See what we’re reading this week at Global Biodefense on topics including the BioWatch program’s potential successor, selecting the 2019-2020 flu vaccine strains, and Ebola’s return to Beni.
POLICY + PRACTICES
Replacing BioWatch
The questionable efficacy of BioWatch hasn’t exactly been a quiet conversation and many have suggested doing away with the system all together. The Trump administration though, is pushing to replace it with BioDetection 21, which will apparently be deployed across the United States in the form of 9,000 devices by 2025. Pandora Report
Measuring the cost-effectiveness of the influenza vaccine
The British version of the CDC’s vaccine advisory committee, the Joint Committee on Vaccination and Immunisation (JCVI) meets three times a year to review the scientific evidence and makes recommendations to the secretary of state for health if there is a need to change the vaccination policy. In assessing vaccine costs to the health system, they concluded that given the vanishingly small number of young, healthy adults who become severely ill or die from the flu, it is not cost-effective to vaccinate this section of the population. The Guardian
Importance of diagnostics in epidemic and pandemic preparedness
Current diagnostic landscapes for selected priority pathogens are presented in this supplement. Identifying overlaps in diagnostic development needs across different priority pathogens is recommended over a pathogen by pathogen approach to allow more timely and cost-effective use of resources. BMJ Global Health open access
Final FY19 Appropriations: National Science Foundation
The National Science Foundation’s budget will increase 4 percent to $8.1 billion under the final spending legislation for fiscal year 2019. The measure provides funding for the agency’s proposed “Big Ideas” and facility construction projects, while also explicitly maintaining support for “core” research and existing infrastructure. American Institute of Physics
MEDICAL COUNTERMEASURES
Ebola vaccine to be given to pregnant, lactating women
This week the Democratic Republic of the Congo (DRC) announced its plans to include pregnant and lactating women in the current Ebola vaccine protocol. “Noting that these experimental vaccines are non-replicating or replication deficient, pregnant and lactating women should be included into the clinical trial protocol.The protocol must include provisions for safety monitoring and for documentation of EVD cases among vaccinees, including follow-up of pregnant women and their offspring,” the WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization said in its interim recommendations. CIDRAP
Soligenix receives US patent expanding protection for its ricin toxin vaccine, RiVax
The patent, titled “Multivalent Stable Vaccine Composition and Methods of making same”, supports combination vaccines protecting against ricin intoxication as well as other toxins, such as those associated with anthrax. Soligenix
WHO changes H1N1 flu vaccine strain, punts on H3N2
WHO’s flu vaccine advisory group met this week to recommend strains to include the Northern Hemisphere’s 2019-20 vaccines and recommended changing the 2009 H1N1 component but decided to wait a month before settling on the H3N2 strain. In a related development, the group reviewed recent zoonotic flu developments and recommended two new candidate vaccines against potential pandemic threats—H5N6 and H7N4 avian flu. CIDRAP
OUTBREAK NEWS + THREAT SURVEILLANCE
Ebola returns to Beni—survivor transmission suspected
In a disappointing development Friday, the DRC health ministry reported a new Ebola case in Beni, coming just 2 days after the former outbreak epicenter had reached the hopeful mark of going a full 21-day incubation period without new illness. The newly confirmed patient from Beni was apparently exposed to the body fluids of an Ebola survivor, the ministry said in its statement today, adding that a thorough investigation and genetic sequencing is underway to determine the epidemiological links between the cases. CIDRAP
French child suspected of reintroducing measles to Costa Rica
A 5-year-old boy who had not received measles vaccine went on holiday to Costa Rica with his parents. The country had been measles-free for five years before his arrival. Now health authorities in the country have put the boy and his parents into quarantine and are trying to locate anybody the family may have infected. Authorities are especially trying to locate the 311 people who flew on the 12-hour Air France flight to Costa Rica. DW
Receptor for bat influenza virus uncovers potential risk to humans
We lack surveillance data to tell us how widely distributed bat flu viruses are, and whether they are carried by bat species with which humans or domestic animals have close contact. Given that receptor use does not seem to be host-restricted, and that the enzyme responsible for replicating the bat flu virus seems to function well in human cells, the lack of human infections by bat flu so far might be due solely to lack of opportunity. Nature
Venezuela’s resurgence of vaccine-preventable diseases
Given Venezuela’s increasingly precarious situation, there is a desperate need to provide public health and health care intervention. The crisis has resulted in a return of measles, which has already bubbled beyond its borders into Colombia; diptheria is back and vaccination rates are falling to herd-immunity critical thresholds; and with the collapse of the public health infrastructure there is a real risk polio could re-emerge. Contagion Live
RESEARCH + TECH
The future of healthcare: Automated pathogen detection that is ‘open-access’
The founder of LexaGene discusses how open-access pathogen detection instruments would equip our front line healthcare providers to rapidly respond to novel threats. “Current automated instruments can not be customized to detect any genetic target of interest. Their lack of flexibility makes us more susceptible to deadly infectious diseases, due to not being able to rapidly respond to new threats — whether bio-engineered or natural (i.e. new strain of avian influenza).” Medium
What does a positive PCR result mean…or not mean?
PCR results alone don’t fulfil a need to see replicating virus in a host before assigning any sort of causal role to that virus. But that is often impractical and frequently unnecessary because a positive PCR result is generally a reliable proxy for the presence of active virus infection. Culturing an isolate wouldn’t assign causality for a pedant either. It just proves the virus was in the patient’s sample. Similarly, a positive serology result detects antibodies to the virus, proving only that it was recognized by an infected patient’s immune system at some point. The sorts of studies needed to actually prove causality are usually well down the priority list in a public health management phase such as we are in when a new virus emerges. Virology Down Under
SPECIAL INTEREST
Pandemics, Bioterrorism, and Global Health Security – Summer Workshop
This three-day summer workshop is designed to introduce participants to the challenges facing the world at the intersection of national security, public health, and the life sciences. The workshop faculty are internationally recognized experts from the government, private sector, and academia who have been extensively involved with research and policy-making on public health, biodefense, and national security issues. George Mason University Schar School
The NextGen Global Health Security (NGGHS) Mentorship Program
This annual program aims to connect early to mid-career professional and students interested in global health security with experts in the field to enhance professional development. Applications are currently being accepted. GHSA NextGen
NACCHO’s Preparedness Summit 2019
March 26-29: The event is a unique learning and networking opportunity for emergency preparedness officials and their partners to share perspectives and engage in dialogue on key public health preparedness issues. Students interested in public health preparedness can also gain valuable knowledge and connections by attending this year’s conference. Preparedness Summit
HISTORICAL REFLECTIONS
Cortés had a microscopic secret weapon
Although Cortés was a skilled leader, he and his force of perhaps a thousand Spaniards and indigenous allies would not have been able to overcome a city of 200,000 without help. He got it in the form of a smallpox epidemic that gradually spread inward from the coast of Mexico and decimated the densely populated city of Tenochtitlan in 1520, reducing its population by 40 percent in a single year. PBS