Pandora Report 8.18.2017

ECDC Tool for Prioritizing Biothreats
The European Centre for Disease Prevention and Control has released their tool for the prioritization of infectious disease threats. “This qualitative tool, implemented as an Excel workbook, is based on multi-criteria decision analysis. It ranks infectious disease threats in a transparent, comparable and methodologically reproducible manner. The tool enables the relative ranking of different infectious disease threats. It is intended as a supplement to other methods that also support decision-making in preparedness planning.” Part of the tool involves a scoring of diseases, in which it suggests that a multidisciplinary expert group works to establish reliable information and adequate scoring. The ECDC tool also includes a handbook and manual for users to get the most out of it.

 Long Ignored: The Use of CBW Against Insurgents
GMU Biodefense PhD alum Glenn Cross investigates the use of chemical and biological weapons in counterinsurgency campagins like that of Rhodesia, South Africa, and Syria. Cross notes that history has shown the efficacy of CBW against ill-equipped and often poorly trained insurgents. He points to the debate regarding application of use – some say that these weapons are used when conventional forces are ineffective and often a last resort, while others note that the lack of an international and effective response have given insurgents incentive. “The conclusion from these examples is that regimes in extremis — when the battle is for their very survival — seem to have little compunction about resorting to chemical and biological weapons use. The much-heralded international norms and conventions prohibiting and condemning chemical and biological development and use go out the window when a regime’s survival is at stake. The examples of Rhodesia and Syria show that the international community must be united and demonstrate the requisite political will to enforce norms if the use of chemical and biological weapons is to be prevented.” Cross highlights two case studies, Rhodesia and Syria, pointing to the use of biological weapons by Rhodesian forces as being the only example of a nation using bioweapons since the end of WWII. While the regime was aware of treaty obligations, it had no bearing on their decision to use such weapons. So what are effective constrains on the use of CBW? The case studies reveal that regimes care little about their efficacy, international norms, or international agreements, but it is really deterrence that likely prevents the use of such weapons. The credible threat of military action is the strongest deterrent and realistically, until international norms include uniform enforcement amongst nations, they won’t be as effective. “As we’ve seen in Syria, such consensus is elusive, and the international community has failed to act. As a consequence, the world faces a sad, but inevitable conclusion. The Syrian regime is unlikely to ever face justice for its use of chemical weapons.”

A View from the CT Foxhole: Edward You, FBI Weapons of Mass Destruction Directorate, Biological Countermeasures Unit
As if we need any more reasons to think Edward You is a biosecurity action hero! The Combating Terrorism Center recently sat down with Supervisory Special Agent in the FBI’s WMD Directorate, Biological Countermeasures Unit, and discussed not only his role within the FBI but also their work and coordination with partners. You notes that hisprimary mission is to support outreach and engagement, but probably most importantly it is to backstop the WMD Coordinators who are positioned in the field. They have to cover the whole broad range of modalities—chem, bio, nuke, explosives. They do the initial engagements, the partnerships, the initial response, but they can always call back to headquarters where we leverage all of our expertise as subject matter experts. We can bring in the laboratory division; we can bring in Centers for Disease Control and Prevention (CDC), if necessary, the Department of Homeland Security to support them when they run into an incident out in the field.” He emphasizes the importance of the relationship the FBI has with the private sector, not only in terms of shared interests, but also communicating security problems to help get more buy-in and coordination. When asked about the DIY biohacker, You notes that “We look at these community labs as a big positive force in the economy and engines of innovation. That has helped us overcome the natural tendency for such outfits to be a little bit anti-establishment. By engaging with them, we’re helping them to raise their level of awareness that they could potentially be targeted by malicious actors seeking to subvert their work, steal their technology, or recruit insiders on their staff. By helping them establish a form of ‘neighborhood watch,’ they will be best positioned to identify and report on instances of suspicious activity both internal and external to their community. Who better to identify threats than the community members themselves?” While the partnerships with DIY labs haven’t garnered any leads to potential threats, they help the FBI understand the direction biotech is heading, which allows them to flag areas of concern faster than if they used a top-down approach. You also addresses the 2016 Europol warning of potential ISIS experimentation with bioweapons, commenting that “With ISIS, al-Qa`ida, or any other threat actor for that matter, we are faced with two significant challenges. The first is ideology. What happens if that lone individual that becomes persuaded by their ideology happens to be a microbiologist or a biochemist? The counter WMD mission has always proceeded by identifying the actors expressing the intent to acquire, develop, or use WMDs (e.g., counterproliferation efforts). And historically, significant effort and investments have been made to counter the biological weapon threat ranging from state/non-state actors to individual level biological crimes (e.g., attempted ricin poisonings). But this introduces the second challenge. Unlike the chemical and radiological/nuclear realms where materials of concern are highly regulated and the expertise is almost arcane, biology could be classified as dual use or multi-use. The strength of the field is based on the fact that it is inherently open in nature (e.g., peer-reviewed scientific journals), which has led to significant advances in areas such as healthcare.” Lastly, You points to what he considers the greatest biosecurity threat facing the U.S. – the concerns of non-state actors, but also the role of data in terms of gene editing and other biotech, noting that “we may have have been short-sighted. Most of our legal frameworks have been focused on privacy and not on security.” “Because there’s a lack of understanding about where bio is going, we’re in danger of falling behind, and my biggest concern is that for lack of our foresight and being strategic in this space, I think China is going to become a potential biological superpower.” Did I mention that Edward You is frequently a speaker at our summer workshops?

North Korea’s Chemical Arsenal Complicates U.S. Options 
As concerns over North Korea’s nuclear weapons program grows, the threat of chemical weapons has seemingly been downplayed. Tackling nuclear threats through preemptive strikes could push North Korea to utilize their chemical weapons program and sizable stockpile, which is considered to be one of the largest. “Experts are also disturbed by Kim Jong-un’s brazen public assassination of his half-brother using the nerve agent VX, saying it demonstrates the regime’s willingness to use deadly toxins. ‘I think if people paid more attention to the chemical side, they’d be less inclined to talk about preemption and going first against North Korea,’ said Greg Koblentz, a researcher of weapons of mass destruction at George Mason University.” In the event that chemical weapons are deployed, the South Korean capitol of Seoul would surely take a hit, which is home to 25 million people. While details of North Korea’s biological weapons program have given little insight into what is actually going on, there is considerably more knowledge regarding their chemical weapons initiatives. “The exact composition and size of North Korea’s chemical arsenal is unclear, but it’s believed to include everything from antiquated chlorine gas all the way up to sarin, VX, and other highly lethal nerve agents. These weapons are distributed at facilities across the country, often tucked away in underground bunkers or other sites unknown to U.S. and allied intelligence. The weapons are also deployed along the armistice line, which sits just 35 miles north of Seoul.” While there are limits to their chemical weapons capabilities, they surely provide little comfort to South Korean citizens and those living in Seoul.

 Chatting With the WHO
New WHO Director-General Tedros Adhanom Ghebreyesus spoke with Foreign Affairs’ regarding his plans for the future of the WHO and efforts to combat global disease. Tedros notes that epidemics or pandemics keep him up at night, especially something like the 1918 pandemic and the “serious gaps we have”. He comments that “I think the world should unite and focus on strong health systems to prepare the whole world to prevent epidemics—or if there is an outbreak, to manage it quickly—because viruses don’t respect borders, and they don’t need visas.” In regards to irrational beliefs as a public health threat, Tedros highlights the role of governments (and the WHO in supporting them) to communicate with communities and use media as a tool for teaching. Tedros discussed the WHO’s response to Ebola and when asked about hesitancy governments may experience regarding raising the alarm for an outbreak, he noted that “it’s not an issue between the WHO and the member state in question; it’s about the overall implementation of the International Health Regulations [the rules that govern how states respond to outbreaks]. That involves not only the country in question but other countries, as well. For instance, a country may fear the impact on the economy if it reports a certain disease. And if the other countries, instead of banning travel or other measures, could be supportive and implement the IHR, then the country could be encouraged to report immediately.”

Book Review – Barriers to Bioweapons
As the summer winds down, you may find yourself needing a new book to delve into. GMU biodefense professor Sonia Ben Ougrham-Gormley‘s book, Barriers to Bioweapons, is a great addition to any lover of health security and the realities of biological experiments. This latest book review gives a witty and entertaining overview of her work, noting that “Barriers to Bioweapons argues that actually, we’re not all living on borrowed time – that there are real organizational and expertise challenges to successfully creating bioweapons. She then discusses specific historical programs, and their implications for biosecurity in the future.”

Pandemic Preparedness & A Global Catastrophic Biological Risk By Any Other Name Would Smell As Sweet

GMU biodefense PhD student Saskia Popescu tackles the importance of pandemic preparedness and the latest publication from the Center for Health Security regarding global catastrophic biological risks. “We may think written plans and the occasional table-top exercise are making us more prepared to handle a pandemic, but true preparation goes far beyond that. The ability to prevent, detect, respond, and control outbreaks is a hefty investment that countries are still struggling to make, and as a new report recently revealed, a paltry amount of countries may be ready for a pandemic.” She highlights the latest World Bank report that only six countries have truly taken efforts to evaluate their readiness to handle a pandemic. Like many things, the devil is in the details, and often that is as simple as a real name for a problem. A recent publication from the Johns Hopkins Center for Health Security sought to fix this by establishing a working definition for global catastrophic biological risks (GCBR). “What makes this definition unique, aside from it being the first working definition for GCBRs, is that it highlights several components, such as sustained catastrophic damage, and instead of highlighting a specific number of deaths, it looks to a range of negative outcomes, such as infertility. The challenging task of defining such a globally feared, but poorly understood risk was daunting; however, the Center for Health Security has provided us with a working tool that can now be applied to policy, and future preparedness and response efforts.”

H5 Hits the Philippines and Plague in Arizona
The Philippines is reporting its first highly pathogenic H5 avian influenza outbreak. Hitting a commercial poultry farm in Luzon, the outbreak began in July and killed 36,485 of the 190,000 birds. “A report today in the Manila Times, based on a media briefing with Emmanuel Pinol, the country’s agriculture secretary, said the outbreak was confirmed in the city of San Luis and that six poultry farms were affected. Most of the poultry deaths were in layer chickens. Pinol told reporters that the outbreak may have begun as early as April when deaths were reported in quail housed above ducks. He said ducks are the likely source of the outbreak, since they had contact with migratory birds. The Manila Times report said the outbreak site is 37 miles north of Manila and is close to swamps that are stopovers for migratory birds from the Asian mainland.” Public health officials in Arizona have announced that fleas in two counties have tested positive for plague (Yersinia pestis). While plague is endemic in the southwest, public health officials still work to ensure residents are aware that there is an increased risk. Officials are warning residents to be mindful of the potential for exposure via pets. “Fleas can bite rabbits, prairie dogs and other rodents — and anything that may eat them — and transfer the disease to pets, who in turn can infect humans. Cats who get plague transmit it through their cough. Dogs typically carry the fleas on their fur. Health officials cautioned county residents and visitors to keep their pets leashed and to avoid touching dead animals. Evidence of a large die-off could indicate plague is present, they say.”

Strategies for Identifying and Addressing Biodefense Vulnerabilities Posed by Synthetic Biology
Don’t miss out on these events by the National Academies Committee on Strategies for Identifying and Addressing Biodefense Vulnerabilities Posed by Synthetic Biology:

  • August 21 – the committee’s interim report and proposed framework will be released at 11am EDT here
  • August 22 – a public release webinar and report briefing will be held from 11am-12pm EDT. Committee Chair Michael Imperiale and committee members Patrick Boyle and Andrew Ellington will be reviewing the interim report and the proposed framework. This webinar is free to attend and open to the public, but you must register to attend. You can register at the following link:  https://nasevents.webex.com/nasevents/onstage/g.php?MTID=e39277a767b1f0190db4f7ee491c01271  You will be able to submit questions and comments during this webinar through a text-based feature but will not be able to speak directly with the presenters.
  • August 23-24: The meeting will be held at the National Academies of Sciences, Engineering, and Medicine’s Keck Center at 500 5th Street NW, Washington, DC Room 208. You must register to attend the meeting in person; the Keck Center is a secure building and we will need to have your name on the guard’s list to enter the building. You can register by emailing synbiodefense@nas.edu. If you would like to attend via teleconference, you can access the conference by dialing the following: to listen, please dial 1-(866) 668-0721 and use conference code 380 454 1676.

The committee is also soliciting feedback from the public on the interim report and the associated framework. You can submit questions or comments through September 5, 2017 at the following link:  http://www.surveygizmo.com/s3/3758337/A-Proposed-Framework-For-Identifying-Potential-Biodefense-Vulnerabilities-Posed-By-Synthetic-Biology  Due to the anticipated volume of questions, the committee may not explicitly address every comment received but all comments will be considered and reviewed. PLEASE NOTE: if you submit a question, your question and any associated identifying information you provide will be added to the study’s public access file as per the National Academies’ requirements to comply with FACA.

Stories You May Have Missed:

  • Uganda Ebola-like Illness Demystified- Public health officials in Uganda are sighing with relief as results from the Uganda Virus Research Institute (UVRI) have reported the death of a 20-year-old woman in Luweero was due to carbon monoxide poisoning and not the suspected Ebola virus. “There are currently 3 female cases admitted at Bishop Asili hospital, Luweero. However, results from UVRI indicate that all cases were negative for Ebola, Marburg, Crimean-Congo hemorrhagic fever, Rift Valley fever, and Sosuga viruses. ‘The ministry of health team is working closely with the District Health Team to monitor, review, and manage these cases as well as orienting health workers on management and referral protocols of suspected cases,’ reads the statement.”

Pandora Report 6.23.2017

TGIF! Before we begin our weekly dose of all things biodefense, have you ever wondered the traits that predict animal or host spillover?

What Does A Post-Polio World Look Like?
Decades of battling diseases in eradication efforts has been a struggle throughout public health history, but what happens when you finally reach the finish line? Donors around the world have worked to eliminate polio and in the final stretch and last ditch efforts, many are asking what will happen when polio is eradicated and the donors are gone? The truth is that many polio eradication programs (which include vaccination and surveillance campaigns) actually form the foundation of public health for many countries and rural areas. These programs have been the backbone of establishing some semblance of public health for areas that many not receive it otherwise. “If and when polio is gone, however, much of the transition may fall to national governments. International funding stands to shrink dramatically. About 27 percent of WHO’s $587 million in spending in 2016 went to polio eradication efforts. The African region would also be particularly hard hit. Forty-four percent of WHO spending there went to polio efforts, and about 90 percent of all immunization staff and infrastructure on the continent are funded through the WHO’s Global Polio Eradication Initiative.” We haven’t really considered what it means to eradicate a disease like polio and how the withdrawing of funds and personnel might impact countries. Moreover, many of the polio eradication programs are closely tied to other vaccination programs (measles, tetanus, pertussis, etc.) and if funds are lost because polio is eradicated, these other vaccination programs could take a hit. Aside from vaccination initiatives, if stable public health programs are not established prior to eradicating polio, there is also a risk for loss of disease surveillance. Current polio eradication programs highlight the role of surveillance, which is also used to facilitate laboratory development, all of which could impact pandemic preparedness and global health security. It is vital that efforts to eradicate polio are also met with work from political leadership to ensure a transition occurs that maintains public health efforts. “The transition as polio is eradicated will be complex, and needs to be carefully managed, country specific and country led. Polio surveillance systems can provide an important foundation, and are tremendous assets to health care systems, said Irene Koek, the deputy assistant administrator of global health at the United States Agency for International Development. Civil society organizations will have a role to play in advocating to keep local governments and ministries on target, said John Lange, the United Nations Foundation‘s senior fellow for global health diplomacy.”

Instructor Spotlight – Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
We’re getting closer to the July 17th start date for our workshop (and the July 1st early registration discount expiration!) and this week we’re excited to show off one of our very own GMU Biodefense professors, Dr. Sonia Ben Ouagrham-Gormley. An economics and defense expert, biodefense guru, and world traveler, Dr. Ouagrham-Gormley is the kind of professor whose class you spend the entire time on the edge of your seat. Sonia Ben Ouagrham-Gormley, PhD, is an Associate Professor in the Schar School of Policy and Government at George Mason University. She holds affiliations with GMU’s Biodefense Program, Center for Global Studies, and the Department of History and Art History’s Master of Arts in Interdisciplinary Studies (MAIS) program. Prior to joining the faculty at George Mason in 2008, Professor Ben Ouagrham-Gormley was a Senior Research Associate with the Monterey Institute of International Studies’ James Martin Center for Nonproliferation Studies (CNS). While at CNS, she spent two years at the CNS Almaty office in Kazakhstan, where she served as Director of Research. She also was the founding Editor-in-Chief of the International Export Control Observer, a monthly publication focusing on proliferation developments and export controls around the globe. From 2004 to 2008, she was an adjunct professor at Johns Hopkins’ School of Advanced International Studies in Washington, D.C. She is the author of Barriers to Bioweapons: The Challenges of Expertise and Organization for Weapons Development (Cornell University Press, 2014). She received her PhD in Development Economics from the Ecoles des Hautes Etudes en Sciences Sociales (EHESS) in Paris; a graduate degree in Strategy and Defense Policy from the Ecoles des Hautes Etudes Internationales in Paris; a master’s degree in Applied Foreign Languages (triple major in economics, law, and foreign languages —Russian, and English) from the University of Paris X-Nanterre, and a dual undergraduate degree in Applied Foreign Languages and English Literature from the University of Paris X-Nanterre. She is fluent in French, English, Russian, and spoken Arabic, and possesses beginner competence in Kazakh. For more information, visit https://schar.gmu.edu/about/faculty-directory/sonia-ben-ouagrham-gormley

President’s Budget Would Leave U.S. Vulnerable to Global Health Security Threats and Why We Need An Emergency Fund For Future Outbreaks
Cuts to public health, health research, and international aid have some pretty far-reaching implications and faculty from the Johns Hopkins Center for Health Security are pointing to the inherent vulnerability that would come from Trump’s proposed budget. Health security incorporates several programs and the reality is that an epidemic anywhere means an epidemic everywhere – simply put, the outbreaks that could pose a threat to the U.S. commonly begin abroad. “The proposed budget would cut $76 million from CDC’s Global Health programs, including cuts to Global Disease Detection and other programs that train and prepare countries to diagnose and respond to emerging diseases, and to the Global Immunization Program. It would reduce by $65 million CDC’s Emerging and Zoonotic Infectious Diseases programs, which aim to prevent and control outbreaks of diseases such as Zika. It cuts by $136 million the CDC Preparedness and Response Capability budget, which includes the funding for CDC’s Emergency Operations Center and the deployment of its people abroad to emergencies such as the Ebola epidemic in West Africa.” The CDC, among other agencies with biodefense positions, has a significant volume of vacancies that haven’t been filled.  More over, the authors point to the gap within the president’s budget regarding the future work of the GHSA, which is a vital multi-lateral effort to strengthen global health security. The budget has many worried because together, these cuts paint a bleak future for health security efforts – impacting surveillance, preparedness, and response efforts across the board. Global health security is simply not an investment we can afford to ignore. Did I mention that co-author Jennifer Nuzzo is also an adjunct professor at GMU’s biodefense program? Even if you’re not worried about the impact of the budget on health security, Ebola and Zika revealed just how necessary an emergency fund for outbreaks really is. “Creating a similar ‘rainy day’ fund—and providing the Centers for Disease Control and Prevention with permission to use it in advance—could save lives and money, both at home and overseas. The idea behind an emergency fund is not to displace efforts to combat infectious disease but to ramp them up to meet a crushing temporary need. During an outbreak the CDC can call on many doctors and nurses to work without pay, but the costs of transportation, medical supplies and protective equipment still have to be covered.” While the president’s 2018 budget includes such a fund, it fails to give a specific dollar figure and is already cutting into public health funding, which may be counterintuitive. “Lawmakers need to follow through by approving one or both of the proposed measures for the president to sign to ensure that the money will be there when the next public health emergency strikes.”

North Korea & A Sea of Sarin
The threat of nuclear-armed ballistic missiles from North Korea is a growing concern and while many focus on their nuclear and ballistic missile ambition, Reid Kirby is examining North Korean chemical weapons. Looking at the Terminal High Altitude Area Defense (THAAD) missile system and South Korean capital of Seoul, which houses more than 10 million people, many worry about North Korea’s ongoing vague threats. “Proponents of preemptive military action against North Korea’s nuclear program, along the lines of Israel’s 1981 Operation Opera against Iraq’s nuclear program, typically ignore North Korea’s history of asymmetrical responses. But North Korea’s capacity to inflict mass chemical casualties on the Seoul area in a ‘sea of sarin’ attack rivals its capacity for nuclear destruction.” In 2010, it was estimated that North Korea possessed 2,500-5,000 tons of chemical weapons (mostly sarin and VX) and maintains roughly eight manufacturing facilities, which could ramp up production to 12,000 tons. Kirby addresses estimates of rounds per minute and calculations of how much sarin Seoul might receive in such an attack, noting that “a heuristic approach to estimating the total quantity of sarin required to inflict 25 percent casualties on a city such as Seoul under the specified conditions simplifies the problem into a box model of 600 square kilometers, with casualty rates integrated by area to find the necessary quantity. Using this approach, a ‘sea of sarin’ attack on Seoul would require about 400 kilograms of sarin per square kilometer”. He highlights the consequences of a 240-ton sarin attack on Seoul, noting that it would kill around 6.5% (higher lethal dosage) or potentially 25% of the population (if lower lethal dosage assumed). “If publicly stated intelligence estimates are to be believed, North Korea’s chemical arsenal represents a credible and present threat. How North Korea could apply this threat as a deterrent is speculative. But the destructive potential of the threat should give reasonable cause to hesitate regarding preemptive military options against North Korea’s nuclear weapons ambitions.”

Pandemic Flu Plan – A New Approach
The US Department of Health and Human Services (DHHS) just released their updates to pandemic flu plans. “The original plan was geared toward a more severe scenario and set a goal of delivering pandemic vaccine within 6 months of a pandemic declaration. The new document incorporates lessons learned from the 2009 H1N1 pandemic, which resulted in a less severe event. It also spells out the goal of having the first vaccine doses ready within 3 months of pandemic strain emergence, along with approved broad-spectrum antivirals.” Within the plan there are now seven domains of focus, which include objectives, goals, and key steps. The domains are: surveillance, epidemiology, and lab activities, community mitigation measures, medical countermeasures, healthcare system preparedness and response, communications and public outreach, scientific infrastructure and preparedness, domestic and international response policy, incident response, and global partnerships. You can read the plan here, in which HHS notes that they are exploring several innovative approaches to pandemic flu preparedness like re-conceptualizing respiratory protection, accelerating vaccine and antiviral development, building on emerging technologies for innovative diagnostic and diagnostic testing, etc. “Taken together, the updated domains reflect an end-to-end systems approach to improving the way preparedness and response are integrated across sectors and disciplines, while remaining flexible for the conditions surrounding a specific pandemic. This more-nuanced and contemporary approach recognizes the interdependence of domain areas, which should lead to a better understanding of how the system functions as a whole.” The updated HHS pandemic plan emphasizes that while the nature of influenza and pandemics may change, the importance of planning and strengthening critical infrastructure will always be necessary.

DoD Tick-Borne Disease Research Program
There’s been increasing attention to the threat of tick-borne diseases and the DoD is ramping up research efforts. Their Tick-Borne Disease Research Program (TBDRP) looks to help increase not only treatment efforts, but also diagnostic capacity. Created in 2016, the TBDRP works to fill the gaps within tick-borne disease research through programs like the Idea Award which encourages and supports investigators in the early stages of their career. The New Investigator aspect of this award aims at those postdoctoral fellows working to develop independent research and in the early stages of faculty appointments. “There are currently at least 16 known tick-borne illnesses, with emerging diseases being discovered all the time. In the United States, the yearly cases of Lyme disease and other tick-borne diseases, including spotted fever rickettsiosis, anaplasmosis, and ehrlichiosis, have been increasing steadily for years, currently totaling tens of thousands of people diagnosed annually, with more likely undiagnosed. Globally, the US Military prioritizes tick-borne Crimean-Congo hemorrhagic fever as an operational threat abroad. The FY17 TBDRP intends to support conceptually innovative, high-risk/potentially high-reward research in the early stages of development that could lead to critical discoveries or major advancements that will accelerate progress in improving outcomes for individuals affected by Lyme disease and/or other tick-borne illnesses.”

Health Sector Resilience Checklist for High- Consequence Infectious Diseases
Johns Hopkins Center for Health Security and the CDC jointed together to take the lessons learned from Ebola and build a checklist to strengthen the U.S. in the event of such high-consequence outbreaks. This checklist focused on high-consequence infectious diseases (HCIDs), which are novel, moderate to highly contagious, moderate to highly lethal, not easily controllable by MCM or non-pharmaceutical intervention, and cause exception public concern (think Ebola, MERS, H5N1, etc.). “The principal aim of this project was to develop evidence-based recommendations to enable communities to build health sector resilience to events involving HCIDs based on the domestic response to confirmed cases of EVD in the United States.” Aside from the checklist, their findings highlight issues with governance and coordination, communication, public health issues, health-care specific issues, EMS, and laboratories.  The general checklist itself includes sections on preparedness, leadership, creative flexibility, command structure, public trust, managing uncertainty, and crisis and emergency risk communication. There are also checklists for public health, healthcare, EMS, and elected officials, which includes things like a collaborative relationship with partners at other healthcare facilities and awareness of resources related to public health law expertise.

Stories You May Have Missed:

  • Anthrax: DoD Develops Biological Select Agents & Toxins Surrogate Solution – “The Defense Biological Product Assurance Office (DBPAO), a component of the Joint Program Executive Office for Chemical and Biological Defense, has announced the development of a Biological Select Agents and Toxins (BSAT) surrogate solution that will mitigate the risks associated with shipment and use of Bacillus anthracis. In addition to risk mitigation for Department of Defense (DoD) stakeholders and the community at large, this product demonstrates DBPAO’s commitment to providing quality reagents to the DoD and to the biodefense community. To accomplish this task, the DBPAO developed a Bacillus anthracis surrogate strain named Recombinant Bacillus anthracis with Assay Targets (rBaSwAT) using a recombinant DNA approach to create a BSL-2-level genetically modified organism that will allow continuation of operations with reduced risk. The strain is built in a novel, non-virulent Bacillus anthracis background and carries a comprehensive complement of anthrax specific molecular and immunological markers.”
  • Bioviolence- Matt Watson from Johns Hopkins Center for Health Security, is taking us through the history of bioviolence aka using infectious diseases for violent purposes. While not everyone truly sees the immediate threat of biological agents, Watson highlights the newer threats like synbio and biotechnologis that have growing potential for misuse. He also takes care to highlight the history of bioweapons to truly show the range of their application. “Of all the scourges of mankind, plagues and warfare are almost certainly the most dreaded and dangerous. Several times throughout history—and more frequently than most people are aware of—there have been attempts by individuals, organizations, and nation-states to harness the former in service of the latter.” If you want a brief overview of historical biological weapons and to truly understand the future of biothreats, don’t miss out on this great op-ed.
  • New York City Legionnares’ Cluster – Health officials are scrambling to investigate the source of a NYC Legionnaires’ cluster in Manhattan. “In a Jun 16 statement, the New York City Department of Health and Mental Hygiene (DOHMH) said seven illnesses have been confirmed over the past 11 days. Four people are recovering in the hospital, two have been discharged, and one person in his or her 90s with underlying health conditions has died. Authorities are sampling and testing all cooling tower systems within a half-kilometer radius of the affected area of Lennox Hill. The health department is urging New Yorkers who have respiratory symptoms such as fever, cough, and chills to promptly seek medical care. In a typical year, about 200 to 400 Legionnaires’ cases are reported in New York City.” Legionnaires’ can be deadly for immunocompromised patients and is often a result of water treatment issues or poor disinfecting processes with spas, hot tubs, humidifiers, condensers, etc.

 

Pandora Report 5.24.15

Two quick updates before we get into the weekly wrap-up.

First, the Early Registration Deadline for the Pandemics, Bioterrorism, and International Security professional education course at the GMU Arlington Campus has been extended to June 15. For more information and registration, please click here.

Second, we here at Pandora Report wanted to let you know about a new website designed to provide resources for biosecurity professionals and practitioners and key stakeholders. The International Biosecurity Prevention Forum (IBPF) brings together the world’s leading experts from the health and security communities to share expertise on key biosecurity and bioterrorism prevention issues. Registering to join IBPF is free and easy. Go to http://www.ibpforum.organd click the “Request Membership” button to request an IBPF member account. Members get access to a discussion section and projects, resources, and best practices submitted by other members. Contact the IBPF support team at IBPForum@ic.fbi.gov if you have any questions or problems.

Now, onto the news. This weekend we have stories about British nuclear submarines, anti-vaccine legislation in California, the development of bird flu vaccines, and other stories you may have missed.

Enjoy your Memorial Day weekend!!

Britain Investigates Sailor’s Disaster Warning Over Nuclear Subs

Able Seaman William McNeilly—a weapons engineer who served aboard HMS Vanguard, one of the four British submarines carrying Trident missiles—wrote a “lengthy dossier” released on the internet which says that the “Trident nuclear defense system was vulnerable both to enemies and to potentially devastating accidents because of safety failures.” McNeilly has since gone AWOL and both police and naval officials are trying to locate him.

The Japan Times—“The Royal Navy said it totally disagreed with McNeilly’s “subjective and unsubstantiated personal views,” describing him as a “very junior sailor.” But it added it was investigating both his claims and the “unauthorized release” of his dossier. “The naval service operates its submarine fleet under the most stringent safety regime and submarines do not go to sea unless they are completely safe to do so,” a spokeswoman said.”

A Blow to Anti-Vaxxers: California Approves Forced Vaccination Bill

By now, we all know that the measles outbreak that started last winter at Disneyland was a result of unvaccinated individuals. In California, the State Senate has passed a bill which limits parent’s use of the “personal belief exemption” in order to get out of getting their children vaccinated. Under the bill, parents who don’t get their children vaccinated would not be able to send their kids to state-licensed schools, nurseries, or day care centers.

State Column—“Only children who have a medical reason for why they can’t be vaccinated would still be allowed to attend schools without receiving their vaccinations under Senate Bill 277, which was sponsored by a California Sen. Dr. Richard Pan (D-Sacremento), a pediatrician, and Ben Allen (D-Santa Monica), a former school board member and the son of a survivor of polio, according to a Forbes report.”

Vaccines Developed for H5N1, H7N9 Avian Flu

Findings appearing in the Journal of Virology indicate that the U.S. Department of Homeland Security’s Center of Excellence for Emerging and Zoonotic Animal Diseases have developed a vaccine for both H5N1 and H7N9—two strains of avian influenza which can be transmitted from poultry to humans. The vaccine was developed by cloning the Newcastle disease virus and transplanting a small section of the H5N1 virus into it; the same method was used for the H7N9 vaccine.

Toronto Sun—“‘We believe this Newcastle disease virus concept works very well for poultry because you kill two birds with one stone, metaphorically speaking,” Richt said. “You use only one vector to vaccinate and protect against a selected virus strain of avian influenza.’”

Stories You May Have Missed

  

Image Credit: UK Ministry of Defence

Pandora Report 3.15.15

For those of us at Mason, Spring Break is nearing its end. For the rest of us, however, it’s business as usual. This week we’ve got stories about engineering nuclear worries in South Africa, the eradication of guinea worm, the lasting health impacts of Ebola, and other stories you may have missed.

Have a great week, enjoy the longer daylight hours, and we’ll see you back here next weekend!

U.S. Unease about Nuclear-Weapons Fuel Takes Aim at a South African Vault

Located in a former silver vault at a nuclear research center near Pretoria, South Africa, is enough nuclear weapons explosive to fuel half a dozen bombs. Roughly 485 pounds of highly enriched uranium exist as remnants of the apartheid regime’s nuclear weapons program. U.S. officials worry that not only does this stockpile give South Africa the theoretical ability to regain its status as a nuclear-weapons state, but the stockpile’s vulnerability makes it a target for terrorist thieves. This isn’t a far-fetched concept, because in November 2007 two teams of raiders breached the fences at the nuclear center, entered the site, and broke into the central alarm station. Obama has urged President Jacob Zuma to transform the nuclear explosives into benign reactor fuel—with U.S. assistance—to no avail.

The Washington Post—“‘The bottom line is that South Africa has a crime problem,” [arms control expert Jon] Wolfsthal said. “They have a facility that is holding onto material that they don’t need and a political chip on their shoulder about giving up that material. That has rightly concerned the United States, which is trying to get rid of any cache of HEU [highly enriched uranium] that is still out there.’”

Tug of War: On the Verge of the Greatest Public Health Triumph of the 21st Century

As people work around the world to eradicate Polio, another public health enemy is about to be eliminated first—guinea worm. This parasite, found in rivers and streams, enters the body in larval form through contaminated drinking water. The larvae mature inside the body and move towards the skin’s surface in the form of a burning blister. When the infected human puts water on the blister, the worm bursts out into water, continuing the source infection cycle. However, the number of cases of guinea worm is way down—from 3.5 million cases in 1986 to 126 cases in 2014—thanks to a simple nylon filter attached to a drinking straw. The weave on the nylon is tight enough to filter out the larvae from drinking water.

Slate—“Vanquishing guinea worm would be arguably the first great public health triumph of the 21st century. It would also give new life to the human disease eradication movement, which suffered through 35 mostly frustrating years following the conquest of smallpox in 1980. The victory would prove to governments and private foundations that we can still accomplish eradication.”

Ebola Could Cause Thousands More Deaths—By Ushering in Measles

As Liberia removed their Ebola crematorium—with the declaration that the outbreak is contained—new cases of the disease are still popping up in Sierra Leone and Guinea and have resulted in nearly a dozen American volunteers returning to U.S. facilities for treatment.  And this week, in Science, researchers from NIH and four universities have warned that Ebola’s interruption in other health services—like immunization campaigns—could result in epidemics of preventable diseases with larger fatality numbers than Ebola. Specifically, they warn that up to 100,000 cases of measles could result in 16,000 additional deaths.

Wired—“Measles is already present in West Africa, so the team is not arguing that Ebola will revive an eradicated disease — although, poignantly, hard work in the three countries had recently forced measles incidence way down. “Between 1994 and 2003, the countries reported — and this is just how many they reported, not necessarily how many occurred — about 100,000 cases of measles,” Lessler said. “Whereas in the last decade, they’ve only reported 7,000. So they’ve done an excellent job of controlling the virus compared to the previous (decade).’”

Stories You May Have Missed

 

Image Credit: FEMA

Pandora Report 12.7.14

I hope all of you had a wonderful Thanksgiving! There were a lot of stories to consider for this extra long (extra late) week in review. We cover the AIDS pandemic, Avian Influenza, Polio in Pakistan, and, of course, Ebola. For those of you in school, I hope your papers and exams aren’t too overwhelming! For everyone else, have a wonderful week, hopefully paper and exam-free week!

AIDS Campaigners Say Pandemic Has Finally Reached Tipping Point

A report released by the ONE campaign to mark World AIDS Day on December 1 said that “the world has finally reached “the beginning of the end” of the AIDS pandemic that has infected and killed millions in the past 30 years.” What is the tipping point? The number of newly infected HIV patients is lower than the number of HIV positive patients who have access to retroviral medications that keep AIDS at bay. However, this doesn’t mean the fight is over.

Reuters—“‘We’ve passed the tipping point in the AIDS fight at the global level, but not all countries are there yet, and the gains made can easily stall or unravel,” said Erin Hohlfelder, ONE’s director of global health policy.”

FAO, OIE Warn of Avian Influenza’s Rapid Spread

The Food and Agriculture Organization of the United Nations and the World Organization for Animal Health have warned that the new avian flu strain detected in Europe is similar to those found in Asia and pose a significant threat to the poultry sector. Evidence of H5N8 has been found in Germany, the Netherlands, and the United Kingdom, as well as China, Japan, and South Korea. So far, it doesn’t appear this strain is infecting people, however, this week there were reported human cases and deaths from H5N1.

The Poultry Site—“The new virus strain provides a stark reminder to the world that avian influenza viruses continue to evolve and emerge with potential threats to public health, food security and nutrition, to the livelihoods of vulnerable poultry farmers, as well as to trade and national economies. Therefore extreme vigilance is strongly recommended while progressive control efforts must be sustained and financed.”

Pakistan Polio Outbreak ‘Will Probably be Fixed Next Year’ says WHO Official

So far this year there have been 262 cases of polio detected in Pakistan, which is the highest number of cases in 14 years. Pakistan is one of only three countries in the world, including Afghanistan and Nigeria, where the virus remains endemic. Despite these numbers, a WHO official in Pakistan says the disease will “most probably be fixed in the first half of 2015.” Military campaigns around the country have not only made vaccination more difficult but have faced tribal militants who banned all vaccinations.

The Guardian—“Persistent public awareness campaigns have not fully quashed popular fears that the drops given to children – a solution of highly weakened polio virus – are part of a western conspiracy to make Muslims infertile.

The Pakistani Taliban have attacked and killed health workers who conduct door-to-door campaigns, forcing the government to mount massive security operations during major vaccination drives.”

This Week in Ebola

We’ve got a lot of news from the last two weeks, so today, let’s start stateside.

The CDC says you can stop worrying because it is very unlikely that Ebola will become airborne, so you can stop cancelling your African safaris. Ebola anxiety has left the U.S. buying up all the PPEs leaving little for workers in West Africa, while the Director of the Harvard School of Public Health Emergency Preparedness has said that U.S. quarantine policy could discourage volunteers from going to help the outbreak. However, recently, no one has been caught in quarantines entering New York and New Jersey airports. 35 American hospitals have been designated as Ebola centers and already the U.S. government is looking past Ebola for the next health disaster. Meanwhile, the first human trial of an experimental vaccine for the virus has produced promising results.

Overseas, the German airline Lufthansa adapted an A340-300 to transport Ebola patients. In Liberia, the President has banned election rallies and mass gatherings under the reasoning that they risk worsening the spread of the virus and Ebola moves out of the cities, it is ‘pingponging’ into rural areas. In Sierra Leone there are approximately 80-100 new cases of Ebola daily, they are running out of beds, and in protest of non-payment, burial workers are dumping bodies in public in the city of Kenema. One piece of good news coming out of this outbreak that has affected more than 16,000 people is that female genital mutilation is on the decline. Also, a new 15-minute test for Ebola is being tested in Guinea, which, if it works, will help medical staff identify and isolate Ebola patients sooner.

The UN warns that the longer the disease is allowed to spread unchecked in West Africa, the more likely it is that Ebola will appear in new places in the world but EcoHealth journal notes that closer study of zoonotic diseases could help prevent Ebola and other diseases from affecting humans. Don’t worry though, according to North Korea Ebola isn’t a zoonotic disease, it is a bioweapon created by the U.S.

Stories You May Have Missed

 

Image Credit: Free Internet Pictures

Pandora Report 11.9.14

We’ve got some timely stories this week: just in time for Veteran’s Day, we look at military exposure to chemical agents in Iraq, and at the beginning of flu season we look at the newest suspension of Yoshihiro Kawaoka’s H5N1 research. We’ve also got an Ebola update.

Have a great week!

More Than 600 Reported Chemical Exposure in Iraq, Pentagon Acknowledges

With Veteran’s Day on Tuesday, The New York Times uncovered an unfortunate military oversight that could affect over 600 service members. Originally, NYT found 17 soldiers who had been exposed to abandoned, damaged, or degraded chemical weapons in Iraq. Later 25 more came forward, and after a review of Pentagon records, Defense Secretary Chuck Hagel has said that hundreds of troops told the military they were exposed. The Pentagon says it will now expand outreach to veterans who believe they may have been exposed.

The New York Times—“Phillip Carter, who leads veterans programs at the Center for a New American Security, called the Pentagon’s failure to organize and follow up on the information “a stunning oversight.” Paul Rieckhoff, founder and executive director of Iraq and Afghanistan Veterans of America, said the military must restore trust by sharing information.”

Kawaoka’s Controversial Flu Research at UW-Madison On Hold Again

Once again, Yoshihiro Kawaoka has halted his research of H5N1 at the University of Wisconsin-Madison. Kawaoka created an altered version of the H5N1 flu virus to look at transmissibility between mammals. On October 17, the Obama administration said they would postpone federal funding for gain-of-function studies, including those involving flu, SARS and MERS. Roughly 50% of Kawaoka’s work involves gain of function, and he paused all experiments that “might enhance pathogenicity or transmissibility.”

Wisconsin State Journal—“The White House announcement comes in response to incidents this year involving anthrax, flu and smallpox at the Centers for Disease Control and Prevention and the Food and Drug Administration. “The incidents occurring at federal facilities this summer have underscored the importance of laboratory safety, and they also prompted calls for a reassessment of the risks and benefits that are associated with research involving dangerous pathogens,” Samuel Stanley, chairman of the National Science Advisory Board for Biosecurity, said during a meeting of the group Oct. 22.”

This Week in Ebola

The Ebola ‘outbreak’ in Texas is over and MSF has confirmed the decline of cases in Liberia, however, Ebola cases have risen ‘sharply’ in Sierra Leone. While Kari Hickox remained in the news explaining the reasons she fought against quarantine, it appears, as feared, that mandatory quarantine for volunteers returning from West Africa is causing some to re-consider their commitments. Meanwhile the U.S. Army has identified five possible bases for returning troop quarantine and the Pentagon has awarded a $9.5 million contract Profectus BioSciences, Inc. for development of an Ebola vaccine. President Obama asked Congress for $6 billion to fight Ebola in the U.S. and West Africa. NBC News reported that “The U.S. is keen to be seen as leading the international response to Ebola” but there is another country in the Americas contributing to the fight—Cuba. Also in the Americas, Canada’s policy of denying visas for people coming from West Africa is called into question, and five American airports are learning a lot about infection control. Back in West Africa, Nigeria’s success in fighting Ebola has been attributed to their fight against polio. Lastly, on the heels of Mark Zuckerberg’s $25 million donation to fight Ebola, he launched a button at the top the newsfeed that links users to places where they can donate, too.

Stories You May Have Missed

 

Image Credit: NBC News

Pandora Report 11.2.14

For this edition of the Pandora Report we look at Jonas Salk, avian influenza in China, TB and diabetes as a co-epidemic, and, of course, an Ebola update. As the weather is turning cooler, don’t forget to get your flu shot, and remember to protect yourself by washing your hands!

Have a great week!

On Jonas Salk’s 100th Birthday, A Celebration of his Polio Vaccine

If you visited Google.com on Tuesday you may have seen one of their famous doodles dedicated to Jonas Salk. Salk’s polo vaccine was declared safe and effective in 1955 and was, interestingly enough, never patented. “The notion handed down to us is that Salk decided not to patent the vaccine as a noble act of self-abnegation.”

The Los Angeles Times—“But the more important reason the vaccine went unpatented, as related by David M. Oshinsky in his 2005 book, “Polio: An American Story,” is that legally it was thought to be unpatentable. The National Foundation and the University of Pittsburgh, where much of the work was done, had looked into patenting the vaccine. They were dissuaded by Salk, who informed them that his techniques weren’t novel and his work had been based on years of prior work by others.”

Five Strains of H5 Avian Flu Reported Across China 

The Chinese veterinary authority reported outbreaks of five different subtypes of Highly Pathogenic Avian Influenza (HPAI) to the World Organization of Animal Health (OIE) on October 24. There were a total of 51 positive findings of the following strains; H5N3, H5N8, H5N2, H5N6, and H5N1. A map of all strain outbreaks is available here.

CIDRAP—“Two of the strains—H5N8 and H5N3—have not been reported by China to the OIE before. Two outbreaks of the former were reported in September, each involving one bird (a duck and an unspecified bird) sampled during a national surveillance plan. One was at a slaughterhouse and the other in a wetland area; both were in Liaoning province in the northeast.”

Unlikely Marriage of Diseases: TB and Diabetes Form a ‘Co-Epidemic’

A white paper presented on Wednesday at the 45th Union World Conference on Lung Health in Barcelona, Spain, warns, “diabetes is fueling the spread of TB.” The paper warns that having diabetes increases the risk that a person will become sick with TB will make TB more difficult to manage, adding that a patient with both diseases is more likely to have complications that do not exist when only one disease is present.

NPR—“The TB/diabetes double-whammy has at least two important differences from the TB/HIV co-epidemic. [1.] It involves the interaction of an infectious disease (TB is the world’s second-deadliest, next to HIV/AIDS) and a non-communicable chronic disease, rather than two infections. [2.] It has potentially more global impact. The TB/HIV co-epidemic was concentrated in sub-Saharan Africa, where 18 countries saw TB rates quadruple because of HIV. Many more countries have high rates of TB and, increasingly, of diabetes.”

This Week in Ebola

Not sure if it was because of Halloween or what, but it seemed to me there were fewer Ebola stories this week. Dallas nurse Amber Vinson, was finally released from Emory Hospital, free of the Ebola virus. Many other stories this week focused on quarantine. Kaci Hickox, the nurse who worked treating patients in Sierra Leone, first protested over her isolation in New Jersey, and then broke her quarantine in Maine, was reportedly ‘humbled’ when a judge in her home state of Maine ruled she can come and go as she pleases. She was still in this news this weekend as it was reported that her roommate in Africa tested positive for Ebola and there was a skit about her on SNL. President Obama has said that quarantines may dissuade doctors and nurses from traveling to West Africa, while Secretary of Defense Chuck Hagel has said that U.S. military personnel returning from West Africa will be subject to a 21-day quarantine. The WHO reported that Ebola infections are slowing in Liberia, and the New England Journal of Medicine says they have a suspect zero for this whole outbreak.

Stories You May Have Missed

 

Image Credit: Google

Pandora Report 10.11.14

With so many stories being dedicated to Ebola, I was absolutely delighted to see coverage of influenza this week. We’ve also got stories about the proliferation of antibiotic resistant bugs in nursing homes, George Washington as the first father of vaccination, and of course, an Ebola update.

There will be no news round up next week, so I will see you all back here on October 25. Enjoy your weeks and don’t forget your flu shot!

Ebola’s Bad, but Flu’s Worse

With the coverage of the Ebola outbreak in media (and even on this blog) it may have inadvertently caused unreasonable panic in the American populace. The fact of the matter is one person in the U.S. has died from Ebola. Every year, according to the CDC, more than “226,000 Americans are hospitalized with flu and approximately 36,000 die from flu-related complications.” News outlets this week quietly reported on flu vs. Ebola and offered points of clarification about both diseases as well as tips for staying well. These include getting your flu vaccination, washing hands frequently especially after using the restroom and before eating or preparing food, and avoiding touching eyes, nose, or mouth to limit spread of germs.

Times Union—“‘The reality is there are vaccinations and treatment options available for the flu that are not available for Ebola. The reason for concern is there is no magic bullet to stop Ebola,’ said [Dr.Edward] Waltz [director of the Center for Public Health Preparedness at the University at Albany]. ‘I think the most important message to get is, take action on the things that you can control. We have so many things that affect our health that we can’t control, get yourself a vaccination if it is available.’”

Medical Superbugs: Antibiotic-resistant Bacteria Carried by More than a Third of Nursing Home Residents

A study out of Melbourne, Australia, reported that more than 1/3 of nursing home residents tested were carriers of antibiotic-resistant bacteria. And this problem isn’t just plaguing other countries. In fact, a report from the U.S. Centers for Medicare and Medicaid Services found rising rates of pneumonia, urinary tract infections, viral hepatitis and MRSA. The Australian study also found that more than half of the tested residents had received antibiotics within three months of being tested. Overuse of antibiotics can lead to higher rates of superbugs or other infections like C. difficile, which can be lethal in seniors. (On a personal note, my grandmother recently died from complications after a C. diff infection.)

ABC—“‘(Our concern is) that nursing homes are acting as a kind of reservoir, if you like, of antibiotic-resistant bacteria. We know these residents have fairly frequent movement in and out of acute care institutions, and this obviously poses risks to acute care hospitals for transmission. It could be transmitted to other patients in an acute care hospital, if the resident actually has an infection they might be infected with a more resistant bacteria – they’re the two main concerns.’”

George Washington, the First Vaxxer

This week, the Daily Beast provided an excerpt from historian Tom Shachtman’s new book, Gentlemen Scientists and Revolutionaries: The Founding Fathers in the Age of Enlightenment. At a time where people are choosing to forgo vaccinations and alarm over Ebola grows worldwide, it is amazing to see George Washington—Virginian, 1st President, Founding Father, serious boss, and old fashioned speller—decide that army immunization would not only save the lives of soldiers, but indirectly safeguard a young American nation. Shachtman recounts a February 1777 letter from Washington to John Hancock, President of the Continental Congress.

The Daily Beast—“‘The small pox has made such Head in every Quarter that I find it impossible to keep it from spreading thro’ the whole Army in the natural way. I have therefore determined, not only to innoculate all the Troops now here, that have not had it, but shall order Docr Shippen to innoculate the Recruits as fast as they come in to Philadelphia. They will lose no time, because they will go thro’ the disorder while their cloathing Arms and accoutrements are getting ready.’”

This Week in Ebola

The first (and only) patient with a domestically diagnosed case of Ebola died this week in Dallas, TX amid calls, and responses, about tightening airport screening and travel restrictions. Six major American international airports have enhanced screening for travellers arriving from West Africa while airline workers at LaGuardia have protested over what they say are inadequate protections from potential Ebola exposure. In other air travel related news, a passenger was removed from a US Airways flight after joking about being infected with Ebola and a sick passenger traveling from West Africa to Newark airport does not have Ebola. A nurse in Spain did get infected with the virus this week, as other European nations fear further spread inside their countries. American Ebola survivor Dr. Rick Sacra was hospitalized and treated this week for pneumonia and another American Ebola survivor, Dr. Kent Brantly donated his blood in order to help treat an infected NBC cameraman.

Evidently one fifth of Americans, according to a Gallup poll, are concerned about getting Ebola which is causing the ‘apocalypse business’ to boom. Meanwhile, West Africans living in the U.S. are taking action to spread information within their communities about the virus and there was a wonderful piece on how Nigeria beat Ebola. Finally, CDC director Dr. Tom Frieden spoke this week on how this Ebola outbreak is like the AIDS epidemic and why he doesn’t support a travel ban to combat the outbreak. All of this comes at a point in time where the number of deaths from the outbreak has reached over 4000.

Stories You May Have Missed

Image Credit: Immunize.ca

Pandora Report 4.18.14

I think I was coming down with something yesterday. It manifested as a pretty debilitating headache, so I am pretty sure it wasn’t Ebola, but I also had no desire to drink water, so it might have been rabies. Either way, I’m feeling much better today, and am excited to bring you a Saturday issue of Pandora Report. In fact, I’m pretty sure there is nothing that is more fun on the weekend…so let’s get into it!


Highlights include Bird Flu in North Korea, a TB drug that may be the answer to drug resistance, a new strain of Ebola, MERS CoV’s spread to Asia, and Tamiflu’s real utility. Have a great weekend and see you here next Friday!

Highly Pathogenic Avian Influenza (HPAI) outbreak in North Korea

On April 16, the North Korean veterinary authority sent a notice to the World Organization for Animal Health (OIE) alerting them to two H5N1 outbreaks among poultry in the isolated nation. This is a surprisingly transparent move. The first outbreak occurred at the Hadang chicken factory in Hyongjesan starting on March 21. All 46,217 birds died. A second outbreak occurred on March 27 in the same region at the Sopo chicken factory where an unreported number of birds died in the same cage. The source of the infection remains unknown.

The Poultry Site—“Usual control measures have been put in place to control the spread of infection: quarantine, movement control inside the country, screening and disinfection of infected premises/establishment(s). There is no vaccination and no treatment of affected birds.”

Could a new TB drug be the answer to resistance?

A research study at the University of Illinois shows that a new drug under clinical trials for tuberculosis treatment—SQ109—may be the basis for an entirely new class of drugs that could act against bacterial, fungal, and parasite infection and yet evade resistance. Lead researcher, chemistry professor Eric Oldfield, believes that multiple-target drugs like SQ109 and its analogs hold the key to new antibiotic development in the era of drug resistance and “the rise of so-called ‘superbugs’.” His claim is bolstered by experiments with SQ109 and TB where no instances of resistance have been reported.

Science Codex—“’Drug resistance is a major public health threat,” Oldfield said. “We have to make new antibiotics, and we have to find ways to get around the resistance problem. And one way to do that is with multi-target drugs. Resistance in many cases arises because there’s a specific mutation in the target protein so the drug will no longer bind. Thus, one possible route to attacking the drug resistance problem will be to devise drugs that don’t have just one target, but two or three targets.’”

Outbreak in West Africa is caused by a new strain of Ebola virus

As the death toll from the Ebola outbreak in West Africa climbs above 120, scientists are reporting that the virus is not the same strain that has killed in other African nations.  While the source of the virus is still unknown, blood samples from Guinea victims has confirmed that it is not imported strains of Ebola Zaire—the original strain of the virus discovered in Democratic Republic of Congo (formerly known as Zaire.)

The Huffington Post—“‘It is not coming from the Democratic Republic of Congo. It has not been imported to Guinea” from that country or from Gabon, where Ebola also has occurred, [Dr. Stephan] Gunther [of the Bernhard Nocht Institute for Tropical Medicine in Hamburg, Germany] said.

Researchers think the Guinea and other strains evolved in parallel from a recent ancestor virus. The Guinea outbreak likely began last December or earlier and might have been smoldering for some time unrecognized. The investigation continues to try to identify “the presumed animal source.’”

MERS CoV leaves the Middle East and travels to Asia

Though the method of transmission of Middle East Respiratory Syndrome (MERS) remains unknown—a report last week from the CDC finds the virus can stay alive in Camel milk—and thankfully, transmission from human to human has been rare, the disease has now spread beyond the Middle East to Asia via an infection emerging in Malaysia. A Malaysian man returning from Mecca, in Saudi Arabia, tested positive for, and died from, MERS on April 13. So far, a reported 33 people who have travelled to the Middle East for the Haj have tested negative for presence of the virus in neighboring Singapore.

Today Online—“There is currently no advisory against travel to countries of the Arabian Peninsula, or to countries reporting imported cases of MERS-CoV (including Malaysia).

Frequent travellers to the Middle East and Umrah/Haj pilgrims have been advised to take precautions, such as being vaccinated against influenza and meningitis. Those aged 65 years and above or with chronic medical conditions should also get vaccinated against pneumococcal infections before travelling. Pilgrims with pre-existing chronic medical conditions like diabetes, chronic heart and lung conditions should consult a doctor before traveling, to assess whether they should make the pilgrimage.”

A closer look at Tamiflu

With seasonal flu season behind us in the U.S., maybe it is time to look at better treatment options. A study published last week in the British Medical Journal, calls into question the effectiveness of Oseltamivir—brand name, Tamiflu. The international team of researchers found that while Tamiflu can shorten flu symptoms it does not reduce hospital admissions or medical complications. The study also demonstrated that Tamiflu can also cause nausea and vomiting and increases the risk of headaches and renal and psychiatric symptoms.

Global Biodefense—“‘The trade-off between benefits and harms should be borne in mind when making decisions to use oseltamivir for treatment, prophylaxis, or stockpiling,” concludes the study authors from The Cochrane Collaboration, an independent global healthcare research network. “There is no credible way these drugs could prevent a pandemic,” Carl Heneghan, one of the lead investigators of the review and a professor at Oxford University, told reporters. “Remember, the idea of a drug is that the benefits should exceed the harms. So if you can’t find any benefits, that accentuates the harms.’”

(Image credit: Robert Sharp/Flickr)

The Pandora Report 2.14.14

Highlights include H7N9 in Hong Kong, H5N1, a new case of MERS, and a new global initiative to counter infectious diseases. Happy Friday, stay warm, and Happy Valentine’s day!

Hong Kong Reports Fifth H7N9 Bird Flu Case

We wrote earlier this week about the H7N9 case in Malaysia, in which a Chinese tourist brought the virus to Malaysia. Hong Kong has since reported its fifth case of the virus. The patient is a 65 year old male with underlying medical conditions.  Tensions are understandably running high in the area, with Chinese authorities recently arresting a man for spreading false rumors about the virus.

Naharnet – “Preliminary investigations showed the man had traveled to the neighboring Chinese province of Guangdong from January 24 to February 9, and had purchased a slaughtered chicken in the village near his residence on January 29. Seven family members had remained asymptomatic, with five classified as close contacts to be admitted to hospital for observation and testing. Hong Kong late last month slaughtered 20,000 chickens after the deadly H7N9 bird flu virus was found in poultry imported from Guangdong. Fears over avian flu have grown following the deaths of three men from the H7N9 strain in the city. All had recently returned from mainland China.”

Canadian who died from H5N1 flu might have caught it in illegal bird market
It is thought the Canadian who contracted H5N1 became infected after passing through an illegal live poultry market in Beijing. Such markets have been banned in the city since 2005 – local demand for fresh poultry, however, has caused a thriving illicit industry to spring up.

CBC – “The source of the woman’s infection has been a mystery; she spent her entire trip in Beijing, where H5N1 reportedly hasn’t been discovered for some time, and her travelling companion said she did not have contact with live birds while there. But scientists from Beijing’s Centre for Disease Prevention and Control are hypothesizing that illegal live bird markets may have been the source of the woman’s infection.”

Camel-owner in Abu Dhabi in intensive care after contracting MERS virus
A camel-owner in the UAE has presented with MERS, giving further credence to the theory of camels as potential hosts. The 67-year old man had previously existing medical conditions, becoming symptomatic on January 20th.  There have been 182 laboratory-confirmed cases of the virus to date, with 79 deaths.

The National – “A camel owner in the emirate has become the latest person to be infected with the Mers coronavirus. The Emirati, 66, is in intensive care after complaining of respiratory problems and was found to have contracted the virus, it was confirmed on Thursday…He owns camels in the UAE and had recently travelled to Oman where he was in contact with other beasts, the World Health Organisation says.”

U.S. launches new global initiative to prevent infectious disease threats
Working with WHO, the Food and Agriculture Organization, and the World Organization for Animal Health, the US launched a new global initiative to help countering emerging infectious diseases. Speaking about the threat of emergent infectious diseases, Health and Human Services Secretary Kathleen , “A threat anywhere is indeed a threat everywhere”.

Washington Post – “Faced with what they describe as a perfect storm of converging threats from infectious-disease epidemics, U.S. officials launched a global effort Thursday with more than two dozen countries and international organizations to prevent deadly outbreaks from spreading. The goal is to prevent, detect and respond to infectious-disease threats where they start. That’s more effective and less costly than treating sick people after diseases spread. The new initiative is intended to bolster security at infectious-disease laboratories, streng-then immunization programs and set up emergency-response centers that can react to outbreaks within two hours.”