Pandora Report 10.25.2024

Happy almost Halloween! This week’s Pandora Report includes news from the Biodefense Graduate Program and discussion of the Biden administration’s latest National Security Memorandum, a new multilateral effort from the US, Canada, and Mexico to improve regional health security, the WHO’s praise for Rwanda’s swift and effective Marburg response, and more.

Upcoming Virtual Information Sessions on the Biodefense Graduate Program

If you are interested in a career in biodefense or global health security or want to develop the knowledge and skills necessary to work at the nexus of health, science, and security, find out what the Schar School of Policy and Government has to offer. 

The Schar School PhD programs will be holding a virtual open house on Wednesday, October 30 from 6-7:30 PM. Please join Dr. Gregory Koblentz, director of the Biodefense Graduate Program, to learn more about the Biodefense PhD program and ask any questions you may have. Register here.

GMU Biodefense Students Tour Mason’s Biomedical Research Laboratory

Last week twelve Biodefense students had the opportunity to visit George Mason’s 52,000 square-foot Biomedical Research Laboratory (BRL) located on the SciTech campus in Manassas, Virginia. The BRL was inactive after being decontaminated for annual maintenance . The tour, led by the BRL’s Director of Research Operations, Rachel Pepin, provided students with a firsthand look at Mason’s Biosafety Level 3 (BSL-3) and supporting Biosafety Level 2 (BSL-2) labs. Among the many highlights was the BRL’s autoclaves and gloveboxes, which left students impressed.

The BRL is one of 12 Regional Biocontainment Labs in the United States funded by the National Institute of Allergy and Infectious Diseases NIAID. Constructed in 2010, it became an active “hot” lab in 2012. Fifteen Mason faculty members and thirty students at any time work within the facility on research pertaining to a variety of infectious diseases, new vaccines, diagnostics, and therapeutics. The stated mission of Mason’s BRL is to 1) advance pathogen biology, 2) train the future workforce to safely handle infectious agents and conduct innovative research in BSL-3 environments, 3) evaluate diagnostics, therapeutics and vaccines, and 4) serve as a resource in the event of a bioterrorism or infectious disease emergency. Overall, students gained an appreciation for the critical work and numerous safety controls in George Mason’s BSL-3 laboratory.

This write up was written by Biodefense MS Student Will MacDonald.

OPCW Workshop on Legislative and Regulatory Frameworks for Chemical Security
On October 21-22, 2024, Dr. Gregory Koblentz, director of the Biodefense Graduate Program, attended a meeting of chemical security experts sponsored by the Organization for the Prohibition of Chemical Weapons (OPCW) to discuss best practices for establishing legislative frameworks for chemical security. According to INTERPOL, from the records of 4,100 captured ISIS members, 109 of them have a background related to chemistry, science, technology, engineering, and mathematics. Meanwhile, across the word, the chemical industry and trade are rapidly growing, increasing the risk of toxic chemicals being misused, especially by non-state actors. Many countries are therefore seeking to strengthen their legal and regulatory regimes to address risks such as attacks on chemical facilities, the theft of toxic chemicals, or their release with malicious intent. Initial take-aways from the meeting included a recognition that there is an urgent need for robust national legislative frameworks for chemical security in many countries, that national threat assessments and risk analyses should be the basis for identifying legislative needs, and best practices are most useful if they can be adapted to country-specific contexts and resource setting. This meeting of an international group of chemical security experts kicks off a longer-term discussion on best practices for establishing legislative frameworks for chemical security sponsored by the Implementation Support Branch of the International Cooperation and Assistance Division at OPCW.
A Risky Review of Research
On September 25, 2024, Senator Rand Paul introduced a revised version of the Risky Research Review Act (S. 4667) which was voted out of the Senate Homeland Security and Government Affairs Committee by a vote of 8-1. In a recent OpEd in StatNews, Gregory Koblentz, director of the Biodefense Graduate Program, and David Gillum and Rebecca Moritz, past presidents of the American Biosafety Association (ABSA) wrote of the original bill: “this legislation threatens to cast a shadow over the future of life sciences research and slow it down.” While this revised bill contains some positive changes, it remains deeply flawed and does not represent a viable solution to the challenges posed by dual-use research. You can read their analysis of the good, the bad, and the ugly of the revised Risky Research Review Act here.
Russia Expanding Secret BSL-4 Lab at Sergiev Posad
The Washington Post has identified new construction activity at Sergiev Posad-6, part of the former Soviet and current Russian biological weapons program, consistent with the building of additional high containment laboratories, including BSL-4 lab suites. The construction started in 2022, shortly after Russia’s invasion of Ukraine which was accompanied by unfounded allegations that Ukraine was developing biological weapons with the help of the United States and other NATO countries. Dr. Gregory Koblentz, director of the Biodefense Graduate Program, is quoted in the article as saying, “I would not be surprised if some influential segment of the Russian national security community has drunk the Kool-Aid and really believes that the United States really is developing biological weapons.” Satellite imagery obtained and analyzed by the Washington Post has identified the construction of “10 new buildings, totaling more than 250,000 square feet, with several of them bearing hallmarks of biological labs designed to handle extremely dangerous pathogens.” The Global BioLabs Initiative identified Sergiev Posad-6 as having a BSL-4 lab in 2021. The existence of a BSL-4 lab at this site was confirmed by a 2017 scientific article co-authored by a researcher at the 48th Central Research Institute of the Ministry of Defense at Sergiev Posad. Russia has not declared the existence of a BSL-4 lab at this site on Form A of the confidence building measures that it submits to the Biological Weapons Convention. 

White House Releases New National Security Memorandum on Advancing AI Leadership

The Biden administration issued this week the first-ever National Security Memorandum (MSM) on AI. The NSM direct the federal government to take steps to 1) “ensure that the United States leads the world’s development of safe, secure, and trustworthy AI,” 2) “harness cutting-edge AI technologies to advance the U.S. Government’s national security mission,” and 3) “advance international consensus and governance around AI.”

The NSM directives are focused on actions to improve chip supply chain security and diversity, making collection on competitors’ operations against the US AI sector a top-tier intelligence priority, formally designating the AI Safety Institute, doubling down on the National AI Research Resource, directing “the National Economic Council to coordinate an economic assessment of the relative competitive advantage of the United States private sector AI ecosystem,” and more.

Among its other measures, the NSM also directs the creation of a Framework to Advance AI Governance and Risk Management in National Security, which was published alongside the NSM. This framework and any successor document will specify that each covered agency has a chief AI officer and guidance boards, offer guidance on AI activities that pose “unacceptable levels of risk and that shall be prohibited,” and more.

A fact sheet for the new NSM is available here.

US, Canada, and Mexico Announce Efforts to Improve Regional Health Security

This week, the US Departments of Health and Human Services, State, Agriculture, and Homeland Security, along with their counterparts in Canada and Mexico made good on commitments made at the 2021 and 2023 North American Leaders’ Summits in releasing the North American Preparedness for Animal and Human Pandemics Initiative (NAPAHPI). NAPAHPI is “…a flexible, scalable, and cross-sectoral platform to strengthen regional capacities for prevention, preparedness, and response to a broad range of health security threats that builds on lessons learned from COVID-19 and other health security events in the last decade. It is based on a long-standing trilateral collaboration under the 2007 North American Plan for Avian and Pandemic Influenza and the 2012 North American Plan for Animal and Pandemic Influenza. This initiative recognizes that the high degree of interconnectedness among our three countries of our critical infrastructure, supply chains, and societies means that disruptions affecting one country often impact the others. Only by working together can we protect the health security of our region.”

Learn more here.
Egypt Declared Malaria Free

Egypt was officially certified malaria-free by the World Health Organization this week. Following Morocco and the UAE, Egypt is just the third country in the WHO’s Eastern Mediterranean region to receive this certification. Globally, 44 countries and one territory currently have this designation.

“This certification of Egypt as malaria-free is truly historic, and a testament to the commitment of the people and government of Egypt to rid themselves of this ancient scourge,” said WHO Director-General Tedros Adhanom Ghebreyesus in a statement. “I congratulate Egypt on this achievement, which is an inspiration to other countries in the region, and shows what’s possible with the right resources and the right tools.”

WHO Praises Rwanda’s Marburg Response

WHO Director-General Tedros Adhanom Ghebreyesus praised Rwanda’s response to its Marburg virus outbreak, noting their success in treating patients infected with this especially deadly disease. As of earlier this week, Rwanda has made it a full week with no new cases, and its total number of patients still in treatment is down to just one. “Leadership from the highest levels of government is essential in any outbreak response, and that’s what we see here in Rwanda,” Tedros said during the press briefing. The Director-General also noted that multiple patients experiencing multiple organ failure were put on life support, intubated, and eventually extubated. “We believe this is the first time patients with Marburg virus have been extubated in Africa. These patients would have died in previous outbreaks,” Tedros explained. 

Burgers, Deli Meat, and Waffles-Oh My! US Responding to E. Coli and Listeria Outbreaks

It has been a rough couple of weeks for many major food suppliers in the United States amid headlines about recalls and reports of multiple cases of E. coli and listeria across the country. McDonald’s, KFC, Burger King, and other restaurant chains have pulled onions from their menus following an outbreak of E. coli traced back to McDonald’s Quarter Pounders. The CDC announced this week it is investigating 49 cases linked to “slivered onions used in the Quarter Pounder and sourced by a single supplier than serves three distribution centers.” One person is dead and ten more have been hospitalized. The supplier, Taylor Farms, has issued a recall on all of its peeled, diced, and whole peeled yellow onion packs due to potential contamination.

This comes amid multiple listeria outbreaks affecting several kinds of products, including deli meat, frozen waffles and pancakes, and even salmon. While these recalls are certainly nothing to ignore, they might not necessarily be happening more frequently than before as some have suggested. Dr. Céline Gounder, CBS News medical contributor and editor-at-large for public health at KFF Health News, told CBS this week that “Every step of food processing, there’s the opportunity for contamination. That’s number one. Consumers want ready-to-eat food, so of course, they’re more processed as a result.” She continued, saying “We have better tests. So it used to be we might not have been aware or known what made you sick. Now we can actually test, detect and tell you what made you sick.”

“Assessing the Burden of and Potential Strategies to Address Antimicrobial Resistance”

From NASEM: “Antimicrobial resistance (AMR) is linked to millions of deaths globally each year. As an evolving public health threat, there is a need to further develop methods to quantify AMR’s burden within medical practice and other sectors like food production. The National Academies Forum on Microbial Threats hosted a public workshop in March 2024 to explore the burden of AMR and discuss clinical, scientific, and policy strategies for addressing the growing AMR health threat across sectors.”

“This proceedings highlights the presentations and discussions that occurred at the workshop.”

“The Changing Face of Pandemic Risk: 2024 Report”

From GPMB: “The 21st century has seen a significant rise in global health threats. Epidemics and pandemics are now a constant danger rather than rare events. The 2024 GPMB reportThe changing face of pandemic risk, is a call to action for global leaders, policy-makers, health professionals, and communities to build a safer, more resilient future. It outlines the key drivers of pandemic risk and provides a roadmap for strengthening our defences.”

“Mpox: Neglect Has Led to a More Dangerous Virus Now Spreading Across Borders, Harming and Killing People. Leaders Must Take Action to Stop Mpox Now”

McNab et al. recently published this opinion article in PLOS Global Public Health, writing in part “In other words, mpox is an ever-growing regional health crisis in Africa, and without urgent action to stop the epidemics when and where they occur, it will continue to spread across borders and continents. The few tools we have that could help to stop the outbreaks have yet to become adequately available in the most affected low-income countries where they are urgently required, as is financing to support the public health response. Mpox cannot be allowed to continue spreading widely across the African continent or anywhere. The world cannot continue to simply ‘learn’, but not apply the costly lessons of neglecting disease outbreaks.”

“Are We Ready For A Bird Flu Vaccination Campaign?”

Ram Koppaka and Richard Hughes IV discuss the possibility of H5N1 human transmission and a hypothetical mass vaccination program against this virus in this piece for Health Affairs. They write in their conclusion, “The most recent pandemic clearly demonstrated the inadequacy of our existing level of vaccine preparedness. So far, we have failed to seize this moment and put in place the infrastructure to support immunization of both children and adults. Worse still, it indicates a failure to learn some of the pandemic’s hardest lessons. As a result, we are destined to once again endure the consequences, knowing that they had been largely avoidable…Or we can do it differently this time. We can act now to be truly ready and prepared to mount a mass vaccination campaign against the next pandemic threat—whenever it comes. We have risen to the occasion before, and we can do it again.”

“COVID, Mpox, Cholera: Is the World Prepared for Another Pandemic?”

Faras Ghani discusses recent outbreaks and infectious disease developments, alongside analysis of global lack of adequate access to essential healthcare services and an interview with Dr. Ahmed Ogwell, Vice President of Global Health Strategy at the UN Foundation, in this piece for Al Jazeera.

“Inside the Bungled Bird Flu Response, Where Profits Collide With Public Health”

Katherine Eban discusses the USDA’s action or lack thereof in responding to H5N1 cases in Texas dairy cattle in this Vanity Fair article, writing in her summary “When dairy cows in Texas began falling ill with H5N1, alarmed veterinarians expected a fierce response to contain an outbreak with pandemic-sparking potential. Then politics—and, critics say, a key agency’s mandate to protect dairy-industry revenues—intervened.”

“Combining AI Breakthroughs and Better Policy to Defeat Superbugs”

Akhila Kosaraju discusses the transformative opportunity AI poses in addressing AMR in this piece for the Stanford Social Innovation Review: “Superbugs may have met their match in generative AI, but to fully tackle the crisis of antimicrobial resistance, policy makers need to find new ways to help scientists and researchers overcome long-standing obstacles and revitalize a broken antibiotic market.”

“NTI | Bio Champions Effort to Enhance Transparency to Strengthen the Biological Weapons Convention”

From NTI: “From September 30 to October 2, 2024, NTI | bio convened more than 30 experts for a workshop on enhancing transparency for bioscience research and development and bolstering confidence in compliance with the Biological Weapons Convention (BWC). Held in Amsterdam, The Netherlands, the workshop gathered an international group of participants from 15 countries spread across five continents with expertise in biosecurity and biotechnology governance and international security, as well as previous experience working to establish a verification mechanism for the BWC and involvement in ongoing discussions to strengthen the Convention.”

“The meeting updated existing concepts and generated new ideas about options to enhance transparency in regard to BWC compliance. NTI helped frame these discussions by tabling a concept paper on this topic, and the group discussed approaches to advance these goals, including through scientific and technical measures for data collection and analysis, procedural approaches, and institutional structures to house such efforts. Dozens of approaches were discussed during the meeting which will inform NTI’s continued efforts to highlight and explore promising opportunities to further advance this work.”

Read more here.

“Preparing for Ecological Disruption: A Strategic Foresight Approach to Ecological Security”

Lily Boland recently authored this report for the Council on Strategic Risks: “This report leverages insights gained from the use of strategic foresight as an approach for better anticipating how risks to global security are heightened by ecological disruption. It offers a range of use-cases for applying the foresight toolkit to the field of ecological security and to establish a knowledge base to assist practitioners, governments, and institutions in enhancing their anticipatory decision-making and planning processes for addressing the security ramifications of large-scale destabilization and decline of the biosphere and ecosystems.”

“How Zombies and Vampires Help Me Grapple with Disaster”

Neil Vora, a physician who has served in the Epidemic Intelligence Service and now treats TB patients and works with Conservation International, discusses what many in this field know all too well-an obsession with works of horror, especially those about contagions and disasters. Vora explains in part, “To help manage my anxieties about the fate of the world, I often turn to scary stories about contagions and other doomsday scenarios. This may seem counterintuitive, but I find the horror genre to be a perfect sandbox to explore pressing societal problems without real-world repercussions. Horror allows me to navigate my fears to their extremes from the comforts of my living room.”

However, the author also cautions, “But while fictionalized catastrophes help me grapple with my worst fears, I’ve also come to realize that consuming them without a critical eye can lead to a paralyzing level of despair—a luxury we can’t afford at this pivotal moment in history.”

While you’re at it, check out this episode of the Poisons and Pestilence podcast guest starring Biodefense PhD Program alumna and faculty member Saskia Popescu reviewing the films, Contagion and Outbreak, and read about her intro to the field at just 9-years-old via Richard Preston’s book, The Hot Zone.

NEW: Vision for Health Forum

From Johns Hopkins: We hope you can join us in November for the Vision for Health Forum with collaboration between Johns Hopkins Howard County Medical Center and Johns Hopkins Applied Physics Laboratory. 

Panel Discussion 
Moderator:  
M. Shafeeq Ahmed, M.D., MBA, F.A.C.O.G
President, Johns Hopkins Howard County Medical Center

Topic: Partnership between JHHCMC and APL
Jeanette Nazarian, M.D., Vice President, Medical Affairs and Chief Medical Officer- Johns Hopkins Howard County Medical Center 

Topic: Revolutionizing Health through Science and Engineering
Sheri Lewis, MPH, Deputy Mission Area Executive, Global Health -Johns Hopkins Applied Physics Lab 

Topic: APL-HCMC Partnership for Project Firstline: Safeguarding Our Nation’s Frontline Healthcare Workers
Lucy Carruth, Ph.D, Assistant Program Manager- Johns Hopkins Applied Physics Lab 
Brian Damit, Ph.D, Project Manager- Johns Hopkins Applied Physic Lab 

This event will take place at the Johns Hopkins Applied Physics Laboratory on November 4 at 4:30 pm EST. Learn more here.

The Advancing Threat Agnostic Biodefense Webinar Series

From PNNL: “Please join us in welcoming Drs. Matthew Kasper and Lindsay Morton from the Department of Defense (DoD) Global Emerging Infections Surveillance (GEIS) program for their talk titled “Challenges and Opportunities in Pathogen Agnostic Sequencing for Public Health Surveillance: Lessons Learned From the Global Emerging Infections Surveillance Program.” This webinar will take place Tuesday, October 29th, at noon PT.”

Learn more and register here.

13th Annual Jonathan Tucker Symposium

“The James Martin Center for Nonproliferation Studies cordially invites you to the 13th annual Jonathan Tucker Symposium on chemical and biological weapons issues on November 13th and 14th, 2024.”

Among this year’s speakers are Dr. Yong-Bee Lim, an alumnus of the Biodefense PhD Program and Deputy Director of the Converging Risks Lab and Biosecurity Projects Manager at the Council on Strategic Risks, who will give a talk titled “Technology Democratization and its Implications for CBW Safety and Security: Lessons Learned from Engagement with Non-Traditional Communities.”

Learn more and register here.

One Health and the Politics of COVID-19 Book Launch

The Writer’s Center is hosting a book launch for Dr. Laura Kahn’s new book, One Health and the Politics of COVID-19 (blurb below) on November 23 at 2 pm EST in Bethesda, MD. Learn more and RSVP here.

One Health and the Politics of COVID-19 unpacks the mysteries of COVID-19’s origins to impart important lessons for future outbreaks. The One Health concept recognizes the interconnected links among the health of humans, animals, plants, and the environment. By comparing the history, science, and clinical presentations of three different coronaviruses—SARS-CoV-1, MERS, and SARS-CoV-2 (COVID-19)—Kahn uncovers insights with important repercussions for how to prepare and avoid future pandemics. The One Health approach provides a useful framework for examining the COVID-19 pandemic. Understanding the origins of this zoonotic disease requires investigating the environmental and molecular biological factors that allowed the virus to spread to humans. The book explores the many ways in which the wild animal trade, wet markets, and the camel industry contributed to the spread of the earlier SARS-CoV-1 and MERS coronaviruses. For SARS-CoV-2 (COVID-19), Kahn examines the biosafety, biosecurity, and bioethics implications of gain-of-function research on pandemic potential pathogens. This book is a must read to understand the geopolitics of the COVID-19 pandemic.”

2024 CBD S&T Conference

From DTRA: “The CBD S&T Conference brings together the most innovative and influential chemical and biological defense community members from around the globe to share insights and collaborate on the emerging chem-bio threats of tomorrow.”

“Join the Defense Threat Reduction Agency’s (DTRA) Chemical and Biological Technologies Department in its role as the Joint Science and Technology Office (JSTO) for Chemical and Biological Defense, an integral component of the Chemical and Biological Defense Program, as we Focus Forward to uncover novel concepts and examine groundbreaking discoveries within the chem-bio defense landscape.”

“The 2024 CBD S&T Conference will be held at the Broward County Convention Center, December 2–5, 2024.”

Learn more and register here.

BID2025 Stakeholder Input Request
“From BARDA: We are excited to host our next BARDA Industry Day (BID) conference on June 30 – July 1, 2025, in Washington, D.C.! BID2025 will delve into the critical intersection of health security and sustainability with experts from various sectors to discuss cutting-edge medical countermeasure (MCM) innovations and strategies.”

“We want to make sure that the event reflects the interests of our attendees. Your feedback will help us curate sessions, speakers, and topics that are relevant and engaging for you. This short questionnaire should take no more than three minutes to complete. Please share your thoughts on what you would like to see at the conference by October 30, 2024.

Share thoughts here.

US AI Safety Institute Issues RFI on Responsible Development of Chem-Bio Models

From AISI: “The U.S. Artificial Intelligence Safety Institute (U.S. AISI), housed within the U.S. Department of Commerce’s National Institute of Standards and Technology (NIST), released a Request for Information seeking insight from stakeholders regarding the responsible development and use of chemical and biological (chem-bio) AI models.”

“Input from a broad range of experts in this field will help the U.S. AISI to develop well-informed approaches to assess and mitigate the potential risks of chem-bio AI models, while enabling safe and responsible innovation.”

“Respondents are encouraged to provide concrete examples, best practices, case studies, and actionable recommendations where possible. The full RFI can be found here.”

“The comment period is now open and will close on December 3, 2024, at 11:59PM Eastern Time. Comments can be submitted online at www.regulations.gov, under docket no. 240920-0247.”

Pandora Report 5.6.2016

May has arrived, summer is upon us, and we’ve got your weekly biodefense scoop..Thursday was Hand Hygiene Day – don’t forget that clean hands save lives! Check out these wonderful infographics on the impact of vaccines on battling infectious diseases in the 20th century. A recent study published in the Journal of the American Medical Association (JAMA) found that 30% of oral antibiotics prescribed in U.S. outpatient healthcare facilities (urgent cares, etc.) are unnecessary. Hocking a loogie may now be a diagnostic method as researchers have found that people have saliva fingerprints. The study revealed that this new analysis could lead to non-invasive methods of disease detection. Think you know your chem-bio weapons? Take a quiz to see if your knowledge is expert level or if you need a review from anthrax to Zika. 

Potential Anthrax Attack Foiled in Kenya 
Screen Shot 2016-05-04 at 7.07.53 AM Kenyan police are claiming to have foiled a “large-scale” bioterrorism attack using anthrax. Three individuals associated with a terrorist group with links to ISIS were arrested. The terrorist group was not named but was noted to have a presence in Kenya, Somalia, Libya, and Syria. Police stated that “Mohammed Abdi Ali, a medical intern at a Kenyan hospital, was in charge of a ‘terror network… planning large-scale attacks akin to the Westgate Mall attack‘ in which 67 people were killed in 2013 in Kenya’s capital, Nairobi.” Mr. Ali is said to have a network that includes medical professionals who would have the tacit knowledge to develop anthrax bioweapons. The Kenyan police chief, Joseph Boinnet, posted the official documents on his Twitter. While there has been no additional information on the terrorist group or the details of their planned bioweapons attack, we’ll continue to keep you updated as more information is released.

Let Loose Your Inner Epi With EpiCore
Ramp up your epidemiology game with the EpiCore community. EpiCore is a joint effort from Skoll Global Threats Fund, HealthMap, ProMED, and TEPHINET. EpiCore is a virtual community that brings together epidemiologists using new surveillance methods. It’s “a new system that is finding and reporting outbreaks faster than traditional disease surveillance methods alone. EpiCore enables faster global outbreak detection and reporting by linking a worldwide member network of health experts through a secure online reporting platform.”

Whole Foods Salad Bar Attack
The FBI has recently arrested a man in Ann Arbor, Michigan, who poured a liquid onto items in the prepared foods bars. Reminiscent of the Rajneeshee attack in 1984, investigators are taking the situation very seriously. Authorities found that the man was spraying mouse poison in fresh foods at three Ann Arbor grocery stores. “According to the FBI, an investigation points to the man spraying a mixture of what is believed to be mouse poison, hand cleaner, and water on open food bars in three stores in the town over the last couple of weeks.” The FBI has also noted that the suspect had visited other grocery stores in recent months and they are currently investigating if those other stores were involved in the poisoning. Would you consider him a bioterrorist or prankster?

Is Texas A New Hot Zone?
Between Ebola and Zika, Texas hasn’t been able to catch a break from emerging infectious diseases (EID’s). The Center for  Strategic & International Studies (CSIS) discusses that the EID attraction to the Lone Star State really began back in 2003 with the first urban dengue fever epidemic in decades. Texas is also “now an epicenter of Chagas disease and leishmaniasis transmission in the United States (parasitic infections transmitted by kissing bugs and sandflies, respectively), as well as murine typhus (transmitted by fleas) and West Nile virus infection.” Many are wondering, why Texas? What makes Texas such a nexus for infectious diseases? CSIS points to several factors – poverty (large population + poverty rate around 16% = ranking one or two in terms of having the largest volume of people below the poverty line), urbanization (when combined with poverty, this rapid growth means the crowded poor neighborhoods are perfect for opportunistic disease), being a global commercial and migration hub (coastal gateway ports), and climate change. These four qualities have created the perfect blend for both emerging and neglected infectious disease presence in Texas. Fortunately, Texas has a strong emergency management system and heightened public health department investment and resources. While Ebola and Zika have surely reinforced preparedness practices in Texas, are they enough? You may remember in December, we recounted the Trust for America’s Health report on state specific preparedness for preventing, detecting, diagnosing, and responding to outbreaks. States were graded on a scale of 1-10 (10 being the best score). Interestingly, Texas was ranked right in the middle with a score of 5. Despite all their recent EID events, I’m surprised Texas is not ranked higher (Delaware, Kentucky, Maine, New York, and Virginia ranked highest with a score of 8). If Texas is the new epicenter of emerging and neglected infectious diseases, let’s hope their capabilities and capacity to respond to such diseases improves in the future.

Lessons Learned from TV/Movie Outbreaks
The CW recently began their new miniseries, Containment. While any show or movie on an outbreak instantly captures my interest, this one is particularly captivating for the same reasons as Outbreak – it’s so bad, it’s good. A recent ranking of the most plausible pathogen and zombie virus outbreaks in movies points to our affinity for outbreak movies with poor scientific backing. I’m a fan of watching these movies, and now Containment on Tuesday evenings, to see not just how wrong people can get outbreak response, but what they think the general public wants to see when it comes to a dramatic epidemic depiction. Did I mention the plethora of epidemiology/infection control faux pas? We’ve all watched a movie or show with a disease outbreak and picked out some ridiculous (and usually hilarious) blunders. The Pandora Report is now starting a list of ways the show demonstrates how NOT to stop/prevent an outbreak. We’re hoping to publish the list after the season ends and would love to include anything YOU find while watching it. Whether it’s the ridiculous infection prevention habits, over-the-top quarantine practices, or SWAT house calls, we want to know what you find while watching the show. Please email (spopesc2@gmu.edu) or tweet with #GMUBiodefense and we’ll incorporate them into our overall list.

Zika Updates
The WHO has released a one-year overview of the outbreak, pointing to the reasons why “an obscure disease became a global health emergency.” They emphasized the potential staying power of the virus and the challenges of diagnostic testing in the field. Many experts are predicting that once there is local transmission in the U.S., Zika virus will become endemic and a “constant low-level threat” requiring annual vaccination. The FDA has issued Emergency Use Authorization to approve the first commercial U.S. Zika virus test. “The Zika Virus RNA Qualitative Real-Time RT-PCR test from Focus Diagnostics, a Quest Diagnostics wholly-owned subsidiary, is a proprietary molecular test is intended for the qualitative detection of RNA from the Zika virus in human serum specimens.” Prior to this, all testing was done at specific laborites designated by the CDC and had limited availability to physicians. The availability of a rapid test will allow for more accurate and timely surveillance and diagnoses. Brazil has reported roughly 1,300 Zika-linked microcephaly cases.  Researchers are finding that mosquitoes infected with the bacterium, Wolbachia, may help stop the spread of Zika. “We are pretty sure that mosquitoes carrying Wolbachia will have a great impact on Zika transmission in the field,” said Luciano A. Moreira, a biologist at the Oswaldo Cruz Foundation in Belo Horizonte, Brazil, and the lead author of a new report on the researchers’ findings, published on Wednesday in the journal Cell Host & Microbe. There is also a growing concern about the potential impact the virus may have in the U.S. as researchers have found Zika in Asian tiger (Aedes albopictus) mosquitoes. This particular mosquito has a larger range within the U.S. and travels farther north. As of May 4, 2016, the CDC has reported 472 travel-associated cases in the U.S.

Stories You May Have Missed:

  • Ebola Survivor Household Contacts At Higher Risk – a recent study in Sierra Leone found that nearly half of household contacts of Ebola survivors contracted the illness. The risk of infection was correlated with level of exposure, but researchers also found that it varied by age. “The adjusted risk also varied by age: 43% for children under 2 years, 30% for those 5 to 14 years; 41% for those 15 to 19, 51% for adults 20 to 29 years, and more than 60% for adults over 30.”
  • Ebola Re-Emergence Involves Virus With Reduced Evolutionary Rate – A recent study found that the mutational rate has waned a bit in the Ebola virus that re-emerged in Liberia. Performing genomic comparisons of the virus in flare-ups, the research “team saw declining genetic divergence in the flare-up strains, perhaps due to diminished evolutionary rates in individuals with persistent infection. Still, the sequence data supported the notion that the flare-ups involved strains related to those in the main outbreak, ruling out re-introduction from a reservoir animal or transmission of distinct strains from active infections elsewhere”.
  • Chinese Espionage and Traded Nuclear Information –  a former Florida Power & Light manager is accused of trading nuclear information for cash to aid a Chinese nuclear power company. He was “recruited by Szuhsiung Ho, also known as Allen Ho, to help China General Nuclear Power Co. develop special nuclear material in China, according to the grand jury indictment.”

 

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Reston Ebola: NOVA’s Namesake Emerging Infectious Disease

By Chris Healey

Almost 25 years before the 2014 Ebola epidemic began spreading through West Africa – and the resulting treatment of two American Ebola patients on U.S. soil – public health officials responded to an Ebola outbreak inside the U.S.

Reston Ebola is the name given to an Ebola species discovered among macaque monkeys in a pharmaceutical research company’s primate quarantine unit in Reston, VA.

In 1989, a veterinarian at Hazelton Research Products, a pharmaceutical research company, contacted the United States Army Institute of Infectious Diseases at Fort Detrick, MD, concerning an unusually high mortality rate among macaques in a shipment from the Philippines. The veterinarian wanted USAMRIID to confirm suspected simian hemorrhagic fever, a viral illness lethal to primates but innocuous to humans. Tests on macaque carcasses unexpectedly showed signs of a deadly filovirus infection – Ebola hemorrhagic fever virus.

Initially, Ebola species Zaire – with mortality rates as high as 90%, and the cause of the 2014 African Ebola epidemic – was implicated as the agent at work. Faced with an unprecedented public health threat, state and federal health agencies converged on the primate quarantine facility in Reston. The Centers for Disease Control and Prevention monitored quarantine facility employees for Ebola symptoms. USAMRIID euthanized primates and sterilized the quarantine facility.

Comprehensive tests later identified the Zaire species identification as an error – Reston Ebola was a new species incapable of infecting humans. However, the enormous public health response was not unwarranted.

Unlike other Ebola species, researchers suspected Reston Ebola demonstrated airborne transmission at the quarantine facility. The longer the virus remained in human presence, the longer it was given opportunities to adapt. If Reston Ebola were to adapt to humans with airborne communicability it would pose a catastrophic public health risk.

Although no quarantine facility employees demonstrated Ebola-like symptoms during the 1989 outbreak, six workers produced Reston Ebola antibodies, meaning the virus elicited an immune response. Reston Ebola’s quick eradication was paramount to ensure that the virus—with its suspected airborne communicability—did not adapt to humans.

Restriction of the 2014 African Ebola epidemic to only a few countries has been attributed to the limited means of Ebola virus transmission. All Ebola species which affect humans are communicable only through direct contact with an infected person or their bodily fluids. Airborne transmission would increase viral spread and undermine containment efforts.

 

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