Pandora Report 10.23.2015

Happy Infection Prevention Week! Make sure to give any infection preventionists you know a big hug or at least a hearty handshake (only clean hands though!). Not only do we get to celebrate National Infection Prevention week, but it’s also National Biosafety Stewardship Month, so get your party hand sanitizer ready to go and let the frivolity begin! Foodborne illness is the name of the game this week and we’ll be discussing outbreaks. Friendly reminder – the influenza vaccine is available in most offices/clinics now, so get your flu shot as there have already been cases springing up across the US. Fun fact – did you know that a report published this week identified Yersinia pestis in the tooth of a Bronze Age individual, which means there were plague infected humans 3,300 years earlier than we thought!

National Biosafety Stewardship Month – October is National Biosafety Stewardship Month (thanks NIH!) to celebrate and encourage people to focus on biosafety policies, practices, and procedures. Given the lab biosafety issues we’ve seen recently, I think we can all safely (or should I say, “biosafely”?) agree that a little extra attention to these issues and the promotion of better practices is a great thing. Institutions are encouraged to use more of a just culture approach to incident reporting and to promote public transparency. Happy National Biosafety Stewardship Month!

Water Quality for the Olympic Games in Rio De Janeiro, 2016
The 2016 Summer Olympics are fast approaching and with any large event, health issues become a main concern. The WHO is providing technical advice to the Brazilian national authorities regarding public health concerns, as well as to the International Olympic Committee and the Local Organizing Committee. Clean drinking water, sewage pollution, and a host of other health issues can become a nightmare during such a large-scale event. While there aren’t recommendations for specific viral testing of the water, the WHO does encourage additional testing in the event of an outbreak. Sanitary inspections and other preventative procedures are being recommended to avoid outbreaks and public health issues. As we get closer to the 2016 Olympics, it is very likely concerns over vector-borne diseases will be addressed through vector control and public health education.

CDC Launches Redesigned FOOD Tool for Foodborne Outbreaks 

Courtesy of CDC FOOD Tool
Courtesy of CDC FOOD Tool

The CDC has updated their online foodborne illness outbreak investigation tool! The Foodborne Outbreak Online Database Tool (FOOD Tool) allows the user to search the outbreak database by state, food, ingredient, year, location of food preparation, and organism. The FOOD Tool also provides the case information related to the outbreak, so users can see the number of affected persons, hospitalizations, deaths and laboratory-confirmed organisms. This database pulls from CDC’s Foodborne Disease Outbreak Surveillance System (FDOSS) and allows users to not only look at data and trends over time, but also compare their cases to other outbreaks.

Syrian Refugee Resettlement and Why We Should Be Letting Them All In 
Dr. Trevor Thrall, one of our amazing GMU Biodefense professors, has written a piece for The Atlantic on the importance and benefits of taking in all Syrian refugees. Dr. Thrall discusses the limitations of addressing the root cause of the Syrian conflict and how the US and its European allies should take in refugees. Discussing the military alternatives to the Syrian crisis, he states, “going in militarily is not the answer, then. Instead, those civilians under threat should get out. Refugees typically receive support in the countries to which they flee, but the vast numbers involved in this case threaten to overwhelm Turkey, Jordan, and Lebanon, which have so far accommodated the vast majority of the outflow.” Dr. Thrall points out that while resettlement would cost a substantial amount of money, it would cost far less than military intervention and you simply can not ignore the moral superiority in aiding refugees.

Chipotle’s Bad Tomatoes Came From Nation’s Largest Field Producer
To our readers in Minnesota, did you happen to eat at a Chipotle in August? If so, we hope you weren’t one of the affected individuals that contracted Salmonella Newport as a result of contaminated tomatoes. The Minnesota Department of Health investigated the 64 cases resulting from this outbreak, however it was just released that the contaminated tomatoes were actually supplied by Six L’s Packing Co (doing business as Lipman Produce), which is actually one of the largest tomato suppliers in the US. Packing 15 million boxes of tomatoes this past year, Lipman was later dropped as a supplier by Chipotle after learning of the source of contaminated produce. The tomatoes were removed but it’s estimated that during the window of exposure, roughly 560,000 people consumed Chipotle. The good news is that we’re out of the incubation period, so if you happened to eat at a Minnesota Chipotle, you’re in the clear.

Stories You May Have Missed:

  • 80 Illnesses Linked to Shigella Outbreak; CA Seafood Restaurant Closed –  Mariscos San Juan in San Jose, CA is currently closed after the Santa Clara County Health Department connected a recent outbreak of Shigella to their food. While the exact source hasn’t been identified, over 93 people were sickened in relation to contaminated food at the restaurant.
  • Subway to Phase Out Poultry Products Raised With Antibiotics–  On Tuesday, Subway Restaurants announced that they will be transitioning to only serve poultry products that have been raised without antibiotics by early next year. Other chain restaurants, like Chick-fil-A and Chipotle, are jumping on the train to phase out chicken and turkey products that were raised with antibiotics.
  • Scottish Nurse and Ebola Complications – Pauline Cafferkey continues to battle post-Ebola complications. Reports last week noted neurological issues and it was recently reported that she has meningitis after the virus persisted in her brain and CSF after her initial recovery. Ongoing research is looking into the long-term effects of the disease as the West African outbreak was the largest in history and researchers have never had the opportunity to look at chronic issues associated with disease recovery.

Pandora Report 10.16.2015

What a busy week in the world of biodefense! First, let’s give a round of applause for Global Handwashing Day (and now, go wash your hands!). This week we saw a nurse from the UK experience Ebola-associated complications months after her recovery. The CDC released a report stating that 17 states exceeded their recommendations for Ebola screening/monitoring and a recent study discussed vaccination rates and herd immunity. Let’s not forget that we’ve got another segment on 2016 Presidential candidate chatter on nonproliferation, a call for papers, and an open house on GMU’s Master’s program. Grab your morning coffee/tea and let’s explore this week’s biodefense news!

Global Handwashing Day 
Global Handwashing Day was Thursday, October 15th, but really we should be celebrating it every day! It may seem like a simple thing but the truth is that hand hygiene is one of the most important things you can do to prevent the spread of infection. Whether it’s a hospital-acquired infection or avoiding illness in the workplace, hand hygiene is the first line of defense. The WHO estimates that hand hygiene, just in healthcare, saved millions of lives in the last years. The CDC even calls it the “do-it-yourself” vaccine – five simple steps (wet, lather, scrub, rinse, dry) to help prevent the spread of infections. Many people think it’s a small or “easy” thing, but coming from an infection preventionist, it’s the small things that make the biggest difference. You’d be surprised how many organisms we carry around on our hands and on fomites, so using alcohol-based hand sanitizer or washing with soap and water is the only way to get rid of those. University of Arizona professor, Dr. Gerba, (we lovingly referred to him as Dr. Germ – funny enough, he even gave one of his children the middle name of Escherichia!) has focussed much of his research on the household and public objects we may not realize are covered in germs. Perhaps the most important take-away from Global Handwashing Day isn’t just its importance in healthcare, but its role as an important part of disease prevention everywhere. In the U.S.  we’re fortunate to have access to the resources that allow us to have phenomenal hand hygiene practices however, it’s the behavior we tend to fall short on. From today forward, I encourage you to make a personal decision to be vigilant in hand hygiene.

Last Call for Papers – Women’s Health in Global Perspective!
Papers sought for a special issue and workshop of World Medical & Health Policy on “Women’s Health in Global Perspective,” to contribute to understanding and improve policy related to women’s health and wellbeing.  Forces ranging from the economic to the climactic have human repercussions whose genesis and solutions demand consideration of their global context.  A wealth of recent research and inquiry has considered the particular plight of women, who often suffer disproportionately from lack of education, compromised nutrition, poverty, violence and lack of job opportunities and personal freedom.  The Workshop on Women’s Health in Global Perspective will consider the broad ranging social determinants of health on a global scale that importantly influence health outcomes for women everywhere, which in turn has implications for economic, political and social development.
Abstract submission deadline (250 words): October 16, 2015 Contact: Bonnie Stabile, Deputy Editor, bstabile@gmu.edu
Notification of selected abstracts: November 13, 2015

Presidential Candidates on Nonproliferation Part II
GMU’s Greg Mercer has put together a wonderful second part to his series on one of our favorite topics (nonproliferation) and what the 2016 presidential candidates are saying about it. Check out Greg’s review of these candidates’ stance so we can track how they might change over the course of the election.

west-africa-distribution-map
Source: CDC

Updates and Mapping Ebola
BBC recently published a nice overview of the Ebola outbreak in West Africa. Since the first case 18 months ago, it has been a whirlwind, in more ways than one, for those of us in the public health/global health security world. Cheerfully, the outbreak region has officially gone two weeks without a new case! Unfortunately, Pauline Cafferkey, the Scottish nurse who was treated and recovered from Ebola in December of 2014, is in critical condition due to a late Ebola-related complication. It was just released that her complications are neurological, including severe central nervous system (CNS) disorder and that the virus was detected in her spinal fluid. Scottish public health officials did identify 58 close contacts and offered them the SV-EBOV vaccine.

Master’s Open House
Learn more about the GMU School of Policy, Government, and International Affairs Masters’ programs on Wednesday, October 21, 2015 at 6:30pm at our Arlington Campus, Founders Hall, Room 126. This informational sessional will discuss our Master’s programs ranging from Public Administration, Biodefense, Political Science, Health and Medical Policy, etc.

Imported Measles and Need for Vaccination –This past week at the IDWeek 2015 meeting, scientists reported on a study reviewing measles vaccination rates in the US and susceptible children in relation to the number of measles cases that have occurred. They noted, “this analysis highlights the need for high measles vaccination coverage to support population-level immunity and prevent reestablishment of indigenous measles transmission in the United States.” The Daily Beast also incorporated this into an article on diminishing herd immunity and anti-vaxxers.

Avian Influenza Vaccine Added to National Veterinary Stockpile
APHIS (United States Department of Agriculture’s Animal and Plant Health Inspection Services) awarded contracts to two companies to ensure manufacturing of the vaccine for avian influenza. The goal is to strengthen the Agency National Veterinary Stockpile. “This action is being taken to develop the Agency’s National Veterinary Stockpile., and does not signal a decision to vaccinate for highly pathogenic avian influenza (HPAI). While APHIS has not approved the use of vaccine to respond to HPAI, the Agency is preparing to ensure that vaccine is available should the decision be made to use it during a future outbreak.”

Stories You May Have Missed:

  • International Infection Prevention Week is next week! October 18-24, 2015 will celebrate the importance of infection prevention and control in healthcare. Let’s celebrate by not just washing our hands, but also considering all the small ways we can prevent the spread of germs in our homes and workplaces!
  • Salmonella Cucumber Outbreak – The CDC has released new data on the Salmonella Poona outbreak related to imported Mexican cucumbers. As of October 14th, there have been 757 people infected across 36 states and 4 deaths related to the outbreak.
  • DHS Wants to Revive Terrorism Alert System – In wake of the attacks in Chattanooga, President Obama’s security officials are initiating a review of the nation’s terrorism alert system to support what many consider a growing threat of domestic attacks. DHS wishes to revise and restart the National Terrorism Alert System to better respond to these evolving attacks.

Pandora Report 9.25.2015

You didn’t think a Papal visit would slow us down, did you? Even in the event of a zombie apocalypse, we GMU Biodefense folks would still find a way to get out the weekly report – perhaps pigeon carrier? Until that happens, don’t forget to check us out on Twitter! This week saw a lot of great focus on collaborations to fight public health threats like antimicrobial resistance and epidemics. Schools in Chicago were closed for concerns over Legionnaires’ disease, yours truly provided a piece on Ebola infection prevention, and we have a wonderful opportunity to contribute to World Medical & Health Policy regarding women’s health on a global stage.

Learned Lessons from Ebola in the US
Sylvia Burwell, Secretary of Health & Human Services, discusses the clinical complexity and reality that “our clinical approach to treating Ebola in a hospital setting posed different challenges.” Several key US health experts weighed in on the pivotal first patient, Thomas Duncan, to unknowingly bring Ebola to the US. The implications for healthcare and preparedness sent a tidal wave of response across US hospitals. Dr. Tom Frieden, director of the Centers for Diseases Control and Prevention (CDC), also highlights three main lessons from not only the cases in Dallas, but also the Ebola epidemic as a whole. He points to the necessity of a strong surveillance and response system, need for rapid international aid, and better infection control in hospitals….which segues beautifully into our next story.

The Infection Prevention Angle of the 2014 Ebola Crisis
Reports and analyses from a range of responders to the crisis have been trickling out for several months now, but there’s a constant in all of them – infection control. Given my background and experiences in this field, I wanted to take our readers down the rabbit hole of what exactly it was like to be an Infection Preventionist during this time. A hopeful start to a series of pieces on this subject, it will give you a taste of not only the daily struggles, but the brevity of what potential Ebola patients meant for US healthcare preparedness.

Partnerships to Support Antibiotic Development
564px-Penicillin_Past,_Present_and_Future-_the_Development_and_Production_of_Penicillin,_England,_1943_D16963The ASPR’s (Office of the Assistant Secretary for Preparedness and Response) Biomedical Advanced Research and Development Authority (BARDA) is part of a larger initiative to use Other Transaction Authority (OTA – flexible advanced research and development funding instruments) to start developing business relationships between government and private industry. The relationships are mutually beneficial, allowing both parties to invest and develop products for biodefense and the growing threat of antibiotic resistance. Given the slowing of new antibiotic development, this joint agreement comes at a pivotal time for antimicrobial resistance efforts.

Three Chicago-area Schools Close in Response to Legionnaires’ Disease Concerns
Three schools in the Illinois U-46 district were shut down on Wednesday and Thursday after cooling tower test results showed “higher than normal levels of Legionella bacteria”. The OSHA recommended threshold is no higher than 1,000 CFU/ml (colony-forming units per milliliter) and with the outbreak among residents of the Illinois Veteran’s Home, it’s not surprising to see many water towers being frequently tested, etc. The important thing to note is that Legionella pneumophila infections are a result of the intensity of the exposure and the immune status of the exposed person. Legionella can’t be totally eradicated from the water supply and a majority cooling towers will contain some amount of growth.

Call for Papers – Women’s Health in Global Perspective
Papers sought for a special issue and workshop of World Medical & Health Policy on “Women’s Health in Global Perspective,” to contribute to understanding and improve policy related to women’s health and wellbeing.  Forces ranging from the economic to the climactic have human repercussions whose genesis and solutions demand consideration of their global context.  A wealth of recent research and inquiry has considered the particular plight of women, who often suffer disproportionately from lack of education, compromised nutrition, poverty, violence and lack of job opportunities and personal freedom.  The Workshop on Women’s Health in Global Perspective will consider the broad ranging social determinants of health on a global scale that importantly influence health outcomes for women everywhere, which in turn has implications for economic, political and social development.
Abstract submission deadline (250 words): October 16, 2015 
Contact: Bonnie Stabile, Deputy Editor, bstabile@gmu.edu
Notification of selected abstracts: November 13, 2015
Workshop March 3rd, 2016
Completed papers due: March 11, 2016

Stories You May Have Missed:

  • Personal Microbial Cloud – researchers found that a person’s microbiome form a cloud around them, allowing scientists to identify a specific person just by sampling their microbial cloud. Food for thought: would this be our microbial cloud version of a fingerprint?
  • C. Difficile Drug Success – Researchers at Stanford University School of Medicine were successful in their ability to get rid of the deadly gastrointestinal toxin via a drug that didn’t focus on the organism, Clostridium difficile, but rather the toxin itself. C. difficile is responsible for 250,000 hospitalizations and 15,000 deaths per year while costing the US more than $4 billion in healthcare expenses. Yay for successful treatments!
  • EC, EU, and WHO Work To Better Share Private Drug Data – The European Commission, European Medicines Agency, and World Health Organization are working to “step up coordination” on EU medicines regarding safety, quality, and efficacy of new drug candidates. The first step in solving a problem is recognizing you have one, right? The new focus on global public health threats is one we can all appreciate!
  • WHO Makes Changes to Southern Hemisphere Flu Vaccine – The WHO committee recommended changes for two of the three trivalent influenza vaccines for the Southern Hemisphere next year due to changes in the circulating viral strains. They suggested using H1N1, H3N2 an A/Hong Hong/4801/2014-like virus, and for influenza B, the Brisbane/60/2008-like virus. In the quadrivalent vaccine, they recommended adding the influenza B Yamagata lineage component, with the A/H1N1 strain staying.