Tag: Mustard gas

Pandora Report 12.11.2015

by spopescu, posted in Pandora Report

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 9.18.2015

by spopescu, posted in Pandora Report, Research Notes, Uncategorized

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

US Confirmation of Islamic State Chemical Weapons

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

Michigan Experiences Imported Plague Case

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

The So-Called Islamic State 2
By Greg Mercer

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

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

 

 

 

 

 

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

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

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

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

 

 

 

 

 

 

 

 

 

 

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

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

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

The Evolution of Cyber War

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

Stories You May Have Missed:

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

Pandora Report 8.16.15

by juliadhomstad, posted in Pandora Report

It looks like the blog isn’t the only place with a lull during the summer. This week was oddly slow for news; maybe it’s an August thing? For our top stories we’ve got ISIS with chemical weapons and, from our neighbor to the north, a disease diagnosing fabric. We’ve even got a few stories you may have missed.

Have a great week!

U.S. Investigating ‘Credible’ Reports that ISIS Used Chemical Weapons

The U.S. is investigating what it believes are credible reports that ISIS fighters used mustard agent against Kurdish Peshmerga fighters in Makhmour in Northern Iraq. ISIS posted about the attack on social media, but American officials have stated they have independent information that left them believing that a chemical weapon was used. A German Ministry of Defense spokesman echoed that they cannot confirm or rule out that a chemical weapons attack occurred. The major question for U.S. officials is to determine if it was mustard gas, and if so, how ISIS came to possess it.

CNN—“Blake Narenda, a spokesperson for the State Department’s Arms Control, Verification and Compliance Bureau, said, “We continue to take these and all allegations of chemical weapons use very seriously. As in previous instances of alleged ISIL use of chemicals as weapons, we are aware of the reports and are seeking additional information. We continue to monitor these reports closely, and would further stress that use of any chemicals or biological material as a weapon is completely inconsistent with international standards and norms regarding such capabilities.”

CNN has previously reported claims from monitoring groups that ISIS used chlorine weapons against Kurdish forces.”

Halifax Scientist Develops High-Tech Fabric that Helps Diagnose Diseases

Yes, you read that right. Christa Brosseau, an analytical chemist at Saint Mary’s University in Halifax, Nova Scotia, is working on the development of a chemical sensor which can be built into fabric and can detect diseases like tuberculosis, malaria, and HIV/AIDS.  How is this even possible? First the scientists make Nanoparticles, then aggregate those particles which ends up as a silver Nanoparticle paste. That paste can be placed on a fabric chip and it then ready to use. The fabric chip interacts with bodily fluids like sweat, saliva, or urine, and is then scanned for information.

CTV—“The technology picks up disease biomarkers and the scientists are able to get results in approximately 30 seconds, by using hand held units, the size of a TV remote control, to scan the samples. The size of the units makes them convenient for working in the field.

Eventually, the scientists hope to see the technology deployed in exercise headbands, or cloth inserts in infant diapers, to better monitor the state of health.”

Stories You May Have Missed

Image Credit: U.S. Army