Tag: epidemic

Pandora Report 3.24.2017

by spopescu, posted in Pandora Report

Welcome to the start of the weekend and World TB Day! The WHO estimates that just in 2015, 1/3 of people with TB missed out on quality care and 480,000 people developed multidrug-resistant TB.

Public Health Concerns in Trump’s New Budget
President Trump’s newly released proposed budget blueprint makes drastic cuts to many programs, of which, one of the hardest hit is HHS. On top of the cuts to science and public health, there is something buried within the budget that is concerning ex-CDC director, Dr. Tom Frieden. Frieden worries about the proposal to award block grants to states, which would allow them to decide how to respond to public health issues (think Ebola, Zika, etc.). “That proposal is ‘a really bad idea,’ according to Dr. Tom Frieden, who until this past January was director of the U.S. Centers for Disease Control and Prevention. Currently, the CDC experts work with state and local governments to devise evidence-based plans to respond to public health issues, such as foodborne and infectious disease outbreaks. With a block grant, states can use the federal money to replace their own spending in certain areas or spend the money unwisely, ‘and never have to report what they have done or be held accountable for it,’ Frieden said.” A withdrawal of one fifth of NIH’s budget would mean a deep slash to biomedical and science research funding.  These cuts will also impact foreign aid, which has many worried about the role of public health interventions in foreign countries. Bill Gates recently talked to TIME magazine regarding the safety implications of cutting foreign aid. “I understand why some Americans watch their tax dollars going overseas and wonder why we’re not spending them at home. Here’s my answer: These projects keep Americans safe. And by promoting health, security and economic opportunity, they stabilize vulnerable parts of the world.” Gates points to the role of overseas public health work like polio eradication, Ebola outbreak response, and America’s global HIV/AIDS effort (PEPFAR), which points to the stabilizing role that strengthening public health can have in a country.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
From Anthrax to Zika, we’ve got the place to be in July for all things biodefense. This three-day workshop will provide you with not only seminars from experts in the field, but also discussions with others interested in biodefense. You can check out the flyer and register for the event here. The best part is that we’re doing an early-bird registration discount of 10% if you sign up before May 1st. A returning participant, GMU student/alumni, or have a group of three or more? You’re eligible for an additional discount! Check out the website to get the scoop on all our expert instructors and the range of topics the workshop will be covering.

Unseen Enemy Documentary 
Mark your calendars for this upcoming infectious documentary on the lurking pandemics that worry experts. Airing on April 7th, Unseen Enemy will follow researchers looking for the early warning signs of diseases that could cause the next pandemic. The National Academy of Medicine will be hosting a special D.C. premiere of the film on April 2nd, that you can even attend.

Expert Views on Biological Threat Characterization for the U.S. Government: A Delphi Study 
Biological threat characterization (BTC) is mixed bag of risk and reward. The laboratory research involving deadly pathogens as a means for biodefense can translate to better risk assessments but also the potential for biosafety failures. To better address this issue, researchers performed a Delphi study to gather opinions from experts around the country. “Delphi participants were asked to give their opinions about the need for BTC research by the U.S. government (USG); risks of conducting this research; rules or guidelines that should be in place to ensure that the work is safe and accurate; components of an effective review and prioritization process; rules for when characterization of a pathogen can be discontinued; and recommendations about who in the USG should be responsible for BTC prioritization decisions.” Following their assessment, the researchers found that experts agree that BTC research is necessary, but there is also a need for continued oversight and review of the research to reduce as much risk as possible. “It also demonstrates the need for further discussion of what would constitute a ‘red line’ for biothreat characterization research—research that should not be performed for safety, ethical, or practical reasons—and guidelines for when there is sufficient research in a given topic area so that the research can be considered completed.”

GMU Schar School PhD Info Session
If you love global health security and have been wanting to further your education, come check out our PhD info session next Wednesday, March 29th at 7pm in Arlington. You can come learn about our biodefense PhD program from the director, Dr. Koblentz, and hear from several students about their experiences. The info session is a great way to find out what a GMU Schar PhD entails, the application process, and what current students think!

What Biosecurity and Cybersecurity Research Have In Common
Kendall Hoyt is looking at the similarities between these two research fields and how work into the unknown can often expose and create vulnerabilities. Did I mention Kendall is one of the instructors at our biodefense Summer Workshop? Hoyt provides two examples to really hone in on this point – to defend against a dangerous pathogen, we have to isolate and grow it to try and develop treatment or a vaccine and to defend against a cyberattack, we need to know how to break into the computer system. That whole dual-use dilemma creates a lot of risk-versus-reward scenarios for biosecurity and cybersecurity researchers. While the research is highly relevant and necessary, government efforts to control or maintain oversight have been challenging. Do we pull back the reigns on innovation or run the risk of a security breach or a big “whoops” moment? “Intellectual property and cybersecurity legislation—namely the Digital Millennium Copyright Act and the Computer Fraud and Abuse Act—has similarly stifled legitimate scientific and commercial activities and delayed defensive applications. In one well-known example, fear of prosecution under DMCA deterred a Princeton graduate student from reporting a problem that he discovered: Unbeknownst to users, Sony BMG music CDs were installing spyware on their laptops.” Hoyt also points out the biosecurity efforts that have begun looking not just at the pathogens and publications, but the laboratory techniques that are used for such research. Certain experiments (like gain of function work) have the capacity to increase transmissibility or host range. “For all of their similarities, key differences between biosecurity and cybersecurity risks and timelines will dictate varied regulatory strategies. For example, zero-day exploits—that is, holes in a system unknown to the software creator—can be patched in a matter of months, whereas new drugs and vaccines can take decades to develop. Digital vulnerabilities have a shorter half-life than biological threats. Measures to promote disclosures and crowd-sourced problem-solving will therefore have a larger immediate impact on cybersecurity. Still, both fields face the same basic problem: There are no true ‘choke points’ in either field. The U.S. government is not the only source of research funds and, thanks in large part to the internet itself, it is increasingly difficult to restrict sensitive information.” In the end, Hoyt notes that both fields and their regulations will need to relax the governance process and be a bit more flexible and mobile with how they control items. Both fields are constantly evolving, which means regulators need to be just as fluid.

How To Prepare For A Pandemic
NPR decided to create a “Pandemic Preparedness Kit” based off the continuous questions related to the ongoing news of increasing infectious disease threats but little info in terms of practical things people can do. While these aren’t things you can go out and buy for your home, the list hits close to home in terms of things we should be focusing our efforts and funding on. Firstly, vaccines. This is a no brainer and yet, we’ve become the habitual users of the theme “create it when we’re struggling to contain an outbreak”. Secondly, virus knowledge. “One of your best weapons during a disease outbreak is knowledge, says Dr. Jonathan Temte of the University of Wisconsin. ‘Keep up with the news and try to understand what threats might be out there,’ he says. For example, new types of influenza are one of the biggest threats right now — in terms of pandemic potential, Temte says. But if you know how to protect yourself from one type of influenza, you can protect yourself from all of them.” Lastly, and my personal favorite, is very clean hands. While every disease is different, one of the most basic and fundamental truths for infection prevention and control is hand hygiene. These three are solid ways to better prepare for future outbreaks, pandemics, emerging infectious diseases, and just about anything infectious that makes you a bit worried.

CARB-X Mission– When I first read the name of this group, I thought it was some kind of fitness fuel, but I was pleasantly surprised to see this initiative is working to fight antibiotic resistance. CARB-X is a collaboration between NIAID and BARDA to help accelerate the development of antibacterials over the next 25 years. The goal is to help combat antimicrobial resistance through a diverse portfolio and partnership. Make sure not to miss their March 30th meeting from 11am-noon on antibiotic resistance. “CARB-X (Combating Antibiotic Resistant Bacteria Accelerator) was launched in August 2016 to accelerate pre-clinical product development in the area of antibiotic-resistant infections, one of the world’s greatest health threats. CARB-X was established by BARDA and NIAID of the U.S. Department of Health and Human Services along with Wellcome Trust, a global charitable foundation dedicated to improving health. This partnership has committed $450 million in new funds over the next five years to increase the number of antibacterial products in the drug-development pipeline.” While CARB-X may not be the latest workout supplement, it’s definitely a boost to performance in the fight against antimicrobial resistance.

New Roles and Missions Commission on DHS Is Urgently Needed
GMU biodefense PhD alum, Daniel Gerstein, is looking at DHS and pointing to the need for a Roles and Missions Commission. It’s been almost 15 years since DHS was created under rapid and urgent circumstances, which means that it’s time to look introspectively. “More generally, a roles and missions review could also examine whether the department is properly resourced for all its missions. For example, a joint requirement council was recently established for the department composed of less than 10 government civilians. Is this adequate for supporting requirements development activities for a department of over 240,000 personnel?” Gerstein looks at some of the big issues that require a comprehensive review, like centralization versus decentralization, management of R&D and engineering, and critical infrastructure issues related to national security and safety. Another component needing review is the human factors issue that impacts homeland security. How are the relationships between departments, with state and local authorities, or with the public? “The effort should not necessarily be viewed as a requirement for change, but rather an opportunity to reexamine DHS and its relations with the rest of government, the nation and its citizens, and even with our international partners across the globe. Finally, a homeland security roles and mission commission would be an ideal lead-in to a much needed update to the original 2002 authorizing legislation.”

Deadliest Enemy: Our War Against Killer Germs
Don’t miss this event on Thursday, March 30th, hosted by New America with speakers Michael T. Osterholm and Mark Olshaker. “In today’s world, it is easier than ever for people and material to move around the planet, but at the same time it is easier than ever for diseases to move as well. Outbreaks of Ebola, MERS, yellow fever, and Zika have laid bare the world’s unpreparedness to deal with the threat from infectious diseases. In Deadliest Enemy: Our War Against Killer Germs Dr. Michael Osterholm and Mark Olshaker marshal the latest medical science, case studies, and policy research to examine this critical challenge.”

Stories You May Have Missed:

  • The Feds Are Spending Millions to Help You Survive Nuclear War – North Korea’s recent firing of four ballistic missiles from Pyongyang into the ocean off Japan’s coast has brought back worries of nuclear attacks. While the days of stocking a bomb shelter are in the past, the U.S. government isn’t slowing down efforts to protect Americans. “Over the last ten years the US has poured millions of dollars into technologies and treatments it hopes to never have to use, but could, in the event of a nuclear catastrophe. From assays that measure radiation exposure to cell therapies that restore dwindling blood cells to liquid spray skin grafts, government officials are now far better equipped to deal with diagnosing and treating people if the unthinkable were to happen. And the next generation of treatments are being funded right now.” DHHS projects like BARDA and Project BioShield are just some of the sources for ongoing research to strengthen protection, whether it be a nuclear blast or reactor melt-down.
  • Disinfection and the Rise of the Superbug – GMU biodefense PhD student Saskia Popescu is addressing the growing disinfection needs as we teeter on the edge of the antibiotic abyss. Disinfection is already a challenge in healthcare however, the rise of more resistant germs means that efforts often need to be ramped up. The recent influx of Candida auris infections that we talked about last week really brings this issue to point in that this emerging infection is difficult to get rid of via traditional disinfection routes. “As new organisms are identified and existing ones become resistant to antimicrobials, the availability of strong disinfecting products has become even more pivotal.”
  • China and EU Cut Brazilian Meat Imports Amid Scandal– If you’re a fan of importing Brazilian meat, you may have to hold off for a while. A recent police anti-corruption probe is accusing inspectors of taking bribes to allow the sale of rotten and salmonella-contaminated meats from the largest exporter of beef and poultry. As the news unfolds, the Brazilian government is criticizing gate police as alarmist. “As the scandal deepened, Brazil’s Agriculture Minister Blairo Maggi said the government had suspended exports from 21 meat processing units.”
  • Study on Interferon for Treatment of Ebola Infection – The common hepatitis treatment is now being tested out on Ebola patients to help alleviate their symptoms. The pilot study was performed from March-June of 2015 and  had some interesting results. “When compared to patients who received supportive treatment only, 67 per cent of the interferon-treated patients were still alive at 21 days in contrast to 19 per cent of the former patients. Additionally, the viral blood clearance was faster in those patients treated with Interferon ß-1a. Many clinical symptoms such as abdominal pain, vomiting, nausea and diarrhea were also relieved earlier in the interferon-treated patients. A further 17 patients in other Guinean treatment centres who matched the interferon-treated patients based on age and the amount of Ebola virus in their blood were included in the analysis. These added patients, who did not receive interferon, more than doubled their risk of dying as a result of not being treated with the drug.”

Pandora Report 2.24.2017

by spopescu, posted in Pandora Report

Happy Friday and welcome to your weekly dose of all things biodefense! A preliminary report from the Malaysian police has found that VX nerve agent was most likely used to murder Kim Jong-nam.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security: From Anthrax to Zika 
Want to dabble in the world of global health security? Don’t miss out on the GMU Biodefense three-day, non-credit summer workshop on July 17-19, 2017! Participants will look at the challenges facing the world at the intersection of national security, public health, and the life sciences. Instructors for the workshop range from FBI special agents to biodefense professors and USAMRIID commanders. The workshop will look at the spectrum of biological threats – including naturally occurring disease outbreaks such as SARS, Zika, and Ebola, lapses in biosafety, dual-use research of concern, and the threat of bioterrorism. From now until May 1st, you can take advantage of the early bird registration discount!

Progress Report on BARDA & Project Bioshield 
A 10-year report card was recently published for these two efforts to defend the U.S. against biological threats. The report found 80 candidate countermeasures, 21 stockpiled countermeasures, and 6 FDA approvals supported by BARDA and Project Bioshield. “Over a decade has passed since the anthrax attacks of 2001; preparedness has increased substantially since that time, and defense against CBRN threats has become melded into national security. Both BARDA and Project Bioshield are essential elements of national security, and, especially in light of a change in presidential administration, it is important to emphasize the critical role these agencies have had in fortifying the nation against intentional CBRN threats. Larsen and Disbrow note, however, that despite the reauthorization of Project Bioshield in 2013 with annual funding at $2.8 billion (from 2014-2018), that funding is subject to annual congressional appropriations; as such, only a fraction of that funding has been appropriated.”

BWC Newsletter 
If you’re looking to keep tabs on the Biological Weapons Convention, we’ve got just the place for you. The BWC Implementation Support Unit has prepared a newsletter to better support communication among States Parties and encourage involvement in BWC-related issues and events. The first issue discusses the recent Eighth Review Conference and news like the launch of EU projects to support BWC universalization and a Confidence-Building Measures reminder letter (deadline for submission is April 15th!).

screen-shot-2017-02-21-at-2-11-26-pmCDC Lab Closure Due to Safety Concerns
The CDC has temporarily closed down its Biosafety Level-4 laboratories following the finding that their air supply hoses to researchers in protective suits were not approved for use. “‘We have no evidence that anybody has suffered ill health effects from breathing air that came through these hoses,’ Stephan Monroe, associate director for laboratory science and safety at the CDC, told Reuters. Monroe said he was confident scientists were not exposed to pathogens because the air they breathed passed through HEPA filters. The suits they wear also use positive air pressure to prevent pathogens from entering the suit.” Safety tests are currently being performed while employees are being notified and monitored. Interestingly, Monroe’s position is a newly minted one, having been established in 2015 to combat the continuous findings of major lab safety failures involving anthrax, avian influenza, and Ebola in CDC labs.

Why Bill Gates Worries About Biological Threats
Bill Gates recently spoke to Business Insider following his speech for the Munich Security Conference, in which he highlighted his real concerns for global health security. He noted that conflict areas and regions that are struggling to find stability are perhaps the most challenging in terms of outbreak containment. Gates emphasized the vulnerability for genome editing of a virus to make it more contagious, and also the advances in biotechnology that may help prevent the spread of an epidemic. “The point is, we ignore the link between health security and international security at our peril. Whether it occurs by a quirk of nature or at the hand of a terrorist, epidemiologists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year. And they say there is a reasonable probability the world will experience such an outbreak in the next 10-15 years.” Perhaps the most important thing on our “to-do” list is to invest in vaccines, drugs, and diagnostics. We have a tendency to put these priorities lower on the totem pole until a major public health crises occurs however, Gates highlights their relevance. The launch of the new Coalition for Epidemic Preparedness Innovations (CEPI) is one step closer to bridging this gap. “The really big breakthrough potential is in emerging technology platforms that leverage recent advances in genomics to dramatically reduce the time needed to develop vaccines. Basically, they create a delivery vehicle for synthetic genetic material that instructs your cells to make a vaccine inside your own body.” Gates also emphasized the importance of strengthening basic public health systems, especially in vulnerable countries – adding to that age old saying, “an outbreak anywhere is an outbreak everywhere”.

screen-shot-2017-02-23-at-7-48-50-amFinancing Pandemic Preparedness At the National Level = First Line of Defense
Pandemic preparedness funding is one of those common sense investments…right? Unfortunately, many don’t always make it a priority. Ebola alone cost billions, including a $2.27 billion allocation for response by the U.S. government. Dozens of after-action reports and papers on lessons learned have been published since the outbreak. Peter Sands noted that “all these reviews – including the one I chaired  for the US National Academy of Medicine – agreed on three key priorities: strengthening preparedness at a national level; improving coordination and capabilities at a regional and global level; and accelerating R&D in this arena.  Over the last twelve months progress has been made in implementing many of these recommendations, but big gaps and weaknesses remain. As a recent paper in the British Medical Journal put it, there has been ‘ample analysis, inadequate action’.” The highest priority though is preparedness at a national level. The International Working Group on Financing Pandemic Preparedness was created in 2016 as a means to propose ways in which national governments and partners can work to establish sustainable financing to strengthen their pandemic preparedness. Their focus “includes domestic resource mobilization, development assistance and private sector engagement. For many countries, financing preparedness through the domestic public sector budget is the best way to ensure sustained funding and seamless integration with the rest of the health system. This requires ensuring sufficient priority is attached to investing in pandemic preparedness in budget allocations. In some countries, there may also be scope to increase the fiscal envelope through improvements in tax design and collection or even hypothecated taxes.”

Insider Threats 
Get ready to add this new book to your reading list. Matthew Bunn and Scott D Sagan are looking at insider threats like nuclear material theft and Edward Snowden. “Insider Threats offers detailed case studies of insider disasters across a range of different types of institutions, from biological research laboratories, to nuclear power plants, to  the U.S. Army.” Don’t miss the chapter from Jessica Stern and Ronald Schouten, “Lessons Learned from the Anthrax Letters”. Stern and Schouten look at the investigation of the Amerithrax attacks and provide a portrait of Ivins and his troubling behavior. They also address “the combination of regulatory changes, red flags missed by Ivins’s colleagues, and the organizational and cognitive biases that contributed to the failure to identify Ivins as a potential insider”, and the current environment and new regulations.

Stories You May Have Missed:

  • Former Secretary of Defense Outlines the Future of Warfare – “Two years ago, Barack Obama appointed a new Secretary of Defense, Ashton Carter—a technocrat physicist, an arms control veteran, and a professor at Stanford—to help close this divide.” Carter recently sat down with WIRED magazine and discussed the challenges facing the White House. When asked about the impact of autonomy on warfare, Carter notes that it will change it in a fundamental way, but also points biotechnology. “I think if there is going to be something ever that rivals nuclear weapons in terms of the pure fearsomeness of their destructiveness it’s more likely to come from biotechnology than any other technology. Looking back decades from now, I do think the biological revelation could rival the atomic revolution for the fearsomeness of the potential. I think that’s one reason we need to invest in it. And although biotechnology has not been a traditional area for Defense, the new bridges that they build shold not only be to the IT tech community but also to the biotech communities in the Valley.”
  • Did Salmonella Take Down the Aztecs?– History and infectious disease? That’s surely the best way to start a weekend! Researchers recently looked at the DNA of a 500-year-old bacteria to study one of the worst epidemics in history. “In one study, researchers say they have recovered DNA of the stomach bacterium from burials in Mexico linked to a 1540s epidemic that killed up to 80% of the country’s native inhabitants. The team reports its findings in a preprint posted on the bioRxiv server on 8 February. In 1519, when forces led by Spanish conquistador Hernando Cortés arrived in Mexico, the native population was estimated at about 25 million. A century later, after a Spanish victory and a series of epidemics, numbers had plunged to around 1 million.” After extracting and sequencing the DNA from the teeth of 29 buried people buried in the highlands of southern Mexico, all but five were found to be linked to cocoliztli. “Further sequencing of short, damaged DNA fragments from the remains allowed the team to reconstruct two genomes of a Salmonella enterica strain known as Paratyphi C. Today, this bacterium causes enteric fever, a typhus-like illness, that occurs mostly in developing countries. If left untreated, it kills 10–15% of infected people.”

Pandora Report 1.20.2017

by spopescu, posted in Pandora Report

We’ve got lots of biodefense goodies for you this week, so grab your PPE and let’s get rolling!

Billion-Dollar Vaccine and Epidemic Preparedness Project 
The Coalition for Epidemic Preparedness Innovations (CEPI) launched this week at the World Economic Forum with an initial $460 million backing from Norway, Germany, Japan, the Welcome Trust, and the Bill & Melinda Gates Foundation. CEPI expects to raise the rest of the needed $1 billion by the end of the year. Their focus is on pre-emptively developing and stockpiling vaccines to better prevent and respond to outbreaks. CEPI marks the largest vaccine development initiative and their plan is to start with vaccines against Nipah virus, MERS-CoV, and Lassa fever. While this is wonderful news, it may just be one step closer to marginalizing the WHO, which has been struggling to stay both relevant and effective. The WHO response to Ebola started drawing more recent attention to the organization’s struggles which were only fueled by slow vaccine procurement/development. These issues culminated with their recommendations to dilute the yellow fever vaccines during last year’s outbreak in Africa due to poor planning. Vaccine development and stockpiling is truly vital to outbreak response. “The CEPI intends to support research at every stage, from basic lab work to vaccine discovery and clinical trials. It also made its first call for research proposals on 18 January, and teams have until 8 March to submit preliminary proposals for grants. ‘For too long, we have separated out the academic work from the next step of taking it into all that is actually required to make a vaccine,’ says Farrar. There is also no market for vaccines against ‘potential’ epidemic threats, he notes, which explains why there is no commercial incentive to take research leads out of the lab and into clinical development’.”

ABSA DURC Roundtable
Don’t miss the Dual Use Research of Concern (DURC) Roundtable Discussion offered by ABSA International on March 15th! This distance learning opportunity will be offered from 12-2pm (CDT), and will aid the user in finding resources and guidance on the U.S. government DURC policies, developing a network of biosafety professionals, and more! “One size does not fit all when it comes to solutions to comply with research policy. The goal of this webinar is to provide best practices, provide insight on how several different institutions are meeting the DURC policy requirements, and help participants troubleshoot issues surrounding DURC that they may have at their institutions. Participants will have the opportunity to submit questions regarding DURC prior to the start of the webinar as well as during the live webinar.”

GMU Trains First Responders Against Infectious Disease  firstrespondertraining3_davefarris
GMU’s Office of Safety, Emergency, and Enterprise Rise Management is now providing local and national first responders with infectious disease training so that they’re better able to protect themselves during outbreaks. The program was made available through a three-year grant from the National Institute of Environmental Health Sciences. “This training is a natural extension of a program Mason’s Biomedical Research Lab biosafety manager Diann Stedman has offered to regional emergency response personnel since the 2010 opening of the lab on the Science and Technology Campus. Stedman is leading the training with Julie Zobel, assistant vice president of safety, emergency and enterprise risk management, and David Farris, executive director of safety and emergency management. Collectively, the three have more than 30 years of experience in the health and safety field, much of it focused on biological safety.”

Completing the Development of Ebola Vaccines 
CIDRAP and Welcome Trust have just released their report – Completing the Development of Ebola Vaccines: Current Status, Remaining Challenges, and Recommendations. “This is the third major report from the Wellcome Trust–CIDRAP Ebola Vaccine Team B. The first report, Recommendations for Accelerating the Development of Ebola Vaccines: Report and Analysis, was released in February 2015, and the second, Plotting the Course of Ebola Vaccines: Challenges and Unanswered Questions, was released in March 2016. In this report, similar to our previous efforts, we have three primary objectives. The first is to track progress toward ensuring that safe, effective, and durable multivalent Ebola vaccines are readily available and can be rapidly deployed when the next outbreak occurs. The second is to identify challenges and barriers where additional efforts are needed, although some of the remaining issues are complex and will require substantial resources to resolve. Our third objective is to provide a set of high-level recommendations that we believe, if implemented, will facilitate the goal of having a robust Ebola virus disease (EVD) prevention program in place that allows prophylactic vaccination of high-risk frontline workers and provides well- maintained vaccine stockpiles to facilitate rapid control of Ebola outbreaks.” The report highlights current clinical evaluations of Ebola vaccine candidates, funding, and regulatory activities. Some of the recommendations include reassessing the leadership structure for Ebola vaccine preparedness, developing strategies for mitigating the financial uncertainties and risks for manufacturers, etc. This report has left many experts pointing to the reality that we’re just not ready for another Ebola outbreak. 

Center for Health Security Joins Johns Hopkins Bloomberg School 
The Center for Health Security has a new home in Johns Hopkins Bloomberg School of Public Health! Previously affiliated with the University of Pittsburgh Medical Center, the CHS will now have significant new opportunities for research and work in national and international public health policy. Originally founded in 1998 by the late D.A. Henderson at Johns Hopkins, the center has been affiliated with UPMC since 2003. “The mission of our center is a perfect fit with the Johns Hopkins Bloomberg School of Public Health because we share a commitment to improving global health and to protecting lives through large-scale change,” says Tom Inglesby, director and CEO of the Center for Health Security. “Moving to the Bloomberg School will expand the reach of the center and help us collaborate with and tap into the universe of great talent at Johns Hopkins. We look forward to joining our expertise on health security and preparedness policy to Johns Hopkins’ internationally recognized community of scientists and public health scholars.” We’re looking forward to seeing all the great work that will be done as the center returns to Johns Hopkins!

Zika Outbreak Updates
As the dust settles, some are looking to the WHO and public health infrastructure failures regarding the Zika outbreak as many are pointing out how the response failed millions. “But the positives were counterbalanced by many negatives, experts said. They harshly criticized the partisan bickering that delayed a Zika-funding bill in Congress for months, and they decried the failure of every city in the hemisphere — other than Miami — to control mosquitoes.” You can also read an opinion piece here, from a pregnant woman living in Miami who tested positive for the Zika. As of January 18th, the CDC has reported 4,900 cases of Zika in the U.S.

Stories You May Have Missed:

  • screen-shot-2017-01-19-at-12-31-34-pmCDC Director’s Departing Words- As CDC director, Dr. Tom Frieden, prepares to leave office after 8 years, he’s offering some words of wisdom. Dr. Frieden has been tested by major health events like Ebola, Zika, MERS, 2009’s H1N1, and a growing domestic overdose issue. “Fundamentally, Americans are healthier and safer because of the work CDC has done over the last eight years. Americans are safer because we have better capacities in place, better infrastructure in place in this country and around the world to find threats early, stop them quickly and prevent them wherever possible. We’ve done that through laboratory work that looks at microbial genomics so we can stop outbreaks sooner. We’ve done that by training the next generation of public health specialists — more than 1,000 of them, fresh out of college and graduate school — deployed out to state and local governments. These people will be protecting Americans for decades to come.”
  • Proposed Presidential Autism-Vaccine Panel Could Help Spread Disease– The potential panel is drawing increasing attention as Robert F. Kennedy Jr. is poised to be the leader. The environmental lawyer has been vocal in his vaccine skepticism, which has led many to worry in terms of federal support for vaccine programs. “Although the autism–vaccine claim has been studied and debunked, the president-elect has also suggested a connection. His team later hedged about the panel, saying that nothing had been decided. (Kennedy’s office declined an interview request.) Nevertheless, public health experts and autism advocates are deeply worried that an effort with presidential backing could undermine public confidence in vaccines and trigger epidemics of all-but-eradicated diseases.”
  • Assad Linked to Syrian Chemical Attacks – The Syrian President has officially been linked to a series of chlorine bomb attacks in 2014/2015. “International investigators have said for the first time that they suspect President Bashar al-Assad and his brother are responsible for the use of chemical weapons in the Syrian conflict, according to a document seen by Reuters. A joint inquiry for the United Nations and global watchdog the Organisation for the Prohibition of Chemical Weapons (OPCW) had previously identified only military units and did not name any commanders or officials.”

Pandora Report 3.11.2016

by spopescu, posted in Pandora Report

TGIF! We’ve got loads of global health security updates to keep you busy why you enjoy the warm spring weather. American special forces recently captured the chief ISIS chemical weapons engineer and you may want to avoid Wonderful Co. pistachios for a bit as they’re being linked to a salmonella outbreak.

The Smallpox Battlegrounds – Laboratories and Virtual RealityScreen Shot 2016-03-07 at 10.49.30 AM
Video game fans will be excited to hear about the new Tom Clancy game, The Division, released on March 8th. This isn’t your normal action-packed video game, but rather it has something more sinister about its premise. The Division focusses on a biochem attack involving a take over by a group called the Strategic Homeland Division aka “The Division”. The Division is compromised of sleeper agents that “act independently in the interest of restoring order after a mass event”. Now here’s where it gets spooky, the game’s premise involves a scenario that may give deja vu to many in the biodefense world- Operation Dark Winter. Operation Dark Winter was a June 2001 exercise/senior-level war game put on by the Center for Strategic and International Studies, the Johns Hopkins Center for Civilian Biodefense Studies, the ANSER Institute for Homeland Security, and the Oklahoma City National Memorial Institute for the Prevention of Terrorism. The scenario focussed on the impact and response of a smallpox outbreak coupled with tensions in the Taiwan Straits and additional crises. In a nutshell, the scenario found that “current organizational structures and capabilities are not well suited for the management of a BW attack”, media management would be challenging for the government, containment and infection prevention would present several issues, and we’d pretty much be in a whirlwind of trouble. If you’re more of a purest and The Division doesn’t appeal to you, there’s also The Collapse, which is an internet-based game that lets you simulate a smallpox outbreak. Unlike other games where the player designs the outbreak, this one is from the viewpoint of the patient. You’re patient zero with a weaponized strain of smallpox and your decisions carry with them a world of outcomes involving the spread of the disease and rate of infection. I spent some time playing The Collapse (starting at GMU for sheer irony) and found it to be very detail oriented and enjoyed the decision making components like which pharmacy I would go to, my travel destination, etc. If you’re not much of a gamer, here’s the recent WHO report on the deliberations regarding the destruction of variola virus stocks. To destroy smallpox or not to destroy smallpox, that is the question.

GMU Course Sampler & Open Houses
Looking to study and work with people that share your love of biodefense? Come check out our March 23rd GMU SPGIA Open House at 6:30pm, in Founders Hall, room 126 at our Arlington Campus! Not only will you be able to chat biodefense, but we’ll have an informational session afterward (7pm) with Dr. Koblentz (you can check out the 2/25 one here). Each session allows us to discuss global health security and answer questions related to our program and the growing field of biodefense. Can’t attend in person? Enjoy our 3/23 biodefense breakout session virtually! If you happened to miss our biodefense course sampler from 3/2, check out the recording from Dr. Koblentz’s talk on Biosecurity as a Wicked Problem.

Chinese Admission of False Korean War Allegations Involving US BW Use
Biodefense expert, Milton Leitenberg, discusses the allegations by North Korea, China, and the Soviet Union, that the US used bioweapons during the Korean War. While the Soviet Central Committee declared the allegations fraudulent in 1998, China and North Korea continued to maintain that bioweapons were used. The recent publication by Wu Zhili (previously the director of the Chinese People’s Volunteer Army Health Division during the Korean War) refutes these claims. Published posthumously, Wu’s testimonial is critical in dismantling the claims as he was “critically involved in the Chinese government’s manipulations that produced the Korean War BW allegations.” The initial allegations claimed that the US was testing bioweapons (specifically plague) on native Inuit peoples of Alaska and then was spreading smallpox in North Korea between December 1950- January 1951. The major allegation campaign began on February 22, 1952 though, as “the North Korean Foreign Minister again issued an official statement addressed to the United Nations Secretariat, charging that in January and February the US had made multiple air drops over North Korea, littering the earth with insects infected with the microorganisms that caused plague, cholera, and other diseases.” Leitenberg discusses these allegations and the Soviet admission of being “misled” and their claims that “the accusations against the Americans were fictitious…Soviet workers responsible for participation in the fabrication of the so-called ‘proof’ of the use of bacteriological weapons will receive severe punishment.” He goes on to discuss Wu’s publication and explanation of the tasks that were carried out to further the belief in US bioweapon applications.

Gain of Function Research
Researchers, Dr. Lipsitch, Dr. Relman, and Dr. Ingelsby, have joined together to discuss the realistic future for research that seeks to alter pathogens. Pointing to the National Academy of Sciences (NAS) meeting, they note that it “marks a turning point in a year-and-a-half-long policy process to consider the risks, benefits, oversight, and regulation of experiments that are designed to create influenza and other viruses that are simultaneously highly virulent and readily transmissible by respiratory droplets between mammals.” Focus has traditionally been on the pros and cons of gain-of-function (GOF) projects however, as time passes, a narrowing of concern seems to be focussed on experiments that seek to build chimeric viruses that are highly dangerous and transmissible. They recommend the following policy approach: lift the moratorium on GOFoc, seek international consensus, secure national and international agreement to restrict the performance of GOFoc studies, design a board, establish clear red lines for GOFoc research, and require the purchase by research institutions of specific liability insurance policies. You can also read the interview with the researchers regarding the implications of such research censorships. Dr. Filippa also discusses engineering a super flu here, noting that “the debate is really about risk assessment of this gain of function work and about who should be making those assessments. Should it just be scientists, should it be their institutions, should it be funders, should it be publishers or, much more broadly, should it be regulators, vaccine manufacturers, ethicists? ”

Zika Updates
CDC and NIAID officials are becoming frustrated as they feel Congress is blocking key efforts to fight the outbreak. A recently published report on research priorities to inform public health and medical practice for domestic Zika virus can be found here. The report emphasizes the growing spread of infection and subsequent need for additional research related to transmission, infection during pregnancy, and disease characteristics . The recent WHO stakeholders meeting provided updates on the most urgently needed tools to fight the growing pandemic. The roadmap includes diagnostic tests, inactivated vaccines targeted to childbearing-aged women, and new vector control mechanisms.  As of March 9th, there were 193 confirmed travel-associated Zika cases in the U.S.  A recent study found that 42% of questioned Americans believe the virus has high mortality rates. Aedes mosquitoes are also developing resistance to the go-to insecticide.

7 Sources for Understanding Epidemics
Feeling like all this Zika news has you needing to catch up on your outbreak cliff notes? The Washington Post has put together a nice list of seven books and movies you can enjoy to help ramp up your knowledge regarding the world of pandemics. This list is a great way to understand the different viewpoints of outbreaks and pandemics from social, medical, political, and scientific viewpoints. If you find yourself wanting more, here are some additional recommendations I’m throwing in: Spillover by David Quammen, Pandemic: Tracking Contagions, from Cholera to Ebola and Beyond by Sonia Shah, and The Coming Plague by Laurie Garrett. Feeling like something a little bit more dramatic? Check out Richard Preston’s The Hot Zone or Demon in the Freezer, or the movies Outbreak or World War Z. With the success of Contagion, I’m still hoping Hollywood will continue to back scientifically grounded films about pandemics (between ebola and Zika virus, they’ve got enough material!).

Stories You May Have Missed:

  • Why Are Mosquitoes Just So Good At Spreading Disease? Mosquitoes have been causing outbreaks since the days of ancient Rome and yet we’re still battling them in the fight against Zika, dengue, chikungunya, and more. “According to Janet McAllister, an entomologist with the U.S. Centers for Disease Control and Prevention (CDC), not all mosquitoes are good at transmitting disease, but the ones that are have evolved to live closer to humans.”
  • Global Health Security Agenda– GHSA was launched in 2014 as a multilateral approach to help protect the world from infectious disease threats. Endorsed by the G7, this agenda facilitates a “partnership of nearly 50 nations, international organizations, and non-governmental stakeholders, GHSA is facilitating collaborative, capacity-building efforts to achieve specific and measurable targets around biological threats, while accelerating achievement of the core capacities required by the World Health Organization’s (WHO’s) International Health Regulations (IHR), the World Organization of Animal Health’s (OIE) Performance of Veterinary Services Pathway, and other relevant global health security frameworks.”
  • Fumbling Ebola– The San Francisco-based epidemiology company, Metabiota, is being charged with making several mistakes according to the Associated Press (AP). Recovered communication reveals that the company fueled an already chaotic situation via misdiagnoses, adding to confusion, and poor sample tracking.
  • Guidelines for Ebola Survivor Care– The WHO has published guidelines on the management and care of patients who were previously infected with Ebola. Since there are roughly 10,000 ebola survivors and several have required hospitalization for complications, these recommendations are extremely prudent. The report includes counseling, considerations for special patient populations, and common sequelae and management recommendations.

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