Pandora Report 3.2.2018

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

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

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

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

Pandora Report 1.5.2018

Welcome to our first Pandora Report of 2018! While things may have been relatively quiet over the holidays, we still have some health security gems for you to start the new year right.

 An Infection Preventionist’s Take on the 2017 Biological Weapons Convention
GMU Biodefense Phd student and infection preventionist Saskia Popescu recently attended the BWC Meeting of States Parties and is discussing the importance of civil society and why even the most unlikely participants are important for the future of the BWC. “It seems an unlikely story that an infection prevention (IP) epidemiologist would attend a Meeting of the States Parties (MSP) at the United Nations (UN), but here’s why civil society has an important role in the work that IPs do.” Highlighting the Confidence Building Measures (CBMs) and the role of NGOs, she uses communicable disease reporting as an example of how so many of us play an unsuspecting role. “In fact, I feel that there are 2 things that should underline the importance of NGOs and civil society being involved in international treaties such as the BWC: 1.) Inherently, our work plays into the CBMs. Who does communicable disease reporting at a county level? Yours truly, and that feeds into the state health departments and then up through the Centers for Disease Control and Prevention (CDC), which goes into the CBM. 2.) With the rapid pace of advancements in the life sciences—such as gain-of-function research or genome editing like CRISPR—it is critical that treaties like the BWC be modernized to maintain relevancy. This requires experts from civil society who can work across international borders.”

Enhancing BioWatch Capabilities Through Technology and Collaboration
The latest proceedings of a workshop report from the National Academies are now available online. “The Department of Homeland Security’s (DHS’s) BioWatch program aims to provide an early indication of an aerosolized biological weapon attack. The first generation of BioWatch air samplers were deployed in 2003. The current version of this technology, referred to as Generation 2 (Gen-2), uses daily manual collection and testing of air filters from each monitor, a process that can take 12 to 36 hours to detect the presence of biological pathogens. Until April 2014, DHS pursued a next-generation autonomous detection technology that aimed to shorten the time from sample collection to detection to less than 6 hours, reduce the cost of analysis, and increase the number of detectable biological pathogens. Because of concerns about the cost and effectiveness of the proposed Generation 3 system (Gen-3), DHS cancelled its acquisition plans for the next-generation surveillance system.” Within the report, you can find an overview of BioWatch priorities, collaborative planning, recommendations from the GAO and DHS responses, and future opportunities at the state and local level. Some of the GAO’s findings included failure by DHS to develop performance requirements that would allow for conclusions about Gen-2’s ability to detect attacks, and that the modeling and simulation studies that DHS commissioned had not directly and comprehensively assessed Gen-2’s capabilities.

 GMU Biodefense MS Open House
Mark your calendars for the February 21st Master’s Open House at GMU’s Arlington campus! The session will provide an overview of our master’s degree programs, an introduction to our world-class faculty and research, and highlights of the many ways we position our students for success in the classroom and beyond. Our admissions and student services staff will be on hand to answer your questions. This is a great chance to speak with biodefense faculty, learn about some of the awesome classes our students get to take, and find out why we study health security threats from anthrax to Zika.

Winter 2018 Mid-Atlantic Microbiome Meetup Biodefense and Pathogen Detection
Don’t miss out on this January 10th event at the University of Maryland College Park. The University of Maryland Institute for Advanced Computer Studies (UMIACS) is hosting this regional conference next week, the Winter 2018 Mid-Atlantic Microbiome Meetup, with a focus on biodefense and pathogen detection. The workshop is a great way to learn about the latest in synthetic biology, biodefense, and pathogen detection. Several federal agencies are sending experts, and the conference will include a keynote talk from Tara O’Toole, executive vice president of In-Q-Tel.

Three Global Health Issues To Watch in 2018
What are the biggest stories health reporters are looking to follow this year? STAT polled their reporters and predicted that the three big stories in public health would be the final push to end polio, how the WHO will do with a new Director General amidst shaken confidence, and vulnerability to pandemics as we march into the centennial of the 1918 Pandemic. “This year marks the centenary of the Spanish Flu, the influenza pandemic of 1918, which killed somewhere between 50 million and 100 million people as the H1N1 flu virus swept the globe. Many of the people who died were in the prime of life. There are unsettling reports of people who were well at breakfast and dead by dinner. This uniquely fatal outbreak haunts influenza scientists and emergency response planners to this day. The latter know health systems don’t have the capacity to cope with the huge upsurges in illness that would accompany a major disease outbreak. A regular old bad flu season can severely tax hospitals. Those who worry about these issues will use the anniversary to focus attention on the risk of ‘the next Big One’.” What do you think the big pubic health topics will be this year? Tweet us @PandoraReport and we’ll report back on what the biodefense community is saying!

Three Children Hospitalized With Dengue Following Vaccination
Three Filipino children have been hospitalized with suspected dengue infections following their immunization with Dengvaxia, the latest Sanofi Pasteur dengue vaccine. “The hospitalizations come 1 month after Sanofi recommended Dengvaxia not be used in anyone who is dengue-naive. In recipients without previous dengue infections, the vaccine can lead to more severe illness.”

Stories You May Have Missed:

  • Raw Water” Trend Sparks Public Health Concern – This is both hysterical and deadly – a new Silicon Valley obsession with untreated and unfiltered “raw” water. “When food-safety expert Bill Marler saw The New York Times’ trend piece on Silicon Valley’s recent obsession with raw water, he thought he was reading a headline from The Onion. According to The Times, demand for unfiltered water is skyrocketing as tech-industry insiders develop a taste for water that hasn’t been treated, to prevent the spread of bacteria or other contaminants.”

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 12.1.2017

Are you registered for the Read-Out on the GHSA Summit in Kampala? Just a friendly reminder – we’ll be on hiatus next week as we attend the Biological Weapons Convention Meeting of States Parties. Make sure to look out for a packed newsletter on 12.15 as we’ll be covering both the Read-Out on the GHSA Summit and the BWC meeting! If you’d like real-time updates, check out our Twitter account @PandoraReport.

 Read-Out on the GHSA Summit in Kampala
Global health security on your lunch break? Only at the Read-Out on the GHSA Summit will you get lunch and an in-depth recap of this international health security event. Don’t miss this exciting opportunity to hear from global health practioners and young professionals who attended the 4th annual Global Health Security Agenda (GHSA) Ministerial Meeting in Kampala, Uganda in October. You’ll want to register ASAP for this exciting opportunity on December 4th, from 12-1:30pm at the George Mason University Founders Halls in Arlington. The GHSA meeting, Health Security for All: Engaging Communities, Non-governmental Organizations, and the Private Sector, was a multi-sectoral collaboration between governments, civil society, and industry dedicated to the strengthening of globaly capacity to prevent, detect, and respond to infectious disease threats. Attended by the ministers of health, finance, and agriculture and other senior officialfs from more than 50 nations, this was the first Ministerial GHSA Meeting held on the African continent. The meeting was held in late October at the same time as an unprecedented outbreak of pneumonnic plague in Madagascar and a rare outbreak of Marburg in Uganda itself. These outbreaks were timely, but unfortunate reminders, that global health security is still very much a work in progress. Our panel will include four participants who were on the ground in Kampala and actively engaged in this historical step forward for global health security. Attendees will have the opportunity to engage and hear the perspectives of esteemed public health practitioners and rising health security professionals. Lunch will also be provided. This event is free and open to the public.

Mason, Stanford Researchers Join Forces To Study The Science, Benefits And Dangers Of Genome Editing
GMU Biodefense researchers are teaming up with Stanford University to better address the complexities of genome editing and what it means for science, security, and governance. “The study is the only unclassified, independent academic project of its kind, said Gregory Koblentz, director of George Mason’s Schar School of Policy and Government biodefense graduate program and co-principal investigator. The Mason and Stanford researchers will examine scientific advances in the field of genome editing that can have benefits for human health and the bioeconomy, as well as the security aspects of preventing the misuse of this technology. They expect to deliver a suite of policy recommendations based on their research in summer 2018.” Genome editing has not been without controversy, as the technology allows the deletion and replacement of DNA within living organisms and many are concerned about the dual-use nature of such work. While there is potential to eradicate disease and strengthen agriculture, there is also worry that such technology will be misused for nefarious purposes or even poorly handled and result in negative outcomes. This collaborative effort is a huge step to ensuring we’re aware of the risks, benefits, and oversight needed for this exciting new technology.

Maintaining U.S. Investment in Global Health Security
Progress must continue on the global health security front and industrialized countries like the United States have a critical role in sustaining forward movement. “However, the work of the GHSA, including motivating and assisting countries to improve their capacities to prevent epidemics like Ebola from reoccurring, is now at a crossroad. Even though senior officials in the Trump administration have voiced support for the GHSA, and at a recent GHSA ministerial meeting in Uganda signed onto the Kampala Declaration to extend the GHSA for at least another 5 years, US funding for the initiative is ending and no commitment for future financial support has been made. Without additional funding, prospects for the next phase of the GHSA will be endangered. It is important for the United States to commit to support the GHSA to help protect the nation and the rest of the world from epidemic disease.” U.S. financial support encourages other countries to pledge funds but if our efforts waver, it may cause a domino effect. Not only does U.S. engagement encourage others to support the GHSA, but it also supports our own national security. “If vulnerable countries do not have the capacity to quickly cope with disease outbreaks, those outbreaks are more likely to spread internationally, including to the United States.” You can hear more about the importance of the GHSA from Jennifer Nuzzo (one of the authors of this paper) at the Read-Out on the GHSA Summit in Kampala event on December 4th!

Failure to Diagnose Monkeypox Highlights Nigeria’s Poor Health Infrastructure
Like most outbreaks, Nigeria’s monkeypox cases have exposed weaknesses in the country’s ability to rapidly identify and test potential patients. These inadequacies highlight gaps within their International Health Regulations compliance as there were no national labs that could test patients for the disease. “Consequently, for more than two weeks after the outbreak (from the September 22 to October 13), there was no conclusive confirmation that the suspected case was actually that of monkeypox. According to experts, the implication of this is that the country may be dealing with a dangerous outbreak, but unsure of what it is dealing with on time, thereby giving room for a lot of things to go wrong during the waiting period. For instance, during the waiting period for the monkeypox confirmation, different statistics on the actual number of cases were being bandied, even as the large number of suspected cases (94 cases) and the manifestation of the disease had already caused fright and panic.” Laboratory delays can be devastating to outbreak control as it can delay treatment, isolation, quarantine, and data collection. Public health laboratories are the early warning system in many ways. Many are drawing attention to these gaps as a way to reinforce the need to strengthen country-level laboratory infrastructure and capacity. The National Centre for Disease Control (NCDC) was established in 2011, but still is struggling to find the capacity to respond to health threats due to funding and personnel issues. As 14 more cases of monkeypox were reported in Nigeria, this services as a reminder of  why the GHSA is so vital!

The WHO Reports on Fake Drugs
This week the WHO released a report on medical products  that shed light upon the startling realities of patient safety and public health in low and middle income countries. The report, “Global Surveillance and Monitoring System for Substandard and Falsified Medical Products”, found that 1 in 10 products circulating in such countries are either substandard or fake. The findings of this report are extremely worrying as it means that people are taking medications intended to treat life-threatening ailments and they are either fake or not effective. In many cases, the individual is paying a considerable amount of money for such medications and can have severe medical complications from contaminated or expired products. “Substandard and falsified medicines particularly affect the most vulnerable communities,” says Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Imagine a mother who gives up food or other basic needs to pay for her child’s treatment, unaware that the medicines are substandard or falsified, and then that treatment causes her child to die. This is unacceptable. Countries have agreed on measures at the global level – it is time to translate them into tangible action.” You can read the report here. The report also cites some of the work being done around this endemic issue – 17 WHO training workshops, 126 Member States and more than 400 regulatory personnel trained, 1500 product reports, etc.

How Will We Handle Contamination On An Airplane?
What would happen if you were on a plane with a patient who had a highly infectious disease like SARS or Ebola? What’s our national plan to deal with such issues? Hint: we don’t have a plan. How do flight attendants or pilots relay to ground control that a patient or entire plane needs to be quarantined? These are all the sorts of questions that need to be considered when planning and responding to such events. How would we quarantine an entire plane? On February 7, 2011, such an event occurred – a pilot issued a public health emergency to the air traffic control tower in Milwaukee, WI, for 3 (of 115) passengers with flu-like symptoms. “Airport officials soon learned something interesting about Flight 703 that could point to the presence of a communicable disease. The plane included at least 12 people who had returned from Cozumel, Mexico, on a cruise in which many of the passengers had fallen ill with flu-like symptoms. The incident revealed gaps in America’s emergency planning for communicable diseases aboard planes — gaps that were still present four years later when the U.S. Government Accountability Office investigated. ‘The United States lacks a comprehensive national aviation-preparedness plan aimed at preventing and containing the spread of diseases through air travel,’ the GAO found.” Sadly, it seems as if there’s still no plan. The creation of such a plan would require collaboration between the CDC and U.S. Department of Transportation, and while meetings have occurred, it is reported that no one has taken the lead. So, how are airports currently handling infectious disease incidents? “The lack of uniformity in dealing with communicable diseases during air travel was evident when the National Academy of Sciences asked 50 different airports in the U.S. and Canada how they expect to learn of an incident aboard a plane. They found 15 different notification procedures.” Report after report has found a gap within these response efforts and with the holiday season upon us and airline travel to be busy, it seems that should a public health emergency arise, we may be flying by the seat of our pants.

 Flu Season is Upon Us!
Flu season is starting to hit the United States as the CDC reports an up-tick is influenza positive tests. A majority of the positive specimens have been Influenza A (78% are H3, 13% have been H1N1). “Three southeastern states are reporting high or widespread flu activity, and the CDC said it received reports of five more pediatric flu deaths. In its report, which covers the week ending Nov 18, the CDC also reported one more novel flu infection, an H1N1 variant (H1N1v).Globally, flu activity in the Northern Hemisphere is rising, with H3N2 and influenza B the most frequently detected strains, the World Health Organization (WHO) said yesterday in an update.” Flu season and vaccination compliance is increasingly becoming an issue even in healthcare – in fact, many hospitals are terminating employees who don’t get their flu shot. Remember – get your flu vaccine, stay home when sick, wash your hands, and cover your cough!

Stories You May Have Missed:

  • Exclusive Interviews: Tackling Regulatory and Economic Challenges of Antimicrobial Resistance – “It is imperative for medical experts and drug discovery specialists to stay on top of the latest clinical advancements, developments and industry initiatives related to antimicrobial resistance. SMi Group will gather industry experts and government bodies to share their insights at the 20th annual conference on Superbugs and Superdrugs taking place on 19-20 March 2018 in London, UK. SMi Group recently had the opportunity to sit down with three of the event’s featured speakers to discuss some of the challenges they face in the industry and their strategies for overcoming them.”
  • Raw Flour and E. coli – this whole time we thought it was the eggs in the cookie dough that were doing it, but it seems that flour may also be a culprit for foodborne illness! “Research published today in the New England Journal of Medicine describes how raw flour, an unlikely suspect, caused an Escherichia coli outbreak in 2016. Because of its low-moisture properties, flour was not thought to be a conduit of E coli bacteria, but a multistate team of investigators discovered that flour processed in one facility was linked to the outbreak.”

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

Pandora Report 11.24.2017

We hope you had a wonderful tryptophan-induced holiday and are ready for your weekly dose of all things biodefense! Roughly 46 million turkeys were eaten on Thursday, but did you ever wonder if yours was antibiotic-free? (hint: we’re venturing down antimicrobial resistance rabbit hole in this week’s newsletter).

Russia Shuts Down The UN Probe Into Syrian Chemical Weapons
Despite the launch of the 2015 Joint Investigation Mechanism (JIM) by the UN and the Organization for the Prohibition of Chemical Weapons (OPCW), efforts to investigate the use of chemical weapons by President Assad in Syria, have been stalled and challenged by Russia. The latest move by Russia to kill international investigations into such attacks has come in the form of Security Council vetoes. “Russia’s actions have enraged al-Assad’s Western critics, who accuse the Syrian leader of secretly stockpiling chemical weapons in contravention of UN resolutions, and who now want to deliver accountability by other means.” This latest hurdle leaves many to wonder how we got here and if the OPCW can potentially overcome these protests. “As it happens, the OPCW’s top decision-making body, the 192-nation Conference of States Parties, is also scheduled to meet next week. Although that meeting is not directly related to the chemical weapons crisis in Syria, it ‘can’t ignore Syria’s continued non-compliance,’ says Gregory Koblentz, a nonproliferation expert at George Mason University who spoke to IRIN last week.” Not only did the vetoes do damage to inspections, but a draft Russian-Iranian decision that was circulated at the OPCW was recently obtained, in which the objectives were to overturn OPCW inspector procedures and information sharing practices. “(Russia‘s) supreme goal is to compromise the ability of the (OPCW) fact-finding mission to do its job professionally and without political interference,” said Gregory Koblentz, a non-proliferation expert at George Mason University, in the U.S. state of Virginia.“This draft resolution has to be seen as part of a Russian strategy to undermine all international investigations into the use of chemical weapons by the Syrian government,” he said.

Antimicrobial Resistance: An Underrated Biological Threat
GMU Biodefense PhD student Saskia Popescu is hoping to change the narrative for how we look at antimicrobial resistance. AMR isn’t the kind of flashy disease that gets the headlines or surges of funding, and yet it’s been wreaking havoc for decades. Popescu points to the need to address AMR as the global biological catastrophic event that it is rather than a neglected public health issue that is predominantly seen as medical or agricultural. Citing the ominous predictions of the antibiotic abyss, challenges in drug research and development, and why this is such a difficult beast to tackle, Popescu highlights just how devastating AMR is on a global level. “One of the biggest impediments to developing effective treatments is the normalization of AMR. Researchers, infection prevention and control practitioners, and medical professionals have been raising the red flag for decades. Drug-resistant infections, such as methicillin-resistant Staphylococcus aureus(MRSA), used to be rare events in health care but are now considered a common occurrence.” She notes that “AMR poses a national security threat due to its ease of transmission and its potential for a major public health crisis. Unfortunately, the spread of highly resistant diseases has received far less concern and funding than emerging infectious diseases.”

Read-Out on the GHSA Summit in Kampala Event – Save the Date!
We’re excited to announce that on Monday December 4th, GMU will be hosting a seminar on the GHSA Ministerial Meeting from several health security experts who attended. Held at the Arlington campus in Founders Hall from 12-1:30pm, guests will hear from Jamechia Hoyle, Coordinator of the Next Generation Global Health Security Network, Jennifer Nuzzo, Senior Associate at the Johns Hopkins Center for Health Security, and two GMU Biodefense MS students – Anthony Falzarano and Stephen Taylor. More details will be be provided in the coming days, but make sure to save the date as this is a great chance to hear about this critical meeting and the future of the GHSA.

Potential Role of Social Media in Combatting Antimicrobial Resistance
As we continue to see the rise of MCR-1 gene, antimicrobial stewardship and predictions of the future become increasingly important, but just how accurate is this information? GMU Biodefense MS student Janet Marroquin is fact-checking the predictions of the post-antibiotic apocalypse and how the media has portrayed this threat. “In this era of fake news, the credibility of articles circulating on social media can be dubious, particularly when citations are not readily available.  Further investigation of the statistical data used in the video yielded mixed results.” Marroquin points to a NowThis video-based news report and how antimicrobial resistance has been portrayed and introduced to the public through such venues. “Although the dissection of the data used in the NowThis video revealed a few inconsistencies, the attention that 90 seconds can bring to various aspects of AMR to the general public is much. As of November 6, 2017, the video has had 2.1M views and has been shared by 12,333 users on Facebook, retweeted by 175 users on Twitter, and has been featured on news sites. Interestingly, a few days after the release of the NowThis video, NBC News Mach published an online news article addressing the ‘post-antibiotic apocalypse’.”

Ready for a Global Pandemic?
Director of the Center for Health Security Tom Inglesby and Stanford law student Benjamin Haas are evaluating just how likely a pandemic is and how prepared we might be with the current administration. Between the rapid growth of people in densely populated areas and globalization, microbes have a sort of novel freedom that hasn’t been seen before. Biological threats go beyond pandemics to the potential for bioterrorism or even laboratory accidents. So what is the U.S. government doing to prepare? Efforts have ranged from NIH-funded research into pathogens of pandemic potential, the development of Biomedical Advanced Research and Development Authority (BARDA), reinforcing the Strategic National Stockpile (SNS), etc. “Unfortunately, President Donald Trump has not indicated so far that his administration takes this issue seriously. Initially, his 2018 budget proposed slashed funding for such programs by nine percent, or $1.25 billion, from the preceding year, which would be the largest reduction in over a decade.” “Although the civil-servant workforce has continued to make progress in important programs, it remains to be seen whether the administration’s political leadership will push biosecurity efforts forward in a meaningful way. In the months ahead, there are four elements to look for in evaluating just how seriously the Trump administration will pursue these issues: its budget priorities for the new fiscal year, its impending biodefense strategy, its approach to overseeing research on novel and highly dangerous pathogens, and its level of engagement in the Biological Weapons Convention (BWC) process.” Inglesby and Haas highlight the importance of supporting the Global Health Security Agenda (GHSA), approaching complex topics like certain kinds of scientific research, and ensuring funding for vital agencies. “The administration has opportunities to make substantial headway on pandemic risks at the national and international levels. Its budget, biodefense strategy, approach to high-consequence research, and engagement on the BWC are all key. The means exist to diminish the spread of pandemics—through science, intelligence, medical and public health preparedness, diplomacy, and smart governance.”

Bird Flu Moves Throughout Asia
China is experiencing its fifth wave of H7N9 infections since 2016 and of the 1,600 laboratory-confirmed human cases, 40% have died. While most  of the human cases have occurred due to poultry exposure, there is concern that some are related to transmission between people. Responding to the threat of avian influenza has been challenging  – wanting to avoid total alarmism and hysteria, but also ensuring the public health response is adequate and prepared. “In September, the Centers for Disease Control and Prevention summarized some disturbing developments. The H7N9 virus had become lethal to birds, which made it potentially more dangerous to people but also easier to spot. And the virus had split into two lineages — called Yangtze and Pearl, after the river deltas in which each was spreading — complicating efforts to make vaccines. In October, the World Health Organization put out an update citing new cases of H7N9 infection as cold weather set in and noting that poultry farmers were vaccinating flocks against both this virus and other strains.” Avian influenza still circulates in Egypt and Indonesia and H1N1 is now a common strain for seasonal flu, but just how close are we to continued transmission of H7N9 between humans?

Addressing Challenges in Global Health Security: Executive Program
The Geneva Centre for Security Policy will be hosting this event as a Swiss contribution to the GHSA – it’s free of charge for the representatives of GHSA member states! “Leaders are expected to formulate policies for best practices and strategies for dealing with future health contexts and crisis scenarios. This programme provides an opportunity to learn the basics of current health practices, policies, implementation schemes, and approaches for the road ahead. Throughout the programme, participants will examine emerging health challenges and their governance implications, working together to understand and devise ways to mitigate potential health threats.” This event runs January 29th – February 1st, 2018, in Geneva and applications are due November 29th, 2017.

Center for the Study of WMDs – Spotlight Seminar on Japanese Germ Warfare
Don’t miss this December 12th seminar “Hidden Atrocities: Japanese Germ Warfare and American Obstruction of Justice at the Tokyo Trials” from 1230-1400 at NDU’s Lincoln Hall in the Proceres Conference Room (Lincoln Hall 3212). “In the aftermath of World War II, the International Military Tribunal for the Far East, also known as the Tokyo Trials, tried 28 Japanese political and military leaders and more than 5,700 personnel with war crimes. Yet U.S. military intelligence and Washington decision makers prevented the indictment of the government leaders and scientists responsible for Japan’s secret germ warfare program, Unit 731. In an effort to acquire Japan’s biological warfare expertise to gain an advantage over the Soviet Union, the United States covered up the extent of the program, jeopardizing international justice with lasting consequences. Dr. Jeanne Guillemin, Senior Advisor in the MIT Security Studies Program, will discuss her new book, Hidden Atrocities, and its account of both the Japanese program and the subsequent collusion.” RSVP is required. All non-DOD-affiliated visitors will need to fill out the attached JBM-HH Base Access Form, even if you have attended previous Spotlight events. We ask that you send us this form to cswmd-admin@ndu.edu no later than 5 December 2017.  You may also bring the completed form with you. Please allow extra time for the new security procedures.*

Stories You May Have Missed:

  • Raw Milk Brucella Outbreak Across 4 States– The CDC has issued a warning for people “in four states—Connecticut, New Jersey, New York, and Rhode Island—who drank raw milk from Udder Milk may be infected with a rare but serious Brucella abortus RB51 bacterium and should see their doctors for antibiotic treatment.”
  •  New Malaria Parasite Discovered in Bonobos – A new malaria parasite has been found in the African animals, as researchers have confirmed the bonobos are a host. “Now, by sampling more bonobos in geographically diverse settings, scientists writing in Nature Communication show that bonobos harbor a new species of malaria parasite, called Plasmodium lomamiensis. The parasite is a previously unknown Laverania species, which are closely related to P falciparum, one of the parasites that causes human malaria infections.”

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 10.27.2017

TGIF and Pandora Report day! Buckle up because we’ve got an abundance of biodefense news that covers GHSA, chemical weapons, synbio, and more.

 Global Health Security – WHO & PATH Reports and GHSA Ministerial Meeting
As the Global Health Security Agenda Ministerial meeting in Kampala, Uganda takes place this week, several reports were released highlighting the deficiencies in global biosecurity and biosafety efforts, as well as the importance of investing in global health security. Fortunately, on the eve of the GHSA Kampala summit, the Trump administration endorsed the future of the GHSA. Don’t forget to stay tuned to our weekly reports as two GMU Biodefense graduate students are participating (as recipients of the George Mason Global Health Security Ambassador Fellowship) in the Ministerial meeting alongside NextGen GHSA and they’ll be reporting on their experiences in the coming weeks. The first report this week is from NTI, which called on countries to improve biosecurity after WHO demonstrated that there are substantial biosecurity/biosafety gaps worldwide. NTI analyzed 39 Joint External Evaluation (JEE) peer reviews and mapped the related biosecurity and biosafety related scores. Here are their findings: “74% of the assessed countries demonstrated limited or no capacity for a whole-of-government national biosafety and biosecurity system. 64% of the assessed countries demonstrated limited or no capacity for biosafety and biosecurity training and practices. 41% of the assessed countries demonstrated limited or no capacity for linking their public health and security authorities during a suspected or confirmed biological event.” The map they’ve created is also a great visualization for how truly weak biosecurity and biosafety efforts are on a global scale. NTI also used this information to track commitments and biosecurity assistance and partners. The next report comes from PATH, which just released their work: Healthier World, Safer America: A US government Roadmap for International Action to Prevent the Next Pandemic The latest PATH analysis focuses on global health security and global efforts to respond to threats. “This paper aims to examine the benefits of investments in pandemic preparedness, as well as recommends the US Administration and Congress come together behind a comprehensive US strategy, robust investments, and continued vigilance both at home and abroad. The recommendations focus on global leadership, a US plan for international action, and research and development; underpinned by the risks of unsustainable funding, with special focus given to the Ebola supplemental funding sunset set to occur in FY2019.”

Reauthorizing & Improving The Department of Homeland Security
Don’t miss the recent National Interest series by GMU Biodefense PhD alum Daniel Gerstein  on the DHS reauthorization bill. This three-part series starts with a focus on why it’s time to improve the Department of Homeland Security. Gerstein notes that “reauthorization of the Department of Homeland Security is vital to clarifying responsibilities and setting expectations for the continued evolution of the department.” The second part in the series highlights methods for fixing the fractured department. “The question is not whether reauthorization of DHS is necessary. It  most definitely is. However, we should also ask whether the bill goes far enough and what other issues should a comprehensive DHS bill encompass? This second commentary considers whether the DHS structure with  relatively weak central authorities should be reevaluated. Interestingly, each successive secretary has sought to consolidate power and authorities at the department level. Is it time to legislate this outcome? ” Lastly, Gerstein addresses why updating the DHS Acquisition System matters. “This third commentary considers how to better align the department’s requirements, research, development and acquisition processes. Currently, the processes are not synchronized and should be harmonized to better align these critical departmental systems.”

Global Health Security Forum 2017 
Don’t miss out on this November 7th event hosted by the Center for Strategic & International Studies. The all-day event will be held at the CSIS headquarters and will even include an entire session on “Hurtling Toward a Genomic 9/11”! Don’t miss out on the “CSIS’s annual flagship conference on the top challenges facing U.S. and global security. This year’s Forum will focus on national security priorities ten months into the Trump Administration and one year prior to U.S. midterm elections.”

 The Collision Of Civil War And Threat Of Global Pandemics
Infectious disease outbreaks can be challenging for even the most stable country and those experiencing civil war are even more impacted by such biological events. Currently, there are 30 civil wars going on around the world – between cholera in Yemen, polio in Syria, and yellow fever in the DRC, countries that have experienced civil war also tend to experience infectious disease outbreaks. “The Daedalus issue, “Civil War & Global Disorder: Threats and Opportunity,” explores the factors and influences of contemporary civil wars. The 12 essays look at the connection of intrastate strife and transnational terrorism, the limited ambitions of intervening powers, and the many direct and indirect consequences associated with weak states and civil wars. Barry and Wise believe there is significant technical capacity to ensure that local infectious outbreaks are not transformed into global pandemics. But those outbreaks require some level of organized and effective governance—and political will. Prevention, detection, and response are the keys to controlling the risk of a pandemic. Yet it’s almost impossible for these to coincide in areas of conflict.” Civil war impacts not only communication, but access to health resources and can challenge early detection and response of outbreaks. Moreover, the traditional hotspots for emerging infectious diseases (tropical and subtropical areas where spillover is likely) are also areas continually “plagued by civil conflict and political instability.”

Chemical Weapons and Syria
On Tuesday, Russia vetoed a vote at the United Nations Security Council that would “renew a mandate to continue an investigation into who was responsible for the use of chemical weapons during Syria’s civil war.” The Joint Investigative Mechanism (JIM) was initially set up in 2015 to help identify those responsible for chemical attacks and is currently reviewing the April nerve agent attack in Khan Sheikhoun. “But Russia could not get enough support and instead used its veto to block adoption. Russia, along with the UK, China, France and the US, have veto powers at the Security Council. It is the ninth time Russia has blocked action against its ally Syria, something rights group Amnesty called ‘a green light for war crimes’.” The United States has already released a statement through the State Department – “We are disappointed, we are very disappointed that Russia put what it considered to be political considerations over the Syrian people who were so brutally murdered,”.

The Good, The Bad, and The Ugly of Pandemic PredictionPreparation, and Medical Countermeasure Communication 
Pandemic preparedness often feels like a teetering game of picking your poison. Will we see an avian influenza like H7N9 or will it be a novel disease? The CDC “evaluates every potentially dangerous strain, and gives them two scores out of 10—one reflecting how likely they are to trigger a pandemic, and another that measures how bad that pandemic would be. At the top of the list, with scores of 6.5 for emergence and 7.5 for impact, is H7N9.” While there isn’t strong transmission capacity between humans with the H5 and H7 viruses, the H7 strains are more worrisome in that they require fewer mutations to get to that point. Our efforts against avian influenza pandemics go beyond surveillance, and also focus on vaccine responses. “In the meantime, vaccines are being developed to match the viruses seen in the fifth and current epidemic. Other control measures have waxed and waned. When the first of the epidemics struck, Chinese health ministries closed markets and slaughtered birds. But as Helen Branswell reports in STAT, some of those containment efforts became more lax in 2015 and 2016.” Preparedness and response exercises can also gives great insight into problems that may arise when dealing with a pandemic. A recent pandemic simulation was held during the World Bank’s annual meeting in Washington D.C., in which participants addressed everything from hospital closures to mass quarantine. “For the World Bank simulation, organizers looked at the impact on travel and tourism of an outbreak of a mysterious respiratory virus in a hypothetical country. Discussions during the 90-minute session were off the record. But in interviews after the event, organizers said the step-by-step scenario made the theoretical possibility seem very real for participants. In particular, it drove home the need for speedy, accurate information-sharing and strong coordination within and across governments and institutions.” These kinds of exercises are crucial to not only address gaps, but bring together a variety of people that will be critical to pandemic response and recovery. The Johns Hopkins Center for Health Security also just released their self-guided exercise scenario that focuses on communication dilemmas that occur during development of medical countermeasures. The exercise is aimed at public health communicator and risk communications researchers, and revolves around a novel coronavirus outbreak in 2025. “Over a 3-year period, the virus spreads to every US state and more than 40 countries, where case fatality rates vary depending on the capabilities of local health systems. In the United States, an existing drug is repurposed to treat SPARS symptoms while federal regulators work with a pharmaceutical company to fast-track the production of a SPARS vaccine. The response differs in other nations. What follows is a nationwide vaccination effort and lingering strains on the US healthcare sector from a steady stream of patients seeking treatment for serious post-SPARS complications.”

Security Implications of Genome Editing – Meeting of Experts in Hanover
Earlier this month, a meeting of scientists and experts on policy and security gathered to discuss the potential implications of genome editing technologies like CRISPR. GMU Biodefense professor Dr. Sonia Ben Ouagrham-Gormley attended, noting that “Over 100 CRISPR scientists form all over the world (China, India, U.S., Europe, Africa), and policy and security experts gathered in Hannover, Germany,  to discuss the security implication of the new gene-editing technique CRISPR.The group reviewed various threat scenarios and discussed potential policy responses. The meeting was particularly successful as both the scientists and security experts engaged in a productive dialogue about the importance of ensuring security without hampering the use of this new technology to promote progress in medicine and agriculture among other things.” The conference focused on establishing proactive international dialogue about genome editing and incorporating experts that range from ethics and philosophy to economics and political science. “Many workshop participants emphasised that it is vital to support and sustain a culture of responsibility and integrity in research and innovation and to engage with stakeholders. Moreover, researchers and policy makers must commit to continuing an open and inclusive dialogue that builds trust. As with other new and emerging technologies, a lack of communication about any uncertainties may undermine public confidence in science. Scientists and security experts should listen to concerns or fears regarding the misuse of genome editing, and provide their expertise on what is and is not likely.”

Synthesizing Biological Threats—A Small Leap From Horsepox to Smallpox
GMU biodefense PhD student Saskia Popescu discussed dual-use research concerns with GMU professor and graduate program director Dr. Gregory Koblentz and how these relate to healthcare and infectious disease professionals. Drawing on the recent horsepox synthesis, Dr. Koblentz emphasized how this opens Pandora’s box even wider for potential smallpox synthesis and misuse of synbio. Popescu highlighted these concerns and how important it is for healthcare workers to be aware of such events and vulnerabilities. “From the healthcare perspective, it may not seem like something we should worry about, but the direction of gene editing and dual-use research of concern is something that is intrinsically linked to public health. Nefarious outcomes of such experiments, regardless of the origin or intent, will inevitably make their way into an emergency department, urgent care, or worse, the community. Although we may not be seeing the implications today, as medical providers and healthcare workers, we must keep our ears to the ground, listening for these biotech advancements, and then thinking through what they mean for us tomorrow.”

Step Away From The Backyard Poultry
Do you keep poultry in your backyard? If so, you may want to rethink it as the number of Salmonella infections related to contact with backyard poultry has quadrupled since 2015. “This year, nearly every state has been pecked by outbreak strains; only Alaska and Delaware can crow about dodging them. The Centers for Disease Control and Prevention has confirmed 1,120 cases. Nearly 250 of those involved hospitalization, and one person died.But that is likely just scratching the surface of the real numbers, according to CDC veterinarian Megin Nichols. ‘For one Salmonella case we know of in an outbreak, there are up to 30 others that we don’t know about,’ she told the AP.” The issue is that chickens and other fowl can carry organisms without having symptoms and shed them in their feces. While some hatcheries will test prior to selling their birds, it’s important that owners be aware of the risks for such infections.

The Schar School of Policy & Government Presents: Strategic Trade and International Security: Policy and Practice
This Brown Bag Seminar Presentation by Dr. Andrea Viski is the place to be on Thursday, November 2nd, from noon to 1:30pm. “Dr. Andrea Viski is the founder and director of the Strategic Trade Research Institute, an independent organization dedicated to providing authoritative research on issues at the nexus of global security and economic trade. She is also the editor-in-chief of the Strategic Trade Review, a peer reviewed journal dedicated to sanctions, export controls, and compliance. She previously worked for Project Alpha at King’s College London and for the Stockholm International Peace Research Institute (SIPRI). She has published numerous articles and book chapters in the areas of strategic trade controls, nuclear non-proliferation, and international law. Dr. Viski received her Ph.D. from the European University Institute, her M.A from Georgetown University’s Institute for Law, Science and Global Security, and her B.A in International Politics from Georgetown University’s School of Foreign Service.” The seminar will be at Founders Hall 602, 3351 Fairfax Drive, Arlington, VA 22201.

Stories You May Have Missed:

  • Uganda’s Marburg Outbreak – Uganda has just confirmed the death of a 50-year-old woman as a result of the hemorrhagic fever, Marburg. “The victim, a 50-year old woman, died on October 11 at a hospital in eastern Uganda after “she presented with signs and symptoms suggestive of viral hemorrhagic fevers”, the minister said. The woman had nursed her 42-year old brother who died on September 25 with similar signs and symptoms and also participated in cultural preparation of the body for burial, she added.”
  • Big Chicken – Are you reading the latest book by Mary McKenna on antibiotic misuse in the poultry industry? “In Big Chicken, McKenna lays out in extensive detail the unintended consequences that resulted from experiments performed at Lederle Laboratories in December 1948 when scientist Thomas Jukes began adding trace amounts of the antibiotic aureomycin (later to be known as chlortetracycline) to chicken feed. The discovery that the drug could quickly fuel growth in chicks raised in confinement revolutionized the poultry industry, turning chicken into America’s favorite protein.”

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 10.13.2017

What could be spookier than a Friday, 13th, in October? Actually, a few things – antimicrobial resistance, biological weapons, plague in Madagascar…..

The Trump Administration’s Misaligned Approach to National Biodefense
This recent publication from Reid Kirby is casting light upon the calamitous state of current and future U.S. biodefense efforts. Kirby points to several factors that will ultimately impact the new administration’s ability to create a new national biodefense strategy – the dysfunction rampant throughout the White House, the anti-science culture that continues to bubble up, a general inability to appoint fill key positions in a timely manner, and the disparage between the Trump administration’s ability to strategize and execute effective actions. “Again, how is the Trump administration doing so far in national biodefense? To answer this question, it is helpful to think in terms of ways, means, and ends – where the “ends” amount to security itself, the “ways” are formation of strategy, and the “means” are execution of strategy. What is concerning about the Trump administration is that the ways and means through which it pursues biodefense policy are fundamentally mismatched with the execution of meaningful biodefense ends.” Kirby highlights these failures through several examples, like the administration’s continued disrespect for science, whether it be climate change or nuclear energy. The administration’s resistance against government-sponsored research (and science in general), is in direct opposition to what a new biodefense strategy will need. “The Trump administration’s worldview, and its inability to distinguish between defense and security, may well be incompatible with a biodefense strategy. Biodefense is a scientific and technological endeavor.” Kirby states that “the administration has expressed a desire to formulate a comprehensive biodefense strategy, but the ways and means it is marshalling are not in alignment with achieving that goal. The future of US biodefense is at significant risk.

North Korea’s Biological Weapons Program – The Known and Unknown
The Harvard Kennedy School’s Belfer Center has just released a new report on North Korea’s biological weapons program. There’s been significant attention recently on their nuclear program however, there is still speculation regarding the real capacity for a biological weapons program. Bioweapon programs are always challenging to determine from the outside – so much of the equipment has dual-use capacity that makes external monitoring inaccurate at best. The new report utilizes publicly available information and interviews with experts to investigate the knowns and unknowns of North Korea’s BW program. Researchers “examine where policy on North Korea’s BW stands. We focus our analysis on the policies of South Korea and the United States, rather than at an international level, as North Korea has had limited participation in the Biological Weapons Convention (BWC).” The report also provides recommendations on how to improve assessment and surveillance efforts, not to mention current policies regarding North Korea’s BW program. Within this report, you’ll also find sections regarding means of delivery, strategic and tactical usage, gaps in current policies, how to improve nonproliferation policy, etc.

GMU Biodefense MS Open House – October 19th
Next week, GMU’s Schar School will be hosting a Masters Open house for prospective students, which means you get another chance to learn about our engaging and exciting Biodefense MS programs! You’ll be able to speak to faculty, learn about admissions, and how you can study biodefense on campus or remotely, at 6:30pm on Thursday, October 19th at our Arlington campus.

Biodefense: Federal Efforts to Develop Biological Threat Awareness
The most recent report from the U.S. Government Accountability Office (GAO) is drawing attention to biothreat awareness and how key agencies, like the DHS, DoD, USDA, HHS, and EPA, work to develop such awareness, regardless of the origin of the threat. The report highlighted three categories of efforts – intelligence gathering, scientific research, and analysis activities. “Federal agencies with key roles in biodefense share biological threat information through many different mechanisms designed to facilitate collaboration among government partners, including working groups and interagency agreements. For example, agency officials reported using collaborative mechanisms to coordinate activities and avoid duplication and overlap. However, as GAO and others have noted, opportunities exist to better leverage shared resources and inform budgetary tradeoffs. Recent legislation requires key biodefense agencies to create a national biodefense strategy that has the potential to help address these issues, by, among other things, supporting shared threat awareness. Until the strategy is developed, the extent to which it will meet this need is unknown.” Due to the variety of sources that biological threats can originate from, this report was established to review how federal agencies not only develop, but also share threat information and how this impacts future biodefense efforts. GAO utilized policies, directives, and strategies that were all related to biodefense to appropriately assess processes and the main agencies that would have critical roles within biodefense efforts.

NASA Backs Research on Evolution of Viruses in Extreme Environments Understanding how viruses adapt and infect hosts is a critical component to predicting movement and hopefully, prevention. NASA has recently funded Portland State biologist Ken Stedman to study viral evolution and how hybrid viruses work. “The study stems from a bizarre virus Stedman discovered in a hot spring at Lassen Volcanic National Park five years ago. The virus’s genetic code is derived from both DNA and its evolutionary predecessor, RNA. The vast majority of life on Earth switched its genetic code from RNA to DNA about four billion years ago, so the fact that this virus has both is highly unusual, according to Stedman.” The NASA grant will allow Stedman and his research team to study hybrid viruses, who they infect, and how they were able to adapt to such extreme environments.

Pandora Report Twitter
Feeling like you need a little extra biodefense information and humor in your life outside of our weekly reports? Check out our Twitter account (@PandoraReport) for a pretty constant stream of not only informative headlines, but also a taste of the hysterical biodefense community. The hidden world of biosecurity/biodefense twitter nerdom is pretty outstanding and probably the best thing on twitter (well, we may be a bit biased, but find out for yourself!).

Seychelles Identifies A Case of Plague
As Madagascar is struggling against a severe outbreak of plague, a nearby chain of islands, Seychelles, has just identified its first imported case. Seychelles is currently working to prophylactically treat fifteen people who were in close contact with the 34-year-old man who fell ill after returning from Madagascar. This is the first case that has spread beyond Madagascar, so officials are working diligently to avoid secondary cases. The WHO is currently sending 1.2 million antibiotics to Madagascar to fight the plague outbreak that is rapidly spreading, especially since many of the cases are pneumonic. Currently, there have been 50 deaths and 500 cases in Madagascar since the outbreak began in August.

Backing the Global Health Security Agenda
After months of speculation and concern regarding the Trump administration’s support for the future of the GHSA, Secretary of State Rex Tillerson brought forth a wave of relief. In a recent keynote speech, Tillerson “voiced support for US collaboration on global infectious disease issues, including ongoing efforts to battle threats such as HIV and malaria. He also signaled US support for extending to 2024 the Global Health Security Agenda (GHSA), a partnership of 50 nations, international organizations, and nongovernmental organizations geared toward building countries’ capacity to prevent and respond to infectious disease threats.” While discussing the importance of the President’s Emergency Plan for AIDS Relief (PEPFAR), he also highlighted that HIV/AIDS is not the only biological threat that needs addressing, commenting that the GHSA was a useful framework. Tillerson noted that “While we’ve made tremendous progress since GHSA was launched in 2014, considerable work remains. That is why the United States advocates extending the Global Health Security Agenda until the year 2024. the United States commitment to working in multi-sectoral partnerships to counter infectious diseases through the Global Health Security Agenda will remain constant,”.

Strategies Against Antimicrobial Resistance
We’ve been waging war on antimicrobial resistance (AMR) for decades now, but the truth is that future strategies may require thinking outside the box. Here are some of the potential avenues for helping to stop the global burden of microbial resistance – utilizing the human micro biome to help develop new antimicrobials and deploying tiny semiconductors – “A minuscule amount of drug with some light can treat some of the worst superbug infections we tested in clinical strains acquired from a Colorado hospital,” Nagpal says. “Of course, more work and extensive studies in preclinical and clinical trials need to be done before we can administer these quantum dots to patients. However, this initial study shows a lot of promising features.” Efforts also includes infection killing polymers, changing the culture of research to move away from siloing and towards efforts across multiple channels, making existing antibiotics stronger, etc. In fact, if you want to see how AMR spreads around the world, check out this graphic from Pew Charitable Trusts.

Stories You May Have Missed:

  • Puerto Rico’s Post-Hurricane Infectious Disease Woes – Following the destruction of Hurricane Maria, Puerto Rico is now working against the clock of infectious diseases. “Four deaths in Hurricane Maria’s aftermath are being investigated as possible cases of a disease spread by animals’ urine, Puerto Rico’s governor said Wednesday amid concerns about islanders’ exposure to contaminated water. A total of 10 people have come down with suspected cases of leptospirosis, Gov. Ricardo Rossello said at a news conference.”
  • The Interesting Case of the World’s First Vaccine– a recent report on a 115-year-old smallpox vaccine vile is shedding light onto the ingredients of this revolutionary medical countermeasure. “With the evolution of science and the advanced tools now used to conduct it, it has become clear that vaccinia — the virus used in modern smallpox vaccines — is neither cowpox nor horsepox. Whether it is a virus that formerly infected some species of animals — rodents, maybe — or is something that evolved in laboratories through the deliberate mingling of pox viruses isn’t clear.”

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 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.’”

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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).’”

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Image Credit: FEMA