Pandora Report 5.5.2017

Welcome to your weekly dose of all things biodefense. We hope you’ll celebrate World Hand Hygiene Day today by practicing awesome hand hygiene to help stop the spread of germs! Will Bill Gates save us from the next Ebola?

Summer Workshop Discount Extended
We’re excited to announce that the early registration deadline has been extended to June 1st for the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security! This is a great opportunity to experience a 3-day workshop led by some of the top biodefense people in the field, not to mention networking opportunities with fellow global health security gurus. Don’t miss out on this July 17-19th workshop in which you’ll learn about bioterrorism, synthetic biology, dual-use research of concern, and how experts are working to stop the next pandemic.

Three Insights from the World Bank’s Tim Evans on Global Health
“While in the previous year the U.S. was the biggest single source of development aid finance for health at $12.8 billion — 34 percent of the global total — its future position is less clear. Specifics on U.S. commitments to global health were lacking in U.S. President Donald Trump’s ‘skinny budget‘ released in March. The latest budget document released this week, meanwhile, shows proposed cuts to USAID’s global health funds.” At a recent event hosted by the Kaiser Family Foundation and the Center for Strategic and International Studies, Tim Evans, senior director of health, nutrition, and population at the World Bank Group, pointed to three important lessons. Firstly, we must catalyze domestic resource mobilization. Domestic spending impacts a country’s capacities and universal healthcare development. “Evans said the global health community needs to rethink the way it views and packages development assistance, from largely being linked to service provision to one that can strengthen countries’ domestic resource mobilization.” Second, he notes that it is crucial to build a demand for health. Policy shifts and economic strain increasingly threaten global health security efforts. He notes that there is a “very strong need to think about building demand and not to pretend that because you’re doing health and saving lives that everybody thinks that’s a great idea,”. “Actively cultivate that community, because you know if you don’t, then it doesn’t take much of a counter force — and we’ve seen this in the areas of vaccines and immunizations — to erode that base of support.” Lastly, the growing threat of disease requires that we expand beyond the “public sector-only mindset”. It’s critical to consider and utilize the private sector for public health efforts. He mentioned that “the public sector has massively important functions. But we have to look in a granular way, various ways, in which the private sector is active, will be active, and work with that in ways that are going to address burden of disease in cost effective manners,”.

Has The Deep State Hoodwinked Trump?
GMU Professor Charles P. Blair and biodefense MS student Rebecca Earnhardt are pointing to Trump’s recent military action in Syria and what really happened behind closed doors. “Though many of the administration’s more centrist supporters cheered the US missile strike on the Syrian air base, characterizing it as a bold move necessitated by the weakness of Barack Obama, other Trump supporters argued that the president had been tricked into a grand mistake. Was Trump the victim of a ruse by the ‘deep state’—a monolithic alignment of federal power centers so intent on maintaining command that it was willing to derail the new administration by encouraging it to pursue unwise military action? Or was the president misled by an even more ominous version of the deep state: one that subverts legitimate civilian leadership in a bid to recouple the United States to ‘regime change’ and similar globalist policies of militant ‘humanitarian’ interventionism?” Blair and Earnhardt look at this history of “deep state”, the rise of the “new world order”, and the growth of fringe beliefs in conspiracy and the notion of a hidden organization (think The X-Files, Men in Black, and the Matrix). “This elevated circulation of cross-pollinated conspiratorialism, now manifest in the increasingly normalized views of the fringe far right, has been facilitated not just by television and movies, as discussed above, but also by Internet platforms.” While not all associate the deep state with some totalitarian global group (which reminds me of James Bond‘s Spectre and Mission Impossible‘s Syndicate), the increasing belief in “sanitized conspiracies” has highlighted some changes how we form beliefs and what that translates to. Earnhardt and Blair also note that that while such beliefs have increased while faith in government, science, and the press have declined.

Why Are We More at Risk Than Ever for a Global Pandemic? 
GMU Biodefense PhD student, Saskia Popescu, looks at the seven reasons we’re more at risk than ever for a global pandemic. While concurring with a recent list following CNN’s pandemic documentary, she highlights two gaps within it – attitude towards infectious diseases and the role of healthcare infrastructure. “The current attitude towards infectious diseases puts us more at risk. Ebola brought the realities of borderless outbreaks to the forefront, especially with availability of faster information. Industrialized countries view diseases—emerging infectious diseases, in particular—differently than developing countries. In the United States, we relish our vaccine availability enough that we refuse it and often see emerging diseases as third world problems. Ebola showed us two things; the unfounded and irrational fear that occurred in the United States, and the lack of preparedness or acknowledgement that a disease in West Africa could venture across the pond.” She highlights the damaging implications of viewing emerging infectious diseases as “third world country problems” and what cultural shift is needed for this to change. The second missing component to the list is healthcare infrastructure and infection control efforts. “Physicians and nurses alike are desperately needed in developing countries; however, it is important to include another role that is often forgotten: infection control and prevention. Although there are fewer doctors and nurses in outbreak regions, there is also something to be said about the grossly underfunded and underutilized role of infection control as a preparedness and response tool. Whether it is in the United States or in a developing country, infection prevention and control programs are vital for both patient and employee safety, frequently understaffed, and economically strained.” Highlighting the nosocomial cases in Dallas, TX, she notes that infection control is bigger than just hospital-acquired infections and trickles down to antimicrobial resistance, communicable disease reporting, and patient isolation. “Overall, the way we look at emerging infectious diseases, our role in preventing and responding to them, and how we utilize (or fail to utilize) healthcare have created a substantial vulnerability for future public health threats. We have more than enough proof to show how vulnerable we all are to infectious diseases and how vital hospital infection control is to not only internal infections, but also preventing the spread from the community. Now is the time to truly utilize a holistic approach—including infection control programs, public education and cultural awareness, and more—to prevent the next pandemic.”

U.S. Biodefense Failures
Despite the bipartisan nature of biothreat preparedness, the U.S. struggles to to support such efforts. A recent Blue Ribbon Study Panel on Biodefense meeting highlighted yet again, the lack of leadership for U.S. biodefense efforts -whether that be an agency or person. “For at least two decades, infectious disease experts have been urging the U.S. government to do more to keep the country prepared for outbreaks of diseases such as a new strain of flu, Ebola and severe acute respiratory syndrome, or SARS. They’ve also noted that other countries have prepared biological weapons such as smallpox and anthrax and have used chemical weapons — such as Syria’s use of sarin gas against its own citizens.” Despite the constant supply of warnings from experts regarding the eventuality of a new flu pandemic, the 2014 Ebola outbreak, and concerns over dual-use research and gene editing, we just can’t seem to get it together. We know what the threat of infectious diseases, whether it be natural, intentional, or accidental, is real and will only increase as populations grow and globalizations strengthens. “The United States needs to be ready ahead of time, with stockpiles of drugs, vaccines and equipment, plans for deploying them and someone with the authority to make fast decisions, Cole and other experts said. The 2017 budget agreement worked out early Monday by Congress would provide just $57 million specifically to prepare for a new pandemic of influenza.” The truth is that U.S. response tends to be more reactive than proactive. We’ve gotten lucky so far in that the diseases weren’t highly transmissible with high fatality rates, but the truth is that our luck won’t hold forever.

Contaminated CRISPR Kits
This is quite an interesting twist in the concerns over DIY-gene editing…. While many worry about the outcomes of biohackers and garage genome editors, a recent finding of contaminated CRISPR kits sold by the company, The Odin, has added a new worrisome layer. The kits are normally sold online for $150 for those interested in doing gene engineering at home however, this recent finding by the European Centre for Disease Prevention and Control (ECDC) has resulted in a halting of all CRISPR kits imported into Germany. The kits were meant to contain harmless laboratory strains of E. coli HME63, however multiple kits were found to be contamined with several pathogens, including some that are antibiotic resistant. Klebsiella pneumoniae, Enterobacter, and Enterococcus faecalis were the microbial culprits found in the contaminated kits. The ECDC has stated that there is a low risk for users “because the manipulation of the kit does not involve percutaneous injury-prone manipulations. However, infection resulting from the contamination of broken skin or mucous membranes may occur, even though the kit recommends and provides disposable gloves. Furthermore, the kit includes lyophilised materials that need to be reconstituted, which may lead to contamination of the mucosae of the eyes, mouth and nose. Finally, the risk of infection may be increased for immunocompromised or immunosuppressed persons.” You can find the ECDC statement here, which notes that LGL, the Bavarian Health and Food Safety Authority, issued the press release in late March. There is also concern related to the potential release of drug-resistant organisms into the environment, of which the ECDC noted, “the potential contribution of the contaminated kit to the increasing burden of antimicrobial resistance in the EU/EEA is marginal, and the associated public health risk is considered very low”. They also encouraged users of the kits to appropriately dispose of their used materials to avoid releasing any drug-resistant bacteria into the environment.

Eastern Europe Antibiotic Usage Report
A new WHO report is providing information regarding antibiotic consumption and usage in 11 non-EU countries and Kosovo from 2011-2014. “The most commonly used class of antimicrobials was beta-lactams, whose share of the total ranged from 35.4% in Belarus to 65.6% in Azerbaijan, the report says. Cephalosporins accounted for between 6.1% (Azerbaijan) and 30.3% (Turkey) of total consumption, while the share for quinolones ranged from less than 0.1% in Uzbekistan to 17% in the Republic of Moldova. The report notes that cephalosporins and quinolones are broad-spectrum antibiotics and are considered second-line drugs in many prescribing guidelines. The two groups combined accounted for 10% (Azerbaijan) to 38% (Moldova) of total consumption.”

Workshop on Strategies for Identifying and Addressing Biodefense Vulnerabilities Posed by Synthetic Biology
Don’t miss this May 25th event at the National Academy of Sciences Building! This meeting will be open to the public, and will run from 8:30am until 4:30pm. The committee will hear from speakers who will discuss the current state of the science in DNA synthesis, assembly, and engineering; pathogen engineering and zoonosis; and ease of use as it relates to synthetic biology. There will be question and answer periods following each panel discussion, and members of the public will be invited to ask questions of the panelists, so we invite you to attend in person, if you are able. You can also check out the draft agenda here. It will be interesting to see if the workshop will discuss CRISPR kits and the potential for contamination.

Stories You May have Missed:

  • NIH Sets Research Cap on Funding for Scientists–  On Tuesday it was announced that for the first time, the NIH will restrict the amount of funding any individual scientists can hold at a given time via a point system. It is “part of an ongoing effort to make obtaining grants easier for early- and mid-career scientists, who face much tougher odds than their more-experienced colleagues. According to the agency, just 10% of grant recipients win 40% of the agency’s research money. Advocacy organizations and groups that advise the NIH director have been urging the agency to address this inequality for more than a decade. They are also concerned that increasing competition for grant money drives researchers to spend more time on paperwork and personnel issues associated with grants, and less time in the lab.”
  • Yellow Fever Vaccine Levels Are Dangerously Low – The CDC recently announced that the supply of yellow fever vaccine will be depleted by this summer. France is said to be able to cover the U.S. populations in need of the vaccine by the time the U.S. supply runs out, however the ongoing manufacturing problems continue to strain response efforts. “A number of vaccine doses were lost while Sanofi was transitioning vaccine production from an old site to new construction, slated to open in 2018.The United States uses 500,000 doses of yellow fever vaccine each year, distributed to travelers and military personnel who will be visiting yellow fever–endemic regions. Just 1 dose of the vaccine confers lifelong immunity, with recipients showing 80% immunity to yellow fever virus 10 days after inoculation and 99% immunity within 30 days. According to unpublished data from Sanofi, approximately 60% of these doses are distributed among about 4,000 civilian clinical sites.”
  • Attacking Antibiotic Resistance With Behavioral Approaches
    A recent Dutch study looked at antimicrobial stewardship strategies and found that by letting providers determine the root-cause of inappropriate antibiotic prescribing, they were more effective in responding to the problem. “The aim of the study was to test the effectiveness of a stewardship approach in which prescribers were asked to determine the root causes of inappropriate antimicrobial prescribing in their department, then develop one or more interventions to improve prescribing based on those root causes. The theory behind this strategy is that if you respect prescriber autonomy and allow prescribers to create their own program to improve prescribing, they will value this approach more and show more commitment to it.  Overall, there were 21,306 clinical admissions during the baseline period and 15,394 clinical admissions during the intervention period, with the appropriateness surveys including 1,121 patients and 882 patients, respectively. In the baseline period, 64.1% of antimicrobial prescriptions were considered appropriate, compared with 77.4% in the intervention period, an increase of 20.7% that equaled 4,927 improved days of therapy.”

Pandora Report: 2.10.2017

Have you ever wondered what some of the most deadly diseases looked like in person? Check out this video depicting some of these germs and how they’d appear if you sat next to an infected person. Fortunately, this week was full of disease-filled media like this germ history video regarding the golden age of germs and how humans cause pandemics (spillover anyone?)

The Colosseum that is CRISPR Patent Wars
It seems like the ultimate display of gladiator games – researchers from major university (UC-Berkley, Harvard, and MIT) are in the midst of a battle for patent protection. You can check out the timeline here, but it seems that despite it being over two months since proceedings started, we’re not much closer to a conclusion. “A key feature of the U.S. debate is over which research group was the true first inventor of the CRISPR/Cas9 system, especially its use in eukaryotic cells. At the time the first patent applications were filed, the U.S. had a ‘first-to-invent’ system—which means the first person to develop an invention is entitled to have the patent, even if they were not the first to file a patent application (or the first to get a patent granted) for that invention. UCal has started “interference proceedings” against the Broad Institute to determine who was the first to invent the CRISPR/Cas9 system. UCal claims that they were the first to invent the use of the CRISPR/Cas9 system for gene editing, and that their earliest patent application enabled gene editing in eukaryotic cells. In contrast, The Broad Institute are arguing that UCal had not invented the use in eukaryotic cells at the time of filing its first patent application and are therefore claiming that The Broad Institute were the first to invent the use of CRISPR/Cas9 in eukaryotic cells.”

Public Health’s Greatest Threats 
We all have opinions regarding the greatest global threat- especially in terms of public health. Is it obesity? Cancer? Exposure to toxins or new emerging diseases? What about bioterrorism or bioerror? Dr. Larry Brilliant is an epidemiologist who focuses on the worst disease throughout history. He notes that the greatest threats to public health can be divided into biological and socio-political. “In the last 30 years, there have been at least 30 heretofore unknown viruses that have jumped from animals to humans, for worrying reasons Brilliant attributes to modernity and our increase in animal protein consumption. Still, the socio-political threats are the more immediately dangerous. There are centrifugal forces at play that are pushing society to two extreme camps. The domestic and global division caused President Trump’s ‘America First’ mentality and disregard for public health leaves us vulnerable to new viruses that, if they aren’t detected early enough, could be the next pandemic. ‘Right now because of the re-organization and nationalism… and dislike for the United Nations and its agencies, I think we’re in a period of grave vulnerability,’ says Brilliant.” Dr. Brilliant points to the reality that public health threats aren’t just biological, and as we saw with the 2014/2015 ebola outbreak (and Zika), the socio-political response can hinder or help public health efforts. While we’re always vulnerable to new diseases, are we becoming increasingly more susceptible from a socio-political standpoint?

ASM Biothreats 2017
From synthetic biology to national bioterror emergency response, the ASM conference was packed with biodefense goodies. We’ll be providing a detailed overview regarding certain sessions and the conference as a whole, so make sure to keep your eye out next week!

Find Out What New Viruses Are Brewing In your Backyard  screen-shot-2017-02-08-at-7-47-55-am
NPR is looking at what causes pandemics and where new diseases tend to spring up. By reviewing EcoHealth Alliance data, they note that within the past sixty years, the amount of new diseases appearing has quadrupled. Scarier yet, the number of outbreaks occurring each year has more than tripled since 1980. “We’re in a hyperinfectious disease world,” says epidemiologist Michael Osterholm, who directs the Center for Infectious Disease Research and Policy in Minneapolis. While the tools for surveillance and detection have gotten better, it also became apparent to researchers that old diseases are returning from the grave, while emerging diseases are transgressing into new regions. “So the big question is: Why? Why is this era of new diseases happening now? ‘Well, we’ve been boiling the frog for a long time. Eventually, it’s cooked,’ says Toph Allen, a data scientist with EcoHealth Alliance, a nonprofit that is trying to prevent pandemics by looking for diseases in wildlife. Wait. We’re boiling the frog? You mean, humans are responsible? Yes. Many scientists say we, humans, are to blame for this new disease era. That we’re responsible for turning harmless animal viruses into dangerous human viruses.” Unfortunately, it seems that humans have become especially skilled at causing spillover.

Center for Global Security Research Student Internship
Calling all GMU biodefense students! Lawerence Livermore National Laboratory’s Center for Global Security Research is looking for a student intern! The center has “openings for undergraduate and graduate students and recent bachelors or master’s level graduates within one year, to engage in practical research experience to further their educational goals.” The student may conduct “research in the fields of nuclear engineering, computational sciences, materials science and engineering, cyber security, interactive data mining, political science and international relations to support United States (US) policy and decision makers in developing strategies for national and international security. The Center for Global Security Research’s (CGSR) mission is to provide technology, analysis, and expertise to aid the US government in preventing the spread or use of weapons of mass destruction (WMD), and examining the policy implications of proliferation of WMD, as well as deterrence.”

Zika’s New Strategy – Spillback?
With over 5,000 cases in the U.S. alone, the Zika virus outbreak may be slowing, but it’s not gone. We’ve talked about spillover before, but what about spillback? We tend to worry about diseases spilling over from animals into humans, but what about the opposite direction? Researchers are now worried about Zika spillback into monkeys. “In areas where Zika infections are prevalent among humans and mosquitoes are abundant, the virus may be transmitted to wild primates, disease ecologist Barbara Han said February 6 at the American Society for Microbiology Biothreats meeting. If the disease gets established in monkeys or other wild primates, the animals may serve as reservoirs for future human outbreaks.” As scientists work to study this process and establish potential at-risk species, it’s a helpful reminder that infectious diseases like to keep us on our toes. Or should I say, paws?

Stories You May Have Missed:

  • Over 350 Organizations Write Trump About Vaccine Safety – More than 350 organizations have written to President Trump highlighting their “unequivocal support for the safety of vaccines”. Leading medical organizations and healthcare professionals have resorted to this measure since the January meeting Trump had with Robert F. Kennedy regarding a potential commission on autism and vaccines. “Vaccines protect the health of children and adults and save lives,” the letter opens. “Vaccines have been part of the fabric of our society for decades and are one of the most significant medical innovations of our time.” It continues: “Claims that vaccines are unsafe when administered according to expert recommendations have been disproven by a robust body of medical literature.”
  • Got C-diff? Grab Some Vancomycin!Clostridium difficile is an infection preventionist’s worst nightmare. This spore-forming bug is tough to kill, can cause mortality, and often wreaks havoc on hospitals. A recent study looked at the treatment efficacy of vancomycin versus metronidazole, with the goal of preventing recurrence of the disease. “Analysis of the data showed that there was no difference in risk of recurrence between those treated with vancomycin or metronidazole in any of the severity groups. And in patients with mild-to-moderate disease, there was no significant difference found in the risk of all-cause 30-day mortality. But among the patients with severe infection, patients treated with vancomycin were 4% less likely to die within 30 days of any cause than those treated with metronidazole. Stevens and her colleagues calculated that to prevent one death among patients with severe C difficile infection, 25 would need to be treated with vancomycin.”
  • Fighting Cholera– Cholera has been a scourge throughout history and sadly, we’re still battling it. Researchers have finally developed an effective vaccine and stockpiled it, however efforts are still in progress to get it to the most hard-hit countries, like Bangladesh. “Merely creating that stockpile — even of a few million doses — profoundly improved the way the world fought cholera, Dr. Margaret Chan, secretary general of the W.H.O., said last year. Ready access to the vaccine has made countries less tempted to cover up outbreaks to protect tourism, she said. That has sped up emergency responses and attracted more vaccine makers, lowering costs. ‘More cholera vaccines have been deployed over the last two years than in the previous 15 years combined,’ Dr. Chan said.”

 

 

Pandora Report 10.7.2016

TGIF and cheers to another week of biodefense news! Check out the GAO multimedia video on the risks of incomplete inactivation of pathogens. A whistleblowing former Pasteur Institute official in South Korea is reporting that a scientist for the South Korean branch took MERS-CoV samples on a commercial flight from Seoul to Paris without proper clearance and violated UN rules and French laws. The CDC is reporting a spike in the number of acute flaccid myelitis (AFM) reported. This rare polio-like illness can cause paralysis and was linked to outbreaks of enterovirus D68 in 2014. Ever wondered about opportunities to finance pandemic preparedness? Bill Nye has a new video on the “science illiteracy” of U.S. leaders, pointing to Ebola and climate change response as indicators of mistrust of science within the U.S.

Don’t Miss the Biological Threats in the 21st Century Book Launch!
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Make sure to RSVP by Sunday for the upcoming (October 14th)  book launch of Biological Threats in the 21st Century! Biological Threats in the 21st Century introduces readers to the politics, people, science and historical roots of contemporary biological threats through rigorous and accessible chapters written by leading scholars and supplemented by expert point-of-view contributions and interviews. The book launch will feature a panel discussion on the threat of biological weapons and the role of scientists in bioweapons non-proliferation and disarmament. The event is free and open to the public. Lunch will be available, first come, first serve, beginning at 11:45 AM so please RSVP. Attendants will also be able to pick up the book at a 15% discount.

GMU Biodefense Graduate Program Open Houses Biodefense_133x400
We invite you to attend an open house to learn more about the Schar School of Policy and Government. The session will provide an overview of our master’s degree programs, an introduction to our world-class faculty and research, and highlights of the many ways we position our students for success in the classroom and beyond. Our admissions and student services staff will be on hand to answer your questions. Check out the next MS info program on Wednesday, October 19: 6:30pm-8:30pm- Arlington Campus, Founders Hall, Room 126

Drawing on world-class original research and high-level practical experience, our faculty prepare students to be creative and effective participants in policy-making and political discourse.  By working closely with these faculty to conduct research that influences decisions at the local, national and international levels, our PhD graduates emerge prepared for high-powered careers in the public, private, and nonprofit sectors. The next PhD info session will be on Wednesday, October 12, 2016: 7:00pm-8:30pm – Fairfax Campus, Johnson Center, Room 334

The State of Vaccine Skepticism in Maps
Typically, we look at graphs of vaccine exemptions, but you can now explore vaccination confidence throughout the world via interactive maps. A recent study looked at public confidence in vaccines, asking 66,000 people in 67 countries their thoughts and beliefs in vaccines. Researchers found that France was the least confident in vaccine safety and that “one peculiar conflict emerges from Southeast Asia, where the public seemingly has little doubt as to the safety, importance, or effectiveness of vaccines, yet may eschew them on religious grounds.” Attitude and confidence in vaccines is strongly correlated with vaccine exemptions or refusal. As we saw with California and the Disneyland-associated measles outbreak in 2015, vaccine-preventable disease are becoming a growing issue, not just within the U.S., but on a global level. Since we’re on the topic – make sure to get your annual flu shot as the CDC is recommending people get their flu vaccines before the end of October. You can find more on the 2016/2017 flu season here.

Las Alamos is Now Tracking Global Disease Outbreaks
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Biosurveillance is a mixed bag of tricks – some prefer focusing on symptoms, others on vectors, but overall, there’s been a steady dispute regarding how best to pursue it. Los Alamos National Laboratory in New Mexico is working to break through the fog and establish a new method “describing disease that is designed to bring this disparate field together and gain international traction. Their new system of classification is called the Anthology of Biosurveillance Diseases, and they have set up an online database to support it.” The new system takes into account many important parts of the epidemiology and biosurveillance practices for disease tracking. Detailed description of vectors, search capabilities by symptoms, and a wide range of synonyms for diseases are all components to this new system. This is no easy task and the system designers know that as new diseases are found or knowledge expands for existing ones, there will be no rest for the wicked. Biosurveillance has so many moving parts and this database is the first step in trying to get them all into one area to better strengthen the surveillance system and thus the capacity for response by public health. While they work to make the updating process automated,  the database has been made available online here.

ISSF Roundtable on Barriers to Bioweapons
If you haven’t read GMU Biodefense Associate Professor Sonia Ben Ouagrham-Gormley‘s Barriers to Bioweapons: The Challenges of Expertise and Weapons Development, get the scoop from this latest review. Dr. Ouagrham-Gormley’s book breaks down the realities behind bioweapons development and that weaponization of biological agents is much more difficult than many realize. Not only is this one of my favorite books, depicting the realities of tacit knowledge as a major roadblock for non-state bioweapons development, but this review gives great insight from multiple subject matter experts from several academic institutions. “The reviewers place Ben Ouagrham-Gormley’s work in the context of the literature on nuclear power and nuclear weapons, and note that she impressively draws from multiple literature, including business school case studies, anthropology, and organizations and management. To these strengths, I would like to add three others: first, Barriers to Bioweapons is well organized and very well written—a model of rich empirics and theoretical sophistication. Second, Ben-Ouagrham-Gormley successfully tackles a large and hard problem: showing how state structures and processes shape specific technical and scientific outcomes. Third, in addition to her excellent discussion of tacit knowledge, Ben Ouagrham-Gormley writes with great insight about knowledge reservoirs, knowledge transfer, and knowledge loss in and across organizations.”

Enhancing International Nuclear Nonproliferation in an Increasingly Dangerous World
GMU Biodefense PhD alum, Daniel M. Gerstein points to the vulnerability of international nuclear nonproliferation and how this U.S. national security strategy is “teetinger on a dangerous precipice.” What can the U.S. do? Between North Korea’s recent nuclear and missile tests and Russian President Vladimir Putin’s halting of the bilateral Plutonium Management and Disposition Agreement with the U.S., the stakes are progressively getting higher. Gerstein notes that new national programs tend to focus on deterrence against regional adversaries and terrorist interest in acquisition of nuclear capabilities hasn’t waned, but rather the interest has grown as proliferation challenges become chronic. He notes several key steps to help reverse these trends – “First and foremost, the United States should reassure allies about the viability of U.S. nuclear security guarantees and the stockpile. The next administration will need to conduct a Nuclear Posture Review to set the country’s nuclear policy for a five- to 10-year period. Second, the United States should emphasize its absolute support for the goals of the Nuclear Non-Proliferation Treaty, or NPT – nonproliferation, disarmament and peaceful uses of nuclear energy. Third, the two most immediate state nuclear proliferation issues must be addressed: Iran and North Korea. On Iran, the United States should build support for the JCPOA, both domestically and across the globe.” International strategies must account for the unpredictable nature and capabilities of North Korea and push for China to increasingly pressure them to abandon their nuclear program.

All Things Zika
After reporting an additional 2,391 cases of locally acquired Zika virus in the first week of September, Puerto Rico is continuing to battle the disease as their case counts top 20,000. Texas is currently enhancing Zika surveillance in the Rio Grande Valley. Brazilian researchers are reporting a constellation of brain injuries from their work with 11 babies whose congenital Zika infections were detected before birth. “Though brain damage varied among the babies, the most common findings were brain atrophy and changes related to disturbances in neuronal migration. Defects ranged from mild brain atrophy and calcifications to severe malformations including absence of the thalamus and lissencephaly. Other findings included hypoplasia of the cerebellum, cerebellar vermis, and corpus callous.” As the outbreak rages on, U.S. public health officials are bracing for the first wave/generation of babies born with Zika-related birth defects. This Generation Zika is expected to be an extraordinary demand on special-needs care. “Data on newborns in Colombia suggests that Zika-infected women who are asymptomatic may give birth to children with Zika-related abnormalities. With that in mind, the U.S. Centers for Disease Control and Prevention has recommended testing for Zika during routine obstetric care for pregnant women who may have been exposed to the virus.” As of October 5th, the CDC has reported 3,818 cases of Zika in the U.S. Hurricane Matthew will be hitting Florida soon and as the state braces for impact, there are growing concerns about the increase of mosquito populations following flooding.

Stories You May Have Missed:

  • Legionnaires’ Outbreak Grows – The Minnesota Department of Health is reporting another spike in Legionnaires’ cases in the midst of an ongoing outbreak. They recently reported 23 new cases, all of which are people who live, work, or spend time in the Minneapolis suburb, Hopkins. “Seven locations with cooling towers have been identified as possible sources. Samples have been collected from those towers. But officials point out that cooling towers are not regulated in Minnesota, so there is no registry or master list of towers.”
  • The Biology of Anthrax Conference- Make sure to check out the upcoming November 15-18 conference in Tampa, Florida. While primarily a sporadic pathogen of herbivores, its use as a bio-terror agent has highlighted its ability to infect humans. This conference aims to bring together investigators active in this area with a view to sharing observations and ideas and fostering new collaborations and synergies. Participants at previous conferences in Cardiff in 2009 and 2014 included representatives from academia, industry, policy makers and government.

Pandora Report 2.5.2016

Fear of mosquitoes continues to grow as Zika virus joins the list of burdening arbovirus infections. Perhaps the biggest surprise this week wasn’t that imported Zika cases continue to spring up across the US, but rather that the first sexually transmitted case occurred in Dallas, Texas. I’m starting to think Dallas, TX, could use a break from emerging infectious diseases… As influenza season picks up in the US, Avian influenza outbreaks are popping up in Taiwan, South Africa, and Macao. Good news- it’s safe to go back to your favorite burrito bowl! The CDC declared the Chipotle-associated E. coli outbreak over, however, their co-CEO has voiced frustration over delayed reporting. In the interview, he felt that it gave the “mistaken impression that people were still getting sick” and news was “fueled by the sort of unusual and even unorthodox way the CDC has chosen to announce cases.” Before we venture down the biodefense rabbit hole, don’t forget to stay healthy and safe this Super Bowl Sunday. Spikes in cases and flu-related deaths (in those >65 years of age) can jump by 18%  in the home regions of the two teams. Take care to avoid respiratory viruses and food-borne issues while cheering on your favorite team this weekend!

Medical Counter Measures for Children
Having worked in pediatrics, I was thrilled to see the American Academy of Pediatrics publish the updated guidelines. Throughout my work in infection prevention and collaborations with hospital emergency preparedness and local county health departments, it became increasingly evident that in many ways, this is a patient population that is easily forgotten. There is a woefully apparent gap in preparedness methodology to recognize and modify practices to meet the unique needs of children. While many may laugh at the notion that “children aren’t just little adults”, those who have worked in pediatrics can attest to these common misconceptions. Children are not only more susceptible to the devastation of disasters and CBRN attacks, the medical counter measures often do not account for pediatric dosages. The published report discussed their work over the past five years to better address and fill major gaps in preparedness efforts when it comes to medical counter measures (MCM) for children. “Moreover, until recently, there has been a relative lack of pediatric MCM development and procurement; many MCMs were initially developed for use by the military and have been evaluated and tested only in adults.” Some of the recommendations that were made from this report include: “the SNS and other federal, state, and local caches should contain MCMs appropriate for children in quantities at least in proportion to the number of children in he intended population for protection by the cache” and “federal agencies collaborating with industry, academia, and other BARDA partners, should research, develop, and procure pediatric MCMs for all public health emergency, disaster, and terrorism scenarios and report on progress made.” Perhaps one of the most interesting recommendations was that “the federal government should proactively identify anticipated uses of MCMs in children during a public health emergency and, where pediatric FDA-approved indications do not exist, establish a plan to collect sufficient data to support the issuance of a pre-event EUA that includes information such as safety and dosing information and the federal government should use existing entities with pediatric SMEs, such as the PHEMCE, PedsOB IPT, and the DHHS National Advisory Committee on Children and Disasters, and continue to collaborate with private sector partners offering pediatric expertise to provide advice and consultation on pediatric MCMs and MCM distribution planning.” Overall, these recommendations and the push for data collection and clear progress reporting are definitely a step in the right direction.

GMU Open House
Interested in a master’s degree that allows you to focus on bioweapons, global health security, and WMD’s? Check out GMU’s School of Policy, Government, and International Affairs (SPGIA) Open House on Thursday, February 25th at 6:30pm, at our Arlington Campus in Founders Hall, room 126. Representatives from our Biodefense program will be there to answer all your questions. Better yet, check out our Biodefense Course Sampler on Wednesday, March 2nd, at 7pm (Arlington Campus, Founders Hall, room 502). Dr. Gregory Koblentz,  director of the Biodefense graduate program, will be presenting “Biosecurity as a Wicked Problem”. Come check out our curriculum and get a taste of the amazing topics we get to research!

From Anthrax to Zikam6502e1f
Researchers at the University of Greenwich are finding a potential cancer-fighting strategy using the anthrax toxin. Lead scientist, Dr. Simon Richardson, is working with his team to convert the anthrax toxin into a delivery tool for medications.“This is the first time a disarmed toxin has been used to deliver gene-modulating drugs directly to a specific compartment within the cell. We’ve achieved this without the use of so called helper molecules, such as large positively charged molecules like poly(L-lysine). This is important as while these positively charged molecules, known as polycations, can condense DNA and protect it from attack by enzymes before it reaches the target, they are also known to be toxic, break cell membranes and are sent quickly to the liver to be removed from the body. In this study we demonstrate that using disarmed toxins without a polycation is effective, at a cellular level.” In the world of Zika virus….On Monday, the WHO Zika virus team met and announced that the outbreak should now be considered a public health emergency of international concern. Dr. Margaret Chan, WHO director general, stated, “I am now declaring that the recent cluster of microcephaly and other neurological abnormalities reported in Latin America following a similar cluster in French Polynesia in 2014 constitutes a public health emergency of international concern.” Given the level of uncertainty regarding the disease, many feel this was a justified classification of the outbreak. The first case of sexual transmission within the US also occurred in Dallas, Texas. The patient became sick after having sexual contact with an individual who became symptomatic upon return from Venezuela. Chile and Washington DC have just confirmed their first three cases this week. Mexico’s Health Ministry is trying to downplay the Zika impact on tourism, however as the outbreak unfolds, it will be interesting to see long-term tourism repercussions within the affected countries. The state of Florida is ramping up their mosquito elimination, control, and education efforts to combat the growing epidemic, as it is one of the mosquito-heavy states within the US. Governor Rick Scott recently declared a health emergency in four Florida counties. If you’re on the lookout for educational tools, there are several helpful CDC informational posters regarding mosquito bite prevention.

US Military and the Global Health Security Agenda
In effort to protect military members and support global public health, the DoD (specifically, the Military Health System in coordination with the Defense Health Agency’s Armed Forces Health Surveillance Branch) developed the 2014 Global Health Security Agenda (GHSA). The GHSA established a five-year plan with specific agenda items, targets, and milestones that would incorporate its 31 partner countries. The DoD’s Global Emerging Infections Surveillance and Response System (GEIS) will also support these efforts through their biosurveillance practices in over 70 countries. The international work is as varied as the challenges one might see in global biosurveillance. The Armed Forces Health Surveillance Branch (AFHSB) “leveraged existing febrile and vector-borne infection control efforts in Liberia to support the recent Ebola outbreak response. The Liberian Institute for Biomedical Research served as a central hub for Ebola diagnostic testing with the help of the Naval Medical Research Unit-3 in Cairo, Egypt and two Maryland-based facilities, the Naval Medical Research Center in Silver Spring and the U.S. Army Medical Research Institute of Infectious Diseases in Frederick.” Surveillance efforts will also look at antimicrobial resistance and the development of additional research laboratories to work in coordination with host-nations and certain regional networks. You can also read Cheryl Pellerin’s work on DoD Biosurveillance and the role it plays in maintaining global public health efforts. Pellerin reports on the duties of the GEIS and the US Army Medical Research Institute of Infectious Disease (USAMRIID) in not only global health security, but also protecting US military personnel from infections while abroad.

Norovirus Outbreak in Kansas
There are few things that will make a food-borne disease epidemiologist (or infection preventionist for that matter) as frustrated as a norovirus outbreak. It hits quickly, is highly infectious, and tends to leave you with stories from case-control interviews that will make you either laugh, cry, or need some fresh air. A Kansas City suburb is currently experiencing a 400 person outbreak of gastroenteritis associated with the New Theatre Restaurant. Initial lab reports have confirmed norovirus as the culprit. The Vice President of the restaurant said that three employees have also been confirmed as norovirus cases. To date, the almost 400 people who reported symptoms are said to have eaten at the restaurant between January 15 to present. Norovirus is a pretty unpleasant gastroenteritis (you’ve probably heard it called the “cruise ship bug”) as it has a low infectious dose (estimates put it as low as 18 viral particles, while 5 billion can be shed in each gram of feces during peak shedding). Norovirus outbreaks tend to spring up quickly and infect high volumes of people, making it difficult for public health officials to jump ahead of the outbreak. Perhaps one of the biggest components to stopping the spread of infection is good hand hygiene, environmental cleaning, and staying home when sick.

TB Transmission on Airplanes
We’ve all been there – you’re seated next to someone with a nasty cough or cold and you just know you’re going to get sick. But what happens if you’re on a plane and there’s a person a few rows away that has tuberculosis (TB)? The European Centre for Disease Prevention and Control (ECDC) reviewed evidence of TB transmission on airplanes to update their Risk Assessment Guidelines. Of all the records/studies reviewed, 7/21 showed some evidence for potential in-flight (all flights lasted more than 8 hours) TB transmission, while only one presented evidence for transmission in this environment. The interesting component is that this low transmission risk is considered only for in-flight, as they excluded transmission on the ground since the before and after flight ventilation system is not in full-function mode. The one study that did show transmission risk involved six passengers that were in the same section as the index case, of which, four were seated within two rows. After their review, they found that the risk for TB transmission on airplanes is “very low”. They noted that “the updated ECDC guidelines for TB transmission on aircraft have global implications due to inevitable need for international collaboration in contact tracing and risk assessment.”

Stories You May Have Missed:

  • Resistant HIV – A recent study published in The Lancet discusses drug resistance after virological failure with the first-line HIV medication, tenofovir-containing ART (antiretroviral  therapy). This treatment is used as both a prevention and pre-exposure prophylaxis (PrEP). Researchers found “drug resistance in a high proportion of patients after virological failure on a tenofovir-containing first-line regimen across low-income and middle-income regions”. This study highlights the growing need for surveillance of microbial drug resistance.
  • Active Monitoring of Returning Travelers – Ebola Surveillance – The CDC’s MMWR for the week of January 29, 2016, discussed NYC monitoring of returned travelers from October 2014-April 2015. Monitoring of returned travelers from Ebola-affected countries was one strategy the US employed to prevent imported cases. This report reviews the 2,407 travelers that returned from affected countries, of which no cases were detected. The NYC Department of Health and Mental Hygiene (DOHMH)’s active monitoring system proved successful, however it was very taxing on resources and reinforces the need to minimize duplication and enhanced cooperation. Speaking of Ebola, investigators from the University of Texas Medical Branch at Galveston, Vanderbilt University, the Scripps Research Institutem and Integral Molecular Inc., have performed research to establish that “antibodies in the blood of people who have survived a strain of the Ebola virus can kill various types of Ebola.” Further work will now seek to understand immune response to the virus and how we can modify treatments and potential vaccines to be more effective.
  • DoD BioChem Defense take a glimpse into the global biosurveillance and defense efforts within the DoD Chemical and Biological Defense Program (CBDP). Working within several joint programs and striving to get ahead of outbreaks and attacks with early warning systems, this program faces the challenges of monitoring biochem threats on an international scale.

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Pandora Report 12.4.2015

This week, Washington, DC hosted the Summit on Human Gene Editing, where the ethical and legal implications of gene editing technologies, like CRISPR-Cas9, were heavily discussed. In this week’s report, Greg Mercer works his magic, revealing the internet and social media trends following the shootdown of a Russian SU-24 on November 24th. We’re also reporting updates in the Zika virus and dengue fever outbreaks as well as the Harvard-LSHTM Panel Report on Global Response to Ebola. France is currently experiencing an increase of highly pathogenic avian influenza cases while a Black Angus beef cow in Alberta was discovered to have bovine spongiform encephalopathy (BSE). Fun history fact Friday – on December 3, 1967, the first human heart transplant was performed in Cape Town, South Africa and on December 4, 1945, the Senate approved US participation in the UN. Before we start our weekly roundup, make sure to mark your calendars to attend GMU’s seminar on Ebola surveillance and laboratory response this Monday, December 7th from 4:30-6pm at our Fairfax campus (details below!).

Zika Virus Outbreak – Updates
The growing outbreak of Zika virus has now seen locally acquired cases reach ten countries, causing the Pan American Health Organization (PAHO) to issue an alert, “urging countries in the region to be on the lookout for the disease and to watch for unusual patterns in newborn.” Brazil has been hit hard with a rise from 739 on November 27th, to 1,248 cases reported on November 30th. Six of the ten countries saw cases occur in November, hinting that the outbreak could just be starting. The growing concerns regarding the outbreak are also related to the newest evidence linking microcephaly and maternal cases. Zika virus genome was found in the amniotic fluid of two pregnant women and fetal diagnosis of microcephaly was performed via ultrasound. Even more so, French Polynesian health officials reported an unusual spike in nervous system malformations in babies that were born during a Zika virus outbreak in the region from 2014 to 2015. The concern regarding neurological conditions raises red flags as Brazilian health officials are reporting neurological complications, like that of Guillain-Barre syndrome, in Zika virus patients. The WHO reported 739 Brazilian microcephaly cases in newborns and while there is only ecological evidence linking the virus and microcephaly, investigations are ongoing. The outbreak first started in February 2014, on Easter Island (Chile) and has seen been identified in Colombia, Guatemala, Brazil, El Salvador, Mexico, Paraguay, Panama (confirmed cases as of December 4, 2015), Suriname, and Venezuela. Spread by Aedes mosquitoes, this vector-borne organism has similar symptoms to dengue fever and illness tends to last between four and seven days.

Event: Ebola Surveillance & Laboratory Response – Lessons for Global Health SecurityScreen Shot 2015-12-03 at 9.34.57 AM
Time/Location: Monday, December 7, 2015 from 4:30pm-6pm in Robinson A-203 at George Mason University.
As the recently released Harvard-London School of Hygiene and Tropical Medicine Independent panel on the Global Response to Ebola indicates, the West African Ebola epidemic highlighted
many gaps in national and international health and response systems that are critical for protecting global health security.  Join leaders and experts who helped to lead the U.S. response for Ebola to discuss the international response to the epidemic, the importance of robust biosurveillance systems, and how the experience with Ebola influences our approach to Global Health Security. Speakers:

  • Dr. Matthew Lim, Senior Policy Advisor for Global Health Security, HHS, fmr Civil-Military Liaison Officer to WHO
  • May Chu, Ph.D. fmr Assistant Director for Public Health, Office of Science Technology and Policy, White House; Senior Science Advisor, CDC
  • Jeanette Coffin, Manager U.S. mobile laboratory deployment, MRIGlobal

It’s Definitely Maybe World War 3
GMU’s Greg Mercer breaks down the November 24th Turkish shootdown of a Russian SU-24. Greg reviews the media attention following the event and the “immediate buzz about declarations of war, what exactly NATO owes Turkey vis-à-vis Russia, and the possibility of military confrontation between Russia and the West.” Through his use of google trends and Twitter, Greg shows just how much hype and concern the notion of WWIII got during this time. Take a look at his recap and debunking of the WWIII buzz and how quickly it caught like wild fire.

Reporting from the Panel on the Final Report of the Harvard-LSHTM Independent Review of the Global Response to Ebola
If you missed the Center for Strategic & International Studies (CSIS) Global Health Policy Center’s Launch of the final report of the Harvard-LSHTM Independent Panel on the Global Response to Ebola, don’t worry! I was fortunate to attend and a great deal of the report (we reported on last week) heavily emphasized “on the ground” capacity. Dr. Peter Piot, Director and Handa Professor of Global Health, London School of Hygiene and Tropical Medicine (LSHTM), joined via video link and started by saying that this would not be a WHO-bashing event. As one of the original researchers on Ebola during its 1976 discovery, he mentioned that the Democratic Republic of Congo (DRC) is a great example of local capacity in their success of ridding themselves of the disease within a few months of the outbreak starting. Dr. Piot heavily emphasized the work of several countries and how the WHO brought together multiple ethicists to review research during such a terrible outbreak. Lastly, Dr. Piot noted that “we risk focussing too much on global and not enough on local” in our future efforts. Dr. Suerie Moon, Research Director and Co-Chair of the Forum on Global Governance for Health at Harvard Global Health Institute, then spoke on the “weak coordination of global response” and how it severely aided the spread of Ebola. Dr. Moon highlighted the need for a global strategy to ensure adequate funding (external financing for the poorer countries and transparent tracking of financing) and the necessity for external assessment of country capacity. She pointed to the need for political and economic incentives and disincentives to not only report cases but also discourage the hiding of outbreaks. Reviewing each recommendation, the panel noted that “human health is a vital part of human security”. In one of her closing comments, Dr. Moon stated that “there are many unanswered questions regarding ebola response and we need to address a number of aspects that went wrong” and “a major theme is accountability at all levels, across all types of players.” Dr. Moon pointed out that the necessity of so many reforms shows just how much work is needed and that now is the time to see political support occur. Muhammad Pate, former Nigerian Minister of State for Health, expressed that “one of the lessons, at the national level, in terms of surveillance and accountability to respond, was missing and something that national leaders need to own up to is building their own public health systems.” Dr. Sophie Delaunay, Doctors Without Borders/MSF, then discussed the role of medical innovations and how the outbreak provided us with a unique opportunity to collect data. Dr. Delaunay said it will “be a complete nightmare to connect all the dots” in this outbreak and there is a desperate need for better R&D regarding disease outbreaks and response. “We ask for governments and policy makers to support collaboration on R&D to demonstrate their willingness to be more effective in the next outbreak” noted Dr. Delaunay. She heavily pushed for global financing efforts to facilitate investment in R&D and response. After the initial panel, there was a secondary group that shared their thoughts on the report, including Dr. Tom Frieden (CDC Director), Julie Gerberding (Exec. VP for Strategic Communications, Global Public Policy and Population Health, Merck) and Ron Klain (Former US Ebola Response Coordinator, White House and General Counsel, Revolution LLC). Ron Klain pointed to the failure of the WHO and “if institutions failed us, individuals shined. We did see extraordinary compassion from the rest of the world and tremendous outpouring of support. ” Mr. Klain mentioned that “the scariest thing about Ebola is the warning signs of how badly we failed this when the threat could’ve been worse and the epidemic we face could be much much more dangerous in the future.” Dr. Frieden emphasized the need of human resources management improvement at the WHO and how global outbreak response could work to support each other better. Lastly, Dr. Frieden emphasized a topic near and dear to my heart; infection control and it’s necessity in global disease prevention. Overall, the panel touched on several key points to the outbreak, emphasizing the need for the biggest players (including MSF) to lead by example via data sharing, etc. The push for political support on incentives and local capacity/accountability was perhaps one of the biggest recommendations and points emphasized from this event.

Gene Editing and CRISPR!
This was a busy week in the biotech world. The International Gene Editing Summit kicked off in Washington, DC. Bringing together experts from around the world, the summit touched on the newest technical innovations, ethical and legal concerns, and even social implications of genome editing advances. Genome Web has provided a great overview of the summit. Nature also published their Four Big Questions related to genome editing, touching on points related to editing the human germline and the ethical implications for technology that “researchers are still grappling with the known unknowns”. Recently, biologist, Emmanuelle Charpentier, discussed CRISPR-Cas9 and that it’s simply too early to begin gene editing as “the tools are not ready” and “as of today, I’m in favor of not having the manipulation of the human germlines. As long as they’re not perfect and ready, I think it’s good to have this ban against editing the germline.” Buzzfeed noted that over the course of the conference, there was a substantial push for a delay in the use of genetic engineering in fertility clinics due to the risk of making “designer babies”. Given the heavily debated nature of this topic it’s not surprising that the US National Academy of Sciences, Engineering and Medicine, the UK’s Royal Society, and the Chinese Academy of Science, all agreed that it “would be irresponsible to proceed with any clinical use of germline editing.” While the future is left open to gene editing on humans, there was heavy accentuation throughout the conference on the ethics and societal views of these scientific breakthroughs and the necessity to revisit their applications on a regular basis.

Dengue Fever Outbreak in Hawaii 
The Dengue fever outbreak on Hawaii Island is still growing. Now at 122 confirmed cases, this is one of the biggest outbreaks they’ve seen with local transmission. As of 12/2, the confirmed cases involved 106 Hawaii Island residents and 16 visitors. The Hawaii Department of Health (HDOH) has published information, hoping to aid prevention efforts, regarding the Aedes aegypti and Aedes albopictus mosquitos that are responsible for spreading the disease. There have been 313 reported potential cases and you can even find a map of the case distribution here!

Stories You May Have Missed:

  • 2015/2016 Flu Season- Where Are We?– The CDC 2015/2016 influenza activity showed a bit of a spike during the November 15-21 week. Influenza A (H3) is still the predominant species in laboratory confirmed cases. If you’re looking to keep an eye on seasonal flu, Google Flu Trends may no longer be operational, but you can still keep an eye on Flu Near You or the CDC’s page.
  • MERS-CoV Severity and Incubation Period– The CDC & Emerging Infectious Diseases published a report regarding the association of severe MERS-CoV illness and a shorter incubation period. Analyses of 170 patents in South Korea revealed a longer incubation period associated with a decreased risk for death while “patients who died had a shorter incubation period.” This mirrors the results of a previous study that had similar results with SARS coronavirus.
  • Salmonella Outbreak Associated With Recalled Nut Butters – The CDC is currently investigating 11 illnesses across nine states that may be linked to recalled nut butters. The Salmonella serotype is Paratyphoid B variant L (+) tatrate (+) (previously called Salmonella Java) and has caused illness in California, Colorado, Georgia, Hawaii, Idaho, Illinois, North Carolina, and New Jersey.
  • Taiwan CDC Holds Bioterrorism Drill – Involving 70 participants, the course utilized a subway union station to allow people to simulate first responders and real-life operations. “CDC bioterrorism teams are tasked with the investigation and identification of biological threats and attacks. Members take on containment and mitigation of damage for any individuals that are harmed during and as a result of an attack.” Go Taiwan!

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Pandora Report 9.18.2015

What an interesting week! Ongoing salmonella cases, imported plague in Michigan, ISIS was found to be using chemical weapons, and a new prion disease was discovered. Pretty busy in the world of biodefense, I’d say. The Pandora Report is also fortunate to share with you a great piece by one of our graduate students, Greg Mercer, who tapped into Google Trends to look at ISIS nomenclature, and an upcoming book written by Dr. Brian Mazanec, regarding cyber warfare. So sit back and relax while we catch up on the week’s biodefense news.

US Confirmation of Islamic State Chemical Weapons

Operational_Readiness_Exercise_121014-F-LP903-827Sulfur mustard traces were found on fragments of ordnance used by the Islamic State, as well as on scraps of clothing from victims in Syria and Iraq. There have been several accounts by Kurdish officials that have claimed chemicals, like chlorine, were dispersed this summer, which is concerning for the ongoing use of these internationally banned substances. Testing done in the US was reported by officials on Friday, September 11, 2015, stating that, “there’s no doubt ISIS has used this,”. Officials have also said that the chemical residue recently found does not match known chemical ordinance that was used in the former Iraqi inventory. Overall, the use of chemical weapons is highly distressing and the method of acquisition, either manufacturing or from undeclared stocks, is under investigation.

Michigan Experiences Imported Plague Case

 A Michigan woman is the second case of bubonic plague that was traced back to the Little Rainbow area of Colorado. The Michigan resident was visiting family in Salida, CO during a music festival in late August. While her exact exposure hasn’t been established, she became ill after returning home and was hospitalized shortly thereafter. Lucky for the diagnosticians, she displayed textbook plague symptoms, leading to CDC involvement and antimicrobial treatment. Fortunately, she was released from the hospital and is beginning the long road to recovery, although it’s probably the last time she’ll attend that particular music festival or go hiking around it….

The So-Called Islamic State 2
By Greg Mercer

In February, I wrote about a topic that had been puzzling me- the contentious nomenclature of the Islamic State, or ISIS, or ISIL, or Daesh.  I decided to revisit this question now that the issue is a staple in the news, and that we’re probably saying it more frequently while thinking less about what we call it.  So I fired up my good friend Google Trends[1] again to take a look.  Google is a decent measure of public interest in a subject.  It’s the most popular search engine[2] in the world, with 66.78% of search volume worldwide as of August 2015.

Last time, I found that ISIS was the most popular term by a fair amount.[3]  This seems to be true this time around too, which isn’t terribly surprising.  Here’s what I got:
Screen Shot 2015-09-17 at 6.24.26 PM

 

 

 

 

 

This time around, ISIS is still the most popular, but Google’s added a feature that tells us a little more.  While I suspected that the terrorist organization was driving most of the searches for ISIS before, it’s true that ISIS is the only of the names that has other popular uses, notably an Egyptian goddess, a think tank, and of course a fictional intelligence organization.  The new “topics” option in Google Trends lets us identify search volume for an entire subject.  The dotted purple line indicates all searches for the organization, regardless of naming specifics.  Since the searches for “ISIS” specifically and all of the searches for the organization are strongly correlated, it’s safe to say that mythology enthusiasts, nuclear scholars, and Archer fans aren’t skewing the trends.

It’s also still the case that search volumes for all of the names spike with major news events- no surprise there.

I also found the search trends by country interesting, here’s a look at the different terms and how they show up globally:

Screen Shot 2015-09-17 at 7.33.14 PM
Click on image to see Google Trend analysis and additional graphs

 

 

 

 

 

 

 

 

 

 

A couple of takeaways:  Looking at the organization as a whole, the two most interested parties (by Google search) are Iraq and Iran.  That’s not too surprising.  Iran is also #1 for “Daesh”, which is used in both Arabic and Farsi and is considered more a disparaging name.  In fact, the Iranian foreign minister told Iranian state media in January (fair warning, this links to Iran Daily) that he hates the term “Islamic State” and prefers “Daesh.”  In my earlier article, I noted that other foreign policy practitioners share this sentiment, and prefer a name that doesn’t recognize the organization as a state or representative of Islam.  This is also definitely the least popular name in mainstream American media.[4]  Ethiopia and Peru are the highest by volume for ISIS and ISIL, respectively, neither of which I would have expected offhand.

It’s interesting to see how these trends break down, and to look at a single massive political issue and international crisis with such a proliferation of terms.  I think the name that finally sticks remains to be seen.

[1] This links to the search parameters I used for this article, so you can play around with the data.
[2] This site is really cool if you’re into this sort of thing- you can see what site users choose based on browser, operating system, and device type.
[3] Personally, I tried ISIL in the name of accurate translation, but I tended to use ISIS when being flippant, and then it ended up sticking.
[4] To get anecdotal, the only person I’ve heard use it is my buddy who does Arabic translation and Middle East studies for a living.

The Evolution of Cyber War

Screen Shot 2015-09-18 at 6.39.11 AMGMU’s very own, Dr. Brian Mazanec, delves into the world of cyber warfare and the reality of this threat. “Already, major cyber attacks have affected countries around the world: Estonia in 2007, Georgia in 2008, Iran in 2010, and most recently the United States. As with other methods of war, cyber technology can be used not only against military forces and facilities but also against civilian targets. Information technology has enabled a new method of warfare that is proving extremely difficult to combat, let alone defeat.” Available on November 1, 2015, we’re excited to share Brian’s phenomenal work!

Stories You May Have Missed:

  • Flu vaccination rates went up a bit for the 2014/2015 season, however, the efficacy was only 18% due to an antigenic drift. Fortunately, vaccination compliance for healthcare workers increased and overall rates showed that women were more likely than men to get vaccinated.
  • The Australian government will pass a new law, the “No Jab, No Pay Bill“, that will penalize parents who don’t vaccinate their children by withholding child care and other payments.
  • An additional 77 cases of Salmonella Poona were reported since September 9, 2015, related to the multi-state cucumber outbreak. The total infected is now 418 people across 31 states, with 91 hospitalizations.
  • A new prion disease has been identified by a team of scientists led by Stanley Prusiner. Their report outlines the discovery and the potentially infectious nature of this new prion.

Pandora Report 7.26.15

Mason students are working through their summer courses and I’m happy to say mine is OVER! Let the summer begin (two months late)! This week we’ve got great news about Polio in Nigeria and a somber anniversary in Japan. We’ve also got other stories you may have missed.

Enjoy the rest of your weekend and have a great week!

A-Bomb Victims Remembered in Potsdam, Where Truman Ordered Nuclear Strikes

Coming up on the 70th anniversary of the atomic bombs being dropped on Hiroshima and Nagasaki, German and Japanese citizens in the city of Potsdam held a remembrance ceremony for both the victims that died in the blast and the future. Japan has become, according to the former President of the International Court of Justice, the world’s conscience against nuclear weapons and power. Why? Japan is “the only country in the world to have been the victim of both military and civilian nuclear energy, having experienced the crazy danger of the atom, both in its military applications, destruction of life and its beneficial civilian use, which has now turned into a nightmare with the serious incidents of Fukushima.”

Japan Times—“The Potsdam Conference was held between July 17 and Aug. 2 in 1945. The United States dropped an atomic bomb on Hiroshima on Aug. 6 and another bomb on Nagasaki three days later. On Aug. 15 that year, Emperor Hirohito announced to the nation that Japan had accepted the Potsdam Declaration, in which the United States, Britain and China demanded the nation’s unconditional surrender.”

Nigeria Beats Polio

Very, very, very exciting news: Nigeria has not had a case of polio in a year. A year! This makes Nigeria polio free and the last country in Africa to eliminate the disease. The achievement was possible with contributions from the Nigerian government (where elimination of the disease was a point of “national pride”), UNICEF, the WHO, the CDC, the Bill and Melinda Gates Foundation, Rotary International, and other organizations. With Nigeria’s accomplishment, there are only two other countries in the world where polio still exists—Afghanistan and Pakistan.

Voice of America—“Carol Pandek heads Rotary International’s polio program. She told VOA via Skype that a year being polio-free is a milestone for Nigeria, but noted that it is not over. “Now they need to continue to do high quality immunization campaigns for the next several years,” she said, as well as have a strong surveillance system so, should there be any new cases, they can be identified as soon as possible.”

Stories You May Have Missed

 

Image Credit: Fg2

Pandora Report 10.11.14

With so many stories being dedicated to Ebola, I was absolutely delighted to see coverage of influenza this week. We’ve also got stories about the proliferation of antibiotic resistant bugs in nursing homes, George Washington as the first father of vaccination, and of course, an Ebola update.

There will be no news round up next week, so I will see you all back here on October 25. Enjoy your weeks and don’t forget your flu shot!

Ebola’s Bad, but Flu’s Worse

With the coverage of the Ebola outbreak in media (and even on this blog) it may have inadvertently caused unreasonable panic in the American populace. The fact of the matter is one person in the U.S. has died from Ebola. Every year, according to the CDC, more than “226,000 Americans are hospitalized with flu and approximately 36,000 die from flu-related complications.” News outlets this week quietly reported on flu vs. Ebola and offered points of clarification about both diseases as well as tips for staying well. These include getting your flu vaccination, washing hands frequently especially after using the restroom and before eating or preparing food, and avoiding touching eyes, nose, or mouth to limit spread of germs.

Times Union—“‘The reality is there are vaccinations and treatment options available for the flu that are not available for Ebola. The reason for concern is there is no magic bullet to stop Ebola,’ said [Dr.Edward] Waltz [director of the Center for Public Health Preparedness at the University at Albany]. ‘I think the most important message to get is, take action on the things that you can control. We have so many things that affect our health that we can’t control, get yourself a vaccination if it is available.’”

Medical Superbugs: Antibiotic-resistant Bacteria Carried by More than a Third of Nursing Home Residents

A study out of Melbourne, Australia, reported that more than 1/3 of nursing home residents tested were carriers of antibiotic-resistant bacteria. And this problem isn’t just plaguing other countries. In fact, a report from the U.S. Centers for Medicare and Medicaid Services found rising rates of pneumonia, urinary tract infections, viral hepatitis and MRSA. The Australian study also found that more than half of the tested residents had received antibiotics within three months of being tested. Overuse of antibiotics can lead to higher rates of superbugs or other infections like C. difficile, which can be lethal in seniors. (On a personal note, my grandmother recently died from complications after a C. diff infection.)

ABC—“‘(Our concern is) that nursing homes are acting as a kind of reservoir, if you like, of antibiotic-resistant bacteria. We know these residents have fairly frequent movement in and out of acute care institutions, and this obviously poses risks to acute care hospitals for transmission. It could be transmitted to other patients in an acute care hospital, if the resident actually has an infection they might be infected with a more resistant bacteria – they’re the two main concerns.’”

George Washington, the First Vaxxer

This week, the Daily Beast provided an excerpt from historian Tom Shachtman’s new book, Gentlemen Scientists and Revolutionaries: The Founding Fathers in the Age of Enlightenment. At a time where people are choosing to forgo vaccinations and alarm over Ebola grows worldwide, it is amazing to see George Washington—Virginian, 1st President, Founding Father, serious boss, and old fashioned speller—decide that army immunization would not only save the lives of soldiers, but indirectly safeguard a young American nation. Shachtman recounts a February 1777 letter from Washington to John Hancock, President of the Continental Congress.

The Daily Beast—“‘The small pox has made such Head in every Quarter that I find it impossible to keep it from spreading thro’ the whole Army in the natural way. I have therefore determined, not only to innoculate all the Troops now here, that have not had it, but shall order Docr Shippen to innoculate the Recruits as fast as they come in to Philadelphia. They will lose no time, because they will go thro’ the disorder while their cloathing Arms and accoutrements are getting ready.’”

This Week in Ebola

The first (and only) patient with a domestically diagnosed case of Ebola died this week in Dallas, TX amid calls, and responses, about tightening airport screening and travel restrictions. Six major American international airports have enhanced screening for travellers arriving from West Africa while airline workers at LaGuardia have protested over what they say are inadequate protections from potential Ebola exposure. In other air travel related news, a passenger was removed from a US Airways flight after joking about being infected with Ebola and a sick passenger traveling from West Africa to Newark airport does not have Ebola. A nurse in Spain did get infected with the virus this week, as other European nations fear further spread inside their countries. American Ebola survivor Dr. Rick Sacra was hospitalized and treated this week for pneumonia and another American Ebola survivor, Dr. Kent Brantly donated his blood in order to help treat an infected NBC cameraman.

Evidently one fifth of Americans, according to a Gallup poll, are concerned about getting Ebola which is causing the ‘apocalypse business’ to boom. Meanwhile, West Africans living in the U.S. are taking action to spread information within their communities about the virus and there was a wonderful piece on how Nigeria beat Ebola. Finally, CDC director Dr. Tom Frieden spoke this week on how this Ebola outbreak is like the AIDS epidemic and why he doesn’t support a travel ban to combat the outbreak. All of this comes at a point in time where the number of deaths from the outbreak has reached over 4000.

Stories You May Have Missed

Image Credit: Immunize.ca

Pandora Report 10.4.14

This week the round up includes Russian bird flu, pregnancy and flu, ISIS threats to British troops, and of course, an Ebola update.

Have a great weekend, don’t forget your flu shot, and keep smart about your news!

Russia Reports First Cases of Deadly Bird Flu in Two Years

Domestic chicken, geese, and ducks in the Altai Krai region of Russia, near the border of Kazakhstan, were found to be infected with the H5N1 serotype of bird flu. These are the first cases of the highly pathogenic flu in this area in nearly two years.

Reuters—“The latest outbreaks in Russia, which led to the death or culling of 344 birds, were thought to have come from wild birds. “Probably, hunted ducks and geese trophies had been placed in backyards where mortality occurred later in domestic birds,” the farm ministry said in its report.”

Why is Flu Virus Higher Risk for Pregnant Women? 

While HHS continues to prepare for pandemic flu, which could kill 60 million people, researchers at Stanford University have looked at the effects flu has on pregnant women. A pregnant woman’s immune system is strongly suppressed, but researchers say this alone cannot explain vulnerability to influenza. Researchers looked at the proportion and behavior of natural killer cells and T cells, which in the presence of flu increased and changed in function. These findings offer a possible treatment path—changing inflammatory response rather than just fighting replication of the virus.

Star Tribune—“Women who get the flu while pregnant have a much higher risk of hospitalization and death and are four times more likely to deliver a premature baby. During the 1918 epidemic, in fact, the death rate among pregnant women was at least 28 times that of the general population.”

ISIS Threatens to Gas British Troops in Iraq: Soldiers Ordered to Carry Chemical Suits

British Special Forces training Kurdish Peshmerga fighters and identifying RAF bombing targets in Northern Iraq have started carrying chemical protection suits. Intelligence sources warned that ISIS fighters may have stolen poison gas from Syrian forces who withheld the agents from destruction. ISIS is thought to have stolen sarin and chlorine gases when they raided a Syrian Air Force base two months ago.

The Mirror—“The [British] soldiers now carry nuclear and biological warfare protection and respirators. All vehicles are being fitted with gas detectors and an RAF Regiment trained in chemical warfare is on standby to fly to the region.”

This Week in Ebola

Oh, Ebola. The big story this week is that the virus arrived on American shores, with the first confirmed case in Dallas and potential cases of Ebola in the DC area being ruled out, the CDC is using contact modeling to help track potential cases in Texas. Arrival in the U.S. has caused an absolute avalanche of news stories and opinion pieces throughout the media. They have ranged from fear mongering about an epidemic in the U.S. and how quarantines would be ineffective, to why you shouldn’t worry about Ebola as a bioweapon. We saw the White House urging calm (and making awesome infographics) and medical facilities saying the average American citizen has nothing to worry about. Meanwhile, there were reports that Ebola poses a greater risk than SARS and AIDS and Louis Farrakhan tweeted that Ebola is a bioweapon against Africans. Use of hyperbole and misinformation do a disservice to those trying to responsibly inform Americans. We saw a case of a doctor in Liberia who quarantined herself in order to keep others safe and another Liberian doctor who seems to have effectively treated Ebola using HIV drugs. And, of course, the biggest problem was that Ebola could affect the cocoa trade. Oh wait, no, that’s what we in “the biz” call a #champagneproblem.

Stories You May Have Missed

 

Image Credit: Pregnant In The City

Pandora Report 9.6.14

This week we cover dengue in Japan, dog flu in NYC, more forgotten lethal specimens in government labs, and of course, an Ebola update.

Canine Influenza Cases Spreading in Manhattan

Flu season is rapidly approaching, and evidently, it doesn’t only affect humans. Veterinarians in Manhattan have reported cases throughout the borough. The cases are likely due to dogs playing with other infected dogs at parks and dog runs. Vets warn owners to watch for coughing dogs and if they are present to take their dog to another area. The good news is, just like their human counterparts, dogs, too, can receive a flu vaccine.

The Gothamist—“According to the ASPCA, symptoms include coughing, sneezing, difficulty breathing, fever, lethargy and loss of appetite; most dogs will recover within a month, but secondary infections like pneumonia can be problematic.”

 

New Cases of Dengue Fever Should be a Wake-Up Call for Japan

As many as 70 people in Japan have been infected with Dengue fever—traditionally, a disease found in tropical climates—the country’s first outbreak since 1945. The diagnoses prompted authorities to fumigate an area of Yoyogi Park in Tokyo’s Shibuya Ward, which was the apparent source of the infections. Dengue fever is transmitted by mosquitos and produces an extremely high fever and pain in the joints. The disease is not transmitted person to person.

The Asahi Shimbun—“The most effective way to deal with a global dengue epidemic is to step up the efforts to exterminate mosquitoes in countries with a large number of patients, especially in urban areas.”

 

Forgotten Vials of Ricin, Plague, and Botulism found in U.S. Government Lab 

A strong feeling of deja vu hit this week when we learned about yet another case of forgotten vials of dangerous pathogens at U.S. labs. In this case, the containers were discovered during an investigation of NIH facilities after scientists found vials of smallpox earlier this summer. This search discovered a century (!!) old bottle of ricin, as well as samples of tularemia and meliodosis. The FDA also reported they found an improperly stored sample of staphylococcus enterotoxin.

The Independent—“The NIH does have laboratories that are cleared to use select agents, and those pathogens are regularly inventoried, the director of research services Dr. Alfred Johnson said. However, these samples were allowed to be stored without regulation.”

 

This Week in Ebola

We learned that new cases of Ebola in Democratic Republic of Congo are genetically unrelated to the West African strain and that researchers from the Broad Institute and Harvard are working to sequence and analyze virus genomes from the West African outbreak. Senegal is working hard to manage contacts with the Guinean student who tested positive for the virus in the capital, Dakar. Human trials of an Ebola vaccine continued in the U.S. and are planned to take place in Mali, the U.K., and Gambia. A third American infected with Ebola will return to the U.S. and will be treated at a Nebraska medical containment unit which was built for the SARS outbreak. I read an article that hypothesized that Ebola may be able to be transmitted sexually which could account for a high number of cases, while the Washington Post pointed to the fact that the West Africa outbreak is drawing attention from diseases which are more widespread and kill more people—it’s the Kardashian of diseases. Lastly, CDC Director Dr. Thomas Frieden said that this outbreak of Ebola is “threatening the stability” of affected and neighboring countries, and Dr. Daniel Lucey, of the Georgetown University Medical Center, predicts that the current outbreak “will go on for more than a year, and will continue to spread unless a vaccine or other drugs that prevent or treat the disease are developed.”

 

Image Credit: Wikimedia Commons