Pandora Report 5.19.2017

Your weekly dose of all things biodefense is here to fill you in on Ebola in the DRC, antibiotic resistance, the role of the U.S. in global health response, and more!

Ebola Rears Its Ugly Head in the DRC
Sadly, Ebola has returned as cases are sprouting up in the Democratic Republic of the Congo (DRC). On Friday, May 12th, the WHO confirmed an outbreak of the Zaire strain involving nineteen cases and three deaths. “WHO and partners are completing the epidemiological investigation to better understand the extent of the current outbreak and who are potentially at risk of Ebola,” WHO spokesperson Tarik Jasarevic told CIDRAP News. “If pertinent, ring vaccination, as used in the phase 3 study in Guinea, would be the recommended delivery strategy.” These new cases will truly be a test to see if response efforts have changed since the 2014/2015 outbreak in West Africa. Between the WHO response and the potential for real-world testing of the new Ebola vaccine, many are hoping this will be the game-changer. The Global Outbreak Alert and Response Network (GOARN) has been activated and per the WHO website, “the need and feasibility of potential Ebola ring vaccination is being discussed.” Reuters reported that “the GAVI global vaccine alliance said on Friday some 300,000 emergency doses of an Ebola vaccine developed by Merck could be available in case of a large-scale outbreak and that it stood ready to support the Congo government’s efforts to bring the epidemic under control.Under an agreement between GAVI and Merck, the developer of an Ebola vaccine known as rVSV-ZEBOV, it said up to 300,000 doses of the shot would be available in case of an outbreak.” MSF (Medicins sans Frontieres) announced, shortly after the WHO confirmation of cases, that they would be sending a team of 14 people to Likati to launch “an emergency intervention” and that a team of 10 people from the Ministry of Health would also be joining. MSF noted that “the team will be made up of doctors, nurses, logisticians, water and sanitation experts, health promoters and an epidemiologist. Along with organisations already present in the area, the MSF emergency team will conduct an assessment of the situation and may construct an Ebola treatment centre and help care for those suspected or confirmed to be affected by the virus. Fifteen tonnes of medical and logistical supplies will be sent by cargo plane from Kinshasa to allow the team to immediately begin their intervention in Likati.” You can read more about the outbreak timeline here and check out this latest article on how the WHO is preparing to use the experimental vaccine.

Summer Workshop Instructor Spotlight: Andrew Kilianski
As we get closer to the July 17th start date for the Summer Workshop on Pandemics, Bioterrorism, and Global Health security, we’d like to show off some of the wonderful instructors. Dr. Kilianski is currently a GMU professor and biological scientists at the Depart of Defense. His work focuses on combating current and future threats from weapons of mass destruction in addition to teaching classes on biosurveillance and virology in the GMU Biodefense graduate program. Dr. Kilianski was previously a National Research Council fellow with the US Army at Edgewood Chemical Biological Center. During his tenure at ECBC, his research focused on biosurveillance and the identification and characterization of novel agents that threaten today’s warfighter. Dr. Kilianski’s research interests also included emerging viral pathogens and public health and biodefense policy, and he was selected as an Emerging Leaders in Biosecurity Initiative Fellow for 2015.  His research has been published in peer-reviewed journals such as PLoS Pathogens, Journal of Virology, and Emerging Infectious Diseases while also publishing multiple commentary and op-ed articles.  He received his Ph.D. in Microbiology and Immunology from Loyola University Chicago where his dissertation research involved uncoupling virus-host interactions important for coronavirus pathogenesis and developing antiviral compounds against emerging coronaviruses (SARS-CoV and MERS-CoV). During the workshop, Dr. Kilianski will be lecturing on biosurveillance and its role as an integral component of any biodefense strategy and how U.S. policy has mandated that such efforts be accelerated. He notes that “this construct, and how the US and international entities engage in biosurveillance will be covered, as well as how recent Ebola and Zika virus outbreaks have tested the system. Emerging technologies and their role in biosurveillance will also be reviewed. Finally, paths toward integrated biosurveillance for the US and international communities will presented for group discussion discussion.” Dr. Kilianski is a wonderful instructor and his lectures are both engaging and thought-provoking. Don’t miss out on the early-bird registration discount (10%) being offered until June 1st!

GMU Biodefense PhD Student’s Research Could Change Disease Response, Especially When Air Travel Is Involved
Have you ever wondered about the role of air travel during outbreaks? Nereyda Sevilla will be graduating this month with her PhD in biodefense after looking into this very issue. “She believes she has a way to change how authorities and the public respond to disease outbreaks perceived to be transmitted by air travel. If she’s right, it could potentially save billions of dollars in misdirected federal and state money and give millions of air passengers more precise information about infections.” A civilian aerospace physiologist for the Medical Research and Acquisitions Division in the Office of the Air Force Surgeon General, and all around biodefense fan, Nereyda focused her research on the role of air travel and the spread of disease. Utilizing outbreaks like SARS, H1N1, and Ebola, she looked at air travel as a potential incubator for disease transmission. “Sevilla pointed out that despite the numerous aircraft involved, no one became infected with Ebola on an airplane. And yet authorities spent billions on entry and exit screenings, which heightened fear among the general population. Sevilla used an open-source model to study what would happen during a possible future outbreak of pneumonic plague, an infectious lung disease that continues to rear its deadly head around the world. The model could be a game-changing tool, said her professor.” Nereyda says that she’s “found the airplane is not what’s going to get you infected with disease. You’re more likely to get sick from waiting in the boarding area next to some one with a cold.” You can also read this article she wrote regarding the open-source model. Nereyda is a great example of the diverse and passionate students within the GMU biodefense program and we’re excited to show off her amazing research and congratulate her on graduating!

Global Health and the Future Role of the United States
The National Academies of Science just released their report on global health and the role of the U.S. as a leader through efforts like PEPFAR (U.S. President’s Emergency Plan for AIDS Relief), etc. The U.S. has taken a major role in strengthening global health security, whether it be through efforts like the Global Fund to Fight AIDS, TB, and Malaria, or through collaborative international efforts to help strengthen national health systems like the Global Health Security Agenda. “However, resources are not unlimited, and the case for continued commitment must be made. Against the backdrop of the influential legacy of the United States on the global health stage, the new administration is now faced with the choice of whether or not to ensure that gains in global health—won with billions of U.S. dollars, years of dedication, and strong programs—are sustained and poised for further growth.” The report also notes that “approximately 284,000 deaths were attributed to the 2009 H1N1 influenza outbreak, for example, and 2 million excess deaths are projected for a future moderate influenza pandemic. In only a few short months in 2003, the outbreak of severe acute respiratory syndrome (SARS) cost the world $40–$54 billion, while in 2014, the United States alone committed $5.4 billion in response to the Ebola outbreak, $119 million of which was spent on domestic screening and follow-up of airline passengers.” Following a rigorous review, the committee established 14 recommendations that would aid in the delivery of a strong global health strategy and help the U.S. maintain its role as a leader in global health security. The 14 recommendations/actions are: improve international emergency response coordination, combat antimicrobial resistance, build public health capacity in low- and middle-income countries, envision the next generation of the President’s Emergency Plan for AIDS Relief, confront the threat of tuberculosis, sustain progress towards malaria elimination, improve survival in women and children, ensure healthy and productive lives for women and children, promote cardiovascular health and prevent cancer, accelerate the development of medical products, improve digital health infrastructure, transition investments toward global public goods, optimize resources through smart financing, and commit to continued global health leadership.

Would You Survive the Oregon Trail?
If you ever played the video game, you know the chances of making it through this covered-wagon adventure without snakebites, dysentery, or some other misery, were quite low. “The game, one of the earliest educational computer games to reach wide distribution, simulated a 1848 covered-wagon trip from Missouri through the wild frontier of the western US.” Diseases were common to those of us who ventured across the Oregon Trail, but now you can take a quiz to see just how much you really know about those historic bugs.

GAO Report: U.S. Needs To Do More To Prevent Possible Bird Flu Pandemic
A recent Government Accountability Office report is pointing out just how vulnerable the U.S. would be if faced with an avian influenza pandemic. The GAO report focused on three areas – how outbreaks of avian influenza have affected human and animal health, and the U.S. economy, the extent to which the USDA has taken actions to address lessons learned from outbreaks in 2014 and 2016, and the ongoing challenges federal agencies face in their efforts to reduce the potential harm of such an outbreak. The report comes at a crucial time as China is currently battling an outbreak of the deadly H7N9 strain. Within the report there are several findings: “Unless the agency is responding to an emergency, the Agriculture Department doesn’t have the authority to require poultry producers to take preventive biosecurity measures to keep avian influenza from spreading from farm to farm.” The report notes that the USDA has found lessons learned from its responses to previous events however, they have not established plans for evaluating if these corrective actions actually resolved the issues. The topics within the lessons learned include biosecurity, communication, continuity of business, diagnostics, etc. Simply put, while they identified problems and took corrective actions, there has been virtually no evaluation as to their efficacy. Another issue raised within the GAO report focuses on vaccination and the challenges of egg-based vaccine manufacturing. DHHS stockpiles vaccines supplied by four companies, however only one has a U.S.-based manufacturing facility for egg-based vaccines. “We identified two other issues that federal agencies face associated with mitigating the potential harmful effects of avian influenza. First, outbreaks of the disease threaten the poultry that produce the eggs used in the production of human pandemic influenza vaccine. Second, funding for a voluntary surveillance program that gathers data on influenza A viruses in swine that could pose a threat to human health will be exhausted in fiscal year 2017”. Overall, the USDA must focus more on evaluation and working towards preparedness to combat the growing threat.

Getting Our Hands on Older Antibiotics & The Broken Chain of Hospital Reporting
A recent article in Clinical Microbiology and Infection looked at the recommendations and availability regarding older antibiotics. Researchers found that these antibiotics are not universally available or marketed, which means that physicians have to use other, less optimal, antibiotics that are broad-spectrum. “For example, in the treatment of sore throat, amoxicillin is used instead of penicillin. Fluoroquinolones are used instead of nitrofurantoin, fosfomycin or pivmecillinam for the treatment of cystitis, and co-amoxiclav or cephalosporins for the treatment of skin and soft tissue infections instead of appropriate oral formulations of antistaphylococcal penicillins. Additionally, some old antibiotics such as temocillin or i.v. fosfomycin are valuable alternatives for the treatment of some resistant bacteria. The limited access to these old antibiotics is a threat to antibiotic stewardship.” “In 2011, the ESCMID Study Group for Antimicrobial stewardshiP (ESGAP) showed that 22 out of 33 old but potentially useful antibiotics were marketed in fewer than 20 of the 38 included countries in Europe, USA, Canada, and Australia; economic motives were the major reason for not marketing these antibiotics. ESGAP and the international network ReAct (Action on Antibiotic Resistance) updated this survey in 2015. The situation was worse than in 2011, with even fewer antibiotics available in the included countries.” As if the battle of the resistant bug wasn’t bad enough, it seems that hospitals and their federal oversight systems are failing. Hospital reporting and CMS (Centers for Medicare and Medicaid) validation of such data was recently found to be not only poor, but often inaccurate. GMU biodefense PhD student, Saskia Popescu, looks at the process for which hospitals report healthcare-associated infections and drug resistant organisms for reimbursement through CMS and just how broken the CMS data validation process actually is. “During their annual data evaluation, CMS is supposed to randomly select 400 participating hospitals and request samples of medical records to evaluate the clinical-process-of-care measures and HAI measures. Additionally, they are encouraged to look at a targeted sample of 200 additional hospitals based off a certain threshold, which would be if they failed validation the year before or submitted data after the CMS deadline. CMS has several selection criteria for this ‘targeted’ sample, which includes ‘threshold-based criteria’—hospitals that fail to report half of their HAI’s, late reporting, a new hospital, etc.—or, ‘analysis-based criteria’—abnormal or conflicting data patterns and a rapid change in data patterns. Unfortunately, the report shows that CMS failed to use these measures when they did this targeted sample review in 2016 (which looked at data from 2013/2014). During this review, CMS only selected 49 hospitals and none of these hospitals were chosen from this analysis-based criteria (ie, they were not looking for those with aberrant data patterns or suspicious changes in reporting).”

Stories You May Have Missed:

  • Operation Whitecoat Documentary– Don’t miss out on the June 1st release of the post-WWII documentary on Operation Whitecoat (1954-1973). “During the Cold War, more than 2,300 non-combatant conscientious objectors from the Seventh-day Adventist church volunteered to serve their country by participating in U. S. Army medical experiments focused on developing defensive medical countermeasures against the Soviet Union’s bio-warfare capabilities. These volunteers were exposed to experimental vaccines and infectious pathogens.Operation Whitecoat tells the story of these patriots–their commitment to both their religious principles and desire to serve in America’s defense, their courage to participate in these tests, and their contributions that went far beyond Army biodefense.”
  • How Plagues Help Scientists Puzzle Out the Past –I imagine bioarchaeologists as a mix between Indiana Jones and one of the researchers from Contagion – learning about the past to prevent future pandemics. Plagues and pandemics carry with them a lot of information – how society at the time handled it, health and wellness, medical care, etc. “The tragedy of mass causalities exposes lives that would, statistically, rarely be unearthed, including the adolescents and adults who form the bulk of a living population, so rarely represented in a cemetery. Calamities such as plague that knock everyone into the grave with one indiscriminate sweep are one of the few chances bioarchaeologists have to overcome something known as the Osteological Paradox, a term coined by researcher James Wood and colleagues to cover the very awkward point that, in studying past lives, the evidence bioarchaeologists actually have to go on are past deaths. “

 

 

Pandora Report 5.12.2017

TGIF and welcome to your favorite weekly dose of all things biodefense! Check out this film from PBS Digital Studios Brain Craft exploring the technical and ethical questions about CRISPR and genetic engineering.

The Growing Threat of Pandemics: Enhancing Domestic and International Biosecurity
The Bush School of Government and Public Service at Texas A&M University just released their new white paper on biosecurity measures. The paper highlights the increased threat of pandemics due to globalization and ease of transportation. In their review they found nine priority areas that will help address the current biodefense problem. Their priority areas/action items are leadership, international response, the anti-vaccine movement, animal and human health, uniform health screening, public health and healthcare infrastructure, effective outbreak response, cultural competency, and academic collaborations. The white paper notes that “there should be uniform health screenings for individuals seeking permanent or extended temporary residence in the United States. Currently, there are discrepancies between the vaccination requirements for immigrants and the vaccination requirements for refugees.” The inclusion of the anti-vaccination movement was particularly interesting as few reports truly capture this in regards to biodefense efforts. “The increasing influence of the anti-vaccine movement in the United States is another growing threat. Leaders of the movement spread misinformation to parents with questions or anxiety over the safety of vaccines. Many within the anti-vaccine movement incorrectly believe that vaccines cause autism and the number of individuals seeking nonmedical exemptions to the vaccination requirements of schools is on the rise.”

Pandemic Summer Workshop Sneak Peek 
We’re getting closer to the July 17-19 workshop on pandemics, bioterrorism, and global health security, which means that starting next week, we’ll be highlighting some of the amazing faculty teaching the courses. Make sure to look for our spotlight on Dr. Andy Kilianski in next week’s Pandora Report as we’ll be looking at his work on biosurveillance and its role within U.S. biodefense efforts! Make sure to take advantage of the early registration discount before June 1st!

2017 Infectious Disease Mapping Challenge
Don’t miss this wonderful chance to show off your infectious disease mapping skills! The Next Generation Global Health Security Network and DigitalGlobe Foundation are “seeking undergraduate and graduate students, in a team or individually, to generate up to three maps (one map is perfectly acceptable) that illustrate a research question related to any of the categories detailed below. Maps can be analytic (examining relationships between multiple domains, phenomena, or data sources) or descriptive (depicting a single phenomenon or data source). While analytic projects are ideal, descriptive projects will be accepted as long as students/teams describe why their map depicts a notable phenomenon. Similarly, while international maps are preferred, domestic maps will be accepted if the student/team can provide justification as to why a map focusing on the U.S. is necessary (e.g., U.S. data sets on a given topic are the most comprehensive).”

Scientists Take On HIV By Using CRISPR
Researchers have just made headway in the battle against HIV/AIDS by using the genome editing technology, CRISPR-Cas9. Current treatment for HIV involves anti-retrovirals, which are pretty harsh on the body and come with several nasty side effects. In their fight against HIV, the research team used the CRISPR technology like a pair of scissors to get rid of the HIV-1 DNA in the body of mice. “If you cut out the DNA, you stop the virus from being able to make copies of itself. The team is the first to show HIV can be completely annihilated from the body using CRISPR. And with impressive effect. After just one treatment, scientists were able to show the technique had successfully removed all traces of the infection within mouse organs and tissue.”

Public Interest Report – Chemical Weapons
Don’t miss the latest publication from the Federation of American Scientists, which includes several articles on chemical weapons. The Public Interest Report (PIR) is a great source for articles on human rights, counterterrorism, and more. The most recent edition includes articles on the threat of toxic chemicals, investigations regarding the chemical attacks in Syria, the value of scientific analysis of chemical weapons attacks, and more. The president of the Federation of American Scientists, Charles D. Ferguson, also wrote a special message regarding the value of scientific analysis, specifically in regards to chemical weapons attacks. He highlights several articles regarding chemical weapons attacks over the years, one of which includes an analysis of symptoms and potential agents used. This specific work includes analysis from GMU professor, Keith Ward, and highlights the use of chemical weapons in Darfur and Sudan and the limitations of NGO documentation of chemical warfare agents. The article points to the specific symptoms following chemical weapons attacks and notes that “NGOs find themselves at considerable disadvantage compared to national governments when faced with evaluating evidence of alleged attacks using chemical weapons.”

Could Saving Animals Prevent the Next Pandemic?
70% of emerging infectious diseases are zoonotic, meaning that some type of a spillover event had to occur. Ebola, HIV/AIDS, H1N1, and avian influenza are all examples of spillover that has resulted in human morbidity and mortality. The USAID PREDICT program is working to combat this growing threat of zoonotic diseases. PREDICT works to establish a global surveillance system for infectious diseases that can spillover into humans. PREDICT is a collaborative effort between the University of California at Davis’s One Health Institute and the School of Veterinary Medicine, as well as the Wildlife Conservation Society, Metabiota, EcoHealth Alliance, and the Smithsonian Institute’s Global Health Program. “In its first five years, PREDICT trained 2,500 government and medical personnel in 20 countries on things like the identification of zoonotic diseases and implementing effective reporting systems. They collected samples from 56,340 wild animals, using innovative techniques like leaving chew ropes for monkeys then collecting saliva afterwards. They also detected 815 novel viruses—more than all the viruses previously recognized in mammals by the International Committee on Taxonomy of Viruses.” One of the tools PREDICT uses for surveillance is to monitor animal health and diseases that are circulating in them. “When you disrupt an ecosystem by removing a species through culling, you have a less healthy ecosystem and higher risk of disease,” says Megan Vodzak, a research specialist for Smithsonian’s Global Health Program. “Sometimes you increase the level of the virus within the population because you eliminate some but not all of the animals, and they’re still circulating it.” This brings about a humbling notion – conservation and human health might go hand in hand. Some researchers note that by protecting wildlife, we can help prevent spillover events and outbreaks. This concept however, is a bit more complex and has many on the fence regarding the actual role of conservation in human diseases. Some work has found that increases in biodiversity have no impact on human health, emphasizing the murky water of those trying to sell conservation as a tool for fighting pandemics. “When researchers do embark on conservation projects, she cautions that they should also consider other possible outcomes besides the protective benefit humans get from healthy wildlife and ecosystems. ‘We have to recognize that conservation could provide benefits for public health and it could endanger public health,’.”

The Battle of the Resistant Bug
We often think of an infectious disease threat emerging from some hidden jungle or quiet spillover event. While these are are true scenarios, I offer one more – the moment a bacteria becomes resistant to antimicrobials. Whether it be related to over-use in farming or over prescribing in healthcare, this is often a forgotten battleground. We’ve become accustomed to the ease and availability of antibiotics, which has translated to increased and improper use. Antibiotic resistant has frequently been overshadowed by the flashier of infectious disease threats however, this is to our detriment. Antimicrobial resistance (AMR) has proven time and time again to not only be a devious adversary, but one that gets little attention. Research and development into new antibiotics has lagged in recent years, which has only compounded the issue. One of the issues is also the lack of coordinated international surveillance and response strategies. Interestingly, Russian scientists recently developed an interactive world map, which shows human gut microbiota and their potential for resistance. The ResistoMap (pretty outstanding name, right?) makes it easier to track national resistance trends and potentially create an international response plan. “Using the ResistoMap, it is possible to estimate the global variation of the resistance to different groups of antibiotics and explore the associations between specific drugs and clinical factors or other metadata. For instance, the Danish gut metagenomes tend to demonstrate the lowest resistome among the European groups, whereas the French samples have the highest levels, particularly of the fluoroquinolones, a group of broad-spectrum anti-bacterial drugs.” While the rise of an emerging infectious disease should not be ignored, it is important that we remember the slower burn of antimicrobial resistance. Even Alexander Fleming saw the future involving a world without effective antibiotics, as he noted just following his acceptance of the 1945 Nobel Prize, “The thoughtless person playing with penicillin treatment is morally responsible for the death of the man who succumbs to infection with the penicillin-resistant organism.”

Regional Action Needed to Prevent Syrian Chemical Weapons Attacks
GMU biodefense PhD alum, Daniel M. Gerstein, is focusing on the role regional actors could play with respect to Syria, especially in terms of dissuading the use of chemical weapons. Despite the horrific attack in early April, global response has been surprisingly tepid and Russian support is ongoing, but Gerstein also highlights the “deafening silence” on the issue by countries within the region. Pressure could be applied from surrounding countries to indicate a strong message that the use of such weapons will not be tolerated. “Borders with Syria could be sealed to prevent any of the re­maining stocks from leaving the country. This would likely require a mix of military, law enforcement and border police to ensure that any illicit crossings are immediate­ly halted. In the event that chemi­cal weapons do breach the Syrian border, response forces should be prepared to stop suspect ship­ments, conduct searches of cargo and have appropriate protection to avoid becoming casualties them­selves.” Gerstein also notes that regional leaders could direct efforts towards Assad specifically, making it clear that Syria’s future will not include him, by calling for the International Criminal Court to indict him for war crimes.”Over the past 15 years, the norms against the use of chemical weap­ons have continued to be threat­ened, with increasing state and non-state actor use. Most of these attacks have occurred in the Middle East. This trend cannot be allowed to continue.”

The Chemical Attack in Syria – Sorting Truth from Propaganda
Rod Barton takes us through the April chemical weapons attack in Syria and argues against those who claim it was a “false flag” operation, staged by rebels to draw the U.S. into further intervention efforts. The most notable proponents of this argument have been former MIT professor Theodore Postol and Sydney University professor, Tim Anderson. In efforts to help break the cycle of a false narrative, the U.S. has released intelligence reports however, those who support the “false flag” narrative continue to point to misinformation and confusion about the April 4th attack as evidence. Barton argues against the “false flag” narrative by highlighting several points as evidence for the attack – victims seeking medical care following a Syrian air strike with classic symptoms of nerve agent poisoning, analysis samples that confirmed sarin, and the air raid crater found in the road north of the town, which tested positive for sarin and hexamine. Postol, on the other hand, while continuing to claim that the U.S. intelligence reports fail to prove definitively that the attack was done by the Assad regime, does not argue that it was sarin that killed the people in Khan Sheikhoun. “His case is largely based on the nature of distortion of the metal fragment in the crater – he claims this proves that it was not dropped from an aircraft, as stated by US intelligence. His theory is that a sarin-filled tube, possibly a 122mm artillery rocket body, was placed on the road by individuals on the ground and overlaid with a small explosive charge to disperse the agent.” Barton argues against Postol’s comments for several reasons – Postol fails to explain the origin of the sarin in the tubes, how the rebel groups managed to coordinate the detonation of their device with that of a Syrian government air raid, and that Postol fails to account for the evidence of a second chemical round that detonated around 300m from the road crater. Barton notes that “Postol was an eminent scientist and his views cannot simply be ignored. However, on this occasion the evidence to support his argument is not there – he has got it wrong. His writings on this subject have nevertheless been useful in that they have forced analysts to question the evidence closely to determine their degree of certainty in their assessments. But while the particulars are difficult to ascertain, there is still sufficient evidence to state beyond reasonable doubt that the Syrian military is responsible for the attack. In other words, the jury should convict – sadly, in today’s world, the reality may be different.”

Stories You May Have Missed:

  • 3-D Structures vs. Infectious Diseases– Northwestern University Feinberg School of Medicine is leading a team of international researchers to determine the 3-D atomic structure of more than 1,000 proteins to help develop treatments and vaccines against infectious diseases. “Almost 50 percent of the structures that we have deposited in the Protein Data Bank are proteins that were requested by scientific investigators from around the world,” said Wayne Anderson, PhD, professor of Biochemistry and Molecular Genetics at Feinberg, and director of the project. “The NIH has also requested us to work on proteins for potential drug targets or vaccine candidates for many diseases, such as the Ebola virus, the Zika virus and antibiotic-resistant bacteria. We have determined several key structures from these priority organisms and published the results in high-impact journals such as Nature and Cell.”
  • The Million Dollar Minnesota Measles Outbreak – the growing measles outbreak in Minnesota is projected to cost the state $1 million and is quickly growing. “When it began last month, public health officials knew this outbreak could be large and ongoing, because many Somali-Americans have been refusing the measles, mumps, and rubella (MMR) vaccine for years over unfounded rumors that the childhood immunization, whose first dose is routinely given to babies at 12 to 15 months, causes autism.” Sadly, the vaccination declinations in the Somali-Americans in Minnesota are considered to have been a result of targeting from anti-vaccine groups.

Pandora Report 5.5.2017

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

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

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

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

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

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

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

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

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

Stories You May have Missed:

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

Pandora Report 3.24.2017

Welcome to the start of the weekend and World TB Day! The WHO estimates that just in 2015, 1/3 of people with TB missed out on quality care and 480,000 people developed multidrug-resistant TB.

Public Health Concerns in Trump’s New Budget
President Trump’s newly released proposed budget blueprint makes drastic cuts to many programs, of which, one of the hardest hit is HHS. On top of the cuts to science and public health, there is something buried within the budget that is concerning ex-CDC director, Dr. Tom Frieden. Frieden worries about the proposal to award block grants to states, which would allow them to decide how to respond to public health issues (think Ebola, Zika, etc.). “That proposal is ‘a really bad idea,’ according to Dr. Tom Frieden, who until this past January was director of the U.S. Centers for Disease Control and Prevention. Currently, the CDC experts work with state and local governments to devise evidence-based plans to respond to public health issues, such as foodborne and infectious disease outbreaks. With a block grant, states can use the federal money to replace their own spending in certain areas or spend the money unwisely, ‘and never have to report what they have done or be held accountable for it,’ Frieden said.” A withdrawal of one fifth of NIH’s budget would mean a deep slash to biomedical and science research funding.  These cuts will also impact foreign aid, which has many worried about the role of public health interventions in foreign countries. Bill Gates recently talked to TIME magazine regarding the safety implications of cutting foreign aid. “I understand why some Americans watch their tax dollars going overseas and wonder why we’re not spending them at home. Here’s my answer: These projects keep Americans safe. And by promoting health, security and economic opportunity, they stabilize vulnerable parts of the world.” Gates points to the role of overseas public health work like polio eradication, Ebola outbreak response, and America’s global HIV/AIDS effort (PEPFAR), which points to the stabilizing role that strengthening public health can have in a country.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
From Anthrax to Zika, we’ve got the place to be in July for all things biodefense. This three-day workshop will provide you with not only seminars from experts in the field, but also discussions with others interested in biodefense. You can check out the flyer and register for the event here. The best part is that we’re doing an early-bird registration discount of 10% if you sign up before May 1st. A returning participant, GMU student/alumni, or have a group of three or more? You’re eligible for an additional discount! Check out the website to get the scoop on all our expert instructors and the range of topics the workshop will be covering.

Unseen Enemy Documentary 
Mark your calendars for this upcoming infectious documentary on the lurking pandemics that worry experts. Airing on April 7th, Unseen Enemy will follow researchers looking for the early warning signs of diseases that could cause the next pandemic. The National Academy of Medicine will be hosting a special D.C. premiere of the film on April 2nd, that you can even attend.

Expert Views on Biological Threat Characterization for the U.S. Government: A Delphi Study 
Biological threat characterization (BTC) is mixed bag of risk and reward. The laboratory research involving deadly pathogens as a means for biodefense can translate to better risk assessments but also the potential for biosafety failures. To better address this issue, researchers performed a Delphi study to gather opinions from experts around the country. “Delphi participants were asked to give their opinions about the need for BTC research by the U.S. government (USG); risks of conducting this research; rules or guidelines that should be in place to ensure that the work is safe and accurate; components of an effective review and prioritization process; rules for when characterization of a pathogen can be discontinued; and recommendations about who in the USG should be responsible for BTC prioritization decisions.” Following their assessment, the researchers found that experts agree that BTC research is necessary, but there is also a need for continued oversight and review of the research to reduce as much risk as possible. “It also demonstrates the need for further discussion of what would constitute a ‘red line’ for biothreat characterization research—research that should not be performed for safety, ethical, or practical reasons—and guidelines for when there is sufficient research in a given topic area so that the research can be considered completed.”

GMU Schar School PhD Info Session
If you love global health security and have been wanting to further your education, come check out our PhD info session next Wednesday, March 29th at 7pm in Arlington. You can come learn about our biodefense PhD program from the director, Dr. Koblentz, and hear from several students about their experiences. The info session is a great way to find out what a GMU Schar PhD entails, the application process, and what current students think!

What Biosecurity and Cybersecurity Research Have In Common
Kendall Hoyt is looking at the similarities between these two research fields and how work into the unknown can often expose and create vulnerabilities. Did I mention Kendall is one of the instructors at our biodefense Summer Workshop? Hoyt provides two examples to really hone in on this point – to defend against a dangerous pathogen, we have to isolate and grow it to try and develop treatment or a vaccine and to defend against a cyberattack, we need to know how to break into the computer system. That whole dual-use dilemma creates a lot of risk-versus-reward scenarios for biosecurity and cybersecurity researchers. While the research is highly relevant and necessary, government efforts to control or maintain oversight have been challenging. Do we pull back the reigns on innovation or run the risk of a security breach or a big “whoops” moment? “Intellectual property and cybersecurity legislation—namely the Digital Millennium Copyright Act and the Computer Fraud and Abuse Act—has similarly stifled legitimate scientific and commercial activities and delayed defensive applications. In one well-known example, fear of prosecution under DMCA deterred a Princeton graduate student from reporting a problem that he discovered: Unbeknownst to users, Sony BMG music CDs were installing spyware on their laptops.” Hoyt also points out the biosecurity efforts that have begun looking not just at the pathogens and publications, but the laboratory techniques that are used for such research. Certain experiments (like gain of function work) have the capacity to increase transmissibility or host range. “For all of their similarities, key differences between biosecurity and cybersecurity risks and timelines will dictate varied regulatory strategies. For example, zero-day exploits—that is, holes in a system unknown to the software creator—can be patched in a matter of months, whereas new drugs and vaccines can take decades to develop. Digital vulnerabilities have a shorter half-life than biological threats. Measures to promote disclosures and crowd-sourced problem-solving will therefore have a larger immediate impact on cybersecurity. Still, both fields face the same basic problem: There are no true ‘choke points’ in either field. The U.S. government is not the only source of research funds and, thanks in large part to the internet itself, it is increasingly difficult to restrict sensitive information.” In the end, Hoyt notes that both fields and their regulations will need to relax the governance process and be a bit more flexible and mobile with how they control items. Both fields are constantly evolving, which means regulators need to be just as fluid.

How To Prepare For A Pandemic
NPR decided to create a “Pandemic Preparedness Kit” based off the continuous questions related to the ongoing news of increasing infectious disease threats but little info in terms of practical things people can do. While these aren’t things you can go out and buy for your home, the list hits close to home in terms of things we should be focusing our efforts and funding on. Firstly, vaccines. This is a no brainer and yet, we’ve become the habitual users of the theme “create it when we’re struggling to contain an outbreak”. Secondly, virus knowledge. “One of your best weapons during a disease outbreak is knowledge, says Dr. Jonathan Temte of the University of Wisconsin. ‘Keep up with the news and try to understand what threats might be out there,’ he says. For example, new types of influenza are one of the biggest threats right now — in terms of pandemic potential, Temte says. But if you know how to protect yourself from one type of influenza, you can protect yourself from all of them.” Lastly, and my personal favorite, is very clean hands. While every disease is different, one of the most basic and fundamental truths for infection prevention and control is hand hygiene. These three are solid ways to better prepare for future outbreaks, pandemics, emerging infectious diseases, and just about anything infectious that makes you a bit worried.

CARB-X MissionWhen I first read the name of this group, I thought it was some kind of fitness fuel, but I was pleasantly surprised to see this initiative is working to fight antibiotic resistance. CARB-X is a collaboration between NIAID and BARDA to help accelerate the development of antibacterials over the next 25 years. The goal is to help combat antimicrobial resistance through a diverse portfolio and partnership. Make sure not to miss their March 30th meeting from 11am-noon on antibiotic resistance. “CARB-X (Combating Antibiotic Resistant Bacteria Accelerator) was launched in August 2016 to accelerate pre-clinical product development in the area of antibiotic-resistant infections, one of the world’s greatest health threats. CARB-X was established by BARDA and NIAID of the U.S. Department of Health and Human Services along with Wellcome Trust, a global charitable foundation dedicated to improving health. This partnership has committed $450 million in new funds over the next five years to increase the number of antibacterial products in the drug-development pipeline.” While CARB-X may not be the latest workout supplement, it’s definitely a boost to performance in the fight against antimicrobial resistance.

New Roles and Missions Commission on DHS Is Urgently Needed
GMU biodefense PhD alum, Daniel Gerstein, is looking at DHS and pointing to the need for a Roles and Missions Commission. It’s been almost 15 years since DHS was created under rapid and urgent circumstances, which means that it’s time to look introspectively. “More generally, a roles and missions review could also examine whether the department is properly resourced for all its missions. For example, a joint requirement council was recently established for the department composed of less than 10 government civilians. Is this adequate for supporting requirements development activities for a department of over 240,000 personnel?” Gerstein looks at some of the big issues that require a comprehensive review, like centralization versus decentralization, management of R&D and engineering, and critical infrastructure issues related to national security and safety. Another component needing review is the human factors issue that impacts homeland security. How are the relationships between departments, with state and local authorities, or with the public? “The effort should not necessarily be viewed as a requirement for change, but rather an opportunity to reexamine DHS and its relations with the rest of government, the nation and its citizens, and even with our international partners across the globe. Finally, a homeland security roles and mission commission would be an ideal lead-in to a much needed update to the original 2002 authorizing legislation.”

Deadliest Enemy: Our War Against Killer Germs
Don’t miss this event on Thursday, March 30th, hosted by New America with speakers Michael T. Osterholm and Mark Olshaker. “In today’s world, it is easier than ever for people and material to move around the planet, but at the same time it is easier than ever for diseases to move as well. Outbreaks of Ebola, MERS, yellow fever, and Zika have laid bare the world’s unpreparedness to deal with the threat from infectious diseases. In Deadliest Enemy: Our War Against Killer Germs Dr. Michael Osterholm and Mark Olshaker marshal the latest medical science, case studies, and policy research to examine this critical challenge.”

Stories You May Have Missed:

  • The Feds Are Spending Millions to Help You Survive Nuclear War – North Korea’s recent firing of four ballistic missiles from Pyongyang into the ocean off Japan’s coast has brought back worries of nuclear attacks. While the days of stocking a bomb shelter are in the past, the U.S. government isn’t slowing down efforts to protect Americans. “Over the last ten years the US has poured millions of dollars into technologies and treatments it hopes to never have to use, but could, in the event of a nuclear catastrophe. From assays that measure radiation exposure to cell therapies that restore dwindling blood cells to liquid spray skin grafts, government officials are now far better equipped to deal with diagnosing and treating people if the unthinkable were to happen. And the next generation of treatments are being funded right now.” DHHS projects like BARDA and Project BioShield are just some of the sources for ongoing research to strengthen protection, whether it be a nuclear blast or reactor melt-down.
  • Disinfection and the Rise of the Superbug – GMU biodefense PhD student Saskia Popescu is addressing the growing disinfection needs as we teeter on the edge of the antibiotic abyss. Disinfection is already a challenge in healthcare however, the rise of more resistant germs means that efforts often need to be ramped up. The recent influx of Candida auris infections that we talked about last week really brings this issue to point in that this emerging infection is difficult to get rid of via traditional disinfection routes. “As new organisms are identified and existing ones become resistant to antimicrobials, the availability of strong disinfecting products has become even more pivotal.”
  • China and EU Cut Brazilian Meat Imports Amid Scandal– If you’re a fan of importing Brazilian meat, you may have to hold off for a while. A recent police anti-corruption probe is accusing inspectors of taking bribes to allow the sale of rotten and salmonella-contaminated meats from the largest exporter of beef and poultry. As the news unfolds, the Brazilian government is criticizing gate police as alarmist. “As the scandal deepened, Brazil’s Agriculture Minister Blairo Maggi said the government had suspended exports from 21 meat processing units.”
  • Study on Interferon for Treatment of Ebola Infection – The common hepatitis treatment is now being tested out on Ebola patients to help alleviate their symptoms. The pilot study was performed from March-June of 2015 and  had some interesting results. “When compared to patients who received supportive treatment only, 67 per cent of the interferon-treated patients were still alive at 21 days in contrast to 19 per cent of the former patients. Additionally, the viral blood clearance was faster in those patients treated with Interferon ß-1a. Many clinical symptoms such as abdominal pain, vomiting, nausea and diarrhea were also relieved earlier in the interferon-treated patients. A further 17 patients in other Guinean treatment centres who matched the interferon-treated patients based on age and the amount of Ebola virus in their blood were included in the analysis. These added patients, who did not receive interferon, more than doubled their risk of dying as a result of not being treated with the drug.”

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: 2.10.2017

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

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

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

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

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

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

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

Stories You May Have Missed:

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

 

 

Pandora Report 12.23.2016

microbiallsnowmanHappy Holidays from your friends at the Pandora Report and GMU Biodefense! If you’re starting a New Year’s resolutions list for things to improve, it sounds like you’ve got company – the WHO is rethinking how it responds to outbreaks.

The Grim Forecast of Antimicrobial Resistance 
In the wake of the growing threat of antimicrobial resistance, it seems that the worried voices are getting louder but the barriers are growing higher. The return to colistin use points to a growing desperation as physicians are forced to use antibiotics that were previously avoided due to such harsh side effects. Many hospitals have shared their tales of MDRO outbreaks – some stopping as mysteriously as they began, while others have clear culprits. Some hospitals have even begun initiating isolation for any patient who was hospitalized abroad within the last couple of years. It’s also becoming increasingly common for hospitals to pre-emptively test patients via MDRO screening to more rapidly isolate them. The concern is also that few truly new antibiotics have been developed in recent years. “Thirty-seven antibiotics are currently undergoing clinical trials, according to the Pew Charitable Trusts, which keeps track of the U.S. pipeline. Most, however, are based on existing drugs. While these derivatives are cheaper and easier to develop than new classes of drugs, bacteria have a head start in developing resistance to them.Further, most drugs in the pipeline target so-called Gram-positive bacteria, a group that includes the well-known superbug methicillin-resistant Staphylococcus aureus (MRSA). But recently, the main emerging threats have come from the group known as Gram negatives, which are harder to treat because they are encased in tough membranes that repel many drugs.” Many are pointing to a tipping point in 2017 – antibiotics will be consumed by farm animals more than humans worldwide. The UN General Assembly is calling for countries to start getting smart in terms of antibiotic usage but hasn’t set specific goals. Sadly, it seems that there aren’t many more ways this impending reality can be shared – data, shocking titles, future predictions, etc. Check out this factsheet on the use of antibiotics in agriculture and why it impacts resistance. The report has some great suggestions for future work, like refining antibiotic labels and working to collect and report better data. Here’s a spot of good news in this dismal truth – the FDA has just cleared a new one-hour MRSA test to help rapidly identify the lead bug in healthcare-associated infections.

Homeland Biodefense: Science & Technology Capability Review
Just in time for the holidays, it’s like the National Science and Technology Council just knew what biodefense geeks wanted. This report is the product of a comprehensive review of U.S biodefense capabilities, which aided in the prioritization of S&T issues to better strengthen response. The end result is a product of two phases- stage 1: “The goal of this activity was to identify S&T needs articulated by Federal subject matter experts including both science program managers and agency officials in charge of operational programs, to elicit feedback on where additional S&T investments could address operational needs.” Stage 2: “The goal of this activity was to provide coordinated interagency feedback on which needs represent the highest priority to the interagency working group, and to identify which Department or Agency should recommend or coordinate on actions to respond to each of those priority needs.” Scenarios were limited to a handful of events like aerosolized anthrax, avian influenza outbreak (possibly deliberate), food-borne attacks, etc. Perhaps some of the most notable findings were the need to improve abilities to systematically assess how much risk has been mitigated by biodefense investments, understand the impact of bioattacks on companion animals and wildlife, several deficiencies in regards to technical staff and lab infrastructure, etc.

Greek Food Terrorism Threats 
Member of an eco-anarchy group in Greece, FAI/IRF, are announcing their threats for food terrorism over the holiday. The time frame for attacks is December 22nd – January 5th, 2017 and the group has said that their focus is on causing economic disruption, not poisoning people. FAI/IRF has shown their process for poisoning various food and beverage items as their targets include Coca-Cola, Nestle, Unilever, and Delta. Many of these companies have chosen to withdraw specific products from an area in Greece. The group has shown how they can poison foods/beverages with chlorine and hydrochloric acid while leaving the packaging in place. “The four companies that withdrew products were named in the FAI/IRF statements. The eco-anarchists claim to be opposed to both capitalism and Marxism. They contend in their statement that Coke profits from ‘forced labor’ in China and Nestle is ‘held responsible’ for the death of 1.5 million children in the third world. No substantiation was provided for either claim.”

80140100189470lThe Commandant’s Reading List 
In the latest Army Chemical Review (Professional Bulletin of the Chemical Corps) you can find the Commandant’s Reading Program, compiled by Lieutenant Colonel James P. Harrell, which contains a great assortment of books to add to your reading list (or last minute shopping list!). From Laurie Garrett’s The Coming Plague to Michael Oldstone’s Viruses, Plagues, & History, you can pick up some top CBW books. GMU Biodefense’s very own director and professor, Gregory Koblentz, had his book, Living Weapons: Biological Warfare and International Security, make this list, so make sure not to miss it!

Test Driving Genetically Engineered Mosquitoes
Take a tour through the world of genetically engineered mosquitoes at Imperial College London with genetic engineer, Andrew Hammond. What makes these particular mosquitoes especially unique is the use of gene drive to ensure virtually all offspring acquire the desired effects. “Hammond’s team is genetically engineering the Anopheles gambiae mosquito, which is the primary species that spreads the malaria parasite. Nearly all of the offspring of the modified mosquitoes inherit mutations that knock out the genes females need to make eggs. ‘If we can sterilize the females,’ he says, we ‘can actually eliminate a whole mosquito population without affecting those mosquitoes that don’t have the capability to transmit malaria’.” Hammond gives a great tour of the process for creating gene-drive mosquitoes while discussing the dangers of gene drive and genetic engineering. While there is a wealth of opportunity to do good with tools like CRISPR, there’s also the concern that there could be unintended consequences or events we can’t even imagine. To combat the potential risks, there are also research teams working to keep CRISPR in check.  “A team of scientists that previously identified genes within bacteriophage genomes that code for anti-CRISPR proteins has now discovered phages that harbor an antidote to the Cas9 enzyme that is a key component of the predominant CRISPR system that is today used as a gene-editing tool. The team, led by the University of Toronto’s Alan Davidson, described three bacteriophage-encoded, anti–Cas9 genes and showed that the corresponding proteins are able to block the activity of CRISPR-Cas9—derived from bacterial type II CRISPR-Cas systems—in human cells.”

FEMA’s Ricin Mishap 
Going through the Center for Domestic Preparedness (CDP) training a few years back was a fascinating experience – how many times do you get to train with ricin or anthrax and then move into a pandemic preparedness exercise? For this biodefense student, that’s what I call a good time! Sadly, CDP just announced their entry into the club of biosafety failures. The facility is blaming an outside lab for shipping the wrong form of ricin powder…since 2011. “The training center says it submitted order forms asking for a type of ricin extract that is unlikely to cause serious harm. But officials from Toxin Technology, the Florida company that sent nine shipments to the center since 2011, told USA TODAY that its ricin products were all accurately labeled as ‘RCA60’ – a scientific name for the whole ricin toxin, which can be deadly. It’s unclear why training center staff didn’t recognize for years that they were working with a far more dangerous substance.” The news broke late last week and on Saturday, I received an email from CDP regarding the suspension of those classes and some comments on the incident. Here are some of the highlights:
-In November 2016, while making a purchase of ricin A-chain for training, CDP staff recognized an ongoing discrepancy in the documentation related to the type of ricin being provided. The vendor has now said the more toxic holotoxin version of the materials was provided since 2011. It was previously believed that all remaining ricin on campus had been destroyed. This week, it became known that, while CDP had indeed destroyed all of the ricin in question, additional ricin training material, a solution marked A-chain remains securely stored on the premises. This material was not received from the vendor in question and we are working with the appropriate authorities to safely dispose of the additional ricin material.
-As an example, the protective gear you wore exceeded what would be required for working with ricin slurry.  Students who trained with the agent were in full Level C personal protective equipment at all times when training.  We have no indication that students were exposed directly to the holotoxin or harmed by it.

Zika Outbreak Updates
Not surprisingly, researchers are pointing to the impacts of climate change on infectious diseases. Recently, many have noted the role of climate change and El Niño on laying the groundwork for Zika to spread so quickly and proficiently throughout South America. A new study describes interworking of the virus and the mechanisms it utilizes for damage in pregnant women and developing babies. The CDC has reported 4,756 cases in the U.S. as of December 21st.

Stories You May Have Missed:

  • Public Health Preparedness Assessment for Each State – The Trust For America’s Health assessment was just released for each state based on 10 indicators for preparedness. Sadly, it seems that most states are not prepared for disaster. Twenty-six states and Washington, D.C. scored a six or lower on the indicators for public health preparedness. “The most striking are gaps in the ability of the health care system to care for a mass influx of patients during a major outbreak or attack and lack of a coordinated biosurveillance system. ‘Biosurveillance does remain a major ongoing gap,’ Segal said. Given all the recent technological advances, there is the potential for a ‘near real-time’ surveillance system to detect outbreaks and to track containment effort, yet the dream eludes our government, she said.”
  • How A Pandemic Might Play Out Under Trump – The Atlantic’s Ed Yong is looking at how the incoming administration will handle the growing threat of emerging infectious diseases. Outbreaks can make or break leaders and often are canaries in the coal mine for systemic weaknesses. “They demand diplomacy, decisiveness, leadership, humility, and expertise—and they quickly unearth any lack of the same. ‘As far as I can tell, Trump has zero experience on this,’ says Jack Chow from Carnegie Mellon University, who has worked at both the World Health Organization (WHO) and the State Department under Colin Powell. ‘If I asked him, ‘What is your stance on global health?,’ I don’t know what he’d say. I don’t think anyone really does’.”

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: 7.29.2016

Happy Friday! With the Olympics right around the corner, there’s a lot of buzz surrounding the games (not just Aedes mosquitoes) and the athlete living quarters. Make sure to watch the PBS special, “Spillover- Zika, Ebola & Beyond“, on August 3rd at 10/9c. The special will look at the rise of spillover diseases like Nipah and the impact of human behavior on the spread of zoonotic diseases. The Society for Healthcare Epidemiology of America (SHEA) reported a new study that finds three key factors increase the risk for patient-to-patient transmission of the extremely resistant CP-CRE. The Democratic National Convention closed last night and Hilary Clinton made it a point to say, “I believe in science”, which highlights  the stark differences between the candidates on topics like climate change and stem cell research. 

What Damage Could CRISPR Do To The BWC?
Daniel Gerstein points to the approaching Eighth Review Conference of the Biological Weapons Convention and the assessment of new technologies, like CRISPR. Since James R. Clapper, Director of National Intelligence, stated that genome editing is a global danger, many are waiting to see what the convention will say about the future threats of technologies like CRISPR. Gerstein notes that, “if the seven previous review conferences are any indication, the gathering in November will recognize Crispr’s contribution to the biotech field, then enthusiastically declare the convention fit to address any problems it might create. But will that be enough?” The flexible nature of the convention is meant to support the ever-changing world of science and technology, however this also means that any potential bans on experiments are that much more challenging. In his article, Gerstein discusses the assessment of CRISPR as a nonproliferation threat and the risks associated with limiting technological innovation. Despite the challenges of banning certain biotechnologies, there are things that can still be done within the conference. Surveillance and training are imperative, especially in terms of “spotting the development of new pathogens or the modification of existing ones”, and national responsibility needs to be part of this equation. Gerstein’s points on not just national implementation, but also national responsibility emphasizes the transition from a traditional method into an emphasis on people and activities. Practices need to match the pace of biotech development, which means expanding the Implementation Support Unit, strengthening surveillance capabilities, and reinforcing institutional structures. “Those gathering at the review conference in November must seriously consider whether advances in biotechnology have made the existing bioweapons convention obsolete, but they must also ask what more the convention can do, as the reigning body for regulating biological weapons, to ensure that new biotechnologies continue to be used for peaceful purposes only.”

Half of Americans Say Infectious Disease Threats Are Growing  

Courtesy of Pew Research Center
Courtesy of Pew Research Center

The Pew Research Center conducted a recent survey in the wake of the very public Zika virus outbreak. While some may have noted that Americans aren’t as worried about Zika, the survey found that 51% of U.S. adults feel that, compared to 20 years ago, there are more infectious diseases threats to health today. 82% of Americans polled stated that they pay at least some attention to the news regarding infectious disease outbreaks and 58% believe that Zika is a major threat to the health of women who are pregnant. 31% believe that Zika is a major threat to the U.S. population as a whole, while 58% felt it was a minor threat. The poll also found that more people had heard of Ebola at the time of the 2014 outbreak than Zika as a problem right now. Broken down by demographics, those most worried about Zika include older adults, especially women.

Containment: Lessons Learned and Cringe-Worthy Moments2015_0326_Biohazard_Suits
Tuesday nights won’t be the same since Containment ended – what will we do without the asymptomatic super-spreaders like Thomas, the overly gory hemorrhaging, or the suspension of infection prevention practices? Like any science-based show, there are moments of accuracy and moments of pure dramatic exaggeration. Check out our list of the things we enjoyed about the show and some of the more eye-rolling moments. While it’s rare to have a prime-time show involving an outbreak, we’re hoping that the future will hold more scientifically accurate series that will dismantle the hysteria we too often see during public health emergencies.

Australia Utilizes Bioterrorism Algorithm to Predict Flu Outbreaks
Victoria’s health department is currently using a tool, EpiDefend, that can “accurately predict flu outbreaks up to eight weeks in advance.” Combining environmental data, lab results, and more, the tool is funded by the US Department of Defense and designed by the Australian Department of Science and Technology (DST) to aid in Australian disease prediction practices and strengthen global bio-surveillance. ”Our team’s goal is dual-purpose, we want to fulfil our defence charter, protecting our forces against intentionally released biological agents; but disease forecasting will also support the national security and public health areas,” said Tony Lau, defence scientist. EpiDefend incorporates electronic health records (EHR) via the healthcare sector, which means it can be especially powerful, but also requires the presence and reliability of EHR. The system uses an algorithm that is still being refined. “Particle filtering is a technique which helps us close in on the degree of uncertainty by the help of information gathered from particular situation. In other words, it helps the algorithm churn out more precise readings.”

Zika Virus
The Department of Health and Human Services (HHS) has published a webpage on what you need to know about Zika virus. A recent study is estimating that as many as 1.65 million women in Latin American could be infected while pregnant. Researchers, from another study published in the Annals of Internal Medicine, are pointing to a low risk for international Zika spread from the 2016 Olympics in Brazil.  Researchers calculated “the worst-case estimates of travel-associated Zika virus by assuming visitors encounter the same infections exposures as local residents. This is highly unlikely, as visitors would be staying in screened and air-conditioned accommodations, as well as taking personal preventive measures. But under the authors’ pessimistic conditions, they estimate an individual traveler’s probability to acquire infection in Rio de Janeiro is quite low. Specifically, they estimate anywhere from 6 to 80 total infections with between and one and 16 of those infected experiencing any symptoms.” Florida officials announced the investigation of another two potential cases of local-transmission. These new cases have pushed the FDA to curb blood collection in Florida. A new study performed a real-time Zika risk assessment in the U.S, suggesting that 21 Texas counties along the Texas-Mexico border, the Houston Metro area, and throughout the I-35 corridor (San Antonio to Waco) have the greatest risk for sustained transmission. As of July 27th, the CDC has reported 1,658 cases of Zika in the U.S. 

Stories You May Have Missed: 

  • CSIS Curated Conversations on Pandemic Preparedness & the World Bank – The Center for Strategic & International Studies has made its Curated Conversations podcast available on iTunes, which means you can check out the June 3rd episode, “the World Bank President on Preventing the Next Pandemic”. The World Bank Group president, Jim long Kim, discusses funding to help prevent the next pandemic and lessons learned from Ebola.
  • Joint West Africa Biopreparedness Efforts – The DOD is investing in the Joint West Africa Research Group to help improve and sustain biopreparedness within the region. Following the Ebola outbreak, this new program will build upon existing programs and strengthen lab and clinical resources, as well as biosurveillance efforts.
  • Yellow Fever in the Americas? The Pan American Health Organization is currently investigating a case of yellow fever in a man who traveled to Angola. Genetic testing is underway, but there is concern that the virus could ramp up in the Americas during a vaccine shortage.

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.”