Tag: preparedness

Pandora Report 1.13.2017

by spopescu, posted in Pandora Report

Make sure to get the CRISPR a cappella song stuck in your head for not only a catchy tune, but one that educates you on the genome editing tool! In light of the recent sanctions, GMU Biodefense Director, Gregory Koblentz is discussing why holding the Assad regime accountable for its use of chemical weapons is likely a lost cause.

Recommended Policy Guidance for Potential Pandemic Pathogen Care & Oversight
On Monday, the White House Office of Science and Technology Policy (OSTP) released their report “Recommended Policy Guidance for Departmental Development of Review Mechanisms for Potential Pandemic Pathogen Care and Oversight (P3CO).” It would seem that P3CO is the new term for GoF research of concern (or GoFROC). Although, as Megan Palmer of Stanford noted, it’s going to be a challenge not calling it the C3PO policy. Adoption of these recommendations will satisfy the requirements for lifting the current moratorium on certain life sciences research that could enhance a pathogen’s virulence and transmissibility to produce a potential pandemic pathogen (an enhanced PPP). This policy follows the 2016 NSABB Gain of Function (GoF) research oversight recommendations, which emphasizes the importance of domestic and international stakeholder input, tracking of lab incidents, etc. One of the suggestions was to refer to the GoF research (meeting the specific criteria) as GoFROC as to avoid lumping all GoF research within the same category of concern. Per the press release, “First, HHS will ask the NSABB to continue to provide advice on the oversight of the creation, transport, or use of enhanced PPP.  After HHS has reviewed its paused projects and made decisions about whether and how those projects will proceed, NSABB will review the process employed by HHS and provide advice, if necessary. Continued NSABB input will be essential to ensuring robust oversight of these projects. Further, discussing the department-level review process with NSABB will promote transparency and provide valuable forums for continued public dialogue. Second, given that studies involving enhanced PPP are often described as ‘dual use’ research, HHS is currently conducting a review of the implementation of policies for the oversight of dual use research of concern (DURC). HHS has asked NSABB to host a series of regional stakeholder meetings to gather information about the implementation of the DURC policies, and it will also solicit feedback more broadly related to their implementation.” Some of the proposed suggestions include risk mitigation and project oversight comments like “modifying the design or conduct of the project” or “if the risks posed by the project cannot be adequately mitigated with these measures, agencies should determine whether it is appropriate to: request voluntary redaction of publications or communications resulting from the project.” The plan will help U.S. agencies decide if they want to fund projects that will enhance the virulence and transmission capacity of dangerous organisms, which will hopefully end a two-year moratorium on GoF work regarding MERS, SARS, and H5N1.

Thinking About Bioterrorism with Schelling’s ‘Thinking About Nuclear Terrorism” 
GMU Biodefense MS student, Greg Mercer is looking at bioweapons through the lens of Thomas Schelling. Professor Schelling, who passed away in December, was an economist and Nobel laureate famous for his work on nuclear strategy and coercive diplomacy. Mercer uses Schelling’s 1982 article, Thinking About Nuclear Terrorism, to consider how he might have addressed the threat of biological weapons in the hands of terrorists. “As with nuclear weapons, it is immensely difficult to acquire and weaponize pathogens. Using them to coerce might be even harder. There are a very few distinct examples of bioterrorism. The Aum Shinrikyo cult, in addition to their sarin gas attacks on the Tokyo subway, pursued biological weapons. This was never viable, thanks to a number of mistakes, including using the wrong strain of anthrax.”

Whole Genome Sequencing in Developing Countries
The WHO/Pan-American Health Organization are working towards utilizing Whole Genome Sequencing (WGS) as a surveillance tool in developing countries. Experts will be meeting this week in DC to discuss the applications and practical advice needed by the recipient countries of such mechanisms. “WGS has the potential to change the way we detect, assess, investigate, manage, and monitor microbiological hazards and to improve the treatment of people suffering from infectious diseases. It allows for the identification and characterization of microorganisms with a level of specificity not previously possible. The technology provides significant cross-sector potential, enabling uniform typing systems across animal, food and human sectors.” This will be a new roadmap for WGS in developing countries, as its history has been primarily research based. While many agree that there are several roadblocks ahead, the potential for application is promising however, it needs the correct leadership to maintain efficacy.

Pandemics, Bioterrorism, and Global Health Security on LinkedIn
Looking for a LinkedIn group that is dedicated to analyzing the challenges facing the world at the nexus of health, science, and security? We’ve got just the one – Pandemics, Bioterrorism, and Global Health Security. The group’s purpose is to serve as a unique forum for discussions and debate on the critical issues on global health security. Nearing 3,000 members, you’ll find a diverse and engaged group of people who are looking to tackle the challenges that are posed by biological threats, regardless of source. This group is devoted to bridging the gaps between science and policy and between health and security to develop new strategies for reducing the risks posed by transnational threats to global health security. It is hoped that this group can serve as a means of keeping scientists informed about the latest policy developments in the global health security domain as well as to educate practitioners about the policy implications of emerging infectious diseases and advances in the life sciences and biotechnology.

America’s Growing AMR Problem  

Courtesy of Reuters
Courtesy of Reuters

Let’s start with a bit of a good news – for the first time, federal injury reports will include healthcare-associated antibiotic resistance bacteria infections in attempts to set penalties for healthcare facilities. The fourth installment in Reuter’s investigational series regarding antimicrobial resistance is out and it brings the issue full circle. Focusing on the costs of AMR, the lack of new antibiotics, and personal accounts, this series is everything we need to paint the full picture of the antibiotic abyss. The fourth installment, Deadly Silence, is particularly fascinating as it looks at the problem from a healthcare reporting perspective. Coming from this infection preventionist, it isn’t surprising to see the lack of required AMR reporting across the U.S. however, it is shocking to see the general indifference towards changing it. Focusing on long-term care facilities (like nursing homes or rehab centers), it becomes increasingly apparent that they’re uniquely vulnerable to outbreaks and have little incentive or responsibility to report cases or events. “As Reuters reported in September, the Centers for Disease Control and Prevention, the national public health monitor, lacks regulatory power to track superbug deaths. It also lacks the authority to enforce outbreak reporting. Instead, it sometimes assists states with their outbreak investigations, a spokesman said, but each state decides which diseases must be reported.” The reporting issues are especially important because it’s not just that we have a problem with lack of new antibiotics or a growing number of antimicrobial resistance, or even a growing usage of antibiotics among humans and animals, but also that we lack the oversight and enforcement to ensure healthcare facilities monitor the problem and do something about it. This gap means that we have little true understanding for not only the depth of the issue, but also the breadth of it. Simply put, we need a new game plan for combating the growing threat of antibiotic resistance.

PHEMCE Strategy & Implementation Plan
HHS recently released their 2016 Public Health Emergency Medical Countermeasures (PHEMCE) Strategy and Implementation Plan (SIP). The report provides updates and a blueprint regarding their plans to enhance national health security via medical countermeasures (MCM). Within the PHEMCE SIP, you can find a summary of their major accomplishments, activities currently being pursued, recap of the advanced research and development and procurement awards, and more. “In FY 2015, BARDA continued to work closely with NIH and DoD to monitor the progress of programs supported under research and development and transition promising candidates. In FY 2015, BARDA re-issued the three BAAs to support advanced development of CBRN and Influenza MCMs and the BAA for Innovations. They were modified to align with the 2015 PHEMCE SIP and to address remaining gaps in preparedness as well as address new initiatives such as CARB and EID.”

Zika Outbreak Updates
As Angola reports cases, a new Moderna Therapeutics mRNA vaccine enters clinical trials. “A $54.2 million grant in 2016 from BARDA has supported the development of the vaccine through the scale-up for larger phase 2/3 efficacy trials. Based on the vaccine’s performance and availability of more funding, BARDA may provide up to $125.5 million to further advance the development of Moderna’s vaccine.” On January 11th, the CDC reported a total of 4,866 cases of Zika within the U.S. Physicians have released a photo showing symptoms of the first person to experience local Zika transmission in the U.S.

Stories You May Have Missed:

  • FDA Drops Plan to Release GMO Mosquitoes – Initial FDA plans to drop millions of genetically engineered mosquitoes in Key Haven, Florida, were halted after local residents voted against it.  The plan “was designed to help fight the Zika virus with mosquitoes that had been genetically altered. It would have been the first such initiative executed in the United States. However, attorneys for Key Haven and concerned citizens noted that the FDA did not complete adequate testing on the potential impact the release would have on people, the local environment, nor area species concerned threatened and endangered. Local residents were presented with the issue via voting ballot in November 2016, in which voters unanimously shot down the release. The Florida Keys Mosquito Control Division met after the Nov. 8, 2016, public referendum and voted against the trial run in Monroe County in Florida, according to http://www.flkeysnews.com.”
  • The Woes of Camel Vaccination Plans – In efforts to test an experimental vaccine against MERS, researchers are trying to slow the spread via camel vaccination. We often forget the battles that make up public health and vaccine development, but camel vaccination is definitely a new one. “Camels are not a very, let’s say, cooperative kind of animal from this point of view,’’ Segalés told STAT. “To get them out from the truck was not that easy. To get them into the facility was not that easy. And to get them into the box (holding pen) was not that easy. Trying to push them in was quite difficult sometimes. And the worst-case scenario was trying to take them out.”
  • Trump Picks Vaccine-Skeptic to Lead Vaccine Safety Commission– “Robert F. Kennedy Jr., a proponent of a widely discredited theory that vaccines cause autism, said Tuesday that President-elect Donald Trump asked him to chair a new commission on vaccines. Hours later, however, a spokeswoman for Trump’s transition said that while Trump would like to create a commission on autism, no final decision had been made.”

Pandora Report 12.23.2016

by spopescu, posted in Pandora Report

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

Pandora Report 5.27.2016

by spopescu, posted in Pandora Report

Before you start your holiday weekend, what’re your thoughts on Usain Bolt outrunning a mosquito? The Jamaican sprinter jokingly responded to questions regarding athlete concerns over Zika virus, noting that he’s not worried “because I’m fast – they can’t catch me”. (Hint – it looks like he can outrun a mosquito with his 22 mph capabilities versus the 1.12-3.35 mph of an Aedes mosquito). Sticking with the Olympian theme..bacterial teams? Researchers recently found that two strains of E.coli, resistant to different antibiotics, can protect each other in an environment containing both antibiotics. The phenomenon is called mutualism and researchers at MIT are now looking looking into the range of this practice and the potential for population synchronization. At the 69th World Health Assembly this week, the WHO revealed plans to revamp itself however, many point out that for an agency better at giving advice than taking action, it’s too little too late. In the case of the WHO, critics are calling for acta non verba. 

The World Bank Rolls Out the Pandemic Insurance Plan
Following the Ebola outbreak in West Africa, the World Bank has announced a new program that will enable funds to rapidly be mobilized during outbreaks. In hopes of ensuring a more speedy response to infectious disease disasters, World Bank President Jim Yong Kim stated that “pandemics pose a serious threat to global health and economic security.” The new Pandemic Emergency Financing Facility (PEF) is “a combination of catastrophe insurance and bonds, is a direct reaction to the sluggish donor response to the outbreak of Ebola”. Presented at the G7 meeting for finance advisors, Japan has already committed support with a $50 million contribution. The insurance will cover several classes of infectious disease outbreaks most likely to cause epidemics – ranging from new influenza or coronavirus strains, filoviruses like Marburg and Ebola, and other zoonotic diseases. The initial plan is to have a total of $500 million  and hopefully avoid outbreaks, like Ebola, rapidly growing due to poor financial support and response.

Antibiotic Apocalypse
As much as I’d love to say this title is a dramatic take on the issue of antibiotic resistance, the truth is pretty startling. A report done by the Review on Antimicrobial Resistance  (commissioned by the UK government and reviewed by officials including economist Jim O’Neill), estimated that by 2050, 10 million lives per year and $100 trillion are at risk due to drug-resistant infections. That’s quite a stark estimate, but as many have pointed out “the problem of drug-resistant microbes isn’t just about biology and chemistry; it’s an economic problem at heart, a catastrophic and long-bubbling mismatch between supply and demand. It’s the result of the many incentives for misusing our drugs, and the dearth of incentives for developing new ones.” Can we really tackle this issue though? It still amazes me hearing people in an emergency department or urgent care asking for an antibiotic and the physician having to explain that they have a viral infection or that antibiotics simply aren’t warranted. In many ways, when we are sick enough to go to the doctor, we want to walk away with some “cure” and the notion of bedrest and hydration isn’t all that comforting. So what can we do? The report notes some steps to help prevent this impending reality – massive global public awareness campaigns, improve hygiene, improve global surveillance of drug resistance and antimicrobial consumption in humans and animals, promote development and use of vaccines, promote new, rapid diagnostics to cut out the unnecessary use of antibiotics, better incentives to promote investment for new drugs and improve existing ones, improve the numbers, pay, and recognition of people working in infectious diseases (hear, hear!), etc. Other recommendations include improving sanitation and a global innovation fund for early-stage research. Scientists were recently startled to find for the first time in the U.S., a patient with a bacteria that is resistant to antibiotics that are used as a last resort. While the predictions are daunting, the threat of antibiotic resistance is one we can get ahead of if we make the commitment and start immediately.

The Growing Threat of Spillover Screen Shot 2016-05-23 at 9.38.18 AM
The United Nations Environmental Programme (UNEP) released their 2016 Frontiers Report “Emerging Issues of Environmental Concern”. One of the six major issues was zoonosis. “There is a worldwide increase in disease emergence and epidemics particularly from zoonoses – diseases that can be passed on between animals and humans. The report illustrates how the emergence and re-emergence of zoonotic diseases are closely interlinked with the health of ecosystems. The risk of disease emergence and amplification increases with the intensification of human activities surrounding and encroaching into natural habitats, enabling pathogens in wildlife reservoirs to spill over to livestock and humans.” The report notes that around 60% of all infectious diseases in humans are zoonotic and 75% of emerging infectious diseases are zoonotic. You can also find several great infographics that paint a very surprising picture regarding the emerging zoonotic disease events from 1940-2012 and the top three reported zoonoses for specific continents. The growing Zika epidemic is just another in a long list of spillover cases including those of MERS, SARS, Ebola, and Rift Valley fever.

A Need To Rebalance
GMU Biodefense professor and Program Director, Dr. Gregory Koblentz, is pointing to the need for the U.S. to refocus its nonproliferation efforts on South Asia. Given the region’s high risk for nuclear crisis as a result of territorial disputes, cross-border terrorism, and increasing nuclear arsenals, there is a crucial need to re-allign nonproliferation efforts to include South Asia. “As of 2015, India was estimated to have 120 nuclear warheads while Pakistan was believed to possess 130 weapons. Both countries have also continued to develop, test, and deploy new missiles designed to deliver nuclear warheads. Pakistan has tested seven different types of nuclear-capable ballistic and cruise missiles, including the 2,750-kilometer range Shaheen-3 ballistic missile. Meanwhile, India has tested nine different types of nuclear-capable missiles, including the Agni-V intercontinental ballistic missile with a range of over 5,000 kilometers.” Dr Koblentz points to the impacting introduction of tactical nuclear weapons in South Asia and their ability to be deployed on short-notice – also concerning is India’s planned development of strategic missile submarines, which will likely trigger development from Pakistan. He notes that the international community can help restrain this dangerous competition by encouraging both countries to adopt confidence-building measures (limits on development of tactical nuclear weapons, etc.) and engage in high-level talks with “other nuclear weapon states to discuss measures that could further reduce the risk of nuclear weapons being used deliberately, by accident, or in an unauthorized manner.”

Rebuilding Trust in Biology 
Between the gain-of-function talks and biosecurity failures at major U.S. labs, there’s been a subtle shifting in the trust and support for biological sciences. New regulations could change oversight for sciences within the U.S. and many are wondering how we can restore trust back into this field. While we can all agree that forgotten smallpox vials and an accidental bird flu release translates to a need to revamp practices and facilitate more effective and efficient oversight, there’s been little mention of how we can combat the trust issues. This week the National Science Advisory Board for Biosecurity (NSABB) met to conclude their 18-month deliberation on select pathogen research practices and regulations. Let’s hope that with more effective and efficient practice recommendations, they are also looking into repairing the reputation of science and biology. Dr. Filippa Lentzos and Dr. Nicholas Evans recommend four ways to rebuilt this trust- transparency in process and outcome of experiments and review, life scientists need to play their part in monitoring and preventing deliberate misuse of biology, accountability needs to be built into scientific norms, and decisions on pursuing dangerous experiments need more transparency in regards to their process. “There should also be clear, internationally-recognized red lines about the sorts of experiments—such as attempting to make Ebola virus transmit like the flu, or modifying an extinct virus like smallpox—that simply should not be done.”

Energy & Commerce Subcommittee Looks at U.S. Biological Threat Preparedness
The Energy and Commerce Subcommittee on Health held a hearing regarding H.R. 3299, Strengthening Public Health Response Act, last week to discuss and review legislation that would enable the U.S. to prepare and defend against biological attacks. The act was presented in response to the October 2015 Blue Ribbon Study on Biodefense that highlighted the general lack of preparedness against emerging biological threats. “Thirty-three recommendations to improve the U.S. response to biological threats were made by the Blue Ribbon Study on Biodefense, which was led by former U.S. Sen. Joe Lieberman (I-CT) and former Pennsylvania Gov. Tom Ridge, the first Secretary of Homeland Security. The panel’s report was based on meetings, interviews and research.” Acting Biomedical Advanced Research and Development Authority (BARDA) Director Dr. Richard Hackett noted that “the array of threats for which we must be prepared is vast. Such threats include bioterrorist agents such as anthrax, smallpox and botulism; evolving and emerging threats causing substantial regional disruption such as Ebola and Zika; and highly communicable diseases with pandemic potential such as influenza.” This act would also expand the Priority Review Voucher program within DHS and work to facilitate BARDA’s partnership with the private sector.

Weekly Zika Updates
On Monday, WHO Director-General Dr. Margaret Chan pointed to the failure to maintain mosquito-control efforts and the spread of Zika. “Let me give you a stern warning. What we are seeing now looks more and more like a dramatic resurgence of the threat from emerging and re-emerging infectious diseases. The world is not prepared to cope. Above all, the spread of Zika, the resurgence of dengue, and the emerging threat from chikungunya are the price being paid for a massive policy failure that dropped the ball on mosquito control in the 1970s,”. The European Centre for Disease Control and Prevention (ECDC) released a risk assessment for European travelers to the Olympic Games, finding that they’re most at risk for gastrointestinal illness and vector-borne diseases. Researchers are also considering the association between Zika virus and eye problems in babies that have microcephaly. During your holiday weekend, take a minute to learn about the Scottish professor who discovered Zika virus. Experts are also pointing to the role of misinformation (via social media conspiracy theories) in prevention efforts.  “The researchers behind the study—from Johns Hopkins University, George Washington University, and the University of Georgia—say the misinformation they detected by analyzing thousands of Twitter posts could cause many vulnerable people to refuse future Zika vaccinations.” The CDC has estimated that a fetus infected with Zika virus during the first trimester has a 1-13% risk of developing microcephaly. As of May 25th, the CDC has reported 591 travel-associated and 11 sexually transmitted cases in the U.S.

Stories You May Have Missed:

  • Why Victorian Diseases Are Making a Comeback – Scarlet fever and TB have been on the rise in the UK and many are pointing to the growing threat of antibiotic resistance and poor vaccination compliance. Many of these diseases have been under control for centuries so any uptake can cause a sensational public response, however it’s important to remember the recent plethora of measles outbreaks and just how vital vaccination is. Antibiotic resistance alone could bring back these diseases and take us back to a time where infectious diseases were the major cause of death.
  • The Threat of Agroterrorism and Zoonotic Disease in the U.S. –  Gary Flory, Agricultural Program Manager of the Virginia Department of Environmental Quality, discusses the threat of these diseases for the Non Conventional Threat CBRNe Meeting. “The threat of agroterrorism and naturally occurring disease outbreaks in the United States continues to expand as new diseases emerge and existing diseases become endemic in many parts of the world. The food and agricultural sector is one of the easiest sectors of any nation’s economy to disrupt and its disruption could have catastrophic consequences both nationally and regionally. Both developing and developed countries will be impacted by a disease outbreak or agroterrorism attack.”
  • The Awful Diseases on the Way– check out this overview of Sonia Shah’s book, Pandemic: Tracking Contagions from Cholera to Ebola and Beyond, that also discusses the impact of infectious disease outbreaks from smallpox to Ebola. The review is done by a pediatric physician who has worked with UNICEF and the Global Fund to Fight AIDS across three continents. Aside from the wonderful points on infectious disease outbreaks and the importance of public health, Annie Sparrow gives a delightful segment on the corrupt schemes of outbreak coverups.

Pandora Report 4.15.2016

by spopescu, posted in Pandora Report

It’s been a big week in the world of biodefense – today is International Biomedical Laboratory Science Day! Biomedical Laboratory Scientists work hard to ensure procedures and patient care happens in a safe environment and that patient safety comes first! April 10th marked the anniversary of the Biological Weapons Convention opening for signature in London, Moscow, and Washington in 1972. The U.S. Geological Society also just released evidence that Alaska remains a “hot spot” for avian influenza to enter North America.

GMU Participation in UNSCR 1540 Civil Society Forum
IMG_3260This week our GMU Biodefense Professor and Graduate Program Director, Dr. Koblentz, participated in the UN’s 1540 Civil Society Forum – A Dialogue with Academia and Civil Society. Dr. Koblentz presented a paper on the role of academia in implementing and strengthening Resolution 1540, as well as moderating a panel regarding academic outreach. Resolution 1540 (2004) “imposes binding obligations on all States to adopt legislation to prevent the proliferation of nuclear, chemical and biological weapons, and their means of delivery, and  establish appropriate domestic controls over related materials to prevent their illicit trafficking. It also encourages enhanced international cooperation on such efforts.” Dr. Koblentz’s  work with the UNSCR 1540 Civil Society Forum addresses the evolution of WMD proliferation threats related to non-state actors, 1540 obligations that pertain to the academic community, and the importance of academia in these efforts. The forum also focussed on how to enhance review and analysis of 1540 implementation via communication between civil society, national governments, and the 1540 Committee.

Written Testimony for April 14 Senate Committee on Homeland Security & Governmental Affairs Hearing – “The Federal Perspective on the State of Our Nation’s Biodefense”
You can now catch up on the written testimony from this hearing on biodefense within the U.S. Pointing to the evolution of threats to include more emerging infectious diseases and the role of DHS in biodefense, this overview gives insight into the current biodefense situation within the U.S. The hearing addressed the National Biosurveillance Integration Center (NBIC), BioWatch Program, Public Health Emergency Medical Countermeasures Enterprise, and state and local responder engagement. “In the wake of these growing threats, the Department of Homeland Security (DHS) remains fully engaged and proactive in attempting to characterize the threat, providing warning of emerging and imminent threats, and coordinating whole of government response. During the most recent Ebola Virus Disease outbreak in West Africa, DHS provided intelligence analysis to the interagency, state and local governments, and first responders, and it directed research to better characterize the threat and fill gaps in public health and operational responses.” You can read the testimony before the Committee on Homeland Security and Governmental Affairs, “The Nation Faces Multiple Challenges Building and Maintaining Biodefense and Biosurveillance” here.

Preparing for the Next Zika
Kendall Hoyt and Richard Hatchett are tackling the struggle of U.S. preparedness efforts for future infectious disease outbreaks. “The development of new biomedical countermeasures—vaccines, therapies and diagnostic—requires the coordination of a wide number of institutional and industry actors to succeed. We argue here that international efforts to develop countermeasures for emerging infectious diseases should build on lessons learned from US programs to develop closely related biodefense products.” While the WHO declaration of Zika virus as a public health emergency has pushed for the rapid development of a vaccine, Hoyt and Hatchett highlight the empirical delay that comes with vaccine development. Overall, they emphasize that lessons from the U.S. biodefense program should inform international efforts to build and strengthen medical countermeasures for emerging infectious diseases. If you enjoyed their article, you can also hear from the experts, in person, at GMU’s Pandemics, Bioterrorism, and Global Health Security summer program. Dr. Hoyt will be one of the instructors for our professional education course this summer (information will be made available shortly), so don’t miss out on getting to chat with experts in the field about all things biodefense.

GMU SPGIA PhD Information Session
Considering a PhD? Check out GMU’S School of Policy, Government, and International Affairs PhD Informational Session on Thursday, April 21, 7-8:30pm at our Arlington Campus, Founders Hall, Room 126. Dr. Koblentz will be discussing the Biodefense program and available to answer questions!

Lab Safety Tracking Website – Improving Select Agent Lab Oversight
In response to ongoing scrutiny and biosafety failures, federal regulators have launched a new website that will allow them to track their progress “improving oversight of safety and security at facilities working with bioterror pathogens such as anthrax and Ebola.” While still a work in progress, many are pointing to this site being a step in the right direction towards transparency. The CDC released their Federal Select Agent Program (FSAP) report card to look more closely at biosafety and security issues surrounding this work. Unfortunately, some note that the report card still fails to meet the requested details on labs violations and incidents at specific labs. The increased scrutiny and attention to lab safety failures has brought attention from the White House, initiating a push for more transparency regarding the research and incidents in labs working with bioterror agents.

HIV Fights Off CRISPR
Just when you thought CRISPR-Cas9 could do just about anything, HIV brings its A-game. Since its creation, many researchers have attempted to use CRISPR to combat HIV. Unfortunately, the virus has been skilled at fending off these efforts. “The very act of editing—involving snipping at the virus’s genome—may introduce mutations that help it to resist attack.” There are a handful of strategies for using CRISPR gene editing technologies against HIV – editing the T helper cells to avoid the virus from getting in or aiding the T cells with the capabilities to seek out and destroy any HIV that infects them. “When HIV infects a T cell, its genome is inserted into the cell’s DNA and hijacks its DNA-replicating machinery to churn out more copies of the virus. But a T cell equipped with a DNA-shearing enzyme called Cas9, together with customized pieces of RNA that guide the enzyme to a particular sequence in the HIV genome, could find, cut and cripple the invader’s genome.” Sounds like a good plan, right? Unfortunately, a team from McGill University found that the newly equipped T cells were, within two weeks, churning out virus particle copies that had avoided the CRISPR attack. The team performed DNA sequencing to get a closer look at what exactly what going on – they found that the virus had actually “developed mutations near the sequence that the CRISPR-Cas9 enzyme that been programmed to cut.” The team believes that it’s not actually the copying error-caused mutations that helped beat CRISPR, but rather that things went wrong when Cas9 cut the viral DNA. A team at the University of Amsterdam experienced similar results and both groups agree that this problem can be overcome and there is still a possibility for a CRISPR-Cas9-based HIV treatment.

All Things Zika
On 4/13, the CDC formally concluded that Zika virus causes microcephaly and other birth defects. Zika virus may now also be tied to another brain disease. The American Academy of Neurology published a report regarding a study that was released on April 10th, in which “Zika virus may be associated with an autoimmune disorder that attacks the brain’s myelin similar to multiple sclerosis”. While it’s a small study, these findings point to the neurological effects Zika virus is capable of causing and the need for further research. Experts are warning governments in Latin American to “fill a shortfall of investment to prevent further human tragedies” despite economists denying that there will be major impact from the virus. These experts are pointing to the already weakened economies that are plagued with “chronic underinvestment in water and sanitation”, which can aid in the spread of such diseases. On Monday, April 11th, the White House said that the released funds for Zika virus won’t be enough to combat the growing threat. Dr. Fauci of the National Institute of Allergy and Infectious Diseases highlighted that the more information that is gathered on Zika virus, the more worrisome it becomes. “One big problem, Fauci said, is that pharmaceutical companies could be reluctant to work with the federal government if they don’t have confidence that there will be a stable source of money.” A recent study published in PLOS Neglected Tropical Diseases, suggests that the virus may have been brought to Latin America via the 6th World Sprint Championship Canoe Race in August 2014.  USAID has put out a call for problem solvers to share groundbreaking ideas to help combat Zika virus. The Combating Zika and Future Threats Grand Challenge will invest up to $30 million in solutions. As of April 13th, the CDC has reported 358 travel-associated and 7 sexually transmitted cases of Zika in the U.S. You can also get the full WHO Zika situation report here.

Predicting and Evaluating the Epidemic Trend of Ebola in the 2014/2015 Outbreak and the Effects of Intervention Measures Screen Shot 2016-04-11 at 9.41.51 AM
Researchers developed several transmission models for Ebola to predict epidemic trends and evaluate just how efficient and effective the intervention methods were following the 2014 outbreak. Accounting for effective vaccination rates, a basic reproductive number as an intermediate variable, and fluctuations of diseases transmission based on a SIR model, this study evaluates the effects of control and prevention measures. “Measures that reduced the spread of EVD included: early diagnosis, treatment in isolation, isolating/monitoring close contacts, timely corpse removal, post-recovery condom use, and preventing or quarantining imported cases. EVD may re-emerge within two decades without control and prevention measures.”

Stories You May Have Missed:

  • National Science Advisory Board for Biosecurity (NSAAB) Meeting – Don’t miss out on the NSAAB meeting on May 24, 2016! Agenda items include: (1) Finalization of NSABB findings and recommendations on a conceptual approach to evaluating proposed gain-of-function (GOF) studies; (2) discussion of next steps for U.S. government policy development regarding GOF studies; and (3) other business of the Board. The meeting will also be webcast here at the time of the event!
  • BMBL Virtual Town Hall and Workshop – The National Academies of Science, Engineering, and Medicine presents an opportunity for stakeholders to provide input for a revision of “Biosafety in Microbiological and Biomedical Laboratories”. This is a virtual town hall that is open for comments from April 4-May 13th. There will also be a workshop on May 12th in Washington, DC that you can register for here.
  • DARPA INTERCEPT Program for Biodefense Countermeasures – The Defense Advanced Research Project Agency (DARPA)’s Biological Technologies Office (BTO) is hosting a Proposers Day for the INTERfering and Co-Evolving Prevention and Therapy (INTERCEPT) program. “The goal of the INTERCEPT program is to explore and develop a new therapeutic platform to outpace fast-evolving viral pathogens, based upon virus-based therapeutic particles that interfere with viral infection and co-evolve with viral targets.”
  • Angola Yellow Fever Outbreak – The WHO has reported that as of April 10th, there have been 1,751 suspected cases and 242 deaths associated with the yellow fever outbreak. 582 of the cases were laboratory confirmed, of which 406 were from the Luanda province.

Enjoying your weekly dose of the Pandora Report? Sign up to receive it every week so the fun never ends! 

Pandora Report: 2.26.2016

by spopescu, posted in Pandora Report

It’s been quite a week for global health security. Even the X-Files covered worldwide pandemics (that’s right, multiple diseases), CRISPR-Cas9, and military vaccination programs. Measles is hitting Nigeria hard as Lagos state officials announced the deaths of 20 children related to the outbreak. A recent study released by the University of Pennsylvania’s Annenberg Public Policy Center found that more than one third of participants believed Zika virus was a conspiracy theory related to genetically modified mosquitoes. Maybe they were also watching the X-Files? Before we begin, meningitis vaccine efforts were celebrated at the Meningitis Vaccine Project (MVP) conference, due to success within Africa’s meningitis belt.

GMU Biodefense Students Awarded UPMC Biosecurity Fellowship
We’re happy to announce that two GMU Biodefense students have been selected as Fellows for the UPMC Emerging Leaders in Biosecurity Initiative (ELBI)! Congrats to biodefense MS alum Francisco Cruz, and PhD candidate Siddha Hover! “The Emerging Leaders in Biosecurity Initiative is a competitive fellowship program designed to create and sustain an energetic, multidisciplinary, and intergenerational biosecurity community made up of motivated young professionals as well as current leaders. UPMC has selected 28 US and international emerging leaders in biosecurity from a wide array of backgrounds, including biological science, medicine, policy, the military, law, public health and the private sector.” Siddha Hover works for BAI, Inc. as an embedded contractor with the Department of Homeland Security, where she serves as DHS’s sole treaty analyst. In her role, she is responsible for reviewing all relevant DHS-sponsored research and activites for compliance with applicable arms control agreements. Siddha is currently pursuing her PhD in Biodefense. She holds a MSc in Biodefense from George Mason University and a MSc in International Relations from the London School of Economics. Siddha notes that, “the GMU Biodefense program provided me with the foundational knowledge necessary to confidently begin a career in biodefense and enabled me to successfully apply for the ELBI Fellowship.” Francisco is a biologist in the Field Operations Branch of the U.S. Environmental Protection Agency’s (EPA) Chemical, Biological, Radiological, and Nuclear Consequence Management Advisory Division (CBRN CMAD). As CBRN CMAD’s Biologist, Francisco provides operational guidance to federal, state, and local responders in the areas of decontamination and emergency response related to biological incidents. Francisco holds a B.A. in Biological Sciences from the University of Delaware. During his time at GMU, Francisco earned a Graduate Certificate in Critical Analysis and Strategic Responses to Terrorism, and earned his M.S. in Biodefense in December 2015. Congrats to Siddha and Francisco in their work furthering the field of global health security and representing GMU Biodefense in the ELBI program!

GMU Biodefense Course Sampler- “Biosecurity as a Wicked Problem”
If you’re on the fence about going back to school, curious about our program, or just want to hear what a class in biodefense would be like, check out our course sampler on Wednesday, March 2nd, at 7pm, in our Arlington Campus in Founders Hall, Room 502. “The United States and the world face unprecedented threats to global biosecurity, including emerging infectious diseases, pandemics, natural disasters, bioterrorism, and laboratory accidents. Find out about the challenges posed by these threats and strategies for enhancing global health security.” How many times can you sample a course from not only an expert in the field, but also the director of the program? Dr. Koblentz will be your host for this evening lecture on biodefense, dual-use research, CRISPR-Cas9, biosecurity, and much more. Can’t attend in person? Don’t worry – we’re also live-streaming here. Come join us for a look behind the curtain of not only our GMU graduate programs, but also the world of global health security.

CRISPR and The Battle of Genetically Modified Mosquitoes 
CRISPR-Cas9 technology has been a hot topic since it was discovered and things have only ramped up since a Chinese research team announced last Spring that they successfully edited human embryo genes. While many raised concerns over “designer babies” and genetically modified livestock, the case for genetically modified mosquitoes has also been discussed. What if science could modify mosquito capabilities to carry disease? CRISPR-Cas9 research is getting much closer to making this a reality with the help of two research teams. “The first group, led by Valentino Gantz and Ethan Bier at the University of California–San Diego, and Anthony James at the University of California–Irvine, engineered a gene drive carrying a pair of genes designed to kill the malaria parasite inside the mosquito.The second group, led by Nikolai Windbichler, Andrea Cristanti, and Tony Nolan at the Imperial College London, developed a more brute force approach, building a gene drive that breaks an important mosquito gene and renders the females sterile—a strategy designed to decimate a mosquito population. Both groups reported that, when the genetically modified insects were crossed with wild ones, as much as 99 percent of the offspring carried the modified genes, a clear sign that the gene drives were working.” While field tests are still necessary to establish efficacy, it’s important to note the researchers are taking great strides to ensure public buy-in given the sensitivity of such work. Gene drive is becoming more accessible and the applications appear limitless however, ethical use of this pioneering innovation is crucial for future work.

Climate Change & Zika Virus – What’s the Link?
Somewhere between reporting on CRISPR-Cas9 mosquitoes and Zika updates, it seems like a perfect place to discuss what kind of impact climate change is having on infectious diseases…especially Zika virus. GMU Biodefense MS student and one of our contributors, Greg Mercer elaborates on the role climate change may have on the growing geographical distribution of mosquitoes that pose some of the biggest threats. Greg points out that “exactly how climate change drives the spread of Zika and other diseases is hard to define. In 2013, researchers at the University of Arizona published a paper examining the effect of climate factors on dengue and its Aedes vectors. Their conclusion highlighted just how far scientists still have to go in understanding the climate-disease link: ‘Climate influences dengue ecology by affecting vector dynamics, agent development, and mosquito/human interactions,’ they wrote, but ‘although these relationships are known, the impact climate change will have on transmission is unclear.’ Climate change introduces additional complications into an already complex system, the study authors explained: It’s difficult enough to understand how weather, climate, human interaction, or mosquito behavior contribute to the spread of a virus.” Researchers are now comparing the global distribution of Aedes mosquitoes and the spread of Zika, which leaves many to wonder if the threat of global disease will evolve with that of global climate change.

BARDA Seeks Advanced Public Health Consequence Modeling
The Biomedical Advanced Research and Development Authority (BARDA) is currently working to find partners that can aid in the development of a modeling system that would support federal decision makers in their planning and response to CBRN events. “The tools developed under this acquisition will assist Federal decision makers with medical and public health decision making for the advanced development and implementation of an integrated National medical countermeasures infrastructure (e.g., vaccines, therapeutics, diagnostics, and medical devices).” They’re hoping to build partnerships to establish a network for medical consequence modeling, simulation, visualization, and decision support. BARDA plans to include two functional areas within the network, 1- decision support, reach back, analysis, and modeling (DREAM), and 2- professional services and systems integration (PSSI). “These activities include assisting government decisions makers during the development of preparedness plans, the implementation of response strategies, and communications with a wide variety of stakeholders, both during day to day operations and in the course of declared public health emergencies as part of the BARDA Modeling Coordination Group.” Each functional area will have multiple Indefinite Delivery/Indefinite Quantity (IDIQ) awards that can be earned and they are encouraging interested stakeholders to submit proposals.

To Zika and Back 

Courtesy of the Council on Foreign Relations
Courtesy of the Council on Foreign Relations

As Zika virus continues to spread and South Africa reports the first of their cases, many are wondering how these outbreaks tend to go from 0-60 in a hot minute. NIAID director, Anthony Fauci, discusses the reality of disease surveillance and revealed this slide during an interview, of which you can see the global examples of emerging and re-emerging infectious diseases. Dr. Fauci points to the unpredictable nature that is public health and global health security. Global public health is still reeling from the effects and imperfect response of Ebola 2014, coupled with the scrutiny of a response to H1N1 that was considered too zealous. I’ve always considered public health and disease prevention to be the kind of work where few realize when you’ve done your job correctly but when you fail, it’s something you’ll be hearing about for decades. Global health security is challenging on a good day and public health tends to get little funding, especially in the countries that need it most. After the devastation of Ebola and all the after-action reports, many are wondering how did we miss the rise of Zika virus? Dr. Ken Stuart, director of the Center for Infectious Disease Research in Seattle, says, “We were unaware of the severity of the disease … [and] were unaware this virus had the capability for getting distributed so rapidly.” Regarding the funding issues that often plague infectious disease efforts, he noted that “this really goes back to funding priorities. Much of the funding devoted to infectious disease today is in reaction to outbreaks. Therefore, we’re not generally prepared to respond quickly. In other cases there are diseases that are very rare but they have an advocacy group that generates research activities. In the case of diseases like Zika, which were isolated in remote areas of the world where that population had no resources or advocacy group, there was no push to do research.We’re not stuck with what we’ve got. There are conversations between federal funding agencies and private organizations to try to prioritize the utilization of their resources, and I would say the NIH has been a leader in supporting the fundamental research that actually, probably positions us best to be prepared to respond to these disease outbreaks.” In other Zika news, a CDC team just arrived in Brazil to study the associated birth defects and the White House is urging Congress to provide emergency funds to support Zika response efforts, rather than just re-directing funds from Ebola-related projects. You can also see a map tracing the spread of Zika and some background here. As of February 24, the CDC has reported 107 travel-associated cases in the U.S.

The Rise of Chikungunya
I always thought it sounded like the name of a monster and in some ways, that’s pretty spot on. The Pan American Health Organization (PAHO) reported 16,668 confirmed and suspected cases of Chikungunya in 2016 so far. Colombia shouldered the majority of 2016 disease burden, with a spike of 1,189 new cases added to their previous count of 5,752. The PAHO is still playing catch-up on their year-end reporting for 2015, but it looks like 28,722 additional infections were added to their 2015 data. These updates mean that this region experienced 726,478 cases in 2015, and with the the new cases reported as of February 19, this current outbreak has been responsible for 1.89 million infections. Starting in 2013, this outbreak began on St. Martin and has been gaining traction ever since. Hopefully with the mosquito-control efforts related to Zika virus, the mosquito population also responsible for Chikungunya will begin to decline.

Stories You May Have Missed:

  • Breaking Down the Barriers of MDRO’s:  Scientists in the UK have discovered how drug-resistant bacteria create and maintain their defensive wall. Using the Diamond Light Source machine to “investigate in tiny detail a class of bugs known as Gram-negative bacteria”, they were able to find a defensive wall and it’s assembly beta-barrel machinery (BAM). This new research means that future treatments can aim at preventing bacteria from building these defense measures versus just attempting to attack the bacteria itself.
  • Melbourne Measles Outbreak – 14 cases have already been confirmed in the suburb of Brunswick, of which 2 were children from a primary school. Students that attend the same school and are not fully immunized were instructed to stay home to avoid exposure.
  • E. coli Outbreak in Raw Milk – Not surprisingly, a recall has been issued related to unpasteurized raw milk from a local dairy farm in Fresno, CA. 10 people have been confirmed with Shiga-toxin producing E. coli 0157:H7. Thankfully the shelf-life of the product has passed and public health officials, while stating that the investigation is on going, have confirmed that no health alert was issued since the product is believed to no longer be within the marketplace. Moral of the story – avoid raw, unpasteurized milk.

Enjoying your weekly dose of the Pandora Report? Sign up to receive it every week so the fun never ends! 

Pandora Report: 12.18.2015

by spopescu, posted in Pandora Report

Hungry, hungry anthrax hippos? If there’s one thing we love about the science community, it’s when a gem pops up in your inbox like this (thanks ProMed!). In Ebola news, public health officials are exploring the possibility that survivors may be a potential source of case surges. Fun history fact Friday: On December 18, 1620, the Mayflower docked at Plymouth Harbor and passengers began settlement and on December 14, 1980, the CIA issued a warning about Soviet arms sales to Third World nations. Take a break from holiday preparations with this week’s Pandora Report – we’re discussing everything from zombies to Bob Dylan lyrics!

Epidemiology of a Zombie Outbreak
Tara C Smith and the writers of The BMJ certainly know how to hook a biodefense nerd – epidemiology of zombie infections? Don’t mind if we do! Using historical tales and movie outbreaks, Smith takes us through several hypothetical zombie outbreaks we’ve experienced as viewers or readers for the past few decades. Tracing the origins of certain outbreaks and the transmission patterns via bite, this scientific approach to one of our favorite topics is fascinating.  Potential etiological considerations included weaponized Yersinia pestis, a mutation of bovine spongiform encephalopathy, or a genetically modified form of the Ebola virus that was tested on chimpanzees (that later escaped!). Last but not least, we can’t forget to consider the ethical implications of such an outbreak. How do we handle resource depletion or quarantine? All things to consider before the zombie apocalypse!

Risk & Benefit Analysis of Gain of Function Research 
With the National Science Advisory Board for Biosecurity (NSABB) meeting fast approaching (January 7-8, 2016!), we’re recapping the role of gain-of-function (GoF) research in biodefense. Earlier this year, Gryphon Scientific was awarded a NIH contract related to assessment of GoF research and the risk-versus-benefits that may impact future federal funding. With the intent to make future recommendations, the assessment had three major tasks: a risk analysis (RA) of accidents and natural disasters, a biosecurity RA, and a benefit assessment. Extensive review and analysis of data from the intelligence and law enforcement community reviewed potential gaps within security practices. “The biosecurity RA is delivered in two parts because risks posed by malicious acts targeting laboratories that conduct GoF required a different analytical approach than the assessment of the risk generated by the misuse of published GoF research.” GMU Biodefense alum and previous Pandora Report editor, Julia Homstad, is also the lead author on Chapter 11 (Risk of Loss of Trust in Science). Perhaps one of my favorite points from the report was that “this assessment requires the identification of scientific and non-scientific barriers to the realization of these benefits.” You can also find Michael Selgelid’s White Paper regarding the ethical implications of GoF research. While the 1,001 pages may seem a daunting task, this is not only a highly relevant report, but approaches GoF concerns and risks in an engaging and holistic manner.

Bob Dylan Lyrics in Medical Literature?
Have you ever read a scientific article and felt a complete unknown, like a rolling stone? Scientists at the Karolinska Institute in Sweden have been sneaking Bob Dylan song lyrics into their papers as part of a long-standing bet since 1997. “It all started in 1997 with a review in Nature Medicine entitled ‘Nitric oxide and inflammation: the answer is blowing in the wind.'” Carl Gornitzki and colleagues from The BMJ decided to do some additional digging in Medline and found that 213 of 727 found references were unequivocally citing Bob Dylan. Starting a few years after his musical debut, research papers included a variety of biomedical topics, like those of Hermanson et al., who managed to work “like a rolling stone” into their paper on epigenetics. The variety of lyrics found throughout the literature is certainly more than a simple twist of fate.

Outbreak Preparedness 2015 Report
Ever wonder how your state ranks in terms of emerging infectious disease preparedness? Trust for America’s Health and the Robert Wood Johnson Foundation recently published their 2015 report regarding state capabilities to protect against new infectious disease threats (MERS-CoV, multi-drug resistant organisms, etc.) and “resurging illnesses like whooping cough, tuberculosis, and gonorrhea.” The report found that over half of US states ranked at five or lower on a scale of ten. The five all-star states (scoring eight) were Delaware, Kentucky, Main, New York, and Virginia (go Virigina!). The report findings noted that “the nation must redouble efforts to protect Americans” and included points on healthcare-associated infections, flu vaccination rates, food safety, and superbugs. Check out the report to find where your state ranked!

Fighting Antibiotic Resistance in the United States18170_lores
On Thursday, the House Appropriations Committee presented the 2016 Omnibus Appropriations bill, which revealed discretionary funding plans for the federal government. Buried in new legislation, the FDA and NIH will receive part of this discretionary funding to help fight antibiotic resistant bacteria and “advance prevision medicine initiatives”. The FDA is set to receive $2.7 billion, which was over a $10 million increase from FY2015. Within the bill, there is “funding for the Combating Antibiotic Resistance Bacteria (CARB) initiative ($8,732,000), the precision medicine initiative ($2,392,000), and the Orphan Product Development Grants Program ($2,500,000). The NIH will receive an extra $2 billion for FY2016, which supported projects specially for Alzheimer’s diseases research, brain research, antibiotic resistance, the Precision Medicine Initiative, etc. Given last week’s report on the phantom menace CRE and growing cases of multi-drug resistant organisms, it’s extremely important antibiotic resistance be given more attention.

Stories You May Have Missed:

  • CDC Establishing Flu Vaccine Efficacy Lab Network – The CDC has provided funding for a network of US institutions to collect and analyze information related to annual flu vaccine effectiveness. “Participating institutions will coordinate enrollment of patients with acute respiratory illness, confirm influenza infection using a standardized reverse-transcription PCR (RT-PCR) assay, and estimate vaccine effectiveness.” The 30 million dollar funded project will run from July 2016-2021.
  • Avian Influenza in France – France has reported 30 outbreaks of avian influenza, specifically one of the highly pathogenic influenza. Unfortunately the strain in the most recent cases hasn’t been identified, but these outbreaks been attributed to one of the H5 strains.
  • Hawaiian Dengue Outbreak Update – Cases of dengue virus on Hawaii Island have now reached 157. There are 7 individuals considered still infectious and the Hawaii Department of Health (HDOH) continues their efforts to identify cases and reduce transmission. 140 of the cases are Hawaii Island residents, and 34 of the overall cases have been children under the age of 18.

Enjoying your weekly dose of the Pandora Report? Sign up to receive it every week so the fun never ends! 

Pandora Report 10.30.2015

by spopescu, posted in Pandora Report, Program News, Uncategorized

The witching hour is upon us! Halloween is tomorrow and with that we must ask, how good are your zombie fighting skills? Good news if you’re in Arlington, VA, as it’s considered one of the top ten cities to survive the zombie apocalypse – good thing GMU has a campus there (we biodefense folks are the ultimate planners!). This week was busy with the release of the Blue Ribbon Study Panel on Biodefense’s National Report. I was able to attend the panel event, so read on for my comments and your weekly dose of biodefense news!

DSC_3586GMU Biodefense Program News & Alumni 
We’ve added a new page to salute our biodefense alumni and all that they do with their GMU education. GMU Biodefense students have a diverse background in their education, experiences, and interests, and we absolutely love getting to brag about all the amazing things they accomplish after their studies. Whether it’s a new publication or an award, we hope to pass along their accolades, so please check out our new page to see how GMU Biodefense alumni are contributing to the world of global health security!

12111966_10104338304988922_3051154411712634566_n-1Blue Ribbon Study Panel on Biodefense Releases Report– I had the pleasure of attending the Blue Ribbon panel on Wednesday, in which they reviewed their report, “A National Blueprint for Biodefense: Leadership and Major Reform Needed to Optimize Efforts”. The panel event saw Senator Joe Lieberman, former Governor Tom Ridge, and former Homeland Security Advisor, Kenneth L. Wainstein, discuss the challenges of biodefense, the report, and answer several questions regarding their findings. The report is comprised of 33 recommendations that range from unification of biodefense budgeting to optimizing the National Biosurveillance Integration System and to improving surveillance and planning for animal and zoonotic outbreaks. Along with these 33 recommendations, there are 100 action items. Perhaps one of the biggest take-aways from the report is the recommendation that the Office of the Vice President of the US assume authority over biodefense efforts. There is heavy emphasis on a unified budget and centralization to combat the redundancy and current siloing we see in existing programs.  Senator Lieberman discussed the role of the research and private sector’s involvement, with former Gov. Ridge noting that “we need to start thinking differently about how we incentivize the private sector.” The panel discussed that despite our past efforts, the Ebola outbreak in 2014 showed that the “threat is real, lets not wait for it to occur” and as former Gov. Ridge noted, “we don’t give bioweapon threats the attention they need. The threat is ahead of us.” Senator Lieberman commented on the Ebola situation,  noting that our response was dismal and despite 10 months of warning, basic human errors led to a failure in providing hospitals with general guidelines. Whether it is an intentional bioweapons attack, outbreak of an emerging infectious disease, or unintentional, accidental release due to lab safety errors, the panel’s goal of having centralized leadership reveals the complex nature of these challenges. Also, did I mention that they included infection control in their guidelines (#18)?! Overall, I found the event highly engaging and was pleased to hear the panel members approach these topics with not only a sense of urgency, but a holistic manner to meet the challenges of biodefense.

Jump Start – Accelerating Government Response to A National Biological Crisis
UPMC Center for Health Security has released their July 2015 report that “examines a scenario in which the US is suddenly faced with a newly emerged intentional biological threat that could produce catastrophic public health consequences and threaten our economy, government, and social structure.” The report reviews governance, public health response, medical countermeasures, healthcare system response, decontamination and remediation, and environmental detection, while making recommendations. Utilizing published literature and subject matter expert interviews, the Jump Start report scenario occurs in central Moscow subway stations and Red Square. It discusses responses in a post-Amerithrax world and highlights the need to stop the spread of infectious diseases while emphasizing that in a similar scenario, the US government should push out table-top exercises at a national level to test readiness to biothreats. The role of healthcare infrastructure and capacity comes into play, highlighting the limitations that diagnostic testing plays – even if the solutions aren’t available. I’d be curious to see a more detailed analysis of how we approach novel agents and the time-lag this can often cause in diagnosis. Also – what would be the ethical dilemmas regarding invasive medical treatments for a novel agent? Medical ethics became a very real issue during Ebola preparedness (perhaps not as well discussed in media circuits) as the invasive care capabilities of healthcare professionals in the US correlates with increasing risk for disease transmission.

White House Calls for Better Biosafety –  As fallout from several lab safety breaches, the White House issued recommendations that focus on labs that are registered to work with pathogens from the Select Agents list. Ranging from increased training to assessing the number of high containment labs we have in the US, this memo, with a deadline for the recommendations, sets the tone for change when it comes to biosafety.

Saudi Arabi MERS Cluster – reports from Saudi Arabi’s Ministry of Health have confirmed a healthcare-associated cluster of MERS-CoV cases that involved seven individuals. The initial patient was seen in the emergency department of Almana General Hospital, with five other patients exposed in the hospital, and an additional case that is believed to not have had a healthcare exposure. All patients are under observation in the King Fahad Hospital. One of the patients is reported to be a nurse. In previous weeks, there was a cluster of cases related to janitors living together in Riyadh.

Stories You May Have Missed:

  • The African Development Bank Group (AfDB) has approved a $33.3 million grant towards a Post Ebola Recovery Social Investment Fund (PERSIF) for efforts in Guinea, Liberia, and Sierra Leone. The US State Department is contributing a $5 million grant towards this to help support livelihood development for women, girls, and orphans from the affected countries. The goal is to build resilience in the affected countries and strengthen the economic systems while improving governance and communication.
  • Nigeria was just removed from the WHO’s list of polio-endemic countries! After halting the spread of wild poliovirus transmission during a 15 month period, Nigeria was declared free of the disease! The WHO is continuing to work on the remaining two polio-endemic countries; Afghanistan and Pakistan.
  • Three more cases of Ebola in Guinea were reported this week. The three patients are all family members, with one being a pregnant woman. Guinea experienced several cases last week while Liberia has been EVD-free since September 3rd and Sierra Leone just passed their six week mark without a new case.
  • The WHO announces that TB surpassed HIV as the leading cause of death from infectious disease in 2014. Better surveillance enabled global public health teams to identify new cases. In Indonesia alone, there were one million new cases reported this year. The WHO notes that while surveillance efforts are revealing new cases, progress is still insufficient, especially in regards to drug resistance.

 

Pandora Report 9.13.14

by juliadhomstad, posted in Pandora Report

This week we look at a report that claims DHS is not prepared for a pandemic and information about Chemical Weapons in Syria, still. We also have an Ebola update, and if you’re interested in learning more about the West African outbreak, join us Wednesday for our September Biodefense Policy Seminar!

Have a great weekend!

Homeland ill-prepared for Pandemic, Doesn’t Even Have Enough Drugs to Protect Secret Service

In a recently released report, the Office of the Inspector General claims that “the Department of Homeland Security may not be able to provide sufficient pandemic preparedness supplies to its employees to continue operations during a pandemic.” DHS, however, has disagreed with much of the report claiming it misrepresents the agency’s preparedness for an outbreak.

The Washington Times—“One of the biggest problems, investigators said, is that most of the stockpiles are of antiviral drugs that are expiring. By the end of 2015, the IG said that 81 percent of Homeland Security’s stockpiled antiviral medication will be past its shelf life. In addition, 84 percent of the agency’s stock of hand sanitizer has already expired, some batches by as long as four years, inspectors said.”

Watchdog Says Chlorine Gas Used as a Chemical Weapon in Syria

The Organization for the Prohibition of Chemical Weapons reports that chlorine gas was used “systematically and repeatedly” as a weapon in northern Syria earlier this year. U.S. officials say that the Assad regime is the only force capable of launching such an attack. Even after the destruction of Syria’s chemical weapons stockpiles, chlorine is not a forbidden substance under the CWC. However, the use of any chemical as a weapon is prohibited by the CWC. This news comes among concerns that any hidden weapons stockpiles may fall into the hands of terrorist or extremist groups, like ISIS

The Wall Street Journal—“The OPCW team traveled to the sites of attacks and interviewed victims, doctors and witnesses. According to the report, victims’ symptoms and the effect of the gas led the mission ‘to conclude with a high degree of confidence that chlorine, either pure or in mixture, is the toxic chemical in question.’”

This Week in Ebola

Another American Ebola patient was sent to Emory University in Atlanta for treatment and American Ebola survivor Dr. Kent Brantly donated blood to the American patient, Dr. Rick Sacra, who is being treated in Nebraska. The thought is that Dr. Brantly’s blood will help confer passive immunity to Dr. Sacra. On last Sunday’s Meet the Press, President Obama pledged U.S. military assistance in setting up isolation units and providing security for health workers in West Africa but House Republicans indicated they would provide less than half of the White House’s requested funding for fighting Ebola. The Bill and Melinda Gates Foundations has pledged to contribute $50 million to support emergency efforts to contain the outbreak in West Africa. There were reports this week of a U.S. air marshal who was injected with a syringe at the Lagos Airport in Nigeria. Though it appears that the syringe was not infected with Ebola, it has caused fears that Ebola could be used as a weapon. All of this comes at a time when disease modelers at Northeastern University predict that as many as 10,000 cases of Ebola could be detected by the end of the month and there have been 60 cases resulting in 35 deaths from the Ebola outbreak in Congo.

Image Credit: WGBH News

Delving Deeper: Emergency Preparedness

by Siddha Hover, posted in News, Research Notes

By Yong-Bee Lim

As the past two years of disaster events have displayed, it is more important than ever for individuals, families, and organizations to prepare for self-sufficiency for extended periods of time.[1] However, there is a universal human tendency to avoid thinking about negative events such as possible emergencies.[2] This deliberate lack of attention to local emergency plans and personal emergency preparedness can be vividly seen in a 2006 study by “The Council for Excellence Government Report”. This report, composed post-Katrina, displayed that only a 1/3 of the population lacked knowledge of local government plans, roughly half did not have an alert emergency situation in their community, and only 8% of the public has done everything required to fully prepare supplies and plans for an emergency incident.[3]

This lack of preparedness in the U.S. population is a large problem for a number of reasons. In emergency situations, a majority (52%) of Americans have reported the loss of electricity for 3 or more days. This, among other issues, creates a number of negative implications, which include:

1)       Potential lack of potable water[4] and other nutritional media (breast milk)[5]

2)       Lack of food, whether in the household or the local grocery store[6]

3)       Diminished visual, security, and communication capability[7]

These types of disruptions are likely to negatively impact populations as natural routines are disrupted. Furthermore, different types of disasters will occur in different areas of the United States; while earthquakes may occur more often in California, tornadoes may more likely affect the Midwestern regions. While parents are likely to be negatively affected by the effects of disaster incidents, children are likely to be affected more severely; due to their psychological, social and physical development differences, children are particularly vulnerable to feelings of powerlessness[8]. The fact that children are exponentially impacted represents a problem as children comprise 25% of the U.S. population.[9]

Emergency Preparedness: Child “Ambassadors”

While events such as natural and man-made disasters cannot be completely eliminated, there are ways to bolster emergency preparedness awareness and implementation. Furthermore, there are not only means to not only empower children by including them in the emergency planning and preparedness process, but means to actively engage children in the emergency planning and preparedness process. This not only provides children with the confidence to deal with unexpected situations, but also helps in mitigating feelings of anxiety and powerlessness in an actual emergency.

To this end, several interactive resources have been made available (both online and in educational settings) to impress, educate, and promote the importance of emergency preparedness in the youth population. Furthermore, as youth “ambassadors” of emergency preparedness, these youths can spark discussions, spur action, and educate their parents and communities about the importance and need to address all aspects of emergency planning and preparedness.

Government Resources

FEMA: The Federal Emergency Management Agency has a number of sources to educate children in the importance and practices of emergency preparedness. Some of these include:

  1. Flat Stanley and Flat Stella: These two characters, crafted as ambassadors for children to teach emergency preparedness, promote students to be child ambassadors by provide information such as the necessary facts, plans, and instructions to build a kit for emergency purposes: http://www.ready.gov/flatstanley
  2. Teen CERT: The Teen Community Response Team is a 20-hour program that provides teenagers with both tacit and experiential learning in regards to readiness and response skills; beyond just relaying the information of their learning to others, these students gain techniques in controlling a variety of emergency-related situations: https://www.citizencorps.gov/cert/teencert/images/Teen_CERT_Brochure.pdf

Private Resources

1)       Sesame Street [Let’s Get Together!]: This series of videos, documents and worksheets, all of which includes fun visuals and Sesame Street character cameos, engages both parents and children in the purpose of, efficacy, creation, and basic planning for emergencies: http://www.sesamestreet.org/parents/topicsandactivities/toolkits/ready

2)       American Red Cross’ [Master of Disaster]: This series of programs (numbering over 200), which are specifically tailored to lower elementary (K – 2), middle elementary (3 – 5), and middle school (6 – 8) are meant to educate children through a series of ready-to-go lesson plans that help students not only prepare for emergency events, but to also be able to adapt in the fact of unexpected events: http://www.redcross.org/prepare/location/school/preparedness-education

Regional Sources

1)       Virginia’s Emergency Preparedness: This document provides a step-by-step process for children and families to go through the emergency preparedness process, as well as offer resources in the State of Virginia for emergency issues: http://www.chkd.org/documents/CareConnections/EmergencyPreparednessforFamilies.pdf

2)       Texas’ Project SECURE Gulf Coast [through CIDRAP]: This project developed a disaster curriculum for Houston schools intended to promote preparedness education for children, and between children and families. An ambassador (known as the Disaster Ambassador Preparedness Program [DAPP]) was created to educate schoolchildren who, in turn, educated their parents. Learned skilled included how to make a family emergency plan, items to store in a family emergency supply kit, ways to receive up-to-date information during a disaster, and how to sign up for transportation assistance: http://www.publichealthpractices.org/practice/curriculum-trains-children-act-disaster-preparedness-ambassadors-their-families

Conclusion

While these programs have yet to display true efficacy data (through the use of a longitudinal study), the results of projects (like Project SECURE) appear to display significant improvements in both emergency planning and preparedness. Following the 2-year Project SECURE program, many families have followed recommended guidelines for emergency planning and preparedness for hurricanes, and the program is to be continued at the schools it was implemented at.

While man-made and natural disaster incidents are difficult to speak of due to a number of emotional and ethical reasons, it is clear that properly advanced preparation and planning is the key to mitigating the harm that might arise from any form of incident. It is, therefore, important to instill the concepts of emergency planning and preparedness early in our nations’ youth.  These youth, who will end up being our future, will also be empowered to aid their families and communities with the knowledge they have been given.

(image: Kakela/Flickr)

[1] FEMA, Ready.Gov Online. Accessed 12/13/12. http://www.ready.gov/make-a-plan

[3] The Council for Excellence in Government Online. Accessed 12/12/12. http://www.citizencorps.gov/downloads/pdf/ready/pri_report.pdf

[6] Columbus Community Hospital Online. Accessed 12/19/12. http://www.preped.org/Resources/20Wkstockpiling.pdf

[7] Pacific Disaster Center Online. Accessed 12/18/12. http://www.pdc.org/iweb/hazard_info_checklist.jsp

[9] ChildStats Online. Accessed 12/20/12. http://www.childstats.gov/americaschildren/tables/pop1.asp

Virus or Bacteria?

by Siddha Hover, posted in News

If you thought quickly determining whether a patient is suffering from a viral or a bacterial infection should be straightforward and easy, you would be wrong. The difficulty in answering this seemingly simple question is what has contributed so heavily to our current war against antibiotic-resistant bacteria. Luckily for all of us, researchers at Duke University are on it. According to a new study, taking a molecular snapshot of gene activity – when infected with a virus, your body activates a specific set of genes, which are entirely different from the set activated to fight a bacterial infection. The entire process currently takes 12 hours, a number which the researchers are hoping to slash to near-instant. The value in immediately determining something as simple as what kingdom the infectious agent belongs to would be a boon in fighting everything from over prescription of antibiotics to emergent pandemics.

Read more on viral signatures here.

(image: Thomas Splettstoesser)