Pandora Report 11.16.2018

We’re back from the 5th Ministerial Meeting of the Global Health Security Agenda (GHSA)! We’ll be reporting out on this event in the coming weeks, so keep an eye out for all things GHSA. Influenza season is ramping up and you’ll want to check out the latest article on looking beyond the decade of vaccines.

Preventing Pandemics and Bioterrorism: Past, Present, and Future
We’re just weeks away from this exciting event – are you registered? Preventing Pandemics and Bioterrorism: Past, Present, and Future is a special event in celebration of the 15th anniversary of the George Mason University Biodefense Program at the Schar School of Policy and Government. We invite you to attend this exciting opportunity to hear from Dr. Kadlec of ASPR about lessons learned for pandemic preparedness since the 1918-1919 influenza pandemic, plans for implementing the new National Biodefense Strategy, and the importance of education for the future of biodefense. Following his speech and Q&A session, you are invited to an informal reception for academic and professional members of the biodefense community to socialize and network. Make sure to RSVP soon as seats are limited for this December 4th event.

Russian Disinformation & the Georgian “Lab of Death”
A recent BBC investigation has found some disturbing information regarding Russian media making false claims about a U.S.-funded lab in Georgia. “The Russian Foreign Ministry, Defence Ministry and pro-Kremlin media claimed recently that untested drugs were given to Georgian citizens at the lab, resulting in a large number of deaths. The US has accused Russia of disinformation in order to distract attention away from incidents such as the Salisbury poisonings.” This episode is part of a series the BBC is providing on disinformation and fake news.

Ebola Outbreak Updates
The Ebola virus disease outbreak in the DRC continues to grow. 15 cases were reported on Monday as well as another violent attack in Beni. “WHO Director-General Tedros Adhanom Ghebreyesus, PhD, said on Twitter that he had been briefed on a violent attack that occurred in Beni on the night of Nov 10. ‘All WHO staff safe, but my heart goes out to families who have lost loved ones in this appalling and unacceptable attack, which we condemn in the strongest terms,’ he wrote. According to a local media report translated and posted by H5N1 Blog, which focuses on infectious disease news, at least five civilians were killed and several children kidnapped in an attack by rebels with the Allied Democratic Forces (ADF) in Beni’s Mayimoya district. The report said two other people were killed in two other attacks the same day in Beni’s Runwenzori neighborhood, one linked to ADF rebels and the other by suspected Mai Mai militia members.” The latest situation report lists 333 cases and 209 deaths, with 31 new confirmed cases reported during the reporting period (Nov 5-11). Early this morning, the DRC announced three more cases and 1 death. Health officials are also reportedly planning to launch a clinical trial of three antibody treatments and an antiviral drug, within the area. These drugs are currently in utilization in the Ebola treatment centers within the area but only under compassionate use. The UK is contributing funds to help Uganda step up prevention and preparedness efforts as well. “On a recent visit to The Medical Research Council/Uganda Virus Research Institute (URVI) and the London School of Hygiene and Tropical Medicine Research Unit in Entebbe, UK Minister for Africa Harriett Baldwin announced that the UK will support Uganda’s National Task Force with up to £5.1 million ($6.6 million USD) to support Ebola preparedness and prevention efforts in Uganda. This funding will support surveillance in high-risk districts at the border with the Democratic Republic of Congo (DRC); risk reduction communication in communities; infection prevention and control measures as well as provide for improved case management.” Peter Salama, WHO Emergency Response Chief, has noted that the outbreak could last another six months – “It’s very hard to predict timeframes in an outbreak as complicated as this with so many variables that are outside our control, but certainly we’re planning on at least another six months before we can declare this outbreak over,”.

ELBI Fellowship Application Opens
The Emerging Leader for Biosecurity Initiative (ELBI) run by the Center for Health Security is now accepting applications. This is a great opportunity that several Biodefense students have been able to take advantage of for the last several years. GMU Biodefense has had several fellows – Yong-Bee Lim  is currently an ELBI fellow and Saskia Popescu, Siddha Hover, and Francisco Cruz have represented our biodefense program in previous years. If you’re a current GMU biodefense student or alumni and are interested in applying and plan to request a letter of recommendation from the Biodefense program director, please do so ASAP. Dr. Koblentz asks that applicants send a copy of their application materials (personal statement, essay, and current resume or cv) and an unofficial GMU transcript by December 5, 2018.

 One Health in the 21st Century Workshop
The One Health in the 21st Century workshop will serve as a snapshot of government, intergovernmental organization and non-governmental organization innovation as it pertains to the expanding paradigm of One Health. One Health being the umbrella term for addressing animal, human, and environmental health issues as inextricably linked, each informing the other, rather than as distinct disciplines. This snapshot, facilitated by a partnership between the Wilson Center, World Bank, and EcoHealth Alliance, aims to bridge professional silos represented at the workshop to address the current gaps and future solutions in the operationalization and institutionalization of One Health across sectors. The workshop will be held on November 26th at the Wilson Center. You can RSVP here.

USDA ARS 5th International Biosafety & Biocontainment Symposium: Biorisk and Facility Challenges in Agriculture
Registration is open for this February 11, 2019 event! The symposium will provide 2.5 days of scientific presentations and exhibits regarding agricultural biosafety and biocontainment.

WHO Report on Surveillance of Antibiotic Consumption
The WHO has just released their report on global antibiotic consumption and the surveillance methods surrounding efforts to reduce antimicrobial resistance. “Since 2016, WHO has supported capacity building in monitoring antimicrobial consumption in 57 low- and middle-income countries through workshops, trainings and technical support. At this stage, 16 of these countries were able to share their national data with WHO. Other countries are currently in the process of data collection and validation.In total, 64 countries and Kosovo1 contributed data on antibiotic consumption for this report, with the bulk of data coming from the European region and countries with pre- existing, mature surveillance systems. The consumption data showed wide intra- and interregional variation in the total amount of antibiotics and the choice of antibiotics consumed. The overall consumption of antibiotics ranged from 4.4 to 64.4 DefinedDaily Doses (DDD) per 1000 inhabitants per day.”

Stories You May Have Missed:

  • Influenza Vaccine Efficacy Among Patients with High-Risk Medical Conditions in the U.S. – Researchers utilized data from the US Influenza Vaccine Effectiveness Network from 2012-2016 to analyze vaccine effectiveness (VE) “of standard-dose inactivated vaccines against medically-attended influenza among patients aged ≥6 months with and without high-risk medical conditions. Overall, 9643 (38%) of 25,369 patients enrolled during four influenza seasons had high-risk conditions; 2213 (23%) tested positive for influenza infection.Influenza vaccination provided protection against medically-attended influenza among patients with high-risk conditions, at levels approaching those observed among patients without high-risk conditions. Results from our analysis support recommendations of annual vaccination for patients with high-risk conditions.”

 

 

Pandora Report 9.28.2018

Happy Friday biodefense gurus! October is right around the corner, which means the flu vaccine will be available soon. Make sure to get vaccinated this season, as the CDC just announced that 80,000 people died of the flu during the 2017/2018 season, which is the highest death toll in 40 years.

GMU Global Health Security Ambassador
We’re excited to announce that two graduate students from the Schar biodefense program will be attending the 5th GHSA Ministerial Meeting in Bali, Indonesia. The two students, Annette Prieto and Saskia Popescu, will observe the Global Health Security Agenda in action and the the GHSA 2024 planning. Following their attendance in early November, we’ll be providing a report out on the events. Meet our two GMU Global Health Security Ambassadors – Annette Prieto has a background in Microbiology and Immunology and is currently a Biodefense student in the Master’s Program here at George Mason University. Before coming to George Mason, Annette focused on medical Microbiology at the University of Miami before moving into the laboratory and becoming a Teacher’s Assistant. From there, Annette became an Adjunct Instructor at Daytona State College and taught for a year before entering the Biodefense Program. Annette is also a part of the Next Generation Global Health Security Network. Saskia Popescu is a biodefense doctoral candidate at GMU and infection preventionist. She worked as an infection preventionist during the Dallas Ebola cluster, a 2015 measles outbreak, and is an external expert for the ECDC. She is a 2017 ELBI fellow and trained infectious disease epidemiologist. Saskia’s research focuses on the utilization of infection control in the U.S. healthcare system and it’s impact on biodefense. Make sure to check back in the weeks following their trip to learn about their experiences at the ministerial meeting.

Why Poor Pandemic Preparedness is Deadly
Ebola response efforts in the DRC are struggling and were suspended earlier this week, after violence between rebels and armed forces. While outbreak response in Beni have resumed, events like these are a prime example of why outbreaks can quickly spread beyond control and ultimately emphasize the need for pandemic preparedness. Drs. Tom Inglesby and Eric Toner from the Johns Hopkins Center for Health Security recently discussed the importance of investing in biopreparedness and how their Clade-X tabletop revealed many of the existing weaknesses. “Could a natural or man-made pandemic happen today? Yes. New lethal viruses are emerging from nature, and dizzying developments in biotechnology mean that biological weapons no longer are the sole province of a few state-sponsored programs — a manufactured pandemic could be unleashed by a rogue regime or by terrorists utilizing one of the thousands of laboratories around the world capable of making a dangerous pathogen. If the worst-case scenario unfolds, strong pandemic preparedness planning would save millions of lives. But progress is possible only with effective leadership.”

Rebuilding Health Security in the Wake of Ebola
GMU Biodefense graduate student Stephen Taylor discusses the latest talk from Georgetown University on global health security following the 2013-2016 Ebola outbreak. “In the midst of this disaster, the U.S. Centers for Disease Control turned to health security experts at the Georgetown Center for Global Health Science and Security to support the expansion and augmentation of the Guinean public health infrastructure.  Dr. Alpha Barry, Dr. Erin Sorrell, Dr. Claire Standley, and Ms. Aurelia Attal-Juncqua supported on-the-ground efforts to develop and implement improved health security policy that would make Guinea more resilient against future infectious disease outbreaks.  The Guinean government’s priorities for capacity and capability building were to prevent further outbreaks of zoonotic diseases, improve the capacity of surveillance laboratories and capabilities of the healthcare workforce to identify outbreaks, and to better respond to outbreaks by streamlining and coordinating emergency response operations.  On September 14th, 2018, as part of its Global Health Security Seminar Series, Georgetown University hosted a panel discussion of Dr Sorrell, Dr. Standley, and Ms. Attal-Juncqua on their efforts in Guinea.”

 The AMR Challenge
The United Nations (UN) General Assembly was held this week and one particular topic captured our attention – antimicrobial stewardship and a new initiative to combat resistance. “The AMR Challenge is a way for governments, private industries, and non-governmental organizations worldwide to make formal commitments that further the progress against antimicrobial resistance. The challenge encourages a One Health approach, recognizing that the health of people is connected to the health and animals and the environment. The AMR Challenge launches at the United Nations (UN) General Assembly in September 2018. Organizations can make commitments beginning September 25, 2018 until September 2019. CDC will feature commitments throughout the year. At the 2019 UN General Assembly, antimicrobial resistance will continue to be a priority topic for world leaders.” Within the Challenge, there are commitments to tracking and sharing data, reducing the spread of resistant germs through infection prevention and control, improving antibiotic use, decreasing antibiotics and resistance in the environment, and investing in vaccines, therapeutics, and diagnostics.

NASEM – Review & Assessment of Planetary Protection Policy Development Processes
How do we protect the Earth from contamination following space exploration? How can we avoid bringing microorganisms from Earth to other planets and solar system bodies? The latest NASEM report discusses how scientists tackle these issues and implement such policies. As you read the text, you’ll also see one of the Center for Health Security’s ELBI fellows in there – Betsy Pugel of NASA. “For decades, the scientific, political, and economic conditions of space exploration converged in ways that contributed to effective development and implementation of planetary protection policies at national and international levels. However, the future of space exploration faces serious challenges to the development and implementation of planetary protection policy. The most disruptive changes are associated with (1) sample return from, and human missions to, Mars; and (2) missions to those bodies in the outer solar system possessing water oceans beneath their icy surfaces.” This gives new insight into a field we may not be considering in health security – what about interstellar health security?

The Spanish Flu, Epidemics, and the Turn to Biomedical Responses
We already discussed the impact of poor pandemic preparedness, but what about biomedical efforts? A recent article from AJPH discusses the role of the 1918/1919 pandemic in bringing biomedical approaches to the forefront of outbreak response. “A century ago, nonpharmaceutical interventions such as school closings, restrictions on large gatherings, and isolation and quarantine were the centerpiece of the response to the Spanish Flu. Yet, even though its cause was unknown and the science of vaccine development was in its infancy, considerable enthusiasm also existed for using vaccines to prevent its spread. This desire far exceeded the scientific knowledge and technological capabilities of the time. Beginning in the early 1930s, however, advances in virology and influenza vaccine development reshaped the relative priority given to biomedical approaches in epidemic response over traditional public health activities. Today, the large-scale implementation of nonpharmaceutical interventions akin to the response to the Spanish Flu would face enormous legal, ethical, and political challenges, but the enthusiasm for vaccines and other biomedical interventions that was emerging in 1918 has flourished.”

HHS Sponsors TPOXX
Speaking of biomedical measures…the Department of Health and Human Services (HHS) just announced its sponsorship of a new formulation of the world’s first approved smallpox treatment – TPOXX. This purchase will be used for the Strategic National Stockpile and will work with Siga Technologies to develop an IV formulation of the drug. “Purchase of TPOXX in pill form and development of an IV formulation will be completed under a contract between Siga Technologies and the Biomedical Advanced Research and Development Authority (BARDA), part of the HHS Office of the Assistant Secretary for Preparedness and Response. BARDA will use funding from the Project BioShield Special Reserve Fund. The contract can be extended for up to 10 years and $629 million if necessary to complete development of the IV formulation.”

NASEM – Engaging the Private-Sector Health Care System in Building Capacity to Respond to Threats to the Public’s Health and National Security
Don’t miss the latest NASEM report on the intersection of preparedness and healthcare. From Ebola patients to natural disasters, and even terrorism, the private-sector healthcare system plays a critical role in response. “As a result, disasters often require responses from multiple levels of government and multiple organizations in the public and private sectors. This means that public and private organizations that normally operate independently must work together to mount an effective disaster response. To identify and understand approaches to aligning health care system incentives with the American public’s need for a health care system that is prepared to manage acutely ill and injured patients during a disaster, public health emergency, or other mass casualty event, the National Academies of Sciences, Engineering, and Medicine hosted a 2-day public workshop on March 20 and 21, 2018. This publication summarizes the presentations and discussions from the workshop.”

USDA ARS 5th International Biosafety & Biocontainment Symposium
ABSA has just announced this event being held on February 11-14, 2019 in Baltimore, Maryland. “The focus of the symposium will be Biorisk and Facility Challenges in Agriculture. Seven professional development courses will address topics including life science security, facility maintenance and operational issues, agricultural risk assessment, emergency response and preparedness for livestock disease outbreaks, waste management, and strategic leadership. Courses will be held on Monday, February 11. There will be 2 1/2 days of scientific presentations covering various topics including; governance updates, design methodologies, deferred maintenance, rabies, occ health laboratory to the field, gene editing, risk management and communication, and many others. The poster and networking reception will be held on Wednesday, February 13, attendees will have the opportunity to meet with presenters and discuss their presentations. Exhibits showcasing the latest biosafety, biosecurity, and biocontainment products and services will be open February 12-13.”

Next Generation Biosecurity Webinar 
Don’t miss this webinar today, Friday 9.28, at 11am (CDT, Mexico City). Hosted by Next Generation GHSA, this webinar will be with Luis Alberto Ochoa Carrera, Coordinator of Biosafety and Biochemistry of the GHSN and Coordinator of the Biosafety Laboratory Level 3 of the National Reference Laboratory (InDRE) of Mexico.

Stories You May Have Missed:

  • Airplanes and Airports – Hubs for Germs: GMU biodefense doctoral candidate Saskia Popescu discusses the latest on germ transmission during air travel. “Most people have a general sense that air travel tends to involve exposure to germs. Whether it’s through the thousands of people we will come into contact with, the sick person next to us on the plane, or the dirty surfaces, many of us get a sense of unease knowing there is a real chance we may arrive at our destination with a microscopic companion.”

 

Pandora Report 8.17.2018

Happy Friday fellow biodefense nerds! Welcome to your weekly roundup of all things global health security. If you’re finding yourself a food source for mosquitoes and ticks this summer, just a friendly heads up – the associated diseases are on the rise (hint: climate change may be a big reason).

The Lingering Scare of Smallpox
The recent FDA approval of TPOXX to treat smallpox, a disease eradicated since 1980, has many wondering, especially those of us born in a time where the vaccine was not necessary, why so much attention is being raised. It’s an easy thing to forget – the peril of a disease long since eradicated, but the threat of smallpox is very much still a concern in biodefense. Between the concerns of a laboratory biosecurity/biosafety incident at the two remaining stockpile locations or the chance that a frozen corpse (aka corpsicle) who died of smallpox could defrost as the Arctic permafrost melts. Did I mention the risk of a de novo synthesis like the horsepox one in Canada? These are the reasons we haven’t been able to shake the nightmare that is smallpox. “The greatest threat is advances in synthetic biology, which could permit a rogue lab to re-engineer a smallpox virus. In 2016, researchers in Canada announced that they had created horsepox using pieces of DNA ordered from companies. A synthetic smallpox virus could be even more dangerous than the original, because it could be designed to spread more easily or with ways to survive new therapies.” While we eradicated smallpox and proved that such a feat was possible, there is the painful reality that such efforts left an unvaccinated and inherently vulnerable population.

Biological Events, Critical Infrastructure, and the Economy: An Unholy Trinity
Biodefense graduate student Stephen Taylor is reporting on the latest Blue Ribbon Study Panel. “At its recent meeting about resilience, the Blue Ribbon Study Panel on Biodefense explored the potential impacts of a biological event on critical infrastructure in the United States, as well as the best way to approach risk mitigation.  Ann Beauchesne, former Senior Vice President of the National Security and Emergency Preparedness Department at the U.S. Chamber of Commerce, summed up critical infrastructure as ‘the critical services for our society and the backbone our economy.’  Projected increases in global travel, trade, and development all rely on critical infrastructure, magnifying the potential impact of insults to infrastructure systems.  Concurrently, biological threats are also on the rise. As the world warms and urbanizes, natural infectious disease outbreaks manifest in unexpected places.”

Ebola, Healthcare Workers, and the Pandemic Potential in Vulnerable Countries 
Every day brings news of the Ebola virus disease outbreak along the eastern border of the DRC. On Thursday, cases jumped by seven – one of whom is a healthcare worker. The outbreak is up to 73 cases, 46 of which are confirmed and 27 are probable. 43 deaths have been reported. Nearly a thousand people are under surveillance as contacts of cases and healthcare workers are again, experiencing increased risk of transmission. On Tuesday, it was reported- “that health worker Ebola infections could amplify the current outbreak in the Democratic Republic of Congo (DRC), the country’s health ministry today reported five more confirmed cases, including four involving health workers at a health center in Mangina. The other is a patient recently treated at that facility.” The hope is that the new vaccine can help put an end to the outbreak and curb the risk for healthcare workers. The recent outbreak draws attention yet again, to the inherent danger that infectious disease outbreaks pose in vulnerable countries. We’ve seen how fast and unexpectedly such outbreaks can spread beyond international borders (SARS, MERS, Ebola, etc.), which means that these are global health security issues. The 2013-2016 Ebola outbreak taught us a “great deal about how to respond in a fragile state setting. Traditional leaders and faith leaders played an important role in communicating necessary information and behavior change requirements to isolated groups who did not necessarily trust the government or health care workers.” Preventative measures like stronger public health and healthcare infrastructure can make a world of difference. “Preventative investments can mean the difference between life and death for people in those countries and the difference between an outbreak being contained or becoming an epidemic. As we face repeated outbreaks of infectious diseases, including new pathogens, it is essential that U.S. policy-makers continue funding the operations that make containment possible.”

BWC Meeting of Experts
Don’t miss out on the daily reports from Richard Guthrie on the latest MX. You’ll definitely want to check out days six and seven, where national implementation and preparedness were discussed. How would countries respond to a potential act of bioterrorism? Guthrie notes that “Concerns were raised about whether bodies such as the World Health Organization should be engaged with any assessment of the cause of an outbreak if there were indications it was deliberate in case this brought the health body into the security realm with potential negative consequences for other health work. A number of contributions to the discussion noted that health officials would have different roles to officials looking to attribute the cause of an attack and there was a need to ensure that effective ways of operating together were established. An example of the challenges was given in WP.10 from the USA in the section on ‘preservation of evidence’.” The response and preparedness measures for each country can be complex and challenging when considering the global context of the BWC. For example, Saudi Arabia discussed its own preparedness measures for natural events during times when influxes of people were expected (pilgrimages).

 The Economic Burden of Antimicrobial Resistance and the Drive For Intervention
A recent study enumerated the economic cost of antimicrobial resistance per antibiotic consumed to inform the evaluation of interventions affecting their use. Their model utilized three components – correlation coefficient between human antibiotic consumption and resulting resistance, economic burden of AMR for five key pathogens, and the consumption data for antibiotic classes driving resistance in these organisms. “The total economic cost of AMR due to resistance in these five pathogens was $0.5 billion and $2.9 billion in Thailand and the US, respectively. The cost of AMR associated with the consumption of one standard unit (SU) of antibiotics ranged from $0.1 for macrolides to $0.7 for quinolones, cephalosporins and broad-spectrum penicillins in the Thai context. In the US context, the cost of AMR per SU of antibiotic consumed ranged from $0.1 for carbapenems to $0.6 for quinolones, cephalosporins and broad spectrum penicillins.” Ultimately, they found that the cost of AMR per antibiotic frequently exceeded the purchase cost, which should encourage policy and consumption changes.

NASEM Report: Cooperative Threat Reduction Programs for the Next Ten Years and Beyond
The latest report from the National Academies is now available regarding the Cooperative Threat Reduction (CTR) Program. “The Cooperative Threat Reduction (CTR) Program was created by the United States after the dissolution of the Soviet Union to provide financial assistance and technical expertise to secure or eliminate nuclear weapons delivery systems; warheads, chemical weapons materials, biological weapons facilities, and nuclear, biological, and chemical weapons technology and expertise from the vast Soviet military complex. In a 2009 report, Global Security Engagement: A New Model for Cooperative Threat Reduction, the National Academy of Sciences (NAS) recommended adoption of a modified approach to thinking about CTR, including the expansion of CTR to other countries and specific modifications to CTR programs to better address the changing international security environment.” The report has insight from some of the time minds in the field of biological threats – Elizabeth Cameron, David Franz, James Le Duc, etc.

Stores You May Have Missed:

  • Key Global Health Positions and Officials in the USG – Have you ever wondered who is in charge for global health programs throughout the government? Look no further than this comprehensive list by the Kaiser Family Foundation.
  • CEPI Collaborative for Lassa Fever Vaccine“In a deal worth up to $36 million to advance the development of a vaccine against Lassa fever, the Coalition for Epidemic Preparedness Innovations (CEPI) today announced a new partnership with Profectus BioSciences and Emergent BioSolutions.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report: 7.20.2018

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
This week Schar Biodefense hosted a three-day workshop on all things health security, from anthrax to Zika. Highlights from the first two days include a rousing discussion by Dr. Robert House surrounding medical countermeasures and the potential for nefarious actors to highjack the immune system, Sandy Weiner delving into the history of the 1976 influenza pandemic, GMU professor and virologist Dr. Andrew Kilianski breaking down some hard realities of biosurveillance, and Edward You of the FBI discussing the importance of working with the DIY biohacker community and protecting the bioeconomy. While the workshop continues through today, make sure to check back next week for more coverage.

 Vaccine Causing Polio in Africa? Context From An Expert
GMU Biodefense PhD alum Christopher K. Brown sat down with Lucien Crowder of the Bulletin of the Atomic Scientists to discuss vaccine derived polio and the implications of these outbreaks. Brown discussed the vaccine production process, how they can cause an “infection light”, and the current outbreak in the DRC. “In the Democratic Republic of the Congo, a vaccine-derived type 2 poliovirus is responsible for the current outbreak, even though it is no longer a component of the live, attenuated oral vaccine that most countries use (when, that is, an oral, attenuated vaccine is used instead of a fully inactivated injectable formulation that is safer but potentially less effective). Despite a World Health Organization–led switch from the three-type, or trivalent, vaccine to a bivalent preparation, the vaccine-derived type 2 virus continued to spread from person to person undetected, slowly mutating to regain the neurovirulence that can cause paralysis in those who are infected. Now, to stop the current outbreak, health officials are deploying a monovalent vaccine formulated specifically for type 2 poliovirus. The key is to reach susceptible individuals—namely, those who did not receive the trivalent option previously—with the vaccine before the virulent strain of the virus does. If enough people are vaccinated, the mutated, vaccine-associated strain will not continue to infect new people and the outbreak will subside.” Brown took care to discuss how these incidents are high-jacked by the anti-vaccination movement, but that “the argument that vaccines cause injury often focuses on the myth that certain chemicals in vaccines—including preservatives, like Thiomersal, that are no longer used in vaccine formulations—cause autism. The polio outbreak in the Democratic Republic of the Congo is a case in which a strain of virus that was rendered safe for vaccinating most people has regained some of its disease-causing abilities through genetic mutation. That’s sort of similar to why bugs that are more common problems in developed countries, like staphylococcus and gonorrhea, stop responding to antibiotics: They acquire genetic mutations that make them resistant to certain drugs. What is most important here is to consider the level of risk associated with vaccine-linked outbreaks, or cases of paralysis, compared to the effects of polio in an unvaccinated population. While the attenuated poliovirus in the vaccine itself may lead to no more than four or five cases of paralysis among every million individuals vaccinated, there would likely be thousands of cases of serious disease among a million exposed, unvaccinated people.”

Why Aren’t We More Worried About The Next Epidemic?
In the past couple of months, we’ve seen outbreaks of Ebola, MERS, Zika, Nipah virus, Rift Valley fever, and Lassa fever – so why aren’t we more worried about the next epidemic? Globalization makes the movement of people and goods easier and faster – consider that 107 countries received frozen vegetables now being recalled for Listeria. The good news is that information technology allows us to know about these outbreaks and have the ability to notify necessary agencies and resources at a rapid pace. “Several major factors are to blame for why the world is seeing more of these increasingly dangerous pathogens. The combination of massive widespread urbanization, explosive population growth, increased global travel, changing ecological factors, steady climate change and the exploitation of environments is driving an era of converging risk for outbreaks, experts say.” Dr. Thomas Inglesby, director of the Johns Hopkins Center for Health Security, noted that ‘We don’t know when the next Ebola outbreak will come but we do know it will come again, and again, and again’.” Outbreaks like SARS and Ebola have shown the devastating impact outbreaks have on not only the healthcare system, but also the economy. Unfortunately, emergency preparedness and healthcare response is a tough problem to fix. The CDC director of the Center for Global Health, Rebecca Martin, stated that “Gaps in public health emergency response capabilities remain a serious vulnerability for the entire world,” she added. “While we don’t know when or where the next pandemic will occur, we know one is coming”. We know the next pandemic is coming, the unknowns are from where, when, and what it will look like. This makes response, including medical countermeasures, that much more difficult. R&D is a critical component to this, but as Dr. Inglesby noted, “The problem with public health in particular and with R&D is what we’re ultimately trying to do is prevent bad things from happening. When you succeed, it’s relatively invisible ― so the public doesn’t get to see why investment is so important.” Inglesby also recently highlighted the six ways countries can prepare for the next pandemic. From enhancing capabilities to develop new vaccines/medical countermeasures, to investing in more robust public health systems, there are several ways we can facilitate stronger national capacity to respond to pandemics.

Crucial Steps Forward: the National Academies of Science’s 2018 Study, “Enhancing Global Health Security through International Biosecurity and Health Engagement Programs”
GMU biodefense MS student Alexandra Williams recently attended the NASEM meeting regarding global health security through international biosecurity and health engagement programs. Within her recap, Williams discusses the background of CBEP (Cooperative Biological Engagement Program) and CTR (the DoD’s Cooperative Threat Reduction program), noting their efforts to strengthen health security within the U.S. and abroad. “As challenges continue to arise in timely and accurately detecting and responding to disease outbreaks—as we saw in 2014 with Ebola in West Africa, and in 2016 with Zika—U.S. health and security agencies are working to better meet these challenges, and examine how they need to evolve to meet unforeseen hurdles that lay ahead. This NASEM study is timely and critical because it addresses and examines these issues head-on, and will serve as the launch point for how the U.S. can rethink, reshape, and improve its already critical and successful work in biosecurity and global health security.”

Book Review – Dirty War: Rhodesia and Chemical Biological Warfare
Glenn Cross, GMU biodefense PhD alum, has taken great care to investigate and detail the history of Rhodesia’s chemical and biological warfare program against insurgents from 1975 to 1980. If you’re on the fence about adding a new book to your reading list, check out Ryan Shaffer’s latest review. “Organized topically, the book’s preface offers a brief overview of Rhodesia’s colonial history and demographics, discussing the ethnic and racial divisions arising from a white minority’s control of the government over a disenfranchised and mostly rural black African population. Cross describes the Rhodesian War with emphasis on “the regime’s inability to defeat decisively a growing guerrilla insurgency through conventional arms alone.” (39) He explains the conflict’s evolution in the context of post-war British decolonization and the manner in which the Unilateral Declaration of Independence was designed to maintain white minority rule, as well as the ensuing international sanctions that isolated Rhodesia. By the late 1960s, government opponents shifted strategy, believing the only way to change the country was to forcibility seize control. Meanwhile, the CIO had penetrated the opponents’ ranks, gathering intelligence and setting up the Selous Scouts to work against the guerrillas.” Shaffer notes that “the book is a well-researched study that sheds light on the reasons a government broke international norms to use CBW, a tactic more likely to target local non-state actors than foreign militaries.”

 Antibiotic Prescribing Failures in Urgent Care Centers
Disrupting antibiotic resistance is challenging due to not only the vast array of sectors that play a role, but also the cultural components. Prescribing habits are one of those culturally-engrained practices that can be difficult to alter. A new study has found that antibiotic stewardship is desperately needed in urgent care facilities. “Researchers with the Centers for Disease Control and Prevention (CDC), the University of Utah, and the Pew Charitable Trusts report that 45.7% of patients who visited urgent care centers in 2014 for respiratory illnesses that don’t require antibiotics end up with prescriptions for those conditions, followed by 24.6% of patients treated in emergency departments (EDs), 17% of patients who went to medical offices, and 14.4% of patients who visited retail clinics. The findings are based on analyses of 2014 claims data from patients with employer-sponsored health insurance. Previous estimates of outpatient antibiotic prescribing by some of the same researchers had pegged the amount of unnecessary prescribing at 30%, a number that some experts believe is conservative. Study coauthor David Hyun, MD, a senior officer with Pew’s antibiotic resistance project, said the findings suggest that could very well be the case.” The sad reality is that these numbers are likely to be higher across the U.S. as inappropriate prescribing practices are a systemic issue. This finding is one piece of the puzzle, which underscores the progress that needs to be made. Fortunately, countries are working to reduce antimicrobial resistance and while it’s slow, some movement forward is better than none at all.

Rift Valley Outbreak in Uganda
Uganda has reported an outbreak of Rift Valley fever across two districts. Rwanda is also reporting cases in animals and potential cases in humans. “The WHO said the affected districts are in the ‘cattle corridor’ that stretches from the southwest to the northeast regions of the country. ‘The outbreak in Uganda is occurring at a time when Kenya is having a large RVF outbreak and Rwanda is experiencing an epizootic, with suspected human cases,’ the WHO said. In Kenya, where an outbreak has been under way since May, four more Rift Valley fever cases have been reported, raising the outbreak total as of Jul 4 to 94, 20 of them confirmed. Ten deaths have been reported. Illnesses have been reported in three counties: Wajir, Marsabit, and Siaya. The country’s agriculture ministry has reported several outbreaks in animals over the past few months, especially in areas that had experienced flooding after heavy rainfall.”

Stories You May Have Missed:

  • The Strange and Curious Case of the Deadly Superbug Yeast- Maryn McKenna discusses the latest resistant bug we’re worrying about – “It’s a yeast, a new variety of an organism so common that it’s used as one of the basic tools of lab science, transformed into an infection so disturbing that one lead researcher called it “more infectious than Ebola” at an international conference last week. The name of the yeast is Candida auris. It’s been on the radar of epidemiologists only since 2009, but it’s grown into a potent microbial threat, found in 27 countries thus far.”

Pandora Report 7.6.2018

 

We hope you had a lovely holiday this week and are ready to get back into the world of biodefense! News is still unfolding regarding the two British citizens who were hospitalized after exposure to the nerve agent, Novichok, but we’ll keep you updated as more information becomes available.

Summer Biodefense Workshop – Pandemics, Bioterrorism, and Global Health Security
In less than two weeks the summer workshop on all things health security, from anthrax to Zika, will be taking place – are you registered? This three-day workshop will cover everything biodefense from the most recent Ebola outbreak, to DIY biohackers and vaccine development, and also the challenges of defending against biothreats. Speakers include experts in the field like David R. Franz, who was the chief inspector on three United Nations Special Commission biological warfare inspection missions to Iraq and served as technical advisor on long-term monitoring. His current standing committee appointments include the Department of Health and Human Services National Science Advisory Board for Biosecurity (NSABB), the National Academy of Sciences Committee on International Security and Arms Control, the National Research Council Board on Life Sciences, and the Senior Technical Advisory Committee of the National Biodefense Countermeasures Analysis Center. Jens H. Kuhn will also be speaking on filoviruses and what it was like to be the first western scientist with permission to work in a former Soviet biological warfare facility, SRCVB “Vektor” in Siberia, Russia, within the US Department of Defense’s Cooperative Threat Reduction (CTR) Program. These are just two of our speakers who will be leading discussions over the three days – come join the conversation at our workshop from July 18-20!

All Hands on Deck – U.S. Response to Ebola in West Africa
Princeton University’s Innovations for Successful Societies has just released their report on the quality of the U.S. response to Ebola. The case study is part of a series on Liberian response to the outbreak and includes great information on coordination, political response, and the challenges of international outbreak management. “Although the deployment, which scaled up earlier assistance, took place five months after the first reported cases and required extensive adaptation of standard practices, it succeeded in helping bring the epidemic under control: the total number of people infected—28,616—was well below the potential levels predicted by the CDC’s models. This US–focused case study highlights the challenges of making an interagency process work in the context of an infectious disease outbreak in areas where health systems are weak.”

Bats and Military Defense
Sure, your first inclination might be a vampire or Batman joke, but there’s actually a significant history regarding the U.S. military and utilization of these mammals. Historically, efforts focused on employing them as bombs in Japan but a more modern plan focuses on their uncanny ability to carry deadly diseases. “‘What we are trying to do is to study bat immunology, but that turned out to be a very difficult thing to do when starting from scratch,’ said Thomas Kepler, a professor of microbiology at Boston University. It took decades to create the reactive substances necessary to study human or mouse antibodies. With bats, he explained, they were starting from zero.” Battling potential Russian bioweapons means thinking outside of the box, right? The truth is that fruit bats have a pretty amazing weapon of their own – a super immunity that might just lend itself to curing Marburg and other devastating infections. “The Marburg virus is classed as a Category A bioterrorism agent by the Centers for Disease Control and Prevention, and Kepler’s study was supported by the Defense Threat Reduction Agency, a Defense Department division established during the Manhattan Project era to combat weapons of mass destruction. If the virus is ever deployed as biological warfare, the fruit bat’s super-immunity may hold the answer to preventing its spread. But it may also go some way toward redeeming the bat in the eyes of the U.S. military — and could even make the animal an unlikely hero.”

 NASPAA Pandemic Simulation
How would you handle a pandemic? GMU’s Schar School team qualified for the final round of the Network of Schools of Public Policy, Affairs, and Administration (NASPAA) pandemic simulation, in which student teams had to respond to a constantly evolving situation and make real-time decisions regarding quarantine, trade, etc. “‘The simulation is an especially valuable experience for the biodefense students since the pandemic crisis provided students with complex problems like those that they will tackle in their professional careers,’ said director of the Schar School’s biodefense graduate program, Gregory Koblentz. ‘These exercises also test the students’ ability to bridge the gap between the science and policy-making, a key goal of the biodefense programs’.”

Gene Editing – Last Week Tonight With John Oliver and How DARPA Wants to Boost Body Defense Through Gene Editing
This week’s episode of Last Week Tonight featured one of our favorite topics – gene editing! While there’s only so much you can cover in the span of 20 minutes, it was nice to see some of the complexities, personalities, and technical hurdles, covered by John Oliver. From biohackers to germline edits, Oliver mixed humor into a discussion on the very real issues surrounding gene editing technologies like CRISPR (although his version of the acronym is much more comical – Crunchy Rectums In Sassy Pink Ray-bans). Make sure to check out the episode to get a humorous overview on this gene-editing technology. Meanwhile, DARPA (the Defense Advanced Research Projects Agency) is actually working to harness gene editing to make your body’s natural defenses that much stronger through specific gene expressions. The project is called PREPARE (PReemptive Expression of Protective Alleles and Response Elements) and works to provide temporary boots to your natural defenses. “In contrast to recent gene-editing techniques, such as CRISPR, which focus on permanently changing the genome by cutting DNA and inserting new genes, the PREPARE program will concentrate on techniques that don’t make permanent changes to DNA. These techniques target the ‘epigenome,’ or the system that controls gene expression. Genes can be turned on or off by making external modifications to DNA, which don’t change the DNA sequence, but instead affect how cells ‘read’ genes. To start, the PREPARE program will focus on four key health challenges: influenza viral infection, opioid overdose, organophosphate poisoning (from chemicals in pesticides or nerve agents) and exposure to gamma radiation, the statement said.” While there are a lot of hurdles to overcome, the overall goal is to extend the platform to known and unknown threat application.

Improving Mass Casualty Management: The Role of Radiation Biodosimetry 
How would we handle the medical response of large-scale radiological exposure? GMU Biodefense PhD student Mary Sproull presented on this very topic and the work she and her team are doing, which is aimed at making testing more efficient and effective. “Drs. Sproull and Camphausen are working to make the medical management process more efficient and effective in the event of a mass casualty radiation exposure. Specifically, they are developing a dosimetry dose prediction model to determine how radiation biodosimetry diagnostics can help physicians estimate just how much radiation exposure a patient has experienced. (Radiation biodosimetry diagnostics estimate a person’s radiation exposure by measuring changes in biological markers that include cytogenic assays like dicentric chromosome assay.)”

Everything You Need to Know About Ricin
A few weeks back a Tunisian man was arrested by German police regarding suspected plans for a bioterrorism attack with ricin. German police were searching his residence in Cologne and found enough ricin for 1,000 toxic doses. During the fervor of the news, it was reported that such a a plot could have been more devastating than 9/11 – but what’s the reality behind ricin? Check out this comprehensive review of what ricin is (a naturally occurring biological poison), its history as a biological weapon and WMD, and more. “In summary, ricin’s status as a biological weapon is quite mixed. In terms of actual potential for harm, it is more at the level of knives than bombs. Its status as a WMD is a legal one, not so much a practical one. It would be useful to the public debate and our general social assessment of risk if the media could reflect this, rather than churn out hysterical reporting.”

Stories You May Have Missed:

  • VA Study Reveals Antibiotic Prescribing Habits – “A team of researchers establishing baseline data on antibiotic use by the Veterans Administration (VA) healthcare system in Pittsburgh found that about 75% of all antibiotic prescriptions were inappropriate, meaning they were either not indicated or were used for a duration that’s not recommended. The study, which took place over 12 months, looked at prescribing information, medical records, and charts of 40,734 patients, who were written 3,880 acute antibiotic prescriptions by 76 primary care providers (PCPs). The median antibiotic index was 84 antibiotic prescriptions per 1,000 patients per year.”
  • Drone Crashes Into French Nuclear Plant – “GREENPEACE activists say they have crashed a drone into a French nuclear plant to highlight the lack of security around the facility. The drone, which was decked out to resemble a tiny Superman, slammed into the tower in Bugey, 30 kilometers (20 miles) from the eastern city of Lyon, according to a video released Tuesday by Greenpeace. The environmental group says the drone was harmless but it showed the lax nuclear security in France, which is heavily dependent on nuclear power, using it for about 75 percent of its energy needs.”

Pandora Report 6.29.2018

The month of June is nearly over, which means there’s only a few more weeks to register for the Workshop on Pandemics, Bioterrorism, and Global Health Security. Don’t miss out on the early registration discount if you sign up before July 1st!

Cost Analysis of 3 Concurrent Public Health Response Events: Financial Impact of Measles Outbreak, Super Bowl Surveillance, and Ebola Surveillance in Maricopa County
Have you ever wondered the cost of public health response for local health departments during a crisis? Imagine that within the course of six months, your county sees a measles outbreak, super bowl surveillance requirements, and Ebola surveillance. A new article is addressing the cost of this trifecta for the largest county health department in Arizona. GMU biodefense PhD student Saskia Popescu was a part of not only this response, but also aided in developing the research so that we can truly address the financial burden of public health events. “Maricopa County Department of Public Health (MCDPH) in Arizona. The nation’s third largest local public health jurisdiction, MCDPH is the only local health agency serving Maricopa’s more than 4 000 000 residents. Responses analyzed included activities related to a measles outbreak with 2 confirmed cases, enhanced surveillance activities surrounding Super Bowl XLIX, and ongoing Ebola monitoring, all between January 22, 2015, and March 4, 2015. Total MCDPH costs for measles-, Super Bowl-, and Ebola-related activities from January 22, 2015, through March 4, 2015, were $224,484 (>5800 hours). The majority was for personnel ($203,743) and the costliest response was measles ($122,626 in personnel costs). In addition, partners reported working more than 700 hours for these 3 responses during this period.” Public health is chronically underfunded, but the response efforts can be immensely expensive. Based off these events and the cost of response, perhaps it’s time we start investing more in public health.

Forget RoboCop, Meet the DNA Cops
Biotechnology is moving at a rapid pace and the ability for DIY biohacking means that frank conversations need to be had regarding the potential for someone to build a lethal biological weapon. Ginkgo Bioworks has just the team to overcome this herculean task. Remember that horsepox synthesis last year? “The study’s publication ‘crosses a red line in the field of biosecurity,’ wrote Gregory Koblentz, a professor in the biodefense department at George Mason University, in a public comment to the journal. ‘The synthesis of horsepox virus takes the world one step closer to the reemergence of smallpox as a threat to global health security’.” Hoping to get a leg up on the threat, the intelligence community is working with Ginkgo Bioworks to address the science, security, and safety. “Gingko quickly saw the potential security risks in its work. It began working with Weber, the former Obama administration official, in 2016 to get advice on how to best preserve national security.  ‘We are doing more of this genetic engineering than anybody, we think we’re going to get better at it than anybody, so we have a responsibility to be keeping our eye on both sides of that coin,’ Kelly said. ‘How do we protect and defend against that while protecting our ability to get all the positive outputs of biotechnology?’” Synthetic biology has the potential to do damage, but also the chance to counter these threats (and even emerging infectious diseases) through vaccine development. Joint efforts like those between Ginkgo Bioworks and agencies like IARPA, are critical during this time when the technology is still spreading and evolving.

Genome Editing and Security: Governance of Non-Traditional Research Communities?
GMU Biodefense doctoral student Katherine Paris has provided a detailed account of the latest National Academies webinar on gene editing and biosecurity/biosafety developments. Paris notes that “at the workshop, concerns were expressed over the extent that advancements in technology allow a greater range of people to access, and possibility misuse, genome editing technologies.  Dr. Millet and Dr. Kuiken addressed these concerns during the webinar by describing what two non-traditional research communities—the International Genetically Engineered Machine (iGEM) competition and do-it-yourself biology (DIYbio) community laboratories—are doing to foster biosafety and biosecurity.” Check out her account of this informative talk to learn more about how iGEM is demonstrating real-world application of biosecurity and biosafety practices.

The Culture of Biosafety, Biosecurity and Responsible Conduct in the Life Sciences
Curious about biosecurity, biosafety, and what it means to have a culture of responsibility in the life sciences? Look no further than this amazingly comprehensive literature review by ABSA International, which happens to include former GMU Biodefense student Kathleen Danskin and current doctoral student Elise Rowe. Identifying over four thousand unique articles published between 2001 and 2017, they reviewed 326 articles to truly evaluate the literature on ways to strengthen the biosafety/biosecurity culture. “We found that while there were discussions in the literature about specific elements of culture (management systems, leadership and/or personnel behavior, beliefs and attitudes, or principles for guiding decisions and behaviors), there was a general lack of integration of these concepts, as well as limited information about specific indicators or metrics and the effectiveness of training or similar interventions. We concluded that life scientists seeking to foster a culture of biosafety and biosecurity should learn from the substantial literature in analogous areas such as nuclear safety and security culture, high-reliability organizations, and the responsible conduct of research, among others.”

Roadmap for Implementing Biosecurity and Biodefense Policy in the U.S. 
This new report and roadmap from Gryphon Scientific, National Defense University, and Parsons, analyzes biosecurity and biodefense policy within the United States. “We developed a framework for analyzing opportunity costs of new or changing regulations (the opportunity cost analysis framework), and a framework for evaluating the successful implementation of biosecurity and biodefense policies. These analyses enabled the development of a roadmap for implementing U.S. biosecurity and biodefense policy to maximally leverage science and technology advances while simultaneously, minimizing risks. This project was funded by a generous grant from the U.S. Air Force Academy and Defense Threat Reduction Agency under their Program on Advanced Systems and Concepts for Countering Weapons of Mass Destruction.” The report includes policy and opportunity cost case studies, as well as evaluation metrics framework.

How Will Trump Lead During A Pandemic and How Well Prepared Is Your Country?
Between several science vacancies within the administration and the fundamental truth that a global epidemic is on the horizon, many are concerned about what a response would be like under Trump. “’There is a real reason for us to be scared of the idea of facing this threat with Donald Trump in the White House,’ said Ron Klain, who served as President Obama’s Ebola czar, at the Spotlight Health Festival, which is co-hosted by the Aspen Institute and The Atlantic. Klain said the ‘president is anti-science’ and ‘trades in conspiracy theories. All those things would lead to the loss of many lives in the event of an epidemic in the United States, where we need the public not to trade in conspiracy theories, not to believe that the news was fake, but to respect scientific expertise,’ said Klain, a veteran Democratic operative who served in both the Clinton and Obama administrations.” Klain underscores the importance of having pro-science leadership, which isn’t exactly something the current administration is known for. He points to several gaps within U.S. preparedness – funding, leadership, science, policy, etc. “But the biggest gap, he said, is the global gap: ‘We can’t be safe here in America when there’s a risk of pandemics around the world,’ Klain said. ‘The world’s just too small. Diseases spread too quickly … There is no wall we can build that is high enough to keep viruses and the disease threat out of the United States. We have to engage in the world’.” If you’re curious about the current state of preparedness around the globe, check out the latest site from Resolve to Save Lives, the initiative run by former CDC director Dr. Tom Frieden. Prevent Epidemics is a tool that rates countries from 0-100 on their ability to find, stop, and prevent outbreaks. “ReadyScore is calculated using data from the Joint External Evaluation (JEE), a rigorous, objective and internationally-accepted epidemic preparedness assessment developed by the World Health Organization (WHO) and other partners. The ReadyScore consolidates key information from the JEE about a country’s preparedness in the form of a simple and easy-to-understand number that makes it easy for countries to measure their preparedness gaps and fill them”

UK, Allies – Empower Chemical Arms Watchdog to Assign Blame For Attacks
The UK, US, and EU are pushing a new proposal to increase the powers of the Organization for the Prohibition of Chemical Weapons (OPCW) in efforts to strengthen the ban on chemical weapons and the ability to hold countries, like Syria, accountable for use. “‘The widespread use of chemical weapons by Syria in particular threatens to undermine the treaty and the OPCW,’ said Gregory Koblentz, a non-proliferation expert at George Mason University, in the United States. ‘Empowering the OPCW to identify perpetrators of chemical attacks is necessary to restoring the taboo against chemical weapons and the integrity of the chemical weapons disarmament regime’.”

Stories You May Have Missed:

  • Pull Incentives – A New Strategy for AMR – The World Economic Forum is supporting these initiatives to help spur the development of new antibiotics and facilitate their profitability. The financial challenges for antibiotic development can be significant hurdles – demand is unpredictable, stewardship efforts seek to decrease use which decreases sales, and clinical trials are costly. “Existing incentives for developing new antibiotics are mostly of the ‘push’ type, the report notes. Push incentives provide support for research and development, but they don’t ensure that a company can get an adequate return on a new antibiotic once it wins approval. The concept of pull incentives has attracted increasing attention in recent years. A chart in the report shows that 10 current research and development initiatives on antimicrobial resistance (AMR) involve push incentives, while no such initiatives involve pull incentives exclusively. Combinations of push and pull incentives are being used to support four existing R&D initiatives, the chart indicates, but it doesn’t give any details on those.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report: 4.20.2018

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security: From Anthrax to Zika
The early-bird registration discount deadline is fast approaching, so make sure you’re signed up for the workshop on all things health security from July 18-20! Whether it’s the 2001 anthrax letter attacks, SARS and avian influenza, Ebola in West Africa, or dual-use research of concern, we’ll be covering it all in this three-day workshop. Where else can you mingle with some of the top minds in the field, engage with other passionate health security professionals, and learn about the latest issues in biodefense?

80,000 Hours Interview With Dr. Tom Inglesby – Careers & Policies That Can Prevent Global Catastrophic Biological Risks
If you’re not listening to the 80,000 Hours podcast, make sure to add it to your list. This is a wonderful podcast on making the right career choices and lucky us, they’re covering global health security jobs. In October, NTI’s Dr. Beth Cameron spoke about fighting pandemics and the challenge of preparing an entire country. Cameron spoke about the current state of American health security, what we’ve learned, new technologies, and more. This week, they spoke with Dr. Tom Inglesby from the Johns Hopkins Center for Health Security on how passionate health security gurus can pursue a career in the field, the top jobs, worrisome scientific breakthroughs, etc. You’ll even catch Dr. Inglesby discuss PhD programs and advisors in the field, in which he names GMU’s very own Dr. Gregory Koblentz! During his talk, Inglesby notes that “I don’t think it’s a good approach to think about it [catastrophic biological risk] as zero sum with other epidemic problems and here’s why: I think in many cases it’s gonna be similar communities that are thinking about these problems. I don’t think it’s likely, even if we really decided to get very serious as a world, I don’t think it’s likely that there will be a community solely dedicated. I don’t want to say never, because it could happen, but I don’t think it’s likely that there will be a robust enduring community of professionals that would only, solely be dedicated to global catastrophic risk, biological risks alone.”

An Afternoon with ASPR – Dr. Robert Korch and Dr. Dana Perkins
GMU Biodefense MS student Anthony Falzarano is reporting on his time at the National Academies monthly series on biological, chemical, and health security issues. “This luncheon – consisting of an open forum session with a two-member panel and a moderator – featured Dr. George W. Korch and Dr. Dana Perkins, both from the Department of Health and Human Services office of the Assistant Secretary for Preparedness and Response (ASPR). Drawing from their current roles with ASPR as well as their illustrious careers and vast experiences, two presenters made for a compelling afternoon discussing health security issues and the work being done by ASPR to prepare for and address them.” Make sure to read his report-out on this luncheon to learn Dr. Korch’s favorite priorities for ASPR!

Chemical Weapons Attack on Douma – Update
Last Saturday, 105 missiles were fired against three Syrian chemical weapons facilities in a joint effort by the U.S., UK, and France. While this is unlikely to have completely removed Assad’s chemical weapons capabilities, many are wondering how effective the airstrike truly is. “‘This is now part of their standard combat doctrine’,” said Gregory Koblentz, a chemical weapons expert at the Schar School of Policy and Government at George Mason University. The attack April 7 that triggered the U.S.-led retaliatory strikes forced the surrender of a rebel group holed up in a suburb of Damascus. ‘It changed the course of battle on the ground,’ Koblentz said.” Social media is also increasingly playing a large role in the U.S. and Russian dialogue of the attacks. “The heavy reliance of President Donald Trump’s administration on publicly available information marks a shift from his predecessor’s, which insisted on obtaining physical evidence of chemical weapons use with an established chain of custody before considering the use of force. It also highlights the difficulties Western intelligence agencies have faced in obtaining such evidence — blood, hair, or soil samples — from the Damascus suburb of Douma in the days following the April 7 chemical weapons attack that left nearly 50 dead and hundreds wounded.” The Director-General of the OPCW (Organization for the Prohibition of Chemical Weapons) recently provided an update on the fact-finding mission (FFM) in Douma, which you can find here. Challenges were found in OPCW actually getting into the site. “The United Nations Department of Safety and Security (UNDSS) has made the necessary arrangements with the Syrian authorities to escort the team to a certain point and then for the escort to be taken over by the Russian Military Police. However, the UNDSS preferred to first conduct a reconnaissance visit to the sites, which took place yesterday. FFM team members did not participate in this visit.On arrival at Site 1, a large crowd gathered and the advice provided by the UNDSS was that the reconnaissance team should withdraw. At Site 2, the team came under small arms fire and an explosive was detonated. The reconnaissance team returned to Damascus.” “The delay in the inspectors’ arrival, 10 days after the attack, will raise fresh concerns over the relevance of the OPCW investigation and possible evidence-tampering. The efforts to investigate the attack, which has been blamed on Bashar al-Assad’s government and sparked a joint operation by the US, Britain and France to bomb chemical weapons facilities near Damascus, has been repeatedly delayed despite Syria’s claim to have established full control over Douma and the surrounding region.” Koblentz notes that “Douma has been completely surrounded by the Syrian government and has been subject to intensive bombardment as part of the regime offensive since February,. The problem is that the territory is now occupied by the Syrian government and the crime scene is no longer secure. It doesn’t lend itself to a credible investigation. It’s like the criminals came back to the scene of the crime and they can do whatever they want with the evidence before the cops show up.”

CRISPR, Avengers, & Super Soldiers, Oh My! 
As we get closer to the release of Marvel’s Avengers: Infinity War, discussions about super soldiers and genome editing are growing like a mean, green, fighting machine. A frequent topic of conversation during the December 2017 Meeting of States Parties (at least among the ELBI attendees!), Matt Shearer posed the question – is Captain America a biological weapon? What about the other Avengers though – like Hawkeye, who is one of the few “normal” humans in the group? “Hawkeye’s accuracy with a bow and arrow is heavily dependent on his eyesight, which is clearly more advanced than the average human’s. As far as we know, his genome has not been intentionally altered, leading us to believe that Hawkeye has inherited his extraordinary eyesight from his parents. This theory is strengthened by the fact in the Marvel comic books, Barney Barton, Clint’s brother, is also an accomplished archer thanks to his enhanced vision. Perhaps Hawkeye’s advanced eyesight is the result of thousands of years of genetic evolution in the form of adaptation, genetic drift, or mutation of his ancestor’s DNA.” Writers at Synthego decided to look at which genes would need CRISPR modification to improve vision – like targeting specific opsin genes OPN1SW, OPN1MW, etc.

Survey – Most Americans Favor More Funding to Support Biosecurity Capabilities
A new survey by Alliance for Biosecurity has found that public confidence in US preparedness to address biosecurity has dropped. “Nationally, 73% of the 1,612 Americans surveyed say they would have a favorable reaction ‘if Congress decided to increase the budget this year for developing preventive measures for biological and chemical threats.’ How elected officials act on biosecurity issues is important enough to affect voters at the ballot box, according to the survey. A majority of Americans – 52% –  say they are more likely to support their elected representative if that representative is ‘actively engaged in promoting and supporting biosecurity.’ Similarly, 52% say they would become less likely to re-elect a representative who voted AGAINST providing additional funding to the Strategic National Stockpile (SNS) and Biomedical Advanced Research and Development Authority (BARDA). Only 20% say voting against the additional funding would make them more likely to re-elect that representative.” The survey found that only 31% of Americans are confident in our national preparedness, which is a drop from the 50% found in a March 2016 survey.

Curious 2018
Are you planning on being in Germany July 16-18? Don’t miss out on the Curious2018 Future Insight conference in Darmstadt. “The Curious2018 Future Insight conference is a world-renowned event around the future of science & technology and its application to build a better world for humanity. The best minds in science, technology, and entrepreneurship will come together to make great things happen and join forces to realize the dreams of a better tomorrow.” Topics will include healthy lives, materials & solutions, life reimagined (synthetic biology!), vibrant digital, and bright future.

Foodborne Illness Outbreaks – Romaine Lettuce and Eggs
Cobb salads may be taking a beating this week as two main ingredients are setting food epidemiologists into overtime with E.coli and Salmonella outbreaks. Three days ago, it was announced that the source of a 16-state E. coli O157:H7 outbreak, had been identified as a romaine lettuce farm in Yuma, AZ. The CDC recently announced that 53 people have been sickened and the common ingredient amongst them was chopped romaine lettuce, which was traced back to the Yuma region. If that wasn’t bad enough, over 206 million eggs have been recalled across 9 states due to a Salmonella outbreak linked back to eggs from a farm in Hyde County, N.C., and distributed by an Indiana company. “The FDA said the voluntary recall is the result of 22 illnesses reported in East Coast states, which led to extensive interviews and an inspection of the Hyde County farm. The outbreak involves the Salmonella Braenderup subtype. Federal and state officials have been investigating the outbreak since early March.”

Stories You May Have Missed:

  • Holding Russia Accountable in Salisbury– During this week, the UN Security Council and the Executive Council of the Organization for the Prohibition of Chemical Weapons (OPCW) met to discuss the most recent OPCW findings. Per the U.S. State Department – “The OPCW’s independent report, released last week, confirms the UK lab analysis regarding the identity of the chemical used in Salisbury. We applaud the OPCW’s expeditious support and technical efforts to uncover the facts. We fully support the UK and the need for today’s special meetings of the OPCW Executive Council and the UN Security Council to discuss the chemical weapons attack in Salisbury and the OPCW’s detailed independent analysis.”
  • Apartment Mice: Harborers of Disease? “In a study today in mBio, the researchers report that a genetic analysis of droppings collected from house mice in New York City detected several types of bacteria capable of causing gastrointestinal disease, including Shigella, Salmonella, Escherichia coli, and Clostridium difficile. They also found genes that confer resistance to fluoroquinolones, beta-lactam antibiotics, and methicillin. Overall, more than a third of mice carried at least one potentially pathogenic bacterium, and nearly a quarter carried at least one antibiotic resistance gene.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 3.23.2018

TGIF and Pandora Report day! Tomorrow is World TB Day, in which we celebrate the progress made to eradicate TB, but also recognize the work that still needs to be done. Did you know that 53 million lives were saved through effective TB diagnosis and treatment from 2000-2016? In 2016 alone, there were nearly 500,000 cases of multidrug-resistant TB around the world and it takes $2.3 billion a year to fill the resources needed for existing TB interventions. If you happen to be traveling by air anytime soon, make sure to read these tips from public health experts.

How Prepared Are You For the Next Pandemic? Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
Three days filled with global health security and all things biodefense from anthrax to Zika – what more could you want in a workshop? Learn from the top minds in the field when it comes to pandemic preparedness, vaccine development, biosecurity, etc. Between the centennial of the 1918 influenza pandemic, the recent horsepox synthesis, and the lift on the gain-of-function research moratorium, these three days will be packed with exciting topics and discussions. From July 18-20th, come get your biodefense on with us in Arlington, VA – registration prior to May 1st also gets an early bird discount!

Shining A Spotlight On Soviet Nerve Agents
A nerve agent attack in the UK has made the poison, Novichok, a household name, but also pointed a very large spotlight on Russia’s scientists and defense labs. “Few experts in the rarefied area of chemical weapons defense are willing—or able—to shed further light on them. Information about the Novichok nerve agents is classified, says one U.S. military scientist who, like other U.S. government scientists, declined to speak with Science.” Whatever the plan, this failed attempt for the quick deaths of Skripal and his daughter have left many questions about delivery of the agent and how this heavily guarded secret nerve agent found its way onto UK soil. An article from The Trench discusses the use of these nerve agents, formal accusations from the UK, and compliance of the Chemical Weapons Convention (CWC). “The OPCW experts travel to the UK under Article VIII, 38(e), which qualifies their activity as a ‘Technical Assistance Visit’ to help with the evaluation of an unscheduled chemical (the Novichock agent) is not listed in any of the three schedules in the Annex on Chemicals).  They will likely visit the sites of investigation and collect their own samples (if for no other reason than to validate any laboratory samples they may receive), take all materials and documents related to the forensic investigation back to the Netherlands where the sample will be divided up and sent to two or more designated OPCW laboratories.” On Wednesday, Russian diplomatic and military officials reportedly accused the UK of hiding evidence in the investigation of the attack. “Speaking to a lecture hall of diplomats, Vladimir Yermakov, deputy head of the ministry’s department for non-proliferation, suggested that the UK was ‘hiding facts’ about the case that may later ‘disappear’.” British diplomat Emma Nottingham noted that “Russia has offered us so far no explanation of how this agent came to be used in the United Kingdom and no explanation as to why Russia has an undeclared chemical weapons programme in contravention of international law,”.

Pandemic Preparedness
“Are we prepared for the next pandemic?” Such a question pulls at the string of a much larger web that tends to leave many feeling unsettled. The scary truth is that we’re not ready. We know there will be a pandemic – history, science, and society, all tell us this. Encroachment on nature, increasing globalization and populations, and struggles against more frequent threats like seasonal flu and even antimicrobial resistance, all reveal a severe vulnerability to infectious diseases. Lessons from HIV, Ebola, and Zika, are just the latest and on the centennial of the 1918/1919 influenza pandemic, many hope that we learned from such events and can help prevent future ones. Predictions trickle across many sectors – loss of healthcare worker lives, financial and economic struggle, etc. “Such a pandemic could cause a global stock market crash that obliterates the livelihoods and savings of millions of survivors. ‘A severe and prolonged global pandemic could … hit global GDP by as much as 5-10% in the first year,’ noted the authors of the Bank of America/Merrill Lynch 2015 Global Pandemics Primer report. Oxford Economics has suggested that the cost of a global pandemic, including spillover across industry sectors, could be as great as $3.5tn – an impact far greater than the magnitude of the great financial crisis of 2008.” With funding for the GHSA in peril, the question of preparedness becomes even more relevant…and pessimistic. The tricky thing about infectious disease threats is that we’re not sure where the next one will come from. We have hints and sometimes we’ll get a whiff of which way the wind is blowing before the storm hits, but ultimately, there is so much we can’t predict. Given these challenges, prevention efforts, like those of the GHSA, should be seen as even more critical. Infectious disease prevention strategies are always a good return on an investment. It’s also the unexpected that impacts disease control and surveillance efforts. Local news is one that doesn’t often come to mind when considering epidemiology and infectious disease forecasting. “Epidemiologists rely on all kinds of data to detect the spread of disease, including reports from local and state agencies and social media. But local newspapers are critical to identifying outbreaks and forecasting their trajectories. ‘We rely very heavily on local news. And I think what this will probably mean is that there are going to be pockets of the U.S. where we’re just not going to have a particularly good signal anymore,’ said Majumder, a Ph.D. candidate at the Massachusetts Institute of Technology.”

GMU Biodefense MS Open House & PhD Information Session
Looking to earn a Masters or PhD in a field that’s at the nexus of foreign policy and public health? GMU Biodefense is just the place for that. We’re hosting two information sessions for our biodefense graduate degrees – the MS Open House is next Wednesday at 6:30pm (Arlington Campus) and the next PhD Information Session is on Wednesday, April 18th at 7pm, in Arlington, VA. These are great opportunities to hear from faculty and students in each biodefense program about not only the application process, but also the classes and what it’s like to study what you love!

CDC Selects New Director
Dr. Robert R. Redfield was just announced as the new director for the CDC. Redfield will take over for interim director Dr. Ann Schuchat, who many were hoping would take post. The new director has a background in HIV and is said to be a dedicated researcher and physician. Unfortunately, Redfield also comes with a rather novel history for CDC directors – he has never worked for a public health department. “Critics also point to a resume marred with controversy. In the 1990s, Redfield was accused of falsifying data about an experimental HIV vaccine he worked on. He was eventually cleared of those charges, but the data had to be corrected.” On Tuesday, Sen. Patty Murray (Wash.) raised concerns regarding his appointment, noting that, “This pattern of ethically and morally questionable behavior leads me to seriously question whether Dr. Redfield is qualified to be the federal government’s chief advocate and spokesman for public health.”

Brazil Calls for Country-Wide Yellow Fever Vaccination
Brazil has been battling a yellow fever outbreak since 2017 and vaccine shortages have only fueled the challenges of outbreak response. “Brazil announced yesterday that all citizens should be vaccinated against yellow fever. The country is currently experiencing a spike in cases in what has shaped up to become the largest yellow fever outbreak to hit the country since the 1940s.The Associated Press (AP) reported that Ricardo Barros, Brazil’s health minister, said all 27 of Brazil’s states will be targeted in a vaccination campaign that will aim to reach 78 million people by 2019. Before the announcement, the vaccine was recommended in all but four Brazilian states.”

Importance of GHSA
GMU Biodefense PhD student Saskia Popescu wants clinicians to understand the importance of the GHSA and why US investment is critical. “Like many components of public health and infectious disease, the importance of prevention is often forgotten until an outbreak occurs. Hospital preparedness and infection prevention were not necessarily ‘big ticket’ items in the United States until we had Ebola in Dallas, Texas, but it only takes 1 laboratory incident to remind us of the importance of biosecurity and biosafety.”

Food Defense Conference
The Food Protection and Defense Institute will be hosting this conference on May 22 & 24th in Minneapolis, MN. “As the food system is becoming ever more global, companies need to be prepared to protect not only their products but also their reputation. The Food Protection and Defense Institute will be hosting a 2-day Food Defense Certification Training Course on May 21 & 22, 2018 that will teach food industry professionals how to navigate basic food defense principles, recognize vulnerabilities, and create a tailored food defense plans.”

Stories You May Have Missed:

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 3.9.2018

Nerve agent attacks, horsepox synthesis, and funding global health security, oh my! On top of all the biodefense news we’ve got in store for you this week, we’re also thoroughly excited to announce the 2018 summer workshop on pandemics, bioterrorism, and global health security.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security – From Anthrax to Zika
We’re delighted to release the dates for the summer workshop on all things global health security. The recent publication of the horsepox synthesis study, uncertain future of U.S. investment in global health security, and a severe flu season, are just a handful of the topics we’ll be addressing in this three-day workshop from July 18-20, 2018. Did I mention that it’s also the centennial of the 1918/1919 pandemic? We face unprecedented microbial challenges in this modern age – whether it be the risk of nefarious actors misusing genome editing, antimicrobial resistance, or the speed at which a disease can circumvent the globe. Our workshop is the perfect place to learn from experts in the field and meet with a diverse group of fellow biodefense gurus. If you register before May 1st or are a returning member or GMU alum, you can even get a discount! From anthrax to Zika, our July workshop is the place to be for all things health security.

 The Herculean Challenge of Assessing the De Novo Synthesis of Horsepox 
Nine-headed Hydra or cleaning out the Augean stables? None of these tasks were particularly easy, and neither is truly assessing the risks and benefits of the recent horsepox synthesis. Two of the latest articles analyzing the implications of this research have been released this week in mSphere.  In the editorial, Michael J. Imperiale points to the increased attention on DURC and the debate surrounding the benefits of a new vaccine versus the potential for a nefarious actor to misuse the process. “The two articles posted today come from Gregory Koblentz at George Mason University, who argues that this work was poorly justified on two fronts, scientifically and commercially, and from Diane DiEuliis and Gigi Gronvall from National Defense University and the Center for Health Security at Johns Hopkins University Bloomberg School of Public Health, respectively, who discuss this study in the larger context of how the risks and benefits of dual use research are assessed and managed. (mSphere asked the leadership of Tonix to submit a manuscript, but we received no response.)” Koblentz first underlines the weak scientific foundation for the claim that the horespox synthesis aids in the development of a new smallpox MCM. He states that the “combination of questionable benefits and known risks of this dual use research raises serious questions about the wisdom of undertaking research that could be used to recreate variola virus.” Within his commentary, Koblentz addresses the scientific and commercial rationale for synthesizing the virus as well as the weak scientific basis for its use as a safer alternative for human vaccine use and the lack of demand for a new smallpox vaccine. “At the heart of the dual use research dilemma is the need to assess and balance the benefits and risks presented by an experiment or line of research. This is a difficult task given the largely theoretical risks posed by unknown adversaries in the future and the enticing yet uncertain benefits that the research may eventually yield. Indeed, measuring risks and benefits and weighing them can be a wicked problem that defies simple or straightforward conclusions. The difficulty of the task, however, does not excuse researchers, funders, or journal editors from trying to do so. While the benefits of biotechnology and life sciences research are beyond question, we should not take for granted the benefits of specific experiments or avenues of dual use research.” In their counterpoint article, Diane DiEuliis and Gigi Kwik Gronvall emphasize that the horsepox researchers went through due biosecurity diligence at their research institution, the importance of utilizing an analytical framework for assessing the risks and benefits of DURC, and discuss “relevant components of biosecurity policy and the biodefense enterprise (including the acquisition of medical countermeasures) in the United States.” DiEuliis and Kwik Gronvall point to the horespox synthesis (and the controversy) as an opportunity to evaluate how dual-use risks should be handled, the complicated approach to stockpiling MCM, and “the challenges of forecasting risks and benefits from a particular scientific discovery or technology”. They highlight the National Academies Imperiale report framework for evaluating the capacity for technology to be misused, which includes factors like weighing the use of the technology itself against consequence management, etc. They also note three issues that have been raised by the horespox paper that require additional consideration – “The decision of what to do with a technology or research area that is dual use cannot be black or white, MCMs cannot be a check-the-box procedure for the USG, The synthesis of and booting up of a pathogen should serve as strategic warning that current biosecurity controls and preparedness are insufficient.” DiEuliis and Kwik Gronvall note that “Now that the work has been published, the authors examined the research according to the Imperiale report framework, which aims to provide a systematic way to evaluate biosecurity risks. We again found that while dual use information would benefit highly experienced actors who are intent on misuse, the recreation of smallpox virus may require additional research and development steps than have been described in this publication: smallpox virus is less similar to horsepox virus than horsepox virus is to vaccinia virus, the tools to recreate horsepox virus were originally developed for vaccinia virus, and they might require additional troubleshooting for re-creation of smallpox virus.”

NTI Launches GHS Video: Act Now to Protect U.S. Investment in Global Health Security
The Nuclear Threat Initiative (NTI) has launched a new video urging Congress to act now and ensure funding for global health security. Dr. Elizabeth Cameron, NTI VP, global biological policy and programs, is spear-heading the endeavor to turn the tides and ensure sustained funding for global biodefense. “Without sufficient funding of $208 million a year for the Center for Disease Control (CDC) and $172 million a year at the United States Agency for International Development (USAID), we weaken the global network of protection, increase risk to American lives, and threaten investments from other governments and the private sector. Urge Congress to act now to provide sustained funding for global biodefense.” Cameron notes that “in response to the devastating Ebola crisis of 2014, the United States Congress authorized over $900 million in supplemental funding to support the Global Health Security Agenda (GHSA) for five years to help countries prepare for and address biological threats. This critical funding runs out at the end of fiscal year 2019, placing up to 80% of our global health security efforts abroad – offices, personnel, and programs – at risk. Also at risk?  U.S. health security and extended biodefenses. Without sufficient funding of $208.2 million a year for the Center for Disease Control (CDC) and $172.5 million a year at the United States Agency for International Development (USAID), we weaken the global network of protection, increase risk to American lives, and threaten investments from other governments and the private sector.”

Ominous Biosecurity Trends Under Putin
If you ever needed a reminder of the importance of investing in global health security, this just might provide that cold dose of reality. The latest book from Raymond Zilinskas and Philippe Mauger, Biosecurity in Putin’s Russia, assesses Russia’s actions regarding DURC and biosecurity measures. “They investigate — solely through open sources — the current Russian position. They especially dig into issues such as ‘genetic weapons’ (bioweapons aimed at damaging DNA, potentially of specific individuals or groups) and biodefence research. Their underlying intention throughout seems to be to examine the likelihood that the Russian government is itself willing to engage in banned activities related to biowarfare agents. The book thus becomes a technical-scientific detective story.” This is an in-depth analysis by two top biological weapons specialists – definitely worth the read!

A Nerve Agent, An Ex-Russian Spy, And A Bench in the U.K. 
Speaking of Russia…..a former Russian spy was recently found alongside his daughter in critical condition on a bench in Salisbury. The former spy, Sergi Skripal, and his daughter, Yulia, were found slumped over on Sunday and in desperate need of medical attention. It is now being reported that they were poisoned by a nerve agent, which has raised the suspicion that this was an assassination attempt. “The development forces the British government to confront the possibility that once again, an attack on British soil was carried out by the government of President Vladimir V. Putin, which Western intelligence officials say has, with alarming frequency, ordered the killing of people who have crossed it. Prime Minister Theresa May and her cabinet ministers held a meeting on Wednesday of the government’s emergency security committee to discuss the matter. ‘This is being treated as a major incident involving attempted murder by administration of a nerve agent,’ said Mark Rowley, Britain’s chief police official for counterterrorism and international security.” Twenty-one people are also being treated for exposure to the nerve agent in connection to the attack.

Netflix Documentary – Rajneesh Salad Bar Bioterrorism
Get ready for some Netflix and nerdom on March 16th as the documentary on the largest bioterrorist attack in the United States is released. “In 1984, more than 700 people in The Dalles, OR, contracted Salmonella infections after followers of Rajneesh sprinkled the pathogen on salad bar ingredients in 10 local restaurants. The action was an effort to swing the results of an election.” Don’t miss out on the biosecurity twitter activity during a virtual viewing party – @pandorareport!

#NoImpunity: Will The Newest International Effort to Stop Chemical Attacks in Syria Succeed?
How can we stop the use of chemical weapons if there is no authority on attribution? GMU professor Gregory Koblentz is delving into the latest strategy to hold the Assad regime accountable for their continued use of chemical weapons. Between Russian vetoes that halt OPCW efforts and the death of the Joint Investigation Mechanism, many worry that the lack of punishment will encourage further CW use by the Assad regime. “To fill this gap in the global anti-chemical weapon architecture, France launched an international initiative in January to pressure the Assad regime to halt its use of chemical weapons. The Partnership Against Impunity, which uses the hashtag #NoImpunity on Twitter, is a group of 25 countries motivated by the twin goals of deterring future chemical attacks and bringing to justice the perpetrators of past attacks.” Sure, the sanctions by some of these countries are ultimately more symbolic than behavior-changing, but they are now infusing a dose of public shaming into the mix. “First, by curating a public database that lists all of the front companies and procurement agents used by the SSRC, the Partnership Against Impunity makes it easier for other countries and companies around the world to avoid doing business with Syria’s chemical weapons program. While sanctioning these shadowy companies and middlemen is like playing ‘whack-a-mole,’ it is an essential element of preventing Syria from rebuilding the capabilities that the OPCW destroyed after Syria joined the Chemical Weapons Convention.” The Partnership Against Impunity is also laying “the groundwork for future prosecutions of military officers and government officials who engaged in war crimes” and establishing a “concrete manifestation of the noble goal enshrined in the preamble of the Chemical Weapons Convention ‘to exclude completely the possibility of the use of chemical weapons’.”

 Assessing CRISPR – The Dread And the Awe
Genome editing is a hot topic – both in terms of future possibilities, but also potential peril. GMU biodefense professor Sonia Ben Ouagrham-Gormley and doctoral student Saskia Popescu are teaming up to review two new books on this gene editing technology. First, A Crack in Creation by Jennifer Doudna, one of CRISPR’s creators, who discusses the revolutionary marvel with a mixture of hope and dread. “Doudna became aware of this paradox soon after publishing the seminal 2012 article that announced her discovery. She was surprised and delighted by the technology’s rapid spread and its use in a variety of fields, yet some applications—such as the use of Crispr to edit human embryos, as performed for the first time by Chinese scientists in 2015—made her uneasy about the future of the technology. Unscrupulous individuals’ interest in using Crispr for pure profit made her uneasy as well.” Next, Modern Prometheus by computational biologist and freelance writer, Jim Kozubek. “He ponders the power of genetic manipulation as a gateway to the dehumanization of medicine and the objectification of human beings. Kozubek draws comparisons with ‘Jurassic Park’ and Mary Shelley’s Frankenstein to pose larger questions about genetic engineering—and also to point out that, though people are fascinated with technological advances, they often neglect to consider technologies’ implications, notably on people themselves.”

The U.S. and Global Health Security At A Time of Transition
The Kaiser Family Foundation will be hosting this free event on Monday, March 12th from 2-3:30pm EDT at the Kaiser Family Foundation Barbara Jordan Conference Center in Washington, D.C. This event will seek to explore the future of U.S. global health security efforts, what role the U.S. will play in the future of the GHSA, and more through a panel of experts. “Jen Kates, Vice President and Director of Global Health and HIV Policy, will provide opening remarks, and Anne Schuchat, Acting Director, Centers for Disease Control and Prevention (CDC), will give a keynote address on U.S. global health security efforts. Josh Michaud, Associate Director of Global Health Policy at the Kaiser Family Foundation, will moderate a follow up discussion with Beth Cameron, Vice President for Global Biological Policy and Programs at the Nuclear Threat Initiative (NTI); Rebecca Katz, Associate Professor and Co-Director of the Center for Global Health Science and Security at Georgetown University; Nancy Knight,Director of the Division of Global Health Protection at CDC; and J. Stephen Morrison, Senior Vice President and Director of the CSIS Global Health Policy Center.”

New Paradigms for Global Health: Building Capacity through Science and Technology Partnerships
The American Association for the Advancement of Science and Hitachi Ltd. will be hosting this event on March 21st from 11:30am-12:30pm at the AAS headquarters in New York City. “Why are science and technology partnerships — and science diplomacy — more critical to global health than ever before? Jimmy Kolker, former U.S. ambassador to Uganda and to Burkina Faso and the Obama Administration’s chief HHS health diplomat, offers a practitioner’s perspective on new ways of integrating and advancing global health science, security, and assistance. Public-private and technical partnerships can enable the best experts to build sustainable capacity in low- and middle-income countries, strengthening global health science, policy, systems, and delivery.”

Stories You May Have Missed:

  • The Troubling Truth About Medicine’s Supply Chain –  Maryn McKenna (author of Big Chicken and all around global health guru) is lifting back the curtain on the painful reality that is America’s hospital supply chains. While not something the public generally considers, it’s something we need to start fixing. “Missing IV bags and missing pharmaceuticals seem like unrelated problems, a temporary disruption layered on top of a longstanding problem. But in fact, they are unavailable for the same reason. The United States has allowed the manufacturing of most of its drugs and medical devices to drift offshore, at the end of long, thin supply chains.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 2.16.2018

 

 White House Budget Hits Public Health
The White House has released their new plan, “Efficient, Effective, Accountable: An American Budget”, which sees an increase in military spending, funds for a U.S.-Mexico border wall, and a 10%  increase in spending from 2017. “The plan also calls for major cuts to Medicare, Medicaid, food stamps and other social programs — reductions that conservatives have long sought. But even with these reductions, which add up to more than $3 trillion in cuts over 10 years, the proposal would not bring the budget into balance because of the lost tax revenue and higher spending on other programs.” The 2019 budget proposal also includes $9.2 billion added after Congress lifted mandatory spending caps. “But the 2019 budget might not be as steady as it seems, because the White House is calling for the creation of three new institutes within the NIH. They include a National Institute for Research on Safety and Quality, which would replace the $324-million Agency for Healthcare Research and Quality within the Department of Health and Human Services (HHS). The Trump plan would also transfer the National Institute of Disability, Independent Living, and Rehabilitation Research from the HHS’s Administration for Community Living, and the National Institute of Occupational Safety and Health (NIOSH) to the NIH from the US Centers for Disease Control and Prevention (CDC).” The plan also includes a cap for how much salary a scientist can draw from an NIH grant (90%), gives NIH an additional $750 million for research towards the opioid crisis ($400 million of which must “be spent on public-private partnerships to develop new treatments”). Unfortunately, this proposed budget significantly weakens public health preparedness and response plans with a 43% reduction in the CDC’s Public Health Preparedness and Response Program. Furthermore, it includes hitting the CDC hard with a 12% reduction and plans to move the strategic national stockpile (SNS) to ASPR. Such plans severely impact global health security as funding for the GHSA is expected to drop. You can read a further overview on the health security outlook by the Johns Hopkins Center for Health Security here. There has also been increasing concern regarding the lack of a nominee for the head of the Office of Science and Technology Policy, especially since the de facto advisor is a 31-year-old political science major from Princeton

GMU Schar School MS Open House
Don’t miss out on our information session next week. This is a great chance to chat with faculty about the GMU Biodefense MS program (both online and in person). “The session will provide an overview of our master’s degree programs, an introduction to our world-class faculty and research, and highlights of the many ways we position our students for success in the classroom and beyond. Our admissions and student services staff will be on hand to answer your questions.” FYI – GMU biodefense students are making headlines for their dedication and passion for health security, come join the nerdom!

Next Generation Global Health Security Mentorship Program
Interested in becoming a mentor  or protege in health security? The NextGen Global Health Security Mentorship Program is a great way to build partnerships and collaborations for those passionate about health security. “The NextGen Global Health Security (NGGHS) Mentorship Program is an annual program aimed at connecting early to mid-career professional and students interested in global health security with experts in the field to enhance professional development. Mentors and Protégés are free to establish a program that suits them best. Meetings can be based on current events, suggested topics and/or other common areas of interest. The pair will maintain correspondence either in person, over the phone or by email, as often as they have decided feasible.” If you’re a GMU biodefense alum, also make sure to update your information in Stay Connected so you’ll get the latest in biodefense program news and opportunities!

The Anniversary of Kim Jong Nam’s VX Assassination
February 13th marked the one-year anniversary of the assassination of Kim Jong Un’s half brother at the Kuala Lumpur airport. Kim Jong Nam was attacked by two women who smeared VX nerve agent on his face. “The women claim they were tricked into believing they were part of a reality show, but the U.S. and South Korea say the murder was orchestrated by Pyongyang. The brazen killing came as North Korea was starting to accelerate its missile tests and countries around the world came under mounting pressure to enforce ever-tightening U.N. sanctions against Pyongyang.” In the wake of the attack, Malaysia is working to distance itself from its previously close relationship with Pyongyang. The murder trial, which started in October of 2017, is set to end in March of this year, with the two women maintaining their innocence. 

Biosafety Failures in UK Lab
The Health and Safety Executive (HSE) released findings from their investigations into more than 40 “mishaps” at specialist labs from 2015-2017. The labs were run by hospitals, private companies, and Public Health England (PHE), which reveals an unfortunate trend across many sectors. “One scientist at a PHE laboratory became sick after contracting Shigella, a highly contagious bacterial infection that causes most cases of dysentery in Britain. The incident led the HSE to send the agency an enforcement letter to improve its health and safety practices.” Incidents range from failure to communicate safety requirements for mailing samples to airflow failures and lab workers acquiring illnesses from lab safety mishaps.

Antimicrobial Resistance: Forging A New Strategy Against An Old Threat
GMU Biodefense students love all things health security and that includes antimicrobial resistance. PhD student Saskia Popescu is tackling the woefully insufficient response we’ve had over the years to this growing threat. Pointing to current challenges, initiatives, and research strategies, Popescu discusses current trends and hopeful plans to combat AMR. “What is to be done? There are several initiatives, like the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator (CARB-X), that seek to infuse life into the research and development of new drugs. There is also a push on health care providers and agriculture to reduce the use of antimicrobials. But these are all long-term solutions that may take years or decades to implement. Although long-term plans are critical, if you were hospitalized today with a highly resistant infection, what would be the short-term plan of action your heath care providers would take?”

ABSA Risk Group Database App
Check out the latest Risk Group Database resource (and app!) from the Association for Biosafety and Biosecurity (ABSA) International. “In many countries, including the United States, infectious agents are categorized in risk groups based on their relative risk. Depending on the country and/or organization, this classification system might take the following factors into consideration: pathogenicity of the organism, mode of transmission and host range, availability of effective preventive measures (e.g., vaccines), availability of effective treatment (e.g., antibiotics), and other factors.”

Blue Ribbon Study Panel on Biodefense Receives Grant to Advance Leadership and Reduce Catastrophic Risk
“The Blue Ribbon Study Panel on Biodefense announced today a $2.5 million grant from the Open Philanthropy Project. The grant allows the Panel to continue its leadership role in assessing our nation’s biodefense, issuing recommendations and advocating for their implementation, and identifying viable avenues for needed change to policy. The grant comes amidst heightened global tensions as North Korea and other regimes seek to develop biological weapons. It also arrives on the 100th anniversary of a catastrophic influenza pandemic that took the lives of millions around the world, a stark reminder of the dangers of biological events.”

Stories You May Have Missed:

  • DHS Announces Finalists in $300k Biothreat Prize Competition –  “The Department of Homeland Security (DHS) Science and Technology Directorate (S&T), in collaboration with the Office of Health Affairs National Biosurveillance Integration Center (NBIC), today announced five finalists for Stage 1 of the Hidden Signals Challenge. The challenge calls for the design of an early warning system that uses existing data to uncover emerging biothreats. The announcement was made at the American Society for Microbiology’s 2018 ASM Biothreats meeting.”
  • Seoul Virus Transmission – Have a pet rat at home? Make sure to practice safe rodent handling and hand hygiene as physicians are seeing cases of rodent-to-human transmission of Seoul virus. “After confirming Seoul virus infection in the Wisconsin patients, the CDC and the Wisconsin Department of Health Services investigated the source of the disease. ‘The outbreak spread from sales or trade of infected pet rats between people’s homes or between ratteries’ – places where rats are bred – ‘in 11 states,’ said Kerins, who coauthored the report.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport