Pandora Report 3.17.2017

Happy Friday! In honor of  John Snow‘s birthday (the father of epidemiology), our featured image is the Broad Street pump map he used to combat cholera in the 19th century. Don’t miss out on the early registration discount for our biodefense summer workshop!

NAS Calls for Increased Federal Regulatory Agency Preparation for Growing Biotechnology Products 
The National Academies of Science (NAS) recent press release is emphasizing the need for federal regulatory agencies to prepare for greater quantities and ranges of biotechnology products. As the biotech world constantly evolves, regulatory agencies have struggled to keep up and this latest report states that in the next five to ten years, the pace will outmatch the U.S. regulatory system. According to the report, biotechnology, like CRISPR, has a rapidly growing scale and scope, which already stresses existing staff, expertise, and resources available at agencies like the EPA, FDA, and USDA. “To respond to the expected increase and diversity of products, the agencies should develop risk-analysis approaches tailored to the familiarity of products and the complexity of their uses, the report says. For biotechnology products that are similar to products already in use, established risk-analysis methods can be applied or modified, and a more expedited process could be used. For products that have less-familiar characteristics or more complex risk pathways, new risk-analysis methods may need to be developed.  Regulatory agencies should build their capacity to rapidly determine the type of risk-analysis approaches most appropriate for new products entering the regulatory system.” Within the report, NAS notes that the federal government needs to develop a strategy to combat the current issues and strengthen their ability to scan for future biotechnology products to better prioritize.

GMU Schar School Master’s Open House 
Have you ever wanted to study topics like CRISPR, bioterrorism, global health security, and pathogens of biological weapons? Good news – we’ve got just the program for you! Come check out GMU’s biodefense MS program at our Open House on Wednesday, March 22nd at our Arlington Campus, Founders Hall (Room 126) at 6:30pm. You can talk to some of our biodefense faculty and learn about our program. Whether you’re looking to take classes in person or earn a degree online, the biodefense MS is the best for the intersection of science and policy.

DARPA Works Towards “Soldier Cell” To Fight Bioweapons 
A bio-control system to fight off invading pathogens? Sounds like something out of a science fiction movie! Well, researchers at Johns Hopkins University just received funding from DARPA to develop the capacity to “deploy single-cell fighters” that would target and eliminate the lethality of certain pathogens. “‘Once you set up this bio-control system inside a cell, it has to do its job autonomously, sort of like a self-driving car,’ said Pablo A. Iglesias, principal investigator on the project. Iglesias, a professor of electrical and computer engineering in the Whiting School, shifted his research focus from man-made to biological control systems about 15 years ago. ‘Think about how the cruise control in your car senses your speed and accelerates or slows down to stay at the pace you’ve requested,’ Iglesias said. ‘In a similar way, the bio-control systems we’re developing must be able to sense where the pathogens are, move their cells toward the bacterial targets, and then engulf them to prevent infections among people who might otherwise be exposed to the harmful microbes’.” This angle, which is being focused on bacteria outside of the body, is just one potential tool in the biodefense arsenal.

Yellow Fever Outbreak in Brazil 
Since December of 2016, Brazilian health officials have reported an ongoing outbreak of yellow fever. The CDC has moved the alert to a  Level 2 – Practice Enhanced Precautions. A report recently published in the New England Journal of Medicine looks at the outbreak and the potential for cases in U.S. territories. In Brazil, there were 234 cases and 80 deaths reported between December and February. “Although it is highly unlikely that we will see yellow fever outbreaks in the continental United States, where mosquito density is low and risk of exposure is limited, it is possible that travel-related cases of yellow fever could occur, with brief periods of local transmission in warmer regions such as the Gulf Coast states, where A. aegypti mosquitoes are prevalent.”

GMU Biodefense Represented At Biothreats Conference
If you missed out on our coverage of ASM’s 2017 Biothreats conference, here’s a spotlight on GMU biodefense students attending this captivating three-day event. GMU’s biodefense program sent four graduate students to experience and report on the conference, which addressed biothreat research, policy, and response. “The program was exciting, according to the George Mason students in attendance. Mercer and Goble recall that the conference engaged topics of specific interest to them, their degree, and their futures. ‘I attended a panel that was very closely related to disease forecasting, my graduate thesis topic,’ Mercer said. ‘I was able to hear some of the cutting-edge research in that field, which was really helpful’. ‘I didn’t really have a part I didn’t like,’ Goble said. ‘I enjoyed the niche topics that were presented in both panel discussions and poster  sessions, from emergency operations to the FDA. All of these specific topics were extremely interesting to hear about and to know they are being researched’.”

Just How Well Did the 2009 Pandemic Flu Vaccine Strategy Work?
Researchers from the University of Nottingham recently looked at the success of vaccines in terms of preventing pandemic flu and reducing hospitalizations. Their work looked at the 2009 WHO-declared pandemic of the novel A(H1N1) virus, which infected around 61 million people around the world. Vaccines against the virus were rolled out globally between September and December of 2009, with the majority being inactivated A(H1N1)pdm09 influenza virus. Their work involved reviewing 38 studies between June 2011 and April 2016 regarding the effectiveness of the inactivated vaccine, which covered around 7.6 million people. “We found that the vaccines produced against the swine flu pandemic in 2009 were very effective in both preventing influenza infection and reducing the chances of hospital admission due to flu. This is all very encouraging in case we encounter a future pandemic, perhaps one that is more severe,” noted Professor Van Tam said. “Of course, we recognize that it took five to six months for pandemic vaccines to be ready in large quantities; this was a separate problem. However, if we can speed up vaccine production times, we would have a very effective strategy to reduce the impact of a future flu pandemic.” The 2009 pandemic A(H1N1) vaccine was 73% effective against laboratory confirmed cases and 61% against preventing hospitalizations. Interestingly, when looking at the vaccines’ effectiveness in different age groups, “they were shown to be less effective in adults over 18 years than in children, and effectiveness was lowest in adults over 50 years of age. Adjuvanted vaccines were found to be particularly more effective in children than in adults against laboratory confirmed illness (88 per cent in children versus 40 per cent in adults) and hospitalization (86 per cent in children versus 48 per cent in adults).”

Deadly Fungal Infection Arrives in U.S. 
While many are asking if surveillance methods for tracking the deadly CRE bacteria are adequate, a new issue is emerging in U.S. hospitals. Despite WHO’s recent plea for increased R&D surrounding certain resistant pathogens, it seems that more and more organisms of concern are springing up in U.S. hospitals. Since last summer, roughly three dozen people have been diagnosed with a highly resistant Candida auris infection. The fungal infection has caused worry ever since it was identified in 2009 due to its capacity as an emerging and resistant organism. Candida yeast infections are pretty common and known to cause urinary tract infections however, this strain is especially concerning because it easily causes bloodstream infections, has a stronger capacity for transmission between people, and is much more hardy in terms of living on skin and environmental surfaces. “Of the first seven cases that were reported to the CDC last fall, four patients had bloodstream infections and died during the weeks to months after the pathogen was identified. Officials said they couldn’t be sure whether the deaths were caused by the infection because all the individuals had other serious medical conditions. Five patients had the fungus initially isolated from blood, one from urine, and one from the ear.”

CDC Director Warns Loss of DHHS Funds Could Weaken Infectious Disease Prevention
Acting CDC director, Anne Schuchat, recently testified before Congress to make the case for for increased funding for several programs (one being the DHHS’s Prevention and Public Health Fund). Among other things, the Prevention and Public Health Fund is responsible for 12% of the CDC’s budget. Dr. Schucat’s testimony emphasized the previous usage of these funds in terms of vaccine delivery, disease surveillance, monitoring of water supplies, and tracking hospital-acquired infections. The growth of antibiotic resistance made her testimony and plea to Congress that much more relevant and urgent. “The CDC and other government agencies have in recent years cited the numerous public health threats posed by infectious diseases in general, and have lobbied officials for increased funding for research and development of novel vaccines and treatments as well as programs to effectively distribute interventions as needed. In 2016, for example, the CDC, DHHS, and National Institutes of Health requested federal funding to combat Zika, a request that was not approved until late in the year.”

Stories You May Have Missed:

  • Science on Screen – Don’t miss this great event hosted by Lawrence Livermore National Laboratory! On March 18th, you can watch the second installment of the Science on Screen series, featuring “Lawrence Livermore scientists Monica Borucki and Jonathan Allen, who will present ‘Reconstructing a Rabies Epidemic: Byte by Byte.’ This informative and entertaining lecture will explain how biologists and computer scientists used cutting-edge, ultra-deep sequencing technology to study the dynamics of a 2009 rabies outbreak. This case study, based on a dramatic increase (more than 350 percent) in the gray fox population infected with a rabies variant for which striped skunks serve as the reservoir hosts, will be used to help illustrate the changes in the viral genome during cross-species viral transmission. This lecture is appropriately paired with the feature-length film, “Contagion” (PG-13).”
  • Clorox Gets Spot on EPA A-Team – Clorox just earned its varsity spot on the team against hospitality-acquired infections. The EPA approved two of the company’s products in killing clostridium difficile spores. C-diff is a constant battle in healthcare facilities, so having the new tool in the infection prevention and environmental disinfection toolkit, is a huge advantage for many. “In addition, the cleaners and wipes recently become EPA-registered to disinfect against other bacterial infections, such as those caused by Staphylococcus epidermidis, Candida glabrata, and Enterococcus hirae. Moreover, the products are also effective against several viral pathogens, such as Middle East Respiratory Syndrome (MERS), and Severe Acute Respiratory Syndrome (SARS), measles, and Influenza A and B, among others.”

 

Pandora Report: 7.15.2016

Happy Friday! Don’t forget to read that Federal Select Agent Program report we revealed last week, as many are shocked to find the 199 lab mishaps that occurred. Check out these One Health researchers who are trying to predict and prevent the next disease that will run rampant like Ebola. You can also listen to Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, talk about how superbugs are beating us. Have we reached the end of the Golden Age of antibiotics? 

International Security & Foreign Policy Implications of Overseas Disease Outbreaks Screen Shot 2016-07-12 at 8.40.13 AM
A recent report by the International Security Advisory Board (a Federal  Advisory Committee) has been released regarding the security implications of infectious disease outbreaks and the efforts of the WHO, the Biological and Toxin Weapons Convention (BWC), international academies, etc. Within the report there is a heavy focus on how the Department of State should prepare for such global health challenges and a series of structural solutions, capacity issues, and opportunities that can be taken. The National Bureau of Economic Research recently found that a global pandemic would cost $570 billion per year. “The links between disease and security have become clearer as more disease threats have emerged and global interconnectedness makes a threat anywhere, a threat everywhere. There are few threats to the United States and its global interests that match the potential scale and scope of the threat to life and security and economic interests than those from infectious disease outbreaks, whether naturally occurring or intentionally caused.” Some of the recommendations emphasized the strengthening of U.S. government coordination through the development of plans for responding to such public health emergencies in areas out of control of a central government and/or hostile to U.S. government involvement. Additional recommendations included strengthening by fully integrating public health emergencies and the associated challenges into the national security agenda by “providing resources, developing organizational leadership within the U.S. and internationally, and developing and exercising appropriate plans for preparing for, preventing, and responding to threats.” Whether they are natural, deliberate, or accidental, globalization makes the threat of these outbreaks that much more dangerous.”Public health is now a national security challenge and must be treated as such in terms of planning, resources, and organizational support. It is essential to refocus the U.S. approach to this threat, and to invest in the appropriate level of ‘insurance’ just as we do for traditional defense related needs.”

The National Biodefense Strategy Act of 2016
Introduced in May by Sen. Ron Johnson, the bill amends the Homeland Security Act of 2002 “to require the President to establish a Biodefense Coordination Council to develop a national strategy to help the federal government prevent and respond to major biological incidents.” The bill defines biodefense as “any involvement in mitigating the risks of major biological incidents and public health emergencies to the United States, including with respect to- threat awareness, prevention and protection, surveillance and detection, response and recovery, and attribution of an intentional biological incident.” Within the bill, the President must establish a Biodefense Coordination Council and develop a National Biodefense Strategy in which there must be status updates to Congress every 180 days. The strategy must be updated at least every five years and the bill also requires that an annual report with detailed expenditures and their relevance to the strategy is submitted. The Congressional Budget Office (CBO) recently released its summary on the costs of S. 2967 – “CBO estimates that enacting S. 2967 would cost less than $500,000 annually and about $2 million over the 2017-2021 period; any such spending would be subject to the availability of appropriated funds.”

The Growing Cost of the Next Flu Pandemic
A recent study from researchers at the Society for Risk Analysis (SRA) utilized advanced methodology to calculate the total cost of an influenza outbreak. SRA’s work concluded that if the public used flu vaccines during the pandemic, the U.S. GDP loss would be $34.4 billion. In the event that flu vaccines weren’t used, the cost would rise to $45.3 billion. This particular study is unique in that it addresses public, government, and business responses to an epidemic. Conducted as part of a project by the the Department of Homeland Security’s National Biosurveillance Integration Center (NBIC), the study estimates “the relative prominence of the various economic consequence types,’ as well as complicating factors, many of them not addressed in any prior study. These complicating factors include different types of avoidance behavior, such as the already noted avoidance of public events and facilities.”

A New Case of Super Resistant E. Coli 
A second patient in the U.S. has been found to carry the colistin-resistant E. coli that raised concern in late May when it was also found in Pennsylvanian woman. Colistin resistance means that the antibiotic of last resort, colistin, is no longer effective at killing the organism. The most recent was reported to have had surgery in a New York hospital last year, which begs the question – is this where it was acquired? Were post-operative antibiotics not discontinued properly? The second case is fueling public health fear over the spread of this resistant gene, especially in regards to bacteria that are currently only susceptible to colistin. In the wake of these findings, many are pushing for increased surveillance and focus on antibiotic resistance. “The CDC is planning to establish seven regional laboratories this fall that will have the capacity to do better and faster testing for a broad range of antimicrobial resistance.”

One Health & Antimicrobial Resistance 
On Wednesday, the One Health Commission held a webinar on antimicrobial resistance in the environment. Led by Dr. Laura Kahn, the presentation focussed on the challenges of feeding billions, the growth of antibiotic use in meat, and the reality that antibiotic resistance is an integral part of 21st century challenges. In general, people are eating more meat, with China shouldering a 147% growth in meat consumption, while the U.S. has remained unchanged. Antibiotic usage in meat is not the only concerning source as sewage sludge can easily be a source of antibiotic exposure for animals. Dr. Kahn also discussed that from 2000-2010, global human antibiotic consumption has grown 37% and the top antibiotic consumers are India, China, and the U.S. Interestingly, India and Pakistan have some of the most resistance microbes in the world. A Dutch study looking at archived soil from 1942-2008 found that there were increasing concentrations of resistant genes as time progressed. Expanding human population and demand for animal proteins, rising human and animal waste production, poor sanitation, indiscriminate antibiotic usage, and land/water contamination are all fueling the rise of antibiotic resistance and altering the “global resistome”. So what can be done? Dr. Kahn noted the potential role of bacteriophages as a means of fighting bacteria and the growing threat of microbial resistance. Overall, we need to understand the microbial world better, decrease antimicrobial usage, and tap into the bacteriophage resource.

Weekly Zika News
As more Zika cases are found within the U.S., many are wondering why Congress is holding up funding. Here’s a map of California and where you can expect to find mosquitoes that have the potential to transmit Zika. The CDC has a national map you can also reference with estimated range of the Aedes mosquitoes. Infectious disease and mosquito control expert, Duane Gubler, notes that spraying may not be successful against the Aedes mosquito.  The difficultly lies in that the Aedes mosquitoes tend to live in harder-to-reach areas (garbage, closets, indoors, etc.) and spraying is most effective against mosquitoes living in floodwater. Olympic risk for Zika is considered low following a CDC analysis, which concluded that the visitors expected at the games represent less than 0.25% of the total travel volume to Zika-affected countries. “Estimated travel to the U.S. from Rio for the Games is 0.11% of all 2015 U.S. travel from countries where Zika is now spreading, the CDC said.” You can read the official MMWR release here. Colombia’s low volume of microcephaly and birth defects following Zika infection during pregnancy offer some home that the outbreak may not be as bad as early estimates suggested. A new study published in the Lancet looks to women as possible modes of sexual transmission for Zika. “Our findings raise the threat of a woman potentially becoming a chronic Zika virus carrier, with the female genital tract persistently expressing the virus RNA. Additional studies are underway to answer those essential questions and to assess what would then be the consequences for women of child-bearing age”. CDC Director, Dr. Tom Frieden, writes about the lessons we can learn from the fading Ebola epidemic and how we can apply these to Zika.  Researchers have also recently written that the epidemic in Latin America is “likely to run its course within the next 18 months” – you can read their article in Science here. The CDC has reported 1,306 cases of Zika virus in the U.S as of July 13, 2016. 

Stories You May Have Missed:

  • Malaria and the Duration of Civil War The Journal of Conflict Resolution recently published an article regarding the prolonging of civil war in relation to malaria. Just as geographical factors can impact the duration of civil war, researchers note that malaria can inflict costs and can “indirectly prolong civil war by helping to maintain a socio-geographic environment that is conducive to insurgency”. The rotation of government forces also means they’re likely to have exposures to malaria.
  • The Current State of Our Immunity – Infectious disease physician Dr. Amesh Adalja discusses 21st century immunity to disease. Drawing from points made in Taylor Antrim’s Immunity (set in a post-pandemic world following the 4% loss of global life due to a genetic recombinant of influenza and Lassa Fever), Dr. Adalja relates many of the lessons from his experiences during the West Africa Ebola outbreak and the impact of poverty on resilience. “Today, worldwide extreme poverty — in real terms — is at its lowest. Smallpox has been vanquished with polio and guinea worm about to follow suit. Even Ebola, because of major advances that have occurred in the basic understanding of the clinical illness as well as in vaccine technology since the last outbreak, has been substantially defanged.”
  • The Growing Misuse of Toxic Weapons: Attend the seminar on Monday, July 18th (3:30-5pm) at the James Martin Center for Nonproliferation Studies (1400 K St. NW, Suite 1225, Washington, DC). “We are witnessing today a global threat of toxic chemicals as a means of warfare or terror.  The recent use of chemical weapons and dual-use toxic chemicals in both Syria and Iraq, and possible terrorist attacks against chemical infrastructure, are visible confirmations of a growing threat of misuse of chemicals. This seminar, organized by Green Cross International and the Center for Nonproliferation Studies, will present the results of Chemss2016, an April conference in Poland, including its Summit Declaration which addressed challenges, goals, guidelines, and principles of global cooperation against chemical threats today.”

 

Pandora Report 1.18.15

For those who’ve been reading for awhile, you’ve probably surmised that one of my personal health interests is seasonal and pandemic flu. There were plenty of stories about that this week, so that’s what we’ll focus on. We’ll also look at Ebola and other stories you may have missed. My apologies for posting delays this week, I’m dealing with some rotator cuff and carpal tunnel issues in my right arm, and let me tell you, it is HARD to type with your dominant arm in a sling!

Enjoy your holiday Monday (if you have one) and have a safe and healthy week!

Texas Health Experts Say Universal Flu Vaccine Could be a Reality

The CDC has said that this year’s seasonal flu vaccine was only 23% effective due to unanticipated antigenic drift—meaning the predicted strains in the vaccine didn’t match the dominant strains of the virus that are currently circulating. In order to combat this in the future, scientists at Mount Sinai health system in New York are in the process of testing a universal flu vaccine which will go into clinical trials this year.

KLTV.com—“‘There is work going on to see if, perhaps a different kind of vaccine could be developed maybe against a different part of the flu virus, one that is not so subject to this antigenic drift or to change as readily from one year to the next,” [Dr. Levin of UT Health Northeast] says.”

Scientists Find Brain Protein Aids Influenza Recovery

Scientists at Washington State University in Spokane have found a brain protein that boosts the healing power of sleep and speeds recovery from the flu in mice. Professor James M. Kruger said this discovery could lead to alternative treatments for flu and other infectious diseases by stimulating production of the brain protein called AcPb. This discovery comes at a time where avian influenza is prevalent in Taiwan, Japan, Nigeria, China, Egypt, Canada, the U.S. and Mexico.

Washington State University—“Krueger showed this recovery involves AcPb and an immune system signaling chemical called interleukin-1. AcPb links up with interleukin-1 to help regulate sleep in healthy animals. It also prompts infected animals to spend more time sleeping during an illness.

In the study, mice who lacked the gene for AcPb slept less after being infected with influenza virus. They also became chilled, grew sluggish, lost their normal circadian rhythms and ultimately died in higher numbers than the mice who slept longer.”

This Week in Ebola

As GMU students return to classes, so do students in Ebola affected Guinea. Schools in Guinea will re-open Monday, and schools in Liberia are set to re-open “next month.” No date has been set for schools in Sierra Leone. Despite this, the President of Sierra Leone has declared that there will be zero new confirmed Ebola cases by the end of March the country will be Ebola-free, by WHO standards, by May. These announcements come at a time when Dr. Thomas Frieden, Director of the CDC, has said he was “very confident we can get to zero cases in this epidemic if we continue the way we’re going and nothing unexpected happens” and the outbreak appears to be slowing down. Last week brought record low numbers—for Guinea, the lowest total since mid-August; for Liberia, the lowest total since the first week of June; for Sierra Leone the second week of declines and the lowest level since the end of August. However, there are still “at least 50 micro-outbreaks” underway throughout West Africa.

Pauline Cafferkey, the Scottish nurse infected with Ebola, is “showing signs of improvement” and an American soldier who was found dead in Texas after his deployment in West Africa reportedly showed no signs of Ebola leaving officials to remark that there was “no evidence of a public health threat.”

A seemingly large amount of good news this week left space for new ruminations on Ebola and outbreaks in general. Wired  had an interesting piece on Nanobiophysics and how it could stop future global pandemics while The Chicago Tribune looked at bats and their likely role in Ebola outbreaks and CNBC looked at the price of protection from global pandemics—would you believe $343.7 billion?

Stories You May Have Missed

 

Image Credit: NBC News

New Bat Flu Found

By Jonathon Marioneaux

Halloween is right around the corner, so we continue our coverage of one of the most notable creatures of the season: bats. Previously we covered vampire bats and their role in spreading rabies to humans and livestock in South America.  Considering how bats appear to be vectors for both Ebola and rabies this made left me wondering what other viruses bats carry.

Many animals carry some sort of virus that belong to the Orthomyxoviridae family which is broken into three classes A, B, and C.  Classes B and C primarily infect humans while class A infects a range of hosts including birds, mammals, and reptiles. However, no Orthomyxoviridae virus has been found in bats, or so we thought.  In October researchers from Maryland and Kanas discovered a new flu virus that can be transmitted between bats and in doing so discovered a new lineage of the Orthomyxoviridae family and a potential new pandemic flu.

Influenza is a negative sense RNA virus consisting of 7-8 segments allowing it to recombine during infection and create new combinations of RNA segments.  Multiple types of influenza can infect a host cell simultaneously allowing strains of flu from different hosts to recombine in novel ways.  This ability to be infected with different types of influenza viruses is why there are new outbreaks of the flu every year and why the virus has the potential to become a global pandemic if the correct reassortment happens.


Bats carry many diseases such as Coronaviruses, Filoviruses, and Henipaviruses, but as stated earlier, no Orthomyxoviridae have been previously found.  While trying to sequence genomes the researchers found influenza-like RNA sequences in tissue cultures.  However, when these sequences were introduced into cell cultures they did not replicate efficiently.  The researchers then synthetically altered the surface protein structure and re-infected cell and animal models.  The virus reproduced efficiently in the cell and mice models with high mortality among the mice; thus showing that the virus can reproduce in traditional flu hosts. The researchers indicated that the bat virus does not have the same surface proteins that influenza A and B contain.  This lack of ability to infect the same cells shows high cell specificity that results in a limitation of the cell types that influenza A and bat influenza can infect.  Finally, the genetic differences that are seen in the bat influenza virus indicate that they are a distant relative of the current influenza types, thus potentially making them a new branch of the Orthomyxoviridae family tree.

The difficulty in growing the bat viruses in traditional cells without modification indicates that the virus does not have the necessary surface proteins to enter cells.  However, after synthetic modification the bat virus was very lethal in host cells and animal models.  This indicates that the bat virus is only distantly related to the influenza A and B types that circulate currently.  Therefore, the risk of reassortment between flu viruses is small and there is a smaller risk of a global pandemic.

In conclusion,  bats harbor many viruses and make great Halloween decorations but they pose little risk for a global pandemic of zombie apocalyptic proportions and are great for the environment.  So, make sure you thank the next bat that you see and we will continue our coverage of our winged friends next week.