Pandora Report 4.21.2017

If you missed the Infectious Disease Mapping Challenge webinar last week, you can catch the recording here! Ongoing reports are highlighting that the Trump administration is unprepared for a global pandemic.

How Prepared Is The U.S. For Disease Threats?
Scientific American sat down with former CDC director Tom Frieden to discuss his experiences and what he worries may be on the horizon for public health threats. When asked about immediate health issues facing the current administration, Frieden highlights the ongoing Zika outbreak, antibiotic resistance, emerging infections, and the ever-present risk of influenza. In terms of CDC preparedness, Frieden says that, “It’s a big problem that when there is an emerging threat, we are not able to surge or work as rapidly as we should, as a result of a lack of additional funding and legislative authority. When there is an earthquake, the Federal Emergency Management Agency doesn’t have to go to Congress and say, ‘Will you give us money for this?’ But the CDC does. We have made a really good start working with 70 countries to strengthen lab systems, rapid-response and field-monitoring systems, but it is going to take a while before countries around the world are adequately prepared. A blind spot anywhere puts any of us at risk.”

Bill Gates Warns of Increased Bioterrorism Threat
The entrepreneur and philanthropist has been drawing increasing attention to the threat of infectious diseases, especially in regards to bioterrorism. Speaking at the Royal United Services Institute in London (RUSI), Gates stated that, “bioterrorism is a much larger risk than a pandemic.” “All these advances in biology have made it far easier for a terrorist to recreate smallpox, which is a highly fatal pathogen, where there is essentially no immunity remaining at this point.” He goes further to point out the unique aspects of infectious disease threats that make them more deadly than nuclear bombs. “When you are thinking about things that could cause in excess of 10 million deaths, even something tragic like a nuclear weapons incident wouldn’t get to that level. So the greatest risk is from a natural epidemic or an intentionally caused infection bioterrorism events. Whether the next epidemic is unleashed by a quirk of nature or the hand of terrorist, scientists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year. So the world does need to think about this.” Gates pointed to the insufficient public health response in countries that are likely to experience emerging infections and the importance of foreign aid. Moreover, he highlights two major advancements since the 1918 pandemic – globalization and genetic editing. The DIY biohacker and potential for a single infectious person to travel around the globe in a day are all making the threat of a pandemic that much more real. Lastly, Gates emphasizes that the stability of a country and that of its health systems are vital in that an outbreak is more likely to become an epidemic in a country where both qualities are poor.

Biopreparedness – Developing Vaccines For An Eradicated Disease
Speaking of smallpox and the risk of bioterrorism…Filippa Lentzos is pointing to the smallpox vial discovery at the NIH and that despite the eradication of the disease, a biotech company, Bavarian Nordic, is still working to develop a vaccine. She notes that “possible avenues for the re-emergence of smallpox, including the impact of developments in synthetic biology, and it gives an inside view on the biodefence industry and its unusual business model.” Lentzos is an expert in the field of biodefense and focuses her work on the governance of emerging technologies like synthetic biology.

A Scope, A Resistant Germ, and Missing Data Walk into a Bar
GMU Biodefense PhD student Saskia Popescu is looking into the rise of the resistant bug and how medical equipment can pose increased risks for such infections. In 2015 several outbreaks occurred in patients following a procedure with a type of duodenoscopes made by Olympus. These scopes are “flexible medical devices that look like thin tubes and are inserted through the mouth, throat, and stomach into the small intestine—are reusable $40,000 medical devices that contain many working parts, including a camera, and are used for more than half a million procedures a year. The successful dynamics of the device also make it challenging to clean and disinfect. Just over two years ago, cases of drug-resistant infections started popping up in patients who had recently had the procedure that commonly uses duodenoscopes (endoscopic retrograde cholangiopancreatography or ERCP).” Following an outbreak of the highly resistant carbapenem-resistant Enterobacteriaceae (CRE) at UCLA Medical Center, the scopes were recalled and interim cleaning guidance was provided by the CDC. Unfortunately, there is growing concern that the issues with the scope weren’t fully remedied. “In fact, Sen. Murray highlighted a recent outbreak in Europe (location not disclosed within the US Food and Drug Administration report) tied to the modified scopes. Although, modifications made by Olympus were done in response to the previous outbreaks and meant to reduce the risk of bacteria getting into the device’s channels and preventing proper cleaning and disinfection, Sen. Murray is now questioning Olympus regarding the devices and the role they played in this most recent outbreak. The senator is specifically asking for data proving that the repaired scopes could be properly disinfected between patient use.” As the threat of antibiotic resistance rises, the role of medical devices and manufacturer accountability will become increasingly relevant.

CRISPR Breakthrough Gives Hope for Disease Diagnostics 
CRISPR technology news often comes with a bit of controversy, but research recently published in Science is pointing to exciting new diagnostic capabilities. Feng Zhang and eighteen colleagues “turned this system into an inexpensive, reliable diagnostic tool for detecting nucleic acids — molecules present in an organism’s genetic code — from disease-causing pathogens. The new tool could be widely applied to detect not only viral and bacterial diseases but also potentially for finding cancer-causing mutations.” If you’re a fan of 221b Baker Street, you’ll be pleased to hear that the new tool is named SHERLOCK – Specific High Sensitivity Enzymatic Reporter UnLOCKing. The SHERLOCK tool utilizes the viral-recognition within CRISPR to detect genetic pathogen markers in some one’s urine, blood, saliva, or other body fluids. “They report that their technique is highly portable and could cost as little as 61 cents per test in the field. Such a process would be extremely useful in remote places without reliable electricity or easy access to a modern diagnostic laboratory.” This new finding has amazing potential for public health and rapid disease detection in rural areas to improve time to treatment, isolation, and prevention efforts.

National Science Advisory Board for Biosecurity May 2017 Meeting
Don’t miss this May 11th meeting (2-4:30pm EST)! Items include presentations and discussions regarding: (1) the Blue Ribbon Panel draft report on the 2014 variola virus incident on the NIH Bethesda campus; (2) stakeholder engagement on implementation of the U.S. Government Policy for Institutional Oversight of Life Sciences Dual Use Research of Concern (DURC); and (3) other business of the Board.  A detailed agenda and other meeting material will be posted on this website as they become available. This meeting will be a conference call only; there will be no in-person meeting. To join the call as a member of the public, please use the dial-in information below. The toll-free teleconference line will be open to the public at1:30 P.M. to allow time for operator-assisted check-in.  Members of the public planning to participate in the teleconference may also pre-register online via the link provided below or by calling Palladian Partners, Inc. (Contact: Carly Sullivan at 301-318-0841).  Pre-registration will close at 12:00 p.m. Eastern on May 8, 2017. Make sure to check the website for the public conference line and passcode.

Synthetic Bioterrorism – US Developing Medical Response 
Preparedness efforts against biological threats are now expanding to include synthetic biological threats. “Dr. Arthur T. Hopkins, acting assistant secretary for Nuclear, Chemical, and Biological Defense Programs at the U.S. Department of Defense (DOD), testified that…’emerging infectious diseases, synthetic biology and engineered diseases…[is] an area where we are focusing and we have to continue to focus.’ To counter such current and emerging threats, DOD’s Chemical and Biological Defense Program is developing new strategies to more rapidly respond, especially in the area of medical countermeasures, Hopkins said.” He noted that the DoD has commissioned the National Academy of Science to lead a study on the potential for such an event and its impact on national security.

Chemical Reaction: North Korea’s Chemical Weapons Are A Big Threat- And China Needs to Help Deal With Them
GMU Biodefense PhD alum Daniel M. Gerstein is looking at the “role that China could play with respect to North Korea, in particular dissuading the use of chemical weapons. While tensions are high, the use of chemical weapons could be the “spark that could bring the region to war.” Gerstein notes that while the focus in Syria is internal, if Kim Jong Un used chemical weapons it would most likely be external- against South Korea or Japan (or even the U.S.). It is vital that there be a clear-cut response to the use of chemical weapons and action from China may just be the clear message that’s needed. “To prevent the unthinkable from occurring, the North Koreans must be dissuaded from using chemical weapons. They must be convinced that the use of chemical weapons is a red line that cannot be crossed. China should consider being the messenger for this message. China also should consider taking an active, forward-looking approach to prevent the use of chemical weapons by North Korea. When Syria deployed chemical weapons, there was speculation that Russia may have been complicit or at least aware of plans to conduct the attack.” Or perhaps some friendly games of volleyball are in order?

Wildlife Disease Biologists – An Unstoppable Force 
Neither rain nor sleet could keep APHIS wildlife disease biologists out of the field collecting samples. Animal diseases are a major source for infections coming down the pipeline for humans (i.e. spillover events) and these researchers are on the front lines trying to make sure we have a heads up. APHIS’ Wildlife Services (WS) program includes 36 wildlife disease biologists who work diligently to collect samples from wild birds for avian influenza testing (among other things). “‘By monitoring the avian influenza strains circulating in wild birds, WS and its partners are able to provide an early warning system to America’s poultry producers,’ states Dr. Tom DeLiberto, Assistant Director of WS’ National Wildlife Research Center. ‘Our experts focus their sampling on waterfowl species and locations where we are most likely to detect avian influenza. This ensures our efforts are as efficient and informative as possible’.” I think we can all appreciate the brave few who venture into frigid waters to help trap and test wild birds to help detect the spread of infectious diseases.

Stories You May Have Missed: 

  • Trends in Apocalyptic and Post-Apocalyptic Fiction – Writers frequently use an apocalyptic or post-apocalyptic backdrop for fictional stories. The Doomsday Clock is a visual representation of the general mood and often represents the fear and unease in the environment. Whether it be an environmental event or a killer virus, the end of humanity has been a frequent topic for many writers. “Often it is a fear of a naturally-evolving virus, as in Max Brooks’s World War Z: An Oral History of the Zombie War (2006) or Emily St. John Mandel’s Station Eleven (2014). Yet, with the advent of new biotechnologies, authors also considered the impact a malignant engineered virus would have on humanity, as seen in Margaret Atwood’s Maddadam trilogy (2003 onwards) and Justin Cronin’s The Passage trilogy (2010 onwards).”
  • Ebola Theme Issue – The Royal Society – Philosophical Transactions of the Royal Society B is focusing their latest biological sciences journal on the 2013-2016 Ebola outbreak in West Africa. In this edition, you can find opinion pieces discussing the contribution of engineering and social sciences, old lessons on new epidemics, and a wealth of information on outbreak evaluation and notes from the field.

Pandora Report: 11.13.2015

Given the auspicious nature of Friday, the 13th, how about we start the Easy-Bake Oven version of bioreactors? (insert evil genius laugh). Our report this week is rich in biosafety, GMU Open Houses, and updates on global outbreaks. Fun History Fact Friday – this week in 1989, the Berlin Wall came down! Before we venture down the rabbit hole, don’t forget to get your flu shot before the 2015/2016 influenza season hits too hard!

DIY Bioengineering 
If you’re in search of the perfect holiday gift for your favorite biodefense/bioengineer, you can thank the creators of Amino (personally, I think calling it the Easy-Bake Oven Bioreactor is just so much more fun). The kit starts at $700 and comes with all the essentials for your “recipe” (main bacterial culture, DNA, pipettes, incubators, agar plates and various sensors for monitoring microbial growth). Did I mention it comes in a nice color-coded, pleasing-to-the-eye plywood dashboard? MIT graduate, Julie Legault, is the master genius behind Amino, and uses the “apps” (step-by-step guides) to help make even the most science adverse individual capable of making DNA products. Liz Stinson points out that “they walk users through how to insert the DNA into untransformed bacteria cells, and how to incubate, grow, and maintain the altered microorganisms”. Just make sure your new gift comes with some information on dual-use research of concern and avoids any select agents…

Master’s Open House 
Make sure to swing by our GMU Master’s Open House on Wednesday, November 18th at 6:30pm to learn about all our different programs! Good news – you can virtually attend via this link and even ask questions live! We’ll be talking biodefense and all the ways you can use our MS degree (online or in person!). Whether its fighting food safety issues, pandemic influenza, or zombies, we’re passionately trying to make the world of global health security stronger and more diverse!

Biological Research: Rethink Biosafety 
“Biology must move forward on safety and security. Let’s not reinvent the wheel, but learn from those doing safety better.” Tim Trevan’s comments echo the sentiments of many within the biosecurity field. The anthrax mishaps at Dugway and the CDC BSL-3 lab in Atlanta compound a growing concern over the handling of select agents and the lab safety practices and processes that seem to be failing. Trevan poses the question, “what are the prospects for managing the more intractable risks globally if measures to ensure the safe handling of dangerous pathogens are failing at the best-equipped facilities in the country with the most advanced biotechnology in the world?” In his words, Trevan has hit the nail on the head and summarized the realities of lab safety culture. So what’s to be done? Trevan makes the unexpected recommendation of  using nuclear security experts to advise on biosafety and biosecurity. This strategy utilizes a practice that is also common in healthcare – a culture of safety. By focussing on the prevention of failure, instead of maximizing output, safety becomes an engrained practice in all levels of an organization, transforming it into a “high-reliability organization” (HRO). By using examples within industries like offshore oil drilling, airlines, etc., Trevan points to the growing biotech capabilities that make biosecurity that much more imperative. In healthcare, I’ve seen organizations truly transform their practices by moving to a culture of safety (and utilizing “just culture” when it comes to patient safety) and while it’s not a wholly easy process, the foundations are already present in the existing teachings of patient care. Labs have the training and knowledge for safety, but as Trevan points out, it’s time to bring in those with the expertise to help move towards a culture of safety.

Screen Shot 2015-11-12 at 9.56.04 AM
Courtesy of HDOH

Dengue Fever Outbreak in Hawaii 
If you’re considering a winter retreat to Hawaii, make sure to grab some bug spray. Hawaii Island is currently experiencing a Dengue outbreak that has just reached 33 cases. Dengue is not endemic to Hawaii and while travelers have imported cases from time to time, this is marks the first big cluster of locally-acquired cases since 2011. The Hawaii Department of Health (HDOH) continues investigations and reports (as of 11/11)  25 Hawaii Island residents and 8 visitors have been laboratory confirmed with dengue fever. The HDOH has provided maps related to exposure areas to help people avoid high-risk locations or at least use preventative measures. If you’re traveling to Hawaii Island or an area where dengue is endemic, make sure to take steps to reduce the risk of mosquito bites and the potential for transmission!

Ebola Update
Guinea has reported no new cases in the last week. While they’re still on high alert after the cases surrounding a family, they are hopeful. Liberia and Sierra Leone have hit their 90-day enhanced surveillance period, meaning they have no new cases and are now working towards the WHO’s second objective (managing and responding to residual risks). Pauline Cafferkey has made a full recovery after her hospitalizations due to post-Ebola recovery complications. Researchers at Columbia University’s Mailman School of Public Health used a new statistical model to map the outbreak. Results will be published in the Journal of Royal Society Interface, which shows the development of the outbreak and role early detection and response plays.

Stories You May Have Missed: 

  • Joint Services Mask Leakage Tester (JSMLT) Contract – the DoD has announced that Air Techniques International, Inc. has been awarded a contract regarding the maintenance of the JSMLT. The JSMLT does quality control and ensures proper fitting (portably) on CBRN protective masks.
  • H7N9 Cases in China Rise– China has confirmed two more cases that occurred in October, bringing the total case count to four. Many in public health are noting that these cases bring about a fourth wave of infections (starting in October). The two new cases were a a 62-year-old woman from Shengzhou and a 51-year-old farmer from Hangzhou.
  • Boosting Biosecurity in Nigeria & Kenya– The Institute of Human Virology at the University of Maryland have announced two grants to help build biosecurity in Nigeria and Kenya. The first grant of $13 million will go to strengthen laboratory infrastructure in Kenya, and the second of $10 million will help those in Nigeria quickly detect and respond to emerging infectious diseases.

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Pandora Report 5.24.15

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

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

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

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

Enjoy your Memorial Day weekend!!

Britain Investigates Sailor’s Disaster Warning Over Nuclear Subs

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

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

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

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

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

Vaccines Developed for H5N1, H7N9 Avian Flu

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

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

Stories You May Have Missed

  

Image Credit: UK Ministry of Defence

The Pandora Report 2.14.14

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

Hong Kong Reports Fifth H7N9 Bird Flu Case

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

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

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

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

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

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

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

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

First H7N9 Case Outside of China

The first case of H7N9 detected outside of China has been detected in Malaysia. A Chinese tourist in the country fell ill and has subsequently been stabilized in a local hospital.

From The Star (Malaysia) – “The Health Ministry has confirmed the first Influenza A (H7N9) case in the country, involving a female tourist from China. The import case involves a 67-year-old Chinese woman, who had travelled from Guangdong, China, to Kuala Lumpur on Feb 4. The woman went to Sandakan, Sabah the next day before going on to Kota Kinabalu on Feb 6. ‘The woman was referred to a private hospital in Kota Kinabalu on Feb 7, and (after two screenings) on Feb 11, the sample tested positive for the Influenza A (H7N9) virus. She is currently receiving treatment in the ICU, put on ventilator and is in a stable condition,’ Health Minister Datuk Seri Dr S Subramaniam said in a press conference, here, Wednesday. Dr Subramaniam stressed that there was no cause for panic over the matter as the risk for human transmission of H7N9 is ‘very low’.”

 

The Pandora Report 2.6.14

Highlights include H10N8, H7N9’s second wave, MERS-CoV update, and a Burholderia antrimicrobial. Happy Friday!

New China bird flu a reminder of mutant virus risk

We covered this story when it first came out, but the emergence of a novel strain of highly pathogenic avian influenza (HPAI) is noteworthy enough to mention twice.  It’s H10N8 everyone and it’s in humans. There have been just two cases since the virus jumped from birds to humans in December of 2013, including one fatality. There are a couple things about H10N8 which is troubling scientists. The first is that it’s jumped host, and in the process, opened up a completely naive population (us) to infection. The second is that it’s thought to be reassorted – a mix of a couple other strains of avian flu. Reassortment scares everyone – if it can mutate once to be able to infect humans, it can mutate twice to become readily transmissible person-t0-person. Still, we’re novel hosts, which means the virus isn’t yet well-adapted to us. It’s also worth mentioning here that H7N9 also made the jump from poultry to person, and it remains poorly suited to human hosts.

Reuters – “The death of a woman in China from a strain of bird flu previously unknown in humans is a reminder of the ever-present potential pandemic threat from mutating animal viruses, scientists said on Wednesday. The new strain, called H10N8, has so far infected only two people – a fatal case in a 73-year-old and another in a woman who is critically ill in hospital. But the fact it has jumped from birds to humans is an important warning, they said. ‘We should always be worried when viruses cross the species barrier from birds or animals to humans, as it is very unlikely that we will have prior immunity to protect us’, said Jeremy Farrar, director of Wellcome Trust and an expert on flu.”

China reports 11 new H7N9 human cases

Chinese health authorities have reported a further 11 laboratory-confirmed cases of H7N9, bringing the number of second wave infections up to 181, and the total number of cases up to 317. The majority of the cases are coming from just two Chinese provinces, Guandong and Zhejiang. While the influx of cases in Hong Kong are all thought to originate from poultry imports, there has been no evidence to indicate the virus has been transmitted internationally. Also, aside from one cluster, there has been no evidence of sustained person-to-person transmission.

Xinhua – “Eleven Chinese people were confirmed to be infected with the H7N9 bird flu on Wednesday in four regions, with 8 in critical condition, according to local health authorities. The southern province of Guangdong reported 4 new cases, including a 5-year-old girl and a 42-year-old man in Zhaoqing City, a 49-year-old man in Foshan City and a 56-year-old man in Shenzhen City, said the provincial health and family planning commission. The girl and the man from Foshan are in stable condition while the other two remain in critical condition, according to the commission. The eastern province of Zhejiang, the region hit hardest by the H7N9 virus, confirmed four new human cases on Wednesday, bringing the total number of affected cases to 69 in the province so far this year, said the provincial health and family planning commission.”

Middle East respiratory syndrome coronavirus (MERS-CoV) – update

With H7N9 picking up and H10N8 emerging, MERS-CoV has been flying under the comparative radar. Speaking anecdotally, the number of cases seems to be declining, with just one new case in the last two weeks. Globally, there have been 181 cases to date. While camels remain the likely culprit, no vector or reservoir has been confirmed.

WHO – “The case is a 60-year-old man from Riyadh who became ill on 19 January and who had underlying medical conditions. He was hospitalized on 24 January and died on 28 January. Respiratory specimens were collected and sent to the central laboratory in Riyadh and confirmed positive for MERS-CoV on 28 January. Details of his possible contact with animals are unknown, and he has no history of contact with a laboratory-confirmed case. WHO has also been informed by the United Arab Emirates of the death on 16 January of a previously reported case of a 33 year-old male healthcare worker from Dubai (see Disease Outbreak News update from 3 January 2014).”

U.S. Eyes $90 Million Contract for Bioterror Treatments

The Department of Health and Human Services (HHS) awarded a $19.8 million dollar contract to a company working on  antimicrobials against the agents Burkholderia mallei, the causative agent of glanders,  and B. pseudomallei, the causative agent of melioidosis, respectively.  B. mallei, it should be noted, may have been used during WWI by the Germans, in an ill-fated attempt to use infected horses to spread the disease across the Russian front lines. While B. mallei does cause serious disease in horses and donkeys, cases of human infection are rare.

NTI – “The contract award marked a new investment in ‘broad-spectrum antimicrobials’ by the federal agency’s Biomedical Advanced Research and Development Authority. Such treatments are designed to be of use in responding to a potential biological strike, as well as for handling other health threats. ‘Antibiotic resistance adversely impacts our nation’s ability to respond effectively to a bioterrorism attack and to everyday public health threats,’ BARDA Director Robin Robinson said in a statement. ‘By partnering with industry to develop novel antimicrobial drugs against biothreats that also treat drug-resistant bacteria, we can address health security and public health needs efficiently.’

(image: James Jin/Flickr)

The Pandora Report 1.31.14

Highlights include abrin poisoning, norovirus on another couple cruises, a B. anthracis bacteriophage, and H7N9 fears in Hong Kong. Happy Friday!

Bank worker, 36, ‘spiked her Magistrate mother’s Diet Coke with deadly poison’
A woman in the UK is standing trial for attempting to poison her mother with abrin, by spiking her Diet Coke soda with the toxin. As we mentioned last week after a man tried to sell abrin hidden in candles, abrin is 75 times more toxic than it’s bean-derived cousin, ricin. No word yet on the source of the toxin in the case. The woman was arrested following a counterterrorism effort in the UK – she will not, however, be charged with acts of terrorism or violations of the BWC. She maintains her innocence.

London Evening Standard – “Abrin strikes at the liver, stomach and kidneys and is potentially fatal. It costs between £600 and £900. Kuntal Patel, 36, is accused of spiking a Diet Coke with abrin…Patel was arrested after a hunt for toxic chemicals at her home following information passed to the Met from the US. She has said the substance was intended for a suicide bid which she later abandoned.”

Cruise ship back in Houston after nearly 200 fall ill
We’d like to say upfront that we have a degree of admiration for anyone still willing to go on cruise ships. While we understand that hundreds of ships plow through various bodies of water without issue everyday, when things go wrong on a cruise ship, they have the unique capacity to go spectacularly wrong. In 2013 alone, there were nine outbreak of gastrointestinal illnesses on US-based cruise ships  – 7 caused by norovirus and one caused by E. coli (the cause of the ninth case rather ominously remains “unknown”). Compared to, for instance, last February’s incident involving a week of no power or working toilets, this week’s two incidents – one norovirus outbreak on a ship sickening 170, and another sickening 700, seem relatively tame.

Houston Chronicle – “The Caribbean Princess left the Port of Houston on Jan. 25 bound for the Western Caribbean with more than 4,200 people on board. The vessel was scheduled to return on Saturday. According to CDC spokesman Llelwyn Grant, 162 of the 3,102 passengers and 11 of the 1,148 crew members had reported illness by late Thursday afternoon. Ship employees implemented some of the agency’s recommendations for preventing further infections, he said…Caribbean Princess passengers will remain on the ship until they are cleared by U.S. Customs authorities, which will take several hours, according to Princess Cruises spokeswoman Julie Benson. Besides overnight accommodations in Houston, the cruise line said passengers would be offered a 20 percent credit toward a future cruise.”

Newly-discovered virus has voracious appetite for anthrax
The Tsamsa virus, a surprisingly large, newly-discovered bacteriophage (bacteria-eating virus), seems to have a preferential appetite for Bacillus anthracis. This appetite can hopefully be one day harnessed  The virus was discovered in a zebra carcass in Namibia by an international team of scientists, led by researchers from Universities Berkeley and KwaZulu-Natal  from universities around the world. And people say academia isn’t glamorous.

UC Davis PR– “The virus was isolated from samples collected from carcasses of zebras that died of anthrax in Etosha National Park, Namibia. The anthrax bacterium, Bacillus anthracis, forms spores that survive in soil for long periods. Zebras are infected when they pick up the spores while grazing; the bacteria multiply and when the animal dies, they form spores that return to the soil as the carcass decomposes.”

Hong Kong reports third H7N9 death
China has culled 22, 604 birds following a batch of poultry testing positive for H7N9. Adding to fears over the virus’ spread, yesterday another patient died following an H7N9 infection, the third in the last month. Hong Kong has also shut it’s live poultry market for three weeks to allow for thorough disinfection. The most recent death, which comes just one day before the Chinese new year, has definitely not helped assuage fears. Still no sign of sustained person-to-person transmission

Economic Times – “The 75-year-old man had previously travelled to the neighbouring Chinese city of Shenzhen and died Wednesday morning, a Department of Health spokesman confirmed to AFP without elaborating. Fears over avian flu have grown following the deaths of two men from the H7N9 strain of the virus in Hong Kong since December. A 65-year-old man with H7N9 died on January 14 and an 80-year old man died on Boxing Day last year. Both had recently returned from mainland China.”

(image courtesy of Matt Wade/Wikicommons)

The Pandora Report 1.23.14

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

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

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

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

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

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

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

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

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

(image:Calvin Teo)

Image of the Week: H7N9 in the Lab

Our images of the week is a gallery of H7N9 work at the CDC, tailored for those of you who are nerdy like us and therefore wonder how an emergent agent is dealt with in the lab. Cases of H7N9 in China are currently comparable to peak numbers following the agent’s emergence last Spring. Click on any image below to launch the gallery (all images credited to the CDC, including the one above).

3 new H7N9 cases in China

The weekend saw another three cases of H7N9 in China, bringing the total since the October re-start to 65. An 86 year-old-man was released following a month of quarantine, having consistently tested negative for the virus.

“Commenting on the three new confirmed cases imported from Guandong a day earlier, Chou said Sunday that there is no evidence to exclude human-to-human transmission. Two of the confirmed cases involved a father, who was selling tofu at a local market, and his five-year-old daughter, according to Chou. Pending investigation, it is uncertain whether the girl contracted the virus from her father or from live poultry at the market, Chou said.”

Read more here.