Tag: vaccine

Pandora Report 3.17.2017

by spopescu, posted in Pandora Report

Happy Friday! In honor of  John Snow‘s birthday (the father of epidemiology), our featured image is the Broad Street pump map he used to combat cholera in the 19th century. Don’t miss out on the early registration discount for our biodefense summer workshop!

NAS Calls for Increased Federal Regulatory Agency Preparation for Growing Biotechnology Products 
The National Academies of Science (NAS) recent press release is emphasizing the need for federal regulatory agencies to prepare for greater quantities and ranges of biotechnology products. As the biotech world constantly evolves, regulatory agencies have struggled to keep up and this latest report states that in the next five to ten years, the pace will outmatch the U.S. regulatory system. According to the report, biotechnology, like CRISPR, has a rapidly growing scale and scope, which already stresses existing staff, expertise, and resources available at agencies like the EPA, FDA, and USDA. “To respond to the expected increase and diversity of products, the agencies should develop risk-analysis approaches tailored to the familiarity of products and the complexity of their uses, the report says. For biotechnology products that are similar to products already in use, established risk-analysis methods can be applied or modified, and a more expedited process could be used. For products that have less-familiar characteristics or more complex risk pathways, new risk-analysis methods may need to be developed.  Regulatory agencies should build their capacity to rapidly determine the type of risk-analysis approaches most appropriate for new products entering the regulatory system.” Within the report, NAS notes that the federal government needs to develop a strategy to combat the current issues and strengthen their ability to scan for future biotechnology products to better prioritize.

GMU Schar School Master’s Open House 
Have you ever wanted to study topics like CRISPR, bioterrorism, global health security, and pathogens of biological weapons? Good news – we’ve got just the program for you! Come check out GMU’s biodefense MS program at our Open House on Wednesday, March 22nd at our Arlington Campus, Founders Hall (Room 126) at 6:30pm. You can talk to some of our biodefense faculty and learn about our program. Whether you’re looking to take classes in person or earn a degree online, the biodefense MS is the best for the intersection of science and policy.

DARPA Works Towards “Soldier Cell” To Fight Bioweapons 
A bio-control system to fight off invading pathogens? Sounds like something out of a science fiction movie! Well, researchers at Johns Hopkins University just received funding from DARPA to develop the capacity to “deploy single-cell fighters” that would target and eliminate the lethality of certain pathogens. “‘Once you set up this bio-control system inside a cell, it has to do its job autonomously, sort of like a self-driving car,’ said Pablo A. Iglesias, principal investigator on the project. Iglesias, a professor of electrical and computer engineering in the Whiting School, shifted his research focus from man-made to biological control systems about 15 years ago. ‘Think about how the cruise control in your car senses your speed and accelerates or slows down to stay at the pace you’ve requested,’ Iglesias said. ‘In a similar way, the bio-control systems we’re developing must be able to sense where the pathogens are, move their cells toward the bacterial targets, and then engulf them to prevent infections among people who might otherwise be exposed to the harmful microbes’.” This angle, which is being focused on bacteria outside of the body, is just one potential tool in the biodefense arsenal.

Yellow Fever Outbreak in Brazil 
Since December of 2016, Brazilian health officials have reported an ongoing outbreak of yellow fever. The CDC has moved the alert to a  Level 2 – Practice Enhanced Precautions. A report recently published in the New England Journal of Medicine looks at the outbreak and the potential for cases in U.S. territories. In Brazil, there were 234 cases and 80 deaths reported between December and February. “Although it is highly unlikely that we will see yellow fever outbreaks in the continental United States, where mosquito density is low and risk of exposure is limited, it is possible that travel-related cases of yellow fever could occur, with brief periods of local transmission in warmer regions such as the Gulf Coast states, where A. aegypti mosquitoes are prevalent.”

GMU Biodefense Represented At Biothreats Conference
If you missed out on our coverage of ASM’s 2017 Biothreats conference, here’s a spotlight on GMU biodefense students attending this captivating three-day event. GMU’s biodefense program sent four graduate students to experience and report on the conference, which addressed biothreat research, policy, and response. “The program was exciting, according to the George Mason students in attendance. Mercer and Goble recall that the conference engaged topics of specific interest to them, their degree, and their futures. ‘I attended a panel that was very closely related to disease forecasting, my graduate thesis topic,’ Mercer said. ‘I was able to hear some of the cutting-edge research in that field, which was really helpful’. ‘I didn’t really have a part I didn’t like,’ Goble said. ‘I enjoyed the niche topics that were presented in both panel discussions and poster  sessions, from emergency operations to the FDA. All of these specific topics were extremely interesting to hear about and to know they are being researched’.”

Just How Well Did the 2009 Pandemic Flu Vaccine Strategy Work?
Researchers from the University of Nottingham recently looked at the success of vaccines in terms of preventing pandemic flu and reducing hospitalizations. Their work looked at the 2009 WHO-declared pandemic of the novel A(H1N1) virus, which infected around 61 million people around the world. Vaccines against the virus were rolled out globally between September and December of 2009, with the majority being inactivated A(H1N1)pdm09 influenza virus. Their work involved reviewing 38 studies between June 2011 and April 2016 regarding the effectiveness of the inactivated vaccine, which covered around 7.6 million people. “We found that the vaccines produced against the swine flu pandemic in 2009 were very effective in both preventing influenza infection and reducing the chances of hospital admission due to flu. This is all very encouraging in case we encounter a future pandemic, perhaps one that is more severe,” noted Professor Van Tam said. “Of course, we recognize that it took five to six months for pandemic vaccines to be ready in large quantities; this was a separate problem. However, if we can speed up vaccine production times, we would have a very effective strategy to reduce the impact of a future flu pandemic.” The 2009 pandemic A(H1N1) vaccine was 73% effective against laboratory confirmed cases and 61% against preventing hospitalizations. Interestingly, when looking at the vaccines’ effectiveness in different age groups, “they were shown to be less effective in adults over 18 years than in children, and effectiveness was lowest in adults over 50 years of age. Adjuvanted vaccines were found to be particularly more effective in children than in adults against laboratory confirmed illness (88 per cent in children versus 40 per cent in adults) and hospitalization (86 per cent in children versus 48 per cent in adults).”

Deadly Fungal Infection Arrives in U.S. 
While many are asking if surveillance methods for tracking the deadly CRE bacteria are adequate, a new issue is emerging in U.S. hospitals. Despite WHO’s recent plea for increased R&D surrounding certain resistant pathogens, it seems that more and more organisms of concern are springing up in U.S. hospitals. Since last summer, roughly three dozen people have been diagnosed with a highly resistant Candida auris infection. The fungal infection has caused worry ever since it was identified in 2009 due to its capacity as an emerging and resistant organism. Candida yeast infections are pretty common and known to cause urinary tract infections however, this strain is especially concerning because it easily causes bloodstream infections, has a stronger capacity for transmission between people, and is much more hardy in terms of living on skin and environmental surfaces. “Of the first seven cases that were reported to the CDC last fall, four patients had bloodstream infections and died during the weeks to months after the pathogen was identified. Officials said they couldn’t be sure whether the deaths were caused by the infection because all the individuals had other serious medical conditions. Five patients had the fungus initially isolated from blood, one from urine, and one from the ear.”

CDC Director Warns Loss of DHHS Funds Could Weaken Infectious Disease Prevention
Acting CDC director, Anne Schuchat, recently testified before Congress to make the case for for increased funding for several programs (one being the DHHS’s Prevention and Public Health Fund). Among other things, the Prevention and Public Health Fund is responsible for 12% of the CDC’s budget. Dr. Schucat’s testimony emphasized the previous usage of these funds in terms of vaccine delivery, disease surveillance, monitoring of water supplies, and tracking hospital-acquired infections. The growth of antibiotic resistance made her testimony and plea to Congress that much more relevant and urgent. “The CDC and other government agencies have in recent years cited the numerous public health threats posed by infectious diseases in general, and have lobbied officials for increased funding for research and development of novel vaccines and treatments as well as programs to effectively distribute interventions as needed. In 2016, for example, the CDC, DHHS, and National Institutes of Health requested federal funding to combat Zika, a request that was not approved until late in the year.”

Stories You May Have Missed:

  • Science on Screen – Don’t miss this great event hosted by Lawrence Livermore National Laboratory! On March 18th, you can watch the second installment of the Science on Screen series, featuring “Lawrence Livermore scientists Monica Borucki and Jonathan Allen, who will present ‘Reconstructing a Rabies Epidemic: Byte by Byte.’ This informative and entertaining lecture will explain how biologists and computer scientists used cutting-edge, ultra-deep sequencing technology to study the dynamics of a 2009 rabies outbreak. This case study, based on a dramatic increase (more than 350 percent) in the gray fox population infected with a rabies variant for which striped skunks serve as the reservoir hosts, will be used to help illustrate the changes in the viral genome during cross-species viral transmission. This lecture is appropriately paired with the feature-length film, “Contagion” (PG-13).”
  • Clorox Gets Spot on EPA A-Team – Clorox just earned its varsity spot on the team against hospitality-acquired infections. The EPA approved two of the company’s products in killing clostridium difficile spores. C-diff is a constant battle in healthcare facilities, so having the new tool in the infection prevention and environmental disinfection toolkit, is a huge advantage for many. “In addition, the cleaners and wipes recently become EPA-registered to disinfect against other bacterial infections, such as those caused by Staphylococcus epidermidis, Candida glabrata, and Enterococcus hirae. Moreover, the products are also effective against several viral pathogens, such as Middle East Respiratory Syndrome (MERS), and Severe Acute Respiratory Syndrome (SARS), measles, and Influenza A and B, among others.”

 

Pandora Report 11.11.2016

by spopescu, posted in Pandora Report

The U.S. Election has concluded and whether your candidate is now our presidential elect or you’re just glad it’s all over, here’s something to celebrate – President Obama signed an executive order last week, cementing the GHSA as a national, presidential-level priority. Commitment to GHSA and fighting outbreaks on a global scale is a huge step forward to combating the health crises we’ve seen and will continue to battle in the future. Since researchers recently debunked the myth of Gaëtan Dugas as a primary source for HIV/AIDS in the U.S., check out more stories regarding the misunderstood “patient zero”.  World leaders are starting to realize that the antibiotic clock is ticking away.

Trump and the Issues Within Science
Donald Trump is the new president elect, but where does he stand on issues like Zika? Here’s a compilation of sources that cover his comments and plans for some of the top issues in science. NPR is looking at his comments on global health and humanitarian aid, while some are trying to figure out what Trump’s administration will mean for them and the need for a transition team tutorial. STAT is asking five questions regarding what the Trump administration will mean for science. Sources close to the Trump campaign have stated that two of the “best-known climate skeptics will lead his U.S. EPA transition team“.

It’s Time to Modernize the BWC 
GMU Biodefense graduate program director and professor, Gregory Koblentz teamed up with Filippa Lentzos to discuss why it’s so important for the BWC to modernize. They tackle the reality that while the convention isn’t failing, it’s definitely not flourishing. Despite its dedication to ban a whole class of weapons, the BWC is a somewhat toothless dog. “It lacks a dedicated forum to assess treaty implications of scientific advances, a robust institutional capacity, organized means of helping member nations meet their obligations, provisions for verifying compliance, and an operational role to respond in cases of a serious violations. The upcoming review conference provides a welcome opportunity to begin rectifying some of these shortcomings.” Koblentz and Lentzos point to the consistent challenges of science and technology reviews. Despite a rapidly evolving industry, the BWC hasn’t been able to keep up and maintain an international forum for the debates that are needed. Lagging behind the biotech times means the BWC is running the risk of irrelevance, not to mention the slow shift from the convention towards UNSCR 1540. In this climate, it doesn’t help that there is an even greater need for transparency. Biodefense programs have surged the last two decades, which means that transparency is increasingly important to ensure these programs aren’t biosecurity risks or being perceived as threats and becoming justifications for initiated offensive programs. The reform process is pivotal and this includes organizing a review of relevant S&T developments more systematically, renewing the mandate of an implementation unit, and setting up an Open-Ended Working Group on Providing Reassurance to encourage transparency and engagement in peer review exercises. “The Eighth Review Conference provides an opportunity to revitalize the bioweapons treaty by taking concrete actions to expand its relevance, enhance its capacity to review developments in science and technology, and strengthen the confidence of nations in the peaceful intentions of their fellow treaty members.”

RevCon began this week in Geneva and you can catch the U.S. opening statements by Thomas Countryman, Acting Under Secretary for Arms Control and International Security. You can also read Mr. Kim Won-soo’s remarks as High Representative for Disarmament Affairs. The International Committee of the Red Cross (ICRC) vice president, Christine Beerli, has also commented, noting that “States Parties should not become complacent; it remains their collective and individual responsibility to ensure that the treaty is implemented effectively. Over the past five years of annual meetings, a great deal of information has been shared and many proposals have been made on how to implement the treaty and improve its effectiveness. Disappointingly, however, there has been little collective agreement.” RevCon experts will also be focusing on new threats that may arise from technology. Guinea just became the 178th State Party to the BWC!

armas-biologicas-2NSABB Meeting on DURC and Other Hot Topics
On Friday, the National Science Advisory Board for Biosecurity (NSABB) hosted a call to review policy updates, new activities, updates from the working group on institutional oversight of the life sciences DURC policy stakeholder engagement, and updates from the Blue Ribbon panel that is currently reviewing the 2014 NIH variola incident. The conference call was fast-paced but covered substantial ground – most of it you can find on the Power Point slides. The policy updates focused on initiatives to strengthen biosafety/biosecurity stewardship. The 2016 NSABB report recommended additional, multidisciplinary evaluation prior to funding decisions and appropriate, ongoing oversight if funding were given to projects. It was noted that this is a particularly exciting time for science as we’re seeing so many advancements in human health, however the applications of these technologies are testing the oversight and policies we currently have in place to ensure science is performed safely (and securely). While they may or may not all be under the purview of the NSABB, the emergence of CRISPR and evolution of genomic sequences and gene drive techs, and abilities to create next gen of chimeras – are all examples of biotech that are evolving very rapidly and we may need to rethink how they fit our current policy and framework. NSAAB has been a part of the DURC conversation with policy focus on research responsibilities and institutional approaches. NSABB is also working on how to increase and approach stakeholder engagement in DURC polices. There were several listed strategies and topics, ranging from regional meetings at universities or panel sessions at conferences like ASM and ASV. The biggest focus was on getting dialogue and metrics across institutions, not to mention the need for feedback to evolve an objective oversight system. The Blue Ribbon panel is working on the review of the NIH variola incident but they did note that the event was handled very well and while there were obvious gaps, they were all addressed and that the interagency work between the FBI, NIH, and CDC went very smoothly.

Sverdlovsk, Three Mile Island, and Government Oversight of Biological Safety
Greg Witt is talking to us about government oversight of biological research and the lessons learned from the Three Mile Island nuclear accident (did I mention that Greg is a nuclear systems engineer?). Pointing to the biosafety failures that have happened recently (remember that time a Pasteur Institute employee improperly took MERS samples on a commercial airline???), Greg pulls together the pieces to paint a bigger mosaic of systemic failure to properly control biological agents. Pointing to similarities between these events (they even happened days apart) he notes that “both were caused, in large part, by errors in maintenance: at Sverdlovsk, technicians neglected to replace an exhaust system filter, while at TMI, staff had isolated an auxiliary feedwater pump during routine maintenance in violation of US Nuclear Regulatory Commission (NRC) rules.”

The Glamor of Bad Science02-ebola-w529-h352
Yours truly is talking about the disparaging addiction we have to dramatic science. I’m a fan of any movie that involves an outbreak, but the truth is that an overwhelming majority of these films depict infectious disease outbreaks so outrageously and dramatically, they have become anti-science. After watching the latest, Inferno, it became increasingly apparent that we’ve created a false threshold for science, specifically infectious diseases, in film. By painting the picture of diseases and outbreak response like that of Outbreak, I Am Legend, and more, we’re creating an increasingly de-sensitized culture. The result of this de-sensitization means that it takes a lot more for people to take infectious disease outbreaks seriously in real life. It’s not a genetically engineered airborne organism that will make flesh rot? Meh – not that big of a deal. Our love of bad infectious disease science in film and television could easily create a culture of poor public health support.

Ebola Was Just the Beginning…Are We Ready?
Peter Piot, Director of the London School of Hygiene and Tropical Medicine, is highlighting the realities that we simply aren’t ready for the next big virus epidemic. Piot discusses his work during the early days of Ebola in the 1970s, pointing to the challenges of attempting to figure out a novel virus while trying to put out the fires of an outbreak. Describing the 2014 outbreak as a perfect storm, he notes that the WHO response was too slow to act. The globalization of our interconnected world has made the capabilities of an outbreak much greater than 50 years ago. “Piot also believes there will be a ‘Big One’, a big influenza, similar to the likes of the Spanish Flu in World War One and we’re not quite ready for it. Yet. ‘Are we ready?’ Piot asked. ‘A little bit better than a few years ago but we’re not yet up to the job. We can’t afford to wait but we have a plan, and that’s the good news. The world has learnt from the problems of mobilisation around Ebola and we are now in a better situation; there is better technology to allow for more rapid diagnosis’.” Piot stresses the importance of investment in infrastructure, stronger global governance, and vaccine development incentives.

All Things Zika
The Florida Health Department has released their Zika updates here. PAHO has recommended that Bolivian women delay pregnancy to avoid Zika. “Fernando Leanes, PAHO representative in Bolivia, said at a press conference that it was one of several advised measures to avoid the proliferation of microcephaly cases. ‘The epidemic of Zika, from what we have seen in other countries, will have a rise and fall in Bolivia. Therefore, there are options such as delaying the decision to get pregnant in areas where Zika is spreading. This will avoid the dreaded microcephaly and the complications it represents,’ explained Leanes.” An $18 million plan was just announced to release Zika-resistant mosquitoes into urban areas of Colombia and Brazil.  “A swarm of Aedes Aegypti mosquitoes–the species that transmits dengue, yellow fever, chikungunya and Zika, have been modified to carry a bacterium called Wolbachia pipientis, which inhibits their ability to spread the viruses. Scientist released these ‘good mosquitoes’ in Brazil as part of a successful international program called ‘Eliminate Dengue’.” Many researchers are wondering why Colombia has had such few Zika-associated birth defects. They are the second largest outbreak in the world, yet have much fewer cases of microcephaly than Brazil. Researchers have noted that adult women in Puerto Rico were significantly more likely to develop Zika than men. The CDC has reported 4,175 cases of Zika in the U.S. as of November 9th, 2016.

Stories You May Have Missed:

  • How Trauma Explains Civil War– Don’t miss this event today at GMU’s Arlington campus, Founders Hall, Room 602. Eric Goepner will be discussing his research as to why “hurt people hurt people” and hypothesizing that a population’s prior traumatization predicts future civil war onset.
  • Searching for Ebola’s Hideout – The recent ebola outbreak is over, but this doesn’t mean the disease is gone. In fact, ebola is known for hiding out..so where has it gone? Leigh Cowart and other researchers are looking to stop future Ebola outbreaks by finding its hiding spot. “Such a long-term host, the quiet refuge of a pathogen, is known as a reservoir species. If a reservoir species is Ebola’s safe house, we are its luxury retirement property, a place for it to live out its last days with a bang. The trouble is that we aren’t sure where the safe house is. If we are going to be vigilant against Ebola’s re-emergence, we need to find it.”
  • The UK Forms Special Outbreak Response Team– with a five-year £20m funding, the UK is setting up a specialist team of health experts who will be able to respond to outbreaks around the world within 48 hours. “Public Health England will run the project with the London School of Hygiene and Tropical Medicine. Duncan Selbie, chief executive of Public Health England, said: ‘Speed is key in tackling infectious disease and with this new capability we can now deploy specialists anywhere in the world within 48 hours, saving and protecting lives where an outbreak starts and helping to keep the UK safe at home.'”

 

Pandora Report 11.6.2015

by spopescu, posted in Uncategorized

Happy Friday! The world of biodefense and global health security has been busy this week – between a growing outbreak of E. coli associated with Chipotle restaurants, to a review of Select Agent lab practices, and a recap of the Ebola outbreak in West Africa, there’s more than enough to keep you busy! Fun history fact Friday (it’s our version of “flashback Friday”), did you know that on November 6, 1971, the US Atomic Energy Commission tested the largest US underground hydrogen bomb (code name Cannikin) on Amchitka Island?

CDC/Select Agent List- 90 Day Internal Review
We’ve seen a lot of news lately regarding lab safety and biodefense reform/recommendations. With so much scrutiny regarding biosafety practices, it’s not surprising the CDC would do a deep dive into “how the agency inspects select agent labs” with a 90 day review. The review notes that while it didn’t duplicate the recommendations from Presidential Order 13546, it did find several areas for improvement, leading to nine observations and ten actionable recommendations. The categories for recommendations are inspections, incident reporting, and transparency. The findings point to several areas for improvement, ranging from the standardization of risk assessments to identify high risk activities, to the sharing of inspection data to better encourage public understanding of the work practices performed with these agents. The report highlights several areas for improvement that will hopefully lead to more stable biosecurity and public understanding of how we handle select agents. You can also check out the Federal Select Agent Program for a list of the agents and regulations involved.

2016 Presidential Candidates on Nonproliferation
GMU’s Greg Mercer is at it again with round three of his review on 2016 presidential candidates and their comments on nonproliferation. As of now, he’s reviewed the Republican candidates, but now he’s delving into the Democratic candidates. Greg reviews Hillary Clinton, Bernie Sanders, and Martin O’Malley, noting that ” in contrast to Republicans, most Democrats support the Iran deal, and generally tend to favor international arms control regimes.” With the race only heating up, stay tuned  for more of Greg’s candidate-by-candidate reviews on nonproliferation in the 2016 election.

GMU Master’s Open House and Application Deadlines!
Considering a master’s degree? Come check out the GMU School of Policy, Government, and International Affairs (SGPIA) Open House on Wednesday, November 18th, 6:30pm at our Arlington Campus in Founders Hall (Room 126). There’s even a pre-session for veterans and active duty military at 5:45pm! The Open House is a great way to learn about our different Master’s programs (Biodefense, International Security, Political Science, etc.) and ask real-time questions with faculty. Our Biodefense Program Director, Dr. Koblentz, will be there to discuss global health security and tell you about the pretty amazing things we get to do at GMU! If you’ve already attended or are planning to apply, just a friendly reminder that PhD program applications are due December 1st, and Biodefense Master’s Spring applications are due December 1st as well.

Zika Virus Outbreak in Colombia
Nine new cases have been identified in Sincelejo, Colombia, with an additional three being investigated in Barranquilla. Zika virus is a vectorborne disease that is transmitted through Aedes mosquitos. The CDC notes that vertical transmission (from mother to child) can occur if the mother is infected near her delivery and Zika can be spread through blood transfusion (although no cases have occurred this way) and sexual contact (one case of sexually transmitted Zika virus has occurred to date). Common signs and symptoms are fever, rash, joint pain, and red eyes that last several days to a week. In the past, transmission has occurred in tropical Africa, Southeast Asia, and the Pacific Islands, however, there have been cases in 2015 in Brazil and Colombia. We’ll keep you updated if transmission continues in South America!

There have also been cases of Chikungunya springing up throughout the Caribbean and Americas. The Pan American Health Organization (PAHO) initially reported just over 2,400 cases a few weeks ago, however a new report is showing 13,476 new cases. Initially starting in December 2013, this epidemic began with a single locally acquired case on St. Martin island, and is now totaling 1, 760,798 cases.

Chipotle E.coli Outbreak 
Just when you thought it was safe to go back to Chipotle (we reported that Minnesota  Chipotle customers experienced a Salmonella outbreak in August), an E. coli outbreak is making headlines in Washington and Oregon. Public health officials updated the case total to 41 people as of 11/4, with 6 patients requiring hospitalization. The source of the outbreak hasn’t been identified yet but as a precautionary measure, they’ve closed 14 restaurants. So far, the identified cases have been tied to five restaurants across six counties.

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Stories you May Have Missed

  • CRISPR-Cas9 Utility Broadens – researchers at Massachusetts General Hospital have improved on the utility of CRISPR-Cas9 through application via bacterial sources. The team “reports evolving a variant of SaCas9 – the Cas9 enzyme from Streptococcus aureus bacteria – that recognizes a broader range of nucleotide sequences, allowing targeting of the genomic sites previously inaccessible to CRISPR-Cas9 technology.” The new application allows a more precise targeting within the genomic sequence, which may translate to therapeutic applications. CRISPR-Cas9 has been a hot topic within the science and biodefense community in relation to its potential labeling as dual use research of concern (DURC) and certain ethical debates.
  • Unvaccinated Babies Refused By Some Physicians– Vaccination status is something I’ve grappled with working in pediatrics and is one of the rare things that can turn a calm physician (or infection preventionist for that matter) red-faced and needing a breather. The Boston Globe reported on a recent survey from the American Academy of Pediatrics that touched on pediatricians dismissing families that refused vaccines. The study found that all pediatricians surveyed had encountered at least one parent refusing vaccination for their child and 20% of pediatricians “often” or “always” dismissed families who refuse one or more vaccine. Interestingly, researchers found that “doctors in private practice, those located in the South, and those in states without philosophical exemption laws were the most likely to dismiss families refusing to vaccinate their infant”.
  • Guinea Ebola Tranmission – Guinea continues to experience new cases. As we mentioned last week, the cluster of four patients from the Kondeyah village is being monitored by public health officials. An infected newborn, whose mother died from Ebola recently, is also under observation and care. The infant’s mother was a confirmed case prior to her delivery and died after giving birth. The WHO is currently monitoring 382 contacts in Guinea during this time.

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Pandora Report 9.18.2015

by spopescu, posted in Pandora Report, Research Notes, Uncategorized

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

US Confirmation of Islamic State Chemical Weapons

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

Michigan Experiences Imported Plague Case

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

The So-Called Islamic State 2
By Greg Mercer

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

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

 

 

 

 

 

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

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

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

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

 

 

 

 

 

 

 

 

 

 

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

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

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

The Evolution of Cyber War

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

Stories You May Have Missed:

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

The Ebola Vaccine and the Ethics of Drug Trials

by juliadhomstad, posted in News

By Greg Mercer

The World Health Organization recently announced that a trial of the VSV-EBOV Ebola virus vaccine in Guinea has been “highly effective,” and that randomization in the trial would be stopped to allow for expansion of the range of subjects and protection of more people against the virus.  The trial began in March, and until recently, randomized subjects so that some received the vaccine immediately, while others received it later, after the virus’ gestation period.

A paper published in The Lancet details the study, and finds that the vaccine is highly effective and likely safe to use in the affected population.  The “recombinant, replication-competent vesicular stomatitis virus-based” vaccine is administered in a single dose via the deltoid muscle.  4,123 people received the vaccination immediately, while 3,528 people received the delayed vaccination (more on the study methodology in a moment). The researchers found that no subjects developed a case of Ebola after receiving the immediate or delayed vaccination, meaning that the vaccine proved 100% effective (with p=0.0036 at 95% CI).  These findings are excellent news for researchers, government officials, and those in the affected counties, and are fascinating from a scientific standpoint.

At The New Republic, Timothy Lahey, of Dartmouth, argues that these results, while promising, aren’t necessarily confirmed.  He notes that the lack of a placebo (because of the study’s particular methodology) makes it difficult to determine effectiveness, the vaccine could have failed to protect subjects from infection in a way that the study didn’t detect, and that a statistical aberration could mean that while the vaccine is not actually 100 % effective.  Regardless of whether these potential pitfalls affected the study or not, Lahey raises an important issue in drug testing for a disease like Ebola.  He is concerned that a lower standard for vaccines could mean that lower-income countries might not receive drugs of the same quality as rich countries, and points to past failed vaccines to illustrate the fallacy of believing that all vaccines work as intended.

The ethical dilemmas of drug testing have been front and center in the Ebola crisis.  Back in November, 2014, Nature reported on public health officials weighing the question of whether to use control groups when testing treatments for a disease with 70% mortality.  At the time, some advocated for applying experimental treatments (like the ZMapp antiviral cocktail, which had been used in patients but whose effectiveness was not entirely determined) to all patients, while others argued that these treatments might not be more effective than standard care, and that randomized trials guard against harmful side effects and provide a clearer picture of a drug’s effectiveness.

The VSV-EBOV vaccine was tested in the “ring” method that was previously used in the eradication of Smallpox.  This method eschews the double-blind placebo treatments commonly associated with drug trials.  Instead, this method creates a “ring” around new cases.  Contacts and contacts of contacts were identified by Guinea’s tracking system, and eligible adults were entered into randomization blocks, and received either the immediate or delayed vaccination.  This way, all of the subjects received the treatment, but in varying circumstances to establish effectiveness.  The full study is available via The Lancet.

Ethical drug testing is a crucial consideration, and has an imperfect past.  The National Institutes of Health’s own ethics guide cites a study that led to the United States’ ethics rules: a study that withheld syphilis treatment from 400 African-American men.  And for many, there’s good reason to be concerned about the actions of international organizations and multinational corporations.  In 1996, Pfizer conducted a study of an experimental drug on children with meningitis in Nigeria. While Pfizer maintained that the study was philanthropic, allegations arose from Nigerians and international organizations that children and parents were not informed that they were part of a study, and that Pfizer withheld treatment without consent or administered dangerous drugs.  The incident spawned a series of lawsuits and a panel of Nigerian medial experts condemned Pfizer’s actions in 2006, as reported by The Washington Post.

Epidemics and drug testing present a multitude of practical and ethical concerns, but careful consideration of the issues and sound methodology can, as they did in Guinea, produce exciting scientific and humanitarian results.

Image Credit: Psychonaught

Pandora Report 7.26.15

by juliadhomstad, posted in Pandora Report

Mason students are working through their summer courses and I’m happy to say mine is OVER! Let the summer begin (two months late)! This week we’ve got great news about Polio in Nigeria and a somber anniversary in Japan. We’ve also got other stories you may have missed.

Enjoy the rest of your weekend and have a great week!

A-Bomb Victims Remembered in Potsdam, Where Truman Ordered Nuclear Strikes

Coming up on the 70th anniversary of the atomic bombs being dropped on Hiroshima and Nagasaki, German and Japanese citizens in the city of Potsdam held a remembrance ceremony for both the victims that died in the blast and the future. Japan has become, according to the former President of the International Court of Justice, the world’s conscience against nuclear weapons and power. Why? Japan is “the only country in the world to have been the victim of both military and civilian nuclear energy, having experienced the crazy danger of the atom, both in its military applications, destruction of life and its beneficial civilian use, which has now turned into a nightmare with the serious incidents of Fukushima.”

Japan Times—“The Potsdam Conference was held between July 17 and Aug. 2 in 1945. The United States dropped an atomic bomb on Hiroshima on Aug. 6 and another bomb on Nagasaki three days later. On Aug. 15 that year, Emperor Hirohito announced to the nation that Japan had accepted the Potsdam Declaration, in which the United States, Britain and China demanded the nation’s unconditional surrender.”

Nigeria Beats Polio

Very, very, very exciting news: Nigeria has not had a case of polio in a year. A year! This makes Nigeria polio free and the last country in Africa to eliminate the disease. The achievement was possible with contributions from the Nigerian government (where elimination of the disease was a point of “national pride”), UNICEF, the WHO, the CDC, the Bill and Melinda Gates Foundation, Rotary International, and other organizations. With Nigeria’s accomplishment, there are only two other countries in the world where polio still exists—Afghanistan and Pakistan.

Voice of America—“Carol Pandek heads Rotary International’s polio program. She told VOA via Skype that a year being polio-free is a milestone for Nigeria, but noted that it is not over. “Now they need to continue to do high quality immunization campaigns for the next several years,” she said, as well as have a strong surveillance system so, should there be any new cases, they can be identified as soon as possible.”

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Image Credit: Fg2

Pandora Report 12.21.14

by juliadhomstad, posted in Pandora Report

The winter holidays are here and with them comes the final 2014 news roundup. This week we look at superspreaders, dengue fever, and, of course, Ebola.

There will be no roundup next week as I will be spending time with family and friends. I hope all of you have the opportunity to do the same and are surrounded by those you love during this time of year. It has been a privilege and a pleasure serving as the Managing Editor of the Pandora Report since March. I hope you have enjoyed reading it as much as I’ve enjoyed writing it.

I hope to see you right back here again in 2015!

The 20% Who Spread Most Disease

How did Typhoid Mary spread the disease to dozens of people but never get sick herself?

Researchers at Stanford University are looking into the science behind “superspreaders”—the idea that some people spread more disease than others. Recent experiments have suggested that the body’s immune response might play a role in helping to spread pathogens to others, however, it isn’t clear if the immune system of the superspreader or their behavior plays a bigger role in the passage of disease.

The Wall Street Journal—“‘It’s telling us that these superspreaders…are tolerant of high levels of the pathogen and any little disturbance and added inflammation that this antibiotic treatment did to them,” said Dr. Monack. “I wouldn’t say they have stronger immune systems. I would say it’s in a state that protected them from this added disturbance in the gut.’”

Dengue Fever Vaccine on the Cards After Novel Antibody Discovery

Over the past 50 years cases of dengue fever have soared—nearly 100 million per year. Normally the infection causes a fever which lasts about a week, but some develop hemorrhagic fever which kills about 22,000 a year. Gavin Screaton at the Imperial College in London warns “it’s likely that without a vaccine this disease is not going to be controlled.” That’s why a discovery of a new antibody brings hope that vaccine development may be closer than we thought.

The Guardian—“The researchers spotted the new group of antibodies while they were studying blood drawn from patients who picked up dengue infections in south-east Asia.

They found that about a third of the immune reaction launched by each patient came from a new class of antibodies. Instead of latching on to a single protein on the virus surface – as usually happens – the new group of antibodies latches on to a molecular bridge that joins two virus proteins together.”

This Week in Ebola

It’s been a hard year in West Africa with the worst Ebola outbreak in history still ongoing. In Sierra Leone, the country with the most cases, treatment centers are overflowing with patients. The President has announced that Christmas has been cancelled as news came that the most senior doctor—Victor Willoughby—died. Dr. Willoughby was the 11th of Sierra Leone’s 120 doctors to die from the virus. For the lucky ones who survive, they must cope with after effects including blindness and joint pain. And don’t forget the stigma—a heart breaking article in the New York Times describes the plight of Ebola orphans who aren’t taken in for fear that they are ticking disease time bombs. Cuban doctors are some of the most active on the front lines, but news this week came that the U.S. embargo has delayed payment of those doctors. There are glimmers of hope though, as the U.N. Economic Commission for Africa urged debt cancellation for Ebola affected West African countries and experimental serum therapy treatment made from the blood of recovered patients arrived in Liberia.

Stateside, a child flying though O’Hare Airport in Chicago was quarantined when a high fever was discovered after screening. Johns Hopkins University was chosen as one of the winners in a global competition to create an improved protection suit for those fighting Ebola on the front lines. Lastly, an American doctor—Richard Sacra—who was infected with Ebola in Liberia and returned to the U.S. for treatment, has said that he will return to Liberia in January to continue fighting the outbreak.

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Image Credit: Free Images

Pandora Report 9.27.14

by juliadhomstad, posted in Pandora Report

This week the round up includes concern of growing antibiotic resistance, MERS CoV transmission, and of course, an Ebola update.

Have a great weekend (and don’t forget to get your flu shot)!

White House Orders Plan for Antibiotic Resistance

On Thursday, President Obama signed an executive order to form a government task force and presidential advisory council to address antibiotic-resistant germs. The order calls for new regulations of antibiotic use in hospitals and urges the development of new antibiotics. Scientists at MIT are looking at creating a new class of antibiotic that targets and destroys resistance genes within bacteria.

WTOP—“According to the Centers for Disease Control and Prevention, antibiotic-resistant infections are linked to 23,000 deaths and 2 million illnesses in the United States annually. The impact to the U.S. economy is as high as $20 billion, the White House said, or more, if you count lost productivity from those who are sickened. And the problem is worsening.”

Camels are Primary Source of MERS-CoV Transmission 

A study designed by scientists from Colorado State University and NIH’s National Institute of Allergy and Infectious Disease has transmitted a strain of MERS CoV from human patient to camels. The camels developed a respiratory infection and showed high levels of virus in nasal secretions for up to a week after the infection. Though the camels recovered quickly, the nasal secretions could be the source of transmission to people who handle these animals.

Business Standard—“The researchers theorized that vaccinating camels could reduce the risk of MERS-CoV transmission to people and other camels; NIAID and others are supporting research to develop candidate vaccines for potential use in people and camels.”

This Week in Ebola

This week, the CDC estimated that there could be 500,000 to 1.4 million cases of Ebola by January if the outbreak continues unchecked. Meanwhile, a professor teaching at Delaware State University is telling Liberians that the U.S. Department of Defense, among others, has manufactured Ebola and warns them that doctors are not actually trying to treat them. Claims like this make it even more difficult for those on the ground to relay accurate information about the virus. However, a reverend in Monrovia is working to spread awareness of proper hand washing and social distancing within his congregation and alumni from a State Department funded exchange program help to spread news of the virus throughout neighborhoods. Unsurprisingly, the Ebola outbreak has essentially crippled the fragile Liberian health system which means people are dying from routine medical problems.

Stories You May Have Missed

 

Image Credit: Wikimedia

Pandora Report 8.17.14

by juliadhomstad, posted in Pandora Report

Another 12 hours at Dulles Airport on Friday and, fortunately, no new travel alerts. This week we look at TB detecting rats, an experimental Chikungunya vaccine, and the latest from West Africa.

Giant Rats Trained to Sniff Out Tuberculosis in Africa

APOPO, the Belgian nonprofit organization known for using rats to sniff out land mines, has been training the African giant pouched rat to detect tuberculosis since 2008 in Tanzania and 2013 in Mozambique. The trained rats are used in medical centers in Dar es Salaam and Maputo to double check potential TB samples. The rats are unable to differentiate between standard and drug-resistant strains of the disease however, the cost of training and maintenance of the rats is significantly cheaper than the new GeneXpert rapid diagnostic tests.

National Geographic—“‘What the rats are trained to do is associate the smell of TB with a reward, so it’s what they call operative conditioning,’ [Emilio] Valverde [manager of the APOPO Mozambique TM Program] said.

It is the same principle applied to detecting land mines, only the rats are trained to recognize the scent of specific molecules that reflect the presence of the tuberculosis germ—not the explosive vapor associated with land mines.”

Experimental Chikungunya Vaccine Shows Promise

Chikungunya, of course, is one of the diseases included in the CDC’s travel alerts, and this week we learned of a promising vaccine for the disease that causes fever and intensely painful and severe arthritis. After the vaccine’s first human trials, the next step is to test in more people and more age groups, including populations where the virus is endemic. The trial leader said that it could be more than five years before a finished vaccine could be offered to the public.

CBS News—“‘This vaccine was safe and well-tolerated, and we believe that this vaccine makes a type of antibody that is effective against chikungunya,’ said trial leader Dr. Julie Ledgerwood, chief of the clinical trials program at the U.S. National Institute of Allergy and Infectious Diseases.”

WHO: Ebola Outbreak Vastly Underestimated

The news from West Africa seems to be getting worse and worse. Earlier in the week there was good news when a new quarantine center opened in Liberia. Then two days later, that same center was destroyed and looted. All of this comes, too, when the World Health Organization has said there is evidence that numbers of cases and deaths are far lower than the actual numbers and MSF has said that the outbreak will take at least six months to get under control.

Al Jazeera—“‘Staff at the outbreak sites see evidence that the numbers of reported cases and deaths vastly underestimate the magnitude of the outbreak,’ the organization said.

‘WHO is coordinating a massive scaling up of the international response, marshaling support from individual countries, disease control agencies, agencies within the United Nations system, and others.’”

Image Credit: James Pursey, APOPO

Measles making a comeback through unvaccinated individuals

by juliadhomstad, posted in News

By Chris Healey

Unvaccinated individuals are promoting the spread of measles in the United States.

In a public statement on February 21, health officials said seven of fifteen confirmed measles cases in a 2014 California outbreak were reported in individuals who never received a measles vaccine. Health officials have not determined the vaccination status of 6 cases in the outbreak but it is known that in two cases the patients received the vaccine. Over 39,000 cases of measles were reported in California before the measles vaccine was licensed in 1963. In 2005, a record low of four cases were reported.

This outbreak in California is part of a measles resurgence facilitated by rising numbers of unvaccinated individuals. Similar measles trends have been reported across the U.S. According to the CDC, the average number of U.S. measles cases from 2001 to 2010 was 69.  In 2013, there were 189 cases.

Measles vaccines are delivered in one of two products produced by Merck– M-M-R II and ProQuad. Both are live-attenuated vaccines, which uses viruses incapable of replication as the pharmacologically-active ingredient. Health experts consider live-attenuated vaccines the most effective of all vaccine types. The measles vaccine schedule recommended by the CDC is 99% effective in conferring immunity.

Vaccination of children after measles vaccine licensure was credited with the elimination of measles in the U.S. in 2000. Measles occurs in the U.S. when individuals are exposed abroad and return to the country.  Health officials said three cases in the California outbreak recently traveled to the Philippines. Two traveled to India. Other cases had contact with individuals who traveled abroad.

A growing number of individuals are choosing not to vaccinate their children. Vaccination avoidance has been fueled by unsubstantiated claims of vaccines causing autism in children. The CDC maintains there is no evidence to support a relationship between vaccination and autism. In fact, a recent study published in The Journal of Pediatrics showed no causal link between vaccination and autism.

The CDC’s website states symptoms of measles include fever, cough, inflammation of the mucous membrane, conjunctivitis and a characteristic maculopapular rash. Symptomatic individuals have a chance of developing acute encephalitis and subacute sclerosing panencephalitis, or SSPE, a degenerative disease of the central nervous system. SSPE causes seizures, behavioral problems and intellectual deterioration.

Measles has a fatality rate ranging from one to three deaths for every 1000 cases in the U.S.

Unvaccinated individuals should consult their doctor about receiving a measles vaccine.

 

Photo Credit: CDC/ Amanda Mills