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Biodefense Headlines – 18 Apr 2019

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See what we’re reading this week at Global Biodefense on topics including the state of Yersinia pestis diagnostics, how measles is testing the public health system, and the cholera resurgence in Yemen.

POLICY + INITIATIVES

Key Findings from the Ebola IHR Emergency Committee Meeting

The WHO Director-General accepted the Committee’s assessment and on 12 April 2019 did not declare the Ebola outbreak in the DRC a Public Health Emergency of International Concern. In light of the advice of the Emergency Committee, WHO advised against the application of any travel or trade restrictions. World Health Organization

Measles Outbreak Drains Resources We May Need For a Future Epidemic or Bioterrorist Attack

We need a new, better organized, fully funded national EMS system; a better understanding of real-time pharmacy readiness; a stratified hospital system capable of responding to everything from naturally occurring outbreaks to large-scale biological attacks; authorized and fully executed laboratory networks; and increased funding for public health emergency preparedness, response and recovery. We also need state, local, tribal, territorial and federal elected officials to make addressing the biological threat before events occur one of their highest priorities. USA Today

FAQs on the NYC Public Health Emergency Order on Mandatory Measles Vaccination

Some see NYC’s order for mandatory MMR vaccinations as an unusual exercise of public health authority. It has consequently spurred a flurry of media reports including some inaccuracies. The following FAQs break down the key components of the mandate and the legal requirements. The Network for Public Health Law

Superbugs, Pandemics and Synthetic Biology Put Biological Risks on the C-Suite’s Agenda

The economic burden won’t be limited to industries with direct exposure, like healthcare, farming and food. Cleaning companies and medical device manufacturers are among those who could also face legal and financial jeopardy. Medicare has already cut payments to hospitals with high rates of patient infection. Other healthcare insurers might follow suit. The seriousness of this risk should be on the radar of all risk managers and corporate boards. Zurich Insurance Group

House Members Question the Reliability of New Bioweapons Detection System

A bipartisan group of House members has questioned the Trump administration’s new system for detecting anthrax or other airborne biological weapons — warning it could be “even less reliable” than the nation’s existing, problem-plagued BioWatch program. In a letter to Kevin McAleenan, the acting secretary of Homeland Security, the four lawmakers cited a Los Angeles Times article from Feb. 15 that they said raised “questions and concerns’’ about the department’s approach. Los Angeles Times

The Infectious Disease Physician Well Is Running Dry

Each year, 2 million Americans experience an antibiotic-resistant infection, 23,000 of whom will die. Poor antimicrobial stewardship is a critical part of resistance and, increasingly, poor prescribing practices are carried out by non-infectious disease physicians. A review of the National Resident Matching program found that from 2009 to 2017, hospitals able to fill all of the adult infectious disease training programs fell by 40%. These gaps are reportedly due to challenges with insurance reimbursement and the fact that infectious disease physicians are consult-only providers. Contagion Live

OUTBREAK NEWS + THREAT SURVEILLANCE

Ebola Infects 17 More in DRC Outbreak

The DRC yesterday reported another double-digit rise in Ebola cases, as local leaders such as traditional chiefs and provincial representatives stepped up their efforts to convince community members to support the response efforts to end the outbreak. The flurry of new cases moved the outbreak total to 1,290, which includes 1,224 confirmed and 66 probable cases. Also, health officials are still investigating 251 suspected cases. CIDRAP

Rapid Risk Assessment: Ebola Virus Disease Outbreak in North Kivu and Ituri Provinces

This rapid risk assessment addresses was triggered by an increase of EVD transmission in the affected areas over recent weeks, the persistent occurrence of new cases among contacts unknown at the time of EVD diagnosis, the occurrence of a substantial number of cases outside of the ring vaccination contacts and current challenges for the prevention and control of EVD. The overall case fatality rate is 63%. Eighty-seven healthcare workers are among the confirmed cases, including 31 deaths. European Centre for Disease Prevention and Control

Mounting Concern Over Cholera Health Crisis in Yemen

Yemen is facing a massive resurgence of cholera in what was already one of the world’s worst outbreaks, with more than 137,000 suspected cases and almost 300 deaths reported in the first three months of this year. With well over 2,000 suspected cases being recorded every day – a doubling since the beginning of the year – aid agencies fear they could be facing a major new health crisis. The Guardian

SELECT AGENTS

Henipavirus Infection of the Central Nervous System

Nipah virus and Hendra virus are highly pathogenic zoonotic viruses of the genus Henipavirus, family Paramyxoviridae. While outbreaks of Nipah and Hendra virus infections remain rare and sporadic, there is concern that Nipah virus has pandemic potential.  This review will address Nipah virus basic clinical disease, pathology, and pathogenesis with a particular focus on CNS infection and address the necessity of a model of relapsed CNS infection. Additionally, the innate immune responses to Nipah virus infection in vitro and in the CNS are reviewed as it is likely linked to any persistent CNS infection. Pathogens and Disease (subscription required)

Yersinia Pestis and Plague: An Updated View on Evolution, Virulence Determinants, Immune Subversion, Vaccination, and Diagnostics

The bacillus discovered 125 years ago by Alexandre Yersin has still a lot of secrets to reveal. The ecology of Y. pestis in the environment remains to be fully explored, as novel potential reservoirs are discovered. Some molecular mechanisms of virulence of Y. pestis have been inferred from comparisons with other pathogenic Yersiniae, including the enteric pathogens Y. pseudotuberculosis and Y. enterocolitica, which might bias our understanding of plague. Genes & Immunity

Fast and Simple Detection of Yersinia pestis Applicable to Field Investigation of Plague Foci

There is now a convenient and effective test (F1-dipstick) for the rapid identification of Y. pestis from human patient or rodent samples, but this test cannot be applied to environmental or flea materials because the F1 capsule is mostly produced at 37C. The plasminogen activator (PLA), a key virulence factor encoded by a Y. pestis-specific plasmid, is synthesized both at 20C and 37C, making it a good candidate antigen for environmental detection of Y. pestis by immunological methods. A recombinant PLA protein from Y. pestis synthesized by an E-coli strain was used to produce monoclonal antibodies (mAbs). PLA-specific mAbs devoid of cross-reactions with other homologous proteins were further cloned. A pair of mAbs was selected and used to develop a highly sensitive one-step PLAenzyme immunoassay (PLA-EIA) and an immunostrip (PLA-dipstick), usable as a rapid test under field conditions. These two PLA-immunometric tests could be valuable, in addition to the F1-disptick, to confirm human plague diagnosis in nonendemic areas. HAL Pasteur (.pdf)

MEDICAL COUNTERMEASURES

First-In-Human Trial Begins on Universal Flu Vaccine, Older Adults Still Encouraged To Vaccinate

The NIH has begun its first-in-human clinical trial of a flu vaccine that they hope will teach the body’s immune system to fight multiple types of flu or those that it said, “might cause a pandemic.” Researchers hope the so-called “universal” influenza vaccine will be able to provide long-lasting protection for all age groups. Forbes

The Data Are Clear: Ebola Vaccine Shows ‘Very Impressive’ Performance In Outbreak

The experimental Ebola vaccine being used to try to contain the outbreak in the Democratic Republic of the Congo is protective 97.5% of the time, according to new data released by the World Health Organization on Friday. STAT

Rapid Generation of Medical Countermeasure Candidates Via Computational Variation Analysis

Variability analysis enables computational targeting of pathogens with multiple parallel approaches, including subcomponent and low variability peptide targets for stimulating B-cell and T-cell immune responses as part of vaccinations, bnAb targeting of low variability surface targets, anti-RNA targeting with synthetic miRNA/siRNA, and aptamer targeting of low variability surface targets. Parallel evaluation of these approaches can be evaluated in vitro and in vivo animal studies as part of a rapid medical countermeasures approach. Effectiveness of countermeasures may be enhanced with combination approaches of two or more of these countermeasures. bioRxiv

Needle-Free Vaccine for Bubonic Plague to be Developed in the UK

The collaboration between Enesi Pharma and the University of Oxford aims to develop a needle-free vaccine for the plague. While the vaccine itself is being developed by researchers at the University of Oxford, Enesi will make a solid implantable version of the vaccine and deliver it to patients using a device that doesn’t require needles. Labiotech

Intraperitoneal Treatment with Antimicrobial Peptide Rescues Mice From a Pulmonary Francisella Infection

Previously, this research group searched the peptidome of the American alligator for novel cationic antimicrobial peptides and identified a naturally-occurring C-terminal fragment of apolipoprotein C-1, which they called Apo6. This peptide was found to have antibacterial activity against the ESKAPE pathogens, including those exhibiting multi-drug resistance. In this work, they tested Apo6 and synthetic derivatives for antibacterial activity against Francisella tularensis including the virulent strain F. tularensis SchuS4. bioRxiv

HISTORICAL REFLECTIONS

How Philadelphia Mandated Vaccinations In 1991

“…in that several-month period in early 1991, we had 1,400 cases of measles and nine deaths. It was a major epidemic. I mean, parents were scared to death in this city. The city became a feared destination. It was a nightmare.”  NPR

Yersinia pestis concept illustration

Ology Bioservices Awarded DoD Contract for Countermeasures Against Bioweapons

NIAID Biodosimetry Radiation

Radiation Nuclear Countermeasures Centralized Dosimetry Harmonization Effort