Pandora Report 11.18.2016

 Welcome to World Antibiotic Awareness Week! We all have a part in reducing microbial resistance, including companies like McDonalds, KFC, and large chain restaurants. A recent report from Clinical Microbiology is reanalyzing the threat of bioterrorism. The EU has released their action plan for combatting antimicrobial resistance and you can read the roadmap here. Leishmaniasis infections are on the rise in the U.S. due to ecotourism and military campaigns in Iraq and Afghanistan. CRISPR gene-editing was just tested in a person for the first time. The Chinese research group delivered modified cells into a patient with aggressive lung cancer as part of a clinical trial. The cells were modified to disable a gene that codes for protein PD-1 (this normally would restrict immune response and is frequently manipulated by cancer) and the hope is that without the PD-1, the edited cells will be able to overcome the cancer. Did you know that your birth year can help predict how likely you are to get extremely sick from an outbreak of an animal-origin influenza virus? Don’t miss the Next Generation Global Health Security Network Info Session – today at 11a EST!

ISIS Forces Fired Toxic Chemicals in Iraq
Three chemical attacks were launched by ISIS against the Iraqi town of Qayyarah in September and October. The use of chemical weapons was in retaliation after Iraqi government forces retook the town in late August. “ISIS attacks using toxic chemicals show a brutal disregard for human life and the laws of war,” said Lama Fakih, deputy Middle East director. “As ISIS fighters flee, they have been repeatedly attacking and endangering the civilians they left behind, increasing concerns for residents of Mosul and other contested areas.” Victims of the attacks experienced painful symptoms of blister agents, or “vesicants”. The use of chemical weapons is in direct violation of the 1993 Chemical Weapons Convention. The use of these weapons would be classified, under the Rome Statue, as a war crime.

What Will Be the Next Pandemic?
Researchers at the recent International Meeting on Emerging Diseases and Surveillance discussed what the next SARS or Zika-like disease will be. Kevin Olival of EcoHealth used a predictive formula and pointed to flaviviruses that we normally don’t hear about – Usutu, Ilheus, and Louping. “All three have on rare occasions infected people, but they also infect a number of other animal species, which suggests they may have what it takes to jump species. Virologists sometimes call viruses that can do this ‘promiscuous.’ That means ‘it’s more flexible in its ability to infect across hosts, including mammals,’ Olival said.” While the scarcity of human cases proves difficult for gaining funding, emerging diseases tend to hit us by surprise, pointing to the need to expand the scope of surveillance and preparedness.

PCAST Letter to the President to Protect Against Biological Attacks
In a letter to the President, the President’s Council of Advisors on Science and Technology (PCAST) points to the to the unique challenge of bioterrorism threats in that they could be exacerbated by the rapid pace of biological science and technology developments. PCAST emphasizes the need for a renewed effort since Federal leadership can help state and local infrastructure share data and identify patterns during such an event. “Continuing scientific, technical, and regulatory developments allow the medical community to respond to new outbreaks faster than ever before. Developing medical countermeasures to naturally occurring outbreaks today lays the groundwork for responding to potential engineered biological threats in the future. PCAST supports extending this progress into the foreseeable future, setting the ambitious ten-year goal that, for infectious organisms for which effective approaches to creating vaccines exist, the United States should have the ability to accomplish, within a six-month period, the complete development, manufacture, clinical testing, and licensure of a vaccine. ”

Comic Book Explores a World Without Antibiotics  screen-shot-2016-11-15-at-8-40-41-am
A new, dystopian comic book is transporting us to 2036 London. The world is a bleak place where antibiotics have run out. Surgeon X looks at a time where simple infections and hospitalization means certain death, while the government cracks down to maintain selective control over the few drugs that are available via  a”Productivity Contribution Index”, which determines who gets access to medication. Readers follow a surgeon, Rosa, through her work at a secret clinic and the internal dialogue that comes with a repressive government, Hippocratic oath, and constant threat of infectious disease. Sara Kenney, the author of Surgeon X, notes that her own experiences with two premature children frame much of her comments on microbial resistance. Kenney noted that “it was only when she started building for herself what she calls the ‘story world’ that she realized antibiotic resistance is such a threat to medicine that it needed to be in her narrative as the obstacle the protagonist must overcome. ‘I realized the antibiotics crisis we’re facing is probably one of the most extreme obstacles you could throw at a surgeon,’. She found the complexities of the problem—resistance is believed to kill 700,000 people around the world each year—to be staggering.”

WHO Global Action Plan on Antimicrobial Resistance cxt8sslxgaajprd-jpg-large
The WHO has just released their action plan to fight antimicrobial resistance. Countries have committed to having a national action plan by May of 2017 to better support the radical shift that is needed to combat antibiotic resistance. Antimicrobial resistance (AMR) threatens the foundation of modern medicine and public health capacity. There have been little advancements in the world of antibiotics, however we continue to see a growth of AMR. The WHO global action plan has five objectives: to improve awareness and understanding of antimicrobial resistance through effective communication, education and training; to strengthen the knowledge and evidence base through surveillance and research; to reduce the incidence of infection through effective sanitation, hygiene and infection prevention measures; to optimize the use of antimicrobial medicines in human and animal health; and to develop the economic case for sustainable investment that takes account of the needs of all countries and to increase investment in new medicines, diagnostic tools, vaccines and other interventions.

BWC RevCon 
While the 8th Review Conference is underway, there have been some reports from attendants that civil society/NGO’s were asked to leave the room, which goes against precedent for the last two RevCon’s. Some have noted that Iran was seeking to deny NGO’s access to Committee of Whole by using rules of procedure but there has not been consensus yet. While these comments have been coming in from attendants’ Twitter accounts, as of Tuesday afternoon, it appears that the issue has been resolved – as news continues to trickle in, we’ll keep you posted. You can get daily updates on RevCon here, with the most recent one covering the cross-cutting plenaries that are focusing on implementation, article III, solemn declaration and more. These daily reports are the best way to get detailed play-by-play information as to how RevCon is going.

Zika Updates
A recent study found that women are at greater risk for Zika infections due to suppressed vaginal immune response. “Scientists at the Gladstone Institutes discovered that the vaginal immune system is suppressed in response to RNA viruses, such as Zika. The delayed antiviral immune response allows the virus to remain undetected in the vagina, which can increase the risk of fetal infection during pregnancy.” The Brazilian state of Parana has banned aerial spraying of pesticides in urban areas. Florida’s Department of Healthy has their daily Zika updates here, which shows three new locally acquired cases as of 11/16. The CDC has reported 4,255 cases in the U.S. as of November 16, 2016.

Stories You May Have Missed:

  • How NY Hunts for Early Hints of an Outbreak– the New York City Department of Health and Mental Hygiene has a secret weapon in the war against infectious disease outbreaks – a computer program called SaTScan.  This program utilizes big data to help detect and model infectious diseases. It monitors, maps, and detects disease outbreaks throughout the state by utilizing the data that is reported to the health department daily. “It is just not possible to effectively monitor every communicable disease in real time with human eyes alone,” Sharon Greene said. “To be able to quickly and effectively and precisely detect an outbreak, to kick off an outbreak investigation process — the earlier that you can begin this it helps to limit sickness, it helps to limit death, and it makes it more likely that you will successfully solve the outbreak.”
  • Exposure Patterns in 2014 Ebola Transmission – Researchers are presenting new information regarding the largest Ebola outbreak in history by looking at the drivers of transmission and where control efforts could be strengthened. They reviewed data from over 19,000 cases across Guinea, Liberia, and Sierra Leone. “We found a positive correlation (r = 0.35, p < 0.001) between this proportion in a given district for a given month and the within-district transmission intensity, quantified by the estimated reproduction number (R). We also found a negative correlation (r = −0.37, p < 0.001) between R and the district proportion of hospitalised cases admitted within ≤4 days of symptom onset. These two proportions were not correlated, suggesting that reduced funeral attendance and faster hospitalisation independently influenced local transmission intensity. We were able to identify 14% of potential source contacts as cases in the case line-list. Linking cases to the contacts who potentially infected them provided information on the transmission network. This revealed a high degree of heterogeneity in inferred transmissions, with only 20% of cases accounting for at least 73% of new infections, a phenomenon often called super-spreading.” Future Ebola outbreak response will need to consider super spreaders, safe funeral practices, and rapid hospitalization.
  • Rick Bright Selected as New BARDA Director – DHHS recently announced that Dr. Rick Bright will be the new Deputy Assistant Secretary for Preparedness and Response and Director of BARDA. Dr. Bright has been with BARDA since 2010 and served in their Influenza and Emerging Infectious Diseases division.

 

Pandora Report 9.16.2016

Is it time to outsource key tasks out of the WHO and into more capable agencies? On Monday, the U.S. carried out a massive airstrike on a suspected ISIS chemical weapons facility in Mosul, Iraq. Sri Lanka has made history by being declared malaria-free after three years since its last case. Sri Lanka had previously tried to eradicate malaria over fifty years ago, but the effort was met with failure and is frequently cited by malaria experts. Do you subscribe to the “five-second rule” when it comes to your food? You may want to give it a second thought as Rutgers researchers have recently disproven the notion – sadly, cross-contamination can’t be avoided in most cases. The CDC has added Bacillus cereus Biovar anthraces to the list of Tier 1 Select Agents.

GMU Biodefense Graduate Info Sessions
In case you missed last night’s MS Open House in Arlington, we’ve got plenty more graduate program information sessions. GMU will be hosting several more events this Fall, so make sure not to miss one! The next MS information session (for both in-person and online programs) is on Wednesday October 19th, 6:30pm in Founders Hall, room 126. If you’re looking at a PhD in biodefense, come to our information session on Wednesday, October 12th, from 7-8:30pm, at the Johnson Center in the Fairfax Campus, room 334. From Anthrax to Zika, we cover all the biodefense topics and applications in our information sessions.

Biological Threats in the 21st Century Book Launch!  
On October 14th, join us in celebrating the 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 beginning at 11:45 AM so please RSVP. Attendants will also be able to pick up the book at a 15% discount.

Identifying Future Disease Hot Spots
Check out the latest RAND report in which researchers are asking which countries might be particularly vulnerable to infectious disease outbreaks and how the U.S. can help support these countries to better prepare and respond to public health events. Pulling from a wide variety of literature and data, “authors created an index for identifying potentially vulnerable countries and then ranked countries by overall vulnerability score.” Researchers looked at the 25 most-vulnerable countries, which include the “disease belt” in the Sahel region of Africa. Of the 25 noted countries, 22 are in Africa, and the remaining are Afghanistan, Yemen, and Haiti. “Conflict or recent conflict is present among more-vulnerable countries. Seven of the ten most-vulnerable countries are current conflict zones. Of the 30 most-vulnerable countries, 24 form a solid, near-contiguous belt from the edge of West Africa to the Horn of Africa in Somalia — a disease hot spot belt. Were a communicable disease to emerge within this chain of countries, it could easily spread across borders in all directions.” The 25 least-vulnerable countries were found to be in Europe, North America, and Asia-Pacific. The least-vulnerable countries were found to have larger medical systems and expenditures, better health indicators, less corrupt and more stable governments, better human rights, and often technological sophistication.

Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB) 
You can join (in listen-only) this teleconference and webcast on Monday, September 19th, to gain further insight into the battle of microbial stewardship. “With participation of Member States, non-governmental organizations, civil society, the private sector and academic institutions, the primary objective of this pubic meeting is to summon and maintain strong national, regional and international political commitment in addressing antimicrobial resistance comprehensively and multi-sectorally, and to increase and improve awareness of antimicrobial resistance.”

Ebola & Zika: Cautionary Tales 20988_lores
In the latest issue of Science, Michael T. Osterholm discusses the challenges of combating infectious disease outbreaks and the struggles to respond with vaccine development. Osterholm points to the need to drive development and funding mechanisms in coordination with surveillance of emerging infectious diseases (EID). Upon the indication that an EID is bubbling up, it would be prudent to have vaccines (even if they’re not licensed yet), ready for large trials. Moreover, the looming threat of EID’s should be the best motivator for developing candidate vaccines. “The handwriting is on the wall regarding the current Zika outbreak in the Americas. High human infection rates in the major impact regions, caused by virus-carrying mosquitoes and human sexual transmission, will continue for several more years. Eventually, the number of cases will drop as more of the community develops immunity. Zika vaccine trials in the Americas may be too late to be tested on the current high number of cases.” Pointing to the Coalition for Epidemic Preparedness Innovations (CEPI), he emphasizes the need to fill the vaccine preparedness hole. Current practices are slow and on an “as-needed” basis, but the truth is that we already have the incentives and EID presence to make the push towards correcting the insufficient process.

Weapons of Mass Destruction: A Dialogue with Students
The UN Security Council 1540 Committee and the UN Office of Disarmament Affairs collaborated with the Stimson Center to create an international essay contest for students. On September 30th, from 10:30am-4pm, they will be hosting an on-the-record discussion regarding the proliferation of WMD’s and honoring the winners of the essay contest.  The winners will be announced and some will even be presenting their ideas at this event. “The goals of the competition were to involve the younger generation in understanding and addressing the important issue of proliferation of Weapons of Mass Destruction (WMDs), i.e., chemical, biological and nuclear weapons, and to solicit innovative student approaches to implementing U.N. Security Council Resolution 1540 (2004) to support the Council’s Comprehensive Review of the resolution this year.” Panel discussions will include speakers such as Dana Perkins (Senior Science Advisor, U.S. Department of Health and Human Services, former 1540 Expert), Will Tobey (Senior Fellow, Belfer Center for Science and International Affairs, Harvard University), Craig Finkelstein (Coordinator for the Working Group of the 1540 Committee on Transparency and Outreach), and more! The event will be at Harvard University’s Tubman Building in Cambridge, MA. You can RSVP for all or part of the event here.

Latest Zika News
As more outbreaks occur, the question is quickly becoming – should government officials “allocate resources to support the advancement of traditional drugs and vaccines or emerging broad-spectrum therapies?” If you’re a Miami Beach resident, free Zika testing is now being offered at the Miami Beach Police Department. Utah is keeping public health investigators on their toes with a mystery Zika case.  CDC officials are investigating a man who contracted Zika but was not exposed via a mosquito or sexual contact. Recently published in the CDC’s MMWR, “Patient A was known to have had close contact (i.e., kissing and hugging) with the index patient while the index patient’s viral load was found to be very high,” CDC researchers said in the report. “Although it is not certain that these types of close contact were the source of transmission, family contacts should be aware that blood and body fluids of severely ill patients might be infectious.” If you need a laugh, the Daily Show’s Trevor Noah addressed Zika in a recent episode. Singapore is quickly becoming a Zika hot spot, leaving many researchers stumped about the strain. Experts are suspecting a significant mutation that ramped up the virus’s capability to spread. “What is most intriguing is the question as to whether some mutation has occurred in the Zika virus to make it more transmissible by the Aedes albopictus mosquito—this would be analogous to what happened with chikungunya,” said Paul Anantharajah Tambyah, the secretary-general of the Asia Pacific Society of Clinical Microbiology and Infection. The CDC has reported, as of September 14th, 3,176 cases of Zika virus in the U.S.

Stories You May Have Missed:

  • Biodefense in the Age of Synthetic Biology – the National Academy of Sciences (NAS) has a new contract with the U.S. DoD’s Office of the Deputy Assistant Security of Defense, Chemical, and Biological Defense (NCB/CBD) to assess the nature of biothreats given the innovations within synthetic biology. “NAS will appoint an ad hoc committee to study the manipulation of biological functions, systems, or microorganisms resulting in the production of a disease-causing agents or toxins. The study will start with development of a strategic framework to guide an assessment of the potential security vulnerabilities related to advances in biology and biotechnology, with a particular emphasis on synthetic biology.”
  • Evidence of Airborne H5N2 Found in Distant Barns – a recent study found H5N2 highly pathogenic avian influenza in air samples collected “inside, immediately outside, and up to 70 meters from affected barns during the 2015 outbreak in the Midwest”. The researchers also found H5N2 RNA in air samples collected 1 kilometer from the infected barns. “A total of 26 of 37 (67%) sampling events collected inside and 18 of 40 (45%) collected at 5 meters were positive for H5N2. Sampling at distances from 70 meters to 1 kilometer resulted in about 2% positives and 58% suspected findings. The researchers found HPAI H5N2 viruses in particles up to 2.1 micrometer in diameter.”
  • History of the War on Superbugs – The war on antibiotic resistance may seem new, but it’s actually been waging on for over 60 years. Even Alexander Flemming knew the potential for antibiotic misuse and resistance, noting that “There is the danger that the ignorant man may easily undergoes himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.” Sadly, even the identification of penicillin-resistant germs didn’t scare people, simply because it was a time of antibiotic renaissance – developments were happening all around us and that calmed the fear that should have been brewing.

Pandora Report 4.29.2016

TGIF- We’ve got your weekly dose of biodefense and much more in this edition of the Pandora Report! Kurdish Peshmerga soldiers are saying that recent ISIS attacks have involved chemical weapons. Heads up- you may want to avoid a spiced herbal tea commonly sold at CVS due to a potential contamination with Salmonella. Check out a new study on biodiversity in swine flu and the potential for spillover.  Monday, April 25, 2016 was World Malaria Day! Lastly, here’s a chuckle to help start your weekend.

2016 Survey on U.S. Role in Global Health
A recent survey of Americans performed by the Kaiser Family Foundation addressed the public perception, knowledge, and attitude regarding the role of the U.S. in global health. The survey addressed topics like American awareness of Zika virus and the health issues that are most urgently facing developing countries. The survey found that a “majority of the public wants the U.S. to take either the leading role or a major role in trying to solve international problems generally, as well as in improving health for people in developing countries specifically.” Interestingly, the importance of improving health for developing countries was not ranked as a top priority like protecting human rights, etc. “Seven in ten Americans believe that the current level of U.S. spending on health in developing countries is too little or about right, yet the public is somewhat skeptical about the ability of more spending to lead to progress, with more than half saying that spending more money will not lead to meaningful progress. Republicans and independents are more skeptical than Democrats, and these partisan differences have increased over time. Another notable trend is the decreasing visibility of U.S. efforts to improve health in developing countries; just over a third of the public says they have heard “a lot” or “some” about these efforts in the past 12 months, a decrease of 21 percentage points since 2010.” The survey also found that while Americans believe the U.S. should help women in Zika-affected countries, there was a divide regarding involvement in their family planning and preventative health measures.

GMU Biodefense Alum Awarded Mirzayan Science & Technology Fellowship
Congrats to GMU Biodefense alum, Dr. David Bolduc, on being named a Christine Mirzayan Science and Technology Policy Graduate Fellow! David graduated from GMU with a PhD in Biodefense in 2011 and doctoral work focused on the threats and mechanisms of chemical, biological, radiological and nuclear (CBRN) agents and CBRN proliferation issues such as treaties, histories and the managing of related mass casualty incidences. David is currently a Principal Investigator at the Armed Forces Radiobiology Research Institute. The Mirzayan Fellowship is a very prestigious award – as a program of the National Academies, it is designed to provide mentorship and professional development opportunities to early-career leaders in the field of science and technology policymaking.

Global Health & Military Expenditure 2013_numbers_subregions_2
Last week we discussed the financing of global health versus military.  There was a recent publication by Sipri (Stockholm International Peace Research Institute) that looked at global military expenditure versus health expenditure (in 2015, it was $1676 billion or about 2.3% of the world’s Gross Domestic Product). They utilized the WHO’s recent estimates of government health expenditure as a share of GDP. They reviewed 2013 data and found that “governments worldwide spent just over two and a half times as much on health than on the military in 2013: 5.9% of global GDP went to public health spending, compared with 2.3% for the military.” Here’s the interesting part – it varied regionally. While the U.S. spends a lot on military, healthcare expenditure is still very high. Western and Central Europe spent 7.8% of their GDP on health and 1.5% on military. The Middle East spent 4.6% of their GDP on military versus 3.0% on health expenditures. The study also looks at reallocation of military spending and what that may translate to regarding the UN’s Sustainable Development Goals (SDGs). “Reallocating only around 10% of world military spending would thus be enough to achieve major progress on some key SDGs, supposing that such funds could be effectively channelled towards these goals and that major obstacles, such as corruption and conflict, could be overcome.”

Did Newcastle Disease Virus Sneak Out of the Lab?
Newcastle disease virus (NDV) is a highly infectious disease that impacts domestic poultry and other birds. Virulent NDV strains have been endemic in poultry throughout Asia, Africa, and some countries within South America. Current outbreaks continue to cause food safety and agricultural issue. In the 1940s, the first NDV panzootic occurred, specifically genotypes II, III, and IV. Other genotypes have continued to circulate and cause outbreaks. A recent study performed a complete genomic sequence of contemporary isolates from China, Egypt, and India. Researchers performed genetic analysis to distinguish historical isolates (the outbreak from the 1940s) from currently circulating genotypes (V, VI, VII, and XII through XVIII). Through their work, they found that isolates of genotypes II and IX (which are not normally circulating viruses in the environment) were found to be identical to the historical viruses that were isolated in the 1940s. “The low rates of change for these virulent viruses (7.05 × 10−5 and 2.05 × 10−5 per year, respectively) and the minimal genetic distances existing between these and historical viruses (0.3 to 1.2%) of the same genotypes indicate an unnatural origin.” The virulent strains isolated during the 1940s have been used in labs and research studies. Researchers noted that it is highly unlikely these viruses remained viable in the environment for over sixty years, which means its very possible (and scary…) that the source of these viral samples, taken from poultry and wild birds, may in fact be from a laboratory. So now we have to wonder…how did these specific virulent viral isolates find their way out of laboratories and into nature?

Is Open Science the Secret Weapon Against Zika and Future Pandemics?
Gene editing tools like CRISPR-Cas9 have the potential to combat diseases like HIV and malaria, but there’s also a potential dual-use for these technologies that is much more sinister. The price of laboratory equipment for some synthetic biology experiments is dwindling and many are becoming concerned about potential for misuse. Should science be left open and researchers ultimately allowed to make the call about potential dual-use or should scientific work/publications be regulated to avoid publications of research that could be used to build a biological weapon? Some are saying that the best way to combat global issues is through global cooperation and communication and thus, open-source information. Should Zika be the first in the test subjects of open science and its application in the global health security toolbox? Many have argued that if a research project is receiving public funding, it should be open sourced (including the data). Would this have helped the Ebola outbreak? “When Ebola was raging through West Africa in the summer of 2014, a group at the Broad Institute in Cambridge, Mass. published open repository sequence data for 99 Ebola genomes taken from patients in Sierra Leone’s Kenema government hospital. This open sourcing of critical scientific data was the second instance in the outbreak. A team of international researchers had initially published three genomes from patients in Guinea in April. For the next three months, no more genomic data was released to the public data repositories that had become the go-to source for scientists studying Ebola. The silence puzzled many prominent scientists. A formidable array of genomic sequencing technology was aimed squarely at the virus. Yet the data was not shared.” Since this outbreak, many have pushed more for open science, especially in the wake of a global outbreak like Zika.

The Other Side of the Spectrum – How Genetic Editing Became a National Security Threat
You may recall in February, Director of National Intelligence, James R. Clapper, stated in his World Wide Threat Assessment testimony that gene editing had become a global danger and should be considered a weapon of mass destruction. The history of genetic research has seen a burst of developments since the discovery of the double helix in 1953. CRISPR-Cas9 is the newest in the genetic engineering arsenal…and at at a fraction of the historical price. If it were only so simple as to do away with malaria by genetically modifying mosquitoes to avoid carrying the parasite. Alas, the realities are a bit darker. The truth is that genome editing of wildlife can alter entire ecosystems, not to mention the risk for accidents and negligence, which is a very real possibility. Those concerns aren’t even touching on the frightening potential for biological weapons. “Gene editing techniques could produce forms of diseases that barely resemble their naturally occurring counterparts. Such engineered pathogens could sicken or even kill hundreds of thousands of people. Armed with the proper genetic sequences, states or bioterrorists could employ genome editing to create highly virulent pathogens for use in such attacks. They could, for example, change a less dangerous, non-pathogenic strain of anthrax into a highly virulent form by altering the genome, or recreate pathogens such as the deadly smallpox virus, which was eradicated in the wild in 1980. Or they could develop specific weapons that target either individuals or even entire races: With the right manipulations, a pathogen could be made to have greater invasiveness or virulence in a target population.” So where do we go from here? With no governance of do-it-yourself facilitates, no training for the at-home gene editing experimenters, and endless debate about the dangers of gain-of-function research, what is being done? Many are saying UN Resolution 1540 should be strengthened to consider this technology and the Dual-Use Research of Concern (DURC) policy shouldn’t just apply to research funded by the government, but also small labs and individuals. With the notion of open science and DURC still up for debate, the stakes will only get higher as global outbreaks, like Zika, continue to burn through countries.

Why We Should Be Afraid of Yellow Fever
Angola is getting hit hard by yellow fever and the vaccine shortages only amplified the outbreak. With all eyes on Zika and a century since Rio saw its last case of yellow fever, where’s the link? Global supplies of yellow fever vaccines are pretty much depleted and BioManguinhos/FioCruz in Rio (one of four…yes four… yellow fever vaccine producers in the world) is having production problems. All available vaccines are being rushed to Angola and cases are spilling over into the DRC, Mauritania, and Kenya. Here’s more – “What most people don’t know is that there are a lot of Angolans coming every year to Brazil, and the more who arrive here unvaccinated, but have been exposed to yellow fever in Africa and may be carrying the virus, the greater the risk that they will infect Rio mosquitoes, allowing them to transmit yellow fever to residents and tourists.” Brazil is already waging a massive war against Zika. Add in yellow fever and it’ll be like adding a gallon of gasoline to a house fire. Mosquito control is imperative and now we’re paying the costs of historically lackadaisical efforts.

Zika Updates
The WHO announced that the number of Zika virus cases is dropping in Brazil. A recent study reports that dengue virus antibodies enhance Zika virus infection. Researchers suggest that pre-existing dengue immunity will enhance a Zika infection in vivo and can increase the severity of disease. Many are calling for more research to be done regarding the relationships between Zika and dengue infections. You can also find a timeline of Zika virus here. There are growing concerns regarding blood donations as Zika spreads internationally. The Canadian Blood service noted that new rules to protect against Zika transmission are putting stress on the blood supply. A new study looks at the impact of Zika and the challenges we many face due to the increasing frequency of viral outbreaks. As of April 27, 2016, there were 426 travel-associated cases in the U.S.

Rewiring Outbreak Preparedness and Response
Let’s take more of a deep-dive into why we should apply U.S. biodefense practices to managing and preparing for outbreaks. Hoyt and Hatchett emphasized why we should learn from American biodefense strategies to better fight infectious disease outbreak. “SARS was responsible for 800 deaths but cost $40 billion globally and Ebola has cost West African economies $6 billion plus an additional $4.3 billion in international contributions. Now, consider the cost of developing a vaccine. Hoyt and Hatchett point out that at the most expensive point, it can cost $1.8 billion to develop a vaccine (others argue that is it much closer to $500 million).”

Stories You May Have Missed:

  • Neurological Problems in Ebola Survivors – a recent NIH study found that nearly all Liberian Ebola survivors reported neurological symptoms following their recovery. Symptoms were noted to have persisted for over a year, including headaches, difficulty walking, overall muscle weakness, loss of memory, and depression. Hallucinations during treatment in Ebola treatment units was prevalent in 25% of patients, with 4% having persistent hallucinations at follow up.
  • Ebola in America: Epidemic of Fear – The Center for Strategic & International Studies has put together a video on the fear and U.S. response to Ebola cases in the U.S. and in West Africa. The video discusses stigma and how Ebola was experienced in the Fall of 2014.
  • Biodefense World Summit – The 2016 event will be hosted in Baltimore, MD on June 27-30, 2016. The Knowledge Foundation’s Second Annual Biodefense World Summit brings together leaders from government, academia, and industry for compelling discussions and comprehensive coverage on pathogen detection, sample prep technologies, point-of-care, and biosurveillance. Across the four-track event, attendees can expect exceptional networking opportunities in the exhibit hall, across panel discussions, and shared case studies with members of the biodefense community from technology providers to policy makers

 

Pandora Report: 4.8.2016

Happy National Public Health Week! The American Public Health Association is celebrating the importance of public health partnerships with a full week dedicated to increasing awareness and participation. Enjoy some vaccine history by taking a trip down memory lane with this great infographic. Before we get started, researchers have found a possible pathway for the emergence of zoonotic malaria.

GMU Master’s and PhD Open Houses!
Whether you’re looking to get a Master’s Degree (we have both online or in-person programs!) or a PhD in Biodefense, we’ve got you covered. Come check out the GMU’s School of Policy, Government, and International Affairs (SPGIA) open houses. The Master’s Open House is on Thursday, April 14, 2016 at 6:30pm in our Arlington Campus, Founders Hall, room 126. GMU Biodefense professor and graduate program director, Dr. Koblentz, will be there to answer questions and then lead a biodefense break-out (or should I say outbreak?) session afterwards. If you can’t attend in person, we’re offering the biodefense info session virtually around 7pm (give or take a few minutes) that night. The PhD informational session will be Thursday, April 21, 7-8pm in our Arlington Campus, Founders Hall, room 126. 

MSF Ebola Research
Medecins Sans Frontières (MSF) has released their report on the research they undertook throughout the Ebola outbreak in 2014. MSF was perhaps the strongest and most well coordinated response team on the ground during this outbreak. While their work heavily focused on medical care, they also performed a wide variety of research that ranges from public health to anthropology, and much more. “MSF carried out research in a number of areas including epidemiology (describing the disease and its spread), vulnerable patient groups, clinical trials for new treatments, community views of Ebola, operational issues and effects of the outbreak on general healthcare.” Their report ties together their research with the six pillars of Ebola control – isolation of cases and supportive medical and mental health care in dedicated ETC’s, contact tracing, awareness raising in the community, a functioning surveillance and alert system, safe burials and house spraying, and maintaining healthcare for non-Ebola patients. MSF research on vulnerable groups and community response to returned survivors is both fascinating and important for better response in future outbreaks.

Islamic State Hijacks Mosul University Chemistry Lab to Make Bombs
Having gained control of the “well-stocked university chemistry lab” in Mosul, Iraq, ISIS has been working for the past year to build “a new generation of explosive devices and train militants to make them”. General Hatem Magsosi, Iraq’s top explosives officers, notes that gaining control of this lab has highly strengthened the Islamic State’s capabilities. “They have found ‘peroxide-based chemical bombs and suicide bomb vests like the ones used in the Brussels attacks and by at least some of the Paris attackers.’ The lab also contained ‘nitrate-based explosives and chemical weapons.”

GMU Biodefense Student Awarded ASIS Scholarship
Congrats to Biodefense MS student, Rebecca Earnhardt for receiving the ASIS National Capital Chapter Scholarship! The ASIS scholarship helps support and encourage students to follow a career in the security field. We love getting to celebrate the awesome work and achievements of our biodefense students, and between her dedication to the global health security field, scholarship, and work at START, we’re so happy to have her apart of the GMU Biodefense program!

Leaked UN Report Highlights Poor Sanitation at Haiti Bases

Courtesy of The Haitian Times
Courtesy of Haitian Times

Despite consistent denial regarding their role in the cholera outbreak during the 2010 recovery efforts in Haiti, recent documents have supported the UN’s responsibility. “The report, which was commissioned a month into the cholera crisis in November 2010, found a series of alarming problems in several UN peacekeeping bases including sewage being dumped in the open as well as a lack of toilets and soap.” The authors of the report also alerted UN leadership regarding the ramifications of the sewage disposal failures and “and the poor oversight of contractors carrying out this work has left the mission vulnerable to allegations of disease propagation and environmental contamination.” The recently released report will not only add pressure upon the UN to admit internal failures, but also support the recent lawsuit that was brought forth from 1,500 Haitians. Sadly, the UN has maintained a steadfast refusal to accept liability, despite growing data to support their responsibility for the outbreak. The lawsuit focusses on UN failure to screen the peacekeepers from Nepal for cholera and how a UN-hired contractor neglected to ensure “sanitary conditions and adequate infrastructure” for the UN camps.

Your Weekly Dose of Zika
On Wednesday, it was announced that federal funds left over from Ebola response will be moved to fight Zika virus. $589 million will be provided to aid in research and help limit the spread of the disease. The use of unspent funds was planned for helping to implement the GHSA, however now the focus will now be on Zika virus R&D. For many, the greatest concern is reaching women in their child-bearing years. The WHO is highlighting a case study in Martinique, specifically their first case of Zika-related microcephaly.  You can read the letter here, but the goals of such case-studies are to help researchers better understand the infection, especially the high-risks associated with infection during pregnancy. Following the CDC Zika Summit, some are wondering if the U.S. can coordinate response efforts and cope with the impending advance of mosquitoes.  The Aedes aegypti mosquitoes require a unique approach to vector elimination due to their propensity to live in and around homes.  “CDC Director Dr. Thomas Frieden said health departments need to take a ‘four corners approach,’ targeting the Aedes aegypti mosquitoes indoors and outdoors as well as focusing on killing both larvae and adult insects.” As of March 7, there have been 346 travel-associated cases in the U.S.

Ebola vs. Zika- Why Did the WHO Respond So Differently?
Many have wondered, why was the WHO so quick with Zika, but so slow with Ebola? Interestingly, political science and the workings of international organizations are helping Amy Patterson from The Washington Post, ask these very questions. Firstly, it starts with an outbreak being declared a Public Health Emergency of International Concern (PHEIC). The WHO was slow to call Ebola a PHEIC, especially since it had only used the designation twice before. While the WHO blames the delayed response on budget cuts and poor communication between the ground teams and the WHO headquarters, it has also said that the quick response for Zika was due to a “need for greater scientific knowledge”, not to mention trying to repair their reputation from the slow Ebola response. “Political scientists would argue that the story is still more complicated. In ‘Rules for the World,’ Michael Barnett and Martha Finnemore show that international organizations’ internal workings and technical expertise influence their actions in ways that are sometimes at odds with the goals of the countries that set up these organizations to work on their behalf.” Patterson notes several factors – the WHO has six autonomous regional offices that behave differently, the WHO cares about its reputation among powerful countries, and the message matters. This last point drives home the role of health issue framing and the way messages are conveyed for audiences and policymakers. “What’s more, Ebola aligned with what Priscilla Wald terms the “outbreak narrative.” That’s the conventional view that poor countries have disease outbreaks, and that powerful states only care about those outbreaks when their spread threatens those states. Zika hit far closer to powerful countries — and hit “threat perception” level before Ebola.”

Stories You May Have Missed:

  • Global Health Impacts of Vector-Borne Diseases – The resurgence of vector-borne diseases in new locations and with new organisms has shown devastating global impacts. “Domestic and international capabilities to detect, identify, and effectively respond to vector-borne diseases are limited. Few vaccines have been developed against vector-borne pathogens.”
  • Angola Battles Yellow Fever – Over 450 people have been infected in the worst yellow fever outbreak Angola has seen in 30 years. There have been 178 deaths and the global shortage of yellow fever vaccine is alarming many in the world health community. There have also been imported, travel-associated cases in China and Kenya.
  • FDA Releases Final Rule to Ensure Food Safety During Transport- a new food safety rule was finalized by the FDA under the Food Safety Modernization Act (FSMA). The new rule “will help to prevent food contamination during transportation. The rule will require those involved in transporting human and animal food by motor or rail vehicle to follow recognized best practices for sanitary transportation, such as properly refrigerating food, adequately cleaning vehicles between loads and properly protecting food during transportation.”

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Pandora Report: 3.25.2016

Happy Friday! Ready for some global health security news? Down the rabbit hole we go….the FDA has just approved ANTHIM injection, a new treatment for inhalation anthrax in adults and children. Researchers are considering the possibility that the highly virulent E. coli O104:H4 strain that hit Germany in 2011 may have been an intentional act. “The sudden and unexplainable emerging of a fast increasing number of cases and deaths from bloody diarrhea and HUS might have been caused naturally, accidentally, or intentionally,” a Serbian-German research team writes in the European Journal of Public Health Advance Access for April 15.

The Finances of A Pandemic
From SARS to Ebola and now Zika, the growing threat of emerging infectious diseases doesn’t seem to be slowing down. Has this become our new normal? Will we learn from these outbreaks and start putting the resources and support into prevention? “Ebola has infected almost 30,000 people, killed more than 11,000 and cost more than $2 billion in lost output in the three hardest-hit countries. SARS infected 8,000 and killed 800; because it hit richer places, it cost more than $40 billion. Predicting these losses is hard, but a recent report on global health risks puts the expected economic losses from potential pandemics at around $60 billion a year.” So how do we defend against these international security threats? America’s National Academy of Medicine recently made the suggestion that $4.5 billion a year solely dedicated to pandemic preparedness and defense could halt this impending reality. Even more interesting? This estimate accounts to roughly 3% of what “rich countries spend on development aid”, while the world spends about $2 trillion annually on defense.

U.S. Biothreat Defense Inadequate
American response to Ebola and now Zika reveals a startling trend of slow response, inadequate supplies, and poor cooperation and coordination between agencies. Director of National Intelligence, James Clapper states that “Gaps in disease surveillance and reporting, limited health care resources, and other factors contributed to the outpacing of the international community’s response in West Africa,”. The National Biosurveillance Integration Center (NBIC) is one such agency that was developed in 2007 in attempts to “be a hub of information and coordination for federal agencies tracking disease and biological threats”, however it has been frustrated by poor relationships and sharing from other agencies like the CDC. In essence, agencies that are developed for global health security, like NBIC, suffer from poor cooperation that then trickles into their reputation and capabilities in the eyes of their federal partners. “Congress has put forth a potential legislative fix. The CBRNE Defense Act of 2015 would create a new office within DHS, the Chemical, Biological, Radiological, Nuclear, and Explosives Office, which would place both NBIC and BioWatch under integrated new management.” Just as we reported from the Blue Ribbon Study Panel, federal biodefense efforts and resources need to be better organized and developed.

Rare Blood Infection Outbreak
Elizabethkingiam is currently causing dozens of cases in Wisconsin and now a Michigan resident is suffering from the bloodstream infection. The bacteria that causes the infection, Elizabethkingia meningoseptica, is commonly found in soil but has also caused infections in hospitals. Typical infections have resulted in bacteremia and neonatal meningitis related to the gram-negative bacillus, although it is naturally found in soil, fresh water, and salt water. Most of the 54 cases in Wisconsin have been in patients 65 years and older, of which 17 have died. Public health officials are working to identify the source of the outbreak and the links between the Michigan case and those in Wisconsin. The concerning aspects of this rising outbreak is also the difficulty in treating the organism and prevalence of multi-drug resistant organisms in seniors.

Complex Engineering by Violent Non-State Actors
Check out this special issue on complex engineering by violent non-state actors (VSNAs). “Why and how different VNSAs remain low-level and localized or undertake and achieve complex engineering tasks in pursuit of their objectives are at the heart of understanding the threat environment faced by states.” The authors address several terrorist groups like Aum Shinrikyo (the chapter was actually co-authored by GMU Biodefense Alum Benjamin Ash!), Hamas (also co-authored by GMU Biodefense Alum Alena James!), the Provisional Irish Republican Army (PIRA), etc.  “The approach of this collection moves beyond weapons and embraces facilitating or logistical aspects that support the operations and objectives of the various actors”. This special edition, with an introduction by Jez Littlewood, reviews these organizations and their resources and strategies. The authors also consider the attitudes of leadership regarding innovation in detail to assess the role of complex engineering by VSNAs. Through this close look into the VSNA use of complex engineering, further research and preparedness can occur to understand the threats posed by these actors.

All Roads Lead to Zika 
Now that Spring has officially begun, the impending summer rains are right around the corner, and with those – mosquitoes. Many worry about the potential for local transmission in countries where imported cases have already been identified. The US isn’t immune to these concerns as the CDC reports 273 travel-related cases. Dr. Nabel mirrors the sentiments of Sanofi’s global R&D head, Dr. Elias Zherouni, who emphasizes the need for changes in global public health outbreak response. He notes that “we just run from one crisis to another. It’s not an optimal way to respond. Not when the stakes are so high and when so many people can either lose their lives or have their whole lives changed because of one five-day infection. That’s no way to protect the world’s population. We have to step back and we have to say, ‘Is there a more systematic way to gather the intelligence that we have about these viruses, recognize where they stand in terms of the threat level, and then develop a systematic program where, when the next Ebola outbreak occurs, it’s not that we haven’t done anything since the last outbreak, that we’ve actually moved things forward?’ That’s all possible. It’s just that we have not had the collective will to do it.” Panama has also announced their first case of microcephaly linked to Zika virus outside of Brazil. Chris Mooney from The Washington Post discusses why Zika virus, among other diseases, could disproportionally impact America’s poorer populations.  He notes that scientists have found that more mosquitoes are found in lower-income neighborhoods due to persistent trash and abandoned buildings, which creates a ripe environment for standing water and thus mosquito breeding. Researchers found that when compared to wealthier neighborhoods in New Jersey, “poverty was positively correlated with number of [Asian tiger mosquitoes] captured and accounted for over half the variation”. Many are saying that the “U.S. is botching the Zika fight” due to the problems within the FDA and the Agriculture Department regarding turf. “A genetically tweaked mosquito could stop the illness, but regulators won’t test it. Why would that be?” The combination of worrying reasons, like “budgetary concerns and antagonism to genetic engineering among some senior USDA officials”, leave many feeling that instead of getting ahead of the outbreak, “the U.S. is falling behind, solely because of bureaucratic muddle.” On the other hand, on Friday, the WHO rallied for pilot projects on two projects that would involve genetically modified mosquitoes to help stop the spread of Zika virus. In the meantime, the FDA gave emergency approval for a 3-in-1 test for Zika, Chikungunya, and Dengue.

Syria and the Future of the Chemical Weapons Taboo 

Courtesy of E-International Relations
Courtesy of E-International Relations

Brett Edwards and Mattia Cacciatori tackle the responses that the international security community has taken regarding the use of chemical weapons in Syria and the resulting reinforcement of “a long standing prohibition norm.” The authors discuss the characteristics of chemical weapons taboo and and the significance that the international community gives to these weapons. “This alone does not support the claim episode has strengthened the global norm against chemical weapons. In this piece we have highlighted how this is not immediately apparent due to the fact that problem cases tend to be externalized from dominant institutional discourses, often justified in terms of the need to protect the sanctity of the chemical weapon norm, as well as those institution’s which embody the norm – especially the OPCW.” Overall, the more problematic cases, like those of incapacitating chemical agents, will grow to alter the existing foundation of chemical weapons norms if left ignored or unchecked.

New Ebola Flare Up
The west African Ebola outbreak is like a campfire that wasn’t put out properly – everyone thinks the flames are extinguished, but those hidden embers lurking in the ash end up causing a spark that leads to a massive forest fire. A fifth person has died from the recent flare in Guinea. The most recent death occurred in a man 200k from the initial four cases. Prior to this death, a young girl died from the village of Korokpara following her hospitalization in an Ebola treatment facility in Nzerekore. It’s still not clear how this specific surge began, but many worry about the lingering traces of the virus in the eyes, CNS, and bodily fluids. In response to the fifth death, Liberia has partially shut its bordersEmergency meetings are now underway and the WHO is sending specialist teams in to try and stop the outbreak before it grows beyond the 11,300 mortality count. On a positive note, Sierra Leone has gone two incubations periods (42 days) without a case, which means they’re Ebola-free since their last flare up.

GMU SPGIA Gettysburg Trip
GMU students interested in learning more about the battle of Gettysburg- the Center for Security Policy Studies (CSPS) will be hosting an informational session on April 6th from 4:30-6pm in Merten Hall 1203 regarding the April 9th trip! GMU students and staff will walk the battlefield, discussing the factors that caused the battle to unfold as it did. They will also link the battle into larger discussions about the causes of war and grand strategy.  The cost for the trip will be $35.  Bus transportation will be provided, and will pick up participants from both the Fairfax and Arlington campuses.

Stories You May Have Missed:

  • U.N. Sued Over Haiti Cholera Outbreak– starting in October of 2014, Haiti was hit with an intense wave of cholera that is believed to have started with U.N. peacekeepers. “Poor sanitation at a U.N. camp for peacekeepers allowed cholera-contaminated sewage to enter a tributary of Haiti’s largest river, the Artibonite. Within days, hundreds of people downstream, like Jean-Clair Desir and his mother, were falling ill. The disease subsequently spread to the entire country.” The case is currently being reviewed in US courts and the lawsuit was brought forth by the Institute for Justice in Democracy, asking that the U.N. “end cholera by installing a national water and sanitation system; pay reparations to cholera victims and their families; and publicly apologize for bringing cholera to Haiti.”
  • Exploiting the Challenges to Bioweapons Development – Janne E. Nolan discusses GMU Biodefense Professor, Dr. Sonia Ben Ouagrham-Gormley’s book, Barriers to Bioweapons, in regards to the misleading and often exaggerated notion of easy WMD development. Nolan discusses that understanding both the internal and external factors that impact BW program success would allow the international community to “devise better ways to realistically stem BW proliferation”. He notes that “Ben Ouagrham-Gormley s book is a fascinating study of the phenomenology of scientific knowledge, providing a compelling analysis of how knowledge is acquired, developed, transmitted, and, at the same time, diluted or lost as a result of organizational, social, economic, political, and ultimately very human factors that vary widely within countries and over time.” You can also access it here: Nolan final
  • Five Outbreaks That Stump Epidemiologists– As much as I’d love to say that all outbreaks are investigated and solved, the truth is that epidemiologists are often left with the nagging of an unresolved case. Outbreaks are squirrelly at best, often challenging even the best teams with confounders and biases. Here are some that have stumped public health teams over the years.
  • Lassa Fever Outbreak– Three people are suspected of having the viral infection after coming into contact with an infected American. The initial case was a medical director of a missionary hospital in Togo, who died last month. While there are conflicting reports of disease confirmation, several sources are saying the three contacts of this initial case have been diagnosed and are under observation. The outbreak in Nigeria and Benin has continued to grow, resulting in CDC travel warnings. In Nigeria there have been 254 cases and Benin has seen 71.

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Pandora Report: 3.18.2016

Spring is upon us! Whether you’re suffering from allergies or enjoying the bloom of the cherry blossoms, we’ve got you covered from the biodefense side. Don’t forget to add our GMU SPGIA Master’s Open House to your calendar next week (Wednesday, March 23rd at 6:30pm at our Arlington Campus). We’ll also be hosting a biodefense breakout session at 7pm with Dr. Koblentz (bonus: you can attend virtually! Extra bonus: our MS program is offered online, so you can learn to be a biodefense guru from anywhere in the world!). Bioarchaeologists are at it again in their quest to determine the fall of ancient Rome (hint: Yersinia pestis may have played a larger role than you’d think). Here’s hoping that with the announcement of the new Indiana Jones movie we’ll see Indy doing some bioarchaeology on ancient biowarfare!

The Real Lessons of Ebola and Zika 
Emerging infectious diseases are not a new concept for global public health, so why did Zika and Ebola catch us so off guard? Where was prevention – the backbone of public health- in this fight? After the pledging of billions of dollars and deployment of countless health professionals, the reality of reaction versus proactive prevention was never more apparent than during the Ebola outbreak. As the old saying goes, “an ounce of prevention is worth a pound of cure”. Now, as we trudge our way through the Zika virus outbreak, many wonder why the Aedes mosquitoes are continuing to cause devastation when their role in outbreaks is so well known. “Controlling this mosquito would by itself ameliorate all these disease threats. Ironically, in South America, control of Aedes aegypti was largely successful earlier in the 20th century (with great expenditure of effort), only to be abandoned once the immediate threat receded.” So again, we must ask ourselves, why public health prevention measures are so frequently ignored. Inexpensive in comparison to the cost of an outbreak, these tools (surveillance, diagnostics, worldwide communication, etc.) are increasingly becoming stronger and more available. Zika and Ebola have proven the efficacy of these strategies and the damage of failing to use them, so what more will it take to get global public health measures a seat at the cool kids’ table? A recent study addressed the biosocial approaches to the Ebola outbreak, concluding that “biomedical and culturalist claims of causality have helped obscure the role of human rights failings (colonial legacies, structural adjustment, exploitative mining companies, enabled civil war, rural poverty, and the near absence of quality health care to name but a few) in the genesis of the 2013-16 pandemic.” Globally, we’re still struggling to recover from the outbreak – whether you’re on the the ground in the affected countries or in the public health agencies that attempted to help. In many ways, the lessons from this pandemic will continue to be identified and understood for years to come. The CDC has also just released an article regarding the perspectives on the outbreak here, where they discuss the factors that delayed disease detection, the role of civil instability, and the impact of historically limited ebola experience.

GMU Biodefense Alumni Career Services
Are you a GMU Biodefense alum? Don’t forget to sign up for the SPGIA CareersNow so you can get updates on job postings that are right up your alley! GMU has close ties within the biodefense industry and we love joining students with employers, so please make sure to sign up and utilize this great resource!

ISIS Chemical Weapons Attack
Officials are reporting on that on Saturday, terrorists linked to ISIS fired rockets into a residential part of Taza, a northern Iraqi town. These rockets are reported to have contained unspecified chemical substances that caused numerous deaths and injuries related to burns, dehydration, and suffocation. An American special forces team previously captured the lead ISIS chemical weapons engineer, however, “his capture has not stopped alleged chemical attacks by ISIS or other terrorists associated with the Islamist militant group. Earlier this week, for instance, officials in Iraq’s Kirkuk province claimed that around 100 people were injured in suspected chemical attack, also in Taza.” The attacks are recently reported to have injured 600 people and killed a 3-year-old girl. Many are now asking, where is ISIS getting their chemical weapons from?

Preventing “A Virological Hiroshima”: Cold War Press Coverage of Biological Weapons Disarmament
Since we’re in the middle of an election year, it has become even more apparent the massive role media plays in not just politics, but also security. A recent analysis was published utilizing written pieces from the US New York Times, UK Times, and the Guardian, during the period of the Biological Weapons Convention negotiation in 1972. Representations of biological weapons during this time not only reflect the societal ideologies, but the the high-stakes environment that the journalists were experiencing. “We argue that a conventional discourse can be found wherein biological weapons are portrayed as morally offensive, yet highly effective and militarily attractive. Interwoven with this discourse, however, is a secondary register which depicts biological weapons as ineffective, unpredictable and of questionable value for the military.” Interestingly, at the time of these news reports, journalists only knew of WMD’s via nuclear and chemical weapons. According to the authors, no biological attacks had been documented and the state sponsored programs were still buried in the depths of secrecy. Biological weapons could only be considered in terms of historical pandemics like the Black Death and the 1918 Influenza pandemic. The authors note that “this negative portrayal of biological weapons as unpredictable and ineffective was certainly flagged in the context of downplaying the significance or value of the BWC. But where it was put to more nuanced use, exemplified in the interview with Matthew Meselson in the wake of the Nixon decision to abandon the US offensive programme, biological weapons were indeed portrayed as useless, not because they were innocuous but because they were redundant: the USA already had access to the horrific, indiscriminate means to annihilate entire cities.”

A Little Bit of Zika Goes A Long Way
Recent CDC data reports 258 travel-associated cases within the US. Laura Beil with the New York Times describes the worry that pregnant women are now facing after they traveled to affected regions and later were found to have Zika. You can also find a timeline and map of the outbreak here. Here’s a spot of good news though – the European Commission announced on Tuesday that the European Union released $11.1 million for Zika virus research. Rob Stein from NPR discusses the unique cry of babies with Zika-associated birth defects and the stories from the pediatricians and health professionals that are working to help the affected families. “It’s not just that they cry more easily, and longer — which they do. There’s also something strange — harsher and more pained — about the cries of many of these babies.Screen Shot 2016-03-17 at 1.02.48 PM The realization that they even cry differently than normal babies drove home how many mysteries the world is facing because of the Zika virus.” Not surprisingly, ticket sales for the 2016 Summer Olympics have dropped since the announcement of the outbreak. Olympic-related event ticket revenues dropped 56.4% since mid-January. A new research article was just published regarding the seasonal occurrence and abundance of the Aedes mosquito and it’s role in potential Zika transmission within the US – specifically in regards to local transmission. Here’s a great map regarding the estimated risk of transmission within the US. 

Stories You May Have Missed:

  • Use of Microbial Forensics in the Middle East/North Africa Region – The Federation of American Scientists (FSA) prepared a report for the Department of State Bureau of Arms Control and Verification regarding the use of microbial forensics as a means of combating biosecurity challenges. Whether naturally occurring or man-made, biological threats can pose a major challenge. Source recognition is “the key pre-condition that determines how a country will respond to a biological event, or take action in order to interrupt a potential emerging threat, ultimately centers around the ability to properly attribute the culpable sources (pathogens); in other words, governments need to determine the return address of the culpable microbe(s), be they from countries, individuals, or nature itself.”
  • Rice Krispies Food Safety Attack? An employee was recorded urinating on the production line for the cereal manufacturing company in 2014. Kellogg is now under investigation regarding the criminal activity and potential impact of the employee’s actions. I wonder, would you consider this a small-time biological attack?
  • Determinants and Drivers of Infectious Disease Threat Events in Europe – Researchers identified 17 drivers of infectious diseases threat events (IDTEs), categorizing them into 3 groups: globalization and environment, sociodemographic, and public health systems. They found that a combination of two or more drivers was responsible for most of the IDTEs and the driver “category of globalization and environment contributed to 61% of individual IDTEs, and the top 5 individual drivers of of all IDTEs were travel and tourism, food and water quality, natural environment, global trade, and climate.”

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Pandora Report: 2.19.2016

TGIF! We hope you had a lovely week while avoiding RAW Meal Organic Shake and Meal Replacement products. The FDA recently reported an outbreak of Salmonella Virchow linked to the moringa powder within these products. 11 people across nine states were impacted by the outbreak, leading to an expanded recall due to the contamination. In this week’s Pandora Report, we’re covering Zika virus, CRISPR, GMU’s Biodefense Open House, ISIS use of chemical weapons, and much more. Before we begin, you’ll be happy to hear that as of today, airline passengers flying from Guinea to the US will no longer have to fly through designated airports and undergo screening for Ebola.

Zika Response Plans 
The WHO just released their Zika Strategic Response Framework & Joint Operations Plan for January-June 2016. Within the report, readers can find a timeline of the outbreak, a current situation report (sitrep) and the three objectives, which include surveillance, response, and research. Response strategies include community engagement, control efforts for the Aedes mosquito, and efforts to support and guide “the potential impact on women of childbearing age and those who are pregnant, as well as families with children affected by Zika virus.” The WHO estimates that the community engagement components requires $15.4 million, 10 partners, and will involve public health risk communication, community engagement, and health care personnel. Overall, the WHO estimates that to “kickstart” the international response, it will take $56 million. Fortunately, the World Bank announced it’s commitment of $150 million to combat the growing epidemic. The FDA just released blood donation recommendations related to the outbreak to mitigate risk of contamination. They are recommending that “those at risk of having been infected with the Zika virus should not donate blood for four weeks. These include those who have had Zika virus symptoms or sexual contact with people who have traveled to countries known to have ongoing transmissions.” According to the CDC, as of February 10th, there have been 52 travel-associated Zika virus associated cases in the US. On Thursday, Pope Francis suggested that women could justifiably use contraception to avoid pregnancy in Zika affected countries.

Upcoming Events: SPGIA Master’s Open House and Biodefense Seminar!Biodefense_320x180
Interested in furthering your education and getting to study topics like bioweapons, disease outbreaks, and terrorism? Check out the GMU Master’s Open House on Thursday, February 25th, 6:30pm at our Arlington Campus in Founder’s Hall, Room 126. Dr. Koblentz, GMU biodefense program director and one of our amazing professors, will also be holding an informational session at 7pm. You can even virtually attend if you’re looking to get more details on the biodefense graduate program and what kinds of adventures it entails. Once you’ve gotten your feet wet by attending one of the Open Houses, try our Biodefense Course Sampler on Wednesday, March 2nd, at 7pm in Founders Hall (GMU Arlington Campus), room 502. Dr. Koblentz will be hosting the event to discuss the unique challenges the US faces when it comes to global health security. Ranging from biosafety to natural disasters, and even zombies, this is a great way to get a taste of the GMU Biodefense program! Make sure to RSVP though, since space is limited.

Workshop on Women’s Health in Global Perspective
GMU’s School of Policy, Government, and International Affairs will be hosting this engaging and informational workshop on March 3, 2016 (8:45am-4:45pm), at our Arlington campus, in Founders Hall 111 and 1113. The keynote address will be from Dr. Nancy Lee, director of the Office of Women’s Health in the Department of Health and Human Services. Panels will discuss contraception and prenatal care, violence against women, dealing with disease, cross border concerns, and the role of gender disparities in women’s health outcomes. Lunch will be provided and while this event is free and open to the public, you’ll need to register here.

ISIS Use of Chemical Weapons
On Friday, CIA director John Brennan, confirmed that ISIS fighters have not only utilized chemical weapons, but also have the means and capabilities to make them. Reports indicate that ISIS is capable of making small quantities of chlorine and mustard gas. Brennan also pointed to potential exportation of chemical weapon to the West for financial incentives, noting that “there’s always a potential for that. This is why it’s so important to cut off the various transportation routes and smuggling routes they have used.” Confirmatory lab results from the Organization for the Prohibition of Chemical Weapons (OPCW) established the definitive presence of mustard gas in the attacks on Kurdish forces last year. “The OPCW will not identify who used the chemical agent. But the diplomat, speaking on condition of anonymity because the findings have not yet been released, said the result confirmed that chemical weapons had been used by Islamic State fighters. The samples were taken after the soldiers became ill during fighting against Islamic State militants southwest of Erbil, capital of Iraq’s autonomous Kurdish region.” Given their successful use of mustard gas and growing concerns over development capabilities, Brennan noted that “US intelligence is actively involved in being part of the efforts to destroy ISIS and to get as much insight into what they have on the ground inside Syria and Iraq.”

Ongoing Challenges and Future Considerations for DHS Biosurveillance Efforts 
The US Government Accountability Office (GAO) recently published their findings regarding the Department of Homeland Security’s (DHS) biosurveillance efforts, specifically the National Biosurveillance Integration Center (NBIC) and the BioWatch program. Initial findings in 2009 found that NBIC wasn’t “fully equipped to carry out its mission because it lacked key resources—data and personnel—from its partner agencies, which may have been at least partially the result of collaboration challenges it faced.” Recommendations were made and then in August 2012, NBIC released its Strategic Plan in response to the deficiencies, of which focal points included clarification of its mission and efforts to fulfill its roles of analyzer, coordinator, and innovator. Since 2012 though, GAO has noted several challenges DHS has faced in attempts to justify the BioWatch program. In 2015, “GAO found that DHS lacks reliable information about the current system’s technical capabilities to detect a biological attack, in part because in the 12 years since BioWatch’s initial deployment, DHS has not developed technical performance requirements for the system. GAO reported in September 2015 that DHS commissioned tests of the current system’s technical performance characteristics, but without performance requirements, DHS cannot interpret the test results and draw conclusions about the system’s ability to detect attacks.” Based off their findings, GAO recommended DHS not pursue the upgrades it was considering to the program. Some of the changes NBIC will be pursuing include its modification to the Daily Monitoring List  and better integration of projections and forecasts. You can find the report here, which also includes a table regarding benefits and challenges for structural changes within NBIC. Coincidentally, there was a webinar this week on “Defending Against Bioterror with Improved BioWatch Standards”. During the webinar, the presenters (Dr. Georges Benjamin and Dr. Bruce Budowle) emphasized that BioWatch is an integrated system that “needs to be used with care and caution, but it’s really a marvelous piece of technology.” They also spent time discussing how PCR results may pose problematic for end users and how BioWatch “is a good investment that should continue”.

Mental Health Challenges in Ebola Fighters
The 2014 outbreak left untold damages upon the affected countries. Unfortunately, mental health is one that may have gone unnoticed. While doctors and nurses raced to respond to the outbreak, the response to mental health was given little thought. Fighters in the Ebola battle are now fighting personal struggles with alcoholism, depression, and drug addiction. In countries that have even fewer mental health professionals than medical doctors, many are in desperate need. Some of these include young men that signed up to bury the bodies of Ebola patients in the grassy mud within Liberia. Drew Hinshaw discusses how these “burial boys” found themselves digging graves for their own children and are now left struggling to find work and are suffering from severe PTSD and the emotional effects of such an ordeal. “Liberia has just one psychiatrist for a population of four million, according to the health ministry. Sierra Leone, home to seven million, also has only one. The mental-health wing of the Liberian health ministry has just two staffers on payroll.” The truth is simple- the impact of an outbreak of this magnitude, especially within impoverished countries, has rippling effects that go on for years. Perhaps future outbreak response and preparedness models should include mental health support during and following the outbreak?

Stories You May Have Missed:

  • Future of CRISPR– CRISPR technology has been making headlines since it’s initial discovery, especially with Science naming it the Breakthrough of the Year. Its ease of use has raised many red flags for those within the science and biosecurity community. One of its discoverers, Jennifer Doudna, worked to answer questions and dispel concerns regarding mis-use, stating that “she considers it one of her responsibilities as a researcher to ensure that she educates people about the technology and listens to their questions and concerns about its use. She says one of her biggest fears is “waking up one morning and reading about the first CRISPR baby, and having that create a public backlash where people ban or regulators shut this down, and I think that could be very detrimental to the progress of the field.”
  • UK Parliament Report – Lesson Learned from Ebola – The UK Parliament has released their findings on the 2014 Ebola outbreak and the UK’s response efforts. Pointing to the necessity of strong and reliable communication, they emphasized that research must be started swiftly during such events. “The willingness of Government agencies, third sector organisations, health and aid workers, universities, and pharmaceutical companies to go above and beyond to help tackle the outbreak was phenomenal. The swift pace at which clinical trials were approved and conducted particularly stood out.” For updates on the outbreak, you can see the WHO sitrep here.
  • MERS-CoV Updates – A new report from Emerging Infectious Diseases discusses the infection of alpacas in a region where MERS-CoV is endemic. Given the susceptibility of alpacas, this could broaden the geographical distribution of potential cases. Walter Reed Army Institute of Research (WRAIR) has started a Phase 1 clinical trial (the first to be tested in humans) for a MERS-CoV vaccine.

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Retaking Ramadi and the “Afghan Model”: Stephen Biddle, Air Power, and Maneuver Warfare

By Greg Mercer
On December 29, 2015, Iraqi forces recaptured the city of Ramadi, which was controlled by ISIS. While there remains resistance (in up to 25% of Ramadi), the victory is being hailed by some as a sign that ISIS is in retreat and losing momentum. An editorial in the New York Times lays out the situation and addresses where the US stands in the fight.

Many questions remain about the conflict- where it will go, how it will resolve, the political effort it will require from intervening forces, and ultimately what kind of conflict this is.

Twitter speculation is prescient, as always:

Screen Shot 2016-01-13 at 9.07.17 PM

 

 

 

 

 

That’s NPR’s defense writer Phil Ewing.

To assess this question of COIN-or-conventional, consider the theories of security studies hero and frequent commentator Stephen Biddle.

I have no interest in (mis)representing Biddle’s own opinions on ISIS, which have appeared in the Washington Post’s excellent Monkey Cage blogthe Atlantic, and the Council on Foreign Relations. Instead, I’m interested in two of his works addressing recent US conflicts- his seminal Military Power: Explaining Victory and Defeat in Modern Battle and his paper, Afghanistan and the Future of Warfare: Implications for Army and Defense Policy, wherein he spent a great deal of effort arguing against the idea of a Revolution in Military Affairs (RMA in Pentagonese).[1]

Military Power sees Biddle arguing that war hasn’t really changed all that much since artillery-aided maneuver warfare (Biddle calls this the “Modern System”) emerged in the First World War. This style of combat sees offenses where entrenched enemies are softened up with artillery barrages[2] and then overrun by infantry, using fire-and-maneuver tactics. Biddle supports this claim with a combination of case studies, statistical analysis of conflicts, and computer simulations. It’s something of a methodological cornerstone.

Afghanistan and the Future of Warfare takes on the dueling ideas that early American involvement in Northern Afghanistan, characterized by a Special Forces-Air Power-local allies triumvirate, is either so revolutionary as to herald a new “Afghan Model” of warfare or that it’s a complete topographical fluke unlikely to be repeated elsewhere. Biddle argues it was neither of these, but rather a fairly conventional war between two land forces characterized by its use of Special Forces to target precision guided munitions.

The Afghan Model, if it existed, would allow American air power dominance to “make conquerors” of local allies. Biddle’s test for whether Afghanistan represents a new model (the way some have said that it does) consists of three features:

  • Special Operations Forces and standoff sensors must have been able to find key targets for precision engagement;
  • PGMs must have been able to kill the targets found, at standoff ranges; and,
  • The indigenous allies’ role must have been undemanding.[3]

Basically, the aggregate of these features is a war wherein the US can take care of all of the actual finding and killing of targets with precision munitions targeted from the air, from orbit, or by small Special Forces teams, causing the enemy force structure to collapse, thus allowing local allies to take care of a few remnants and capture the territory. Biddle finds that initial operations in Afghanistan didn’t meet this standard.

These features are also a useful test for the war against ISIS. Again, the best-case-scenario is one where the 630 air strikes conducted by the US and its allies pave the way for local forces (in this case, the Iraqi Army[4]) to retake ISIS-held territory. This has been partially successful, and the Iraqis probably wouldn’t have been nearly as successful if not for friendly skies. But by Biddle’s conditions above, it would be premature to call this a new way of war. The US certainly hasn’t been able to conduct an entirely removed air war, opting to place forces on the ground. Identifying targets hasn’t been easy—ISIS occupies cities and villages populated by the civilians that the US and Iraqis seek to protect. Further complications arise from the proliferation of independent groups and actors on the ground (just look at the debate over what constitutes a Western-friendly moderate worth arming). The role of the allies on the ground has been anything but undemanding. So when we apply Biddle’s reasoning on the 2003 Iraq War and the 2002 Afghanistan War, the war against ISIS begins to look much more like a technologically advanced shade of good old maneuver warfare than a new type of conflict.

The idea of conducting an entire war from the air is compelling, though. What would it take to identify every enemy target and deliver precise munitions? The US already possesses some of the best[5] remote sensing equipment and military hardware out there, but it still requires targeting from allies on the ground or American Special Forces (as we saw in the case of the bombing of the Doctors Without Borders Hospital in Afghanistan, this is not a perfect system). To advance the art of air power to the point where it displaces land war requires near-omniscience and the ability to strike targets anywhere in the world in real time. Technologically or doctrinally, this just doesn’t exist.

Russia is simultaneously conducting airstrikes against ISIS and providing military assistance to allies on the ground. We’ve seen Russian airstrikes kill US-backed rebels and more recently, the leader of an insurgent group resisting Syrian President Bashar al-Assad’s control in Damascus. This begs the question of whether the Russian military sees itself following a conventional model of warfare, an Afghan Model, or some other model entirely. Following this, what happens when two powers try to “make conquerors” of their own local forces?

Finally, what of political solutions? The Times editorial notes that defeating ISIS militarily can’t alone solve the power vacuum and sense of Sunni disenfranchisement in Iraq that ISIS uses to build power. It’s widely understood that this requires a stable political solution, whether from within or without. Carl von Clausewitz tells us that war is an extension of politics, and in this case too we’ll have to see a military resolution and a political one.

[1] More explicitly in the former, but the latter certainly has shades of this.

[2] Biddle says that in WWI, this could mean firepower in the magnitude of nuclear weapons, dispelling the notion of boring-old-conventional-weapons.

[3] Biddle, Afghanistan and the Future of Warfare, 24

[4] And with regards to Ramadi, just the Iraqi Army. The Kurds and Iran-backed Shiites were excluded in favor of US-trained local Sunnis.

[5] Ok, the best.

 

Pandora Report 12.11.2015

If you’re in Boston and enjoying a Chipotle burrito bowl, you may want to put the fork down. As many as 80 cases of norovirus were reported in association with a Boston Chipotle. The norovirus surge occurs just months after the multi-state Chipotle-linked E. coli 026 outbreak. This week we’re discussing superbugs Star Wars style, the decline of infectious disease specialists, Ebola lab stories from the field, and much more. Fun history fact Friday: on December 7, 1941, Pearl Harbor was bombed and on December 10, 1901, the first Nobel Prizes were awarded in Stockholm, Sweden 

“Phantom Menace” Superbug?
In a lab far, far away… How could we resist a Star Wars reference to antibiotic resistance? A recent CDC MMWR reported a growing incidence of a particularly concerning antibiotic-resistant organism. Carbapenem-resistant Enterobacteriaceae (CRE) are continuing to raise concerns due to cases related to endoscopic retrograde cholangiopancreatography (ERCP) scopes. Since it’s discovery, global health experts (including the CDC) have been keeping a close eye on CRE transmission and cases. A variant of CRE, called OXA-48-type carbapenemase, was seen in Enterobacteriaceae in Turkey in 2001. 52 isolates of CRE producing OXA-48-like carbapenemases were found in 43 patients in the US from June 2010-August 2015. A study in 2012 first referenced OXA-48-like carbapenemases as the phantom menace. The concerning issue with this particular CRE strain, aside from its known-resistance, is the growing emergence in the US. The difficulty in treatment and extreme care for isolation precautions makes patient care challenging. Interestingly, for those patients who provided a travel history, the majority (66%) had traveled internationally within the year before specimen collection and 55% were actually hospitalized outside the US for at least one night. The US cases involved several clusters and were spread across 19 states. Even more worrying, the laboratory diagnosis is tricky as “most U.S. clinical laboratories that test for CRE organisms wouldn’t identify this particular type of bacteria because it’s not part of standard testing.” The increase in cases and ease of hospital transmission are just a few more reasons why antimicrobial stewardship is so vital. May the force be with you!

Ebola Surveillance & Lab Response SeminarIMG_4700
In case you missed GMU’s seminar on global health security on Monday, 12/7, here’s a recap! Speakers included Dr. Matthew Lim (Senior Policy Advisor for Global Health Security, HHS, fmr Civil-Military Liaison Officer to WHO), Jeanette Coffin (Section Manager, Biosurveillance Division, MRIGlobal), and Phil Davis (Associate Scientist with MRIGlobal). Ms. Coffin and Mr. Davis discussed the operations, supported by the Defense Threat Reduction Agency’s (DTRA) Cooperative Biological Engagement Program (CBEP). The mobile lab was launched in December 2014. With only six weeks to train, prepare staff, acquire equipment, deliver, assemble, and much more, it’s a pretty impressive feat that this team pulled off. Ms. Coffin and Mr. Davis discussed how they were able to reduce much of the travel delay and time lag for Ebola testing results. Using equipment to perform RNA extraction and PCR’s, lab technicians were working in tight quarters in Moyamba and Lakka, Sierra Leone. To date, the DTRA-CBEP mobile lab operations tested 7,242 samples for Ebola. While they discussed many of the strengths like flexibility, relationship with vendors, and self-containment, there were also several challenges. Difficulties ranged from inadequate power and internet, to road reliability, food/water safety, haggling, and security issues related to petty theft and missing supply containers. Sustainability was heavily discussed as their expected withdrawal is June 2016 and the team hopes to provide education for ongoing surveillance. Next, Dr. Matthew Lim spoke of the history and impact this outbreak had on global health security. He emphasized “how much this has overturned the paradigm we have about health and security”. Dr. Lim’s discussion was fascinating in that he speaks from experience at both the WHO and HHS, pointing to the role of member states and how WHO funding cutbacks impacted outbreak response. He noted that the Global Health Security Agenda heavily emphasizes partnership of it’s 50 state members, NGO’s, and within the 11 action packages. He explained that global health affairs, in many ways, join foreign policy and health policy, highlighting the need for less siloing and more partnership to help encourage capacity measures. Overall, the standing-room-only seminar touched on both the operational struggles and the overarching role of global health security in both the Ebola outbreak, but also future preparedness efforts.

Daesh and Chem/Bioweapons?
The UK and France have moved to call ISIS, “Daesh”, to remove the association with Islam. Given Daesh’s use of mustard gas, is bioterrorism a stretch? Sandra Maksimovic-Sara of Outbreak News Today discusses their attempts to obtain biological and chemical weapons as a means of using non-conventional weapons to change their modus operandi. While she doesn’t mention tacit knowledge, Maksimovic-Sara notes that “for a biological and chemical terrorist attack, there must be some know-how and background and a professional approach, which is so far away from impatient aggressive Islamic terrorists gathered in Daesh. They want fast track acts and fast track results.” While preparedness efforts must account for a variety of attacks, it’s vital to remember technical limitations. As Dr. Sonia Ben Ouagrham-Gormley noted, tacit knowledge is a significant hurdle for non-state actors to overcome in their quest for bioweapons.

To Quarantine or Not To Quarantine? 
The fallout of the 2014 West Africa Ebola outbreak is still ongoing and while many US hospitals feel they are better prepared to handle cases, there are many that experienced negative treatment related to preparedness efforts. There have been several returned travelers from the affected countries that were put into quarantine upon arrival in their home country. While many were involved in patient care, there are several that had no interaction with patients and experienced what many would call, “fearbola“. While quarantine efforts are important for those that may have had patient interaction, risk assessments are vital. Sheri Fink of The New York Times notes that several states “have the legal authority to impose quarantines, often exceeded those guidelines, restricting the movements of returning health workers and others.” Many who were quarantined experienced public harassment, media scrutiny, and some have filed lawsuits for civil rights violations.

France’s Bioterrorism Preparedness
Given the November terrorist attacks in Paris, it’s not surprising that France is looking to ramp up their biodefense efforts. Following the arrival of a third generation vaccine, France has decided to revise its smallpox preparedness and response plans. Last revisited in 2006, the plan is to vaccinate first responders and healthcare professionals that are most likely to identify and care for smallpox cases. Smallpox has long been an organism of concern for bioweapon applications. In coordination with the Secrétariat Général de la Défense et la Security Nationale, (SGDSN- General Secretariat for Defense and National Security) these plans will include the new vaccine, Imvanex, that was developed by the Danish biotech company, Bavarian Nordic, “on behalf of the US under Bioshield”. While the new plan involves “circles” of people, the new transgenic vaccine has vastly decreased the side effects that were commonly associated with first and second generational variola vaccines. In the past, smallpox vaccines were associated with high volumes of side effects, which was a roadblock to previous mass-vaccination efforts as a biodefense strategy. France has several biopreparedness strategies that include a syndromic surveillance program, SurSaUD, a White Plan, and many other efforts to prevent, identify, and respond to health security threats. The updated French plans hope to “frustrate and deter terrorists” as well as respond to concerns of re-emerging infectious diseases. Elisande Nexon presents an overview of France’s biopreparedness efforts and the public health threats they may encounter. While the November attacks in Paris will most likely initiate additional changes to France’s biopreparedness, their existing methods are extensive and reveal national support for biodefense.

Stories You May Have Missed:

  • Infectious Disease Specialists on the Decline – The National Resident Matching Program (responsible for matching medical students with specialty training programs) announced that of the 335 infectious disease fellowship positions available, only 218 were filled. This is especially concerning as it follows several years of low matching for infectious disease positions. The Infectious Disease Society of America has even begun brainstorming recruiting tactics for what many consider a “thinking specialty” that may not have the glamor or pay that draws students into the field. Speaking from experience as an infection preventionist, the infectious disease physicians I have worked with were by far the most dedicated, intelligent, and passionate people. I think we can all safely agree that the world needs more infectious disease specialists, especially following outbreaks like those of Ebola and Zika virus.
  • USAMRIID Supported Study Traces Ebola Outbreak – a recent study lead by USAMRIID found that a majority of the Liberian Ebola cases “can be traced back to a form of the virus transmitted from Sierra Leone”. The sequencing of hundreds of isolates also supports the role of high-density neighborhoods as an accelerant for the outbreak. Interestingly, researchers found that the Ebola strain diversified in Liberia prior to being transmitted to cases in Guinea and Mali.
  • Yamuna River Harbors High Volume of Antibiotic-Resistant Organisms – Researchers found that the Yamuna river in Dehli, India, had an alarmingly high amount of resistant organisms. There were large quantities of several organisms found that showed resistance to many common antibiotics like ampicillin, streptomycin, etc.
  • MERS Was the Most 2015 Googled Word in Korea – also considered Korea’s “hottest” Twitter issue, MERS became the most searched topic after the first patient was confirmed on May 20th.

Pandora Report 10.2

All this rain and grey weather (at least in DC) makes us want to curl up with a good book and luckily, we’ve got just the reading list! This week we’re sharing some top-notch work by our phenomenal faculty and alumni for you to enjoy. Earlier this week, straight out of a James Bond movie, Elon Musk presented Tesla’s Model X and its Bioweapon Defense Mode. Google had its 2015 Science Fair and a pretty amazing high school student took home top honors for her work on Ebola. Did I mention Kansas is prepping for the zombie apocalypse? Needless to say, there was a lot going on this week in the world of biodefense, so let’s venture down the rabbit hole….

 Zombie Preparedness Month Starts for Kansas 
I’m thinking we may need to take a class trip to Kansas since Governor, Sam Brownback, will be signing a proclamation to officially designate October as “Zombie Preparedness Month”! Brownback’s rationale is to emphasize preparedness in any form, stating, “If you’re prepared for zombies, you’re prepared for anything. Although an actual zombie apocalypse will never happen, the preparation for such an event is the same as for any disaster: make a disaster kit, have a plan, and practice it.” During Zombie Preparedness Month, state emergency management services will have activities and information for residents to help get their preparedness on. They’ll also be using social media to engage people people on these topics. The one thing we’ve learned in biodefense, Gov. Brownback, is to never say never!

Connecticut Teen Wins Google Science Award By Developing Affordable Ebola Test
High school junior, Olivia Hallisey, just took home the Google Science Fair top prize for developing an affordable and easy Ebola test in her project, “Ebola Assay Card”, which quickly (we’re talking 30 minutes quick!) detects the virus and doesn’t require refrigeration. Each test only costs $25 and picks up antigens on photo paper. Hallisey summarizes, “In this new device, that is stable and stored at room temperature, 30µl drops of water were used to dissolve silk-embedded reagents, initiating a timed-flow towards a center detection zone, where a positive (colored) result confirmed the presence of 500pg/ml Ebola(+)control antigens in 30min, at a cost of $25,” Hallisey hopes this project will encourage other girls to pursue their passions in science. Hallisey is truly an inspiration and we tip our hats to her passion for solving world problems while encouraging her peers!

Let’s Talk Dual-Use!
Come listen and chat with Dr. David R. Franz, former commander of USAMRIID, about balancing research and regulations when it comes to dual-use!
Date & Time: Monday, October 5, 2015, 4:30-6pm
Location: Hanover Hall, L-003 George Mason University, Fairfax, VA, see map

​Dr. Franz was the Chief Inspector on three United Nations Special Commission biological warfare inspection missions to Iraq and served as technical advisor on long-term monitoring.  He also served as a member of the first two US-UK teams that visited Russia in support of the Trilateral Joint Statement on Biological Weapons and as a member of the Trilateral Experts’ Committee for biological weapons negotiations.  He previously served as member of the National Science Advisory Board for Biosecurity (NSABB). Dr. Franz currently serves on several committees including the National Academy of Sciences Committee on International Security and Arms Control and the National Research Council Board on Life Sciences. Dr. Franz is a leader in the areas of cooperative threat reduction and health security and an expert in the development of U.S. regulations for biological threat reduction and biological security.  Dr. Franz will discuss the history and current debates related to U.S. and international regulations for select agents, dual use research of concern, and gain-of-function experiments.

1977 H1N1 Influenza Reemergence Reveals Gain-of-Function Hazards
Dr. Martin Furmanski discusses the gain-of-function (GoF) research hazards in relation to the 1977 H1N1 strain and it’s laboratory origins. Highlighting a previous article on the GoF debate, Dr. Furmanski notes that “separating the risks of vaccine development from those of basic GoF research is inappropriate, because GoF research seeks to discover antigenic and genomic changes that facilitate human-to-human transmission and/or augment virulence, with the aim of preemptively producing vaccines.” He also notes that while the 1977 H1N1 epidemic originated in a lab and it’s release was unintentional, the culprit laboratory matters little in the GoF debate.

Define Acceptable Cyberspace Behavior
GMU Biodefense alum, Dr. Daniel M. Gerstein, discusses the US-China cybersecurity agreement and the Friday announcement between Chinese Premier Xi Jinping and President Barack Obama. The agreement highlights the mutual desire to prevent cybertheft of business secrets. Dr. Gerstein emphasizes that while this agreement is a step in the right direction, it points to larger preparedness and response capability gaps. He notes, “So while a U.S.-China agreement is a welcome step, it also underscores the greater issues facing the United States, and indeed the international community, in this largely ungoverned space.” Dr. Gerstein highlights the necessity to define cyberspace boundaries, especially as there are delays in DHS security system deployments while US vulnerabilities continue to develop.

Implementation for the US Government Policy for Institutional Oversight of Life Sciences Dual Use Research of Concern
As of September 24, 2015, all institutions and USG funded agencies are now required to comply with the policies. Agencies now must have “a mechanisms in place to evaluate research that is potentially Dual Use Research of Concern (DURC).” Institutions must also organize an Institutional Review Entity (IRE) to review and manage compliance with these requirements.

Dr. Sonia Ben Ouagrham-Gormley’s  new book, Barriers to Bioweapons, received glowing reviews in the latest issue of Perspective on Politics. Her work, which is a staple for biodefense courses, and particularly this text, focusses on the perception of risk and lethality of bioweapons while addressing the realities of these assumptions. Ouagrham-Gormley discusses the key role of tacit versus explicit knowledge in the development and dissemination barriers for bioweapons. “The author identifies important factors internal to a weapons-development program- talented individuals and cohesive groups, corporate culture, communities of practice, organization structure- as critical nodes or ‘reservoirs’ of knowledge that must be configured to optimize the sharing of ideas and information.” The case studies of Iraqi and South African programs, as well as Aum Shinrikyo, lay the foundation for her points on the role of internal and external variables that can hinder or help a bioweapons program. Whether you’re reading  it for class (GMU Biodefense folks, I’m looking at you!) or you’re looking to brush up on nonproliferation, this book is a well-written and captivating necessity to understand bioweapon development. Did I mention how awesome the cover is?
Our very own GMU Biodefense PhD alum, Dr. Denise N. Baken, has a wonderful new book being released – let’s check it out! Al Qaeda : The Transformation of Terrorism in the Middle East and North Africa examines violence and the way it is marketed by the global terrorism industry.  Authors Denise Baken and Ioannis Mantzikos frame the violence discussion through the prism of its use by Al Qaeda, Al Qaeda in the Arabian Peninsula (AQAP) and Islamic State of Iraq and Syria (ISIS).Baken and Mantzikos look at the business parameters of violence –its cost, return on investment, efficiency, and effectiveness; They propose a new approach to that violence. One that looks at violence as a controlled commodity that evolved from Al Qaeda’s initial presentation of future possibilities, AQAP exploited those possibilities and ISIS pushed the boundaries of usability.
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