Pandora Report 1.20.2017

We’ve got lots of biodefense goodies for you this week, so grab your PPE and let’s get rolling!

Billion-Dollar Vaccine and Epidemic Preparedness Project 
The Coalition for Epidemic Preparedness Innovations (CEPI) launched this week at the World Economic Forum with an initial $460 million backing from Norway, Germany, Japan, the Welcome Trust, and the Bill & Melinda Gates Foundation. CEPI expects to raise the rest of the needed $1 billion by the end of the year. Their focus is on pre-emptively developing and stockpiling vaccines to better prevent and respond to outbreaks. CEPI marks the largest vaccine development initiative and their plan is to start with vaccines against Nipah virus, MERS-CoV, and Lassa fever. While this is wonderful news, it may just be one step closer to marginalizing the WHO, which has been struggling to stay both relevant and effective. The WHO response to Ebola started drawing more recent attention to the organization’s struggles which were only fueled by slow vaccine procurement/development. These issues culminated with their recommendations to dilute the yellow fever vaccines during last year’s outbreak in Africa due to poor planning. Vaccine development and stockpiling is truly vital to outbreak response. “The CEPI intends to support research at every stage, from basic lab work to vaccine discovery and clinical trials. It also made its first call for research proposals on 18 January, and teams have until 8 March to submit preliminary proposals for grants. ‘For too long, we have separated out the academic work from the next step of taking it into all that is actually required to make a vaccine,’ says Farrar. There is also no market for vaccines against ‘potential’ epidemic threats, he notes, which explains why there is no commercial incentive to take research leads out of the lab and into clinical development’.”

ABSA DURC Roundtable
Don’t miss the Dual Use Research of Concern (DURC) Roundtable Discussion offered by ABSA International on March 15th! This distance learning opportunity will be offered from 12-2pm (CDT), and will aid the user in finding resources and guidance on the U.S. government DURC policies, developing a network of biosafety professionals, and more! “One size does not fit all when it comes to solutions to comply with research policy. The goal of this webinar is to provide best practices, provide insight on how several different institutions are meeting the DURC policy requirements, and help participants troubleshoot issues surrounding DURC that they may have at their institutions. Participants will have the opportunity to submit questions regarding DURC prior to the start of the webinar as well as during the live webinar.”

GMU Trains First Responders Against Infectious Disease  firstrespondertraining3_davefarris
GMU’s Office of Safety, Emergency, and Enterprise Rise Management is now providing local and national first responders with infectious disease training so that they’re better able to protect themselves during outbreaks. The program was made available through a three-year grant from the National Institute of Environmental Health Sciences. “This training is a natural extension of a program Mason’s Biomedical Research Lab biosafety manager Diann Stedman has offered to regional emergency response personnel since the 2010 opening of the lab on the Science and Technology Campus. Stedman is leading the training with Julie Zobel, assistant vice president of safety, emergency and enterprise risk management, and David Farris, executive director of safety and emergency management. Collectively, the three have more than 30 years of experience in the health and safety field, much of it focused on biological safety.”

Completing the Development of Ebola Vaccines 
CIDRAP and Welcome Trust have just released their report – Completing the Development of Ebola Vaccines: Current Status, Remaining Challenges, and Recommendations. “This is the third major report from the Wellcome Trust–CIDRAP Ebola Vaccine Team B. The first report, Recommendations for Accelerating the Development of Ebola Vaccines: Report and Analysis, was released in February 2015, and the second, Plotting the Course of Ebola Vaccines: Challenges and Unanswered Questions, was released in March 2016. In this report, similar to our previous efforts, we have three primary objectives. The first is to track progress toward ensuring that safe, effective, and durable multivalent Ebola vaccines are readily available and can be rapidly deployed when the next outbreak occurs. The second is to identify challenges and barriers where additional efforts are needed, although some of the remaining issues are complex and will require substantial resources to resolve. Our third objective is to provide a set of high-level recommendations that we believe, if implemented, will facilitate the goal of having a robust Ebola virus disease (EVD) prevention program in place that allows prophylactic vaccination of high-risk frontline workers and provides well- maintained vaccine stockpiles to facilitate rapid control of Ebola outbreaks.” The report highlights current clinical evaluations of Ebola vaccine candidates, funding, and regulatory activities. Some of the recommendations include reassessing the leadership structure for Ebola vaccine preparedness, developing strategies for mitigating the financial uncertainties and risks for manufacturers, etc. This report has left many experts pointing to the reality that we’re just not ready for another Ebola outbreak. 

Center for Health Security Joins Johns Hopkins Bloomberg School 
The Center for Health Security has a new home in Johns Hopkins Bloomberg School of Public Health! Previously affiliated with the University of Pittsburgh Medical Center, the CHS will now have significant new opportunities for research and work in national and international public health policy. Originally founded in 1998 by the late D.A. Henderson at Johns Hopkins, the center has been affiliated with UPMC since 2003. “The mission of our center is a perfect fit with the Johns Hopkins Bloomberg School of Public Health because we share a commitment to improving global health and to protecting lives through large-scale change,” says Tom Inglesby, director and CEO of the Center for Health Security. “Moving to the Bloomberg School will expand the reach of the center and help us collaborate with and tap into the universe of great talent at Johns Hopkins. We look forward to joining our expertise on health security and preparedness policy to Johns Hopkins’ internationally recognized community of scientists and public health scholars.” We’re looking forward to seeing all the great work that will be done as the center returns to Johns Hopkins!

Zika Outbreak Updates
As the dust settles, some are looking to the WHO and public health infrastructure failures regarding the Zika outbreak as many are pointing out how the response failed millions. “But the positives were counterbalanced by many negatives, experts said. They harshly criticized the partisan bickering that delayed a Zika-funding bill in Congress for months, and they decried the failure of every city in the hemisphere — other than Miami — to control mosquitoes.” You can also read an opinion piece here, from a pregnant woman living in Miami who tested positive for the Zika. As of January 18th, the CDC has reported 4,900 cases of Zika in the U.S.

Stories You May Have Missed:

  • screen-shot-2017-01-19-at-12-31-34-pmCDC Director’s Departing Words- As CDC director, Dr. Tom Frieden, prepares to leave office after 8 years, he’s offering some words of wisdom. Dr. Frieden has been tested by major health events like Ebola, Zika, MERS, 2009’s H1N1, and a growing domestic overdose issue. “Fundamentally, Americans are healthier and safer because of the work CDC has done over the last eight years. Americans are safer because we have better capacities in place, better infrastructure in place in this country and around the world to find threats early, stop them quickly and prevent them wherever possible. We’ve done that through laboratory work that looks at microbial genomics so we can stop outbreaks sooner. We’ve done that by training the next generation of public health specialists — more than 1,000 of them, fresh out of college and graduate school — deployed out to state and local governments. These people will be protecting Americans for decades to come.”
  • Proposed Presidential Autism-Vaccine Panel Could Help Spread Disease– The potential panel is drawing increasing attention as Robert F. Kennedy Jr. is poised to be the leader. The environmental lawyer has been vocal in his vaccine skepticism, which has led many to worry in terms of federal support for vaccine programs. “Although the autism–vaccine claim has been studied and debunked, the president-elect has also suggested a connection. His team later hedged about the panel, saying that nothing had been decided. (Kennedy’s office declined an interview request.) Nevertheless, public health experts and autism advocates are deeply worried that an effort with presidential backing could undermine public confidence in vaccines and trigger epidemics of all-but-eradicated diseases.”
  • Assad Linked to Syrian Chemical Attacks – The Syrian President has officially been linked to a series of chlorine bomb attacks in 2014/2015. “International investigators have said for the first time that they suspect President Bashar al-Assad and his brother are responsible for the use of chemical weapons in the Syrian conflict, according to a document seen by Reuters. A joint inquiry for the United Nations and global watchdog the Organisation for the Prohibition of Chemical Weapons (OPCW) had previously identified only military units and did not name any commanders or officials.”

Pandora Report 1.29.2016

Happy Friday! Now that winter storm Jonas is behind us, we can get back to tackling biodefense updates. Unless you’ve been avoiding the news, you’ve undoubtedly seen the surge in reports on Zika virus. Imported cases are popping up throughout the US, raising concerns about vulnerability and response. We’ll be covering the latest in Zika news, not to mention a pretty amazing disease modeling system, plague history, and how Brazil is prepping for the 2016 Olympics. Fun History Fact Friday: on January 28th, 2000, a US government study finally conceded that the cancer and premature deaths of several workers from a nuclear weapons plant (in service since WWII) were caused by radiation and chemicals and sticking with the nuclear weapon theme, on January 29th, 1964, Dr. Strangelove or: How I Learned to Stop Worrying and Love the Atomic Bomb premiered.

Open Source Disease Modeling: to Combat the Next Pandemic
GMU Biodefense PhD student, Nereyda Sevilla, has teamed up with Global Biodefense to discuss how transportation advances of the 21st century make outbreak preparedness and response extremely difficult. In most cases, health alerts and travel restrictions are reactionary to an outbreak that has already reached epic proportions. In response to this, scientists are working to predict disease spread and potential interventions through disease modeling. Spatiotemporal Epidemiological Modeler (STEM)  is one of these modeling systems that looks at several variables and parameters within the spread of an infectious disease and then models the efficacy of interventions. “The unique nature of STEM is that it is a multi-disciplinary, collaborative modeling platform.  The open-source characteristics of the system allow researchers and programmers to add, compare, refine, and validate different scenarios as well as add denominator data based on specialty.  For example, an infectious disease specialist in dengue working in South America may have unique disease characteristics and population data that could be tailored into STEM.” The best part? STEM is already pre-loaded with country data regarding national borders, transportation networks, air travel, and environmental conditions. Utilizing customized graphs and spatial maps, it can even be used to “create a spatial map of animal pens on a farm and to import that graph into the model to study the spread of a veterinary disease.” STEM can easily be downloaded and even has sample projects that many researchers from around the world have shared, like the 2014 Ebola outbreak, dengue fever, H1N1, etc. STEM is undoubtedly a significant weapon in the global health security arsenal to combat future pandemics.

Zika Virus Outbreak Updates
While 200,000 Brazilian troops are being mobilized to battle mosquitoes in a house-to-house strategy, Zika virus has reached 23 countries. As of January 28th, 2016, the WHO has set up an emergency team to respond to the growing epidemic. Meeting on Monday, the WHO team will decide if the Zika virus outbreak should be treated as a global emergency, as they are predicting “three to four million cases” in the Americas. Fear continues to grow in the US as cases are popping up in Los Angeles Country, CA Virginia, New York, and Arkansas, in a returned travelers. President Obama just called for a speeding up of Zika virus research to battle the growing outbreak. Sydney has also confirmed imported cases. While many worry that returning travelers are bringing the mosquito-borne disease back home, it’s important to note that it’s during the first week of infection that the virus is found in the blood and can be transmitted via mosquitoes.  Vertical transmission (from mother to child) is possible if the maternal infection is near the time of delivery, but there haven’t been cases of Zika virus in breast milk. To date, there has been one case of transmission through blood transfusions and one possibly spread through semen and sexual contact. Researchers are working to piece together the origins of this particular outbreak, but one hypothesis is that it came to Brazil from a major sporting event, specifically the 2014 World Cup. At this point, cases have been seen in 23 countries and the WHO has warned that it’s likely to “spread across nearly all of the Americas”. While no local transmission has occurred in the US, locally acquired cases are occurring in the Commonwealth of Puerto Rico. The CDC has also released interim guidance on the evaluation and testing of infants with possible congenital Zika virus.

Brazil’s Olympic Woes

Courtesy of The Guardian & EPA
Courtesy of The Guardian & EPA

The growing outbreak of Zika virus and subsequent concerns over fetal microcephaly are just another public health issue on the laundry list of concerns for Brazil in their Olympic preparations. Building the infrastructure to support such a massive event is taxing on even the most industrialized country. Despite Brazil’s initial dismissal of water quality issues, there have been flourishing concerns over water safety for Olympians (the linked BBC pictures alone would have me rowing the boat back to land at record speed). 13 of the 40-member US rowing team experienced gastroenteritis after a trial run in a lake. While the exact culprit of the GI illness was never identified, it amplified the already increasing fears regarding water quality. It’s never a good sign when rowers are warned not to splash water or jump in at the end of a race, or when a sailor has to be hospitalized due to a severe MRSA infection after field tests. As we mentioned a few months back, an Associated Press investigation found dangerous viral and bacterial levels in the Olympic and Paralympic water venues. “Extreme water pollution is common in Brazil, where the majority of sewage is not treated. Raw waste runs through open-air ditches to streams and rivers that feed the Olympic water sites. As a result, Olympic athletes are almost certain to come into contact with disease-causing viruses that in some tests measured up to 1.7m times the level of what would be considered hazardous on a Southern California beach.” Water issues aside, vector-borne diseases like Zika virus, dengue, malaria, and even yellow fever, can pose a threat to those attending and participating in the events. The Brazilian health ministry has announced response plans in wake of the growing Zika virus outbreak. These large-scale events also raise security concerns, especially after the Paris attacks. Brazilian officials have promised “to guarantee absolute peace”  during the Olympics.

Congrats to 2015 GMU Biodefense MS alum, Francisco Cruz, on his acceptance as a fellow in UPMC’s 2016 Class of Emerging Leaders in Biosecurity Initiative (ELBI) The UPMC ELBI is a highly selective program that brings together and fosters partnerships within the biosecurity field. Biodefense MS alum, Francisco Cruz, will accompany several other prominent members of the biosecurity community in meetings, conferences, and networking. Congrats Francisco!

DNA Investigations from the Great Plague of Marseille
Always a sucker for a mixture of history and epidemiology, I was excited to come across this archaeological gem. Despite its initial devastation in the fourteenth century, the bubonic plague resurged and hit Europe with another destructive wave, “leading to continued high mortality and social unrest over the next three centuries.” Considered to be the last outbreak of medieval plague in Europe, the Great Plague of Marseille (1720-1722) has provided archaeologists with samples that allowed them to reconstruct the complete pathogen genome. Harnessing DNA from the teeth of victims within the Marseille plague pits, their results point to the disease hiding within the shadows of Europe for hundreds of years. Computational analyst Alexander Herbig notes, “we faced a significant challenge in reconstructing these ancient genomes. To our surprise, the 18th century plague seems to be a form that is no longer circulating, and it descends directly from the disease that entered Europe during the Black Death, several centuries earlier”. While they continue their work on tracing the origins of the disease and its mysterious disappearance, I’m hopeful that archaeogenetics is the new inspiration for future Indiana Jones films…

Stories You May Have Missed: 

  • Listeria Outbreak Associated With Dole Salads- A Dole production plan in Springfield, OH, is being linked to an outbreak of Listeria throughout the US and Canada. Twelve cases were identified in the US and another seven were found across five provinces in Canada. All twelve cases involved hospitalization and there has been one associated death. The CDC is continuing updates here.
  • USDA Updates on Highly Pathogenic Avian Influenza Fall Plan- The USDA has updated their plans to combat the highly pathogenic avian influenza with more details regarding reimbursement on virus elimination activities and additional information on the August 2015 industry survey on preparedness.
  • British Government and Bill & Melinda Gates Foundation Roll Out New Plan to Combat Malaria –  The British government has teamed up with the Bill and Melinda Gates Foundation to pledge three billion pounds to help stop malaria in the next fifteen years. Bill Gates and British Chancellor George Osborne stated, “We both believe that a malaria-free world has to be one of the highest global health priorities.” Britain will invest 500 million pounds a year over the next five years and the Bill and Melinda Gates Foundation have put up $200 million this year and will continue with annual donations.
  • Tales from the Front Lines in the Ebola Fight-  Confusion, disorganization, fear, and communication gaps fill the notes from the ground in this interview with VICE correspondent, Danny Gold, during his time in West Africa during the outbreak.

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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.

Pandora Report 8.23.15

We’re starting this update with some big blog news, are you sitting down? This will actually be the last weekend update…at least for a while. We’re in discussion with how to proceed with the blog and social media for GMU Biodefense. Please check back at pandorareport.org and on twitter @PandoraReport for updates as they happen.

Looking back, there have been times since I’ve started as managing editor that the news has been sad, or, frankly, downright depressing. So, for this edition, lets focus on some of the good in the world. The first story comes from (probably the nicest human on the face of the Earth) Jimmy Carter. We’ve also got good news about Polio. Then, of course, we’ve got stories you may have missed.

Thank you for reading… and don’t forget to wash your hands!

Jimmy Carter Wants to See the Last Guinea Worm Die Before He Does

This week, former President Jimmy Carter announced that his cancer had spread to his brain. Though many members of his immediate family died from cancer, Carter said “I’m perfectly at ease with whatever comes.” Rather than fear or sadness over his diagnosis, Carter instead focused on meeting one of the long-term goals of his nonprofit organization—the Carter Center—the eradication of Guinea worm. In 1986 when the Carter Center began its work there were 3.5 million cases of across 21 countries. In 2014 there were 126 cases; today, there are 11.

The Huffington Post—“When Guinea worm has been eradicated, it will be only the second time in human history that a disease has been totally wiped out. The first, smallpox, was eradicated in 1977, according to the World Health Organization. Experts from the Centers for Disease Control and Prevention estimate that Guinea worm will meet the same fate — a final piece in Carter’s legacy.”

WHO Declares Africa Free of ‘Wild’ Cases of Polio

According to the World Health Organization, Africa has been free of wild cases of Polio since July. This doesn’t mean that there are no cases on the continent; there is still ongoing work in Somalia, Kenya, and Ethiopia, but transmission of the illness has been interrupted. The director of the Polio Global Eradication Initiative has said that even though Africa is now free of wild cases, there are still challenges when it comes to eradication, for example, surveillance of the disease.

io9—“The goal of the Initiative has been to interrupt the natural transmission (wild cases) of the virus, which seems to be the case so far. The next step, according to WHO, will be to continue to monitor the region for additional cases. If none appear in the next two years, the continent will be certified Polio-Free.”

Stories You May Have Missed

 

Image Credit: Commonwealth Club