Pandora Report 2.24.2017

Happy Friday and welcome to your weekly dose of all things biodefense! A preliminary report from the Malaysian police has found that VX nerve agent was most likely used to murder Kim Jong-nam.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security: From Anthrax to Zika 
Want to dabble in the world of global health security? Don’t miss out on the GMU Biodefense three-day, non-credit summer workshop on July 17-19, 2017! Participants will look at the challenges facing the world at the intersection of national security, public health, and the life sciences. Instructors for the workshop range from FBI special agents to biodefense professors and USAMRIID commanders. The workshop will look at the spectrum of biological threats – including naturally occurring disease outbreaks such as SARS, Zika, and Ebola, lapses in biosafety, dual-use research of concern, and the threat of bioterrorism. From now until May 1st, you can take advantage of the early bird registration discount!

Progress Report on BARDA & Project Bioshield 
A 10-year report card was recently published for these two efforts to defend the U.S. against biological threats. The report found 80 candidate countermeasures, 21 stockpiled countermeasures, and 6 FDA approvals supported by BARDA and Project Bioshield. “Over a decade has passed since the anthrax attacks of 2001; preparedness has increased substantially since that time, and defense against CBRN threats has become melded into national security. Both BARDA and Project Bioshield are essential elements of national security, and, especially in light of a change in presidential administration, it is important to emphasize the critical role these agencies have had in fortifying the nation against intentional CBRN threats. Larsen and Disbrow note, however, that despite the reauthorization of Project Bioshield in 2013 with annual funding at $2.8 billion (from 2014-2018), that funding is subject to annual congressional appropriations; as such, only a fraction of that funding has been appropriated.”

BWC Newsletter 
If you’re looking to keep tabs on the Biological Weapons Convention, we’ve got just the place for you. The BWC Implementation Support Unit has prepared a newsletter to better support communication among States Parties and encourage involvement in BWC-related issues and events. The first issue discusses the recent Eighth Review Conference and news like the launch of EU projects to support BWC universalization and a Confidence-Building Measures reminder letter (deadline for submission is April 15th!).

screen-shot-2017-02-21-at-2-11-26-pmCDC Lab Closure Due to Safety Concerns
The CDC has temporarily closed down its Biosafety Level-4 laboratories following the finding that their air supply hoses to researchers in protective suits were not approved for use. “‘We have no evidence that anybody has suffered ill health effects from breathing air that came through these hoses,’ Stephan Monroe, associate director for laboratory science and safety at the CDC, told Reuters. Monroe said he was confident scientists were not exposed to pathogens because the air they breathed passed through HEPA filters. The suits they wear also use positive air pressure to prevent pathogens from entering the suit.” Safety tests are currently being performed while employees are being notified and monitored. Interestingly, Monroe’s position is a newly minted one, having been established in 2015 to combat the continuous findings of major lab safety failures involving anthrax, avian influenza, and Ebola in CDC labs.

Why Bill Gates Worries About Biological Threats
Bill Gates recently spoke to Business Insider following his speech for the Munich Security Conference, in which he highlighted his real concerns for global health security. He noted that conflict areas and regions that are struggling to find stability are perhaps the most challenging in terms of outbreak containment. Gates emphasized the vulnerability for genome editing of a virus to make it more contagious, and also the advances in biotechnology that may help prevent the spread of an epidemic. “The point is, we ignore the link between health security and international security at our peril. Whether it occurs by a quirk of nature or at the hand of a terrorist, epidemiologists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year. And they say there is a reasonable probability the world will experience such an outbreak in the next 10-15 years.” Perhaps the most important thing on our “to-do” list is to invest in vaccines, drugs, and diagnostics. We have a tendency to put these priorities lower on the totem pole until a major public health crises occurs however, Gates highlights their relevance. The launch of the new Coalition for Epidemic Preparedness Innovations (CEPI) is one step closer to bridging this gap. “The really big breakthrough potential is in emerging technology platforms that leverage recent advances in genomics to dramatically reduce the time needed to develop vaccines. Basically, they create a delivery vehicle for synthetic genetic material that instructs your cells to make a vaccine inside your own body.” Gates also emphasized the importance of strengthening basic public health systems, especially in vulnerable countries – adding to that age old saying, “an outbreak anywhere is an outbreak everywhere”.

screen-shot-2017-02-23-at-7-48-50-amFinancing Pandemic Preparedness At the National Level = First Line of Defense
Pandemic preparedness funding is one of those common sense investments…right? Unfortunately, many don’t always make it a priority. Ebola alone cost billions, including a $2.27 billion allocation for response by the U.S. government. Dozens of after-action reports and papers on lessons learned have been published since the outbreak. Peter Sands noted that “all these reviews – including the one I chaired  for the US National Academy of Medicine – agreed on three key priorities: strengthening preparedness at a national level; improving coordination and capabilities at a regional and global level; and accelerating R&D in this arena.  Over the last twelve months progress has been made in implementing many of these recommendations, but big gaps and weaknesses remain. As a recent paper in the British Medical Journal put it, there has been ‘ample analysis, inadequate action’.” The highest priority though is preparedness at a national level. The International Working Group on Financing Pandemic Preparedness was created in 2016 as a means to propose ways in which national governments and partners can work to establish sustainable financing to strengthen their pandemic preparedness. Their focus “includes domestic resource mobilization, development assistance and private sector engagement. For many countries, financing preparedness through the domestic public sector budget is the best way to ensure sustained funding and seamless integration with the rest of the health system. This requires ensuring sufficient priority is attached to investing in pandemic preparedness in budget allocations. In some countries, there may also be scope to increase the fiscal envelope through improvements in tax design and collection or even hypothecated taxes.”

Insider Threats 
Get ready to add this new book to your reading list. Matthew Bunn and Scott D Sagan are looking at insider threats like nuclear material theft and Edward Snowden. “Insider Threats offers detailed case studies of insider disasters across a range of different types of institutions, from biological research laboratories, to nuclear power plants, to  the U.S. Army.” Don’t miss the chapter from Jessica Stern and Ronald Schouten, “Lessons Learned from the Anthrax Letters”. Stern and Schouten look at the investigation of the Amerithrax attacks and provide a portrait of Ivins and his troubling behavior. They also address “the combination of regulatory changes, red flags missed by Ivins’s colleagues, and the organizational and cognitive biases that contributed to the failure to identify Ivins as a potential insider”, and the current environment and new regulations.

Stories You May Have Missed:

  • Former Secretary of Defense Outlines the Future of Warfare – “Two years ago, Barack Obama appointed a new Secretary of Defense, Ashton Carter—a technocrat physicist, an arms control veteran, and a professor at Stanford—to help close this divide.” Carter recently sat down with WIRED magazine and discussed the challenges facing the White House. When asked about the impact of autonomy on warfare, Carter notes that it will change it in a fundamental way, but also points biotechnology. “I think if there is going to be something ever that rivals nuclear weapons in terms of the pure fearsomeness of their destructiveness it’s more likely to come from biotechnology than any other technology. Looking back decades from now, I do think the biological revelation could rival the atomic revolution for the fearsomeness of the potential. I think that’s one reason we need to invest in it. And although biotechnology has not been a traditional area for Defense, the new bridges that they build shold not only be to the IT tech community but also to the biotech communities in the Valley.”
  • Did Salmonella Take Down the Aztecs?– History and infectious disease? That’s surely the best way to start a weekend! Researchers recently looked at the DNA of a 500-year-old bacteria to study one of the worst epidemics in history. “In one study, researchers say they have recovered DNA of the stomach bacterium from burials in Mexico linked to a 1540s epidemic that killed up to 80% of the country’s native inhabitants. The team reports its findings in a preprint posted on the bioRxiv server on 8 February. In 1519, when forces led by Spanish conquistador Hernando Cortés arrived in Mexico, the native population was estimated at about 25 million. A century later, after a Spanish victory and a series of epidemics, numbers had plunged to around 1 million.” After extracting and sequencing the DNA from the teeth of 29 buried people buried in the highlands of southern Mexico, all but five were found to be linked to cocoliztli. “Further sequencing of short, damaged DNA fragments from the remains allowed the team to reconstruct two genomes of a Salmonella enterica strain known as Paratyphi C. Today, this bacterium causes enteric fever, a typhus-like illness, that occurs mostly in developing countries. If left untreated, it kills 10–15% of infected people.”

Pandora Report 12.4.2015

This week, Washington, DC hosted the Summit on Human Gene Editing, where the ethical and legal implications of gene editing technologies, like CRISPR-Cas9, were heavily discussed. In this week’s report, Greg Mercer works his magic, revealing the internet and social media trends following the shootdown of a Russian SU-24 on November 24th. We’re also reporting updates in the Zika virus and dengue fever outbreaks as well as the Harvard-LSHTM Panel Report on Global Response to Ebola. France is currently experiencing an increase of highly pathogenic avian influenza cases while a Black Angus beef cow in Alberta was discovered to have bovine spongiform encephalopathy (BSE). Fun history fact Friday – on December 3, 1967, the first human heart transplant was performed in Cape Town, South Africa and on December 4, 1945, the Senate approved US participation in the UN. Before we start our weekly roundup, make sure to mark your calendars to attend GMU’s seminar on Ebola surveillance and laboratory response this Monday, December 7th from 4:30-6pm at our Fairfax campus (details below!).

Zika Virus Outbreak – Updates
The growing outbreak of Zika virus has now seen locally acquired cases reach ten countries, causing the Pan American Health Organization (PAHO) to issue an alert, “urging countries in the region to be on the lookout for the disease and to watch for unusual patterns in newborn.” Brazil has been hit hard with a rise from 739 on November 27th, to 1,248 cases reported on November 30th. Six of the ten countries saw cases occur in November, hinting that the outbreak could just be starting. The growing concerns regarding the outbreak are also related to the newest evidence linking microcephaly and maternal cases. Zika virus genome was found in the amniotic fluid of two pregnant women and fetal diagnosis of microcephaly was performed via ultrasound. Even more so, French Polynesian health officials reported an unusual spike in nervous system malformations in babies that were born during a Zika virus outbreak in the region from 2014 to 2015. The concern regarding neurological conditions raises red flags as Brazilian health officials are reporting neurological complications, like that of Guillain-Barre syndrome, in Zika virus patients. The WHO reported 739 Brazilian microcephaly cases in newborns and while there is only ecological evidence linking the virus and microcephaly, investigations are ongoing. The outbreak first started in February 2014, on Easter Island (Chile) and has seen been identified in Colombia, Guatemala, Brazil, El Salvador, Mexico, Paraguay, Panama (confirmed cases as of December 4, 2015), Suriname, and Venezuela. Spread by Aedes mosquitoes, this vector-borne organism has similar symptoms to dengue fever and illness tends to last between four and seven days.

Event: Ebola Surveillance & Laboratory Response – Lessons for Global Health SecurityScreen Shot 2015-12-03 at 9.34.57 AM
Time/Location: Monday, December 7, 2015 from 4:30pm-6pm in Robinson A-203 at George Mason University.
As the recently released Harvard-London School of Hygiene and Tropical Medicine Independent panel on the Global Response to Ebola indicates, the West African Ebola epidemic highlighted
many gaps in national and international health and response systems that are critical for protecting global health security.  Join leaders and experts who helped to lead the U.S. response for Ebola to discuss the international response to the epidemic, the importance of robust biosurveillance systems, and how the experience with Ebola influences our approach to Global Health Security. Speakers:

  • Dr. Matthew Lim, Senior Policy Advisor for Global Health Security, HHS, fmr Civil-Military Liaison Officer to WHO
  • May Chu, Ph.D. fmr Assistant Director for Public Health, Office of Science Technology and Policy, White House; Senior Science Advisor, CDC
  • Jeanette Coffin, Manager U.S. mobile laboratory deployment, MRIGlobal

It’s Definitely Maybe World War 3
GMU’s Greg Mercer breaks down the November 24th Turkish shootdown of a Russian SU-24. Greg reviews the media attention following the event and the “immediate buzz about declarations of war, what exactly NATO owes Turkey vis-à-vis Russia, and the possibility of military confrontation between Russia and the West.” Through his use of google trends and Twitter, Greg shows just how much hype and concern the notion of WWIII got during this time. Take a look at his recap and debunking of the WWIII buzz and how quickly it caught like wild fire.

Reporting from the Panel on the Final Report of the Harvard-LSHTM Independent Review of the Global Response to Ebola
If you missed the Center for Strategic & International Studies (CSIS) Global Health Policy Center’s Launch of the final report of the Harvard-LSHTM Independent Panel on the Global Response to Ebola, don’t worry! I was fortunate to attend and a great deal of the report (we reported on last week) heavily emphasized “on the ground” capacity. Dr. Peter Piot, Director and Handa Professor of Global Health, London School of Hygiene and Tropical Medicine (LSHTM), joined via video link and started by saying that this would not be a WHO-bashing event. As one of the original researchers on Ebola during its 1976 discovery, he mentioned that the Democratic Republic of Congo (DRC) is a great example of local capacity in their success of ridding themselves of the disease within a few months of the outbreak starting. Dr. Piot heavily emphasized the work of several countries and how the WHO brought together multiple ethicists to review research during such a terrible outbreak. Lastly, Dr. Piot noted that “we risk focussing too much on global and not enough on local” in our future efforts. Dr. Suerie Moon, Research Director and Co-Chair of the Forum on Global Governance for Health at Harvard Global Health Institute, then spoke on the “weak coordination of global response” and how it severely aided the spread of Ebola. Dr. Moon highlighted the need for a global strategy to ensure adequate funding (external financing for the poorer countries and transparent tracking of financing) and the necessity for external assessment of country capacity. She pointed to the need for political and economic incentives and disincentives to not only report cases but also discourage the hiding of outbreaks. Reviewing each recommendation, the panel noted that “human health is a vital part of human security”. In one of her closing comments, Dr. Moon stated that “there are many unanswered questions regarding ebola response and we need to address a number of aspects that went wrong” and “a major theme is accountability at all levels, across all types of players.” Dr. Moon pointed out that the necessity of so many reforms shows just how much work is needed and that now is the time to see political support occur. Muhammad Pate, former Nigerian Minister of State for Health, expressed that “one of the lessons, at the national level, in terms of surveillance and accountability to respond, was missing and something that national leaders need to own up to is building their own public health systems.” Dr. Sophie Delaunay, Doctors Without Borders/MSF, then discussed the role of medical innovations and how the outbreak provided us with a unique opportunity to collect data. Dr. Delaunay said it will “be a complete nightmare to connect all the dots” in this outbreak and there is a desperate need for better R&D regarding disease outbreaks and response. “We ask for governments and policy makers to support collaboration on R&D to demonstrate their willingness to be more effective in the next outbreak” noted Dr. Delaunay. She heavily pushed for global financing efforts to facilitate investment in R&D and response. After the initial panel, there was a secondary group that shared their thoughts on the report, including Dr. Tom Frieden (CDC Director), Julie Gerberding (Exec. VP for Strategic Communications, Global Public Policy and Population Health, Merck) and Ron Klain (Former US Ebola Response Coordinator, White House and General Counsel, Revolution LLC). Ron Klain pointed to the failure of the WHO and “if institutions failed us, individuals shined. We did see extraordinary compassion from the rest of the world and tremendous outpouring of support. ” Mr. Klain mentioned that “the scariest thing about Ebola is the warning signs of how badly we failed this when the threat could’ve been worse and the epidemic we face could be much much more dangerous in the future.” Dr. Frieden emphasized the need of human resources management improvement at the WHO and how global outbreak response could work to support each other better. Lastly, Dr. Frieden emphasized a topic near and dear to my heart; infection control and it’s necessity in global disease prevention. Overall, the panel touched on several key points to the outbreak, emphasizing the need for the biggest players (including MSF) to lead by example via data sharing, etc. The push for political support on incentives and local capacity/accountability was perhaps one of the biggest recommendations and points emphasized from this event.

Gene Editing and CRISPR!
This was a busy week in the biotech world. The International Gene Editing Summit kicked off in Washington, DC. Bringing together experts from around the world, the summit touched on the newest technical innovations, ethical and legal concerns, and even social implications of genome editing advances. Genome Web has provided a great overview of the summit. Nature also published their Four Big Questions related to genome editing, touching on points related to editing the human germline and the ethical implications for technology that “researchers are still grappling with the known unknowns”. Recently, biologist, Emmanuelle Charpentier, discussed CRISPR-Cas9 and that it’s simply too early to begin gene editing as “the tools are not ready” and “as of today, I’m in favor of not having the manipulation of the human germlines. As long as they’re not perfect and ready, I think it’s good to have this ban against editing the germline.” Buzzfeed noted that over the course of the conference, there was a substantial push for a delay in the use of genetic engineering in fertility clinics due to the risk of making “designer babies”. Given the heavily debated nature of this topic it’s not surprising that the US National Academy of Sciences, Engineering and Medicine, the UK’s Royal Society, and the Chinese Academy of Science, all agreed that it “would be irresponsible to proceed with any clinical use of germline editing.” While the future is left open to gene editing on humans, there was heavy accentuation throughout the conference on the ethics and societal views of these scientific breakthroughs and the necessity to revisit their applications on a regular basis.

Dengue Fever Outbreak in Hawaii 
The Dengue fever outbreak on Hawaii Island is still growing. Now at 122 confirmed cases, this is one of the biggest outbreaks they’ve seen with local transmission. As of 12/2, the confirmed cases involved 106 Hawaii Island residents and 16 visitors. The Hawaii Department of Health (HDOH) has published information, hoping to aid prevention efforts, regarding the Aedes aegypti and Aedes albopictus mosquitos that are responsible for spreading the disease. There have been 313 reported potential cases and you can even find a map of the case distribution here!

Stories You May Have Missed:

  • 2015/2016 Flu Season- Where Are We?– The CDC 2015/2016 influenza activity showed a bit of a spike during the November 15-21 week. Influenza A (H3) is still the predominant species in laboratory confirmed cases. If you’re looking to keep an eye on seasonal flu, Google Flu Trends may no longer be operational, but you can still keep an eye on Flu Near You or the CDC’s page.
  • MERS-CoV Severity and Incubation Period– The CDC & Emerging Infectious Diseases published a report regarding the association of severe MERS-CoV illness and a shorter incubation period. Analyses of 170 patents in South Korea revealed a longer incubation period associated with a decreased risk for death while “patients who died had a shorter incubation period.” This mirrors the results of a previous study that had similar results with SARS coronavirus.
  • Salmonella Outbreak Associated With Recalled Nut Butters – The CDC is currently investigating 11 illnesses across nine states that may be linked to recalled nut butters. The Salmonella serotype is Paratyphoid B variant L (+) tatrate (+) (previously called Salmonella Java) and has caused illness in California, Colorado, Georgia, Hawaii, Idaho, Illinois, North Carolina, and New Jersey.
  • Taiwan CDC Holds Bioterrorism Drill – Involving 70 participants, the course utilized a subway union station to allow people to simulate first responders and real-life operations. “CDC bioterrorism teams are tasked with the investigation and identification of biological threats and attacks. Members take on containment and mitigation of damage for any individuals that are harmed during and as a result of an attack.” Go Taiwan!

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

Pandora Report 10.23.2015

Happy Infection Prevention Week! Make sure to give any infection preventionists you know a big hug or at least a hearty handshake (only clean hands though!). Not only do we get to celebrate National Infection Prevention week, but it’s also National Biosafety Stewardship Month, so get your party hand sanitizer ready to go and let the frivolity begin! Foodborne illness is the name of the game this week and we’ll be discussing outbreaks. Friendly reminder – the influenza vaccine is available in most offices/clinics now, so get your flu shot as there have already been cases springing up across the US. Fun fact – did you know that a report published this week identified Yersinia pestis in the tooth of a Bronze Age individual, which means there were plague infected humans 3,300 years earlier than we thought!

National Biosafety Stewardship Month – October is National Biosafety Stewardship Month (thanks NIH!) to celebrate and encourage people to focus on biosafety policies, practices, and procedures. Given the lab biosafety issues we’ve seen recently, I think we can all safely (or should I say, “biosafely”?) agree that a little extra attention to these issues and the promotion of better practices is a great thing. Institutions are encouraged to use more of a just culture approach to incident reporting and to promote public transparency. Happy National Biosafety Stewardship Month!

Water Quality for the Olympic Games in Rio De Janeiro, 2016
The 2016 Summer Olympics are fast approaching and with any large event, health issues become a main concern. The WHO is providing technical advice to the Brazilian national authorities regarding public health concerns, as well as to the International Olympic Committee and the Local Organizing Committee. Clean drinking water, sewage pollution, and a host of other health issues can become a nightmare during such a large-scale event. While there aren’t recommendations for specific viral testing of the water, the WHO does encourage additional testing in the event of an outbreak. Sanitary inspections and other preventative procedures are being recommended to avoid outbreaks and public health issues. As we get closer to the 2016 Olympics, it is very likely concerns over vector-borne diseases will be addressed through vector control and public health education.

CDC Launches Redesigned FOOD Tool for Foodborne Outbreaks 

Courtesy of CDC FOOD Tool
Courtesy of CDC FOOD Tool

The CDC has updated their online foodborne illness outbreak investigation tool! The Foodborne Outbreak Online Database Tool (FOOD Tool) allows the user to search the outbreak database by state, food, ingredient, year, location of food preparation, and organism. The FOOD Tool also provides the case information related to the outbreak, so users can see the number of affected persons, hospitalizations, deaths and laboratory-confirmed organisms. This database pulls from CDC’s Foodborne Disease Outbreak Surveillance System (FDOSS) and allows users to not only look at data and trends over time, but also compare their cases to other outbreaks.

Syrian Refugee Resettlement and Why We Should Be Letting Them All In 
Dr. Trevor Thrall, one of our amazing GMU Biodefense professors, has written a piece for The Atlantic on the importance and benefits of taking in all Syrian refugees. Dr. Thrall discusses the limitations of addressing the root cause of the Syrian conflict and how the US and its European allies should take in refugees. Discussing the military alternatives to the Syrian crisis, he states, “going in militarily is not the answer, then. Instead, those civilians under threat should get out. Refugees typically receive support in the countries to which they flee, but the vast numbers involved in this case threaten to overwhelm Turkey, Jordan, and Lebanon, which have so far accommodated the vast majority of the outflow.” Dr. Thrall points out that while resettlement would cost a substantial amount of money, it would cost far less than military intervention and you simply can not ignore the moral superiority in aiding refugees.

Chipotle’s Bad Tomatoes Came From Nation’s Largest Field Producer
To our readers in Minnesota, did you happen to eat at a Chipotle in August? If so, we hope you weren’t one of the affected individuals that contracted Salmonella Newport as a result of contaminated tomatoes. The Minnesota Department of Health investigated the 64 cases resulting from this outbreak, however it was just released that the contaminated tomatoes were actually supplied by Six L’s Packing Co (doing business as Lipman Produce), which is actually one of the largest tomato suppliers in the US. Packing 15 million boxes of tomatoes this past year, Lipman was later dropped as a supplier by Chipotle after learning of the source of contaminated produce. The tomatoes were removed but it’s estimated that during the window of exposure, roughly 560,000 people consumed Chipotle. The good news is that we’re out of the incubation period, so if you happened to eat at a Minnesota Chipotle, you’re in the clear.

Stories You May Have Missed:

  • 80 Illnesses Linked to Shigella Outbreak; CA Seafood Restaurant Closed –  Mariscos San Juan in San Jose, CA is currently closed after the Santa Clara County Health Department connected a recent outbreak of Shigella to their food. While the exact source hasn’t been identified, over 93 people were sickened in relation to contaminated food at the restaurant.
  • Subway to Phase Out Poultry Products Raised With Antibiotics–  On Tuesday, Subway Restaurants announced that they will be transitioning to only serve poultry products that have been raised without antibiotics by early next year. Other chain restaurants, like Chick-fil-A and Chipotle, are jumping on the train to phase out chicken and turkey products that were raised with antibiotics.
  • Scottish Nurse and Ebola Complications – Pauline Cafferkey continues to battle post-Ebola complications. Reports last week noted neurological issues and it was recently reported that she has meningitis after the virus persisted in her brain and CSF after her initial recovery. Ongoing research is looking into the long-term effects of the disease as the West African outbreak was the largest in history and researchers have never had the opportunity to look at chronic issues associated with disease recovery.

Pandora Report 10.16.2015

What a busy week in the world of biodefense! First, let’s give a round of applause for Global Handwashing Day (and now, go wash your hands!). This week we saw a nurse from the UK experience Ebola-associated complications months after her recovery. The CDC released a report stating that 17 states exceeded their recommendations for Ebola screening/monitoring and a recent study discussed vaccination rates and herd immunity. Let’s not forget that we’ve got another segment on 2016 Presidential candidate chatter on nonproliferation, a call for papers, and an open house on GMU’s Master’s program. Grab your morning coffee/tea and let’s explore this week’s biodefense news!

Global Handwashing Day 
Global Handwashing Day was Thursday, October 15th, but really we should be celebrating it every day! It may seem like a simple thing but the truth is that hand hygiene is one of the most important things you can do to prevent the spread of infection. Whether it’s a hospital-acquired infection or avoiding illness in the workplace, hand hygiene is the first line of defense. The WHO estimates that hand hygiene, just in healthcare, saved millions of lives in the last years. The CDC even calls it the “do-it-yourself” vaccine – five simple steps (wet, lather, scrub, rinse, dry) to help prevent the spread of infections. Many people think it’s a small or “easy” thing, but coming from an infection preventionist, it’s the small things that make the biggest difference. You’d be surprised how many organisms we carry around on our hands and on fomites, so using alcohol-based hand sanitizer or washing with soap and water is the only way to get rid of those. University of Arizona professor, Dr. Gerba, (we lovingly referred to him as Dr. Germ – funny enough, he even gave one of his children the middle name of Escherichia!) has focussed much of his research on the household and public objects we may not realize are covered in germs. Perhaps the most important take-away from Global Handwashing Day isn’t just its importance in healthcare, but its role as an important part of disease prevention everywhere. In the U.S.  we’re fortunate to have access to the resources that allow us to have phenomenal hand hygiene practices however, it’s the behavior we tend to fall short on. From today forward, I encourage you to make a personal decision to be vigilant in hand hygiene.

Last Call for Papers – Women’s Health in Global Perspective!
Papers sought for a special issue and workshop of World Medical & Health Policy on “Women’s Health in Global Perspective,” to contribute to understanding and improve policy related to women’s health and wellbeing.  Forces ranging from the economic to the climactic have human repercussions whose genesis and solutions demand consideration of their global context.  A wealth of recent research and inquiry has considered the particular plight of women, who often suffer disproportionately from lack of education, compromised nutrition, poverty, violence and lack of job opportunities and personal freedom.  The Workshop on Women’s Health in Global Perspective will consider the broad ranging social determinants of health on a global scale that importantly influence health outcomes for women everywhere, which in turn has implications for economic, political and social development.
Abstract submission deadline (250 words): October 16, 2015 Contact: Bonnie Stabile, Deputy Editor, bstabile@gmu.edu
Notification of selected abstracts: November 13, 2015

Presidential Candidates on Nonproliferation Part II
GMU’s Greg Mercer has put together a wonderful second part to his series on one of our favorite topics (nonproliferation) and what the 2016 presidential candidates are saying about it. Check out Greg’s review of these candidates’ stance so we can track how they might change over the course of the election.

west-africa-distribution-map
Source: CDC

Updates and Mapping Ebola
BBC recently published a nice overview of the Ebola outbreak in West Africa. Since the first case 18 months ago, it has been a whirlwind, in more ways than one, for those of us in the public health/global health security world. Cheerfully, the outbreak region has officially gone two weeks without a new case! Unfortunately, Pauline Cafferkey, the Scottish nurse who was treated and recovered from Ebola in December of 2014, is in critical condition due to a late Ebola-related complication. It was just released that her complications are neurological, including severe central nervous system (CNS) disorder and that the virus was detected in her spinal fluid. Scottish public health officials did identify 58 close contacts and offered them the SV-EBOV vaccine.

Master’s Open House
Learn more about the GMU School of Policy, Government, and International Affairs Masters’ programs on Wednesday, October 21, 2015 at 6:30pm at our Arlington Campus, Founders Hall, Room 126. This informational sessional will discuss our Master’s programs ranging from Public Administration, Biodefense, Political Science, Health and Medical Policy, etc.

Imported Measles and Need for Vaccination –This past week at the IDWeek 2015 meeting, scientists reported on a study reviewing measles vaccination rates in the US and susceptible children in relation to the number of measles cases that have occurred. They noted, “this analysis highlights the need for high measles vaccination coverage to support population-level immunity and prevent reestablishment of indigenous measles transmission in the United States.” The Daily Beast also incorporated this into an article on diminishing herd immunity and anti-vaxxers.

Avian Influenza Vaccine Added to National Veterinary Stockpile
APHIS (United States Department of Agriculture’s Animal and Plant Health Inspection Services) awarded contracts to two companies to ensure manufacturing of the vaccine for avian influenza. The goal is to strengthen the Agency National Veterinary Stockpile. “This action is being taken to develop the Agency’s National Veterinary Stockpile., and does not signal a decision to vaccinate for highly pathogenic avian influenza (HPAI). While APHIS has not approved the use of vaccine to respond to HPAI, the Agency is preparing to ensure that vaccine is available should the decision be made to use it during a future outbreak.”

Stories You May Have Missed:

  • International Infection Prevention Week is next week! October 18-24, 2015 will celebrate the importance of infection prevention and control in healthcare. Let’s celebrate by not just washing our hands, but also considering all the small ways we can prevent the spread of germs in our homes and workplaces!
  • Salmonella Cucumber Outbreak – The CDC has released new data on the Salmonella Poona outbreak related to imported Mexican cucumbers. As of October 14th, there have been 757 people infected across 36 states and 4 deaths related to the outbreak.
  • DHS Wants to Revive Terrorism Alert System – In wake of the attacks in Chattanooga, President Obama’s security officials are initiating a review of the nation’s terrorism alert system to support what many consider a growing threat of domestic attacks. DHS wishes to revise and restart the National Terrorism Alert System to better respond to these evolving attacks.

Pandora Report 9.18.2015

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

US Confirmation of Islamic State Chemical Weapons

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

Michigan Experiences Imported Plague Case

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

The So-Called Islamic State 2
By Greg Mercer

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

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

 

 

 

 

 

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

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

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

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

 

 

 

 

 

 

 

 

 

 

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

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

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

The Evolution of Cyber War

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

Stories You May Have Missed:

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

Pandora Report 9.11.15

Miss us? Good news – the Pandora Report weekly update is back! With a new school year comes new faces and some organizational change-up. Dr. Gregory Koblentz is now the Senior Editor of Pandora Report and Saskia Popescu (yours truly) will be taking over from Julia Homstad as the Managing Editor. I come from the world of epidemiology, public health, and infection control. Having just started in the GMU Biodefense PhD program, I look forward to venturing down the rabbit hole that is the Pandora Report!

There’s been some pretty fascinating news over the past few weeks, so let’s try and catch up…

Lab Safety Concerns Grow 

Our very own Dr. Gregory Koblentz, director of the GMU Biodefense program, was interviewed by USA Today regarding the lab security issues that now involve mislabeled samples of plague. “Since there are now concerns about the biosafety practices at multiple DoD labs there needs to be an independent review of the military’s biosafety policies and practices,” Koblentz said Thursday. He said the Critical Reagents Program is an important biodefense resource. “It’s crucial that all problems with handling and shipping inactivated samples be resolved quickly so the program can resume its important role in strengthening U.S. biopreparedness.”

Reviving a 30,000-Year-Old Virus…Isn’t This How the Zombie Apocalypse Starts?

You may recall last year that French scientists stumbled across a 30,000-year-old virus frozen in the Siberian permafrost. Considered to be a “giant virus” (doesn’t that give you a warm, fuzzy feeling inside?), this is actually the fourth ancient, giant viral discovery since 2003. The new plan is to try to revive the virus in order to better study it.

Dr. Claverie told Agency France-Presse, “If we are not careful, and we industrialise these areas without putting safeguards in place, we run the risk of one day waking up viruses such as smallpox that we though were eradicated.” Given the recent concerns over biosafety lab specimen transport, we’re all curious to see how this new organism, coined “Frankenvirus”, turns out!

Cucumbers and A Multi-State Salmonella Outbreak

CDC updates regarding the Salmonella Poona outbreak reveal the brevity of the potentially contaminated product. As of September 9th, there have been two deaths, 70 hospitalizations, and 341 confirmed cases across 30 states. Perhaps the most worrisome is that 53% of affected individuals are children under the age of 18. While the produce company, Andrew & Williamson, issued a voluntary recall of their “slicer” or “American cucumber on September 4th, there have been 56 additional cases reported since then. Isolated samples from cucumbers in question were found in Arizona, California, Montana, and Nevada. The California Department of Public Health issued a warning and pictures of the affected cucumbers. 

Stories You May Have Missed:

Microbes: The 21st Century Astronauts

By Alena M. James

The Third Commercial Resupply (CRS-3) mission was scheduled for launch on Monday, April 14, 2014. Taking off from the Cape Canaveral Air Force Station in Florida, the CRS-3 mission was to head to the International Space Station (ISS) at 4:58pm. However due to a helium leak on the launch vehicle, the launch has been postponed for Friday, April 18 at 3:25 p.m.

If the repairs are made by Friday, the space pioneering company, Space X will be given the opportunity to test its Falcon 9 rocket and its unmanned Dragon cargo capsule in transporting materials and supplies to the ISS.  The Falcon 9 rocket is not the only equipment requiring repairs. A critical computer onboard the ISS also failed to activate last Friday.  Although NASA confirms that the ISS Crew was not any danger with the broken computer, a spacewalk to repair the system has been scheduled for April 22, 2014.

The mission cancelled on Monday will transport materials astronauts can use to repair the computer system, as well as 5,000 pounds of additional supplies. Among these supplies are materials used by astronauts to execute more than 150 scientific investigations. Such investigations include laser optics tests to explore information exchange from space to Earth and National Institutes of Health funded immune system research projects.

Also onboard the unmanned mission will be more than 48 different types of bacterial strands sponsored by Project MERCCURI, which stands for Microbial Ecology Research Combining Citizen and University Researchers on the International Space Station.  Under the project, microbial samples were collected from stadiums, monuments, museums, retired space crafts, and other public sources throughout the United States. The purpose of sending the different types of microbes into space is to determine how the bacteria will grow in the absence of gravity.  In addition to determining the effects of the absence of gravity on microbial growth, Astronauts on board the ISS will collect their own bacterial samples residing on fomites board the station. This study will help to establish the microbial flora of the ISS by identifying the different types of bacteria present.

The study of microbes at zero gravity conditions is nothing new. The National Aeronautics and Space Administration (NASA) has conducted previous studies primarily investigating the virulent nature of pathogenic organisms in space. A study carried out in 2006 revealed Salmonellato express a higher degree of virulence when grown in a zero gravity environment.  According to the study 167 genes and 73 proteins were found to have been altered in structure—the likely cause for the higher degree of virulency. Salmonella strains grown in space were brought back to Earth and their effects tested on mice. The studies showed that mice from the experimental groups were subject to illness at a faster rate than the control groups.  NASA has also completed studies evaluating the effects of antigravity conditions on the human immune system. Their investigations show that the absence of gravity has an adverse effect on the human body and weakens the immune system. In essence, pathogens become stronger in the absence of gravity; while the human immune system becomes weaker. This finding may have grave implications for individuals hoping to travel to space or to be a part of the MarsOne human settlement scheduled for 2024.

Contrary to NASA’s pathogenicity studies, Project MERCCURI’s research focuses on non-pathogenic bacteria and examination of their microbial growth properties. Findings of the study are likely to provide greater insight into the ubiquitous nature of bacteria and make actors in space exploration more cognizant about the bacterial environment around them.

If repairs to the Falcon 9 rocket are successful and the launch continues as planned for Friday, the Dragon space craft is expected to dock at the station for four weeks. After four weeks it will return to Earth bringing with it supplies and experiments performed on the ISS.

 

MERCCURI is a project made possible by the collaborative efforts of microBEnet/UC Davis with the Science Cheerleaders, Space Florida, NanoracksJPL-NASA, and SciStarter.com.

Image of the Week: Salmonella typhimurium!

Salmonella typhimurium

 

From the CDC: “This photograph depicts the colonial growth pattern displayed by Salmonella typhimurium bacteria cultured on a Hektoen enteric (HE) agar medium; S. typhimurium colonies grown on HE agar are blue-green in color, for this organism is a lactose non-fermenter, but it does produce hydrogen sulfide, (H2S), therefore there can be black-colored deposits present.

HE agar is the medium designed for the isolation and recovery of fecal bacteria belonging to the family, EnterbacteriaceaeS. typhimurium causes 25% of the 1.4 million Salmonellosis infections a year in the United States. Most persons infected with Salmonella sp. develop diarrhea, fever, and abdominal cramps 12 – 72 hours after infection. The illness usually lasts 4 – 7 days, and most people recover without treatment. However, in some cases, the diarrhea may be so severe that the patient needs to be hospitalized.”

Image Credit: CDC

The Pandora Report 8.9.13

Highlights include camels as MERS’ vectors, anti-bacterial chemicals hiding Salmonella, a new malaria vaccine, BioWatch in DC, H5N1 in Nepal, African Swine Fever in Belarus, and in case you missed it: mutating H7N9. Happy Friday!

Camels may be source of Middle East’s Sars-like virus

Can we all just take a moment to appreciate the level of epidemiological sleuthing which went in to uncovering this? Researchers attempting to determine the vector of Middle Eastern Respiratory Syndrome (MERS) ended up sampling 50 Omani racing camels, and 105 Canary Islander tourist camels. All camels sampled from Oman, and 15 of those from the Canary Island, possessed antibodies to MERS, indicating prior infection. While the presence of antibodies is compelling, the virus itself was not found in any of the dromedary (vocab word of the day, meaning an Arabian camel with one hump) camels sampled. Also, Oman has reported no human cases of MERS. However, with camels as a possible vector, follow up investigations into whether those people infected had any contact with camels, their meat, or their milk can be conducted.  MERS has infected 94 people to date, killing almost half.

The Guardian – “The scientists said the virus could be slightly different – maybe more transmissible in Oman – or the camels might have been kept in circumstances that made it less likely to spread in the Canaries. But it is also possible that the virus was brought in by one of the three oldest Canary Island camels, who arrived from Morocco more than 18 years ago. ‘We cannot rule out that the population might have once had an outbreak but that by the time of sampling, antibody titres had waned and no new introductions of the virus had occurred,’ they write. ‘The camels have contact with wild rodents, pigeons, and other doves, and possibly also bats. Seven insectivorous bat species, including three pipistrellus [species], are native to the Canary Islands, while Egyptian fruit bats (Rousettus aegyptiacus) have been introduced.'”

USDA reviews whether bacteria-killing chemicals are masking Salmonella

According to recent research, the use of stronger anti-bacterial chemicals at poultry-processing plants may be cloaking the presence of Salmonella and other foodbourne pathogens which remain on the processed meat. Apparently the more stringent chemicals are too strong for current Salmonella tests, potentially resulting in false negatives. The USDA has stepped in to further investigate the research’s claims. For those of you who (like me) didn’t know, apparently the bird is treated with four different chemicals on average.

Washington Post – “To check that most bacteria have been killed, occasional test birds are pulled off the line and tossed into plastic bags filled with a solution that collects any remaining pathogens. That solution is sent to a lab for testing, which takes place about 24 hours later. Meanwhile, the bird is placed back on the line and is ultimately packaged, shipped and sold. Scientists say in order for tests to be accurate, it is critical that the pathogen-killing chemicals are quickly neutralized by the solution — something that routinely occurred with the older, weaker antibacterial chemicals. If the chemicals continue to kill bacteria, the testing indicates that the birds are safer to eat than they actually are.”

Investigational malaria vaccine found safe and protective

A new, live-attenuated malaria vaccine has successfully completed Phase I clinical trials. The vaccine, known as PfSPZ Vaccine, has been shown in a recent NIH to be safe, immunogenic, and  effectively confer immunity. However, a significant drawback of the new vaccine is its intravenous administration – most vaccines are administered subcutaneously, intradermally, or, ideally, orally.  Nonetheless, researchers are optimistic, and a set of follow-up studies are scheduled. According the the WHO, in 2010 (most recent sampling year), malaria caused an estimated 219 million cases globally, with 660,000 deaths, predominantly amongst African children.

Medical Xpress – “The Phase I trial, which took place at the NIH Clinical Center in Bethesda, received informed consent from and enrolled 57 healthy adult volunteers ages 18 to 45 years who never had malaria. Of these, 40 participants received the vaccine and 17 did not. To evaluate the vaccine’s safety, vaccinees were split into groups receiving two to six intravenous doses of PfSPZ Vaccine at increasing dosages. After vaccination, participants were monitored closely for seven days. No severe adverse effects associated with the vaccine occurred, and no malaria infections related to vaccination were observed…Based on blood measurements, researchers found that participants who received a higher total dosage of PfSPZ Vaccine generated more antibodies against malaria and more T cells—a type of immune system cell—specific to the vaccine.”

DHS wants LRS Federal to continue collecting BioWatch air samples for another six months

BioWatch isn’t dead yet, at least if you live in the DC metro region. The Department of Homeland Security has decided to award LRS Federal a six-month contract extension for maintenance of BioWatch in the DC metro area. The $759,000 awarded in the renewal will go towards maintenance of the program, including salaries of those who collect the daily samples and upkeep. No new developments on Gen 3 writ-large.

Government Security News Magazine – “LRS Federal currently manages the teams that perform daily sample collections and routine equipment maintenance on portable air sampling units located throughout the National Capital Region’s ‘BioWatch Jurisdiction,’ in Washington, DC; Baltimore, MD; Richmond, VA; and elsewhere. The notice says that LRS is the only firm that can continue supporting the program’s immediate requirements. ‘Otherwise, the Government will be without support to detect and mitigate the threat of biological air-borne pathogens,’ it added.”

International Recap:

Nepal: H5N1 is still raging in Nepal, with the government considering an extension of the current ban on poultry-product sales. In the weeks following this most recent outbreak, the  Nepali government had come under fire for apparently pandering to poultry groups, resulting in an increase in the virus’ spread. However, it has since began a widespread campaign of restriction of poultry sales and culling. Fears of the virus spreading south to neighboring India remain.  Read more here.

Belarus: It’s not often we get to write about Belarus, Europe’s last dictatorship (no Putin jokes, please). The Eastern European country is currently experiencing an outbreak of African Swine Fever, which only affects pigs. Belarus has admitted difficulty in containing the outbreak. We’ve been unable to track down official numbers (it’s Belarus), but concerns over the disease spreading to Western Europe are mounting. Read more here.

In case you missed it:

– Researchers Mutating H7N9, increasing virulence and able to transmit person-to-person

(image courtesy of Jason Wain/Flickr)