Pandora Report 2.9.2018

Happy Friday fellow biodefense enthusiasts! The Winter Olympics are already starting off with a bang as Korean health officials have confirmed 128 cases of norovirus among security personnel, police officers, and Olympic workers.

WHO Releases List of Blueprint Priority Diseases
The WHO has just released their annual review of the Blueprint list of priority diseases, which includes a special tool for “determining which diseases and pathogens to prioritize for research and development in public health emergency contexts”. While the list includes diseases like Ebola, MERS and SARS, Nipah, and Zika, it is the inclusion of Disease X that highlights the unknowns of infectious diseases in the future.  “Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease, and so the R&D Blueprint explicitly seeks to enable cross-cutting R&D preparedness that is also relevant for an unknown ‘Disease X’ as far as possible.”

BioWatch Documents Left Behind on Flight
Biowatch officials are doing a bit of a damage control at the moment as multiple copies of an official DHS document regarding performances during a bioterrorism simulation were left behind on an airplane prior to the Super Bowl. The errant document offered a critique of how officials performed during a simulated release of the infectious disease anthrax in Minneapolis on the day of the Super Bowl. Other sensitive material was also found, CNN said, without further description.” Ironically, it was a CNN employee who discovered the forgotten papers in the seat-back pocket of a commercial plane. “The reports were accompanied by the travel itinerary and boarding pass of the government scientist in charge of BioWatch, the DHS program that conducted the anthrax drills in preparation for Super Bowl LII in Minneapolis. The reports were based on exercises designed to evaluate the ability of public health, law enforcement and emergency management officials to engage in a coordinated response were a biological attack to be carried out in Minneapolis on Super Bowl Sunday.” CNN waited to publish the incident until after Sunday’s game, but the papers revealed significant areas for response improvement during a bioterrorism incident. While not surprising, the identification of such gaps is critical for improvement however, it is the concerning nature of which they were left behind. Vulnerabilities are always present, but that doesn’t mean we want them being aired in the open for nefarious actors to utilize.

 GMU Biodefense PhD Student Selected As ELBI Fellow 
The Biodefense Graduate Program in the Schar School of Policy and Government at George Mason University is proud to announce that PhD student Yong-Bee Lim has been selected for the prestigious Emerging Leaders in Biosecurity Fellowship (ELBI) program within the Johns Hopkins Center for Health Security. Selected from a group of over 120 international applicants, the 2018 ELBI class includes professionals and scholars with a passion for health security and biosecurity. This year-long fellowship will deepen the biosecurity expertise and broaden the network of those passionate about furthering the field. Yong-Bee was also the recipient of an internship with the Center for Global Security Research at Lawrence Livermore National Laboratory and the SB7.0 Fellowship, which supported his attendance of an international synthetic biology conference in Singapore. His selection also marks the third consecutive year that the Schar School’s Biodefense program has had graduate students named ELBI fellows. Congrats Yong-Bee!

Smallpox Signalling
It’s been a couple of weeks since PLOS One published the horsepox synthesis paper and the truth is that many are still in awe that not only such work was done, but that it was published. Where were broader discussions regarding the merits of this research? Conversations about need to publish it? Moreover, what about the importance of oversight in the private biotech arena and not just those with federal funding? One thing is for certain though, this is a critical moment for life sciences and DURC oversight. “A vaccine against smallpox already exists. The research was carried out unilaterally, without a broader discussion of the merits beforehand. There are apparently few oversight mechanisms when experiments are done with private funding. The restrictions that now cover dual-use research funded by U.S. government — which include an independent review process, and a weighing of the risks and benefits, as well as the ethics — should be expanded to private-sector research.”

Topics of Interest at the DHS Meeting on Sequences of Interest
Synthetic biology has led to the creation of new products, markets, companies, and industries. At the same time, this technology poses potential risks to biosafety and biosecurity, as recently demonstrated by the synthesis of horsepox virus, a cousin of variola, the virus that causes smallpox.  On January 29-30, 2018, the Department of Homeland Security (DHS) Science and Technology Directorate sponsored a workshop to discuss the evolving role of databases that contain genetic sequences of pathogens and toxins that pose safety or security concerns, termed “sequences of interest.” The workshop brought together stakeholders from government, industry, and academia to discuss the need for such databases, review current databases and those under development, explore potential applications and users of these types of databases, and consider the potential risks that they pose due to malicious or inadvertent misuse. The workshop provided a valuable opportunity to explore the scientific and technical aspects of constructing such databases, maintenance and sustainability challenges, and the trade-offs involving functionality, accessibility, affordability, confidentiality, and security. While the workshop did not produce a consensus on the best path forward, it played an important role in educating the participants on the most critical issues and facilitating a dialogue among a diverse range of stakeholders on this important topic.  The workshop also came at a propitious time as stakeholders grapple with the changing landscape of the biotech industry and advances in DNA synthesis technology.  For instance, the International Gene Synthesis Consortium, a group of the leading DNA synthesis companies that have adopted customer and sequence screening protocols to prevent the misuse of their products, has expanded in size and geographic scope and recently updated its biosecurity protocols. The U.S. government is also reviewing the customer and sequence screening guidance it issued in 2010 and is considering whether, and how, to update it.  Should a decision be made to proceed, stakeholder engagement would be a significant part of the review, just as it was a significant part of the guidance’s original development.

The US Can’t Afford to Reduce Public Health Funding
GMU biodefense PhD alum Daniel M. Gerstein is evaluating the decision to reduce funding for global epidemic prevention activities and just how dangerous that would be for the United States. “Recent reporting suggests that the Trump administration is preparing to downsize the Centers for Disease Control’s (CDC) global epidemic prevention activities in 39 of 49 countries starting in 2019 when funding first authorized by Congress in 2014 expires. Such a move is potentially dangerous and could place the U.S. at significant risk.” Gerstein points to the notion of shared responsibility in global health security and how important efforts like the GHSA are for global public health. He also notes that the last decade alone has revealed just how undeniable public health is as a national security issue. “Without renewed funding, the long-term outlook could include weakened global disease surveillance and response systems, less capable partner nations and an increased likelihood of global disease outbreaks that would undoubtedly threaten the U.S.” Wanting more information regarding the implications of CDC cutting back on their global health security funding? Check out this article regarding the funding cliff the CDC is about to fall off.

Biosecurity in Putin’s Russia
The latest book from Raymond A. Zilinskas and Philippe Mauger delves into the biodefense world of Putin’s Russia. “In March 2012, at a meeting convened by the recently reelected Russian president Vladimir Putin, Minister of Defense Serdyukov informed Mr. Putin that a plan was being prepared for ‘the development of weapons based on new physical principles: radiation, geophysical wave, genetic, psychophysical, etc.’ Subsequently, in response to concerns expressed both in Russia and abroad, the Russian government deleted the statement from the public transcript of the meeting. But the question remains: Is Russia developing an offensive biological warfare program?”

Global Monitoring of Disease Outbreak Preparedness
The Harvard Global Health Institute has released their new report that is “a step towards developing a shared framework and monitoring mechanism” for outbreak response and preparedness. “This report is primarily intended for the community of policymakers and researchers concerned about the rising risks of domestic, regional, and global infectious disease epidemics, and the collective failure to take the coordinated actions required to reduce such risks. These risks include the expected health, economic, and societal costs that are borne by countries, regions, and even all nations in the case of pandemics (which are worldwide epidemics). These risks also include the consequences of increasing antimicrobial resistance (AMR) and its spread within regions and globally.” The report focuses on strengthening public health capacity as a foundation, improving S&T, reinforcing risk analysis and incentives for action, strengthening global mechanisms, and revised shared monitoring framework and next steps.

 The Fearsome Future of Flu
This year has been rough for seasonal flu and while it has been a cold dose of reality in terms of hospital response, are we really learning our lesson or just running from fire to fire? 2018 marks the centennial of the 1918/1919 influenza pandemic and with a larger, more connected population, have we made ourselves safer? The next flu virus with pandemic potential will either enhance our response capabilities or exploit our most damning weaknesses. “And influenza viruses excel at the element of surprise. Few would have guessed Mexico as the origin of that 2009 H1N1 pandemic, for example, notes Fukuda. That outbreak was recognized in San Diego—never considered a hotspot—when a little girl happened to seek treatment at a clinic participating in a study focused on diagnosis, Adalja explains. That’s why he believes it is important to build up the diagnostic capacity for frontline clinicians, and not be satisfied with non-specific diagnoses—failing to pin down the specific microbial cause.” Unfortunately, we are still practicing the methods of frenzied response, delayed information sharing, and dangerous hysteria that can spread even faster through social media. These concerns highlight yet another reason why we need a universal flu vaccine.

Johns Hopkins Center for Health Security Event: Healthcare Disaster Resilience
Don’t miss this event at the National Press Club Holeman Lounge on Thursday, February 22nd from 8:30-10am EST. The Johns Hopkins Center for Health Security will release new policy recommendations for building a more effective disaster health system in the United States. Speakers include Dr. Luciana Borio from the White House National Security Council staff, Sally Phillips of HHS, Linda Langston from the National Association of Counties, as well as Drs.Tom Inglesby, Eric Toner, Monica Schoch-Spana from the Center for Health Security.

 Genetic Sequencing and the Dangers of DIY Genome Editing
Nebula Genomics will sequence your genome for just under $1,000 and you can even share it using a blockchain.  “Nebula is the brainchild of geneticist George Church, PhD student Dennis Grishin, and graduate Kamal Obbad, all from Harvard. Mirza Cifric, CEO of Veritas Genetics, which offers a genome-sequencing service for $999, is a founding advisor. When you pay to take a DNA test—through 23andMe, Helix, or Ancestry.com, for example—the company that does the testing owns your genetic data. Nebula wants to sequence people’s entire genomes and let them own it, allowing them to earn digital money by sharing it.” While professionals may be providing your genomic data through these companies, many are looking to actually learn to experiment with genes themselves. DIY gene therapy is becoming increasingly accessible, which has many worried and the FDA issuing a warning to the public. The FDA, on “November 21 cautioned against do-it-yourself (DIY) gene therapies. But even as the agency’s statement also warned that selling gene editing kits aimed at homemade therapeutics is illegal, CRISPR–Cas9 kits are available to buy online, and the number of providers is growing, raising concerns that DIY gene therapy enthusiasts could be putting themselves and others at risk.”

Biodefense Policy Landscape Analysis Tool
B-PLAT is a new tool from Pacific Northwest National Laboratory scientists Rachel Bartholomew and Kristin Omberg that aims to help coordinate national biodefense preparedness. It “captures and presents a slew of information about U.S. efforts to protect its citizens and others around the world from threats as diverse as the flu, diseases like Ebola, threats from terrorists, potential risks to water and food supplies, and myriad other concerns. The tool is freely available. In 2017, PNNL chartered an internally funded working group, the Policy Wranglers, to capture relevant biodefense policy directives, public laws, and corresponding sections of the U.S. Code, in a format conducive to visualization. The resulting tool can be utilized to better understand the current state of the U.S. biodefense enterprise.” A presentation on B-LAT will also be made at ASM’s Biothreats next week as part of a town hall on Tuesday.

Stories You May Have Missed:

  • US Battles IV Bag Shortage During Record-Setting Severe Flu Season – GMU biodefense PhD student Saskia Popescu is looking at the impacts of this IV bag shortage during the severe flu season. “Even prior to Hurricane Maria, the United States was already battling challenges with meeting the demand for IV fluids; however, the storm crippled Puerto Rico-based manufacturing sites for materials. In a news release on January 16, the FDA reported that they were taking additional steps to combat the shortages, such as ‘asking companies to submit data to extend expiration dates for these products.’ They noted that, ‘if expiration dates can be safety extended [for these products], it would allow some near-expiry product that remains at the hospital level to be used’.”
  • DARPA Program to Track Genetic Markers for Past WMD Material Exposure – “The program is being called Epigenetic Characterization and Observation (ECHO), and its endgame is the creation of a field-deployable system that could analyze someone’s epigenome and identify markers of whether or not–in that person’s entire lifetime–been exposed to WMD-associated materials. DARPA officials are billing it as worlds quicker than sending to a lab to test for biological or chemical agents in clothing or hair.”

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

Pandora Report 1.12.2018

 The Bright Side of Synthetic Biology and Crispr
GMU biodefense professor Sonia Ben Ouagrham-Gormley and Phd alum Shannon Fye-Marnien are looking at the realities of synthetic biology and fears of bioterrorism. Biological advances have inspired questions regarding the safety and potential for nefarious use, but are such technologies guilty until proven innocent or innocent until proven guilty? “As with previous advances in biology, Crispr is sometimes characterized as a blueprint for bioweapons development or bioterrorism, and it has elicited calls for increased control and regulation of science. But while it is important to examine the potential dangers of emerging technologies, reaching a balanced assessment of risks and benefits requires that technologies’ potential to improve human life be appreciated as well. Synthetic biology and Crispr offer a potentially enormous package of benefits, spanning from medicine to energy to agriculture and beyond. Discussions about the security and safety of synthetic biology and Crispr should not obscure these technologies’ potential to address a wide variety of complex and pressing problems.”

The United States Battles Influenza
Flu season is hitting hard in the United States as 46 states report widespread activity. 80% of cases are of the H3N2 strain, which is associated with severe symptoms and hospitalizations. “The flu is now widespread across the country and the peak of transmission probably occurred during the Christmas-New Year’s holiday week, just as many people were crowded into planes, buses and cars or in large family gatherings, said Dr. Daniel B. Jernigan, director of the influenza division of the Centers for Disease Control and Prevention. ‘H3N2 is a bad virus,’ Dr. Jernigan said. ‘We hate H3N2’.” 26 states (and New York City) are reporting high influenza-like illness (ILI) activity. The CDC has reported that “Influenza-like illness (ILI) went from 4.9% to 5.8%. ‎These indicators are similar to what was seen at the peak of the 2014-2015 season, which was the most severe season in recent years.” This tough influenza season is a helpful reminder that it could always get worse, especially in the context of the 1918/1919 influenza pandemic, which marks its centennial this year. Michael T. Osterholm and Mark Olshaker recently wrote an OpEd regarding the dismal truth – we’re not ready for a flu pandemic. Pointing to not only massive growth in population, but also challenges of supply shortages, and an outdated approach to vaccine research, they highlight the need to find a universal vaccine that can do battle against all influenza A strains with a longer immunity. “But there is no apparent effort to make these vaccines a priority in the current administration. Its national security strategy published last month cites Ebola and SARS as potential bioterrorism and pandemic threats, yet makes no mention of the risk of pandemic influenza nor any aspect of critical vaccine research and development. The next few weeks will highlight how ill prepared we are for even ‘ordinary’ flu. A worldwide influenza pandemic is literally the worst-case scenario in public health — yet far from an unthinkable occurrence. Unless we make changes, the question is not if but when it will come.”

GMU Biodefense Professor – Robert House
We’d like to welcome back professor Dr. Robert House to GMU biodefense, who will be teaching BioD766: Development of Vaccines and Therapeutics. Dr. House holds a PhD in medical parasitology and is a senior VP for government contracts at Ology Bioservices (previously Nanotherapeutics). The world faces a growing threat from microbiological agents in the form of terrorist weapons, pandemics (particularly influenza) and emerging/re-emerging diseases. Characteristics such as high pathogenicity/toxicity and lack of appropriate animal models, as well as lack of a viable commercial market, make it difficult to develop effective medical countermeasures for these agents. In his course, students will explore how the US Government is developing medical countermeasures (MCM) against these threats and will explore the various threat agents, the context of regulatory considerations, and the specifics of how MCMs are developed.

Infectious Disease Mapping Challenge Launched!
Do you love infectious diseases and maps? The goal of the challenge is to promote the use of geospatial mapping to address the objectives of the GHSA. The NextGen Network has partnered with the U.S. Department of State’s Virtual Student Foreign Service program to launch the 2018 challenge. You can find out more information from this engaging and informative webinar or at the page here. The deadline for signing up for the challenge is January 19, 2018. This is a great way to contribute to the GHSA goal of creating a world safe and secure from the threat of infectious diseases.

Biodefense Alum – Stay Connected! 
Are you a GMU Biodefense alum? If so, please make sure to keep your information updated in our Schar Stay Connected site. We have a strong alum community and would love to keep you up to date on future events and give shout outs for the amazing work our biodefense students accomplish.

Biopreparedness Needs to Start At the Frontlines of Disease Control
GMU biodefense PhD student and infection preventionist Saskia Popescu evaluates the attention to biopreparedness and how our focus on bioterrorism fails to address the major gaps within disease control in the United States. “The Blue Ribbon Panel report and the CNN article both highlight the bureaucratic challenges with coordination at a national level across many agencies and sectors. The crux of it all is that from a grass-roots level, we’re struggling to better prepare and respond for a host of reasons. Public health funding is always in a chronic state of too little too late and often, we don’t push out resources until we’re already in the throes of a major incident (Ebola, Zika, etc.). Preparing for biothreats, regardless of origin, requires that we strengthen the most basic surveillance and response systems within public health and health care. During the 2014–2015 Ebola outbreak, for example, there was a lot of attention on enhanced precautions. Although this was beneficial and brought attention to several gaps infection control and prevention measures, I found myself reminding staff that we can’t truly prepare and respond to rare events if we can’t get our daily practices down. The shear challenges of ensuring staff practice appropriate hand hygiene and isolation precautions in health care are indicators that we are struggling on the frontlines of disease preparedness.”

Lessons from A 2016 CRE Outbreak in A Kentucky Hospital
Hospital outbreaks are tough. The shear volume of people that go into a single patient’s room is considerable (healthcare workers, visitors, ancillary staff, etc.) and enough to spread germs throughout an entire hospital. Now imagine that the organism is a highly resistant one, such as carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE). A hospital in Kentucky experienced this very thing in 2016 and a recent CDC MMWR revealed just how difficult it can be to conquer an outbreak involving one of the worst resistant organisms you can imagine. “Over the next 4 months, scientists identified an additional 21 CRE isolates from patients at the hospital via screening and clinical cultures. The investigators believe organisms were imported into the facility and then spread among patients.” Epidemiological investigation found that five of the thirteen interviewed patients had received healthcare outside the local area and that three of the patients may have brought CP-CRE into the facility. “The authors of the report say their investigation highlights the potential role of cleaning equipment, which frequently moves between patient rooms, in CP-CRE spread. In addition, they note that although there is a low prevalence of CP-CRE in rural areas, rural hospitals should be aware that patients who’ve also accessed healthcare in areas with higher CP-CRE prevalence—primarily urban areas—can introduce these organisms into their facilities.”

Stories You May Have Missed:

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

Image of the Day: Camp Funston

Camp Funston

 

This photo depicts an influenza ward at Camp Funston in Kansas during the 1918 Influenza Pandemic. This flu outbreak occurred between 1918 and 1920 and was one of the most deadly in history, infecting approximately 500 million people and killing 3-5% of the world population (50-100 million.)

That’s killed 3-5% of the entire world–not just infected 3-5% of the world!

Many historical resources cover this worldwise pandemic, also known as “Spanish Flu”, its effects, it causes, and the lasting legacy. Two include flu.gov and John M. Barry’s The Great Influenza.

 

Pandora Report 4.11.14

Ebola is still raging in West Africa and experts are planning for a long battle, however, every week can’t be about Ebola. So let’s jump into it!

Highlights include The START treaty, Chemical Weapons in Syria, H1N1 in otters and public outcry over Chilis (but not their baby back ribs.) Have a great weekend!

New START Data Show Russian Increase, US Decrease Of Deployed Warheads

With many Russia watchers nervously waiting to see if moves are made towards Ukraine, new data this week shows that Russia has actually increased their counted deployed strategic nuclear forces since September 2013 under the START treaty. Under the new treaty, by 2018, both Russia and the U.S. agree to no more than 1,550 strategic warheads on 700 deployed launchers. Russia has been under this limit since 2012—before the treaty was even signed—while the U.S. has yet to reduce below the treaty limits.

Federation of American Scientists– “Since the treaty was signed in 2010, the United States has reduced its counted strategic forces by 104 deployed launchers and 215 warheads; Russia has reduced its counted force by 23 launchers and  25 warheads. The reductions are modest compared with the two countries total inventories of nuclear warheads: Approximately 4,650 stockpiled warheads for the United States (with another 2,700 awaiting dismantlement) and 4,300 stockpiled warheads for Russia (with another 3,500 awaiting dismantlement).”

Another Chemical Weapons Attack in Syria?

 After Syria signed a chemical weapons dismantlement agreement in September 2013 (brokered by Russia, the U.S. and the UN), it appears they have reneged on their word. Reports from “credible” sources say that there have been chemical weapons attacks in the cities of Harasta and Jobar over the past couple weeks. With the eyes of the world on Russia and Ukraine, and U.S. naval destroyers loaded with tomahawk missiles departed from the Mediterranean, Assad may be benefitting from a lack of international oversight.

The Wall Street Journal-“There is no credible evidence to suggest that rebel groups in the Damascus area have acquired the materials or know-how to mount chemical weapons on conventional artillery pieces in their possession. It can therefore be concluded that unless the rebels theatrically fabricated the effects of a chemical attack, the Assad regime was likely responsible for carrying them out. Notably, on March 25, Syria’s U.N. Ambassador Bashar Ja’afari distributed a letter specifically warning that rebels would use chemical weapons in Jobar in order to blame the government. But if any party in the conflict would be prone to such conspiracy, it would be the Assad regime, whose decades of tutelage under the Russian KGB made their Mukhabarat (secret service) frighteningly efficient at false-flag tactics meant to smear the opposition.”

Swine Flu From 2009 Pandemic Also Struck Sea Otters

Turns out, the H1N1 pandemic from 2009 didn’t only affect humans…it affected otters! New research shows that otters off the Western coast of the United States were also infected with H1N1 as it affected people throughout the U.S. Seventy percent of the otters tested in 2011 showed antibodies (demonstrating previous infection) for H1N1. Previous research also showed that elephant seals living off the coast of California had been infected with H1N1 too.

U.S. News and World Report-“‘Our study shows that sea otters may be a newly identified animal host of influenza viruses,” study-co-author and USGS scientist Hon Ip said in a government news release. “We are unsure how these animals became infected,” lead author and CDC scientist Zhunan Li said in the news release. “This population of sea otters lives in a relatively remote environment and rarely comes into contact with humans.” The study was published in the May issue of the journal Emerging Infectious Diseases.”

Chili’s cancels fundraiser with National Autism Association

Last weekend, my favorite mid-range American restaurant, Chili’s announced that they would be partnering with the National Autism Association for a benefit on Monday, April 7. However, outcry over the NAA—and its anti-vaccination stance—forced Chili’s to change its mind (and continue to keep my business.) It is a striking demonstration of the power of consumers and social media and strikes a victory for those in favor of vaccinations and the good they bring to communities and herd immunity.

CNN-“The Chili’s spokeswoman said that the NAA was originally selected for the fundraiser “based on the percentage of donations that would go directly to providing financial assistance to families and supporting programs that aid the development and safety of children with autism.”

Chili’s, which is owned by Brinker International (EAT), went on to say, “While we remain committed to supporting the children and families affected by autism, we canceled Monday’s Give Back Event based on the feedback we heard from our guests.”’

 

(image courtesy of Wikimedia Commons/ Dave Bezaire & Susi Havens-Bezaire)

The Pandora Report 2.21.14

Editor’s note: Hello all Pandora Report subscribers! This is unfortunately my last week as author of the Pandora Report. It’s been such a pleasure having the opportunity to write the Pandora Report, and I would like to thank all of you for taking the time to subscribe and read it. I leave you all in the trusty hands of the new Pandora Report team – goodbye, thank you, and remember to stay away from the bats.

Highlights include PEDv, 1918 Spanish Flu, MERS-CoV, and Ebola. Happy Friday!

As deadly pig virus spreads, USDA warns of impact on hog supply

Porcine epidemic diarrhea virus (PEDv)has spread to a further two states, with Montana and Idaho reporting cases for the first time. The virus, which has a fatality rate approaching 100% in piglets, has swept across the country, with 3,528 cases in 25 states. Contaminated feed was recently put forth as a potential source of the virus’ spread. Before you start autoclaving your pork products, remember that the virus poses no threat to humans.

Chicago Tribune – “PEDv causes diarrhea, vomiting and severe dehydration in pigs. Research by the U.S. hog industry determined it is spread orally through infected pig manure, and can be carried by trucks, boots, clothes and water. But feed containing porcine by-products, including but not limited to plasma, recently came into focus as a means of transmission. The Canadian Food Inspection Agency (CFIA) found the virus in samples of U.S.-origin plasma from a third-party manufacturer for Grand Valley Fortifiers, a livestock feed company based in the province of Ontario. The company recalled the feed.”

Study revives bird origin for 1918 flu pandemic

According to a new study published in Nature, the 1918 (H1N1) Spanish flu virus originated not from reassortment in pigs, but from domestic water and shore birds. This most recent study contradicts finding in a persuasive 2009 study which found the virus to have circulated in humans and pigs for up to 15 years prior to the pandemic. Historical epidemiology is critical to better understanding, and therefore predicting, emerging  pandemic threats.

Nature – “The virus that caused the 1918 influenza pandemic probably sprang from North American domestic and wild birds, not from the mixing of human and swine viruses. A study published today in Nature1 reconstructs the origins of influenza A virus and traces its evolution and flow through different animal hosts over two centuries. ‘The methods we’ve been using for years and years, and which are crucial to figuring out the origins of gene sequences and the timing of those events, are all flawed’, says lead author Michael Worobey, an ecologist and evolutionary biologist at the University of Arizona in Tucson. Worobey and his colleagues analysed more than 80,000 gene sequences from flu viruses isolated from humans, birds, horses, pigs and bats using a model they developed to map evolutionary relationships between viruses from different host species. The branched tree that resulted showed that the genes of the deadly 1918 pandemic virus are of avian origin.”

Saudi Arabia’s MERS Death Toll Reaches 60

The sixtieth MERS-CoV fatality in Saudi Arabia was a 22-year old male with previously existing conditions. The young man was also battling cancer. There have been 182 cases of the virus globally, of which 165 have been in Saudi Arabia. All but nineteen of the fatalities have been in Saudi Arabia. No word yet on whether he had previous contact with camels.

Gulf Business – “The virus, which first appeared in 2012, has affected around 182 people globally and has resulted in 79 deaths till date, according to World Health Organisation (WHO). MERS, a deadly but less transmissible virus than SARS, has symptoms such as coughing, fever and pneumonia. Although the worldwide number of MERS infections is fairly small, the high death rate among confirmed cases and the spread of the virus beyond the Middle East is keeping scientists and public health officials on alert. Cases have been reported in Saudi Arabia, Qatar, Kuwait, Jordan, UAE, Oman and Tunisia as well as in several countries in Europe.”

Man steals phone from Ebola patient, gets infected

As this is my last Pandora Report, it is only appropriate Ebola is mentioned at least once. This story is making the rounds again following it’s use in a promotional AARP blog post (bold move, AARP, bold move). Its moral? Don’t steal things from hospitals. Especially things located in a hospital’s active quarantine zone. Especially things located in a hospital’s active quarantine zone during an Ebola outbreak.

The Daily Monitor (Uganda) – “Security and medical officials in Kibaale District have registered a case in which a man allegedly went in an isolation ward at Kagadi Hospital and stole a cellular phone from one of the Ebola patients…Police detectives began tracking him after he apparently began communicating to his friends using the phone. But as police zeroed in on him, he developed symptoms similar to those of Ebola and sought medication at the hospital…In his confession made to the police, the suspect, now patient, claimed he had visited the isolation ward to give them comfort although he confessed to knowing none in person.”

(image courtesy of NIAID)

H1N1 Deaths on the Rise

From the Washington Post – “The H1N1 virus responsible for the 2009 global pandemic is back. State health officials from across the country say the resurgence is resulting in a dramatic rise in flu deaths in young and middle-aged adults and in children this season. While the reported death tolls so far are only a fraction of what they were four years ago, they are significantly higher than last year. The Centers for Disease Control and Prevention said the flu has been killing at epidemic levels since mid-January. Graphic Since October, 6,655 Americans were hospitalized with the flu. Click Here to View Full Graphic Story Since October, 6,655 Americans were hospitalized with the flu. With one month to six weeks to go in the flu season, which typically ends in March or April, the CDC said the number of people visiting doctors and hospitals for flu-like symptoms is declining overall, but some states are continuing to see high levels of flu activity or even increases in activity. Although the flu usually disproportionately affects the very old and the very young, this season 60 percent of those hospitalized for influenza have been age 18 to 64.”

Read more here.

The Pandora Report 1.23.14

Highlights include dengue in Texas, H7N9 spiking ahead of the Chinese New Year, renaming the 1918 influenza, and a man selling abrin on the black market. Happy Friday (stay warm)!

Rare Disease Linked to Dengue Virus Caused Texas Woman’s Death
A Texan woman thought to have been infected and died with West Nile Virus has been discovered to have actually succumbed to   dengue. The woman’s case was recently published by the CDC, which warned of the need for effective surveillance. Dengue thankfully remains relatively rare in the US – the woman represented just the third case in nearly a decade.

LiveScience – “The woman died after her dengue infection brought on another condition called hemophagocytic lymphohistiocytosis (HLH), in which white blood cells build up in the skin, spleen and liver, and destroy other blood cells. HLH is most frequently associated with Epstein Barr virus infection, but also has been linked to dengue, according to the researchers, from the Centers for Disease Control and Prevention.”

H7N9: Bird flu cases surge ahead of Chinese New Year
As the Chinese New Year approaches, the number of H7N9 cases has steadily increased, with  73 cases in the last three weeks alone. This is making people very nervous  – Chinese New Year often means millions of people travelling in very close quarters, over long periods of times. However, health officials are careful to point out that influenza case numbers, across strains, increase in the colder months. As long as the virus remains poorly transmitted person-to-person, things are fine.

BBC – “Proffesor John McCauley, the director of a WHO collaborating centre on influenza in London, said: ‘I’ve been worried all the time about H7N9; it’s highly virulent and the case fatality is about one in three, so it poses a threat.’ The range of the virus had also spread, he added, with cases in Guangdong province, further south and east than previously. He said the winter might not be the whole explanation, particularly in southern provinces closer to the equator. ‘It may be seasonal, or an alternative is more poultry exposure in the build-up to Chinese New Year, and more poultry going through the markets. They might need to reconsider closure of the markets’.”

1918 Flu Pandemic That Killed 50 Million Originated in China, Historians Say
The 1918 Spanish influenza, like so many strains of the virus, has apparently suffered for decades under an egregious misnomer. According to a new hypothesis, proposed by historian Mark Humphries, the grandfather of modern H1N1 strains may have originated in China. Humphries published his research in the journal War in History, in it arguing that the importation of almost 100,000 Chinese laborers to support the British and French lines may have introduced the virus to Europe. For those of you wondering, the pandemic strain was dubbed the Spanish flu apparently because Spain was one of the only countries to report on its heavy case numbers during the otherwise heavily censored WWI.

National Geographic – “In the new report, Humphries finds archival evidence that a respiratory illness that struck northern China in November 1917 was identified a year later by Chinese health officials as identical to the Spanish flu. He also found medical records indicating that more than 3,000 of the 25,000 Chinese Labor Corps workers who were transported across Canada en route to Europe starting in 1917 ended up in medical quarantine, many with flu-like symptoms…Writing in the January issue of the journal War in History, Humphries acknowledges that his hypothesis awaits confirmation by viral samples from flu victims. Such evidence would tie the disease’s origin to one location.”

Feds: Fla. man sold deadly toxin to NJ agent
A 19 year old in Florida has been apprehended after selling to toxin abrin to an undercover FBI agent. The deal was agreed upon online, with the FBI agent posing as a buyer on an intermediary cyber black market. The suspect was arrested after directing the FBI agent to two candles filled with the toxin, left in a fast food bag at a rest stop in Florida. A McDonalds bag, for those of you wondering about the culinary preferences of illicit toxin sellers. On a less flippant note, abrin is tremendously potent – while it presents similarly to ricin, it is 75 times more toxic.

The Grand Island Independent – “Prosecutors said Korff negotiated over the Internet with the undercover agent in New Jersey.’He allegedly peddled the poison on a virtual black market of illegal and dangerous good, hidden in the shadow of a secretive computer network favored by cybercriminals,’ said New Jersey U.S. Attorney Paul J. Fishman. Korff received $1,500 over the Internet from the agent and left the toxin hidden in two candles at a rest stop near Fort Myers, Fla., authorities said. Korff was arrested after the candles were found to contain abrin.”

(image:Calvin Teo)

The Pandora Report 1.3.13

The first Pandora Report of the new year, and it’s (unsurprisingly) flu heavy. Highlights include H1N1 attacking the young, new MERS-CoV cases, H7N9 in Taiwan, H5N1 in China, and the gain-of-function debate (so more H5N1). Happy Friday!

Notice to Clinicians: Early Reports of pH1N1-Associated Illnesses for the 2013-14 Influenza Season
The CDC has a health alert out, detailing the tendency of this season’s predominant flu strain (which, as we’ve said before, looks like its going to be H1N1) to disproportionately affect the young. This is possibly because the elder amongst us are more resilient, due to cross-reactive immunity – they’ve been around longer, which means there’s a greater chance they have been exposed to similar viruses. The upshot is if you’re young and healthy, get a flu shot.

CDC – “From November through December 2013, CDC has received a number of reports of severe respiratory illness among young and middle-aged adults, many of whom were infected with influenza A (H1N1) pdm09 (pH1N1) virus. Multiple pH1N1-associated hospitalizations, including many requiring intensive care unit (ICU) admission, and some fatalities have been reported. The pH1N1 virus that emerged in 2009 caused more illness in children and young adults, compared to older adults, although severe illness was seen in all age groups. While it is not possible to predict which influenza viruses will predominate during the entire 2013-14 influenza season, pH1N1 has been the predominant circulating virus so far. For the 2013-14 season, if pH1N1 virus continues to circulate widely, illness that disproportionately affects young and middle-aged adults may occur.”

Six new cases of MERS virus hit Saudi Arabia, UAE
The WHO has reported six new cases of MERS-CoV. Of the six, five are Saudi nationals, with one case in the United Arab Emirates. Three of the cases, including one involving a wife tending to an ill husband, are reportedly asymptomatic. Ages of the new patients range from 59 to 73 years old, with the latter succumbing to the virus. The new cases bring the global total to 176, with 74 deaths. There is still no substantive information on the virus’ source, transmission, or vector. Sadly, “it might be camels” remains our most conclusive evidence to date – which is not to impugn the work of the scientists involved, which has been fastidious, but rather to bemoan the complexity of the virus itself.

Reuters – “MERS emerged in the Middle East in 2012 and is from the same family as the SARS virus. It can cause coughing, fever and pneumonia. Although the worldwide number of MERS infections is fairly small, the more than 40 percent death rate among confirmed cases and the spread of the virus beyond the Middle East is keeping scientists and public health officials on alert. Cases have been reported in Saudi Arabia, Qatar, Kuwait, Jordan, United Arab Emirates, Oman and Tunisia as well as in several countries in Europe, and scientists are increasingly focused on a link between the human infections and camels as a possible ‘animal reservoir’ of the virus.”

Hundreds monitored in Taiwan after H7N9 strain of bird flu after infected tourist discovered
A tourist infected with H7N9 spent over a week travelling through Taiwan from mainland China before being hospitalized. Health authorities in Taiwan are scrambling to reach all people he potentially came in contact with during his tour. Three medical personal who had dealings with the infected patient have subsequently developed symptoms of upper respiratory infections themselves. However, it should be emphasized that there remains no conclusive evidence of sustained person-to-person transmission of the virus.

Channel Asia – ”  As many as 500 people may have had contact with him, all of whom are being asked to report to doctors should they develop possible symptoms, the statement added. The 149 people who may have had close contact include two family members accompanying him on the tour, the tour guide, bus driver, medical personnel and patients sharing the same hospital ward, it said.”

China confirms H5N1 bird flu outbreak in Guizhou
Following the death of approximately 8,500 birds on a farm in Southwest China,  health authorities have confirmed an outbreak of H5N1 amongst poultry in the area. The area has subsequently been sealed off, with a further 23,000 birds culled for safety. As of yet, no human cases have been reported in the area.

Xinhua – “The southwest China province of Guizhou has reported an outbreak of H5N1 in poultry, the Ministry of Agriculture (MOA) announced Thursday. Some chickens at a farm in a village of Libo County in the prefecture of Qiannan in Guizhou showed symptoms of suspected avian flu and 8,500 chickens died on Dec. 27, 2013. The National Avian Influenza Reference Laboratory confirmed the epidemic was H5N1 bird flu after testing samples collected at the farm, according to the MOA.”

European Researchers Urge H5N1 Caution
The debate over gain-of-function (GOF) research continues to rage in the scientific community – in the most recent move, fifty scientists have drafted an open letter to the head of the European Commission, urging him to hold a press conference to discuss the merits of GOF research. For those of you not interested in macropolitics within the scientific community, gain-of-function research involves experiments in which viruses are carefully but deliberately mutated to increase pathogenicity in some way – in this case, by increasing transmissiblility between mammals. The research which launched the current maelstrom was Ron Fouchier’s  mutation of H5N1 to make it more transmissible between ferrets (and therefore, also, humans). We’ll leave the polemic arguments to those who are better informed, but in the meantime, the  letter is available here.

Science – “Fouchier’s struggles, which included the Dutch government using export regulations to bar him from publishing his results, compelled the European Society for Virology (ESV) to write its own letter to the EC in October. That letter expressed concern that the Dutch government’s tactics were inappropriate and threatened to set a precedent that could stymie the dissemination of research findings elsewhere. On the scientific side of the debate, some have argued that gain-of-function research, especially those studies that engineer deadly strains of the bird flu virus, can potentially result in inadvertent escapes from the lab and widespread infection. Proponents of the work argue that studying how mutations confer the ability to infect new individuals via novel routes can yield key insights into how the pathogens spread.”

(image of H1N1 via CDC/ Doug Jordan, M.A.)

Flu Season Approaching Peak

The flu is officially here in 10 states, with the dominant strain this season being the H1N1 strain. Alabama, Alaska, Kansas, Louisiana, Massachusetts, New York, Pennsylvania, Texas, Virginia and Wyoming are all reporting widespread activity. The flu season normally peaks in January or early February.

CNN  – “The previous week, only Alabama, Louisiana, New York and Texas reported widespread flu. “Widespread” means that more than 50% of geographic regions in a state — counties, for example — are reporting flu activity. It addresses the spread of the flu, not its severity. However, six states — Alabama, Louisiana, Mississippi, Missouri, Oklahoma and Texas — reported a high proportion of outpatient visits to health care providers for flu-like illnesses. So far, ‘it’s a typical influenza season, if I can use that word,’ said Dr. Michael Jhung, a medical officer in the CDC’s flu division.”

Read more here.

(image via CDC)

The Pandora Report 12.27.13

Highlights include H1N1 in Texas, 59 people with TB, a H7N9 fatality, H5N2 in ostriches, and vaccines coming to a mountain train near you. Happy Friday, and as our last Pandora Report from 2013, Happy New Year!

H1N1 Causes Early Spikes in Flu Cases
The flu season is in full swing, a couple weeks earlier than expected, with five deaths in Texas already. Luckily, the vaccine for this year’s flu contains the H1N1 strain currently predominant. Everyone please get vaccinated!

KUT – “‘[H1N1] is actually in the vaccines this year. So we’re finding that people who have been vaccinated, even if they come down with the illness, have a less severe course of it,’ Hydari said. He added that vaccine shortages that complicated flu season in the past is not an issue this year. Hydari also said that flu vaccines take about two weeks to take affect, and because the flu season typically peaks in January it’s not too late to get a shot this year.”

Dozens Test Positive For Tuberculosis After Exposure at Hospital Neonatal Unit
Fifty-nine people have tested positive for TB following exposure at a hospital in Nevada. A mother and her newborn twins are thought to have brought the bacteria to the hospital over the summer. All three died in the hospital, and were not discovered to have TB until after an autopsy was performed on the mother. Following hospital staff falling ill, and 977 people potentially exposed and subsequently tested, just two had active infections – the 59  mentioned above are latent cases. TB is still very real, and very scary – as this case illustrates, as few as three people can potentially infect dozens.

ABC – “‘Unfortunately, this situation is a hospital epidemiologist’s worst nightmare as neonates are highly susceptible to contracting TB and their infections can progress quite rapidly,’ he said. A mother and her newborn twins died of tuberculosis at Summerlin Hospital over the summer, prompting an investigation by the Southern Nevada Health District. Hospital staff didn’t realize the infected woman had tuberculosis until after she and one of the twins died and they performed an autopsy, according to KTNV, ABC’s Las Vegas affiliate. The other twin was in the NICU being treated without being under quarantine. The second twin also tested positive for tuberculosis and died in August, health department spokeswoman Stephanie Bethel told ABCNews.com.”

 Hong Kong confirms first death from H7N9 bird flu
An eighty-year old male has died from H7N9 in Hong Kong. Still, no confirmed, sustained person-to-person transmission yet.

Reuters – “The man, the second person in Hong Kong to be diagnosed with the virus strain, lived in the southern Chinese city of Shenzhen and had eaten poultry there, media reported. The H7N9 strain was first reported in humans in February in mainland China, and has infected at least 139 people in China, Taiwan and Hong Kong, killing more than 40. Experts say there is no evidence of any easy or sustained human-to-human transmission of H7N9, and so far all people who came into contact with the man had tested negative for the strain, authorities said.”

Low Pathogenic Bird Flu in Western Cape Ostriches
Small outbreaks of H5N2 have been reported in South African ostriches. The low pathogenic influenza strain has been reported in seven farms and roughly 2,000 birds. Authorities remain uncertain as to the source of the outbreaks.

Poultry Site – “The World Organisation for Animal Health (OIE) received follow-up report no. 4 on 23 December. The report states that the affected population comprises commercial ostriches. A total of 10,171 birds were involved, out of which 2,230 tested positive for the virus. None died or been destroyed. According to the OIE’s Animal Health Information Department, H5 and H7 avian influenza in its low pathogenic form in poultry is a notifiable disease as per Chapter 10.4. on avian influenza of the Terrestrial Animal Health Code (2013).”

Keeping Vaccines Fresh
Apparently silicon packets can keep more than your new shoes fresh – scientists at the University of Portland have managed to preserve virus pathogenicity over time by coating the little zombies in a layer of silica. Some viruses subsequently cleansed of the silica coating retained infectivity. While this apparently means viruses may actually be able to survive inside volcanoes (we definitely feel there’s a movie in this somewhere), it also is good news for developing vaccines for use in places lacking widespread refrigeration.

New York Times – “Most vaccines are made of weakened virus or viral bits, and many need refrigeration. Keeping them cold is a major challenge when it comes to protecting children living in villages without electricity.’It’s hard to put a fridge on the back of a donkey,’ said Kenneth M. Stedman, a biologist at Portland State and the lead author of the study. By recreating the chemical-laden hot-spring environment, Dr. Stedman’s team coated four types of virus with silica, stored them, then washed off the silica and tried to infect cells. One heavily studied virus, phage T4, which infects the cells of E. coli bacteria, retained 90 percent of its infectivity for almost a month. The virus used in smallpox vaccines also did well, but it is naturally able to be stored dry.”

(Image: Afrikanischer/Strauss/Wikicommons)