H7N9 – The Pandora Report

Pandora Report: 4.5.2019

April 5, 2019 by spopescu, posted in Pandora Report

Good news- spring is in full effect and flu transmission is starting to slow. With summer around the corner, have you registered for our workshop on all things biodefense, from anthrax to Zika?

The Plague Years – How the Rise of Right-Wing Nationalism is Jeopardizing the World’s Health
Maryn McKenna is calling out a very real issue – politics, vaccines, and the reality that “As nativist appeals undermine public health systems and cooperation among countries degrades, the potential for catastrophe increases. We are always at risk of a new disease breaking out, or a previously controlled one surging back. What’s different now is that the rejection of scientific expertise and the refusal to support government agencies leave us without defenses that could keep a fast-moving infection at bay. Pathogens pay no respect to politics or to borders. Nationalist rhetoric seeks to persuade us that restricting visas and constructing walls will protect us. They will not. ‘Nationalism, xenophobia, the new right-wing populism in Europe and the United States, are raising our risk,’ said Ronald Klain, who was the White House Ebola response coordinator for President Barack Obama and now teaches at Harvard Law School. ‘There’s a focus not so much on stopping infectious diseases as much as there is on preventing the movement of people to prevent the transmission of diseases. And that’s not possible, because no matter what you do about immigrants, we live in a connected world’.” Moreover, that belief system can be seen in the White House, as President Trump tweeted during the 2014 Ebola outbreak – “Keep them out of here,” he tweeted about American missionaries who fell ill in West Africa. “Stop the Ebola patients from entering the U.S.” and “The U.S. cannot allow Ebola infected people back.” As McKenna notes “This is the perverse legacy of nationalism in power: By stigmatizing immigrants and segregating them, xenophobia can turn the lie of the ‘dirty foreigner’ into truth. ”

Hospital-Associated Conditions Penalties: What They Really Mean
Just how good is your local hospital at preventing infections in patients? GMU biodefense doctoral student and infection preventionist Saskia Popescu is breaking down what these quality metrics really mean and how hospitals are scoring. “In 2014, CMS established another rule tying health care quality of care and reimbursement—the HAC Reduction Program. Although this started with reporting of certain conditions, such as central-line associated bloodstream infections, these pay-for-performance programs were expanded over time. The program links hospital performance in certain categories with reimbursement. That’s right, if a hospital performs poorly, they can be hit where it hurts—the bank. Scores are determined by a hospital’s performance in 2 domains—1 includes indicators like pressure ulcers and in-hospital falls with injury, while the second domain focuses on health care-associated infections that include central-line associated bloodstream infections, catheter-associated urinary tract infections, certain surgical-site infections, methicillin-resistant Staphylococcus aureus bacteremia, and Clostridium difficile (C diff) infections. Considering there are 500,000 cases and 15,000 deaths a year related to C diff in the United States, it’s not surprising that CMS would want to crack down on those cases associated with hospitalization.” “There are just over 5000 US community hospitals that will likely receive CMS reimbursement in FY2019, and 800 (16%) of these institutions experienced financial penalties related to poor performance. That’s a pretty substantial amount, but the painful truth is that this number is likely higher considering there have been concerns for hospitals failing to report HACs and a general lack of CMS data validation.”

Ebola Continues to Hit the DRC
We’ve surpassed 1,000 cases and are now beyond the point where the WHO called a PHEIC in the 2014-2016. On Tuesday, the “World Health Organization (WHO) today reiterated that the outbreak in the Democratic Republic of the Congo (DRC) will be defeated only with local communities at the helm of response efforts. The message came from Ibrahima-Soce Fall, MD, WHO assistant director-general for emergency response, who held a brief teleconference this morning from Butembo. With 72 Ebola cases reported last week and 56 in the previous week, March was a low point for responders, as activity spiked and the outbreak topped the 1,000-case milestone.” On Thursday, it was reported that 7 new cases were identified, including a healthcare worker. “The healthcare worker in Musienene brings the total number of health workers infected during the outbreak to 82 (7.4% of all confirmed or probable cases), and 29 of them have died, the DRC said. In an update released late yesterday, the DRC recorded 8 new confirmed cases, and 7 deaths, including 5 community deaths. Butembo and Katwa each had a community death, and Mandima recorded 3. Community deaths have been a compounding factory of this outbreak, as they enable the virus to spread more easily among family members and funeral attendees.” Based off the latest case counts, three main areas have been the hotspots for the outbreak – Katwa, Vuhovi, and Mandima.

Next Generation Biosecurity Online Course
“An open online course exploring biosecurity and biological threats begins this week on FutureLearn. This course is for professionals working in public and global health, international security, politics and international relations. It may be of particular use to biosafety officers in academia, industry or government, and early-career science scholars in the life sciences.” You can access the course here.

Why the Scientific Debate Over a UW Bird Flu Study Isn’t Going Away
“A University of Wisconsin-Madison laboratory is set to resume experiments that could build the foundation of an early warning system for flu pandemics. The research is based on altering a deadly type of the influenza virus in a way that could make it more dangerous, though, and critics say its approval lacked transparency and creates unnecessary risks. Yoshihiro Kawaoka is a virologist and professor at the UW School of Veterinary Medicine and the University of Tokyo who has figured prominently in Wisconsin’s long-term central role in flu research. Kawaoka’s work has been the focus of fierce debate among epidemiologists ever since he announced in 2011 that his lab had successfully altered the H5N1 subtype of the influenza A virus to be transmittable through the air among ferrets. These small mammals are a common laboratory stand-in for studying human flu transmission.” “That debate has lingered since 2011 and intensified in early 2019 after the federal government approved funding for Kawaoka to continue his research. Marc Lipsitch is a professor of epidemiology and director of the Center for Communicable Disease Dynamics at Harvard T.H. Chan School of Public Health. He’s a longtime critic of research that modifies flu viruses to be more dangerous in humans. ‘What worries me and my colleagues is the effort to modify viruses that are novel to humans and therefore to which there’s no immunity in the population, and where a laboratory accident wouldn’t just threaten the person who got infected … but potentially could be the spark that leads to a whole pandemic of infectious disease,’ Lipsitch told WisContext.”

New Plant Breeding Tech for Food Safety
Tackling the issue of food safety is up there with a universal flu vaccine – something we all want, but a task requiring a Herculean effort. A new insight to this problem has come forward though and the authors “argue that with careful deployment and scientifically informed regulation, new plant breeding technologies (NPBTs) such as genome editing will be able to contribute substantially to global food security. Previously, conventional plant breeding through cross- and self-pollination strategies played a major role in improving agricultural productivity. Moreover, the adoption of genetically modified (GM) crops by smallholder farmers has led to higher yields, lower pesticide use, poverty reduction, and improved nutrition. Nevertheless, so far only a few developing and emerging economies—such as China, India, Pakistan, Bangladesh, and South Africa—have embraced GM crops. Even though three decades of research show that GM crops are no more risky than conventional crops, many countries in Africa and Asia are hesitant to promote the use of GM crops, largely because of erroneously perceived risks and fears of losing export markets to Europe.”

Stories You May Have Missed:

Opioid Epidemic Increases Some Infectious Disease Rates – “The United States faces a converging public health crisis as the nation’s opioid epidemic fuels growing rates of certain infectious diseases, including HIV/AIDS, hepatitis, heart infections, and skin and soft tissue infections. Infectious disease and substance use disorder professionals must work together to stem the mounting public health threat, according to a new commentary in the Journal of Infectious Diseases. The article was co-authored by officials from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and the Institute of Human Virology at the University of Maryland School of Medicine in Baltimore. Since 1999, nearly 400,000 people in the United States have fatally overdosed on opioid-containing drugs, with 47,600 deaths in 2017 alone. Many people with opioid use disorder (OUD), who initially were prescribed oral drugs to treat pain, now inject prescribed or illegal opioids. High-risk injection practices such as needle-sharing are causing a surge in infectious diseases. Additionally, risky sexual behaviors associated with injection drug use have contributed to the spread of sexually transmitted infections.”
US Army Develops Fast-acting Spray for CW Decon– “Chemical and biological weapons experts earned the U.S. Army a patent on Tuesday for their groundbreaking work on rapid decontamination. Gregory Peterson, Joseph Myers, George Wagner, Matthew Shue, John Davies, Jr., and Joseph Rossin were listed as the inventors on U.S. Patent 10,245,456, “Process for Decontamination and Detoxification with Zirconium Hydroxide-Based Slurry.” (The patent is linked below). The research team works at the Army’s Chemical Biological Centerin Maryland, and has significantly reduced decontamination time down to less than 30 minutes and the amount of water needed to treat large amounts of equipment coated in deadly toxins.”

Pandora Report 3.2.2018

March 2, 2018March 2, 2018 by spopescu, posted in Pandora Report

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 12.22.2017

December 22, 2017January 6, 2018 by spopescu, posted in Pandora Report

Happy Holidays from your friends at the Pandora Report! We hope you have a lovely holiday weekend and enjoy this warm cup o’biodefense. If you’re still looking for the perfect gift for a microbe-loving person in your life, check out the latest holiday pack here.

International Criminal Court Adds Use of Biological Weapons to Rome Statute
Last week, during the Assembly of States Parties to the ICC, it was decided that three new crimes would be now be classified as war crimes within the Rome Statute. “The new war crimes added to the Rome Statute are, respectively, the use of biological and toxin weapons, the use of weapons causing injuries by fragments which in the human body escape detection by X-rays and the use of laser weapons causing permanent blindness. These weapons kill without discrimination or inflict very severe suffering. Their elevation to the rank of war crimes strengthens international law. The use of these weapons during armed conflicts will become even more difficult. The inscription of these new crimes in the Statute of Rome ensures also legal certainty to the victims and gives a specific recognition to their pain.” The Belgium Ministry of Foreign Affairs has come forward noting that “It was Belgium that had proposed these amendments to the Statute, the founding treaty of the ICC, as early as 2009. Belgium has tirelessly mobilized, through its diplomatic network and the voices of its foreign ministers, its ministers of justice and even its prime ministers to promote the adoption of these amendments.”

2017 National Security Strategy – Biodefense
Just in the nick of time, the National Security Strategy was released – and with a biodefense gem hidden on page 9! Pillar 1 (of 4) within the NSS includes a section on securing U.S. borders and territories, in which the “combat biothreats and pandemics” section is buried. Citing biological threats, whether it be natural outbreaks like Ebola, bioterrorism, or advancements in life sciences that have the potential to be mis-used, the NSS includes several priority actions. The three priority actions to combat biological threats are: “detect and contain biothreats at their source, support biomedical innovation, and improve emergency response. ”

Trump’s Biodefense Strategy – Naught, Nice, or MIA?
GMU biodefense MS student Janet Marroquin is taking a look at the Trump administration’s biodefense strategy and what the past year has shown us in terms of what we can expect. With the release of the NSS this past week, some direction is being given, but just how far have we come in terms of a true strategy? Marroquin delves into the nitty gritty and also gives us a holiday wish list for what we’d like to see on a biodefense strategy. She notes that “An important reform present in the proposed FY 2018 Federal budget is the call to dismantle the Academic Centers for Public Health Preparedness under the CDC and the distribution of its funds among state governments to support state-led public health preparedness. Interestingly, this action seems to contradict expert recommendations to the federal government for the development of a centralized approach to health security.” In response to the release of the NSS, the Blue Ribbon Study Panel has released a statement and highlights, like Marroquin, the importance of a comprehensive approach.

Congrats to GMU’s Biodefense December Graduates!
We’re excited to announce the graduation of several GMU Biodefense students this winter. Congrats to our students graduating with a MS: Zamawang Almemar, Alexander Rowe, and Stephanie Smith – and congrats to those graduating with a Certificate in Biodefense: Mi Chung and Mary Oberlies. We can’t wait to see where the future takes you and the amazing biodefense adventures you’ll have!

Federal Funding Resumes for Gain-of-Function Research
On Tuesday, it was announced that DHHS has ended the funding pause on GoF research. Suspended since the 2014 moratorium, guidance was released in January of this year by the White House Office of Science and Technology Policy (OSTP) for individual agencies reviewing research. While the OSTP P3C0 recommendations provided guidance for agencies looking to conduct, support, or planning to conduct such research, its sole purpose was “to recommend consistent and appropriate Federal agency review and reporting processes for the enhanced oversight of Federally funded research that is anticipated to create, transfer, or use enhanced pathogens with pandemic potential.” In fact, once agencies adopted a review process and satisfied such requirements, they could lift their moratorium on GoF research. It is this week’s NIH announcement however, that fully lifted the moratorium and provided framework for guiding funding decisions about such research (FYI – you won’t find many differences between the framework and the OSTP P3C0). “The framework, condensed into a 6-page document, spells out a multidisciplinary review process that involved the funding agency and a department-level review group that considers the merits and possible research benefits and the potential to create, transfer, or use an enhanced potential pandemic pathogen (PPP).” Funding for GoF research on potential pandemic pathogens, like SARS, MERS, and avian influenza, was resumed jointly with the DHHS framework that seeks to guide funding of proposed research that would involve enhancing such pathogens. “The HHS P3CO Framework is responsive to and in accordance with the ‘Recommended Policy Guidance for Departmental Development of Review Mechanisms for Potential Pandemic Pathogen Care and Oversight’ issued on January 9, 2017 and supersedes the previous ‘Framework for Guiding U.S. Department of Health and Human Services Funding Decisions about Research Proposals with the Potential for Generating Highly Pathogenic Avian Influenza H5N1 Viruses that are Transmissible among Mammals by Respiratory Droplets’.” The new framework includes 8 criteria for department-level review, which includes “An assessment of the overall potential risks and benefits associated with the research determines that the potential risks as compared to the potential benefits to society are justified” and “The research will be supported through funding mechanisms that allow for appropriate management of risks and ongoing Federal and institutional oversight of all aspects of the research throughout the course of the research”.

GMU Biodefense Student Tackles USPS Safety
Speaking of awesome things GMU biodefense graduates are doing…Stephanie Smith is using her forensic chemistry background and new biodefense degree to tackle safety in the USPS. “I’m a forensic chemist by training, that’s what I’ve done my entire career,” she said. “I came to Mason to study the ‘bio-side’ of this complex advisor position, but I realized I was also expanding my knowledge beyond science and into the policy side.” Having studied a range of different topics like agroterrorism and biosurveillance during her time at GMU, Smith’s capstone project “was based on her idea that the method of detecting bioagents in the mail could be improved.” While she was working on her studies at GMU, she was also working at the USPS within the Security and Crime Prevention Group and was tasked with writing the job description for a new permanent scientific advisor position. “Once Smith wrote the job description for the new position of ‘Scientific and Technical Advisor, Dangerous Mail Investigations’ for the Postal Inspection Service, it was determined there was only one person qualified to fill a job that required knowledge of chemistry, biodefense, security and public policy. That would be Stephanie Smith. She got the job.”

2017-2018 PHEMCE Strategy and Implementation Plan
The latest Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) SIP has been released, which highlights some of the priorities that the Department of Health and Human Services will focus on over the next five years. Within the SIP, you can find a summary of the major accomplishments, new activities, updates to the 2016 SIP activities, and specific information required annually under the Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA). The latest SIP includes accomplishments from 2016 that include regulatory science management, Zika and Ebola response, international collaboration on MCMs, etc. Some of the new projects include Ebola response, bacterial threat projects like CARB-X, etc. You can also read the PHEMCE multi-year budget for fiscal years 2016-2020 here.

GMU Biodefense Students Visit DARPA
If you’ve ever wondered what it’s like to go inside the walls of the Defense Advanced Research Projects Agency (DARPA), this article is just for you! GMU biodefense professor Andrew Kilianski took students from one of his classes to visit DARPA and gain a better understanding of their biodefense efforts. Dr. Kilianski is currently a biological scientist at the DoD and his work focuses on combating current and future threats from weapons of mass destruction in addition to teaching classes on biosurveillance and virology in the GMU Biodefense graduate program. In this segment, biodefense MS student Janet Marroquin takes us on a tour of DARPA and some of the fascinating projects they work on. “These projects range from surveillance tools to diagnostics and therapeutics, using futuristic mechanisms such as a dialysis-like purification of pathogen-infected blood or unobtrusive nanoplatforms that continuously monitor the physiological state of the patient for the detection of infectious disease. ”

Preventing An “Outbreak Anywhere” From Becoming An “Outbreak Everywhere”
GMU Biodefense PhD student Saskia Popescu is addressing the trifecta of efforts within global health security – prevention, detection, and response. Drawing on the special edition Emerging Infectious Disease journal, she highlights the importance of prevention and the obstacles that are often met. “Prevention is the first component to health security, but in many ways, it is also the most difficult. Biological threats can come from anywhere: a naturally occurring outbreak, a laboratory accident, or even an act of biological terrorism. How do we prevent biothreats when they come from so many directions? Zoonotic diseases are one place to start as more than 60% of known diseases spread from animals and roughly 75% of new or emerging diseases in humans spread from animals.”

Is Captain America A Biological Weapon?
Attending the Biological Weapons Convention will make you ponder such things and Matt Shearer from the Johns Hopkins Center for Health Security is venturing down that rabbit hole. Article I of the BWC states that each state party will not develop, produce, stockpile, or otherwise acquire or retain “microbial or other biological agents, or toxins whatever their origin or method of production, of types and in quantities that have no justification for prophylactic, protective or other peaceful purposes;” and “weapons, equipment or means of delivery designed to use such agents or toxins for hostile purposes or in armed conflict.” Shearer poses a unique question about what constitutes a biological agent – what if there is no infection but rather a human who has been enhanced? “But normal humans, animals, and plants do not seem to count as “other biological agents” in the context of the BWC, but what about enhanced or modified versions like Captain America or, perish the thought, the accidentally enhanced Teenage Mutant Ninja Turtles? Have we been unwittingly cheering for bioweapons this whole time?”

Stories You May Have Missed:

Cadavers in the Ballroom – Shockingly, this not the title of a zombie wedding movie, but rather a reality of medical conferences. This recent article found that some medical conferences, operating in grand ballrooms, utilize cadavers and body parts for teaching at their lectures. “When the deceased are cut open, there’s an increased risk of a disease being transmitted to others, said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. ‘I will be the first to acknowledge there have been no big outbreaks or situations that have occurred yet from a dead body,’ Osterholm said. ‘But I am absolutely convinced it’s just a matter of time’.”
Building A National Capability to Monitor and Assess Medical Countermeasures Use During A Public Health Emergency – Don’t miss the latest NAS report on MCM use. “During public health emergencies (PHEs) involving chemical, biological, radiological, or nuclear threats or emerging infectious diseases, medical countermeasures (MCMs) (e.g., drugs, vaccines, devices) may need to be dispensed or administered to affected populations to help mitigate the human health impact of the threat. The optimal MCMs determined for use during an emergency might be U.S. Food and Drug Administration (FDA) approved but used in unapproved ways (e.g., in a new age group or against a new agent); FDA approved using animal models because human efficacy testing is not ethical or feasible; or not yet FDA approved for any indication.”

Pandora Report 11.24.2017

November 24, 2017November 24, 2017 by spopescu, posted in Pandora Report

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.”

Pandora Report 10.27.2017

October 27, 2017October 27, 2017 by spopescu, posted in Pandora Report

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 Prediction, Preparation, 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.”

Pandora Report 7.7.2017

July 7, 2017July 7, 2017 by spopescu, posted in Pandora Report

WHO Leadership Prioritization
There are six key positions the new WHO director general should prioritize, according to Mukesh Kapila of The Atlantic. The newly elected, first ever African director general has a lot on his plate and his future efforts will surely be evaluated against the mistakes and successes of his predecessors. Dr. Tedros comes into the position with somewhat of a dark cloud following him – during the election an advisor to his opponent made public comments accusing Tedros of intentionally covering up outbreaks within his home country of Ethiopia. Kapila’s proposed to-do list for Tedros includes six main components. Firstly, promote home-grown national solutions, which focuses on sustainability and developing models that fit them and not a standardized solution for all countries. Secondly, remember that the WHO does not have a monopoly on health wisdom. “Delivering change will require a revisioning of WHO’s long-presumed position as the centre of the global health ecosystem. Today we have many well-resourced international bodies and national institutions with highly-qualified experts. Thus, WHO does not have a monopoly on health wisdom and its norm-setting and convening authority is questioned. It’s high time that the humbleness that has endeared Tedros to many people rubs off on the organisation.” Third, hire diverse talent that helps restore trust throughout member states instead of pulling from just a select few. Fourth, don’t get bogged down in international reform. “Tedros can’t afford to waste his five-year tenure on simply rearranging institutional furniture. All his recent predecessors as director general have huffed and puffed but ultimately failed to reform WHO. An effective and efficient organisation is just a means towards an end. So, Tedros only has to do enough to make WHO fit for the purpose of delivering his vision.” Fifth, look beyond traditional thought leaders – tackle the exhaustive list of issues by thinking outside the box and approach such challenges with a different vantage point. Lastly, accept that the WHO has to live within its means. “WHO is broke with budget gaps in priority areas and excessive reliance on ad hoc voluntary funding. But he should resist setting out with a begging bowl and instead reform the budgetary architecture and agree a new compact for consistent and predictable funding.” WHO headquarters alone are in an expensive location, but overall Tedros must work to truly budget accordingly while re-establishing the WHO as a leader in global health with a reputation that encourages participation and support.

Public Transit Emergency Preparedness Against Ebola and Other Diseases
Globalization and innovative developments in transit allows us to travel around the world within hours rather than days or months. Unfortunately, we’re not the only ones that travel with such new capabilities. Outbreaks like SARS, MERS, and even Ebola have all bubbled outside of their origins thanks to the ability of global travel. What can be done though? “The Transportation Research Board’s Transit Cooperative Research Program (TCRP) Legal Research Digest 50: Public Transit Emergency Preparedness Against Ebola and Other Infectious Diseases considers federal and state laws and available court decisions affecting transit agencies’ responses to infectious disease outbreaks, including potential cohesiveness among transit agencies’ procedures and federal and state guidance”. This finding highlights major topic areas like closures of major traffic generators, quarantine and isolation, employee protocols, etc. Overall, the TCRP digest investigates the legal basis for closures or emergency regulations on transit agencies as a response mechanism to pandemics or outbreaks. One particularly interesting component to the report is section VIII, which discusses infection control and disinfection measures related to transit.

Summer Workshop – Don’t Miss Out!
With just over a week before our Summer Workshop on Pandemics, Bioterrorism, and Global Health Security begins, don’t miss out on the last remaining spots! We’ll have instructors from all over the realm of biodefense discussing a range of topics as diverse as the threats themselves. Biotechnology and medical countermeasures? We’ve got it! Dual-use research and biosecurity? Got it. Don’t worry – we’ve got all the topics covered. You won’t want to miss this three-day workshop filled with wonderful topics and some of the top names in the biodefense field.

How Bill Gates Got Bioweapons Wrong
Following Bill Gates’s comments on bioterrorism, Filippa Lentzos points out that while his intentions were good, his comments about a terrorist wiping out 30 million people with a weaponized disease are wrong, especially as they draw such attention to amateurs as terrorists. Lentzos specifically highlights the tacit knowledge that would be needed for such an act and that frankly, it’s a stretch for terrorists to take advantage of biotech advances. “Available evidence shows that few terrorists have ever even contemplated using biological agents, and the extremely small number of bioterrorism incidents in the historical record shows that biological agents are difficult to use as weapons. The skills required to undertake even the most basic of bioterrorism attacks are more demanding than often assumed. These technical barriers are likely to persist in the near- and medium-term future.” Moreover, Lentzos points out that by making such comments, Gates distracts from those who are more concerning in terms of bioweapons – state-sponsored groups and national militaries. It’s within these groups that the capacity to develop and deploy weapons lies, not within the small DIY garage bioterrorist. “Another factor significantly limiting the use of biological weapons is their lack of perceived military utility. In the near-to-medium term, however, advances in science and technology may enable the development of more capable and more accessible biological weapons. These weapons might allow attacks to be targeted more precisely. Attribution would become more difficult. These technical developments—paired with changes in the social context around biological weapons—may lower barriers to the development and use of biological weapons.” To defend against these degrading barriers, Lentzos urges several things – modernizing the Biological Weapons Convention, use of a collective and convincing response for any breaches in norms against bioweapons or actual use of one, and development of national biodefense capacities. Lentzos leaves the reader with a final plea – within these biodefense programs, ensure biosafety and biosecurity, implement the BWC, declare the program to ensure confidence-building measures are submitted, and regularly review your program to ensure compliance with the BWC. In the end, it’s the state-sponsored or military bioattacks we should worry about rather than drawing attention to the potential for bioterrorists.

Bio: Separating Fact From Fiction
GMU biodefense PhD alum Daniel M. Gerstein evaluates the good, bad, and ugly of DIY biotechnology. Drawing on a range of events and even films, Gerstein first describes what exactly DIY biotechnology is as there is frequently confusion. He highlights the freedom that DIY biologists have in terms of their projects, especially since they aren’t driven by grants or deadlines that companies or universities place on such projects. The promises and perils of DIY bio has been met with an array of critics and supporters – some say that this freedom is how scientific discovery occurs, while others point to the lack of oversight and that people without fundamental understanding of scientific ethics may abuse such technology. “The DIY spirit is embedded in humankind’s quest for discovery and knowledge. As DIY bio continues to evolve, two ‘courses of action’ are available. The first would be to place harsh limitations on such activity, but that would ultimately be counterproductive and likely fail. The second would be to embrace DIY, understand its risks and limitations and work collaboratively with the community to shape activities to ensure the safety of those conducting the experiments and the general population. If and when boundaries are breached, swift and appropriate actions must be taken to remediate the actions and even discipline the offenders. Finally, important outreach will be important to ensure law enforcement and society at large understands DIY bio. The image of DIY bio in the movie Quarantined must be replaced with a more nuanced understanding of the benefits and risks of the use of biotechnology.”

Scientists Utilize Old School Approach Against Resistant Bacteria
In the fight against resistant bacteria, an old strategy may be worth a try – bacteriophages. Using viruses to kill bacteria is an old strategy but it may be effective for our new problem – resistance. While the strategy was first discovered in the early 20^th century, isolating and truly utilizing bacteriophages was challenging. Fortunately, now we have technology and advances in medicine on our side. “As a result, scientists are taking a fresh look at what is called phage therapy. ‘They are starting to dust off their old laboratory notes and re-explore the use of bacteriophages as a ‘new’ way to treat serious, life-threatening infections,’ says William Schaffner, medical director of the National Foundation for Infectious Diseases. Increasingly, specialists in infectious diseases believe phage therapy holds promise against bacterial diseases, especially in cases where antibiotics have failed. In 2016, the approach saved a San Diego man who otherwise would have died. Several similar successes have been reported since then.” While phage therapy isn’t yet FDA-licensed for humans, it can be used in life-threatening situations (like the San Diego case), but researchers are working to combat the challenges with getting it approved. Despite its use in other countries as a means of treatment, there is limited phage data within the U.S. There’s a long road ahead for harnessing the power of phage therapy, but it just may be one of the greatest tools in the fight against the resistant germ.

Stories You May have Missed:

How the DRC Beat Ebola in 42 Days – After the destruction that the virus left in its wake in 2014/2015, the news that the Democratic Republic of the Congo (DRC) had a case, triggered PTSD for many. With the news of their initial case in May, public health response teams were dispatched and within 42 days, the outbreak was over. So how did the DRC manage such a feat? “This swift resolution was partly a matter of luck. The virus hit the remote and sparsely populated Likati region, which is 1,300 kilometers away from the capital city of Kinshasa, and nestled deep in equatorial rainforest. ‘People weren’t moving around in the way they were during the West African outbreak,’ says Anne Rimoin from the University of California Los Angeles, who has worked in the DRC for 15 years. ‘So it was a very small outbreak in and of itself’.”
The Trouble With Ticks– traditionally, we’ve seen ticks as a source for Lyme disease and not much else. Unfortunately, this isn’t the case as a bad tick season is afoot. “Experts say the Northern United States may be in for a bad tick season this summer, raising concerns about Lyme and other scary tick-borne diseases, including the Powassan virus, which causes encephalitis and can leave people with permanent neurological damage. ‘This spring definitely seems worse than others I remember,’ said Dr. Catherine Wiley, chief of general pediatrics at Connecticut Children’s Medical Center. ‘People are coming in from the yard with numerous ticks on them’.”
Ebola Exhibit – While we all remember the fear and frustration surrounding the most devastating outbreak of Ebola, a new exhibit is taking viewers through a visual journey of the epidemic. “A new and poignant special exhibit at the Centers for Disease Control and Prevention, in the agency’s David J. Sencer CDC Museum. Sencer, who died in 2011, happens to have been the CDC’s director in 1976, when the first known outbreak of Ebola occurred in Yambuku, Zaire — now the Democratic Republic of Congo.”

Pandora Report 6.23.2017

June 23, 2017June 23, 2017 by spopescu, posted in Pandora Report

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 17^th start date for our workshop (and the July 1^st 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 6.9.2017

June 9, 2017June 9, 2017 by spopescu, posted in Pandora Report

Hunting For Ebola and The Outbreak In The DRC
The hunt for Ebola’s hiding place has eluded scientists since its identification in 1976. Believing that bats are a natural reservoir, many are tracking them throughout the DRC. While we’ve picked apart the virus in BSL-4 labs for decades and continue to learn about its genomics, we’re tragically unable to truly understand the virus in its natural habitat. “But the virus’s natural history is a mystery, says virologist Vincent Munster, sitting outside his tent in the darkening jungle. ‘We know everything about its replication cycle but fricking nothing about where it comes from and how it causes outbreaks’. Earlier in his career, at the Erasmus Medical Center in Rotterdam, the Netherlands, Munster took part in the controversial ‘gain of function’ experiments that engineered the lethal H5N1 bird flu virus to spread more readily among mammals-including, presumably, people. These days, however, Munster talks less about viral genes and proteins than about virus ecology: the web of interactions that allows a zoonotic virus to travel between species. Logging, hunting, and other human encroachment on pristine environments all play a role, bringing people into contact with the microbes that lurk there.” Researchers, like Munster, are sampling animals (especially bats) to try and find a pattern that would explain why they’re most likely to carry the virus and if that might fluctuate. Trying to find the virus in bats is equally challenging despite knowing that they carry it. Interestingly, the virus is wholly dangerous to primates and many consider it the biggest threat to gorillas apart from poaching. During their work, the researchers were alerted to a chimpanzee carcass and throughout their response, they note just how careful they must be when handling it. “It was covered in maggots, Munster says-‘just a huge, pulsating mess.’ Ebola may be scarce in living animals, but carcasses like that one practically explode with virus. ‘We’ve done those studies,’ Munster says. ‘Every cell, every orifice of that carcass is loaded with Ebola.’ To minimize the risk to researchers, Munster helped develop a protocol for collecting samples from dead animals: swabbing the outside instead of using sharp instruments to collect blood or tissue.” While their work continues, so does the latest outbreak of Ebola in the DRC. The most recent WHO situation reports noted a new suspected case and 15 contacts for monitoring. Currently, there are 5 confirmed cases, 3 probable, and 1 suspected. Four patients have died and four have survived, translating to a 50% case-fatality rate. You can also read the latest WHO new report on response efforts in the DRC here.

Pandemics, Bioterrorism, & Global Health Security Workshop Instructor Spotlight
Our instructor spotlight this week will shine on FBI Supervisory Special Agent Edward You. Mr. You is like the action hero of the biological countermeasures world (ok, that might be a tad of an exaggeration, but wait until you read about all the amazing things he does with the FBI!). Mr. You is responsible for creating programs and activities to coordinate and improve FBI and interagency efforts to identify, assess, and respond to biological threats or incidents. These efforts include expanding FBI outreach to the Life Sciences community to address biosecurity. Before being promoted to the Weapons of Mass Destruction Directorate, Mr. You was a member of the FBI Los Angeles Field Office Joint Terrorism Task Force and served on the FBI Hazardous Evidence Response Team. Mr. You has also been directly involved in policy-making efforts with a focus on biosecurity. He is an active Working Group member of the National Security Council Interagency Policy Committee on Countering Biological Threats and an Ex Officio member of the NIH National Science Advisory Board for Biosecurity. He also serves on two committees for the National Academies of Sciences, the Institute of Medicine’s Forum on Microbial Threats and the Committee on Science, Technology, and Law’s Forum on Synthetic Biology. Prior to joining the FBI, Mr. You worked for six years in graduate research focusing on retrovirology and human gene therapy at the University of Southern California, Keck School of Medicine. He subsequently worked for three years at the biotechnology firm AMGEN Inc. in cancer research. Special Agent You works to keep the communication channels open between the synthetic biology community and law enforcement to help identify threats and strengthen relations with the biohacker community. Don’t miss the opportunity to learn from Mr. You and pick his brain during our summer workshop in July!

South Africa’s History of Chemical & Biological Weapons
GMU biodefense alum Glenn Cross is taking a deep dive into the Rhodesian use of chemical and biological weapons from 1975-1980. His recent book, Dirty War, investigates the prevalence of such weapons during the Rhodesian War. During periods of manpower and material shortage, the army would use such unconventional techniques that included planting contaminated food and beverages, medicine, and other goods into guerrilla supplies. “Some of these supplies were provided to guerrilla groups inside Rhodesia; some were transported to guerrilla camps in Mozambique. In all, deaths attributed to CBW agents often exceeded the monthly guerrilla body count claimed by conventional Rhodesian military units – demonstrating the utility of CBW agents in a counterinsurgency campaign against an elusive enemy.” Cross’s investigation is particularly valuable in that knowledge has been spotty and few insiders have been willing to talk. “All (insiders willing to talk) share a consistent story about Rhodesia’s development and use of chemical and biological agents during the Bush War; they even chillingly admit that chemical and biological agents were used in experiments on captured insurgents.”

Tracking Microbes and Inspiring Antibiotic Development
The June 6^th WHO statement on the Essential Medicines List (EML) is sending ripples throughout the public health community in regards to antimicrobial resistance. The changes to the EML include the creation of three new categories for antibiotics – ACCESS, WATCH, and RESERVE. These categories include recommendations regarding use and aims to shift prescribing to a more accurate practice. “Initially, the new categories apply only to antibiotics used to treat 21 of the most common general infections. If shown to be useful, it could be broadened in future versions of the EML to apply to drugs to treat other infections. The change aims to ensure that antibiotics are available when needed, and that the right antibiotics are prescribed for the right infections. It should enhance treatment outcomes, reduce the development of drug-resistant bacteria, and preserve the effectiveness of ‘last resort’ antibiotics that are needed when all others fail.” The revision to this list highlights a growing need for antibiotic innovation. BARDA director, Joseph Larsen, hopes to change this and speed up the pace of antibiotic development in the face of growing microbial resistance. Current antibiotic development can take years, cost millions of dollars, and often only generates a profit after 23 years. Larsen notes that there hasn’t been a new class of drugs for treating gram-negative bacilli for over fifty years and that the volume of candidate antibiotics in phase 3/4 trials is barely 10% of those in oncology trials. BARDA is hoping to facilitate innovation through their CARB-X program, “which is one of the world’s largest public-private partnerships focused on developing new antibacterial products. When they started this program, BARDA expected 50 grant applications, but received 368 applications within the first 2 cycles. The goal is to deliver at least 2 antibacterial products to clinical development within 5 years. BARDA is planning on investing $250 million over the next five years to CARB-X.” Antibiotic innovation will become increasingly important as resistance grows, which highlights the importance of tracing microbial movement. GMU biodefense PhD student, Saskia Popescu, is looking at a recent study on hospital bacterial tracing and what that means for infection prevention efforts. Researchers sampled patient rooms prior to a new medical center opening and continued sampling for nearly a year, finding that microbial communities had some interesting trends. While hospital disinfection failures are frequently a source for transmission, it was found that the microbial community shifts after the patient has been in a room for 24 hours. Moreover, researchers found that a majority of admitted patients were on antibiotics and that those with longer stays tended to show an evolutionary shift to resistance. “Overall, this new study highlights the movement of microbes within healthcare and how we can start improving our tactics to help reduce the risk of healthcare-associated infections and blossoming bacterial resistance.” Worst case scenario, we could just always stop shaking hands…

Bioterrorism Budget Cuts & DoD Chemical & Biological Defense Annual Report
GMU biodefense PhD alum Daniel M. Gerstein is focusing on just how vulnerable the proposed budget would make the U.S. in the event of a bioterrorism attack. The budgetary cut to NBACC at Ft. Detrick would mean that laboratory and science response to bioterrorism would be significantly gutted without a replacement plan. “The NBACC’s scientists also are capable of conducting experiments to determine what level of concern is warranted if a potential threat is identifiedThe NBACC also has bioforensics analysis capabilities. This provides the ability to understand how and potentially where a pathogen was prepared, its virulence and physical characteristics and even what medical countermeasures and decontamination techniques might be the most effective.” This is especially vital as even the decontamination of a site can be challenging and expensive. The 2001 Amerithrax attacks highlighted these gaps – between responsibility, practices, protocols, and cost, the decontamination of the office buildings and postal handling facilities cost roughly $320 million and pointed out some pretty significant gaps within U.S. bioterrorism response. Gerstein implores policymakers to take a second look at this proposed budgetary cut and decide if leaving the US without these critical capabilities is truly a wise decision. “They should assess whether NBACC’s capabilities, as an insurance policy, is a price worth paying when weighed against the potential cost in human terms of even a limited bioterror attack.”

The 2017 DoD Chemical and Biological Defense 2017 Annual Report to Congress has just been released, which includes specific comments on response to ISIS and synthetic biology activities. Within the report you can find sections on advanced diagnostics, advanced medical countermeasures (check out the section on the cocktail of three monoclonal antibodies developed to fight Ebola), advances in non-traditional chemical agent defense, and more! One of my favorite sections was actually on information systems – “The Global Biosurveillance Portal (G-BSP) program achieved IOC. This capability will provide a web-based, cloud-hosted enterprise environment that will facilitate collaboration, communication, and information sharing in support of the detection, management, and mitigation of man-made and naturally occurring biological events. G-BSP also facilitates the fusion of multiple unclassified information sources for greater situational awareness and decision support.” A recent study published in The Lancet, highlights the importance of diagnostic preparedness. Citing the 2014/2015 Ebola outbreak as a prime example, researchers note that while the diagnostic response eventually worked, it was slow and expensive, which severely impacted outbreak response. “If a focused mechanism had existed with the technical and financial resources to drive its development ahead of the outbreak, point-of-care Ebola tests supporting a less costly and more mobile response could have been available early on in the diagnosis process. A new partnering model could drive rapid development of tests and surveillance strategies for novel pathogens that emerge in future outbreaks. We look at lessons learned from the Ebola outbreak and propose specific solutions to improve the speed of new assay development and ensure their effective deployment.”

Committee on Strategies for Identifying and Addressing Biodefense Vulnerabilities Posed by Synthetic Biology
Don’t miss this July 6th workshop held at the National Academies of Sciences, Engineering, and Medicine’s Keck Center at 500 5^th Street NW, Washington DC. Attendees will hear from several experts and discuss four main topics: human modulation, public health and military preparedness, efficacy of design, and emerging technologies to overcome existing technical barriers. The meeting won’t be webcast or made available virtually, so you’ll want to attend in person.

China’s Battle Against An H7N9 Outbreak
While the outbreak may be slowing, eight new cases were reported this past week. What worries many though are the recent studies published that point to the highly pathogenic variant that was infecting poultry. Currently in its fifth wave of H7N9 activity, Chinese cases are showing a shift to impact more middle-aged adults in rural areas. “In the second report, a team from China described the clinical course and genetic findings in a 56-year-old Guangdong province man who died from a highly pathogenic H7N9 virus that showed a marker for resistance to neuraminidase inhibitors (NIs), the antiviral drugs commonly used to treat influenza.” You can read the press release from the Government of the Hong Kong Special Administrative Region here.

Stories You May Have Missed:

MV-CHIKV Chikungunya Vaccine Clinical Trial Begins – progress is underway against the mosquito-transmitted chikungunya virus. “Led by principal investigator Patricia Winokur, M.D., of the University of Iowa Carver College of Medicine, the new vaccine study will enroll 180 healthy adults ages 18 to 45 at three sites: the University of Iowa in Iowa City; Baylor College of Medicine in Houston; and Emory University in Atlanta. Participants will receive two injections of either low-dose or high-dose experimental vaccine or placebo. Clinic staff will follow up with study participants by phone and during clinic visits over the course of 8 to 13 months to monitor for any adverse reactions or safety issues. The participants will provide blood samples to be analyzed for evidence of antibody production, which would indicate that the vaccine is prompting an immune response.”
Hospital-Associated Legionnaires’ Disease Could Easily Be Prevented– A recent CDC Vital Signs report is drawing attention the prevention capacity for hospital-associated Legionnaires’ disease. The new study found that in 16 of the 21 jurisdictions sampled reported definite cases of Legionnaires’ acquired during hospitalization, which kills 25% of those who get it as a result of hosptialization. Effective water management is a proven prevention method, which is often poorly monitored. “A total of 2,809 confirmed Legionnaires’ disease cases were reported across the United States in 2015, including 85 (3%) definite and 468 (17%) possible healthcare–associated cases. ‘We think 3% is just the tip of the iceberg, the number is probably much higher, and closer to one in five,’ said Schuchat. ‘Each healthcare-associated infection should be considered a potential outbreak’.”

Pandora Report 6.2.2017

June 2, 2017June 2, 2017 by spopescu, posted in Pandora Report

Good news – the early registration discount for the Pandemics, Bioterrorism, & Global Health Security Summer Workshop has been extended to July 1st! We’ve got a full Pandora Report for you this week, so buckle up, it’s going to be quite a ride!

Worries, Woes, and Realities of Global Health Security
Novel diseases are a near certainty in life (perhaps the saying should be death, taxes, and disease?). Whether it be a natural event, an accidental lab exposure, or by the hand of a bioterrorist, the threat of a pandemic is real. Five infectious disease experts recently convened to discuss the threat of pandemics and what worries them most about future outbreaks. From this meeting they found five issues that truly worry them. First, the lack of trust in scientists and experts. Second, learning lessons from the past. “Tom Frieden said he’s concerned that people won’t study responses to recent pandemics enough to improve responses to future ones. ‘The world has a unique opportunity following Ebola to close gaps, to address blind spots around the world and to become much safer. If we don’t take action very quickly to close the gaps that are being identified, we will lose that opportunity,’ he said.” Third, antibiotic resistance and the continuous spread of resistant bacteria. Fourth, destruction of species and environments that might hold the key to future medical breakthroughs (we’ll be talking more about this one in a bit…). Lastly, they worry about funding for public health workers and that they have the resources needed when fighting epidemics on the front lines. Sadly, a newly established score card on global health found the U.S. lacking. This new measurement tool uses the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) to establish a healthcare access and quality index. Countries that improved in deaths avoidable due to healthcare at their economic level over the last twenty-five years were China, Ethiopia, the Maldive Islands, Peru, etc. “By that standard, the United States improved slightly over the same period, 1990 to 2015. But the American ranking is still so low that it’s ‘an embarrassment, especially considering the U.S. spends $9,000 per person on health care annually,’ said the report’s chief author, Dr. Christopher J. L. Murray, director of the University of Washington’s Institute for Health Metrics and Evaluation, created by the Bill and Melinda Gates Foundation.”

Digital-to-Biological Converter
Synthetic Genomics Inc. is bringing a bit of excitement to the world of synbio via their announcement within a peer-reviewed Nature article describing this new technology. The development of the digital-to-biological converter (DBC) marks a huge step in synthetic biology. The DBC produces biological compounds on-demand and without any human intervention. The unit is fully automated and allows the “user to create complex synthetic DNA in a single process. To demonstrate feasibility, researchers digitally transmitted a file with DNA sequence information to the DBC. The DBC converted that digital sequence into oligonucleotides, and utilized synthetic biology tools developed by Synthetic Genomics such as gene synthesis, error correction, and Gibson Assembly™ methods to create large and complex DNA constructs with high fidelity. Utilizing this DNA as a template, the DBC further produced a series of biological materials without any human intervention, such as RNA, proteins, and viral particles.Biological products created on the DBC included DNA templates for an influenza vaccine, an RNA-based vaccine, antibody polypeptides, and a bacteriophage.” Co-founder J. Craig Venter noted that the DBC is also the first machine of its kind and can receive digital biology in the form of DNA sequences via the internet or radio wave! “The DBC prototype fully integrates and automates processes from oligonucleotide design and synthesis to the production of biopolymers. Development of a smaller and portable DBC could enable reliable production at the point of demand and potentially reduce costs and increase access to bio-production in research laboratories. Finally, with the incorporation of large-scale synthesis technologies, one can envision the DBC being used in industrial settings to enable high-volume production of biologics such as proteins and RNA vaccines.”

ISIS & CRISPR Article Critique Writing Competition
Calling all GMU biodefense students! A recent article came out in Foreign Affairs that made some rather interesting comments regarding CRISPR, bioterrorism, and the threat of synthetic biology. We’re holding a competition for biodefense students (past and present) to write a critique on the article (700-1,000 words) and the winner (selected by Dr. Koblentz) will be featured in Global Biodefense. Please email me with any further questions and submissions (spopesc2@gmu.edu). The due date for this is June 17th. We look forward to reading your thoughts!

Pandemics, Bioterrorism, & Global Health Security Workshop Instructor Spotlight
If you’re hoping to learn from a USAMRIID commander, NSABB member, UN Special Commission chief inspector, and veterinarian for the 10th Special Forces Group (Airborne), look no further than Dr. David R. Franz! He’s our spotlight instructor this week and will be teaching at our summer workshop in July. Dr. Franz has current standing committee appointments including the Department of Health and Human Services National Science Advisory Board for Biosecurity (NSABB), the National Academy of Sciences Committee on International Security and Arms Control, the National Research Council Board on Life Sciences, and the Senior Technical Advisory Committee of the National Biodefense Countermeasures Analysis Center. Dr. Franz was the chief inspector on three United Nations Special Commission biological warfare inspection missions to Iraq and served as technical advisor on long-term monitoring. He also served as a member of the first two US-UK teams that visited Russia in support of the Trilateral Joint Statement on Biological Weapons and as a member of the Trilateral Experts’ Committee for biological weapons negotiations. Dr. Franz was technical editor for the Textbook of Military Medicine on Medical Aspects of Chemical and Biological Warfare released in 1997. He serves as a Senior Mentor to the Program for Emerging Leaders at the National Defense University. He also serves on the Board of Integrated Nano-Technologies, LLC. Dr. Franz holds an adjunct appointment as Professor for the department of Diagnostic Medicine and Pathobiology at the College of Veterinary Medicine, Kansas State University. The current focus of his activities relates to the role of international engagement in the life sciences as a component of national security policy. Dr. Franz holds a DVM from Kansas State University and a PhD in physiology from Baylor College of Medicine. Even better, he’ll be lecturing on dual-use research at the workshop, so make sure to register!

Financial Cuts to Biodefense – Are We Digging Our Own Grave?
Despite a stark outlook painted from the looming threat of pandemics and the realities of American public health inadequacies, things are being further compounded by proposed budgetary hits to biodefense. A 10% increase in military spending means that other government agencies will take a hit, of which many are involved in biosecurity and biodefense. “The Office of Public Health Preparedness and Response, which tracks outbreaks of disease, would be cut by $136 million, or 9.7 percent. The National Center for Emerging and Zoonotic Infectious Diseases — a branch of the Centers for Disease Control and Prevention that fights threats like anthrax and Ebola — would be cut by $65 million, or 11 percent. The CDC’s Center for Global Health would lose $76 million, or 18 percent. Its Emergency Operations Center, which conducts real-time monitoring of outbreak responses, and its Select Agents Program, which sets regulations in lethal toxin labs and helps researchers stay ahead of bioterrorists, face unspecified cuts as well.” Fear is flourishing as there are substantial gaps in the appointment of positions within key federal agencies that are responsible for outbreak response and global health security. The 700 vacancies at the CDC alone is troubling as cases of Ebola continue to bubble up in the DRC and China fights back against a deadly outbreak of avian influenza. Many experts, like J. Stephen Morrison, the director of the Global Health Policy Center at the Center for Strategic and International Studies, are horrified and note that these drastic cuts will surely impact health security. A recent op-ed by faculty from the Johns Hopkins Center for Health Security highlights the proposed budget and how it makes the U.S. vulnerable to bioterrorism. In the event of such an attack, there are several links in the response chain that will invariably lose capacity and capability following such budgetary cuts- first responders, hospital staff, public health professionals, MCM research, decontamination efforts, etc. In fact, the recent announcement of the expected closure of NBACC, the Fort Detrick research lab only fuels concern. “While the overall spending for the Department of Homeland Security increases in Trump’s budget request, that department also zeroes out funding for the National Biodefense Analysis and Countermeasures Center (NBACC) at Fort Detrick.” NBACC is barely seven years old and is the government’s leading organization for forensic epidemiology in the event of a biocrime or bioterrorism. It is a world class facility for biodefense, collaborates with NIH and the DoD to conduct research gaps, and maintains several partnerships to strengthen U.S. biodefense and global health security. “’President Trump’s budget undermines important work being done in Frederick County to protect our troops and our national security. It guts federal investment in scientific research that saves lives, keeps our nation safe, and supports good-paying jobs in our state. The National Biodefense Analysis and Countermeasures Center at Fort Detrick, which helps protect America from biological threats, is doing critical work and I will fight these cuts and this ill-conceived budget in the U.S. Senate,’ said Sen. Chris Van Hollen (D), who is a member of the Senate’s budget and appropriations committees.” Governor John K. Delaney (MD) recently voiced his concern for the potential closure of NBACC, noting that he is “100% opposed to the closing of the National Biodefense Analysis and Countermeasures Center in Frederick and will fight this deeply misguided move by the Trump Administration. While DHS may be moving forward with plans to close the facility based on the assumption that the President’s request will be enacted, I want to stress that President Trump’s budget proposal is not law yet, that all funding and appropriations matters must go through Congress and that Trump’s budget overall has very little support in the House and Senate.” Unfortunately, as the threat of infectious diseases only grows, these cuts and closures will severely impact global health security. As the faculty from the Johns Hopkins Center for Health Security noted, “We urge Congress to reject the severe cuts proposed by the Trump administration and to support the continuation of these and other critical national biopreparedness and response assets, which protect the health and safety of all Americans.” On top of the budgetary impact to biodefense efforts, Thursday brought forth the troubling news that President Trump will end U.S. involvement in the Paris Climate Agreement . Many experts are highlighting the untold damage that will come from this move by way of climate change and international relations, but also the unintended consequence that is so easily forgotten – the spread of infectious diseases.

National Biosafety and Biocontainment Training Program (NBBTP)
Don’t miss the July 5th deadline for this amazing opportunity! “The NBBTP was conceived as a partnership between the National Institute of Allergy and Infectious Diseases (NIAID) and the Division of Occupational Health and Safety (DOHS) at the National Institutes of Health in Bethesda, Maryland. The program is administered by CDIC, Inc. The NBBTP Fellowship is a two-year program designed to train Fellows specifically to support high containment research environments by acquiring knowledge and skills necessary to meet the scientific, regulatory, biocontainment, biosafety, engineering, communications, management, and public relations challenges associated with the conduct of research in these facilities. NBBTP Fellows do not engage in any primary patient care activities. The mission of the NBBTP is to prepare biosafety and biocontainment professionals of the highest caliber to meet the needs of the biomedical emerging disease and civilian biodefense research communities through the 21st century.”

Outbreak Insurance
Instead of a tiny gecko or duck, perhaps the mascot would be a friendly looking microbe? Metabiota has a new CEO and a plan for outbreak response that involves insurance. Bill Rossi thinks that this could be the key to stopping outbreaks and Metabiota plans to help by providing the monitoring tools that would facilitate its success. “The company’s chief executive said that the new policies will provide financing in the wake of deadly pandemics and encourage multi-national corporations and nation-states to invest in preventing the spread of disease. Metabiota launched its insurance product last month and has been pitching its services to insurers, nations, and companies ever since. Indeed, Metabiota is partnering with the African Risk Capacity (ARC) agency, an agency of the African Union (AU) to help nations respond to threats.” Rossi points to the growing interest in pandemic insurance since the 2014 Ebola outbreak and acknowledges that there will have to be work to avoid potential abuse of such policies that would result in perverse incentives (i.e. profitable insurance payouts should a country be afflicted by an epidemic). Regardless of insurance, early detection systems are a necessary investment and that’s where Rossi and his Metabiota team come in. Metabiota is working with “sovereign nations and also the insurers who have the financial wherewithal to ensure that policies are put in place to prevent the spread of disease.” Epidemic insurance is looking better every day, especially after the World Bank revealed that most nations aren’t ready for a pandemic. Recently, a working group was tasked with evaluating the world’s pandemic readiness and sadly, they found that most countries simple aren’t prepared. “Recent economic estimates suggest the global total for a moderately severe to severe pandemic could be $570 billion, or 0.7% of the world’s income. The 131-page report said many countries chronically underinvest in critical public health tasks that help with early identification and containment of infectious diseases: surveillance, diagnostic labs, and emergency operations centers. It also spells out 12 recommendations to ensure adequate financial support and infrastructure”. The recommendations include preparing a detailed financial proposal to support implementation of the plan to improve preparedness, developing partners and building on existing collective and bilateral commitments to help finance preparedness in countries needing support, etc.

Unexpected Mutations Following CRISPR
I guess what happens in CRISPR doesn’t stay in CRISPR, eh? A recent letter published in Nature notes that despite the hopes many had for the gene editing technology as a means of solving disease-causing mutations, a new study found that there were some unintended changes to other genes. “When correcting blindness in mice, researchers at Columbia University found that though CRISPR did manage to successfully edit the particular gene responsible for blindness, it also caused mutations to more than a thousand other unintended genes. The off-target effects of CRISPR have long been known, but this new research highlights just how extensive they can be, and highlights the importance of research to understand them.” Shortly after the letter was published in Nature, investments in genome-editing companies took a hit and stock prices dropped.

Ebola in the DRC
This week the DRC approved the use of the experimental Ebola vaccine rVSV-ZEBOV. The WHO plans to use a ring vaccination method to roll out the new vaccine. “The situation report also said that several cases of suspected Ebola have now been ruled out, meaning the outbreak appears to be not as extensive as once feared. As of Sunday, there were 2 confirmed, 3 probable, and 14 suspected cases. No new possible cases have been identified since May 11.” You can read the latest WHO situation reports here for updated case counts and geographic distribution.

Virus Hunters
Researchers are currently hunting for the next lethal virus in the Democratic Republic of the Congo (DRC). The team is in the DRC with the PREDICT project, which is part of USAID’s Emerging Pandemics Threat program to create a database of zoonotic pathogens that are the most likely emerging pandemic threats. “If scientists can detail the places where lethal viruses simmer in wait, the thinking goes, they can head off a swelling pandemic and better manage outbreaks while they are still small and local. Researchers and other outbreak responders could consult this database to begin mapping the source of an emerging disease, for example, and quickly get to work on minimizing transmission and developing potential new vaccines that could save countless lives. ‘We have a job to do,’ Dr. Prime Mulembakani explains. ‘We also have the opportunity to be in contact, in close contact, with people who are on the front line—the communities who are really at risk for a virus spillover from animals into people.’ The irony of potentially disease-carrying bats hanging from the rafters of the local health center is not lost on Mulembakani, an epidemiologist by training, and he pauses for emphasis: ‘We need to stop these events from getting out of control’.”

Stories You May Have Missed:

Pale Rider – The Spanish Flu of 1918 and How It Changed the World – Laura Spinney’s new book, Pale Rider, is coming out this fall, which details the history of the 1918 pandemic. Spinney takes the reader through a journey of the influenza virus history and how the pandemic was quickly forgotten after it took as many as 100 million lives. “By early 1920, nearly two years after the end of the first world war and the first outbreak of Spanish flu, the disease had killed as many as 100m people— more than both world wars combined. Yet few would name it as the biggest disaster of the 20th century. Some call it the ‘forgotten flu’. Almost a century on, Pale Rider, a scientific and historic account of Spanish flu, addresses this collective amnesia”.
Salmonella Outbreak in 47 States – Nearly 400 have been sickened following a salmonella outbreak tied to live poultry. “Since early January and through May 13 the outbreaks have sickened 372 people in 47 states. So far, 71 people have been hospitalized but no deaths have been reported. Just over a third (36%) of the sick patients are children. During the investigations, interviews revealed that 83% (190) of 228 sick people had contact with live poultry the week before they got sick. People bought live baby poultry from a variety of sources, including feed supply stores, Web sites, hatcheries, and relatives.”

Pandora Report 4.21.2017

April 21, 2017April 21, 2017 by spopescu, posted in Pandora Report

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.

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