Pandora Report 11.17.2017

Happy Friday – we hope you had a wonderful time celebrating Antibiotic Awareness Week! As Canada reports rising antibiotic resistance despite decreasing use of antibiotics in humans and animals, it’s important we recognize the importance of stewardship and infection control. November 13-19 marks Antibiotic Awareness week, in which we observe the importance of proper antibiotic use and prescribing practices. In the United States alone, 23,000 people die a year due to an infection that was resistant to antimicrobials. Help stop antimicrobial resistance through antibiotic stewardship.

GMU Biodefense MS student Stephen Taylor

Reflections from the GHSA Ministerial Meeting in Kampala, Uganda
The recent GHSA Ministerial Meeting was not only a success, but also reaffirmed the importance of the agenda and those dedicated to combatting health security threats. We’re excited to provide you with a series of on-the-ground reflections from those who participated through the George Mason Global Health Security Ambassador Fellowship and the Next Generation Global Health Security Network. Within these reflections, you’ll get to hear from Next Generation Coordinator Jamechia D. Hoyle and a wonderful array of international students and professionals. Hoyle notes that “the meeting was called to order during a time where health security professionals were addressing a plague outbreak in Madagascar and a local Marburg outbreak in the host country, Uganda.  This alone was a vivid reminder that health security must remain a priority.” The reflections present unique outlooks on the meeting and range from detailed descriptions of the sessions to visiting the Uganda Virus Research Institute, and more. Make sure you catch reflections from GMU biodefense MS students Anthony Falzarano and Stephen Taylor!

Did Russia Accidentally Provide the Best Evidence of the Syrian Government’s Involvement in Sarin Attacks?
Russia has been trying to downplay the Syrian government’s role in chemical weapons attacks, but their latest press conference may have just backfired on them. The November 2nd press conference in which Russian officials responded to the Organization for the Prohibition of Chemical Weapons – UN Join Mission, included a presentation that revealed a bit more than anticipated. “The presentation included a series of slides, which included diagrams of two types of chemical bombs, designated the MYM6000 and M4000. Remarkably, the Russian presentation appears to be the first-time images of these munitions have been made public, and before the press conference, no other references to MYM6000 or M4000 bombs appear online.” GMU Biodefense Graduate Program Director and Professor Dr. Gregory Koblentz noted that “‘these designations match bombs declared by Syria to the OPCW’, although there appears to be no open source material that provides specifics about the types of bombs declared to the OPCW. In the press conference the source of the diagrams are described as being provided ‘by certain organisations’, but no more specifics are given.” The Russian presentation diagrams provide some pretty clear matches between munitions found during investigations into the attacks. “The only way for the Russian or Syrian governments to now deny the M4000 bomb was used is to produce detailed photographs of the M4000 bomb, showing the same parts indicated above, or, if the Syrians still claim all these bombs were destroyed after 2013, declassify and publish further information about the bomb.”

The Center for Global Security Research – Student Internship                     The Center for Global Security Research, Lawrence Livermore National Laboratory is now accepting applications for Spring 2018 student internships! “The Center for Global Security Research (CGSR) was established at Lawrence Livermore National Laboratory (LLNL) in 1996 to bring together experts from the science, technology, and policy communities to address pressing national security challenges. For more than 20 years, CGSR has engaged diverse perspectives on topics important to national security, deterrence, diplomacy, dual-use technology, arms control, nonproliferation, peacekeeping, cyber defense and energy security.”

A Field Test of CRISPR
Researchers are getting to test, for the first time, treatment of a genetic disorder with gene-editing tools infused into the patient’s blood. The 44-year-old man suffers from Hunter syndrome, which is a metabolic disorder. “The company (Sangamo Therapeutics) inserts a replacement copy of the gene, using gene editing to snip the DNA helix of liver cells in a specific place near the promotor, or on-off switch, for the gene for a protein called albumin. The cells fix the damage by inserting the DNA for the new gene, supplied by the researchers along with the gene editor’s DNA scissors, and the gene’s activity is then controlled by the powerful albumin promotor. The idea is to turn these modified liver cells into a factory for making the enzyme missing in Hunter syndrome.” This is an exciting step forward for gene-editing technologies and their ability to treat chronic diseases. Curious what CRISPR looks like in action? Check out this video here.

Call for Papers- Women’s Health in Global Perspective
World Medical & Health Policy’s call for papers on Women’s Health in Global Perspective seeks to contribute to understanding and improve policy on women’s health and wellbeing around the world. Manuscripts on all factors that influence health outcomes for women will be considered, including social determinants such as education, nutrition, poverty, violence, access to health care, job opportunities and personal freedom.  The 2018 Workshop on Women’s Health in Global Perspective will follow a successful 2016 workshop by the same name (see video at http://www.ipsonet.org/conferences/whgp/2016-womens-health-in-global-perspective-videos), which resulted in a special issue http://onlinelibrary.wiley.com/wol1/doi/10.1002/wmh3.212/full and an ongoing series of articles in WMHP highlighting global women’s health issues and their implications for economic, political and social development. Abstract submission deadline (250 words): December 15, 2017. Contact: Bonnie Stabile, Co-Editor, bstabile@gmu.edu

Three Decades of Responding to Infectious Disease Threats
NIAID Director Anthony Fauci has been fighting infectious diseases in his role since 1984. After 30+ years of work, Dr. Fauci undoubtedly has some fascinating stories, whether it be from the beginning of the HIV pandemic or SARS. “Initial responses to a newly recognized disease, now known as HIV/AIDS, in the early 1980s were criticized as being too slow, the essay notes. ‘The insidious emergence of HIV/AIDS and the lack of due attention by policymakers illustrate how some outbreaks that start subtly can grow to global proportions if they are not aggressively addressed early on,’ Dr. Fauci writes. Between the early 1980s and the early 1990s, federal funding for HIV/AIDS research increased markedly, reaching $1 billion by the end of 1992. The accelerated government response supported both research and research infrastructure, and yielded advances in countering the HIV/AIDS pandemic domestically and internationally. Ultimately, notes Dr. Fauci, sustained support for scientific research coupled with political and community engagement helped transform HIV/AIDS from a nearly universally fatal disease to a condition that can be managed with appropriate treatment.”

The One Health Commission’s Call to Action for Social Scientists
“The One Health Commission, a 501(c)(3) global non-profit organization based in the U.S., stresses recognition of human, animal, and ecosystems interconnections and facilitates collaboration of all professions required to achieve global and planetary health. The One Health Social Sciences Team invites social scientists of all disciplines to become involved in the One Health community. By forging new and innovative partnerships, collaborations across human, animal, plant and ecosystem health communities will collectively enable betterment of health and well-being for all.” To learn more and get involved please contact the One Health and Social Sciences Working Group at ohss@onehealthcommission.org.

What Should The US National Biodefense Strategy Look Like?                                                                                                     The complex nature and painful lessons of biological threats, regardless of source, have challenged U.S. biodefense efforts for decades. As the Blue Ribbon Study Panel on Biodefense pointed out in their report, there is a general lack of clear leadership and coordination. The 2016 National Defense Authorization Act required that the DoD, DHHS, DHS, and USDA, all develop a national biodefense strategy and plan for implantation. Laura H. Kahn has provided a handful of critical strategies that are necessary. “First, human-intelligence-based monitoring of rogue nations and militant groups that use bioweapons is critical. Second, a national strategy must include a plan for disease surveillance of humans and animals, with a view to predicting the next naturally occurring epidemic. This kind of work is difficult, because there are so many viruses that could spill over from other mammals or birds into humans.” Kahn also highlights laboratory security and the importance of high-containment lab biosecurity, review of the Federal Select Agent Program, investigation of large-scale wildlife die-offs, and recognizing the importance of One Health. “Threat to one component in this triad threatens them all. For that reason, animal and environmental health must be taken just as seriously as human health—which requires devoting personnel and resources to monitoring them, which requires sufficient funding for entities like the EPA and the Fish and Wildlife Service.” Kahn also draws attention to the recent GAO report on biological threat awareness and the need to share information and resources. “Most distressingly, the current administration appears willfully ignorant of scientific issues, while at the same time disinclined to fund critical scientific efforts. The White House Office of Science and Technology Policy, which is intimately involved with biodefense issues, remains leaderless and understaffed.” Overall, a national biodefense strategy will not be easy, but it must be as comprehensive and wholistic as the biological threats we face.

The World’s Deadliest Diseases: How Is Biotech Fighting Them?
Biotech has an increasingly important role of health security and infectious disease response. As we saw with CRISPR this week, it has the capacity to help treat chronic conditions, but what about infectious diseases? Rapid diagnostics and development of medical countermeasures are critical during outbreaks and can determine if an epidemic will turn into a pandemic. Ute Boronowsky, pulling on Robert Herriman’s list of the five deadliest diseases, is looking to the biotech approaches for such biothreats. Whether it be plague or amebic meningoencephalitis, biotech advances are providing new avenues for treatment and response. Naegleria fowleri (the amoeba that causes the fatal meningoencephalitis) can be difficult to track within water sources and treatment is even trickier. “In 2015, investigational breast cancer and anti-leishmania drug miltefosine was used successfully on a 12-year-old girl at the Arkansas Children’s Hospital. However, when the same drug was used on two other patients, one of them died, and the other suffered from major neurological damage. This year saw a new therapeutic approach when scientists at the Virginia Commonwealth University found evidence that Naegleria relies on matrix metalloproteases to degrade the host extracellular matrix during infection, identifying these enzymes as potential therapeutic targets.” Other biotech advances, like prion disease therapy kinase inhibitors on the unfolded protein response, or the latest Ebola vaccine, all highlight the importance of biotech advances in combatting infectious diseases.

Stories You May Have Missed:

  • Legionella in Disneyland – GMU biodefense PhD student Saskia Popescu is looking at the latest outbreak of Legionnaires’ disease and how it highlights the challenges of prevention. “There are many factors that may attribute an outbreak, such as warming climates, a large aging population, and increased attention on the disease, which all lead to a better chance of infections being reported. The recent outbreak in Disneyland is a good reminder of the inherent challenges with disinfection efforts and continued vigilance that is needed to ward off this bacterial infection. It is also a reminder that outbreaks can happen anywhere there is a water source, even Disneyland, or other areas that somehow seem to be untouchable.”
  • Bulgaria and South Africa Battle HPAI – The two countries are dealing with outbreaks related to highly virulent strains of avian influenza. “A US vaccine company announced that the US Department of Agriculture (USDA) has conditionally approved the first DNA avian flu vaccine for chickens. Also, the United Nations Food and Agriculture Organization (FAO) provided a snapshot of current highly pathogenic H5 observations and what could play out in the upcoming season, and Chinese researchers reported new findings on airborne spread of avian flu based on sampling in a live-poultry market.”

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

Pandora Report 10.27.2017

TGIF and Pandora Report day! Buckle up because we’ve got an abundance of biodefense news that covers GHSA, chemical weapons, synbio, and more.

 Global Health Security – WHO & PATH Reports and GHSA Ministerial Meeting
As the Global Health Security Agenda Ministerial meeting in Kampala, Uganda takes place this week, several reports were released highlighting the deficiencies in global biosecurity and biosafety efforts, as well as the importance of investing in global health security. Fortunately, on the eve of the GHSA Kampala summit, the Trump administration endorsed the future of the GHSA. Don’t forget to stay tuned to our weekly reports as two GMU Biodefense graduate students are participating (as recipients of the George Mason Global Health Security Ambassador Fellowship) in the Ministerial meeting alongside NextGen GHSA and they’ll be reporting on their experiences in the coming weeks. The first report this week is from NTI, which called on countries to improve biosecurity after WHO demonstrated that there are substantial biosecurity/biosafety gaps worldwide. NTI analyzed 39 Joint External Evaluation (JEE) peer reviews and mapped the related biosecurity and biosafety related scores. Here are their findings: “74% of the assessed countries demonstrated limited or no capacity for a whole-of-government national biosafety and biosecurity system. 64% of the assessed countries demonstrated limited or no capacity for biosafety and biosecurity training and practices. 41% of the assessed countries demonstrated limited or no capacity for linking their public health and security authorities during a suspected or confirmed biological event.” The map they’ve created is also a great visualization for how truly weak biosecurity and biosafety efforts are on a global scale. NTI also used this information to track commitments and biosecurity assistance and partners. The next report comes from PATH, which just released their work: Healthier World, Safer America: A US government Roadmap for International Action to Prevent the Next Pandemic The latest PATH analysis focuses on global health security and global efforts to respond to threats. “This paper aims to examine the benefits of investments in pandemic preparedness, as well as recommends the US Administration and Congress come together behind a comprehensive US strategy, robust investments, and continued vigilance both at home and abroad. The recommendations focus on global leadership, a US plan for international action, and research and development; underpinned by the risks of unsustainable funding, with special focus given to the Ebola supplemental funding sunset set to occur in FY2019.”

Reauthorizing & Improving The Department of Homeland Security
Don’t miss the recent National Interest series by GMU Biodefense PhD alum Daniel Gerstein  on the DHS reauthorization bill. This three-part series starts with a focus on why it’s time to improve the Department of Homeland Security. Gerstein notes that “reauthorization of the Department of Homeland Security is vital to clarifying responsibilities and setting expectations for the continued evolution of the department.” The second part in the series highlights methods for fixing the fractured department. “The question is not whether reauthorization of DHS is necessary. It  most definitely is. However, we should also ask whether the bill goes far enough and what other issues should a comprehensive DHS bill encompass? This second commentary considers whether the DHS structure with  relatively weak central authorities should be reevaluated. Interestingly, each successive secretary has sought to consolidate power and authorities at the department level. Is it time to legislate this outcome? ” Lastly, Gerstein addresses why updating the DHS Acquisition System matters. “This third commentary considers how to better align the department’s requirements, research, development and acquisition processes. Currently, the processes are not synchronized and should be harmonized to better align these critical departmental systems.”

Global Health Security Forum 2017 
Don’t miss out on this November 7th event hosted by the Center for Strategic & International Studies. The all-day event will be held at the CSIS headquarters and will even include an entire session on “Hurtling Toward a Genomic 9/11”! Don’t miss out on the “CSIS’s annual flagship conference on the top challenges facing U.S. and global security. This year’s Forum will focus on national security priorities ten months into the Trump Administration and one year prior to U.S. midterm elections.”

 The Collision Of Civil War And Threat Of Global Pandemics
Infectious disease outbreaks can be challenging for even the most stable country and those experiencing civil war are even more impacted by such biological events. Currently, there are 30 civil wars going on around the world – between cholera in Yemen, polio in Syria, and yellow fever in the DRC, countries that have experienced civil war also tend to experience infectious disease outbreaks. “The Daedalus issue, “Civil War & Global Disorder: Threats and Opportunity,” explores the factors and influences of contemporary civil wars. The 12 essays look at the connection of intrastate strife and transnational terrorism, the limited ambitions of intervening powers, and the many direct and indirect consequences associated with weak states and civil wars. Barry and Wise believe there is significant technical capacity to ensure that local infectious outbreaks are not transformed into global pandemics. But those outbreaks require some level of organized and effective governance—and political will. Prevention, detection, and response are the keys to controlling the risk of a pandemic. Yet it’s almost impossible for these to coincide in areas of conflict.” Civil war impacts not only communication, but access to health resources and can challenge early detection and response of outbreaks. Moreover, the traditional hotspots for emerging infectious diseases (tropical and subtropical areas where spillover is likely) are also areas continually “plagued by civil conflict and political instability.”

Chemical Weapons and Syria
On Tuesday, Russia vetoed a vote at the United Nations Security Council that would “renew a mandate to continue an investigation into who was responsible for the use of chemical weapons during Syria’s civil war.” The Joint Investigative Mechanism (JIM) was initially set up in 2015 to help identify those responsible for chemical attacks and is currently reviewing the April nerve agent attack in Khan Sheikhoun. “But Russia could not get enough support and instead used its veto to block adoption. Russia, along with the UK, China, France and the US, have veto powers at the Security Council. It is the ninth time Russia has blocked action against its ally Syria, something rights group Amnesty called ‘a green light for war crimes’.” The United States has already released a statement through the State Department – “We are disappointed, we are very disappointed that Russia put what it considered to be political considerations over the Syrian people who were so brutally murdered,”.

The Good, The Bad, and The Ugly of Pandemic PredictionPreparation, and Medical Countermeasure Communication 
Pandemic preparedness often feels like a teetering game of picking your poison. Will we see an avian influenza like H7N9 or will it be a novel disease? The CDC “evaluates every potentially dangerous strain, and gives them two scores out of 10—one reflecting how likely they are to trigger a pandemic, and another that measures how bad that pandemic would be. At the top of the list, with scores of 6.5 for emergence and 7.5 for impact, is H7N9.” While there isn’t strong transmission capacity between humans with the H5 and H7 viruses, the H7 strains are more worrisome in that they require fewer mutations to get to that point. Our efforts against avian influenza pandemics go beyond surveillance, and also focus on vaccine responses. “In the meantime, vaccines are being developed to match the viruses seen in the fifth and current epidemic. Other control measures have waxed and waned. When the first of the epidemics struck, Chinese health ministries closed markets and slaughtered birds. But as Helen Branswell reports in STAT, some of those containment efforts became more lax in 2015 and 2016.” Preparedness and response exercises can also gives great insight into problems that may arise when dealing with a pandemic. A recent pandemic simulation was held during the World Bank’s annual meeting in Washington D.C., in which participants addressed everything from hospital closures to mass quarantine. “For the World Bank simulation, organizers looked at the impact on travel and tourism of an outbreak of a mysterious respiratory virus in a hypothetical country. Discussions during the 90-minute session were off the record. But in interviews after the event, organizers said the step-by-step scenario made the theoretical possibility seem very real for participants. In particular, it drove home the need for speedy, accurate information-sharing and strong coordination within and across governments and institutions.” These kinds of exercises are crucial to not only address gaps, but bring together a variety of people that will be critical to pandemic response and recovery. The Johns Hopkins Center for Health Security also just released their self-guided exercise scenario that focuses on communication dilemmas that occur during development of medical countermeasures. The exercise is aimed at public health communicator and risk communications researchers, and revolves around a novel coronavirus outbreak in 2025. “Over a 3-year period, the virus spreads to every US state and more than 40 countries, where case fatality rates vary depending on the capabilities of local health systems. In the United States, an existing drug is repurposed to treat SPARS symptoms while federal regulators work with a pharmaceutical company to fast-track the production of a SPARS vaccine. The response differs in other nations. What follows is a nationwide vaccination effort and lingering strains on the US healthcare sector from a steady stream of patients seeking treatment for serious post-SPARS complications.”

Security Implications of Genome Editing – Meeting of Experts in Hanover
Earlier this month, a meeting of scientists and experts on policy and security gathered to discuss the potential implications of genome editing technologies like CRISPR. GMU Biodefense professor Dr. Sonia Ben Ouagrham-Gormley attended, noting that “Over 100 CRISPR scientists form all over the world (China, India, U.S., Europe, Africa), and policy and security experts gathered in Hannover, Germany,  to discuss the security implication of the new gene-editing technique CRISPR.The group reviewed various threat scenarios and discussed potential policy responses. The meeting was particularly successful as both the scientists and security experts engaged in a productive dialogue about the importance of ensuring security without hampering the use of this new technology to promote progress in medicine and agriculture among other things.” The conference focused on establishing proactive international dialogue about genome editing and incorporating experts that range from ethics and philosophy to economics and political science. “Many workshop participants emphasised that it is vital to support and sustain a culture of responsibility and integrity in research and innovation and to engage with stakeholders. Moreover, researchers and policy makers must commit to continuing an open and inclusive dialogue that builds trust. As with other new and emerging technologies, a lack of communication about any uncertainties may undermine public confidence in science. Scientists and security experts should listen to concerns or fears regarding the misuse of genome editing, and provide their expertise on what is and is not likely.”

Synthesizing Biological Threats—A Small Leap From Horsepox to Smallpox
GMU biodefense PhD student Saskia Popescu discussed dual-use research concerns with GMU professor and graduate program director Dr. Gregory Koblentz and how these relate to healthcare and infectious disease professionals. Drawing on the recent horsepox synthesis, Dr. Koblentz emphasized how this opens Pandora’s box even wider for potential smallpox synthesis and misuse of synbio. Popescu highlighted these concerns and how important it is for healthcare workers to be aware of such events and vulnerabilities. “From the healthcare perspective, it may not seem like something we should worry about, but the direction of gene editing and dual-use research of concern is something that is intrinsically linked to public health. Nefarious outcomes of such experiments, regardless of the origin or intent, will inevitably make their way into an emergency department, urgent care, or worse, the community. Although we may not be seeing the implications today, as medical providers and healthcare workers, we must keep our ears to the ground, listening for these biotech advancements, and then thinking through what they mean for us tomorrow.”

Step Away From The Backyard Poultry
Do you keep poultry in your backyard? If so, you may want to rethink it as the number of Salmonella infections related to contact with backyard poultry has quadrupled since 2015. “This year, nearly every state has been pecked by outbreak strains; only Alaska and Delaware can crow about dodging them. The Centers for Disease Control and Prevention has confirmed 1,120 cases. Nearly 250 of those involved hospitalization, and one person died.But that is likely just scratching the surface of the real numbers, according to CDC veterinarian Megin Nichols. ‘For one Salmonella case we know of in an outbreak, there are up to 30 others that we don’t know about,’ she told the AP.” The issue is that chickens and other fowl can carry organisms without having symptoms and shed them in their feces. While some hatcheries will test prior to selling their birds, it’s important that owners be aware of the risks for such infections.

The Schar School of Policy & Government Presents: Strategic Trade and International Security: Policy and Practice
This Brown Bag Seminar Presentation by Dr. Andrea Viski is the place to be on Thursday, November 2nd, from noon to 1:30pm. “Dr. Andrea Viski is the founder and director of the Strategic Trade Research Institute, an independent organization dedicated to providing authoritative research on issues at the nexus of global security and economic trade. She is also the editor-in-chief of the Strategic Trade Review, a peer reviewed journal dedicated to sanctions, export controls, and compliance. She previously worked for Project Alpha at King’s College London and for the Stockholm International Peace Research Institute (SIPRI). She has published numerous articles and book chapters in the areas of strategic trade controls, nuclear non-proliferation, and international law. Dr. Viski received her Ph.D. from the European University Institute, her M.A from Georgetown University’s Institute for Law, Science and Global Security, and her B.A in International Politics from Georgetown University’s School of Foreign Service.” The seminar will be at Founders Hall 602, 3351 Fairfax Drive, Arlington, VA 22201.

Stories You May Have Missed:

  • Uganda’s Marburg Outbreak – Uganda has just confirmed the death of a 50-year-old woman as a result of the hemorrhagic fever, Marburg. “The victim, a 50-year old woman, died on October 11 at a hospital in eastern Uganda after “she presented with signs and symptoms suggestive of viral hemorrhagic fevers”, the minister said. The woman had nursed her 42-year old brother who died on September 25 with similar signs and symptoms and also participated in cultural preparation of the body for burial, she added.”
  • Big Chicken – Are you reading the latest book by Mary McKenna on antibiotic misuse in the poultry industry? “In Big Chicken, McKenna lays out in extensive detail the unintended consequences that resulted from experiments performed at Lederle Laboratories in December 1948 when scientist Thomas Jukes began adding trace amounts of the antibiotic aureomycin (later to be known as chlortetracycline) to chicken feed. The discovery that the drug could quickly fuel growth in chicks raised in confinement revolutionized the poultry industry, turning chicken into America’s favorite protein.”

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

Pandora Report 8.18.2017

ECDC Tool for Prioritizing Biothreats
The European Centre for Disease Prevention and Control has released their tool for the prioritization of infectious disease threats. “This qualitative tool, implemented as an Excel workbook, is based on multi-criteria decision analysis. It ranks infectious disease threats in a transparent, comparable and methodologically reproducible manner. The tool enables the relative ranking of different infectious disease threats. It is intended as a supplement to other methods that also support decision-making in preparedness planning.” Part of the tool involves a scoring of diseases, in which it suggests that a multidisciplinary expert group works to establish reliable information and adequate scoring. The ECDC tool also includes a handbook and manual for users to get the most out of it.

 Long Ignored: The Use of CBW Against Insurgents
GMU Biodefense PhD alum Glenn Cross investigates the use of chemical and biological weapons in counterinsurgency campagins like that of Rhodesia, South Africa, and Syria. Cross notes that history has shown the efficacy of CBW against ill-equipped and often poorly trained insurgents. He points to the debate regarding application of use – some say that these weapons are used when conventional forces are ineffective and often a last resort, while others note that the lack of an international and effective response have given insurgents incentive. “The conclusion from these examples is that regimes in extremis — when the battle is for their very survival — seem to have little compunction about resorting to chemical and biological weapons use. The much-heralded international norms and conventions prohibiting and condemning chemical and biological development and use go out the window when a regime’s survival is at stake. The examples of Rhodesia and Syria show that the international community must be united and demonstrate the requisite political will to enforce norms if the use of chemical and biological weapons is to be prevented.” Cross highlights two case studies, Rhodesia and Syria, pointing to the use of biological weapons by Rhodesian forces as being the only example of a nation using bioweapons since the end of WWII. While the regime was aware of treaty obligations, it had no bearing on their decision to use such weapons. So what are effective constrains on the use of CBW? The case studies reveal that regimes care little about their efficacy, international norms, or international agreements, but it is really deterrence that likely prevents the use of such weapons. The credible threat of military action is the strongest deterrent and realistically, until international norms include uniform enforcement amongst nations, they won’t be as effective. “As we’ve seen in Syria, such consensus is elusive, and the international community has failed to act. As a consequence, the world faces a sad, but inevitable conclusion. The Syrian regime is unlikely to ever face justice for its use of chemical weapons.”

A View from the CT Foxhole: Edward You, FBI Weapons of Mass Destruction Directorate, Biological Countermeasures Unit
As if we need any more reasons to think Edward You is a biosecurity action hero! The Combating Terrorism Center recently sat down with Supervisory Special Agent in the FBI’s WMD Directorate, Biological Countermeasures Unit, and discussed not only his role within the FBI but also their work and coordination with partners. You notes that hisprimary mission is to support outreach and engagement, but probably most importantly it is to backstop the WMD Coordinators who are positioned in the field. They have to cover the whole broad range of modalities—chem, bio, nuke, explosives. They do the initial engagements, the partnerships, the initial response, but they can always call back to headquarters where we leverage all of our expertise as subject matter experts. We can bring in the laboratory division; we can bring in Centers for Disease Control and Prevention (CDC), if necessary, the Department of Homeland Security to support them when they run into an incident out in the field.” He emphasizes the importance of the relationship the FBI has with the private sector, not only in terms of shared interests, but also communicating security problems to help get more buy-in and coordination. When asked about the DIY biohacker, You notes that “We look at these community labs as a big positive force in the economy and engines of innovation. That has helped us overcome the natural tendency for such outfits to be a little bit anti-establishment. By engaging with them, we’re helping them to raise their level of awareness that they could potentially be targeted by malicious actors seeking to subvert their work, steal their technology, or recruit insiders on their staff. By helping them establish a form of ‘neighborhood watch,’ they will be best positioned to identify and report on instances of suspicious activity both internal and external to their community. Who better to identify threats than the community members themselves?” While the partnerships with DIY labs haven’t garnered any leads to potential threats, they help the FBI understand the direction biotech is heading, which allows them to flag areas of concern faster than if they used a top-down approach. You also addresses the 2016 Europol warning of potential ISIS experimentation with bioweapons, commenting that “With ISIS, al-Qa`ida, or any other threat actor for that matter, we are faced with two significant challenges. The first is ideology. What happens if that lone individual that becomes persuaded by their ideology happens to be a microbiologist or a biochemist? The counter WMD mission has always proceeded by identifying the actors expressing the intent to acquire, develop, or use WMDs (e.g., counterproliferation efforts). And historically, significant effort and investments have been made to counter the biological weapon threat ranging from state/non-state actors to individual level biological crimes (e.g., attempted ricin poisonings). But this introduces the second challenge. Unlike the chemical and radiological/nuclear realms where materials of concern are highly regulated and the expertise is almost arcane, biology could be classified as dual use or multi-use. The strength of the field is based on the fact that it is inherently open in nature (e.g., peer-reviewed scientific journals), which has led to significant advances in areas such as healthcare.” Lastly, You points to what he considers the greatest biosecurity threat facing the U.S. – the concerns of non-state actors, but also the role of data in terms of gene editing and other biotech, noting that “we may have have been short-sighted. Most of our legal frameworks have been focused on privacy and not on security.” “Because there’s a lack of understanding about where bio is going, we’re in danger of falling behind, and my biggest concern is that for lack of our foresight and being strategic in this space, I think China is going to become a potential biological superpower.” Did I mention that Edward You is frequently a speaker at our summer workshops?

North Korea’s Chemical Arsenal Complicates U.S. Options 
As concerns over North Korea’s nuclear weapons program grows, the threat of chemical weapons has seemingly been downplayed. Tackling nuclear threats through preemptive strikes could push North Korea to utilize their chemical weapons program and sizable stockpile, which is considered to be one of the largest. “Experts are also disturbed by Kim Jong-un’s brazen public assassination of his half-brother using the nerve agent VX, saying it demonstrates the regime’s willingness to use deadly toxins. ‘I think if people paid more attention to the chemical side, they’d be less inclined to talk about preemption and going first against North Korea,’ said Greg Koblentz, a researcher of weapons of mass destruction at George Mason University.” In the event that chemical weapons are deployed, the South Korean capitol of Seoul would surely take a hit, which is home to 25 million people. While details of North Korea’s biological weapons program have given little insight into what is actually going on, there is considerably more knowledge regarding their chemical weapons initiatives. “The exact composition and size of North Korea’s chemical arsenal is unclear, but it’s believed to include everything from antiquated chlorine gas all the way up to sarin, VX, and other highly lethal nerve agents. These weapons are distributed at facilities across the country, often tucked away in underground bunkers or other sites unknown to U.S. and allied intelligence. The weapons are also deployed along the armistice line, which sits just 35 miles north of Seoul.” While there are limits to their chemical weapons capabilities, they surely provide little comfort to South Korean citizens and those living in Seoul.

 Chatting With the WHO
New WHO Director-General Tedros Adhanom Ghebreyesus spoke with Foreign Affairs’ regarding his plans for the future of the WHO and efforts to combat global disease. Tedros notes that epidemics or pandemics keep him up at night, especially something like the 1918 pandemic and the “serious gaps we have”. He comments that “I think the world should unite and focus on strong health systems to prepare the whole world to prevent epidemics—or if there is an outbreak, to manage it quickly—because viruses don’t respect borders, and they don’t need visas.” In regards to irrational beliefs as a public health threat, Tedros highlights the role of governments (and the WHO in supporting them) to communicate with communities and use media as a tool for teaching. Tedros discussed the WHO’s response to Ebola and when asked about hesitancy governments may experience regarding raising the alarm for an outbreak, he noted that “it’s not an issue between the WHO and the member state in question; it’s about the overall implementation of the International Health Regulations [the rules that govern how states respond to outbreaks]. That involves not only the country in question but other countries, as well. For instance, a country may fear the impact on the economy if it reports a certain disease. And if the other countries, instead of banning travel or other measures, could be supportive and implement the IHR, then the country could be encouraged to report immediately.”

Book Review – Barriers to Bioweapons
As the summer winds down, you may find yourself needing a new book to delve into. GMU biodefense professor Sonia Ben Ougrham-Gormley‘s book, Barriers to Bioweapons, is a great addition to any lover of health security and the realities of biological experiments. This latest book review gives a witty and entertaining overview of her work, noting that “Barriers to Bioweapons argues that actually, we’re not all living on borrowed time – that there are real organizational and expertise challenges to successfully creating bioweapons. She then discusses specific historical programs, and their implications for biosecurity in the future.”

Pandemic Preparedness & A Global Catastrophic Biological Risk By Any Other Name Would Smell As Sweet

GMU biodefense PhD student Saskia Popescu tackles the importance of pandemic preparedness and the latest publication from the Center for Health Security regarding global catastrophic biological risks. “We may think written plans and the occasional table-top exercise are making us more prepared to handle a pandemic, but true preparation goes far beyond that. The ability to prevent, detect, respond, and control outbreaks is a hefty investment that countries are still struggling to make, and as a new report recently revealed, a paltry amount of countries may be ready for a pandemic.” She highlights the latest World Bank report that only six countries have truly taken efforts to evaluate their readiness to handle a pandemic. Like many things, the devil is in the details, and often that is as simple as a real name for a problem. A recent publication from the Johns Hopkins Center for Health Security sought to fix this by establishing a working definition for global catastrophic biological risks (GCBR). “What makes this definition unique, aside from it being the first working definition for GCBRs, is that it highlights several components, such as sustained catastrophic damage, and instead of highlighting a specific number of deaths, it looks to a range of negative outcomes, such as infertility. The challenging task of defining such a globally feared, but poorly understood risk was daunting; however, the Center for Health Security has provided us with a working tool that can now be applied to policy, and future preparedness and response efforts.”

H5 Hits the Philippines and Plague in Arizona
The Philippines is reporting its first highly pathogenic H5 avian influenza outbreak. Hitting a commercial poultry farm in Luzon, the outbreak began in July and killed 36,485 of the 190,000 birds. “A report today in the Manila Times, based on a media briefing with Emmanuel Pinol, the country’s agriculture secretary, said the outbreak was confirmed in the city of San Luis and that six poultry farms were affected. Most of the poultry deaths were in layer chickens. Pinol told reporters that the outbreak may have begun as early as April when deaths were reported in quail housed above ducks. He said ducks are the likely source of the outbreak, since they had contact with migratory birds. The Manila Times report said the outbreak site is 37 miles north of Manila and is close to swamps that are stopovers for migratory birds from the Asian mainland.” Public health officials in Arizona have announced that fleas in two counties have tested positive for plague (Yersinia pestis). While plague is endemic in the southwest, public health officials still work to ensure residents are aware that there is an increased risk. Officials are warning residents to be mindful of the potential for exposure via pets. “Fleas can bite rabbits, prairie dogs and other rodents — and anything that may eat them — and transfer the disease to pets, who in turn can infect humans. Cats who get plague transmit it through their cough. Dogs typically carry the fleas on their fur. Health officials cautioned county residents and visitors to keep their pets leashed and to avoid touching dead animals. Evidence of a large die-off could indicate plague is present, they say.”

Strategies for Identifying and Addressing Biodefense Vulnerabilities Posed by Synthetic Biology
Don’t miss out on these events by the National Academies Committee on Strategies for Identifying and Addressing Biodefense Vulnerabilities Posed by Synthetic Biology:

  • August 21 – the committee’s interim report and proposed framework will be released at 11am EDT here
  • August 22 – a public release webinar and report briefing will be held from 11am-12pm EDT. Committee Chair Michael Imperiale and committee members Patrick Boyle and Andrew Ellington will be reviewing the interim report and the proposed framework. This webinar is free to attend and open to the public, but you must register to attend. You can register at the following link:  https://nasevents.webex.com/nasevents/onstage/g.php?MTID=e39277a767b1f0190db4f7ee491c01271  You will be able to submit questions and comments during this webinar through a text-based feature but will not be able to speak directly with the presenters.
  • August 23-24: The meeting will be held at the National Academies of Sciences, Engineering, and Medicine’s Keck Center at 500 5th Street NW, Washington, DC Room 208. You must register to attend the meeting in person; the Keck Center is a secure building and we will need to have your name on the guard’s list to enter the building. You can register by emailing synbiodefense@nas.edu. If you would like to attend via teleconference, you can access the conference by dialing the following: to listen, please dial 1-(866) 668-0721 and use conference code 380 454 1676.

The committee is also soliciting feedback from the public on the interim report and the associated framework. You can submit questions or comments through September 5, 2017 at the following link:  http://www.surveygizmo.com/s3/3758337/A-Proposed-Framework-For-Identifying-Potential-Biodefense-Vulnerabilities-Posed-By-Synthetic-Biology  Due to the anticipated volume of questions, the committee may not explicitly address every comment received but all comments will be considered and reviewed. PLEASE NOTE: if you submit a question, your question and any associated identifying information you provide will be added to the study’s public access file as per the National Academies’ requirements to comply with FACA.

Stories You May Have Missed:

  • Uganda Ebola-like Illness Demystified- Public health officials in Uganda are sighing with relief as results from the Uganda Virus Research Institute (UVRI) have reported the death of a 20-year-old woman in Luweero was due to carbon monoxide poisoning and not the suspected Ebola virus. “There are currently 3 female cases admitted at Bishop Asili hospital, Luweero. However, results from UVRI indicate that all cases were negative for Ebola, Marburg, Crimean-Congo hemorrhagic fever, Rift Valley fever, and Sosuga viruses. ‘The ministry of health team is working closely with the District Health Team to monitor, review, and manage these cases as well as orienting health workers on management and referral protocols of suspected cases,’ reads the statement.”

Pandora Report 5.12.2017

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

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

Pandora Report 4.28.2017

If you’ve ever wondered about the 1998 story regarding the WWI anthrax sugar cube, we’ve got this gem for you.

March for Science
This past Saturday (Earth Day), cities around the world saw hoards of scientists and supporters of research marching to both celebrate science, but also push for the preservation of funded and publicly communicated research. “The March for Science is a celebration of science.  It’s not only about scientists and politicians; it is about the very real role that science plays in each of our lives and the need to respect and encourage research that gives us insight into the world.  Nevertheless, the march has generated a great deal of conversation around whether or not scientists should involve themselves in politics. In the face of an alarming trend toward discrediting scientific consensus and restricting scientific discovery, we might ask instead: can we afford not to speak out in its defense?” Cities like Chicago saw 40,000 participating in the march, armed with lab coats, pink knit brain hats, and some pretty outstanding signs. Even some furry friends got involved to celebrate science. The D.C. march battled against rainy weather and included speakers like Bill Nye on the National Mall.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
The May 1st deadline for an early registration discount is fast approaching, so don’t miss your chance to attend this educational and captivating workshop for a lower price! The three-day workshop will provide you with not only seminars from experts in the field, but also discussions with others interested in biodefense. You can check out the flyer and register for the event here. A returning participant, GMU student/alumni, or have a group of three or more? You’re eligible for an additional discount! Check out the website to get the scoop on all our expert instructors and the range of topics the workshop will be covering. From Anthrax to Zika, this is the place to be in July to get your biodefense nerdom on!

French Intelligence Brings Insight Into Syrian Chemical Weapons          A new French intelligence National Evaluation report details the direct evidence linking the April 4th chemical weapons attack in Syria to the Syrian regime. “The French report casts fresh doubts on the efficacy of what at the time was billed as a landmark U.S.-Russian chemical weapons pact, which was signed by U.S. Secretary of State John Kerry and Russian Foreign Minister Sergei Lavrov in late 2013. The pact was touted as practically eliminating Syria’s ‘declared’ chemical weapons program.” The French report is considered the most detailed evaluation of environmental analysis (among others) following the Syrian chemical weapons attacks. Not only does the April 4th sarin match that previously used by the Syrian regime, but it also points to the hexamine chemical signature found in the Syrian chemical weapons program. “The French intelligence report provides the most robust scientific evidence linking the Syrian government to the sarin attack in Khan Sheikhoun,” said Gregory Koblentz, the director of the biodefense graduate program at at George Mason University.”This scientific evidence is a direct refutation of the misinformation being peddled by Russia and Syria.”

The World Needs a DARPA-Style Project to Prevent Pandemics             We truly are not ready for a global pandemic. Across the board, all the reports, studies, and experts say the same and the latest article from Tom Ridge and Dante Disparte highlights this unpleasant reality. Zika, Ebola, SARS, and avian influenza have all shown us just how globally unprepared we are for such an event. “In public health, it is much easier to play offense than it is to play defense. Playing offense well, however, is going to require a lot more coordination – both internationally and within national borders. We believe an important first step in this effort is for the U.S. and governments around the world to develop an equivalent to the Defense Advanced Research Projects Agency (DARPA), that focuses cross-sector efforts on advancing biological and pandemic risk readiness.” No single sector can fix this problem, but rather it requires cross-sector collaboration to tackle organisms that know no borders. Ridge and Disparte insist that a a global “invest now or pay later” economic philosophy is needed to break away from stovepiping that allows biological threats to appear sector specific. “As with DARPA, the science and technology community are the unsung heroes in improving global biodefense and pandemic risk readiness. But unlike advanced military research, which is conducted under strict secrecy, the scientists working on improving our defenses to emerging threats must have a charter that encourages open collaboration and transparency. All too often research and technology investments, particularly those in the private sector, follow a zero-sum approach.”

U.S. Preparedness Index Points to Scattered and Mediocre Progress
The National Health Security Preparedness Index (NHSPI) was just released by the Robert Wood Johnson Foundation, which tracks progress at the state level regarding their capacity to respond to health emergencies. The good news is that overall, the U.S. score has increased over the past couple of years – 6.8 in 2016, up from 6.7 in 2015, and 6.4 in 2013. “Of six main dimensions—ranging from mobilizing resources after health incidents to involving stakeholders during crises—the nation as a whole improved except for one area: the ability to prevent health impacts from environmental or occupational hazards. That area is the only one showing decline from 2013”. Overall trends pointed to preparedness improvements except for those states in the Deep South and Mountain West States. Sadly, Alaska ranked lowest in the 10-point scale. “Challenges some states face include grappling with health policy uncertainties because of health insurance proposals, a situation that detracts attention and energy from other health security needs. Also, the analysis found that extreme weather events are increasing in frequency and intensity in many parts of the country, putting extra burden on food and water systems and other infrastructure areas. Though federal aid helps reduce fiscal capacity differences across states, federal preparedness funding falls far short in eliminating the health security gaps that separate affluent from poorer states, according to the report.” Policy recommendations based off their findings focus on engaging private sector, including health insurance coverage as a health security strategy, developing emerging response funding, etc.

Hospital Preparedness Program Performance Measures 
Speaking of preparedness…the 2017-2022 Hospital Preparedness Program Performance Measures Implementation Guidance was released via the Office of the Assistance Secretary for Preparedness and Response. “ASPR’s Hospital Preparedness Program (HPP) enables the health care delivery system to save lives during emergencies and disaster events that exceed the day-to-day capacity and capability of existing health and emergency response systems. HPP is the only source of federal funding for health care delivery system readiness, intended to improve patient outcomes, minimize the need for federal and supplemental state resources during emergencies, and enable rapid recovery. HPP prepares the health care delivery system to save lives through the development of health care coalitions (HCCs) that incentivize diverse and often competitive health care organizations (HCOs) with differing priorities and objectives to work together.” Within the latest guidance, you can find capabilities regarding healthcare and medical readiness, continuity of healthcare service delivery, and medical surge.

Meeting of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria
Don’t miss the upcoming meeting on the battle against the resistant bug! You can catch this in person or via webcast on May 3rd (9am-5pm ET) and May 4th (9am-3pm ET). “The Advisory Council will provide advice, information, and recommendations to the Secretary of HHS regarding programs and policies intended to support and evaluate the implementation of Executive Order 13676, including the National Strategy for Combating Antibiotic-Resistant Bacteria and the National Action Plan for Combating Antibiotic-Resistant Bacteria. The Advisory Council shall function solely for advisory purposes.” If you’re planning to attend, make sure to register ASAP as this will be a great venue to discuss new treatments, alternatives for antibiotics, and transmission prevention strategies.

Unexplained Deaths in Liberia 
The good news is that heath officials have ruled out Ebola in the nine unexplained deaths following a funeral-related event. The bad news is that we’re still not sure what caused the deaths. “The United Nations has issued a precaution to its staff in Liberia regarding an unusual number of deaths at the FJ Grante Hospital, where the patients died. The agency added that health workers in the area have been advised to don personal protective equipment, even when treating patients who aren’t suspected cases.”

Stories You May Have Missed:

  • Sandia National Labs Honored in Fight Against Ebola– The New Mexico-based laboratories are being honored for their hardworking and dedication during the Ebola outbreak. “On April 11, Dmitri Kusnezov, chief scientist and senior adviser to the secretary of energy, visited Sandia to honor nearly 60 Sandians for work to mitigate the effects of the Ebola epidemic and the work of the Technology Convergence Working Group.” The Sandia lab teams worked to cut down detection times to help reduce the risk of transmission while rule-out cases were awaiting confirmation. Their teams also aided in modeling and analyzing Liberia’s national blood sample transport system.
  • Unpasteurized Cow’s Milk and Cheese Outbreaks – If you’re a fan of unpasteurized milk, you may want to reconsider. A recent study found that unpasteurized dairy products cause 840 times more illness and 45 times more hospitalizations than their pasteurized counterparts. “We estimated outbreak-related illnesses and hospitalizations caused by the consumption of cow’s milk and cheese contaminated with Shiga toxin–producing Escherichia coliSalmonella spp., Listeria monocytogenes, and Campylobacter spp. using a model relying on publicly available outbreak data. In the United States, outbreaks associated with dairy consumption cause, on average, 760 illnesses/year and 22 hospitalizations/year, mostly from Salmonella spp. and Campylobacter spp. Unpasteurized milk, consumed by only 3.2% of the population, and cheese, consumed by only 1.6% of the population, caused 96% of illnesses caused by contaminated dairy products.”

Pandora Report 4.7.2017

Don’t forget to tune in to CNN’s Unseen Enemy tonight at 7pm ET/PT to hear about the next potential pandemic from some of the world’s top disease experts!

Chemical Attack in Syria
On Tuesday, a chemical weapons attack killed dozens in northern Syria. While the Organization for the Prohibition of Chemical Weapons is working to collect data to determine the perpetrator, most are pointing to the Assad regime as the attacks appear to be consistent with a military-grade nerve agent. On Thursday it was announced that the autopsies performed on victims show they were subject to chemical weapons that were likely sarin nerve gas. Later last night, President Trump ordered a targeted missile strike on the Syrian Al Shayrat airfield via 59 Tomahawk cruise missiles. Some are saying the death toll from the chemical attack is between 70 and 100 and the volume of injured reported to be high. Russia is denying involvement in the latest attack that is said to have killed many children. Dr. Greg Koblentz notes that this has the implications of a sarin nerve attack, and if proven to be done by the Syrian regime, it’s one of the largest attacks. He emphasized that the U.S. will need to work to put pressure on Syria and on the Russian and Iranian allies who shouldn’t be immune to suffering the consequences from backing a regime who performs such attacks. Dr. Koblentz also recently spoke to the BBC regarding resolutions and international response towards the chemical attack, highlighting the importance of helping the victims and bringing the perpetrators to justice.

Can Bill Gates Rescue the Bioweapons Convention?
Who can save the Biological Weapons Convention? GMU biodefense graduate program director and professor Dr. Gregory Koblentz highlights the growing monetary deficits within the BWC. Dependent upon international cooperation and funding, many treaty members have been inconsistent at paying their budgetary share, which puts the implementation services unit and future meetings in jeopardy. Pointing to the challenges of acquiring funds, Koblentz draws attention to an individual who is both extremely wealthy, philanthropic, and interested in public health – Bill Gates. “Gates, ever the businessman, pointed out that this dire outcome could be avoided by spending an estimated $3.4 billion a year on pandemic preparedness. To his great credit, Gates and his foundation have already contributed vast sums to global health. Most recently, the Bill and Melinda Gates Foundation provided $100 million to help launch a public-private initiative called the Coalition for Epidemic Preparedness Innovations, with the goal of accelerating the development of new vaccines.” His recent comments at the Munich Security Conference regarding the realities of biological threats shine a harsh light the devastation a biological weapon could cause. Koblentz looks outside the box in this article, highlighting that dire times may call for unusual actions to save the BWC. “The global health community has achieved great gains over the decades, but a single bioweapon attack could reverse all that. Now more than ever, an ounce of prevention is worth a pound of cure.”

Safeguarding the Bioeconomy – Securing Life Sciences Data
Check out the latest meeting recap from the NAS workshop, which worked to assist the FBI WMD Directorate “in understanding the applications and potential security implications of emerging technologies at the interface of the life sciences and information sciences.” This workshop brought together experts from a wide range of fields to help solve the challenges of encouraging a strong bioeconomy, while preventing nefarious use and considering the implications of such data. “Advances in the life sciences are increasingly integrated with fields such as materials science, information technology, and nanotechnology to impact the global economy. Although not traditionally viewed as part of bio-technology, information technology and data science have become major components of the biological sciences as researchers move toward –omics experimental approaches.” “There is currently no government agency charged with holistically assessing the security of the bioeconomy, and the emerging importance of data (and data security) within it. These concerns will continue to grow as the world becomes more digitized and interconnected. There are a number of different types of data that can be aggregated and analyzed as part of the bioeconomy, and the collection, sharing and use of these different types of data may pose different potential concerns.” Within the workshop summary, you’ll see the division of bioconomy economy into clinical and nonclinical data, the biosecurity perspective from academia, technological advances that will further data access, data sovereignty issues, and much more.

Novel Antimicrobials – The Quest For The Grail?
The new CARB-X partnership is trying to combat the growing threat of antimicrobial resistance through innovation and supporting new research. “The CARB-X board thoroughly vetted 168 proposals and selected 11 projects that represent truly exciting early stage research. Three of them could become the first in new classes of antibiotics, and four are innovative non-traditional products. Some of the projects also take new approaches, known as mechanisms of action, to target and kill bacteria. All of the potential new medicines target Gram-negative bacteria prioritized by the U.S. Centers for Disease Control and Prevention and the World Health Organization.” BARDA is also in the race for halting the rise of the resistance bug – they’ve got a clinical-stage antibacterial program which has 13 products that are looking promising. The threat of antimicrobial resistance means that partnerships in even the most unlikely places are unfolding to help develop anything from new drugs to diagnostic tests that can determine if a lung infection is bacterial or viral. The truth is that the looming antibiotic apocalypse truly requires all hands on deck, so what’s the hold-up? At least we may have a potential cure in maple syrup

Pandemics, Personnel, and Politics: How the Trump Administration is Leaving Us Vulnerable to the Next Outbreak
GMU Biodefense graduate program director and professor, Dr. Gregory Koblentz, and MS student Nathaniel M. Morra are looking at the increase in infectious disease outbreaks in recent years (Ebola, Zika, SARS, MERS-CoV) and how the new administration is prioritizing public health. “Despite this heightened risk of a global pandemic, the Trump Administration has dragged its feet in appointing senior officials to key Federal agencies responsible for preparing and responding to a pandemic or bioterrorist attack. These agencies are also subject to steep budget cuts under Trump’s budget for Fiscal Year 2018. The delays in installing senior leaders at these agencies and pending budget cuts puts U.S. and global health security at risk.” Interim directors, a lack of Assistant Secretary for Preparedness and Response within HHS, and a planned cut in funds are already creating vulnerabilities within U.S. health security. “If a major influenza pandemic were to occur, no wall would be high enough to stop the virus from entering the United States. The best defense against pandemics and other disease threats are Federal, state, and local health agencies and international partners with strong leadership and the necessary resources to fund vital surveillance, preparedness, response, and research activities. Mother Nature doesn’t play politics; Trump shouldn’t play politics with global health security.”

Pandemics, Bioterrorism, and Global Health Security LinkedIn Group
If you’re not already already a member, make sure to check out this LinkedIn group “dedicated to the analysis of the challenges facing the world at the nexus of health, science, and security. The group’s purpose is to serve as a unique forum for discussion and debate on critical issues in global health security.” We’re happy to announce that the group just reached 3,000 members thanks to Arthur Seward-El and Veena R. Kumar! If you’re looking for a LinkedIn group dedicated to global health security and includes members from all over the world, don’t miss out!

Center for Health Security Emerging Leaders Take on The Eight Ball
I’m a biodefense nerd – always have been and always will be, so you can imagine my excitement when part of the ELBI class of 2017 fellowship workshop involved getting to visit the Eight Ball near USAMRIID. The Eight Ball is from the days of America’s active bioweapons program and despite its history, is now a rather interesting sight stuck between two buildings and surrounded by trash dumpsters. Dr. Koblentz has provided some great trivia regarding the Eight Ball – it cost $715,468 (in 1950 dollars), is four stories high and weights 131 tons, was used to test animals ranging from mice to horses, and held its first human tests in 1955 as part of Operation Whitecoat. “This one million liter metal sphere is currently tucked away behind a service building, but at one point it was the epicenter of Operation Whitecoat, the US Cold War biodefense program. From the 1950s through the ‘70s, researchers developing treatments for biological agents released small amounts of these selected agents into the eight ball, allowed them to disperse, and then exposed volunteers to this contaminated air via specially rigged gas masks. By treating the volunteers (who signed consent forms) with their newly developed vaccines and therapies, scientists were able to develop effective methods to respond to biological warfare. Whitecoat volunteers were exposed to agents that cause diseases such as rabbit fever (tularemia), Q fever, yellow fever, and plague.”

Digital Surveillance of Emerging Infectious Disease and Outbreaks: A One Health Approach 
Don’t miss out on this Next Generation Global Health Security Network Webinar on April 7th, at 1pm EST. You can check out the webinar here to learn from Maja Carrion, Assistant Director of ProMED, about digital health surveillance in human and animal sectors.

Investing In Public Health Keeps America Great
Simply put, a nation cannot be great if it lacks health. The proposed budgetary measure that drastically cut funding for HHS point to what public health has been battling for decades – a necessary force that receives too little funding amid too many expectations. Investing in public health is the most obvious thing one could do to make a country strong and capable of growth. Whether it be extending life, eradicating disease, or even a thriving workforce, public health is a force that simply can’t be ignored. “Instead of making deep investments in public health, and thus public safety, we allocate pennies. Americans spend more per capita on health care than any other country in the world, but less than 3 percent of all health spending goes to public health. The CDC’s budget has declined slightly over the past decade, and funding cuts at the state and local levels have been ‘drastic,’ says Trust for America’s Health.” At the end of the day, we have to ask ourselves – at what price do we value our own health and that of those around us?

Dynamic Challenges & Opportunities for Global Health Security Talk
All GMU biodefense students and alum are welcome to attend Dr. Gene Olinger’s talk during Professor Nuzzo’s BIOD 710 class on Tuesday, April 11th, from 6:15-7:10pm! Dr. Olinger serves as principal science advisor for MRIGlobal Biosurveillance and Global Health Division and will be talking about global health security as a subject matter expert for multiple federal panels related to biodefense and emerging viral pathogens.

Stories You May Have Missed:

  • Two Very Different Views of Terrorism and What To Do About Them – GMU biodefense PhD alum Daniel M. Gerstein is looking at the reaction to two major events – the aviation electronics ban and the London terrorist attack. He emphasizes that risk perception and personal inconvenience plays a big role in the limitations people are willing to accept in the name of safety. “Risk perception will undoubtedly continue to be an important determinant in the types of security policies and measures that will be acceptable to governments and the public. Clear and precise communications on the various threats faced, the vulnerability to particular attacks and the potential consequences of such attacks, could help reduce inflated perceptions of risk while at the same time making people more accepting of security enhancing initiatives.”
  • Measles Takes Hold in Eastern Europe– Europe is seeing a large outbreak of measles currently as over 500 cases were reported just in January 2017. 474 cases were reported in endemic countries (France, Germany, Italy, Poland, Romania, Switzerland, and Ukraine). “The largest current measles outbreaks in Europe are taking place in Romania and Italy. Romania has reported over 3400 cases and 17 deaths since January 2016 (as of 10 March 2017). The majority of cases are concentrated in areas where immunization coverage is especially low. According to reported data, the 3 measles genotypes circulating in Romania since January 2016 were not spreading in the country before, but were reported in several other European countries and elsewhere in 2015. Comprehensive laboratory and epidemiological data are needed before the origin of infection and routes of transmission can be concluded.”
  • 10 Saudi MERS Hospital-Associated Cases– Infection prevention goes well beyond the normal hand hygiene and healthcare-associated infections. MERS-CoV is a prime example of a disease that takes advantage of poor infection prevention efforts in healthcare. “A MERS-CoV outbreak linked to a dialysis unit at a hospital in Wadi Aldwaser has sickened 10 people, 2 of them with asymptomatic infections, the World Health Organization (WHO) said yesterday in an update covering 18 recent cases in Saudi Arabia.” Two of those infected are healthcare workers.

Pandora Report: 3.25.2016

Happy Friday! Ready for some global health security news? Down the rabbit hole we go….the FDA has just approved ANTHIM injection, a new treatment for inhalation anthrax in adults and children. Researchers are considering the possibility that the highly virulent E. coli O104:H4 strain that hit Germany in 2011 may have been an intentional act. “The sudden and unexplainable emerging of a fast increasing number of cases and deaths from bloody diarrhea and HUS might have been caused naturally, accidentally, or intentionally,” a Serbian-German research team writes in the European Journal of Public Health Advance Access for April 15.

The Finances of A Pandemic
From SARS to Ebola and now Zika, the growing threat of emerging infectious diseases doesn’t seem to be slowing down. Has this become our new normal? Will we learn from these outbreaks and start putting the resources and support into prevention? “Ebola has infected almost 30,000 people, killed more than 11,000 and cost more than $2 billion in lost output in the three hardest-hit countries. SARS infected 8,000 and killed 800; because it hit richer places, it cost more than $40 billion. Predicting these losses is hard, but a recent report on global health risks puts the expected economic losses from potential pandemics at around $60 billion a year.” So how do we defend against these international security threats? America’s National Academy of Medicine recently made the suggestion that $4.5 billion a year solely dedicated to pandemic preparedness and defense could halt this impending reality. Even more interesting? This estimate accounts to roughly 3% of what “rich countries spend on development aid”, while the world spends about $2 trillion annually on defense.

U.S. Biothreat Defense Inadequate
American response to Ebola and now Zika reveals a startling trend of slow response, inadequate supplies, and poor cooperation and coordination between agencies. Director of National Intelligence, James Clapper states that “Gaps in disease surveillance and reporting, limited health care resources, and other factors contributed to the outpacing of the international community’s response in West Africa,”. The National Biosurveillance Integration Center (NBIC) is one such agency that was developed in 2007 in attempts to “be a hub of information and coordination for federal agencies tracking disease and biological threats”, however it has been frustrated by poor relationships and sharing from other agencies like the CDC. In essence, agencies that are developed for global health security, like NBIC, suffer from poor cooperation that then trickles into their reputation and capabilities in the eyes of their federal partners. “Congress has put forth a potential legislative fix. The CBRNE Defense Act of 2015 would create a new office within DHS, the Chemical, Biological, Radiological, Nuclear, and Explosives Office, which would place both NBIC and BioWatch under integrated new management.” Just as we reported from the Blue Ribbon Study Panel, federal biodefense efforts and resources need to be better organized and developed.

Rare Blood Infection Outbreak
Elizabethkingiam is currently causing dozens of cases in Wisconsin and now a Michigan resident is suffering from the bloodstream infection. The bacteria that causes the infection, Elizabethkingia meningoseptica, is commonly found in soil but has also caused infections in hospitals. Typical infections have resulted in bacteremia and neonatal meningitis related to the gram-negative bacillus, although it is naturally found in soil, fresh water, and salt water. Most of the 54 cases in Wisconsin have been in patients 65 years and older, of which 17 have died. Public health officials are working to identify the source of the outbreak and the links between the Michigan case and those in Wisconsin. The concerning aspects of this rising outbreak is also the difficulty in treating the organism and prevalence of multi-drug resistant organisms in seniors.

Complex Engineering by Violent Non-State Actors
Check out this special issue on complex engineering by violent non-state actors (VSNAs). “Why and how different VNSAs remain low-level and localized or undertake and achieve complex engineering tasks in pursuit of their objectives are at the heart of understanding the threat environment faced by states.” The authors address several terrorist groups like Aum Shinrikyo (the chapter was actually co-authored by GMU Biodefense Alum Benjamin Ash!), Hamas (also co-authored by GMU Biodefense Alum Alena James!), the Provisional Irish Republican Army (PIRA), etc.  “The approach of this collection moves beyond weapons and embraces facilitating or logistical aspects that support the operations and objectives of the various actors”. This special edition, with an introduction by Jez Littlewood, reviews these organizations and their resources and strategies. The authors also consider the attitudes of leadership regarding innovation in detail to assess the role of complex engineering by VSNAs. Through this close look into the VSNA use of complex engineering, further research and preparedness can occur to understand the threats posed by these actors.

All Roads Lead to Zika 
Now that Spring has officially begun, the impending summer rains are right around the corner, and with those – mosquitoes. Many worry about the potential for local transmission in countries where imported cases have already been identified. The US isn’t immune to these concerns as the CDC reports 273 travel-related cases. Dr. Nabel mirrors the sentiments of Sanofi’s global R&D head, Dr. Elias Zherouni, who emphasizes the need for changes in global public health outbreak response. He notes that “we just run from one crisis to another. It’s not an optimal way to respond. Not when the stakes are so high and when so many people can either lose their lives or have their whole lives changed because of one five-day infection. That’s no way to protect the world’s population. We have to step back and we have to say, ‘Is there a more systematic way to gather the intelligence that we have about these viruses, recognize where they stand in terms of the threat level, and then develop a systematic program where, when the next Ebola outbreak occurs, it’s not that we haven’t done anything since the last outbreak, that we’ve actually moved things forward?’ That’s all possible. It’s just that we have not had the collective will to do it.” Panama has also announced their first case of microcephaly linked to Zika virus outside of Brazil. Chris Mooney from The Washington Post discusses why Zika virus, among other diseases, could disproportionally impact America’s poorer populations.  He notes that scientists have found that more mosquitoes are found in lower-income neighborhoods due to persistent trash and abandoned buildings, which creates a ripe environment for standing water and thus mosquito breeding. Researchers found that when compared to wealthier neighborhoods in New Jersey, “poverty was positively correlated with number of [Asian tiger mosquitoes] captured and accounted for over half the variation”. Many are saying that the “U.S. is botching the Zika fight” due to the problems within the FDA and the Agriculture Department regarding turf. “A genetically tweaked mosquito could stop the illness, but regulators won’t test it. Why would that be?” The combination of worrying reasons, like “budgetary concerns and antagonism to genetic engineering among some senior USDA officials”, leave many feeling that instead of getting ahead of the outbreak, “the U.S. is falling behind, solely because of bureaucratic muddle.” On the other hand, on Friday, the WHO rallied for pilot projects on two projects that would involve genetically modified mosquitoes to help stop the spread of Zika virus. In the meantime, the FDA gave emergency approval for a 3-in-1 test for Zika, Chikungunya, and Dengue.

Syria and the Future of the Chemical Weapons Taboo 

Courtesy of E-International Relations
Courtesy of E-International Relations

Brett Edwards and Mattia Cacciatori tackle the responses that the international security community has taken regarding the use of chemical weapons in Syria and the resulting reinforcement of “a long standing prohibition norm.” The authors discuss the characteristics of chemical weapons taboo and and the significance that the international community gives to these weapons. “This alone does not support the claim episode has strengthened the global norm against chemical weapons. In this piece we have highlighted how this is not immediately apparent due to the fact that problem cases tend to be externalized from dominant institutional discourses, often justified in terms of the need to protect the sanctity of the chemical weapon norm, as well as those institution’s which embody the norm – especially the OPCW.” Overall, the more problematic cases, like those of incapacitating chemical agents, will grow to alter the existing foundation of chemical weapons norms if left ignored or unchecked.

New Ebola Flare Up
The west African Ebola outbreak is like a campfire that wasn’t put out properly – everyone thinks the flames are extinguished, but those hidden embers lurking in the ash end up causing a spark that leads to a massive forest fire. A fifth person has died from the recent flare in Guinea. The most recent death occurred in a man 200k from the initial four cases. Prior to this death, a young girl died from the village of Korokpara following her hospitalization in an Ebola treatment facility in Nzerekore. It’s still not clear how this specific surge began, but many worry about the lingering traces of the virus in the eyes, CNS, and bodily fluids. In response to the fifth death, Liberia has partially shut its bordersEmergency meetings are now underway and the WHO is sending specialist teams in to try and stop the outbreak before it grows beyond the 11,300 mortality count. On a positive note, Sierra Leone has gone two incubations periods (42 days) without a case, which means they’re Ebola-free since their last flare up.

GMU SPGIA Gettysburg Trip
GMU students interested in learning more about the battle of Gettysburg- the Center for Security Policy Studies (CSPS) will be hosting an informational session on April 6th from 4:30-6pm in Merten Hall 1203 regarding the April 9th trip! GMU students and staff will walk the battlefield, discussing the factors that caused the battle to unfold as it did. They will also link the battle into larger discussions about the causes of war and grand strategy.  The cost for the trip will be $35.  Bus transportation will be provided, and will pick up participants from both the Fairfax and Arlington campuses.

Stories You May Have Missed:

  • U.N. Sued Over Haiti Cholera Outbreak– starting in October of 2014, Haiti was hit with an intense wave of cholera that is believed to have started with U.N. peacekeepers. “Poor sanitation at a U.N. camp for peacekeepers allowed cholera-contaminated sewage to enter a tributary of Haiti’s largest river, the Artibonite. Within days, hundreds of people downstream, like Jean-Clair Desir and his mother, were falling ill. The disease subsequently spread to the entire country.” The case is currently being reviewed in US courts and the lawsuit was brought forth by the Institute for Justice in Democracy, asking that the U.N. “end cholera by installing a national water and sanitation system; pay reparations to cholera victims and their families; and publicly apologize for bringing cholera to Haiti.”
  • Exploiting the Challenges to Bioweapons Development – Janne E. Nolan discusses GMU Biodefense Professor, Dr. Sonia Ben Ouagrham-Gormley’s book, Barriers to Bioweapons, in regards to the misleading and often exaggerated notion of easy WMD development. Nolan discusses that understanding both the internal and external factors that impact BW program success would allow the international community to “devise better ways to realistically stem BW proliferation”. He notes that “Ben Ouagrham-Gormley s book is a fascinating study of the phenomenology of scientific knowledge, providing a compelling analysis of how knowledge is acquired, developed, transmitted, and, at the same time, diluted or lost as a result of organizational, social, economic, political, and ultimately very human factors that vary widely within countries and over time.” You can also access it here: Nolan final
  • Five Outbreaks That Stump Epidemiologists– As much as I’d love to say that all outbreaks are investigated and solved, the truth is that epidemiologists are often left with the nagging of an unresolved case. Outbreaks are squirrelly at best, often challenging even the best teams with confounders and biases. Here are some that have stumped public health teams over the years.
  • Lassa Fever Outbreak– Three people are suspected of having the viral infection after coming into contact with an infected American. The initial case was a medical director of a missionary hospital in Togo, who died last month. While there are conflicting reports of disease confirmation, several sources are saying the three contacts of this initial case have been diagnosed and are under observation. The outbreak in Nigeria and Benin has continued to grow, resulting in CDC travel warnings. In Nigeria there have been 254 cases and Benin has seen 71.

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It’s Definitely Maybe World War 3

It’s Definitely Maybe World War 3
By Greg Mercer

The Washington Post
The Washington Post

On November 24, Turkish F-16s shot down a Russian SU-24 bomber which had been flying over Syria, after an alleged violation of Turkish airspace.[1] Needless to say, the details are still emerging and the facts are still highly contested. The New York Times has an excellent comparison of claims made by Turkish and Russian officials, including the radar maps released by each country showing the airspace violation (or lack thereof).[2] Russian President Vladimir Putin called the shootdown a “stab in the back” and promised harsh consequences. Turkey called for an emergency meeting of NATO.

This incident and its bellicose rhetoric sparked immediate buzz about declarations of war, what exactly NATO owes Turkey vis-à-vis Russia[3], and the possibility of military confrontation between Russia and the West.  One particular phrase was cautioned against by reputable folks and seriously considered by less-than-stellar[4] sources: World War 3. I think this is really interesting, so I turned to good old search analytics to see how the internet reacted:
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Continue reading “It’s Definitely Maybe World War 3”

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 8.9.15

My apologies for lack of update last weekend…but that means a SUPER UPDATE this weekend! This week marked the 70th anniversary of atomic bombs being dropped in Japan. Rather than find an insufficient story that attempted to address the gravity of that event, we’re focusing on a successful Ebola vaccine trial, UN consensus on Syrian chemical weapons, and airplane bathrooms (because I can’t help myself when I see a story like that!) We’ve also got stories you may have missed.

Have a great week!

Vaccine Success Holds Hope for End to Deadly Scourge of Ebola

Some great news from West Africa: an Ebola vaccine trial in Guinea has returned results that are 100% effective. 4,000 people who had been in close contact with a confirmed Ebola case showed complete protection after ten days. A ring vaccination strategy—where those who have close contact with an infected person—was used, and after success was demonstrated, the vaccine is now being extended to 13-17 year olds, and possibly 6-12 year old children.

Reuters—“The success of the Guinea trial is a big relief for researchers, many of whom feared a sharp decline in cases this year would scupper their hopes of proving a vaccine could work. Another major trial in Liberia, which had aimed to recruit some 28,000 subjects, had to stop enrolling after only reaching its mid-stage target of 1,500 participants. Plans for testing in Sierra Leone were also scaled back. That left the study in Guinea, where Ebola is still infecting new victims, as the only real hope for demonstrating the efficacy of a vaccine.”

U.N. Approves Resolution on Syria Chemical Weapons

The UN Security Council unanimously—yes, even Russia—adopted a resolution aimed at identifying those responsible for the use of chemical weapons in Syria over the past two years. The resolution established an investigative body that would assign blame for the attacks “so that the perpetrators can be brought to justice.”

Salt Lake Tribune—“‘Pointing a finger matters,” U.S. Ambassador Samantha Power told the council. “This sends a clear and powerful message to all those involved in chemical weapons attacks in Syria that the [new investigative body] will identify you if you gas people.” But she added that prosecuting perpetrators will take time because there is still no tribunal to investigate alleged crimes during the war in Syria, which has killed at least 250,000 people since it began in March 2011, according to the U.N.”

Airplane Toilets Can Help Researchers Find Disease Outbreaks

A recent study in Scientific Reports finds that researchers can tell what continent you’re from and give early indication of disease outbreaks, all from the poop left in airplanes. (I think this is the first time I’ve been able to say “poop” here on the blog.) The researchers gathered samples from 18 airplanes that departed from nine cities and landed in Copenhagen and were able to identify continental trends. Microbes from Southeast Asia had higher incidence of antibiotic resistance; food transmitted microbes were also more frequent in the Southeast Asian samples; and C. diff was much more common in the North American samples.

Popular Science—“These findings led the researchers to believe that they could start to create a typical microbiome for each continent. And any big shifts that happen in their makeup—say, the concentration of C. diff rises dramatically in samples from Southeast Asia—could indicate a growing public health issue. If it’s caught early enough, public health officials could take preventative action.”

Stories You May Have Missed

 

Image Credit: CDC Global