Pandora Report 11.4.2016

Happy Friday! We’ve got some great news – you can now watch our book launch and panel from the Biological Threats in the 21 Century event via YouTube here. Whether you missed out on attending or want a recap, you can get all the biodefense goodies there. UNMC was recently awarded $19.8 million to build an Ebola and advanced infectious disease training center. Their new center will include a training, simulation, and quarantine section, with the hope of training healthcare workers to treat patients with Ebola and other highly infectious diseases. A recent study found that limited access to Ebola diagnostic and supportive pathology assays facilitated the failure of initial 2014 outbreak control efforts, regardless if the setting was a resource-rich or resource-poor location.  Shocking news – hand hygiene is one of the biggest issues in norovirus infections.

3rd Annual Summit on Global Food Security and Health 
GMU’s Schar School of Policy and Government will be hosting this informational event on Wednesday, November 16th from 10:30am-5:30pm. Speakers include experts from organizations such as the Association of Public Land Grant UniversitiesBread for the World, the International Medical Corps and the US Agency for International Development: Academics will discuss their research on Food Security with an eye to improving access, addressing challenges and developing partnerships to improve global food security and related health outcomes. Organized with the support of the Center for Strategic and International StudiesThe Farm Journal FoundationThe Global Harvest Initiative, Policy Studies OrganizationWorld Medical & Health Policyjournal; Center for the Study of International Medical Policies and Practices (CSIMPP) in the Schar School of Policy and Government at George MasonUniversity; American Public University; and World Food Policy. The conference is free and open to the public, but registration is required. Contact Professor Bonnie Stabile bstabile@gmu.edu with any questions.

FDA Manipulation of Media
A new report from the Scientific American is drawing attention to the FDA’s arm-twisting of journalists “into relinquishing their reportorial independence”. Their investigators found that NPR and a series of other news outlets had a deal with the FDA-  get news announcements early but the FDA would dictate whom their reporters could and couldn’t interview. “This kind of deal offered by the FDA—known as a close-hold embargo—is an increasingly important tool used by scientific and government agencies to control the behavior of the science press. Or so it seems. It is impossible to tell for sure because it is happening almost entirely behind the scenes. We only know about the FDA deal because of a wayward sentence inserted by an editor at the New York Times.” The Scientific American was able to obtain supportive documents via the Freedom of Information Act, which revealed that despite their public demeanor, the FDA denies many reporters access and grows their own group of journalists that will follow their rules. Much of this is held together with the journalistic practice of embargo – a deal between source and journalist that the story won’t be published prior to a specific date/time. This is actually pretty common in the science world, but it can actually create an aura of favoritism and bias. The issue with the FDA situation is far deeper though – aside from getting early access to stories and agreeing not to publish before the agreed date/time (embargo), the other rules stated that journalists could not seek outside comment and in a nutshell, had to give up the ability to do independent reporting. In the end, this kind of control of the media and journalistic favoritism reveals things about both sides of the agreement, but also emphasizes the need for transparency and re-thinking of the embargo system.

BWC 8th Review Conference sheet-1
The eighth RevCon is fast approaching and if you’re behind as to what’s happened since the last RevCon, check out UNLOG’s (The United Nation’s Office at Geneva) Think Zone and the latest information. You’ll also find some great articles from GMU’s Biodefense faculty in there – like Dr. Koblentz’s article on dual-use and Dr. Sonia Ben Ouagrham-Gormley’s article on gene drive. Better yet, check out the BWC RevCon Series from the International Law and Policy Institute. These three papers discuss a series of issues related to the BWC and RevCon. The first, Divide and Delegate: the Future of the BWC, focuses on the pursuit of BWC aims outside RevCons and the normative strengths and operational weaknesses. LPI2, Keeping Up With the Science, looks to support enhanced science and technology review processes. LPI3, is a joint effort by GMU’s very own Biodefense Director, Gregory Koblentz, and the author of your favorite new book (Biological Threats in the 21st Century), Filippa Lentzos. The third paper, Risks, Trade-Offs & Responsible Science , looks at the security trade-off risks of the increasing volume of labs and scientists working on dangerous pathogens. They note that “the 2016 BWC Review Conference must encourage states to implement stringent national biosafety, biosecurity and dual-use research regulations; task the science advisory group to develop clear, internationally- recognized guidelines governing dual-use research of concern (DURC); establish a working group to revise the CBMs; and encourage states to participate in the CBM mechanism as well as more interactive information exchanges such as peer review and compliance assessment.”

RevCon will take place from November 7-25th in the Palais des Nations and a general agenda is available here. Gabrielle Tarini writes that this RevCon will be a “pivotal opportunity for countries to take action to ensure that the treaty remains a relevant and useful tool for preventing the development, spread, and use of biological weapons. A failure by member states to invest the necessary attention, time, and political capital in the conference could mean decreased interest and weakened multilateral engagement in a treaty that was the first to ban an entire category of weapons of mass destruction.” Moreover, the BWC should have a dedicated process, like that of the CWC, to inform and advise member states, pointing to the need for a great capacity to have expert-led meetings and continuous monitoring. Lastly, Tarini highlights that this RevCon will be an opportunity to strengthen and revise the intersessional process and framework. “The treaty should be restructured, with a stronger steering body and increased time for preparation and multilateral engagement. Adding more meetings, and limiting what gets discussed at each of those meetings, would allow the BWC to begin operating more like an international organization and would provide oversight equivalent to that for other nonproliferation treaties.” Can everyone help verify the BWC? Some are saying open source monitoring may just be that sweet spot.

Increasing Transparency in Biodefense: A 2016 Visit to a German Military Medical Biodefense Facility  screen-shot-2014-09-22-at-21-57-41
Filippa Lentzos is taking us on a journey through German biodefense practices and why transparency is so vital for these programs. Citing Germany as a prime example of countries going above and beyond their voluntary BWC efforts, she delves into the world of Germany’s biodefense activities. She notes the visitors were highly encouraged to review Germany’s most recent CBM submission and briefed on the Institute of Microbiology’s safety and health regulations. “Few restrictions were placed on us other than those related to safety and security. We were free to view rooms, lab equipment and installations. The type and scope of access was to be determined by Institute staff on a case-by-case basis. Any access denials could derive from national security, biosafety and health regulations, data privacy issues, unpublished scientific results or ongoing lab work. If access or certain information was refused, the Institute would explain the particular considerations and o er alternatives.” The Bundeswehr institute focuses on three main CBRN tasks – ensuring protection and an ability of the armed forces to act under CBRN threats, preventing vulnerability to potential CBRN threats and weapons via preventative measures, and limiting the consequences should a CBRN event ever occur. The medical biodefense responsibilities focus more on the ability to rapidly diagnose and identify pathogens, distinguishing natural outbreaks from intentional, and controlling outbreaks. The official noted on their visit that within the institute, there are 65 staff and 18 externally funded fixed-term positions over three departments (bacteria/toxins, viruses/intracellular pathogens, and medical biological reconnaissance and bioforensics). From genome sequencers to electron microscope rooms, check out Filippa’s report for a virtual tour of this amazing biodefense facility.

Assessing the Epidemic Potential of RNA and DNA Viruses  screen-shot-2016-11-02-at-7-19-56-am
Researchers from the University of Edinburgh are looking at zoonotic viruses and their transmissibility. The Ebola outbreak in 2014 highlighted the needed to better understand what kinds of pathogens, especially zoonotic, were likely to emerge as potential epidemics. Given the vast diversity and high rates of viral evolution, this was no easy task. “Of human transmissible virus, 37 species have so far been restricted to self-limiting outbreaks. These viruses are priorities for surveillance because relatively minor changes in their epidemiologies can potentially lead to major changes in the threat they pose to public health.” Researchers used the basic reproductive number, R0, as a means of answering this question. They looked at hundreds of viral species and then categorized them into 4 levels with epidemic potential in humans. They found that the taxonomic diversity is wide, but bounded and most human infective viruses are closely related to viruses of other mammals. Transmissibility within the human population is a key determinant, as well as the R0 threshold of>1. “We currently have few clues to help us predict which mammalian or avian viruses might pose a threat to humans and, especially, which might be transmissible between humans. One argument in favor of experimental studies of these traits, including controversial gain of function experiments, is that they could help guide molecular surveillance for high-risk virus lineages in nonhuman reservoirs.The first line of defense against emerging viruses is effective surveillance. A better understanding of which kinds of viruses in which circumstances pose the greatest risk to human health would enable evidence-based targeting of surveillance efforts, which would reduce costs and increase probable effectiveness of this endeavor.”

Spikes in C-diff and MDRO’s 
Halloween may be over but the rise of the resistant bugs is still going on. A recent study looked at the changing epidemiology of MDRO’s (multi-drug resistant organisms) within a specific healthcare network. While they were able to observe a significant reduction in MRSA, there was a sharp rise in other MDRO’s and C-diff (Clostridium difficile). Examining eight years of data from a Utah-based health network, researchers looked at 22 hospitals clinics to establish trends in C-diff and other MDRO’s. Of the 900,000 patient admissions, 1.4% tested positive for an MDRO and/or C-diff. MRSA was by far the most common MDRO (51% of MDRO infections) but they did see a 32% decrease in MRSA infections over the eight years. “Researchers, however, observed a 222% increase in C difficile and a 322% increase in ESBL-positive bacteria. The data also showed that 70% of all MDROs and C difficile cases originated from an ambulatory setting.” There has also been a significant rise in ESBL’s, which points to a need to refine and revise screening protocols. Overall, this points to the complexity and ever-changing habits of infection prevention and control.

Zika Updates
A recent study is showing that Zika infections have caused reduced fertility and low testosterone in male mice. The ECDC has updated their Zika epidemic rapid risk assessment, noting that “although continuing, vector-borne transmission seems to be slowing down in Central American countries and the Caribbean. The outbreak continues to evolve in Mexico and the southern part of the US, as weather conditions still favour seasonal vector activity. In addition to the Americas, cases have been reported in some Asian countries.” Researchers are working to use the Wolbachia bacteria (which naturally infect several mosquito species) against diseases like Zika and dengue. Overcoming the hurdle of infecting Aedes (a species not naturally infected with Wolbachia), they found that the bacteria was able to survive in the mosquito and then was a passed down through generations…but the best news is that those mosquitoes infected with Wolbachia weren’t able to pass dengue. When the Wolbachia-infected mosquitoes were infected with dengue, the virus couldn’t replicate and spread in the mosquito’s salivary glands (i.e. couldn’t be transmitted). This new technique shows some pretty remarkable abilities to reduce the capabilities of Aedes species to spread diseases like Zika, chikungunya, and yellow fever. The CDC has reported, as  of November 2nd, 4,128 cases in the U.S.  Interestingly 53 people in Minnesota have been found to be infected.

Stories You May Have Missed: 

  • Pandemic Simulations – The Ebola outbreak in 2014/2015 taught us a great many lessons regarding international preparedness and response to infectious disease outbreaks. As a result of this, the World Bank Group and the Bill and Melinda Gates Foundation is starting a new project to conduct the first set of pandemic simulation exercises. “President Jim Yong Kim, Bill Gates and Chancellor Angela Merkel of Germany will jointly host simulation exercises on pandemic preparedness for the Heads of State and private sector leaders during the next World Economic Forum in Davos in January 2017 and the G-20 Heads of State meeting in July 2017.  In preparation for the two major events, the World Bank will collaborate with the technical team from WHO, WEF and the German government to conduct similar exercises for G20 technical staff and and G20 Ministers of Health. Simulation exercises help make a theoretical possibility real, by allowing policymakers to role-play and map out gaps and concrete solutions to those gaps along with their peers.”
  • New Genetic Mutations in Antibiotic BW Agent– Researchers at Lawerence Livermore National Laboratory (LLNL) recently found a new genetic mutation in antibiotic-resistant tularemia (Francisella tularensis). Tularemia is a Category A Select Agent, which means it is a prime concern for bioterrorism and public safety. “This perspective allows you to see mutations that are new that we didn’t know about. If you don’t do this type of study, you’re going to miss other mechanisms that cause resistance in the bacteria. So by doing a genome-wide study, it gives you a much more complete picture about what’s going on,” said LLNL biologist and lead author Crystal Jaing. “The study found resistance-conferring mutations in a hypothetical protein, an asparagine synthase, and a sugar transamine/perosamine synthetase in addition to observing known variants.”

Pandora Report 10.28.2016

A leaked report to the UN Security Council from the Organization for the Prohibition of Chemical Weapons, states that Syrian President Bashar al-Assad gave the order for the use of chemical weapons in 2015. The ECDC is seeing the initial cases for the 2015/2016 flu season, so make sure to get your flu shot! Science is sharing six science lessons for the next president. A new study finds that the correct antibiotics are only given half the time for common infections. Make sure to celebrate One Health Day on November 3rd!

Spillover: Ebola & Beyond Film Screening and Discussion
Don’t miss this great event at the National Museum of Natural History on Tuesday, November 15th from 6:30-8:30pm. If you loved the PBS documentary this summer, now is your chance to listen to a panel of experts discuss how they track diseases internationally and locally. “The film extends to the new frontiers of disease detection, prevention, and containment, and travels the world with virus hunters who are tracking old enemies while vigilantly looking out for new foes.” Featured speakers will include Vanessa van der Linden, Anthony Fauci, Yvonne-Marie Linton, and LaQuandra S. Nesbitt. Make sure to register before the event if you’d like to attend.

iow-zoonoses-onpgIf you enjoyed the Spillover documentary, check out this one (from the same team at the Howard Hughes Medical Institute who brought you Spillover) on Nipah virus hunters and their use of bat populations to track the disease. It’s a great film on epidemiology, One Health, and how we can study diseases in bat populations to predict outbreaks in humans. The HHMI has all sorts of wonderful disease-tracking goodies, like this one on the patterns of zoonotic diseases or an interactive on viruses. HHMI has some great interactive and fascinating learning tools for adults and children alike. Nothing like a little zoonotic disease lesson before bedtime, right?

MetaBiota Presentation for GMU Students 14875059_1343053735705798_1059784359_n
This week GMU was fortunate to hold an informational session by MetaBiota in which Dr. Kimberly Dodd discussed the organization and what life is like working on shifting emerging infectious disease response to prevention. GMU Biodefense MS student Greg Mercer was able to  listen to her experiences that range from the front lines of virus chasing to work on PREDICT and the factors that lead to zoonotic spillover. Dr. Dodd deployed to Uganda as part of the CDC’s response to the 2012 Marburg virus outbreak and to Sierra Leone during the West African Ebola outbreak. She described the challenges of trying to set up a BSL-4 equivalent laboratory in the field and the stressed of working with dangerous pathogens and noted that even in an outbreak of a high fear-factor disease like Ebola, there is often an international outpouring of volunteers. Experts are enthusiastic to help both for humanitarian reasons and the promise of cutting edge research to be done. Her experiences responding to outbreaks in the field prompted her interest in what preventative measures can be taken to forecast, identify, and mitigate outbreaks faster. She described her work on USAID’s PREDICT project, which seeks to catalogue viruses with potential to become pandemics. In its first 5 years, PREDICT sampled 56,000 animals, ran 400,000 diagnostics, and detected 984 unique viruses, 815 of which were novel. This new data was fed into Healthmap. In later pahses, PREDICT will go on to more closely examine the human-animal dynamics of spillover events.

Fears and Misperceptions of the Ebola Response System during 2014/2015 Outbreak in Sierra Leone
We’re still learning lessons from the worst Ebola outbreak in history, but will we actually apply this knowledge or continue to make the same mistakes? Public perception of public health response systems is a vastly important aspect of any outbreak response, however researchers are pointing to the severity it had on containment in 2014/2015. This study focuses on Sierra Leone and the barriers that prevented people from trusting and utilizing the Ebola response system that was established during the height of the outbreak. Researchers found that most people feared calling the national hotline for some one they believed to have Ebola as it would result in that person’s death. People tended to self medicate if they developed a fever and assumed it was not Ebola. “Fears and misperceptions, related to lack of trust in the response system, may have delayed care-seeking during the Ebola outbreak in Sierra Leone. Protocols for future outbreak responses should incorporate dynamic, qualitative research to understand and address people’s perception”

Estimating the BioTech Sector’s Contribution to the U.S. Economy screen-shot-2016-10-26-at-2-44-22-am
While the biotech sector has opened the floor for questions over dual-use, there’s no denying its growth. U.S. biotech sector revenue is estimated to have grown on average more than 10% per year over the past decade, which is faster than the rest of the economy..much faster. Data collected from various public and private sources allowed Robert Carlson to pain a much larger picture of what biotech is contributing to the U.S. economy. He found that total domestic U.S. revenue generated by biotech in 2012 reached at least $324 billion, which is the equivalent of >2% of GDP. Biotech revenue growth was >5% of annual U.S. GDP growth every year between 2007 and 2012. While the field is obviously growing, the rapid acceleration also means that there will be decreasing costs and more access to more powerful technology. “Governments around the globe are grappling with the desire to benefit from biotech-driven economic development, while simultaneously facing questions about who should have access to which technology and under what circumstances.” It’s important to not only support and monitor the technologies, but also facilitate data and reporting within the industry as these measurement deficiencies fuels biosecurity concerns. “Alongside the preexisting bioeconomy, we are building a system composed of inherently ‘dual-use’ engineering technologies that will constitute critical infrastructure for the future economy. Assuming that the revenue and growth estimates above are borne out with improved measurement and analysis, biosecurity is now clearly synonymous with economic security. The focus of biosecurity policy must shift from protecting specific targets from specific threats to securing the bioeconomy as a system that increasingly drives economic growth and employment and, ultimately, enables humans to thrive on a global scale.”

Hospitals Add Sinks to Help Fight Infections – Bad Move
Adding more easily accessible hand washing stations is one of the strategies to combating poor compliance and growing infection rates. Unfortunately, there have been some unintended consequences of upping the sink volume. Several hospitals throughout Baltimore, the Netherlands, and Shanghai have noted an increase in infections after adding more sinks (especially in patient rooms). Biofilms were a growing issue, which draws attention to the importance of facility and environmental service maintenance. I was a bit disparaged to see that the article points to the presence of non-sterile water from sinks in rooms with immunocompromised patients. Patients that are severely neutropenic are usually placed into positive pressure rooms (under protective precautions) and almost all hem-oncology units have special water filters on everything in the patient’s room (shower, sink, etc.). The concern for legionella is always an issue for those with weakened immune systems and while it’s important to cut down as much environmental exposure as possible, it’s impractical to think there should be sterile water. Another aspect of this is that patients in pre-op immune-suppression or post-op recovery will be exposed to germs – it’s a simple fact. If you’re concerned about sinks, then the patient should either be in a protective precautions room or you should not allow visitors. A sink is a small piece of the puzzle when it comes to patients that aren’t severely neutropenic. Sink design and cleaning is hugely important, which is another component to hospital infection control as anytime water is temporarily shut off, there needs to be water treatment plans in place, etc. It’s nice to see attention being brought to the environmental aspects of sinks and infection control, however one big aspect of the problem is also that people typically don’t wash their hands correctly. Yes, most people don’t spend the 15-20 seconds correctly lathering, washing all the nooks and crannies of their hands, etc. Needless to say, it takes a village to stop an infection and just one tiny moment to cause one – sinks are just one piece of the pie.

Terrorists Hamper Polio Eradication Efforts in Africa salk_headlines
Global eradication of a disease is never easy, however efforts to rid Africa of polio have encountered barriers that are allowing the disease to resurge. Nigeria has seen lingering polio as a result of “porous borders and shifting populations where travel has been blocked by terrorism.” Despite consistent work and effort to eradicate the disease from Nigeria, it was re-declared endemic in August, which leaves many concerned about it spilling over borders into neighboring countries. While Nigeria has always been a hotspot for polio, there has been increasing religious preaching that parents should not allow vaccination, specifically Muslim imams in Kano state in 2003, claiming that the vaccine had been contaminated to hurt Islamic children. Distrust compounds into lagging vaccination rates and during this time there was a spike in cases, which was coupled with terrorist activity by the Book Haram militia. “They cut off entire provinces, blocking the access needed by teams vaccinating children and epidemiologists counting cases. When the Nigerian military forced the militia out of parts of Borno state, in Nigeria’s northeast corner, the polio campaign discovered that wild polio virus had been circulating there for years.” The area around Lake Chad – Chad, Cameroon, and Niger – all pose problematic for vaccination efforts as the WHO calls the situation a “complex emergency” with more than 150,000 people fleeing across national borders. Despite these challenges, the governments of Nigeria and five nearby countries have initiated a massive emergency vaccination campaign that covers more than five million children per round, of which they’ll perform six rounds. “That may be an even more difficult task than in Afghanistan or Pakistan. In those countries, most of the areas where polio survives are remote, with little traffic in or out. Nigeria, on the other hand, is the most populous country in Africa, and a crossroads for the rest of the continent. There is no quick fix that can make the risk of onward spread go away; it requires yet more of the hard, grinding, repetitive work that eradication campaigners have been doing for almost 30 years.”

Zika Virus – What’s the Latest?
Brits are being warned not to travel to Florida after two British journalists contracted Zika during their travel to the state. The Florida state health department has released their Zika data– there are four new travel associated cases and nine non-travel associated cases. Wellcome Trust medical research charity is warning that we should expect Zika to reach India and Africa. “I think we can anticipate global spread,” said Jeremy Farrar, speaking to the Guardian alongside Sue Desmond-Hellmann, the chief executive officer of the Bill and Melinda Gates Foundation. “Given the [Aedes aegypti] mosquito’s availability across the world, I think the spread will next be across Asia and I think we really have to be prepared for it spreading in Africa. I don’t see any reason why it wouldn’t.” The WHO has released their Zika Research Agenda here, with a goal of “supporting the generation of evidence needed to strengthen essential public health guidance and actions to prevent and limit the impact of Zika virus and its complications”. Scientists are still bewildered by Zika’s path through Latin America as cases continue to grow. The CDC has reported 4,091 cases of Zika in the U.S. as of October 26th.

Stories You May Have Missed:

  • The Antibiotic Era Review – Infectious disease physician Amesh Adalja is discussing Dr. Scott Podolsky’s most recent book on antimicrobial resistance. As the realities of microbial resistance grows larger and gains more attention, it’s important to understand that this isn’t a solely modern issue. Dr. Adalja notes that the book should be required for anyone in the field as it takes great care to incorporate details that paint the larger picture of infectious diseases and antibiotics. “As Podolosky illustrates, in the post WWII era, civilization caused infectious diseases to recede in the US at the same time scores of new treatments (i.e. antibiotics) were coming to the market and experts who knew the (now rare) bug and the drugs used to treat them were valuable.” Adding it to our holiday reading list, thanks for the tip Dr. Adalja!
  • Climate & Evolutionary Drivers of Phase Shifts in Plague Epidemics of Colonial India – A recent study is looking at the climatic and evolutionary forces that impact plague epidemics. Researchers looked at the arrival of plague in colonial India through archival data and were able to identify the evolution of resistance in rats as a significant driver of the shifts within seasonal outbreaks. The findings “substantiate the rapid emergence of host heterogeneity and show how evolutionary responses can buffer host populations against environmentally forced disease dynamics.”
  • 2nd International Who’s Who in One Health Webinar – Don’t miss the One Health Commissions’ upcoming webinar on November 4th, 2016. This webinar is a great place to take part in dialogue with One Health leaders, advocates, professionals, and students The webinar is set to start at 7:45am EST and seeks to create new strategic partnerships and networks for collective, purposeful and coordinated action and educate participants about the One Health paradigm and ways of thinking towards improved health outcomes

Pandora Report 10.21.2016

TGIF! It looks like biodefense and genetic engineering are the new hot topics in Hollywood. Inferno will be opening in theaters next week, but it was also reported that Jennifer Lopez will be starring in a new bioterror TV drama, “C.R.I.S.P.R.“, that takes on topics like genetic assassination. That’s right, JLo will be a CDC scientist exploring “the next generation of terror”. You can get an epidemiological update on the cholera situation in the Americas here. A new Ebola vaccine will be tested by researchers in Canada next month.

Biological Threats in the 21st Century Book Launchimg_0359
Last Friday we celebrated the book launch of Biological Threats in the 21st Century. For those who attended, thank you and we hope you enjoyed it as much as we did! For those unable to attend, don’t fret – we’ll have the recording up ASAP, but in the meant time, here’s a brief recap… We were fortunate to have Dr. Koblentz MC’ing the event, with Andrew C. Weber discussing the threats we face in the 21st century and that the topic is really the orphan of the bunch as nuclear weapons tend to get all the bandwidth. Weber noted that we learned the wrong lesson from Amerithrax and need to remember that one person did it all by himself and despite a very primitive delivery mechanism, it took us eight years to find him. He emphasized the lessons learned from 9/11 and the use of imagination in regards to potential attacks, specifically that we should all challenge ourselves to think about these things and be imaginative. Filippa Lentzos, the editor of the book, took us through her journey to bring together the politics, people, and science of biological warfare. Her goal was to create a one-stop shop for issues regarding bioweapons and socio-politics. Incorporating narratives from people that are both advocates and negotiators of biological disarmament, she highlighted the importance of scientists in building the agenda and biological risk management. Perhaps one of the highlights of the event was the expert panel comprised of Jo Husbands, GMU’s Sonia Ben Ougrham-Gormley, GiGi Gronvall, and Nancy Connell. The panel took questions from the audience and each expert discussed a range of topics – the role of scientists in DURC, GoF experiments and governance efforts, talking to US and Soviet bioweapons specialists from the days of offensive programs, and the efforts to engage scientists and make them part of the solution. Overall, the event was a wonderful mixture of experts, students, and industry people who are all passionate about the world of biodefense.

How Do You Know Your Flu Shot is Working?
GMU Biodefense MS student Greg Mercer is tackling the topic of flu shot performance. Despite the challenges of antigenic drift and forecasting, there has to be a way to check how well the vaccine is performing..right? “The Centers for Disease Control and Prevention (CDC) offers a guide to how they assess flu vaccine effectiveness and efficacy in the United States. These are two slightly different measurements. Efficacy is measured with randomized controlled trials. This is a classic, high rigorous scientific setup designed to eliminate research biases. Effectiveness is measured with observational studies. These are more reflective of real world conditions, since they rely on self-identifying subjects seeking care.”

On Patrol with a Bioterror Cop
For biodefense students, Edward You is pretty much our crime-fighting role model. Supervisory special agent in the WMD directorate in the FBI’s DC headquarters, You monitors the growth of lab tech to help prevent bioterrorism. Trying to find the gaps within the detection chain is no easy feat, but You helps to improve FBI and interagency efforts to identify, assess, and respond to biological threats. What makes his approach so unique is that prior to the FBI, he worked for six years in graduate research focusing on retrovirology and human gene therapy at USC. Simply put, You knows the science, tech, and culture that make biocrimes and emerging biotechnologies worrisome. You’s background and perspective has helped shift FBI credibility within the science community after incidents like the detainment of Buffalo bio-artist, Steve Kurtz. The FBI is now helping to sponsor events like the International Genetically Engineered Machine Competition, and is helping build a network where scientists share concerns. “You is often the first to hear about scientists’ darkest worries. Lately some of these have been connected to the gene-editing method CRISPR, which can be used to create self-spreading gene alterations in insects or DNA-slashing viruses.” You notes that “a threat implies intent, and we haven’t seen that yet,” he says. “But as things become more widely available, more widely distributed, the bar gets lower, and the possibility of an incident gets higher.”

Infection Prevention & Control Week  screen-shot-2016-10-18-at-10-32-54-am
Hand hygiene, PPE, and vaccines, oh my! Infection prevention doesn’t take breaks, so this week we’re celebrating the importance of reducing the spread of infections, specifically in healthcare. The Ebola outbreak lifted back the curtain as to just how impacting minor breaches in infection control can be, but as the threat of antibiotic resistance grows, we need to invest more into this field. Here are a few things you can do to help fight the battle of the bug in healthcare – need to wear PPE? Make sure you’re donning and doffing correctly. Wash your hands! Know about infection preventionists, follow rules of isolation if visiting a sick friend (or you’re sick!), get your annual flu shot and stay up to date on vaccines, make sure to follow directions and finish antibiotics appropriately if you’re taking them, and keep your work environment clean.

Public Health: Biosecurity and the GHSA Distance Learning Opportunity 
Don’t miss out on this great opportunity for a 2-hour webinar session on Wednesday, December 7th, 2016 at 11am CST. The U.S. has taken the lead on a global campaign to fortify both public health and international security. The Public Health: Biosecurity and the Global Health Security Agenda webinar will review the nexus between public health and biosecurity, through the context of the developing Global Health Security Agenda (GHSA). We will learn how modern threat management concepts can be efficiently employed by the GHSA to augment both public health response and preparedness in the event of a natural outbreak, or from the perspective of an intentional attack. The webinar will be presented by Ryan N. Burnette, PhD, Director, International Biosecurity & Biosafety Programs, At Risk International. Upon completion of this webinar, participants will be able to:

  • Define the methods and goals of the GHSA
  • Paraphrase how threat management techniques can be applied at a macro level to augment global security in the context of epidemics and bioterrorism
  • Describe how biosecurity plays a vital role in public and global health

Gene Drives – the Good, the Bad, and the Hype
GMU Biodefense professor, Sonia Ben Ouagrham-Gormley, and Kathleen Vogel are discussing the advances in life sciences and what these new gene-editing techniques could mean for biodefense. “The absence of clear safety guidelines, coupled with ambiguous government regulations, has nurtured fears of an accidental or voluntary release of a gene drive in nature that could cause irreparable damage. On the security front, the presumed simplicity and accessibility of Crispr raise the possibility that states, terrorists, or rogue scientists might use the technology to modify genomes to develop malicious gene drives and create novel bioweapons that could spread more quickly, cheaply, and globally than traditional bioweapons agents.” Caution is always a good strategy, but Ouagrham-Gormley and Vogel emphasize the importance of approaching these new technologies with a realistic approach grounded in empirical findings, rather than the hype of a shiny new toy. Understanding gene drive and the capabilities of CRISPR are necessary to not only proceed with advancements, but also fully assess the risks versus rewards. Gene drive does have some potential benefits, especially in terms of vectors and pest-control, in trying to impact the population of disease-transmitting mosquitoes and invasive mouse species that wreak agricultural havoc. There is also potential for gene drives to aid in endangered species and environmental conservation work as “gene-drive rodent control on islands can mitigate the environmental impact of invasive species, which disrupt island ecosystems by bringing in invasive plants, or eating plants and insects essential for other species’ survival.” Like anything, there is a potential for mis-use or neglect. In the wake of any new exciting innovation, the spread of CRISPR and gene drive technology has amplified concerns over lab safety and establishing a fundamentally better understanding of the technology before such rapid innovative leaps. Concerns over adverse effects on target species and damage to non-target species is crucial and regulators are racing to keep up with this constantly evolving technology. “These two cases show that Crispr-induced alterations have outpaced and continue to defy current regulations, leaving governments around the world to play catch-up. In this context, fears that an altered organism might escape the laboratory to potentially eradicate a whole species, or unexpectedly jump into another population and cause unpredictable economic and environmental damage, do not seem far-fetched.” Lastly, from the viewpoint of a bioweapons threat, the authors note that the perceived low cost, easy availability, and self-propagating nature of gene drives make it appealing to would-be bioterrorists. There are significant technical challenges that do form substantial roadblocks, not to mention that gene drives only work with organisms that produce sexually (in other words, they’re unable to alter a virus or bacteria). “However, to accurately evaluate their potential misuse, one needs to rigorously assess the state of the technology and consider its limitations. Current fears (and hopes) related to gene drives are based on projections of what gene drives could in theory do if they spread in nature. At the moment, these are still anecdotal, speculative claims and are not based on in-depth empirical research and analysis. One needs to keep in mind that the techniques under debate are still in their infancy, and in spite of their apparent progress, they may not prove to be as dangerous or promising as expected.” In the end, it is important to identify the risks when it comes to a lack of Cas enzyme control, capabilities of potentially a state-level gene-editing technology based bioweapons program, and slow regulatory catch-up. Threat estimates are speculative and the authors point to problematic historical security assessments of emerging biotech. Overall, it’s important to have a better understating of the complex and unique factors that push state and non-state actors to develop biological weapons and in the wake of this uncertainty, the authors “are engaged in a project that aims to understand the social and technical factors for how Crispr scientists around the world actually work in the lab.”

A Threat to the U.S. Food System
Food safety is often a forgotten component of biodefense when Anthrax and Ebola tend to steal the spotlight. Sadly, this is America’s soft underbelly as a threat to U.S. food production and security could have devastating economic ramifications. While the Blue Ribbon Study Panel on Biodefense report in 2015 did mention the vulnerability of the agriculture system, it’s easy to forget just how damaging such an event could be. “The agriculture sector in the U.S. is a $1 trillion business and employs approximately 9.2 percent of American workers. In 2012, domestic animal agriculture – livestock and poultry production – generated approximately 1.8 million jobs, $346 billion in total economic output and $60 billion in household income.” Consider even a disease that impacts crops – wheat and rice account for 39% of the world’s total calorie consumption. It’s important to consider the devastation that crop or livestock attacks could have on not only the U.S. system, but also on an international level.

Zika Virus Weekly Updates
Venezuela is struggling to respond to and support cases of Zika-related microcephaly as the government refuses to acknowledge a single case. “Some doctors accuse Venezuela’s unpopular government of hiding the Zika problem amid a deep recession that has everything from flour and rice to antibiotics and chemotherapy medicines running short and spurred fierce criticism of Maduro. They also say government inaction means kids are missing out on targeted state-sponsored therapy programs that would help to stimulate them”. HHS recently announced how the Zika funds will be allocated among players.  “According to Caitlyn Miller, director of the division of discretionary programs for HHS, $394 million will go to the Centers for Disease Control and Prevention (CDC), $152 million to the National Institutes of Health (NIH), and $387 million toward the public health and social services emergency fund. Within that $387 million, $75 million will be used to reimburse healthcare providers who treat uninsured Zika patients, $40 million will be used to expand Zika resources in US territories, and $20 million will go to regional and national projects, such as creating microcephaly registries.” Public health officials have created a color-coded map of Zika zones in Florida. As of October 19th, the CDC has reported 5,016 cases of Zika in the U.S.

Stories You May Have Missed

  • EU Reports Animal Antibiotic Use Is Up– Despite a drop in overall sales, a recent report from the European Medicines Agency (EMA) has revealed the worrisome reality that there has been an increase in the use of medically important antibiotics. While there was a 2.4% drop from 2011-2014 in sales of veterinary antibiotics, there was a sharp increase in “critically important” antibiotic usage. The usage of “fluoroquinolones, macrolides, and polymyxins sold for use in food-producing animals rose significantly—14%, 13%, and 19%, respectively.” The report does note that responsible-use campaigns in some countries could be effective in countering antibiotic resistance, however the increase in usage is raising many red flags.
  • Global Civil Society Coalition for the Biological Weapons Convention – last week Kathryn Millet, on behalf of the Global Civil Society Coalition for Biological Weapons, delivered a statement to the UN General Assembly First Committee. The statement points to the importance of the BWC but also the challenges and necessity of avoiding complacency. The coalition statement emphasizes the importance of recognizing the evolving threat posed by malign use of the life sciences since the last Review Conference and the need for more systematic advice for BWC State Parties on S&T. Further recommendations include the need for States to ensure that the interval between Review Conferences is used more effectively, reexamination and improvement on dealing with compliance with the BWC, and the application of more resources to support work that is necessary to fulfill the BWC’s objectives.

Pandora Report 8.26.2016

A new report by the Organization for the Prohibition of Chemical Weapons (OPCW) is pointing to a harsh reality that despite incomplete and inaccurate Syrian disclosures, there are traces of nerve agents in their laboratories. While they promised to destroy their entire arsenal, there is a growing concern that Damascus has not followed through on commitments to destroy all of its armaments.   Feel like a biodefense arts and crafts project?  You can learn to make a plague doctor’s mask here. Chem-Bio warfare suits may be getting a fashionable upgrade as companies like Lululemon and Under Armor are competing to revolutionize the protective equipment. 

UN Security Council – Calls for Eradicating WMD’s  689139
On Tuesday, GMU Biodefense Graduate Program Director and Professor, Dr. Gregory Koblentz, briefed the UN Security Council on how terrorists could exploit advances in science and technology to acquire weapons of mass destruction. He delivered the briefing as part of a Security Council open debate on WMD nonproliferation that is part of the comprehensive review currently being conducted of Resolution 1540. You can read the summary of the meeting here, but the focus was on the evolving threat of WMD’s falling into the hands of non-state terrorists and actors. Emphasizing the threat of biological weapons, Secretary-General Ban Ki-Moon “questioned the international community’s ability to prevent or respond to a biological attack.  He also suggested giving a closer look at the nexus between emerging technologies — such as information and communication technologies, artificial intelligence, 3-D printing and synthetic biology — and weapons of mass destruction.” Dr. Koblentz (27 minutes into the broadcast of the meeting here) pointed to the Fourth Industrial Revolution as a source for huge gains in both productivity and prosperity, but also a darker potential for mis-use by non-state actors. Within his talk, Dr. Koblentz noted the five advances in science and technology that “increase the risk of CBRN weapons proliferation to non-state actors”. The advances include unmanned aerial vehicles (UAVs), 3D printing, accessibility of illicit items on the Dark Web, malicious software and cyber attacks, and genetic engineering tools like CRISPR-Cas9. While these advances reveal the diverse technology, there are also seven deadly traits within these emerging technologies – dual-use, disruptive, diffusion, reliance on a digital component, decentralization, deskilling, and the DIY (do-it-yourself) movement. Simply put, these seven characteristics make emerging technologies that much more challenging to prevent mis-use. “The international community faces a continuous challenge of encouraging innovation and maximizing the benefits of such innovation with the need to mitigate the security risks posed by these new technologies. I hope the Security Council will take advantage of the Comprehensive Review of Resolution 1540, which this open debate is an important contribution to, to update the resolution to take into account the impact of scientific discoveries and technological breakthroughs on the proliferation of weapons of mass destruction to non-state actors.” There was substantial discussion regarding the strengthening of Resolution 1540, especially to consider the implications of a biological attack in light of recent outbreaks like Ebola, MERS, and SARS.  During her remarks, Ambassador Michele J. Sison, U.S. Deputy Representative to the United Nations, described Dr. Koblentz’s briefing as, “a very interesting, but also very sobering intervention.” Hopefully, with the focus on these evolving threats, the current review of Resolution 1540 can be further strengthened and focused to reduce the risk of terrorists acquiring WMD’s.

A Tribute to D.A. Henderson
There are few times in the history of public health that we can say we’ve eradicated a disease. D.A. Henderson, smallpox guru and disease detective, led such efforts within the WHO and his absence has been felt throughout the health community. A legend among public health and biodefense students, his dedication to the field inspired generations. As an epidemiologist, his work in both infectious diseases and bioterrorism gave me hope that such a career was not only possible, but also filled with the kind of adventure that many only dreamed about. Having just read Scourge (and I would highly encourage you to read it), the dedication to the smallpox eradication efforts is still an inspiration. After conquering what many considered impossible, Henderson worked as Dean of the Johns Hopkins School of Public Health, founding director of the Johns Hopkins Center for Civilian Biodefense Strategies (now UPMC Center for Health Security), and following 9/11, led the Office of Public Health Preparedness. Described as a “Sherman tank of a human being- he simply rolled over bureaucrats who got in his way”, Henderson’s death is truly felt throughout the international community. In the wake of his death, we take a moment to truly applaud and appreciate all he’s given and inspired within global health security.

How Far Will the U.S. Luck Run?
With the anticipation and preparations for Zika having started months before it reached U.S. soil, many are wondering if our luck with infectious disease is running out. We were lucky with Ebola- a handful of cases and once we hit the panic button, we were able to overcome the crisis. Despite insufficient funds and battling diseases we had little to no experience in handling, U.S. efforts have been fortunate in their successes. Zika may be a different kind of ball game though – mosquito control efforts are flawed at best and with a disease that is often asymptomatic, we may have finally hit a wall. Did we really learn from Ebola? Have we strengthened our surveillance and response practices? Dr. Johnathan Fielding notes that “HHS must play a greater role in coordinating the global public health response through implementation of the Global Health Security Agenda, a cooperative arrangement launched in 2014 by over 50 nations, nongovernmental organizations and other stakeholders; better coordination with other government agencies, and state, local and private sector partners; and clear delineation of roles and responsibilities within and among HHS offices.” We need both the monetary and personnel support to properly address the failures from Ebola, but also implement the recommendations that so many have made following the crisis. The contingency funding that has been pushed recently is an indication of our potentially faltering luck – have we reached such an impasse in which our politics will override our disease response capacity or capabilities?

A Lot of Zika Goes a Long Ways 
Palm Beach is seeing its second case of Zika virus, with active transmission continuing in Florida. Florida Governor, Rick Scott, has expressed frustration that the promised federal support of antibody tests and lab support has not been delivered. “In a teleconference on Wednesday, Scott made a plea for more support in fighting Zika, complaining that ‘Congress and the White House have not been good partners.’ Scott said he asked the U.S. Centers for Disease Control and Prevention for 5,000 Zika antibody tests last week, but so far had only received less than 1,200.” Johns Hopkins is opening the first multidisciplinary Zika center, the Johns Hopkins Wilmer Zika Center, which is dedicated to caring for affected patients. As of August 24, the CDC has reported 2,517 cases of Zika virus in the U.S. The CDC has also awarded $6.8 million to partners to help support Zika response. “This funding will help enhance surge capacity for Zika case identification and mosquito surveillance. It will also help improve communications to key populations, by developing focused educational materials, sharing mosquito control guidance, and refining community public awareness campaigns.”

Human Mobility and Epidemics
Tracking infectious disease cases is never an easy task – whether it be an asymptomatic patient, mosquito-spread disease, or global travel, epidemiology and case tracking is not for the faint of heart. An increasingly mobile population is only adding to this difficulty. The first few days of an infection with Dengue or Zika are often so mild that many don’t even seek medical care. How many times have you had a fever and it didn’t stop you from traveling or going about your day? Disease ecologists are now looking at the impact of a fever on human mobility and the shock this may have during an outbreak of a vector-borne disease. “We’ve found that people with a fever visit 30 percent fewer locations on average than those who do not have a fever, and that they spend more time closer to home. It may sound like stating the obvious, but such data have practical applications to understand how human behavior shapes epidemics,” says Gonzalo Vazquez-Prokopec, an assistant professor in Emory University’s Department of Environmental Sciences, and senior author of the study. “No one had previously quantified how a symptom such as fever changes mobility patterns, individually and across a population, in a tropical urban setting like Iquitos.” Not surprisingly, human mobility is a huge driver for spreading these diseases in urban settings. With the ongoing spread of Zika, researchers are continuing to learn about the impact of human behavior and mobility on the spread of these mosquito-spread diseases.

Stories You May Have Missed: 

  • Global Reaches of Antibiotic Resistance – Check out my latest comments on the global implications of antibiotic resistance for first responders and security personnel. It’s a topic we’ve so frequently cited as an international health emergency, and yet it gets so little attention. In this article, I point to the obvious implications, but also the worries that dual-use technologies of concern and genetic modification could allow for increased resistance for a more sinister reason.
  • South Sudan Crisis Calls for Additional WHO Surveillance  – the continued chaos and violence in South Sudan has translated into the WHO ramping up disease surveillance efforts. More than 1.6 million internally displaced persons (IDP) have been caught in the conflict, leaving the region more susceptible to malaria and diarrheal illnesses. “The conflict has exacerbated existing challenges with the health system and disease surveillance,” Dr Usman says. “With so many health workers and partners moving to safety, data is more difficult to collect and challenges have emerged as humanitarian access remains limited.” The WHO is coordinating with the Ministry of Health to strengthen surveillance efforts to help detect and respond to outbreaks.
  • FBI WMD Directorate Marks 10 Years – A program we’d rather have and not need than need and not have, the WMD Directorate within the FBI has been imagining worst-case scenarios for over a decade to better prepare and protect the U.S. “The Directorate has three sections: countermeasures, investigations and operations, and intelligence. In its first five years, the Directorate established itself as a central hub for WMD subject-matter expertise.” Assistant Director, John Perren, notes that while they’re intelligence driven, the things that keep him up at night aren’t what he knows, but what he doesn’t know.

Pandora Report 8.19.2016

The Olympics are winding down and now many are waiting with bated breath to see if those attending the games will bring back more than just memories to their home countries. A recent study revealed that people infected with Ebola were 20% more likely to survive if they were co-infected with malaria-causing Plasmodium parasites.  Yellow fever continues to burn through the DRC and many are wondering if it could become the next pandemic as it’s on the brink of spreading to Europe and the Americas.  The UN has finally acknowledged the role it played in the cholera epidemic that hit Haiti following the devastating earthquake six years ago. The UN acknowledgement comes after years of cited reports and public outrage regarding the importation of the disease as a result of UN peacekeepers. China has reported several cases of human infection with avian influenza (H7N9). While human-to-human transmission has not occurred, it can’t be ruled out.

From Anthrax to Zika – We’ve Got You Covered 

We’re always on the lookout for new pieces written on biowarfare and this week brought some gems to the table. Get the scoop on Russia’s old anthrax bioweapons program and how genomic sequencing revealed more details into both the program and the “biological Chernobyl” that was Sverdlovsk. Researchers like Paul Keim, Matthew Meselson, and Jeanne Guillemin, have been looking to unravel the outbreak in Sverdlovsk and that it wasn’t “unreasonable to suspect that the Soviets would have tried to create a superstrain” of the disease. Interestingly, “the team didn’t see any evidence that Soviet engineers had tried to grow a strain that was resistant to drugs or vaccines, or that they had genetically engineered the bacteria in any way” and there were actually few changes within the genome. You can read more about the genome sequence from the Sverdlovsk 1976 autopsy specimens here.  The good news is that through Keim’s work, it is possible to review anthrax genome sequences from any future outbreaks and determine if it is some leftover Soviet weapon strain or another source. The CDC recently published an overview of biological warfare in the 17th century within the Emerging Infectious Diseases journal. You can venture through time to look at the siege of Candia during the Venetian-Ottoman War of the 17th century. “Plague was first detected in Reval on August 10, 1710, while the army from Russia was still approaching the city. Reval was not besieged, and the Russians merely camped outside the city while attempting to isolate it. The army dumped corpses into a stream that flowed into Reval, but evidence does not show that the dead were plague victims, nor does evidence exist that clarifies whether the intent was contamination of the water supply or disposal of bodies. Original accounts provide no evidence to suggest that Russians hurled bodies into the city, much less plague-infected bodies.”

ISIS’ Chemical Weapon Use: A Serious Threat On The Rise

Senior DoD consultant, Zamawang Almemar is discussing the rising threat of chemical weapons and why the “international community must respond aggressively to this threat and prevent ISIS’ ability to access chemical raw materials and transform them into weapons.” The recent chemical attacks on Kurdish civilians aren’t the first and probably won’t be the last. From President Saddam Hussein to ISIS, the threat of chemical weapons and use of mustard gas (sulfur mustard) has been a consistent tool in warfare. Almemar points to the psychological impact of chemical weapons use against the Peshmerga and that ISIS also employs these tactics to benefit from the lack of protective gear and preparedness within the Kurdish military and civilians. “The Kurdish Peshmerga forces undoubtedly continue to win the war against ISIS with conventional weapons on the battlefield and with help from the U.S. and coalition forces. However, when it comes to unconventional weapons, such as chemical weapons, they are lacking even the most basic protective equipment”. Given the consistent use of these weapons, now is the time for the international community to help supply basic protective gear for both Peshmerga forces and Kurdish civilians, to help prepare and defend against ISIS chemical weapons attacks.

Does the U.S. Need a Rapid-Response Fund for Infectious Diseases?

Greg Mercer talked about this a few weeks back, but I think we can all safely say the answer to this question is a rather enthusiastic “YES”. The Congressional standoff with Zika funds has brought the role of federal emergency funds into the limelight. The good news is that it sounds like lawmakers have learned from this situation and it’s sounding more and more like the next health spending bill will emphasize the creation of a reserve fund for the CDC to use in the next public health crisis. “The House version of the bill, which would fund the federal health agencies for the fiscal year that starts in October, has a $300 million “rapid response reserve fund” for infectious diseases. It’s a smaller version of an idea that Democratic lawmakers and current and former Obama administration officials have been promoting for months, ever since it became clear that Congress was incapable of anything close to a rapid response to Zika.” While there’s no guarantee and it will require the spending bill to be completed before President Obama leaves office, it’s a step in the right direction. The question now becomes, is this enough? Many are pointing out that while this is a great start, $300 million is simply not enough and the fund needs to be labeled as an emergency fund, not a rapid response reserve. CDC Director Tom Friden as been fighting the funding battle for over six months now, pointing to the rising case counts and growing presence of local transmission. “If you were going to do something like create a vaccine, $300 million would be entirely used up by that,” Frieden said. “If you were going to do something like a rapid response while you kind of assessed the disaster … that obviously is enough to get started. It’s not going to provide all of the funding, but it would allow you not to be so stuck.”

Report Details DoD Chem/Bio Defense Programs 

The DoD 2016 report to Congress was released recently, describing the research and development practices that have used to combat chemical and biological threats. In fact, the DoD’s Chemical and Biological Defense Program (CBDP) has provided funding for the new plague drug that was recently approved as a medical countermeasure. “The DoD faces CB threats that are complex, diverse, and pose enduring risks to the Joint Force and Homeland,” the new report said. The variety, origin, and severity of these threats continues to grow while resources shrink. DoD said it performed basic research in genetic engineering and nanoelectromechanical systems related to defense against CB threats, and supported the response to the Ebola outbreak in West Africa, among other initiatives.” Despite their work and progress, there are still challenges when it comes to biosafety, which were noted in regards to the shipping of live anthrax spores from a DoD lab. Budget reductions are expected to translate into a decrease in ChemBio defense research funding, which makes the job of combatting an increasingly complex threat that much more difficult. As the report notes, “this environment translates into increasingly complex program management decisions with no margins for error due to a lack of sufficient and predictable resources.” As Almemar previously noted, the recent use of chlorine gas by Syrian government forces and the ongoing use of chemical weapons by ISIS all point to the imperative need for continued support and funding for chemical weapon defense.

BARDA Medical Counter Measures Industry Day

The Biomedical Advanced Research and Development Authority (BARDA) and the Office of Acquisitions Management Contracts and Grants (AMCG) will be hosting their annual conference to provide a better understanding about federal medical countermeasure requirements. The October 18-20th event in Washington, DC, will allow participants to interact with BARDA and AMCG staff, and network with private sector colleagues. During the conference, participants will also learn about BARDA’s strategies and goals for FY2017 and beyond, challenges of dealing with emergency, as well as current, infectious diseases, new initiatives, and roles and responsibilities of BARDA, AMCG, and private sector partners.

Zika Virus – Emergency State of Affairs

The CDC has declared a public state of emergency in Puerto Rico over Zika virus. Last week saw over 1,900 new cases reported in Puerto Rico, which brings the total case count to over 10,690. Concerns are growing after the massive flooding in Louisiana and the potential risk for increased Zika virus transmission. While flood water may wash away eggs, the risk for containers and abandoned housing as a breeding ground for mosquitoes may support further transmission. Forbes has posted the winners and losers of $81 million in Zika funding hereWhat are the legal implications of employee-related Zika virus infections? Legal teams around the U.S. are starting to gear up for the potential legal ramifications and how employers and/or employees will respond to infections. Check out this personal account of a patient infected with Zika, who experienced the challenges of getting medical care in the U.S.  As of August 17th, the CDC has reported 2,260 cases within the U.S. You can find a timeline of the spread of Zika here.

Stories You May Have Missed:

  • The Women Protecting Us From the Next Pandemic– If you caught the PBS special, Spillover, you saw Dr. Jonna Mazet talk about the powers of the global surveillance system, PREDICT. Having detected over 800 viruses that have pandemic potential, her work looks to the relationships between humans, animals, and nature to predict the next pandemic. “The entire world is vulnerable. … It’s proven to us every single year when influenza comes around. [Viruses occur] as people search for new occupations, as more [development] pushes into wildlands, as there’s more contact between people and wildlife, which are the natural hosts. We’re seeing increases in these spillover events and diseases. …”
  • Smallpox Rising From the Grave? 
    Courtesy of UK DailyMail
    Courtesy of UK DailyMail

    Following Russia’s frozen anthrax problem, many are worried that something much more sinister, like smallpox, could be found in the permafrost. Siberia, like the rest of the world, dealt with smallpox outbreaks in the 19th century. One particular outbreak was in a town that saw 40% of the population die and resulted in the rapid burial under the permafrost soil. With the eroding river banks and disappearing permafrost, time will tell if there are more zombie microbes awaiting their rise from the permafrost grave.

  • Michigan Pigs & H3N2 – The pigs in Michigan are battling H3N2 influenza. Two more county fairs have reported cases within their pigs, with the first testing positive on August 9th. Twenty pigs have tested positive at the Cass County fair, where over 300 pages were displayed. While humans can acquire H3N2 from close contact with infected pigs, the illness is considered mild in humans.

Pandora Report 8.5.2016

August is here and so are the Zika cases…it does seems rather ominous that the Rio Olympics are starting a week after the confirmation of locally-acquired U.S. cases of Zika virus. Despite the outbreak and the concerns over water safety, the games must go on?

Syria Chemical Weapons Attack
Two chemical attacks were reported earlier this week in northern Syria. The first attack occurred in the city of Saraqeb, where chlorine gas-filled cylinders were dropped in a residential area. Russia has already begun denying any role in the attack and while officials haven’t formally called the Saraqeb incident a “chemical attack”, the evidence is mounting. “Evidence points to the Assad regime because the attack came from the sky and the opposition doesn’t have any aircraft, the source added. In the second alleged incident, the Syrian government claimed that ‘terrorist groups’ carried out a gas attack that killed five people in the old town of the besieged city of Aleppo on Tuesday afternoon, according to the state-run news agency SANA.” The second attack caused the death of five individuals and is considered a counteroffensive from Syrian regime forces and Russian allies. A physician tending to victims injured in Saraqeb noted that their symptoms are consistent with those of chlorine poisoning. On Wednesday, the Russian military informed the U.S. that “rebel forces were responsible” for the attacks.

Russia’s Frozen Anthrax Problem
Over ninety people are currently under healthcare observation and surveillance in the Yamalo-Nenets region of Siberia, related to an outbreak of anthrax. Eight cases have been confirmed and a young boy died on Monday from the outbreak that is believed to be associated with an infected reindeer carcass. While anthrax is a  naturally occurring bacteria in the soil and can be endemic in certain regions, the heatwave in Siberia is believed to have caused a decades-old reindeer carcass to become exposed. As a result of the exposure, thousands of reindeer have also been infected and officials are investigating the release of the anthrax spores into the environment from the carcass that was found in the 75-year-old permafrost. Siberia’s Governor, Dmitry Kobylkin, has declared a state of emergency and specialists from the Russian Chemical, Radioactive, and Biological Protection Corps have been called into assist with outbreak control and disposal of infected animals. A mass veterinary vaccination program is also underway to protect animals in northern Russia.

Spillover Special & Human Economic Activity
Wednesday night saw the premiere of the PBS documentary, Spillover, which focused on the impact and rise of zoonotic diseases. Given the recent Ebola outbreak and news of locally-acquired Zika virus cases, this documentary comes at an precarious time. Aside from a few dramatic moments, the documentary was both informative and visually captivating. It was refreshing to see the One Health approach to outbreaks within a documentary. The filmmakers appeared to have taken great care to present the complexity of the spillover process and the importance of global surveillance and the shock humans have on the environment. Between the documentary and Sonia Shah’s new article, the impact of human activity on microbes is becoming a much more prevalent and unavoidable topic. Shah points to an increasingly globalized economy and the glaring reality that sick people do in fact get on airplanes and spread their germs, These are the obvious points in the transmission chain though and she notes that we tend to forget the role of foreclosed homes, imported tires, and decorative bamboo as factors in disease transmission. “Today, abandoned properties and deteriorating infrastructure, brought on by housing crises and climate change, similarly threaten us with epidemics of mosquito-borne pathogens such as Zika.” Shah also points to the need to assess the public health implications of our “built environment the way we assess the environmental impact- before construction begins.” While we consider our carbon footprint, are we considering our epidemic one too?

UK’s HIV Gamechange with PrEP
A recent high court ruling that NHS England can pay for PrEP (pre-exposure prophylaxis) is being marked as a victory for HIV/AIDS campaigners in the UK. PrEP is a medication that can be taken daily to help people, who are at a very high risk of contracting HIV, lower their chances of infection. According to the CDC, “A combination of two HIV medicines (tenofovir and emtricitabine), sold under the name Truvada, is approved for daily use as PrEP to help prevent an HIV-negative person from getting HIV from a sexual or injection-drug-using partner who’s positive. Studies have shown that PrEP is highly effective for preventing HIV if it is used as prescribed. PrEP is much less effective when it is not taken consistently.” The court ruling is especially important as it will not only put pressure on pharmaceutical companies to lower the cost of the drug, but will now be available through the National Health Services (NHS), meaning that it will be widely available and accessible to a far wider range of people. “Condoms are cheap, but among some high-risk populations they are not used consistently. About 4,000 more people acquire HIV in the UK every year. The average cost of a lifetime of treating each one is put at about £360,000. The National Aids Trust brought the high court case following anger and consternation among campaigners after NHS England said it would not fund PrEP because it did not have the power to do so. It argued that it was the role of local authorities, which have been given control of public health measures including reducing smoking and family planning, as well as HIV prevention. Local authorities said they did not have the money to pay.” Accessible HIV prophylaxis is a huge step in prevention and despite the plans of NHS to appeal the decision, they are still putting aside funds for the cost of the medication.

Biodefense in Gaming Courtesy of Pandemic Inc game
Since we’re still reeling from the loss of prime-time contagion drama, nuclear systems engineer and aspiring biodefense wonk, Greg Witt, is helping us through this dark time via the enjoyable but inaccurate world of biodefense in gaming. Greg’s review of several popular video and board games will give you some great options for your next gaming adventure. “With pathogens like Zika, Ebola, and West Nile now household names, biodefense has rarely been more culturally relevant. Depictions of biodefense topics in popular culture are not limited to traditional media, though; numerous video games and board games have been released in the past few years in which biodefense plays an important role.” Discussing video games like Tom Clancy’s The Division and its underlying premise that is almost identical to Operation Dark Winter, to two of my personal favorites – Plague Inc. and Pandemic, Greg gives a tour through the minefield of biodefense gaming. Rest assured though, he points to the scientific failures and epidemiological snafus that plague these games, but do not ultimately deter our enjoyment while bringing biodefense to the general public.

Zika Updates 
Following last week’s news regarding a growing number of locally acquired cases in Florida, it was also reported that 41 U.S. military members have contracted Zika. “All cases were transmitted while abroad and one of the military service members is a pregnant female. Under Pentagon health policies, female service members are permitted to move out of countries where Zika exists.” Here’s a helpful little field guide for identifying the mosquitoes that are known to transmit Zika. A new model used by researchers from Northeastern University is pointing to a vastly underestimated amount of Zika in the U.S. They note that there is probably “way more Zika in the U.S. than has been counted”. Case counts are especially challenging in a disease that leaves many asymptomatic and unlikely to be tested. In response to the growing number of locally-acquired cases (currently at 14 cases) in Miami-Dade County, there will be aerial spraying for mosquito control.  The CDC has reported 1,825 total Zika infections in the U.S. as of August 3rd and has issued a travel warning for the Miami area. President Obama also pleaded with Congress to “do its job” and approve funding to fight the growing outbreak. Donald Trump was also recently asked about how he would handle the outbreak, noting that Florida Governor, Rick Scott, “seems to have it under control”. 

Stories You May Have Missed:

  • In Memoriam of Dr. Roger Gerrard Breeze– Dr. Breeze, a preeminent veterinary research scientist and biosecurity expert passed away in late June in Washington, D.C. We are grateful to have had Dr. Breeze as a professor for GMU’s agroterrorism courses and his contribution to the field of genetic engineering and molecular biology. “Dr. Breeze was a Member of the UK Royal College of Veterinary Surgeons and a member of the U.S. National Academies – Institute of Medicine’s Forum on Microbial Threats and National Academies – Committee on Biodefense Analysis and Countermeasures. For the past decade, Roger served as an advisor on biosecurity and biological/chemical weapons nonproliferation issues to the Defense Threat Reduction Agency (DTRA) and the Lawrence Livermore National Laboratory.”
  • GMU Biodefense PhD Awarded FAA Graduate Research Grant– Biodefense PhD student, Nereyda Sevilla, was recently awarded a grant from the FAA for her dissertation; Germs on a Plane: The Transmission and Risks of Airplane-Borne Diseases. The Graduate Research Award Program on Public-Sector Aviation Issues is a joint sponsorship from the Federal Aviation Administration of the U.S. Department of Transportation and administered by the Airport Cooperative Research Program (ACRP) of the Transportation Research Board/National Academies. You can read more about Nereyda’s work with the surveillance tool, Spatiotemporal Epidemiological Modeler (STEM), here.

 

Pandora Report 12.4.2015

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

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Pandora Report 08.09.14

I spent about 12 hours at Dulles Airport yesterday. I didn’t fly anywhere, but I was ensuring that 120 international students were able to get from Washington DC to their host families all over the country. You may have noticed that in the security areas of Dulles Airport they have televisions that go over proper security screening procedures. On these same screens, they also show CDC travel alerts.

In June (when I was ensuring that 450 students were able to get back to their home countries), the alerts were for MERS and mosquito borne diseases like dengue and Chikungunya. Yesterday, Ebola was on alert for travelers to West Africa.

Last week we looked at the fever pitch of Ebola, today, lets look at the diseases designated by the CDCs travel alerts at Dulles.

 

Zika Virus: Another Threat from the Asian Tiger Mosquito

Travel alerts from the CDC often include Chickungunya and Dengue fever, but another disease from the same vector—the tiger mosquit0—is receiving alerts as well. Zika Fever, was isolated in humans in the 1970s, but has relatively few documented cases. In 2007, the virus demonstrated epidemic capacity with 5,000 cases in Micronesia. In 2013 there were 55,000 cases in Polynesia. Today the CDC has issued Watch Level 1 alerts for Zika in Easter Island, French Polynesia, and the Cook Islands and urges travelers to practice usual precautions.

Entomology Today—“Originally from Asia, the tiger mosquito was introduced to Africa in 1991 and detected in Gabon in 2007, where its arrival undoubtedly contributed to the emergence of dengue, chikungunya, and as shown by this new study, zika. The rapid geographic expansion of this invasive species in Africa, Europe, and America allows for a risk of propagation of zika fever around the world.”

 

Ramadan pilgrimage season in Saudi Arabia mostly free from MERS

Saudi Arabia reported only ten new cases of MERS from June 28- July 28 during the month of Ramadan. In April and May of 2014, hundreds of people were infected by MERS, which raised concerns about infection rates during Ramadan and during the Hajj, which will take place in October, when millions of pilgrims will travel to Mecca. Since 2012, Saudi Arabia has confirmed over 700 cases of infection resulting in nearly 300 deaths. The CDC designates the Hajj as an Alert Level 2, and urges U.S. residents to practice enhanced precautions.

Al Arabiya—“Saudi Arabia and the World Health Organization have said they are imposing no travel or other restrictions due to MERS during the Hajj, but have encouraged very young or old pilgrims, and those suffering from chronic disease, not to come this year.”

 

WHO: Ebola ‘an international emergency’

This week, the World Health Organization declared that the spread of Ebola in West Africa is an international health emergency. They urged coordinated response in order to keep the spread of the virus under control. Though no travel or trade bans have been enacted, the WHO recommends that Ebola cases or contacts should not travel internationally. This comes at a time when states of emergency have been declared in Liberia, Guinea, and Sierra Leone and the number of total cases has reached nearly 1,800 with over 950 deaths. The CDC designates outbreaks in these countries as a Warning Level 3, and urges U.S. residents to avoid non-essential travel.

BBC—“WHO director-general Dr. Margaret Chan appealed for help for the countries hit by the ‘most complex outbreak in the four decades of this disease.’

The decision by the WHO to declare Ebola a public health emergency is, by its own definition, an ‘extraordinary event’ which marks ‘a public health risk to other states through the international spread of disease’.”

 

Image Credit: The Denver Channel