News highlights on health security threats and countermeasures curated by Global Biodefense
This week’s selections include the surge in monkeypox cases and updated orthopoxvirus vaccination recommendations; fractured drug supply chains and shortages; ongoing legal challenges to public health authorities; and recent developments in botulinum neurotoxin detection.
Contents
POLICY + GOVERNMENT
New ASPR Report Shows Frayed, Fractured US Drug Supply Chains
A new US government report characterizes risks in the 100-day supply chains of 143 essential prescription drugs, including 86 priority drugs deemed critical to the health of Americans. The vulnerability of these supply chains, which underlies drug shortages, has been exposed by the pandemic and other recent natural disasters, such as hurricanes in Puerto Rico. The report urges anticipation of shortages using integrated data and supply-chain business metric networks. This would allow preparation of stockpiles, establishment of multiple sourcing options and contingency plans, and maintenance of a strong workforce and robust distribution capabilities. CIDRAP
Belgium Introduces 21 Day Isolation for Monkeypox Cases
On Friday Belgian health authorities introduced a compulsory 21-day isolation for monkeypox patients, becoming the first nation to do so, after reporting four cases of the disease in the last week. Monkeypox contact cases are not required to self-isolate but should remain vigilant particularly if they are in contact with vulnerable people. Politico
C.D.C.’s Pandemic Team Will Surrender Some Responsibilities
Just weeks after the Centers for Disease Control and Prevention began a comprehensive internal review with an eye toward restructuring, the agency’s director announced on Friday that the team that coordinated the national response to the Covid-19 pandemic — the Incident Management Structure —would return some of its functions to other departments. The move signals the beginning of efforts to put in place comprehensive changes at the agency, whose public standing and reputation have suffered in recent years. The announcement was short on details, stating only that the initial data collection phase of the review was complete and next steps are being prioritized. New York Times
‘It’s a Tsunami’: Legal Challenges Threatening Public Health Policy
Mounting legal challenges to pandemic public health rules — and judges’ increasing willingness to overrule medical experts — threaten to erode the influence of the CDC and other government health authorities. The high-profile challenges to the CDC sit atop thousands more lawsuits against state and local health authorities that have been filed during the pandemic. In addition to lawsuits, bills have been introduced in state legislatures across the nation to limit public health authorities’ power, and scores of public health officials have left their jobs in frustration. Politico
Assessing US Congressional Exposure to the Issue of Emerging Infectious Disease Risk Prior to 2020
In the early days of the COVID-19 response, President Trump and some members of Congress stated that they were unaware of the threat of such a consequential pandemic as COVID-19, or of the extent of US vulnerabilities to that threat. Yet for more than 2 decades, Congress received official testimony across a conservative estimate of 167 hearings and 860 witness testimonies that communicated a real and growing infectious disease risk to public health and national security. Many of the issues apparently revealed by COVID-19 were in fact known well before its emergence. It is imperative to consider why congressional awareness did not translate into action sufficient to prevent the major disaster that COVID-19 became. Health Security
World Health Assembly Clouded by Pandemic Treaty Backlash
The World Health Assembly, the decision-making body of the WHO’s 194 member states, recently held its first fully in-person event in two years as some coronavirus-related restrictions are lifted. While the assembly is usually considered a dry, technocratic event, this year it is being framed by conspiracy theorists as a key moment in the battle between democracy and tyranny. “This kind of fearmongering is a reminder of how polarized the public can be on questions of international cooperation. But at the end of the day, there’s just no way any country can deal with pandemics alone.” Washington Post
Opportunity to Reform the Department of Homeland Security’s Biodefense Operations and Governance
“Congress should eliminate funding for BioWatch. As the commission’s report recommends, “Congressional appropriators should deny further funding for BioWatch activities until proven replacement technology is identified and confirmed to meet the needs of the program.” Instead, Congress should support the commission’s substantial recommendation that Congress invest $10 billion per year for 10 years in science and technology research for biodefense, and reallocate the $80 million currently dedicated to BioWatch to support biodetection research. DHS is unlikely to unilaterally shutter this program without a congressional mandate to do so. Recent appropriations language suggests that Congress is willing to support BD21 and its effort to acquire replacement technology for BioWatch but wants to see evidence of progress. Lawfare
Fort Detrick Garrison to Lift Security from National Interagency Biodefense Campus
The National Interagency Biodefense Campus includes facilities for the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) and the U.S. Department of Homeland Security’s National Biodefense Analysis and Countermeasures Center (NBACC). Though each facility employs its own security, Army garrison security personnel currently staff the prescreening area that visitors and employees must pass through before entering the campus. Effective Nov. 1, the four agencies with sites on the Fort Detrick campus will be responsible for their own security needs, garrison spokeswoman Lanessa Hill said in an interview.
The base experienced an active shooter security incident just last year in which a suspect was killed trying to enter Fort Detrick. The suspect had reportedly shot two sailors at an industrial park near the base (at a warehouse rented by the Naval Medical Research Center, Biological Defense Research Directorate), then proceeded to Fort Detrick. After being stopped by guards at a gate to the base, the gunman “pulled off ahead” before he could be searched. The suspect made it about a half mile inside the base and was stopped in a parking lot, where he brandished a weapon. Frederick News-Post
Kansas Governor Vetoes Republican Plan to Ban Mask Mandates
Democratic Gov. Laura Kelly on May 13 vetoed a bill that would prohibit government mask mandates in Kansas and curb the power of state and local health officials during outbreaks of infectious diseases. The bill would prohibit state and local officials from issuing mandates, except for hospitals, other medical facilities and nursing homes they operate. Officials couldn’t require people to show proof of being vaccinated against COVID-19 to use public spaces. The measure also would prohibit state and local health officials from ordering law enforcement agencies to help them enforce orders aimed at controlling infectious diseases. AP News
MEDICAL COUNTERMEASURES
ACIP Recommendations on Use of JYNNEOS (Smallpox and Monkeypox Vaccine) for Preexposure Vaccination of Persons at Risk for Occupational Exposure to Orthopoxviruses
For laboratory personnel and designated response team members, ACIP recommends use of JYNNEOS for primary vaccination as an alternative to ACAM2000. For health care personnel who administer ACAM2000 or care for patients infected with orthopoxviruses, ACIP recommends use of JYNNEOS (as an alternative to ACAM2000), based on shared clinical decision-making. In addition, persons who received the 2-dose JYNNEOS primary series and who are at ongoing risk for occupational exposure to more virulent orthopoxvirus e.g., Variola virus and Monkeypox virus), should receive a booster dose of JYNNEOS every 2 years after the primary JYNNEOS series; persons who receive the 2-dose JYNNEOS primary series and who are at ongoing risk for occupational exposure to less virulent orthopoxviruses, (e.g., Vaccinia virus or Cowpox virus), should receive booster doses of JYNNEOS at least every 10 years after the primary JYNNEOS series. ACIP also recommends that persons who received an ACAM2000 primary vaccination and who are at ongoing risk for occupational exposure to orthopoxviruses may receive a booster dose of JYNNEOS as an alternative to a booster dose of ACAM2000.
JYNNEOS involves a replication-deficient virus and has fewer contraindications, no risk for inadvertent inoculation and autoinoculation, and is associated with fewer serious adverse events compared with ACAM2000. In addition, most health care providers have experience with and are comfortable providing vaccines by subcutaneous administration, the route by which JYNNEOS is administered. ACAM2000, on the other hand, is administered percutaneously through a multiple puncture (scarification) technique, through 15 jabs with a stainless steel bifurcated needle that has been dipped into the reconstituted vaccine, a vaccination technique that is unique to orthopoxvirus vaccinations. JYNNEOS involves 2 vaccine doses 28 days apart and vaccine protection is not conferred until 2 weeks after receipt of the second dose; ACAM2000 involves 1 dose of vaccine and peak vaccine protection is conferred within 28 days. CDC MMWR
Does Paxlovid Help People Who Have Been Vaccinated Against Covid-19? Show Us the Data!
Paxlovid appears to be highly effective, with a clinical trial showing an 89% relative reduction in hospitalizations or death among high-risk patients who receive it. The trial supporting the FDA’s emergency use authorization of Paxlovid included only unvaccinated people who had never previously had Covid-19. Since 76% of U.S. adults are now vaccinated, and an estimated 58% of Americans have already had Covid, the trial supporting Paxlovid is not directly applicable to a majority of Americans. Pfizer has begun a trial of Paxlovid in high-risk individuals who have been vaccinated, but this trial combines vaccinated and unvaccinated patients, potentially clouding the issue. More importantly, results of the trial will not be made available until November 2022. STAT
U.S. Makes COVID-19 Technologies Available for Use in Developing Countries
The U.S. government has agreed to put licenses for 11 medical technologies developed at the NIH into a so-called patent pool, a move that promises to make it easier for low- and middle-income countries to gain access to vaccines, drugs, and diagnostics for COVID-19. Created in 2010, the patent pool today has patent agreements for several anti-HIV drugs and recently added Pfizer’s Paxlovid and Merck & Co.’s molnupiravir. The new agreement also covers inventions used by companies that make existing COVID-19 vaccines, such as a modification that stabilizes spike, the surface protein of SARS-CoV-2. Companies could also use the technologies to make entirely new products. Research tools for drugmakers and diagnostic assays are also part of the agreement. Science
On the Back of SIGA Technologies’ Win with FDA, the Monkeypox Virus Sees the Company Springing to Further Action
SIGA Technologies is reportedly in talks with several European authorities looking to stockpile its antiviral that can counter monkeypox. The drug known as tecovirimat or Tpoxx was approved by the FDA in 2018 as a vaccine for smallpox but was approved by the European Medicines Agency to also act against monkeypox, cowpox and complications from immunization with vaccinia. The US maintains a stockpile of 1.7 million courses in the Strategic National Stockpile under Project BioShield. The IV version of the drug was approved by the FDA last week and is intended for patients who are unable to swallow the oral versions of the drug. Endpoint News
A Comparison of Sars-Cov-2 Vaccine Platforms: The CoviCompare Project
Since December 2019, the COVID-19 pandemic has spread from China across the world. As the pandemic continues, 19 vaccines using different technologies have been authorized and are now being used for large vaccination programs worldwide. These vaccines are based on different vaccine platforms (mRNA, recombinant viruses, adjuvanted recombinant proteins and inactivated viruses) that have never been compared in terms of immunogenicity using the same standardized immunological readouts. Nature Medicine
FDA Panel to Review Pfizer and Moderna Vaccines for Children Aged Six Month to 4 Years June 14-15
FDA revised the dates of two upcoming Vaccines and Related Biological Products Advisory Committee (VRBPAC) meetings due to new data from sponsors and expected submissions of EUA requests. VRBPAC will discuss Moderna’s EUA request for 6 years through 17 years of age on June 14 and will discuss the Moderna EUA request for 6 months through 5 years of age and Pfizer-BioNTech EUA request for 6 months through 4 years of age on June 15, 2022. Healio
US Plant Closure Portends Drug Shortages—Some Critical
In its first analysis, the newly formed End Drug Shortages Alliance (EDSA) warns that the recent shuttering of a troubled Teva Pharmaceuticals manufacturing plant in Irvine, California, could affect the availability of 24 generic sterile injectable drugs, including 5 essential medications for which the company had an over 15% market share. The FDA, the EDSA said, should expedite approval of any applications for drugs affected by the plant closure or mull their importation, particularly for those without alternatives (eg, streptozocin). Group purchasing organizations should formulate strategies to provide more redundancy for essential medications, and providers and clinicians should practice good stewardship when ordering, prescribing, and administering the affected drugs, EDSA added. CIDRAP
Vir, WuXi Biologics Terminate COVID Antibody Pact as US Rollout Faces Uncertain Future
The U.S. distribution of Vir Biotechnology’s GSK-partnered COVID-19 antibody has been put on hold for more than a month. Now, a collaborator in the therapy wants out. WuXi Biologics has returned China rights to Vir’s COVID antibody, sotrovimab, the latter company said in a securities filing published Friday. The two companies tied the knot at the beginning of the pandemic back in February 2020. Under the deal, WuXi developed the cell line, process and formulation of Vir’s COVID antibody candidates and manufactured initial supply for clinical development. In return, WuXi obtained rights to sell the therapies in China. WuXi exited the deal as the COVID situation has been brought under control. Before WuXi and Vir parted ways, the U.S. federal government suspended distribution of sotrovimab in April because the drug appeared to be ineffective against the dominant omicron BA.2 subvariant. Fierce Pharma
The CDC Is Urging a Pfizer Booster (Third Dose) for Children Ages 5 to 11
The Food and Drug Administration on Tuesday authorized a third shot of Pfizer’s Covid vaccine for children ages 5 to 11 at least five months after their two-dose primary series. The FDA did not convene its committee to discuss the data before authorizing the booster dose. Some committee members have grown frustrated that the drug regulator has repeatedly moved ahead with decisions on booster doses without holding open public discussions.
The CDC’s independent committee of vaccine experts met Thursday, approving the case for a third dose in that age group. CDC Director Walensky backed the recommendation, and the agency moved forward announcing the opening of a third COVID-19 shot to healthy elementary-age kids — just like what is already recommended for everybody 12 and older. Only about 28% of children ages 5 to 11 had received their primary series of two doses as of April. NPR
Pakistan Launches New Anti-Polio Drive After 3rd Case Found
Pakistan launched a new anti-polio drive on yesterday, more than a week after officials detected the third case so far this year in the country’s northwestern region bordering Afghanistan. The campaign — the third one this year — is to last for five days, aiming to inoculate 40 million children under the age of 5 across the country. AP News
BIOSECURITY + BIOPREPAREDNESS
Science in Africa: Lessons From the COVID-19 Pandemic
The continent followed Western nations too closely in its early response to the coronavirus emergency, says Nigerian virologist Oyewale Tomori, noting the epidemiology of COVID in Africa was different from what is happening in Europe and other parts of the world. He further calls for a continent-wide African Center for Disease Coordination, and a more sustainable vaccine-production strategy across the continent. Nature
Clinical Virology in the Pandemic Response — A Missed Opportunity
Clinical virologists are poorly represented on SAGE and other committees advising the UK government on pandemic response when compared to other specialties. Examples illustrate the lack of clinical virology input into the UK pandemic response. This includes the Test and Trace system, which delivered widespread community testing, was established in isolation from NHS and Public Health England clinical virology services, and headed by a person with little experience in healthcare. Test and trace spent £13.5bn in the first year with little evidence on reducing levels of Covid-19 infection. The BMJ
Recommendations to Reduce the Possible Risk of Transmission of Creutzfeldt-Jakob Disease and vCJD by Blood and Blood Components
On May 23, the FDA announced the availability of one final guidance and two draft guidances for blood establishments. The final guidance, “Recommendations to Reduce the Possible Risk of Transmission of Creutzfeldt-Jakob Disease and Variant Creutzfeldt-Jakob Disease by Blood and Blood Components,” removes the recommendations to defer indefinitely blood donors for: 1) geographic risk of possible exposure to bovine spongiform encephalopathy for time spent in the United Kingdom (U.K.) from 1980-1996 and for time spent in France and Ireland from 1980-2001, and 2) receipt of a blood transfusion in the U.K., France, and Ireland from 1980-present. The guidance also provides recommendations for requalification of individuals previously deferred for these geographic risk factors, provided they meet all other eligibility requirements. U.S. Food and Drug Administration
Want to Prevent Pandemics? Stop Spillovers
Decision-makers discussing landmark agreements on health and biodiversity must consider studies which show that changes in the way land is used, particularly tropical and subtropical forests, might be the largest driver of emerging infectious diseases of zoonotic origin globally. Wildlife that survives forest clearance or degradation tends to include species that can live alongside people, and that often host pathogens capable of infecting humans. For example, in Bangladesh, bats that carry Nipah virus — which can kill 40–75% of people infected — now roost in areas of high human population density because their forest habitat has been almost entirely cleared. Nature
Avoiding Crisis Conditions in the Healthcare Infrastructure
Through 2 case studies, researchers identify key tools deployed to reduce surge and barriers to coordinated statewide support of the healthcare infrastructure and offer considerations for operationalizing key tools to alleviate surge and recommendations for stronger statewide coordination in future public health emergencies. Health Security
The Hidden Race to Protect the US Bioeconomy from Hacker Threats
A new partnership between the cybersecurity nonprofit Bioeconomy Information Sharing and Analysis Center (BIO-ISAC) and the Johns Hopkins University Applied Physics Laboratory (APL), which works on emerging research with US government agencies, is highlighting the need for more resources to better secure biomedical, bioindustrial, and biomanufacturing entities. Wired
A Generalizable One Health Framework for the Control of Zoonotic Diseases
Coupled with recommendations for implementing a One Health approach for zoonotic disease prevention and control in technical domains including laboratory, surveillance, preparedness and response, this framework can mobilize One Health and thereby enhance and guide capacity building to combat zoonotic disease threats at the human–animal–environment interface. Scientific Reports
Special Pathogens Readiness in the U.S.: From Ebola to COVID-19 to Disease X and Beyond
This supplement is a collection of papers that highlight the work of National Emerging Special Pathogens Training and Education Center (NETEC) and the national network of Regional Emerging Special Pathogens Treatment Centers (RESPTCs) from the earliest days of the COVID-19 pandemic. It is the story of how RESPTCs made incredible efforts toward special pathogen education and training preparedness that buttressed the US healthcare system’s operational response and clinical research capabilities. These papers underscore how sustained RESPTC operations through the COVID-19 pandemic will contribute to the changing landscape of pandemic preparedness and response, globally. Health Security
SELECT AGENTS + PRIORITY PATHOGENS
WHO Expects More Cases of Monkeypox to Emerge Globally
The World Health Organization says nearly 200 cases of monkeypox have been reported in more than 20 countries not usually known to have outbreaks of the unusual disease, but described the epidemic as “containable” and proposed creating a stockpile to equitably share the limited vaccines and drugs available worldwide. “Available information suggests that human-to-human transmission is occurring among people in close physical contact with cases who are symptomatic.” Although WHO said nearly 200 monkeypox cases have been reported, that seemed a likely undercount. On Friday, Spanish authorities said the number of cases there had risen to 98. U.K. officials added 16 more cases to their monkeypox tally, making Britain’s total 106, while Portugal said its caseload jumped to 74 cases. AP News
EU Health Agency Warns Monkeypox Could Become Endemic in Europe if Outbreak Continues
There is a risk that monkeypox could become endemic in Europe if the current outbreak isn’t brought under control and the virus spills back into susceptible animal species, the European Centre for Disease Prevention and Control said Monday as it issued a risk assessment of the unprecedented event. The health agency said that if person-to-person transmission continues and if the monkeypox virus were to make its way into animal species in the region, it could become entrenched, though it suggested the risk is thought to be “very low.” STAT
Canada Considering Smallpox Vaccine for Monkeypox Cases
Public Services and Procurement Canada put out a tender last month to purchase 500,000 doses of the Imvamune smallpox vaccine on behalf of the Public Health Agency of Canada from 2023 to 2028. Health Canada has also approved that vaccine, from Danish biotech company Bavarian Nordic, for use to prevent monkeypox. CTV News
Recent Developments in Botulinum Neurotoxins Detection
Currently, the mass spectrometry approach is the most sensitive in vitro method for a rapid detection of active or inactive forms of BoNTs. However, these methods require inter-laboratory validation before they can be more widely implemented in reference laboratories. Cell-based assays using neuronal cells in culture recapitulate all functional steps of toxin activity, but are still at various stages of development; they are not yet sufficiently robust, due to high batch-to-batch cell variability. Cell-based assays have a strong potential to replace the mouse bioassay (MBA) in terms of BoNT potency determination in pharmaceutical formulations; they can also help to identify suitable inhibitors while reducing the number of animals used. However, the development of safe countermeasures still requires the use of in vivo studies to complement in vitro immunological or cell-based approaches. Microorganisms
Effect of Recombinant Vesicular Stomatitis Virus–Zaire Ebola Virus Vaccination on Ebola Virus Disease Illness and Death in the DRC
A retrospective cohort study to assess the effect vaccination with the live-attenuated recombinant vesicular stomatitis virus–Zaire Ebola virus vaccine had on deaths among patients who had laboratory-confirmed Ebola virus disease (EVD). Included EVD-positive patients coming to an Ebola Treatment Center in eastern Democratic Republic of the Congo during 2018–2020. Overall, 25% of patients vaccinated before symptom onset died compared with 63% of unvaccinated patients. Vaccinated patients reported fewer EVD-associated symptoms, had reduced time to clearance of viral load, and had reduced length of stay at the Ebola Treatment Center. After controlling for confounders, vaccination was strongly associated with decreased deaths. Emerging Infectious Diseases
Rapid Capsular Antigen Immunoassay for Diagnosis of Inhalational Anthrax: Preclinical Studies and Evaluation in a Nonhuman Primate Model
Analysis of a rapid lateral flow immunoassay that detects capsular antigen of Bacillus anthracis that is shed into blood during infection. The test was evaluated in a robust cynomolgus monkey model of inhalational anthrax. The test has the potential to rapidly triage patients who have been exposed to the microbe and have symptoms suggestive of anthrax. mBio
Metabolic Reprogramming Mediates Delayed Apoptosis of Human Neutrophils Infected with Francisella tularensis
Neutrophil turnover is disrupted during F. tularensis infection and, consequently, neutrophils contribute distinctly to tularemia pathogenesis by exacerbating host tissue destruction. Herein, researchers extended their previous studies of apoptosis inhibition to demonstrate neutrophil metabolic reprogramming by F. tularensis. They show that this bacterium elicits a distinct metabolic signature in human neutrophils that differs from other stimuli studied date. Frontiers in Immunology
Beyond Lassa Fever: Systemic and Structural Barriers to Disease Detection and Response in Sierra Leone
This empirical study explores the implementation of health system processes associated with International Health Regulations (IHR) requirements for early detection and timely and effective responses to the spread of febrile disease, through the case study of Lassa Fever in Sierra Leone. Multiple challenges were identified, including issues with the LF case definition, approaches to differential diagnosis, specimen transport and the provision of results, and ownership of laboratory data. PLOS Neglected Tropical Diseases
Canada Reports Avian Flu in Skunks as Virus Strikes More US Flocks
Following detections of avian flu in foxes in Canada and the United States, veterinary officials in Alberta have detected the virus in deceased skunks. The detections in wild mammals are notable, raising concerns about the zoonotic potential of the circulating virus. CIDRAP
CHEMICAL + RADIOLOGICAL THREATS
A Prosecutor’s Guide to Chemical and Biological Crimes
This Guide aims to provide police, prosecutors, and relevant investigative agencies with guidance to support the successful prosecution of incidents involving the deliberate acquisition, stockpiling, production, transfer, or use of a chemical or biological agent. It is a non-binding high-level guidance document with considerations across key elements associated with the deliberate use of chemical and biological agents and toxins and the impact of these elements on the prosecutorial process. UN Interregional Crime and Justice Research Institute (UNICRI)
The Importance of Covering Surface Transportation Board Issues
Chlorine (or any other toxic inhalation hazard – TIH – chemical) railcars are potentially rolling chemical weapons. While railcars in transit are very hard to secure, they are difficult (from a planning and execution point of view) to attack while they are moving. When they are parked for any length of time, it becomes easier to plan and execute an effective attack. In transit delays due to train crew staffing issues, mis-coordinated deliveries resulting in hand-off issues, and general inept management of rail planning all create opportunities for attacks on these railcars. TSA surface security inspectors should be increasing their surveillance of TIH rail shipments while these service problems continue. Chemical Facility Security News
How Does Homeland Security Combat Weapons of Mass Destruction, and How Could Their Efforts Improve?
CWMD has a number of methods for detecting potential threats coming into the country. For example, radiation portal monitors scan the more than 100 million vehicles passing through U.S. ports annually, looking for elevated levels of radiation. But some partners said that CWMD did not have sustained communication with them, and that communication with some partners had ceased entirely since 2018. CWMD has communication and outreach plans for how it interacts with states, but GAO found that these plans did not specify how often CWMD would convene its partners in each of the threat areas under its responsibility. U.S. Government Accountability Office (GAO)
SURVEILLANCE + DETECTION
The Michigan Mink Mystery: How Did an Interspecies Outbreak Unfold?
Since the early days of the pandemic, when SARS-CoV-2 tore through fur farms, scientists have worried that mink might become a long-term reservoir for the virus and a potential source of new variants. Even as Congress considers a ban on mink farming, there is still no national system for proactive surveillance on mink farms, which are not required to report cases to federal authorities. Together, lack of transparency and spotty surveillance make it difficult to determine how much of a risk mink farms pose for spillover and spillback, scientists say. New York Times
On the Lookout for Monkeypox, CDC Considers Expanding Test Capacity
Federal health officials this week said they’re considering expanding testing networks, even as they’ve stressed the current two-step process is not delaying treatment or containment of the outbreak. The CDC has faced questions about whether the protocol might prolong infection detection, at a time early in the outbreak when active case investigations and severing transmission chains can prevent the virus from becoming established in communities. The scrutiny is heightened by memories of the Covid-19 pandemic’s early days, when faulty tests and slow regulatory action left the country with a dearth of testing capacity — and a hindered ability to track the virus as it exploded. STAT
Puzzling Pediatric Hepatitis Cases Echo an Earlier Mysterious Illness
As public health agencies race to figure out what is behind the unusual hepatitis cases, there are lessons to be learned from the ongoing efforts to solve the mysteries of acute flaccid myelitis (AFM) – and how collecting the right samples, at the right time, is critical. Already, it’s clear that discrepancies in the samples taken from the various pediatric hepatitis cases may be preventing the picture from coming into clear focus. To find adenovirus, testing needs to be done in the first week of symptoms, and preferably in whole blood samples. The same is true for the timing of nasal swab sample collection in AFM case investigations. STAT
Optimizing the Sensitivity of Biological Warfare Particle Detection Through Atmospheric Particle Analysis
Here an adaptive detection algorithm distinguished between normal and biological particles using a laser-induced fluorescence-based biological particle detector capable of real-time measurements and size classification. The algorithm parameters were optimized for the South Korean environment by analyzing light scattering and fluorescent particles in various climates. Sensors
PUBLIC HEALTH
Viral Fragments Lingering in the Gut Could Be Linked to Long COVID
In the chaos of the first months of the coronavirus pandemic, oncologist and geneticist Ami Bhatt was intrigued by widespread reports of vomiting and diarrhoea in people infected with SARS-CoV-2. “At that time, this was thought to be a respiratory virus,” she says. Bhatt and her colleagues, curious about a possible link between the virus and the gastrointestinal symptoms, began to collect stool samples from people with COVID-19. Two years into the pandemic, the scientists’ foresight has paid off: recently published results suggest that pieces of SARS-CoV-2 can linger in the gut for months after an initial infection. The findings add to a growing pool of evidence supporting the hypothesis that persistent bits of virus could contribute to long COVID. Nature
So, Have You Heard About Monkeypox?
Now, because the U.S. catastrophically underestimated COVID, many Americans are panicking about monkeypox and reflexively distrusting any reassuring official statements. “I don’t think people should be freaking out at this stage,” Carl Bergstrom of the University of Washington told me, “but I don’t trust my own gut feelings anymore, because I’m so sick of all this shit that I tend to be optimistic.” Monkeypox, then, is a test of the lessons that the world has (or hasn’t) learned from COVID. Can we better thread the needle between panic and laxity, or will we once again eschew uncertainty in a frantic quest for answers that later prove to be wrong? The Atlantic
The Anti-Vaccine Movement’s New Frontier
A wave of parents has been radicalized by Covid-era misinformation to reject ordinary childhood immunizations — with potentially lethal consequences. Such doubt has been accompanied by, and may have been augmented by, an erosion of confidence in medical expertise generally. In his 14 years of practicing medicine in Littleton, a Denver suburb, pediatrician Robert Froehlke had seen parents decline their children’s vaccines for the sake of a more “natural” lifestyle. He had also seen parents, worried about overstressing their children’s bodies, request that vaccinations be given on different schedules. But until the past nine months or so, he had rarely seen parents with already vaccinated children refuse additional vaccines. Some of these parents were even rejecting boosters of the same shots they unquestioningly accepted for their children just a few years earlier. New York Times
Abbott Caused the Infant Formula Crisis, But the FDA and Public Health Enabled It – Congress Needs to Fix It
Seven months after FDA received the first report of an infant infected with Cronobacter and nearly five months after the agency initiated its in-depth inspection of Abbott Nutrition’s production facility, several questions to the FDA and public health officials remain: In view of what the FDA learned in September 2021regarding Cronobacter-positive environmental and finished product samples at the Abbott facility, why did it take more than four months for the agency to initiate another inspection after receiving the first of the illness reports? As Cronobacter (unlike Salmonella) is not a “reportable” disease in most states, how many additional cases of Cronobacter in infants have gone unreported? Why did it take until February 17, 2022, before the public was made aware of the situation? Food Safety News
SPECIAL INTEREST
Health Solutions Grad Goes from Ebola Crisis to Improving Health Care
When George Karway first came to ASU in 2014, he planned to study education. The Ebola outbreak in his home nation of Liberia made him reconsider that plan. “Fear was so rampant and physicians so scarce when the crisis hit that even suspicion of Ebola infection would land a patient in quarantine,” Karway said. “No one wanted to come close to you. No one wanted to test you if you had any symptoms. I talked to my parents every day, and they would tell me how even health care providers were getting sick and dying. Because people were being quarantined without testing, people who had escaped the virus initially caught it after all.” The crisis prompted Karaway to change majors and go on to complete his Bachelor of Science in biomedical informatics in 2018 and a Master of Science in biomedical informatics in 2019, graduating with summa cum laude honors. He continued on at the College of Health Solutions to earn his PhD in 2022. Arizona State University
About the Cover: Tapeworm Enigma
Among the parasitic organisms that can transmit infections to humans are about 300 species of helminths (parasitic worms). In his book People, Parasites, and Plowshares, Columbia University parasitologist Dickson Despommier notes, “These are the most underappreciated of our parasites that have for centuries kept a low profile, cruising just under the radar screen of the world’s health agencies.” Emerging Infectious Diseases
Also Reading:
Identifying Japanese Encephalitis Virus Using Metatranscriptomic Sequencing, Xinjiang, China Emerging Infectious Diseases
Designing a novel multi‑epitope vaccine against Ebola virus using reverse vaccinology approach Scientific Reports
Aerosol particle emission increases exponentially above moderate exercise intensity PNAS
Safety and immunogenicity of four-segmented Rift Valley fever virus in the common marmoset NPJ Vaccines
Identification of Human Case of Avian Influenza A(H5N1) Infection, India Emerging Infectious Diseases
Familiarity with emergency preparedness and its predictors among nurses and physicians working at public hospitals in east Gojjam zone, northwest Ethiopia SAGE Open Medicine
Analysis of 6.4 million SARS-CoV-2 genomes identifies mutations associated with fitness Science
Experimental Infection of Mink with SARS-COV-2 Omicron Variant and Subsequent Clinical Disease Emerging Infectious Diseases
India wrangles with WHO over COVID-19 death figures SciDevNet
Discovery of Tick-Borne Karshi Virus Implies Misinterpretation of the Tick-Borne Encephalitis Virus Seroprevalence in Northwest China Frontiers in Microbiology
Structural Features of Clostridium botulinum Neurotoxin Subtype A2 Cell Binding Domain Toxins
