nation-level biosafety norms.

Stories You May Have Missed:

 

Pandora Report 6.24.2016

by spopescu, posted in Pandora Report

Welcome back to your weekly biodefense roundup! To start things off on a light note and since it’s official summer, enjoy this satirical piece on the existence of public pools. In truth, public pools are a mixture of fun and risk for waterborne diarrheal diseases, so remember to stay safe. The NIH has given the green light for CRISPR-Cas9 clinical trials for cell therapies related to cancer treatment. Japan is currently on alert for a possible North Korean ballistic missile launch. Lastly, even though the outbreak appears over, many are discussing the aftermath of Ebola and if it’s really behind us

Tales from the Front Lines of Disease Detective Cases
Foreign Policy‘s Laurie Garrett discusses epidemic fighters, especially the work of Ali Khan, and his quest to speak the truth about epidemics. Khan’s work as an EIS officer and former Director of the Office of Public Health Preparedness and Response (PHPR) has given him a wealth of knowledge from being in the trenches of global outbreaks. Khan’s new book, The Next Pandemic: On the Front Lines Against Humankind’s Gravest Dangers, discusses his experiences from the Amerithrax attacks to the debate on smallpox sample destruction. “Khan writes, the most vital problem-solving exercise has little to do with science, and everything to do with social customs. In 2015, Khan was involved in an out-of-control moment in the Ebola epidemic of Sierra Leone. Long after neighboring Liberia had its outbreak down to a handful of cases, the military-run campaign in Sierra Leone was losing the support of the people by imposing mass quarantines, shutting down entire regions of the country for long periods. Out of the discontent over loss of business, food, and trade arose false leaders claiming witchcraft practiced by the foreigners and magic were spreading the Ebola — not intangible things few could comprehend, like ‘viruses.'” The blend of public health preparedness and front-line outbreak response gives Khan a unique and appreciated perspective into the world of global health security.

Why Hasn’t Disease Wiped Out the Human Race?
University of Pittsburgh’s infectious disease physician, Amesh Adalja, discusses why an infectious disease event with the magnitude of the Andromeda Strain is a bit more unlikely than people realize. He notes that an “apocalyptic pathogen” needs to be in the right place at the right time – more specifically, a combination of having no existing treatment or vaccine and high transmissibility prior to the start of symptoms. “The three infectious diseases most likely to be considered extinction-level threats in the world today—influenza, HIV, and Ebola—don’t meet these two requirements. Influenza, for instance, despite its well-established ability to kill on a large scale, its contagiousness, and its unrivaled ability to shift and drift away from our vaccines, is still what I would call a ‘known unknown.’ While there are many mysteries about how new flu strains emerge, from at least the time of Hippocrates, humans have been attuned to its risk.” Adalja notes that beyond these three (I’ll call them the Big Three), all the other infectious diseases out there fall short of meeting the global extinction sweet spot. Perhaps one of the most crucial lessons to take away from Adalja’s comments isn’t that we should ignore or diminish the impact of infectious diseases, but that institutional failure and infrastructure instability can often do more damage during an outbreak than the disease. With the growing concern related to antibiotic resistance Dr. Adalja notes that “to me, antibiotic resistance represents the most pressing challenge in the realm of infectious disease and, if it is not overcome, we face the very real prospect of being dragged back to the pre-penicillin era in which even routine surgery was a gamble.”

Iceland, Horses, and Hendra
GMU Biodefense MS student, Greg Mercer, can’t even go on vacation without thinking about global health security, but lucky for us, that means we get to learn about Icelandic horses and Hendra! Fueling our fascination with all things related to One Health and spillover, Greg discusses the exportation of Icelandic horses (look at them, wouldn’t you want one?) but also that importation of horses is banned in Iceland. Even an Icelandic horse that was sent abroad for a short period of time can’t return home. Greg notes that its been this way for a hundreds of years and while the import rules maintain purebred status, the ban also protects against disease. “Iceland has few natural horse diseases, and the breeder I spoke to said that Icelandic horses are frequently unvaccinated, which would be very unusual in the rest of the world. When they’re exported, they have to be treated as if they don’t have any immune protection. The import ban prevents foreign diseases from entering the country (via other horses, anyway).” Check out Greg’s Icelandic experience and why horse diseases struck a cord during his travels.

Incorporating More One Health Into the Global Health Security Diet
Some may say we need more cowbell, but in the world of global health security, we need more One Health. The One Health Commission and the One Health Initiative are teaming up to help create and promote a global education plan that will focus on the “unifying interconnected health of humans, animals, and the environment that sustains all life on earth.” A recent paper looks to accumulate interested parties and help drive the project forward. The drive behind this partnership is to capture the younger generations and lay a strong foundation of One Health education and support. “The overall intent of the concept paper is to raise awareness about the urgent need for the development  and to explore the concept further through a small pre-project proposal conference (possibly off and/or on-line) with a view to fleshing out a strong plan to fund the envisioned global learning program.” The group is currently organizing the pre-project proposal conference, but in the mean time, if you’ve already got some great ideas or are interested in participating in spreading the One Health message, check out their website here.

Zika Weekly Updates
Inovio Pharmaceuticals announced on 6/20 that it received FDA clearance for the phase 1 clinical trials for its Zika vaccine. Clinical trials are set to begin by the end of this year for the DNA-based vaccine. A new study finds that the Zika epidemic can be fielded by climate variations on multiple timescales.  Researchers utilized a novel timescale-decomposition methodology and found that “the increasingly probable 2016-2017 La Nina suggests that ZIKV response strategies adapted for a drought context in Brazil may need to be revised to accommodate the likely return of heavy rainfall.” The CDC has also recently issued guidance for travelers visiting friends in areas with ongoing transmission of Chikungunya, Dengue, or Zika. The NIH is launching a large study in efforts to answer questions about Zika virus and pregnancy. Hoping to enroll 10,000 pregnant girls and women (ages 15 and older) in their  first trimesters, the study will look to long-term impacts on babies and the role that previous dengue infections play in birth defect frequency. You can find the recently published article regarding the history of a newly emerging arbovirus here, which summarizes “the history of Zika virus from its first detection to its current worldwide distribution.” In the early hours of Thursday morning, the House passed the $1.1 billion Zika funding bill. The White House threatened to veto the bill though. “The threat from deputy White House with press secretary Eric Schultz came as the Senate prepared for a vote next week, likely Tuesday, even though there’s no guarantee that the Senate can round up the 60 votes necessary to break a filibuster as Democrats call the bill partisan and inadequate.” Several studies have pointed to the linkage between earlier dengue infection and worsened Zika infections, however there is also a potential for a certain antibody against dengue being a target for a vaccine. The CDC has confirmed, as of June 22nd, there have been 820 cases within the U.S. and DC.

One Step Closer to the Zombie Apocalypse 
Researchers from the University of Washington recently reported that several hundred genes actually increase in expression after death. Scientists found that “the transcriptional abundance of some 500 genes was significantly changed after death in healthy zebrafish and in healthy mice. While gene expression overall declined after death, the expression of some genes increased shortly after death and others increased 24 hours or 48 hours later. These genes, the researchers note, were commonly involved in stress, immunity, inflammation, apoptosis, and cancer.” It’s believed that this post-mortem gene expression is a result of residual energy and this may happen in humans as well. This new discovery leaves many asking about the definition of death if a person’s genes are still active for up to 48 hours after they die.

Listeria Troubles Dozens of Schools  large-epi-curve-6-2-2016
Pre-prepared sandwiches are being recalled across 38 school districts as a result of a possible Listeria contamination. “The potentially contaminated food was produced at a facility where the U.S. Food and Drug Administration found Listeria monocytogenes ‘on multiple food contact surfaces where the products were produced on several different occasions’ during routine FDA environmental sampling, according to the recall notice.” While students have been let out on summer break, the concern is that Listeria can take 70 days for symptoms to appear. This latest food safety issue comes after Molly & Drew recalled some of its beer bread mix due to concerns over E. coli contamination.  E. coli outbreaks been plaguing the news lately as a result of the General Mills flour outbreak that sickened 38 people across 20 states.

Stories You May Have Missed:

  • CRISPR vs. Flaviviruses – researchers at the Washington University School of Medicine have found a “single-gene pathway that is vital for viruses like Zika to spread infection between cells”. Even better, the team found that when they shut down a gene in this pathway, flaviviruses aren’t able to leave the infected cell and thus replicate. Using CRISPR technology to selectively shut down a single gene in the pathway, they were able to shut down flavivirus infection without negatively affecting the cells.
  • DRC Declares Yellow Fever Outbreak– The DRC Heath Minister recently declared a localized epidemic of yellow fever after reporting 67 cases. 58 of these cases were considered imported as they were from Angola, where the outbreak has grown beyond 3,100 cases and 345 fatalities. The outbreak has crept across Angola, Uganda, and now the DRA as a result of vaccine shortages.
  • MER-CoV Outbreak in Riyadh Hospital –  the WHO released information regarding the outbreak that begin with a woman whose illness wasn’t detected until after her stay in a surgery ward. Her hospitalization exposed 49 healthcare workers and all but 2 of the 22 MERS cases reported in Saudi Arabia (June 16-18) are related to this outbreak.

 

Pandora Report 6.10.2016

by spopescu, posted in Pandora Report

Summer temperatures are soaring (Arizona hit 115F last week, so I guess it’s time to start baking cookies on the dashboard again- just make sure not to use General Mills flour!) and we’ve got your weekly biodefense cool down. Check out this global outbreak monitor, where you can keep an eye on all your favorite cases. The DoD is currently conducting market research to identify vaccine developers for medical countermeasure manufacturing. They’re looking for “advanced manufacturing platforms which are adaptable to incorporating known antigens for use as a prophylaxis countermeasure against weaponizable biological agents.” Before we venture down the biodefense rabbit hole, the Pandora Report will be on hiatus next week (June 17th), but don’t fear- we’ll return the week of June 24th!

Infectious Disease Threat Management
Are emerging infectious disease outbreaks an anomaly or are these events the new norm? Dr. Daniel M. Gerstein points to a 2014 study on the global rise of these outbreaks, which point to the growing threat of zoonotic disease spillover. Gerstein discusses the common trend of failure to predict such events but also the poor response in medical countermeasures and diagnostics. Between West Nile Virus, Ebola, H1N1, and now Zika, we’ve had ample time to get both preparedness and response right. “A recent commentary by Ronald A. Klain — a former White House Ebola response coordinator — should be required reading on the United States’ lack of preparedness for responding to the Zika virus. In it, Klain provided both a dire assessment of Congress’ uncertain funding support for the current response, and made longer-term recommendations for improving our rapid response to infectious disease outbreaks. Yet while these recommendations are spot on, including calls for a dedicated organization with specialized capability to respond to disease outbreaks, more must be done to ensure adequate preparedness against emerging infectious disease in the future.” U.S. preparedness measures utilize epidemiology and biosurveillance, however these are both passive methods that rely on reactive measures, rather than proactive. “This reactive approach to emerging infectious disease should be augmented with an anticipatory model that accounts for the dramatic changes occurring through globalization, greater interactions between human and zoonotic populations, and changes to the environment and climate patterns.” He points to the need for predictive analytical tools and modeling to better focus research and development efforts in order to control and prevent such events. Gerstein acknowledges the long-term and challenging realities of such efforts though, pointing to the need for private sector contributions and strategies to focus on anticipating infectious disease threats.

CDC Biosafety Failures – “Like a Disaster Movie” 
The stories of biosafety failures in U.S. labs working with select agents is enough to send chills through even the toughest of pathologists. Reporters recently gained access to records from the CDC regarding the 2009 events in which safety mechanisms in a CDC biosafety level 4 lab failed. “The gasket seal around the exit door to the changing room deflated to the point that the scientists could see light coming in. And as they held that door shut and started an emergency chemical deluge, things got even worse.” Records include emails that hoped to avoid federal lab regulatory reporting. While these reports are shocking to biosafety experts like Richard Ebright from Rutgers University, CDC officials claim there was no risk from the equipment failures. The release of these records draws further attention to the failures but also the CDC response and challenges in even getting the records released under the Freedom of Information Act. You can read more of the records released to USAToday here and here.

Back to the Future in Global Health Security? 
People frequently think back to the days of the Black Death as a reminder of the progress we’ve made in disease defense. Are we really in a better position though? Globalization, growing populations, rising global temperatures, urbanization, and easy international travel all make it possible for diseases to jump around in a matter of hours. WHO Director-General Margaret Chan noted that “For infectious diseases, you cannot trust the past when planning for the future. What we are seeing is a dramatic resurgence of the threat from emerging and reemerging infectious diseases. The world is not prepared to cope.” The lessons from Ebola, H1N1, and even Zika haven’t truly sunken in yet and there are more outbreaks on the horizon. “International mechanisms must be established to coordinate the upstream research and development (R&D) of new medical tools to respond to priority pathogens and the downstream testing, manufacturing, and delivery of those tools as part of the larger humanitarian response to an ongoing outbreak.” Researchers have suggested four lessons from our past to encourage technological innovation to better prevent and respond to health crises – ensure adequate and sustainable long-term investment, coordinate R&D around a roadmap of priority goals, engage and energize a network of geographically distributed multi-sector partners, and remember that sustainability depends on adequate systems and equitable access. Establishing an environment of coordination and sustainability will be vital to move from a reactive to a proactive practice of global health security.

DoD Biosafety Report
GMU Biodefense MS student, Stevie Kiesel discusses the report the DoD Inspector General published regarding the biosafety and biosecurity failures within DoD labs that work with biological select agents and toxins (BSAT). Stevie’s deep dive into this report addresses the systematic failures that led to such events. Inconsistent internal or external technical or scientific peer reviews and even inspection standards led to not only missing inspections, but also duplicative ones. “Some inspectors failed to review specific vulnerability assessments for their assigned labs to ensure that shortcomings identified during previous inspections had been mitigated.  In some cases, these vulnerability assessments were not reviewed because they had never been conducted, or had not been conducted annually as required.”

Immune System Education and the Realities of the Antibiotic Resistance
Autoimmune diseases and antibiotic resistance have risen in the past half-century…but what does this really mean? The human microbiome (your body’s own community of microbes that help run your immune system) is now being considered as a potential puzzle piece for the increase in autoimmune issues. Have these microbiome communities changed so largely that our entire society is being impacted? “To test this possibility, some years ago, a team of scientists began following 33 newborns who were genetically at risk of developing Type 1 diabetes, a condition in which the immune system destroys the insulin-producing cells of the pancreas. After three years, four of the children developed the condition. The scientists had periodically sampled the children’s microbes, and when they looked back at this record, they discovered that the microbiome of children who developed the disease changed in predictable ways nearly a year before the disease appeared. Diversity declined and inflammatory microbes bloomed. It was as if a gradually maturing ecosystem had been struck by a blight and overgrown by weeds.” Coupled with several other studies, there is a growing thought that toughening the immune system early in life can alter our response later in life or that the kind of microbiome you have will determine your response to viral infections. So what happens if our immune systems begin to fail us and antibiotics are a thing of the past? That’s a pretty devastating notion and it’s right before the weekend, so let’s scale it back to just consider a world without antibiotics – would you still shake hands or take an international flight? Physiologist Kevin Fong notes “If we are to avoid a return to the pre-antibiotic landscape with all its excess mortality we must be bold. To squander the advantage we have so recently gained against microorganisms in the fight for life would be unthinkable.”

The Race Against Zika Screen Shot 2016-06-09 at 1.40.13 PM
The debate regarding the 2016 Rio Olympics took a turn this week as the WHO stated it will look again at the Zika risk during the games.  150 international experts penned an open letter to the WHO regarding their “irresponsible” actions and that the organization was rejecting calls to move or postpone the games due to it’s official partnership with the International Olympic Committee. What are the actual risks? Will the Rio Olympics put the rest of the world at risk for Zika? Here is an interesting infographic and article on that exact question. Bringing thousands of people from different countries together is definitely a gold medal strategy for spreading infectious disease. The ECDC has posted their epidemiological data here, as well as their risk assessment. A new study looks at sexual transmission and the persistence of Zika virus in semen, finding that RNA can persist in semen for 62 days. Researchers found a case of a woman with Zika virus presenting 44 days after the onset of symptoms in her partner, which “corresponds to a sexual transmission occurring between 34 and 41 days after the index case.” This announcement comes after there were no previously reported secondary cases more than 19 days after the onset of signs in a man. Concerns regarding congenital eye issues in babies without microcephaly were also raised after a case was identified. As of June 8th, the CDC has reported 691 travel-associated cases within the U.S.

Stories You May Have Missed:

  • CRISPR’s Gene-Editing Skills on RNA – researchers have now established a method for targeting and cutting RNA. “The new cutting tool should help researchers better understand RNA’s role in cells and diseases, and some believe it could one day be useful in treatments for illnesses from Huntington’s to heart disease.” The process involves using CRISPR to create “blades”. Given the concerns around CRISPR and dual-use technologies of concern, researchers are pointing out that there are far less ethical concerns regarding manipulation of RNA.
  • Legionnaires’ On the Rise – sadly this isn’t the name of a new historical action flick, but rather a public health concern that has the CDC looking into water system integrity. Cases of Legionnaires’ disease have quadrupled since 2000. The CDC has stated that the reason for such a stark increase is most likely due to aging building water systems, an aging population, and better surveillance/reporting systems.
  • Ebola Stability Under Hospital and Environmental Conditions – a new study looks at the role of fomites in EVD transmission, especially in healthcare settings. “To assess the potential contribution of fomites to human infections with EBOV, we tested EBOV stability in human blood spotted onto Sierra Leonean banknotes and in syringe needles under hospital and environmental conditions.” Researchers found that the virus survived more than 30 days in blood in syringes, despite hot/humid conditions, and six days on paper money under experimental conditions.