News highlights on health security threats and countermeasures curated by Global Biodefense

This week’s selections include efforts to create a robust pandemic clinical trial infrastructure; expansion of the Regional Emerging Special Pathogen Treatment Centers; pediatric hospital capacity strain under RSV surge; and the WHO’s priority list of life-threatening fungal pathogens.

POLICY + GOVERNMENT

UN Still Sees No Sign of Biological Weapons in Ukraine

The United Nations is not aware of any biological weapons programs in Ukraine, a senior official in the Office for Disarmament Affairs (UNODA) reiterated on Thursday in a briefing to the Security Council. This marked the third time since the 24 February invasion of Ukraine that the Council has formally met at Russia’s request to address its ongoing allegations. US Ambassador Linda Thomas-Greenfield characterized the meeting as “a colossal waste of time”, saying it was held for the sole purpose of spreading disinformation. UN News

OSTP and NSC Seek Input on U.S. Capacity for Emergency Clinical Trials, Research

The COVID-19 pandemic prompted a host of well-intended but fragmented trials launched, with poor design and low enrollment rates unlikely to yield actionable results. The Biden administration is working to build a more agile clinical trial infrastructure capable of responding to public health emergencies. OSTP is seeking feedback from stakeholders on how to build this capacity. RFI deadline is 27 December 2022. White House

ASM Responds to Senate HELP Report on COVID Origins

“On Oct. 27, the Senate Health, Education, Labor and Pensions (HELP) Committee Minority oversight staff released an interim report titled, “An Analysis of the Origins of the COVID-19 Pandemic.” ASM appreciates the efforts of Senate staff to provide a preliminary overview of existing information related to the origin of SARS-CoV-2, but ASM respectfully disagrees with the report’s conclusion. At this time, ASM does not believe there is enough available evidence about the origins of SARS-CoV-2 to support the report’s overarching conclusion.” American Society for Microbiology

Republican Senate Staff Tout Lab-Leak Theory of the Pandemic’s Origin

Two papers co-authored by Michael Worobey, which argue for a zoonotic jump at a market in Wuhan, China, come in for significant criticism in the report, to which Worobey responded, “These comments are either intentionally misleading or the result of honest misunderstandings, perhaps due to a failure to read our papers, which address these issues in great detail.” The report also demonstrated a failure to understand BSL maintenance and upgrades, depicting those actions, common to labs worldwide, as security risks. Science

13 Hospitals Receive Funding as Special Pathogen Care Hubs

The HHS awarded a total of $21 million to 13 hospitals to serve as region experts on readiness and response efforts to combat infectious diseases caused by special pathogens, including COVID-19, Ebola and monkeypox. Three new healthcare facilities were tapped to serve as Regional Emerging Special Pathogen Treatment Centers: Washington Hospital Center in Washington, D.C., University of North Carolina at Chapel Hill, and Spectrum Health System in Grand Rapids, Michigan. They join 10 centers already in the network. Healthcare Dive

Biointelligence and National Security in the 21st Century

Over the past five years, IARPA has launched 10 new bio-focused programs, a threefold increase compared to IARPA’s first decade of existence. This includes the Finding Engineering Linked Indicators (FELIX) program, which contributed to the first IC public statement that the SARS-CoV-2 virus was not genetically engineered as well as the Molecular Information Storage (MIST) program, which is pursuing new ways of using biology for scalable data storage. This bio-focus coincides with public recognition by the past three directors of national intelligence of the evolving importance of biology and biotechnology. Signal

The Philippines: US Partners with Bureau of Customs for WMD Counterproliferation

The Defense Threat Reduction Agency (DTRA) Strategic Arms Offense Elimination (SOAE) Program partnered with the country’s Department of Trade and Industry-Strategic Management Office (STMO) to conduct a WMD Material Post-Interdiction Disposition Needs and Gap Analysis. During the courtesy call by representatives from the US-DTRA on Customs Commissioner Yogi Filemon Ruiz, the US-DTRA team expressed willingness to potentially assist the BOC with training on identifying, handling, and transporting dual goods before disposal. The US-DTRA and STMO also visited ports to assess the existing protocols and capabilities in handling dual goods and they will provide a report containing their initial evaluation and recommendations. PH Bureau of Customs

To Fix America’s Biodefense Strategy, Think Smaller

There is no doubt that the Biden administration wants to improve the nation’s pandemic preparedness, and a strategy limited to that topic would be much more appropriate, given the significant size and complexity of US health care. There are at least three major obstacles to this effort: poorly defined terms of reference, the lack of context of how these biological threats are addressed, and the challenges inherent to an interagency response to complex issues. None of these are new challenges.  Breaking Defense

National Academy of Medicine Rejects Republican Allegations Against Member Peter Daszak

Republican members of Congress have failed to persuade the U.S. National  Academy of Medicine (NAM) to expel one of its members, conservation biologist Peter Daszak. In an email to its members, NAM concluded there “was no evidence” that Daszak had violated its code of conduct, as the representatives had alleged in a complaint to NAM. Science

MEDICAL COUNTERMEASURES

Advancing Development of Medical Countermeasures: Incorporating COVID-19 Lessons Learned Into Future Pandemic Preparedness Planning

Having in place flexible MCM development and support contracts that can rapidly pivot to and evolve with new viral or bacterial pathogens are required. Improved platform technologies that can be used to develop MCMs faster and with better breadth and duration of protection against new emerging infectious diseases are needed. Working with FDA and industry to design pivotal clinical trials with sufficient power and robust endpoints is critical for expediting regulatory approval. Easy-to-use diagnostics that can be utilized in homes and other non-traditional testing settings greatly improve access to testing and have potential to reduce disease spread. Human Vaccines and Immunotherapeutics

Immune Modulatory Vaccines: Time to Move Into Infectious Diseases

Immune modulatory vaccines represent a new treatment modality that is currently under intense investigation in patients with cancer. Immune modulatory vaccines are a method of stimulating the body’s endogenous anti-regulatory T cells to target immune-suppressive regulatory cells. Immune modulatory vaccines seem to represent a novel way of activating proinflammatory cells that can affect immune inhibitory pathways without inducing increased toxicity. Several antigens for immune modulatory vaccines exist, and each could be utilized alone or together depending on the type and stage of the infectious disease. Thus, further research into the natural role and effect of anti-regulatory T cells in different infectious settings, in addition to the effects of immune modulatory vaccines as monotherapy and in combination with other therapies, is highly warranted. The Lancet Microbe

Moderna Nearing Deal with US Government to Develop Ebola Vaccines

Moderna is reportedly nearing an agreement with the US government to develop vaccines for Ebola and additional viruses considered to be threats. The deal is expected to see Moderna work with researchers from the University of Texas Medical Branch at Galveston to emulate its rapid approach to Covid-19 for such viruses. Endpoints News

New Vaccine Roadmap Eyes Future Threats of Coronaviruses

In the past 20 years, three significant new coronaviruses have jumped from animal reservoirs, causing human epidemics (SARS-CoV-1, MERS, and SARS-CoV-2). “We need to be better prepared for new SARS-CoV-2 variants and coronaviruses that may emerge in the future. “If the redesigning of vaccines is based on variants that are circulating now, we are already behind…The current vaccines should be used. But we need to look at vaccines that address more robust immunity, with a broad breadth of protection.” CIDRAP

Broad-Spectrum Lectin Inhibits SARS-CoV-2 and MERS-CoV Infection in Vivo

Pan-coronavirus antivirals targeting conserved viral components can be designed. This engineered lectin potently inhibits MERS-CoV, SARS-CoV-2 (including Omicron), and other human-pathogenic coronaviruses at nanomolar concentrations — Importantly, and is comparably effective administered intranasally and intraperitoneally. The multiple binding sites on spike likely account for the drug compound’s broad-spectrum antiviral activity and the lack of resistant mutants. Cell Reports Medicine

Immunogenicity and Protection of a Nipah Virus Soluble G Vaccine Candidate in Mice and Pigs

The protective efficacy of the subunit vaccines evaluated in the pseudovirus in vivo infection mouse model strongly suggested that this vaccine could provide protective immunity against NiV. Frontiers in Microbiology

EU Regulator Recommends Clearing Takeda’s Dengue Vaccine

The green light for the Takeda vaccine comes after Sanofi Pasteur’s dengue vaccine triggered a public health crisis in the Philippines in 2017. The Dengvaxia shot was found to increase the risk of severe disease in people who had not previously been infected with dengue and was linked to the deaths of more than 100 children. AP News

Development of Functional Anti-Gn Nanobodies Specific for SFTSV

Severe fever with thrombocytopenia syndrome (SFTS) is an acute infectious disease caused by novel bunyavirus (SFTSV), with a mortality rate of 6.3% ~ 30%. To date, there is no specific treatment for SFTS. Previously, researchers demonstrated that SFTSV surface glycoprotein (Glycoprotein N, Gn) was a potential target for the development of SFTS vaccine or therapeutic antibodies, and anti-Gn neutralizing antibodies played a protective role in SFTS infection. This study screens, selects and validates a nanobody highly specific for Gn. The high-throughput technical route developed in this study could also be expanded to the production of nanobodies specific for other viruses like SARS-CoV-2. Protein Science

Rift Valley Fever Vaccine Development Strategies

Rift Valley fever (RVF) is a mosquito-borne viral zoonosis that causes high fetal and neonatal mortality in ruminants and a mild to fatal hemorrhagic fever in humans. There are no licensed RVF vaccines for human use while for livestock, commercially available vaccines are all either live attenuated or inactivated and have undesirable characteristics. Novel DIVA-compatible RVF vaccines with better safety and efficacy than the licensed ones are being developed, aided fundamentally by a better understanding of the molecular biology of the RVF virus and advancements in recombinant DNA technology. Vaccines

Univercells, Batavia Biosciences on Tap to Help Bring Affordable Measles and Rubella Shots to Africa

Production will take place at a regional manufacturing hub in Dakar called MADIBA, which has been used to make vaccines against COVID-19 and other epidemic diseases. Fierce Pharma

Antiviral Activity and Mechanism of Antifungal Drug, Anidulafungin, Suggesting Potential for Treatment of Viral Diseases

The severe fever with thrombocytopenia syndrome disease (SFTS), caused by the novel tick-borne SFTS virus (SFTSV), was listed among the top 10 priority infectious disease by WHO due to the high fatality rate of 5–30% and the lack of effective antiviral drugs and vaccines and therefore raised the urgent need to develop effective anti-SFTSV drugs to improve disease treatment. Anidulafungin, an antifungal drug of the echinocandin family, demonstrated a strong inhibitory effect on SFTSV entry and exerts an antiviral effect in inhibiting the entry of other viruses including SARS-CoV-2, SFTSV-related Guertu virus and Heartland virus, Crimean-Congo hemorrhagic fever virus, Zika virus, and Herpes simplex virus. BMC Medicine

BIOSECURITY + BIOPREPAREDNESS

Hospital Incident Command System Survey

The National Advisory Committee for the Hospital Incident Command System encourages hospitals and health systems to complete by Nov. 30 a survey on the system’s emergency management performance during the past few years to identify potential improvements. Some hospitals and health systems use HICS, an incident management system, to improve their emergency management planning, response and recovery capabilities. Deadline is 30 Nov 2022. Hospital Incident Command System

Attitudes and Expectations of Investigations and Evidence for Biological Attribution

Historical examples of biological event attribution and origins investigations illustrate significant gaps in processes, from technical capabilities to communications, and have lacked conclusive consensus among decision makers, the public, and scientists. This study aimed to assess attitudes and expectations of a broad range of stakeholders regarding investigations and evidence generated for biological attribution. Authors interviewed 41 experts in disciplines related to attribution and investigations.  Preprints.org

Preparing Health-Care Systems for Future Pandemics

Hospital emergency departments are “sentinel systems” for infectious disease, because they’re often the first places people go to when experiencing unusual symptoms. At present, the diagnostics available in any given hospital usually reflect the illnesses they most commonly encounter. As a result, health-care workers often do not have easy access to tests that would allow them to confirm an unusual illness for their region, as might be the case in the early days of a pandemic. To rectify this, hospitals should establish relationships with laboratories that can test for diseases that aren’t in their own wheelhouse, so that these labs can be called on quickly when needed.  Nature

Effectiveness of International Virtual Training on Biorisk Management in the Context of COVID-19

To address the needs of laboratorians and managers to conduct laboratory activities safely and securely during the pandemic, a highly interactive virtual training (IVT) workshop on biorisk was conducted during the early period of the COVID-19 pandemic when travel was limited. Support from the public and private sectors at national and international levels will have an additional impact on the implementation of biorisk management, in which IVT can play a significant role. Frontiers in Public Health

Five Ways to Prepare for the Next Pandemic

Global sequencing capacity, strengthening medical supply and medical countermeasure manufacturing, and surveillance of zoonoses are among the key recommendations. Nature

Craig Spencer: We May Have Only a Few Months to Prevent the Next Pandemic

At the outset of every outbreak, a small window exists when response means the difference between containment and catastrophe. As the crisis wanes, a similar window exists when there’s enough will among people and politicians to push for better preparation for other pandemics. With Covid, that window is fast closing. While Covid causes over 300 deaths a day in the United States, a largely preventable toll that could amount to double our worst flu season, Congress remains unable to secure funding for future Covid vaccines and response, let alone the $88 billion requested over five years for pandemic preparedness and biodefense. New York Times

SELECT AGENTS + PRIORITY PATHOGENS

WHO Identifies Life-Threatening Fungal Pathogens

The WHO released its first-ever list of fungal “priority pathogens,” identifying 19 fungi that have emerged as significant public health threats because of their ability to cause severe invasive infections and their growing resistance to antifungal drugs. CIDRAP

Decision Support Framework for Informing Selection of Select Agent Toxins with Modelling Studies to Inform Permissible Toxin Amounts

The DSF approach applies key criteria using a logic tree format to identify those toxins which may be of sufficiently low concern that they can be ruled out from further consideration as a select toxin. While it is difficult to predict what toxins a terrorist might employ, the DSF, in accordance with the Bioterrorism Preparedness and Response Act of 2002, aims to identify those toxins that have the potential to pose a severe threat to public health and therefore would be most concerning, would terrorists be able to obtain them. Frontiers in Bioengineering and Biotechnology

Serological Evidence of SFTS Virus and IgM Positivity in Healthy Residents in Vietnam

Severe fever with thrombocytopenia syndrome (SFTS), an emerging tick-borne viral disease with a high mortality rate, is prevalent in East Asia and has also been reported in Southeast Asia since 2019. SFTS patients in Vietnam were first reported in 2019.  To investigate the seroprevalence of SFTSV in Vietnam, researchers collected serum samples from 714 healthy residents in Thua Thien Hue and Quang Nam Province, Vietnam. The seroprevalence ranges in Southeast Asia from 0.23% to 9.17% in China, from 1.9% to 7.7% in South Korea and from 0.14% to 0.3% in Japan, and prevalence rate is 2.5% in Pakistan. The seroprevalence rate in Vietnam is similar to that in Pakistan. Viruses

Pathogenicity and Virulence of Burkholderia pseudomallei

To fully understand the pathogenicity of B. pseudomallei more investment into genetic tools and characterisation of genes important for pathogenesis and persistence is required. With no currently licensed vaccine, and treatment compliance moderate at best, particularly in endemic areas, more work is needed to find novel intervention points which could be used in conjunction with current antibiotic therapies. This review has highlighted many virulence factors, and lifestyle adaptations which are required by B. pseudomallei to cause infection and survive within the host. Virulence

Global Technical Meeting on MERS-CoV and Other Emerging Zoonotic Coronaviruses

Summary of a technical meeting to review the MERS situation globally, the impact of the ongoing COVID-19 pandemic and ways to recommence and integrate preparedness and response activities for MERS. Since MERS-CoV was first identified in 2012, its global epidemiology has been characterized by the sporadic introduction of the virus from dromedary camels into the human population, and the amplification of human-to-human transmission in health-care settings. To date, there have been more than 2,500 laboratory-confirmed cases of MERS-CoV and 888 related deaths reported in 27 countries. World Health Organization

Analysis of Risk Factors Associated with Fatal Outcome Among SFTS Patients from 2015-2019 in Shandong, China

To better understand the progression of severe fever with thrombocytopenia syndrome (SFTS), identify early predictors of mortality, and improve the cure rate, the present study aimed to analyze the demographic feature, clinical characteristics, and laboratory parameters of patients with SFTS and to explore the risk factors associated with fatal outcome.  European Journal of Clinical Microbiology and Infectious Diseases

Kinetics of the Reduction of CJD Prion Seeding Activity by Steam Sterilization

Prions are renowned for their distinct resistance to chemical or physical inactivation including steam sterilization. Impaired efficacy of inactivation poses a risk to patients for iatrogenic transmission of Creutzfeldt-Jakob disease (CJD) via contaminated surgical instruments. Prion inactivation through widely recommended steam sterilization at 134 °C was assessed for several holding times by analyzing the residual prion seeding activity using protein misfolding cyclic amplification (PMCA). Journal of Hospital Infection

Jingmenviruses: Ubiquitous, Understudied, Segmented Flavi-Like Viruses

Jingmenviruses are an unclassified Flaviviridae. Closely related to flaviviruses, they are unique due to the segmented nature of their genome. The prototype jingmenvirus, Jingmen tick virus (JMTV), was discovered in Rhipicephalus microplus ticks collected from China in 2010. Over a hundred human patients tested positive for jingmenviruses after developing febrile illness and flu-like symptoms in China and Serbia.  Jingmenvirus research should be prioritized as they have the potential to emerge as human or veterinary pathogens and have been associated with febrile illness in humans. Frontiers in Microbiology

First Genomic Evidence of a Henipa-like Virus in Brazil

The viral genus Henipavirus includes two highly virulent zoonotic viruses of serious public health concern. Hendra henipavirus and Nipah henipavirus outbreaks are restricted to Australia and Southeast Asia, respectively. The Henipavirus genus comprises mostly bat-borne viruses, but exceptions have already been described as novel viruses with rodents and shrews as reservoir animals. In the Americas, scarce evidence supports the circulation of these viruses. In this communication, researchers report a novel henipa-like virus from opossums from a forest fragment area in the Peixe-Boi municipality, Brazil, after which the virus was named the Peixe-Boi virus (PBV). Viruses

CHEMICAL + RADIOLOGICAL THREATS

Controlling Novichok Nerve Agents After the Skripal and Navalny Incidents

The Chemical Weapons Precursors list features only individually enumerated chemicals rather than families of chemicals because frontline officers who do not have sufficient training in chemistry are unable to interpret them and to infer whether a chemical under scrutiny falls within their scope. However, the adoption of cheminformatics tools promises to fill this gap by equipping frontline officers with a capability to automatically query lists of controlled chemicals and interdict those of concern. NCT Magazine

How Iodine Pills Can—and Can’t—Help Against Radiation

East European governments are starting to distribute the tablets as a precaution, but there are limits to the protection they offer, and who might need them. As unease about Russia’s nuclear saber-rattling grows, along with concerns about the safety of Ukraine’s Zaporizhzhia nuclear power plant, officials in Kyiv are distributing iodine pills to help protect residents against potential radiation exposure. In neighboring Poland, the government is also making free iodine tablets available. Likewise, in Finland, pharmacies are running out of the pills after the country’s health ministry advised households to buy them in case of an emergency. Wired

Detection of Chemical Warfare Agents with a Drift Tube Ion Mobility Spectrometer

In this work, the capabilities and limitations of a miniaturized high-performance drift tube IMS were evaluated for its use in hand-held CWA gas detectors. The spectrometer was examined using live agents such as nerve agents sarin, tabun, soman, cyclosarin, as well as the blister agent sulfur mustard, the blood agent hydrogen cyanide and the choking agent chlorine. Interferent testing was also conducted. Analytical Chemistry

UNICRI Conducts Training on Investigating and Prosecuting Chemical and Biological Crimes

The trainings focused on the successful prosecution of chemical and biological crimes, biosafety and biosecurity issues. A demo moot court exercise included essential topics such as evidence preservation and integrity, intelligence gathering, and how to successfully prosecute a case. The capacity-building exercises are based on the Prosecutor’s Guide to Chemical and Biological Crimes and was attended by participants from Armenia, Bosnia and Herzegovina, Belgium, Germany, Georgia, Kazakhstan, Kenya, Kyrgyzstan, Moldova, Mongolia, Montenegro, North Macedonia, Pakistan, Tajikistan Ukraine, and Uzbekistan. UNICRI

Determination of Lethality Curve for Cobalt-60 Gamma-Radiation Source in Animal Model

Well-characterized and validated animal models are required for the development of medical countermeasures (MCMs) for acute radiation syndrome to mitigate injury due to high doses of total- or partial-body irradiation. Animal models used in MCM development must reflect a radiation dose- and time-dependent relationship, clinical presentation, and pathogenesis of organ injuries in humans. The objective of the current study was to develop the lethality curve for the Armed Forces Radiobiology Research Institute high level cobalt-60 gamma-radiation source in nonhuman primates (NHPs) after total-body irradiation. Radiation Research

Administration of Nitro-Oleic Acid Mitigates Radiation-Induced Hematopoietic Injury in Mice

Limited number of agents that provide protection against hematopoietic acute radiation syndrome led to the evaluation of nitro-oleic acid (NO2OA) as a potential protector/mitigator against radiation-induced hematopoietic injury in C57/BL6 mice. Results show that NO2OA significantly increase bone marrow cellularity including the granulocyte-macrophage colony-forming cells and erythroid progenitors. On the other hand, radiation-induced impairment of peripheral red blood cells, hemoglobin, and platelets were not affected with NO2OA treatment up to 7 days post exposure. Life Sciences

Major Radiological or Nuclear Incidents: Potential Health and Medical Implications

A new document developed by the Administration for Strategic Preparedness and Response (ASPR) Technical Resources, Assistance Center, and Information Exchange (TRACIE) provides an overview of the potential health and medical response and recovery needs following a radiological or nuclear incident and outlines available resources for planners. ASPR Tracie

SURVEILLANCE + DETECTION

Rapid Detection of Whole Active Ricin Using a Surface-Enhanced Raman Scattering Based Sandwich Immunoassay

 This study reports a reliable surface-enhanced Raman scattering (SERS)-based sandwich immunoassay for the detection and differentiation of active ricin from other homologous toxins. In the immunoassay design, magnetic bead conjugated with a monoclonal antibody (mAb) MIL50 which can recognize the ricin in its holotoxin form was used as a capture probe to separate ricin from complex matrix, while both Raman reporter molecule Nile blue A (NBA) and ricin-specific mAb 14C12 were modified on gold nanoparticles (AuNPs) to form SERS-nanoprobes. In the presence of ricin, SERS-nanoprobes bound to the antigen-captured magnetic beads and formed a sandwich immunocomplex to produce specific hot spots and then generated highly sensitive signals. As a result, the whole ricin could be detected as low as 1 ng/mL and 5 ng/mL in PBS and in plasma, respectively. Journal of Raman Spectroscopy

ATP Bioluminescence-Based Strategies for Monitoring Atmospheric Bioaerosols

Bioaerosols play a momentous role in the transmission of human infectious diseases. Based on the universal existence of Adenosine triphosphate (ATP) in bioaerosols, ATP bioluminescence can be used as a powerful technique to detect bioaerosols without interference from non-bioaerosols. When ATP is released from bioaerosols, they can quantify microbial biomass by ATP bioluminescence. This review, we provide the latest methodological improvements that enable more reliable quantification of bioaerosols in complex environmental samples. Journal of the Air & Waste Management Association

The Potential of Genomics for Infectious Disease Forecasting

Models used for infectious disease forecasting often cannot incorporate pathogen diversity and cannot typically be compared with genomic data. These models include the susceptible–infectious–recovered compartmental model and its myriad extensions (for example, latent periods, age structure and vaccination status). Although recent work links birth–death and coalescent phylogenetic models to compartmental models and projections, many modelling frameworks used for forecasting disease do not yet lend themselves to modelling diverse pathogens. Nature Microbiology

Multiplexed Detection of Pathogens Using LAMP for Point-of-Care Applications

Integration of LAMP with the supercritical angle fluorescence (SAF) micro-optic structures as a solid support (SS) in an array format enabled spatial separation of LAMP amplicons in a multiplexed configuration. Important parameters such as length of the SS primers, length of the primer-binding region, the effect of surface density of immobilized SS primers, and cross-reactivity among the primers of different targets were iteratively tested and optimized. The success of SP-LAMP has opened a promising direction toward the development of a multiplex POC system for rapid detection of multiple pathogens. ACS Sensors

ANTIMICROBIAL RESISTANCE

Emerging Carbapenem-Resistant Enterobacteriaceae – Epidemiology and Novel Treatment Options

The rise of carbapenem-resistant Enterobacteriaceae poses a threat to all nations. Enzyme synthesis, efflux pumps, and porin mutations are the main methods by which Enterobacteriaceae acquire resistance to carbapenems. Meropenem–vaborbactam, imipenem–relebactam, plazomicin, cefiderocol, eravacycline, and aztreonam–avibactam are recently reported to be active against carbapenem-resistant Enterobacteriaceae; and are also in ongoing trials for different populations and combinations with other antibacterial agents. Infection and Drug Resistance

Pine-Sol Recall 2022: Clorox Recalls Cleaning Products That May Contain Bacteria

Clorox said some of the affected Pine-Sol products might contain a bacteria called Pseudomonas aeruginosa, which can harm people with compromised immune systems or people with external medical devices because they pose “a risk of serious infection that may require medical treatment.” P. aeruginosa has been shown to possess a high level of intrinsic resistance to most antibiotics. CNN

T2 Biosystems Initiates Studies to Add Acinetobacter Baumannii to the FDA-Cleared Panel

A. baumannii is a cause of bloodstream infections especially in critically ill patients, which can range from a benign transient bacteremia to fulminant septic shock. A. baumannii infections typically occur in people in healthcare settings and pose risk to those who are on ventilators; have devices such as catheters; have open wounds from surgery; are in intensive care units; or have prolonged hospital stays. In a large study of nosocomial bloodstream infections, A. baumannii was the tenth most common pathogen and has a crude ICU mortality rate of 34.0% to 43.4%. Trial Stat

Genomic Characterization of Multidrug-Resistance in Two Intensive Care Units in Hanoi, Viet Nam

Here we present a large prospective genomic surveillance study of ESBL-producing or carbapenemase-producing organisms from three key AMR pathogens from two hospital ICUs in Viet Nam. Despite limiting our study samples to ESBL-producing or carbapenem-resistant isolates belonging to three species, we identified many isolates (an average of 17 isolates per day from patients in one ICU and ten per day in the other). Similar settings in England, UK, have  found a small incidence of ESBL-producing or carbapenemase-producing Enterobacterales. However, across Europe and the USA, the spread of endemic ESBL-producing and carbapenemase-producing Enterobacterales has increased, particularly E. coli and K. pneumoniae, with extensive spread of high-risk lineages, such as K pneumoniae ST258 and ST512 in the USA, Israel, Italy, and Greece. Meanwhile, the burden of carbapenem-resistant A. baumannii remains higher in south Asia than in high-income regions. The Lancet Microbe

Risk Factors of Infections Due to Multidrug-Resistant Gram-Negative Bacteria in a Community Hospital in Rural Thailand

The objectives of this study were to investigate the risk factors of multidrug resistance infections and to develop a risk assessment tool for MDR Gram-negative bacteria (MDR-GNB) infections at a community hospital in rural Thailand. The study revealed 30.77% MDR-GNB among GNB strains. The most common MDR-GNB strains were 63.02% for Escherichia coli and 11.46% for Klebsiella pneumoniae. Tropical Medicine and Infectious Diseases

Prevalence of ESBL-Producing Enterobacter Species Resistant to Carbapenems in Iran

The recent emergence of carbapenem-resistant (CR) and extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae pathogens, which are resistant to nearly all antibiotics, has raised concerns among international healthcare organizations. The pooled prevalence of Enterobacter species resistant to various antibiotics in Iran is as follows: imipenem 16.6%, meropenem 16.2%, aztreonam 40.9%, ciprofloxacin 35.3%, norfloxacin 31%, levofloxacin 48%, gentamicin 42.1%, amikacin 30.3%, tobramycin 37.2%, tetracycline 50.1%, chloramphenicol 25.7%, trimethoprim/sulfamethoxazole 52%, nalidixic acid 49.1%, nitrofurantoin 43%, ceftriaxone 49.3%, cefixime 52.4%, cefotaxime 52.7%, ceftazidime 47.9%, cefepime 43.6%, and ceftizoxime 45.5%. The prevalence rates of MDR and ESBL-producing Enterobacter species in Iran were 63.1% and 32.8%, respectively. International Journal of Microbiology

Potentially Pathogenic Bacteria in Water Bodies and Drinking Water – Bareilly, India

The study was conducted to evaluate the microbial quality of water supplies in Bareilly city and nearby villages. A total of 111 samples comprising community pond water (45), drinking water (36), water tap handle swabs (city, 23) and sewage water (7, city) were analyzed. Total of 363 bacterial isolates belonging to 25 genera were identified of which 71.3%, 47.7% and 30% isolates had multiple drug resistance, carbapenem resistance and produced extended spectrum-β-lactamases (ESBL), respectively. Twenty of the 36 drinking water samples had coliforms and 33.3% were positive for Escherichia coli. 55 samples had ESKAPE bacteria, 43.24% were positive for carbapenem resistant bacteria (CRB) and 24.3% samples had carbapenem resistant Enterobacteriaceae (CRE). In drinking water samples 8.3 % had CRE and 33.3% had CRB. Two thirds (65.2%) of water faucet (tap) handles in public places had CRBs mostly belonging to ESKAPE group of pathogens, and 52.2% carried CRE. The community pond water was still the bigger health hazard since 64.4% and 44.4% of samples were positive for CRB and CRE, respectively. Acta Scientific Microbiology

The Threat of Multidrug-Resistant/Extensively Drug-Resistant Gram-Negative Respiratory Infections: Another Pandemic

Pneumonia and other types of respiratory infections are among the most common infections caused by MDR/XDR Gram-negative bacteria and are associated with high rates of mortality. Future concerns are already heightened due to emergence of resistance to all existing antimicrobial agents developed in the past decade to treat MDR/XDR Gram-negative bacteria and a scarcity of novel agents in the developmental pipeline. This clinical scenario increases the likelihood of a future pandemic caused by MDR/XDR Gram-negative bacteria. This article discussed the role of stewardship, antibacterial oligonucleotides, phage therapy, monoclonal antibodies, and other clinical tools to address the growing crisis. European Respiratory Review

Deciphering the Role of β-Lactamase Inhibitors, Membrane Permeabilizers and Efflux Pump Inhibitors as Emerging Targets in Antibiotic Resistance

This review discusses how synergistic combination so f β-lactamases inhibitors, efflux pump inhibitors and membrane permeabilizers can break resistance to the most commonly used antimicrobials. Indian Journal of Microbiology

Antibiotics In Development for Multiresistant Gram-Negative Bacilli

Approaches include the development of new combinations based on older carbapenemics, together with new β-lactamase inhibitors that are active on carbapenemases (meropenum + vaborbactam); a fourth-generation cephalosporin; aztreonam + avibactam; and a new siderophore cephalosporin (cefiderocol). Medicina Intensiva

SPECIAL INTEREST

We Are Family: Denver Health High Risk Infection Team

During the West African Ebola Outbreak in 2014, Denver Health & Hospital Authority created the High Risk Infection Team (HITeam) to ensure readiness and preparedness for the hospital and staff. A year later, after a thorough review of its biocontainment facilities by the Centers for Disease Control and Prevention (CDC), Denver Health was designated a Regional Emerging Special Pathogens Treatment Center (RESPTC). Whether responding to a potential Ebola case or the monkeypox outbreak, every activation is an opportunity for the Denver team to test their processes and improve them. NETEC

NBAF: Leader of New USDA Research Unit Shares How She Got Into Studying Diseases

With NBAF’s unique capabilities, the U.S. Department of Agriculture created a new unit called the Zoonotic and Emerging Disease Research Unit, or ZEDRU, to better understand these diseases in large livestock and how to mitigate them. “As a community, we have not paid enough attention to the risks posed by viruses jumping from animals to people, from humans to animals or from animals to animals,” said Dr. Lisa Hensley, ZEDRU research leader at NBAF. “The security of our food supply is an incredible vulnerability to our public health and agricultural health, and we need to be proactive in this area.” The Mercury

Prion Diseases with Richard Knight

TWiV podcast discussion with Richard Knight about prion diseases and the outbreak of bovine spongiform encephalitis that led to cases of variant Creutzfeldt-Jakob disease in humans. This Week in Virology

Call for Experts to Serve on the Technical Advisory Panel of the Pandemic Prevention, Preparedness and Response Financial Intermediary Fund

The Technical Advisory Panel (TAP) will possess strong expertise across the full set of technical areas in which the PPR FIF will operate, including scientific, programmatic, operational, systems and structural contexts of PPR and of what it takes to build resilient health and community systems and strengthen IHR core capacities: community health workers; health emergency management; emergency care; infection prevention and control; risk communication and community engagement; and capacity building. World Bank

Addressing the Global Shortage of Biosafety & Biosecurity Professionals through Education: Establishment of a New Undergraduate Degree Program

The COVID-19 pandemic has brought into focus the significant demand on the biosafety and biosecurity profession and many countries face an overall shortage of these specialized individuals. To address this gap, the IFBA is leading a multisectoral effort towards a future sustainable workforce by formalizing a biosafety & biosecurity career path within the higher education system. International Federation of Biosafety Associations

EPA Request for Comments: Clean Air in Buildings Challenge

Building upon the Biden Administration’s Clean Air in Buildings Challenge, a key component of the President’s National COVID-19 Preparedness Plan, the Environmental Protection Agency (EPA) is seeking public comment to inform efforts by EPA and others to support the widespread adoption of actions that lead to improvements in indoor air quality in the nation’s building stock, with a particular emphasis on schools and commercial buildings, to help reduce disease transmission indoors and improve public health. Comments are due by December 5, 2022. EPA

New Cohort Opportunity for Technical Assistance: Infection Prevention and Control Assessment Training (IPC-AT)

NACCHO, with support from the CDC, is accepting applications for a new cohort for local health departments (LHDs) to build infection prevention and control (IPC) capacity through partnership with APIC Consulting, a subsidiary of the Association for Professionals in Infection Control and Epidemiology (APIC). The goal of the Infection Prevention and Control Assessment Training (IPC-AT) project is to enhance IPC capacity in LHDs so they can better respond to infection threats, such as COVID-19 and healthcare-associated infections (HAIs), in long-term care facilities (LTCFs). Specifically, LHDs will receive technical assistance from a locally based board-certified Infection Preventionist who will help LHDs refine their IPC skills by conducting standardized IPC assessments and follow up. The deadline for submitting applications for technical assistance is Friday, December 2, 2022. NACCHO

National Academies Early-Career Research Fellowship: Human Health and Community Resilience Track

The Human Health and Community Resilience track goal focuses on contributing to the understanding and mitigation of factors that may amplify the compounding effects of disasters on the health and resilience of historically disadvantaged, overburdened, or marginalized communities in the Gulf of Mexico region or Alaska. National Academies

OUTBREAK NEWS

COVID-19 PANDEMIC

European, US Officials Track BQ.1 Omicron Subvariant Rises

In an epidemiologic update, the ECDC said initial studies by Asian researchers suggest that BQ.1 has the ability to evade earlier immunity from illness and vaccines, but so far, there is no evidence that infections involving the subvariant are more severe. In the US, BQ.1 and BQ.1.1 are spreading relatively quickly, but still make up a small proportion of the overall variant picture. CDC also said it is keeping a close eye on XBB based on international reports, though it is still very rare in the United States. CIDRAP

Covid, Flu, RSV: Hospitalizations Rise as Wave of Viruses Hits New York

New Yorkers are falling ill with new variants of Covid and old illnesses like flu and RSV that masking and other precautions once held at bay. The Omicron variant that accounted for most infections through the summer, BA.5, is now giving way to a variant soup — a mixture of different Omicron subvariants, including BQ.1 and BQ.1.1, which are even more transmissible and better at dodging immunity. With most testing now done at home, it is hard to get a clear picture of the amount of virus circulating. The city’s official Covid case numbers have been holding steady for two months, at about 2,000 cases reported per day. But hospitalizations have again started to increase. New York Times

U.S. Searches for Backup for Key Covid Therapy for Immunocompromised People

Health officials are bracing for the prospect that the country’s sole preventive Covid-19 treatment for immunocompromised people could be ineffective this winter. AstraZeneca’s Evusheld, the only monoclonal antibody authorized as a periodic injection to prevent infection, has become an essential shot for roughly Americans with weakened immune systems. But news this month that it is not effective against a steadily climbing coronavirus strain sent health officials racing to game out other antibody options and convene a meeting with patient groups. The situation reflects larger questions about the Biden administration’s ability to respond to evolving Covid-19 variants with a shrinking coronavirus response budget (and seeming unwillingness to promote appropriate NPIs in high-risk settings) STAT

COVID ‘Variant Soup’ is Making Winter Surges Hard to Predict

In Europe, North America and Africa, the prevalence of Omicron offshoots in the BQ.1 family is rising quickly, even as overall cases seem to fall. In Asian countries including Singapore, Bangladesh and India, a lineage called XBB has already set off fresh waves of infection. Scientists are closely watching several regions where both are circulating, to see which has the edge. Nature

ACT-Accelerator Launches Six Month Plan as World Transitions to Long-Term COVID-19 Control

The Access to COVID-19 Tools (ACT) Accelerator this week launched its plan for the next six months, setting out how, as a partnership of global health agencies working alongside government, civil society and other partners, it will support countries as the world transitions to long-term COVID-19 control. Priority areas include: focusing research and development (R&D) and market shaping activities to ensure a pipeline for new and enhanced COVID-19 tools; securing institutional arrangements for sustained access for all countries to COVID-19 vaccines, tests and treatments, including oxygen; and concentrating in-country work on new product introduction (e.g., new oral antivirals for those at highest risk) and protection of priority populations (e.g., full vaccination of health care workers and older populations), in support of national and international targets. World Health Organization

EBOLA OUTBREAK – UGANDA

Ebola Update 28 October

As of 26 October, a total of 115 confirmed and 21 probable cases, including 32 confirmed and 21 probable deaths have been reported. Overall, 15 cases with four deaths have been reported among healthcare workers. 1844 contacts were under surveillance in nine districts of the country. A cumulative total of 3166 contacts have been listed since the start of this outbreak, of which 1194 (37.7%) have completed the follow-up period of 21 days. A total of 94 safe and dignified burials (SDB) have been undertaken since the beginning of the outbreak, of which 97.9% (n=92) were community burials. World Health Organization

Merck Locates Frozen Batch of Undisclosed Ebola Vaccine, Will Donate for Testing in Uganda’s Outbreak

In a revelation that may help Uganda combat its outbreak of Ebola, the pharmaceutical giant Merck has acknowledged that it has up to 100,000 doses of an experimental vaccine for the deadly viral disease in its freezers in Pennsylvania and will donate them. The Merck vaccine targets Sudan ebolavirus, the pathogen now circulating in Uganda. Merck quietly made the product in 2015 and 2016, soon after it had a landmark success with a similar vaccine against Zaire ebolavirus, a different virus that caused a big epidemic in West Africa between 2014 and 2016. The company froze the Sudan Ebola vaccine in bulk form and never tested it on people. But it has been shown to protect monkeys intentionally infected with Sudan ebolavirus, and given the efficacy of Merck’s Zaire Ebola vaccine, scientists have high hopes that the Sudan Ebola shots will be safe and effective as well. Science

Uganda Green-Lights Ebola Vaccine Trials

Uganda’s health minister announced yesterday that officials will evaluate three Sudan Ebola vaccine candidates in the coming weeks, and she revealed that healthcare workers are already testing some new treatment options (including monoclonal antibodies, as well as repurposed drugs such as Remdesivir, a broad-spectrum antiviral, that was donated by the US government). The three Sudan Ebola vaccines are from Oxford University in the United Kingdom and Sabin Vaccine Institute and Merck in the United States. CIDRAP

Red Cross and Community Members Fight Ebola’s Spread in Uganda

The IFRC urgently seeks CHF 10 million to address gaps and procure Personal Protective Equipment (PPE) for Uganda Red Cross staff and volunteers, who are at the forefront of the Ebola response. IFRC’s appeal will help address these and other needs, such as building the frontline team’s capacity to manage safe and dignified burials. The Uganda Red Cross has more than 500,000 volunteers and members spread across 51 branches and over 300 staff members including a skilled health department with health experts in areas directly linked to the epidemic response. IFRC

Many U.S. Labs Cannot Test for Ebola Strain Behind Uganda’s Swelling Outbreak

The federal push to scale up U.S. testing capacity for Sudan Ebolavirus comes as authorities have been bracing for the “low” risk that an infected traveler could bring it into the country from Uganda. A few weeks ago, only eight members of the Laboratory Response Network (LRN) had the ability to test. That number has now risen to 22 labs across the network, a CDC spokesperson said Tuesday. Unlike Zaire Ebolavirus, there are no rapid test kits available to spot infections by Sudan Ebolavirus. On Monday, the Biden administration announced it had awarded an additional $21 million to the hospitals and was adding a handful of new facilities to the nation’s “National Special Pathogen System.” CBS News

CHOLERA CRISIS

Cholera Outbreaks Threaten Children’s Survival in the Middle East

As Syria’s first major outbreak of cholera in over a decade spreads, thousands of children in neighbouring countries are also at risk from the deadly disease, with Lebanon’s recorded cases nearly doubling since last week. The acute epidemic in Syria has left over 20,000 suspected cases with acute watery diarrhoea and 75 cholera-associated deaths since its start [1]. In Lebanon, confirmed cholera cases reached 448 in just two weeks, with 10 associated deaths. Unicef

Cholera Overwhelms Haiti as Cases, Deaths Spike Amid Crisis

Since the notification of the first two confirmed cases of cholera in the greater Port-au-Prince area on 2 October 2022, health officials have reported a total of 2,243 suspected cases, including 219 confirmed cases, 1,415 hospitalized suspected cases, and 55 registered deaths. Worsening the situation is a lack of fuel and water that began to dwindle last month when one of Haiti’s most powerful gangs surrounded a key fuel terminal and demanded the resignation of Prime Minister Ariel Henry. Gas stations and businesses including water companies have closed, forcing an increasing number of people to rely on untreated water. AP News, PAHO

POLIO

Four Countries Report New Polio Cases

Four countries have new polio cases this week, all vaccine-derived types. Benin, the Democratic Republic of the Congo (DRC), and Yemen have more circulating vaccine-derived poliovirus type 2 (cVDPV2) cases, while the DRC and Malawi have circulating type 1 (cVDPV1) cases, according to the weekly report published by the Global Polio Eradication Initiative (GPEI). CIDRAP

Wastewater Testing and Detection of Poliovirus Type 2 Genetically Linked to Virus Isolated from a Paralytic Polio Case — New York

Wastewater testing has identified circulating polioviruses genetically related to virus isolated from the Rockland County patient in at least five New York counties. Public health efforts to prevent polio should focus on improving coverage with inactivated polio vaccine. Although most persons in the United States are sufficiently immunized, unvaccinated or undervaccinated persons living or working in Kings, Orange, Queens, Rockland, or Sullivan counties, New York should complete the polio vaccination series to prevent additional paralytic cases and curtail transmission. MMWR

CDC Considers Reintroducing Oral Form of Vaccine for Polio Outbreak in New York

A novel form of the oral, live virus polio vaccine is being considered by the CDC for an outbreak and ongoing detection of the virus in New York, following a presentation by the Polio Vaccine Work Group at the October meeting of the CDC’s Advisory Committee on Immunization Practices (ACIP). The decision to employ the oral vaccine will not be made without further deliberation. “It will be a process. It’s not something that we can pull the trigger on and have it appear overnight. There will be lots of thought and discussion about the reintroduction of an oral polio vaccine into the United States.” Contagion Live

HANTAVIRUS

Confirmed Hantavirus in Neuquén: 6 Close Contacts in Quarantine for 45 Days

The Ministry of Health of the Province of Neuquén, Argentina confirmed a hantavirus case on 26 Oct. The patient is a 28-year-old person from the town of San Martín de los Andes, who remains isolated and hospitalized in intensive care at the local hospital. Six people (including cohabiting and non-cohabiting relatives) must remain quarantined for 45 days in their personal homes and under a strict monitoring program with the aim of avoiding potential infections and detecting new onset illness early. Hantavirus is spread by inhaling contaminated air in open or closed places, where infected rodents eliminate it through saliva, feces and urine. As they dry, they combine with dust and become airborne. In addition, it can be spread by bites or direct contact by touching these living or dead animals that transmit the germ. Diario Hoy

Characterization of the Human Neutralizing Antibody Response to New World Hantavirus Infection

Hantaviruses are high-priority emerging pathogens carried by rodents and transmitted to humans by aerosolized excreta or, in rare cases, person-to-person contact. While sporadic in North and South America, many infections occur in Europe and Asia, with mortality ranging from 1 to 40% depending on the hantavirus species. There are currently no FDA-approved vaccines or therapeutics for hantaviruses. This work describes human monoclonal antibodies isolated from individuals previously infected with Sin Nombre virus or Andes virus. Most SNV-reactive antibodies show broad recognition and cross-clade neutralizing activity, while many ANDV-reactive antibodies show activity for ANDV only. Four mAbs show therapeutic efficacy at clinically relevant doses in hamsters. Vanderbilt University

Evidence for Human-to-Human Transmission of Hantavirus: A Systematic Review

Hantavirus is known to be transmitted from rodents to humans. However, some reports from Argentina and Chile have claimed that the hantavirus strain Andes virus (ANDV) can cause human-to-human transmission of the disease. Based on this review, the balance of the evidence does not support the claim of human-to-human transmission of ANDV. Well-designed cohort and case-control studies that control for co-exposure to rodents are needed to inform public health recommendations. Universidad de Sonora

RSV – RESPIRATORY SYNCTIAL VIRUS

Hospitals Overwhelmed by Pediatric Patients with Respiratory Virus

Hospitals in 33 states are seeing a dramatic rise in children suffering from the respiratory virus called respiratory syncytial virus (RSV). Cases have more than doubled in 25 states, putting a strain on hospitals — with some facilities so overwhelmed, they’re running out of beds. CBS

Flu/RSV Coinfection Produces Hybrid Virus that Evades Immune Defenses

When fused to RSV, influenza A virus is better able to escape antibodies that usually neutralize it, an in vitro study finds. To understand the effects of coinfection in vitro, the team infected human lung cells with IAV and RSV simultaneously. Treating the cells with antibodies against influenza A did not block the spread of infection, the researchers found. The hybrid simply used its RSV proteins to infect cells instead. “Influenza is using hybrid viral particles as a Trojan horse.” The Scientist

Safety and Efficacy of Bivalent RSV Prefusion F Vaccine in Adults Over 60

Slide deck from Pfizer as presented to the Advisory Committee on Immunization Practices (ACIP) providing a summary of the company’s RSVpreF candidate vaccine. CDC

While RSV Surges, Shortage of Pediatric Hospital Beds Delays Care for Some Kids

Pediatric hospital beds are more full now than they have been in the past two years. This crush of young patients filling hospitals now means those with less urgent illnesses may face long waits and sometimes days-long stays in the ER while they wait to be admitted. It also means kids who need cancer treatment or surgery may be sent home to wait until hospitals have beds. CNN

MONKEYPOX

Clinicians at Low Risk of Acquiring Monkeypox from Patients

An investigation by Colorado public health authorities found no monkeypox cases among 313 health care workers exposed to 55 patients with the virus, despite low adherence to preventive measures among the workers. The report adds to evidence that the overall risk to health care workers appears low. At least one US health care worker had a work-related monkeypox infection during the current outbreak and a health care worker in the UK became infected after handling patient linens during a 2018 outbreak. JAMA

Severe Monkeypox in Hospitalized Patients — United States

During August–October 2022, CDC provided clinical consultation for 57 hospitalized patients with severe manifestations of monkeypox, most of whom were Black men with AIDS. Delays were observed in initiation of monkeypox-directed therapies. Twelve patients died, and monkeypox was a cause of death or contributing factor in five patients to date, with several other deaths still under investigation. MMWR

Monkeypox Review

By October 7, 2022, a total of 71,096 cases of monkeypox infection had been reported in 107 locations worldwide, with 70,377 of the cases in countries that have not historically reported monkeypox.53 The largest numbers of cases have been reported in the United States, followed by Brazil and Spain. An analysis of 24,677 cases of monkeypox performed by the ECDC and the WHO, as of October 4, 2022, showed disproportionate numbers of cases in men (98.5%). Sexual orientation was known for 10,729 of the male patients, of whom 10,300 (96.0%) identified themselves as MSM. New England Journal of Medicine

Demographics of Patients Receiving TPOXX for Treatment of Monkeypox

As of 26 October, the cumulative number of patients prescribed or treated with TPOXX reported to the CDC is 4,822. This number likely underestimates the number of patients who are receiving TPOXX treatment as healthcare providers can start treatment before submitting IND paperwork to CDC. CDC

Lack of Clinical Evidence of Antiviral Therapy for Human Monkeypox

Few studies reported on antiviral treatment usage and subsequent clinical courses. To date, one systematic review based on literature up until 2018 has been completed on the potential efficacy of tecovirimat, brincidofovir, and cidofovir against orthopoxvirus infections, including the monkeypox virus [5]. To update and respond to this multi-country monkeypox outbreak in non-endemic countries, our systematic review aimed to evaluate and summarize the existing research on the efficacy and safety of tecovirimat, brincidofovir, and cidofovir for patients with monkeypox. Journal of Infection and Chemotherapy

PCR Positivity and Cycle Threshold Values in Biological Samples from Patients with Monkeypox

To the best of our knowledge, this is the first study to synthesize the PCR positivity rates in patients with monkeypox in the current outbreak and to compare Ct values between samples of different biological materials. Travel Medicine and Infectious Disease

The Need for Better Diagnostics to Support Diagnosis and Surveillance in Monkeypox Endemic Countries

Even though case numbers are now subsiding in non-endemic countries, as of Sept 11, the WHO Regional Office for Africa reported a 12.6% increase in case numbers within 1 week (from 524 in week 35, to 590 in week 36). Notably, the WHO Regional Office for Africa epidemiological update from May 2022, before monkeypox started spreading in non-endemic countries, stated that in the Democratic Republic of the Congo, between epidemiological week 1 and week 15 of 2022, 1152 cases associated with 55 deaths had been reported (amounting to an estimated case fatality rate of 4.8%). The high number of reported deaths is not only due to the different circulating clades of the monkeypox virus (the West African clade responsible for the current outbreak is associated with milder disease), but is also probably due to surveillance artifacts considering that reports of cases and deaths are typically based on symptoms and epidemiological correlations rather than confirmation of infection using molecular or other laboratory diagnoses. The Lancet Microbe

WEST NILE VIRUS

Colorado Sees Worst Year for West Nile Virus Since 2003

Most people who get West Nile virus never know they were infected, and those who do get sick typically have flu-like symptoms. In a small percentage of cases, though, the virus invades the brain or spinal cord, potentially causing disability or death. As of Friday, the state had recorded 195 total cases, which is almost certainly a significant undercount since most people wouldn’t know to get tested. Hospitalizations were at their third-highest level since the state started counting in 2003, with 135 people receiving care for severe symptoms. Denver Post

West Nile Virus Cases Could Set a North Carolina Record in 2022

State health officials have recorded 10 cases of West Nile Virus and 2 fatalities so far this year, with several weeks of warm weather left likely to mean more infections could be percolating. Positive cases have been reported in − among others − New Hanover, Cumberland, Wake, Mecklenburg, and Catawba counties, with both fatalities in Cumberland County. The first death of a North Carolinian from West Nile virus this year was confirmed Oct 4, days after Hurricane Ian dumped several inches of rain on most of North Carolina. Star News Online

Human West Nile Virus Activity in California

As of 27 October, California has recorded 106 total symptomatic WNV human infections and 7 fatalities (from 5 jurisdictions: Fresno, Kings, Merced, Stanislaus and Tehama). They also have positive samples in 16 horses from 10 different counties, 144 sentinel chickens from 13 counties, and 185 dead birds from 23 counties. CA Dept of Public Health

AVIAN INFLUENZA

Avian Flu is Spiking, Taking Out Millions of Holiday Turkeys

The rampant spread of the virus has already eliminated more than 6 million turkeys nationwide, and leaving farmers short of their usual offerings. The virus largely originates with wild birds, which can infect all kinds of poultry via their droppings when they fly over farms. But turkeys seem uniquely vulnerable. While wild birds may carry it without becoming sick, infected domesticated chickens and turkeys may exhibit tremors, trouble breathing and extreme diarrhea followed by a swift death. The USDA has scrambled to educate poultry businesses about best practices and how to identify signs of illness, which experts say has a 90 to 100 percent mortality rate in turkeys and chickens within 48 hours. The virus kills so quickly that multiple dead or dying birds can be the first sign a flock is infected.  Washington Post

Japan Reports First Bird Flu Outbreaks of Season, Culling 340,000 Chickens

Japan has detected its first outbreaks of bird flu for the season in 2022, with a “highly pathogenic” strain identified at a poultry farm on the main island of Honshu, while the other outbreak was found on the northern island of Hokkaido. About 170,000 egg-laying chickens are being exterminated at a farm in Kurashiki city, Okayama Prefecture, the agriculture ministry said on its website on Friday. It also established restricted zones up to 10 km (6.2 miles) from the site. Around 170,000 egg-laying chickens are also being culled at the farm in Atsuma town in Hokkaido, the ministry said. Reuters

Levels of Influenza A Virus Defective Viral Genomes Determine Pathogenesis in the BALB/c Mouse Model

Mammalian infections with highly pathogenic avian influenza viruses (HPAIVs) cause severe disease associated with excessive proinflammatory cytokine production. Aberrant replication products, such as defective viral genomes (DVGs), can stimulate the antiviral response, and cytokine induction is associated with their emergence in vivo. Here researchers show that stocks of a recombinant virus containing HPAIV internal genes that differ in their amounts of DVGs have vastly diverse outcomes in a mouse model. This study also emphasizes the crucial requirement to examine the quality of virus preparations regarding DVG content to ensure reproducible research. Journal of Virology

Airborne Avian Influenza Virus in Ambient Air in the Winter Habitats of Migratory Birds

This study aimed to evaluate airborne AIV, specifically H5, H7, and H9, in a critical winter habitat of migratory birds and assess the factors influencing airborne AIV transmission in ambient air to provide novel insights into the epidemiology of avian influenza. The daily mean temperature and daily maximum temperature had a significant negative correlation with influenza A, H7, and H9. Cold air masses and bird migration were significantly associated with airborne H9 and H7, respectively. In addition, we observed a significant correlation between AIV and the number of pintails, common teals, Indian spot-billed ducks, northern shovelers, Eurasian wigeons, tufted ducks, pied avocets, black-faced spoonbills, and great cormorants. Environmental Science and Technology

UK: New Package of Measures Announced to Support Poultry Industry with Bird Flu

New government support for the poultry industry has been announced today to assist farmers and producers with the impacts of bird flu. The UK is dealing with its worst ever bird flu outbreak with over 200 cases confirmed across the country in the last 12 months. Under the new plans, the Government will alter the existing bird flu compensation scheme allowing compensation to be paid to farmers from the outset of planned culling rather than at the end. The Food Standards Agency, an easement to marketing rules is also being introduced in England. The measures mean that farmers who breed turkeys, geese or ducks for their meat will have the option to slaughter their flocks early and to freeze these products, which can then be defrosted and sold to consumers between the period 28 November and 31 December 2022. This option will give farmers certainty over business planning. GOV.UK

AFRICAN SWINE FEVER

Philippines: African Swine Fever Red Zone Extended to Another Iloilo Town

The provincial government of Iloilo has placed the town of San Miguel under the red zone (infected) classification after African Swine Fever (ASF) was detected among hogs in the municipality. The towns bordering San Miguel and Oton are classified as pink or buffer zones where there are existing checkpoints at the borders for strict monitoring of the entry and exit of live hogs, pork, and pork-based products. Manila Bulletin

India: African Swine Fever Reported in Kerala

Authorities in parts of Kerala shut down meat shops selling pork after African Swine Flu cases were confirmed at a pig farm in the Kottayam district. Steps have been taken to ensure that no pigs are transported from the infected zone. 949 pigs have been culled so far. Livestock experts said they could not rule out chances of the infection spreading to more parts of the state, citing the situation in north-eastern Indian states — which are reeling under the threat of ASF which claimed the lives of almost 80% of domestic pigs. New Indian Express.

EU-Funded Mobile Tool Detects Swine Viral Diseases in Minutes

The SWINOSTICS tool detects six emerging and endemic viruses: African swine fever, porcine reproductive and respiratory syndrome, porcine parvovirus, porcine circovirus type 2, classical swine fever and swine influenza. National Hog Farmer

Withdrawal of Select Agent Regulatory Exclusions for Two Strains of African Swine Fever Virus

The Animal and Plant Health Inspection Service (APHIS) has withdrawn the select agent regulatory exclusions for two African swine fever virus strains. APHIS withdrew the select agent regulatory exclusions for these strains because it has evaluated new information and determined that they have the potential to pose a severe threat to animal health or animal products. Possession, use, and transfer of the designated ASFV strains must now comply with the select agent and toxin regulations under the authority of the Agricultural Bioterrorism Protection Act of 2002. Federal Register

Draft Genome Sequence Analysis of the Genotype II African Swine Fever Virus from India

African Swine Fever (ASF) is an alarming threat to the pig population across the world. ASF virus entered the northeastern NE part of India early in 2020, causing huge economic loss to the pig sector. Here, researchers present a brief report on the draft genome sequence of an ASFV strain from Assam state of NE India belonging to genotype II.  This will strengthen the baseline data needed for epidemiological investigations and for the generation and design of diagnostics and vaccines. Microbiology Resource Announcements

Review of the Pig-Adapted African Swine Fever Viruses in and Outside Africa

Whilst ASF vaccines are critical for high-production systems, global food security relies on parallel efforts to improve biosecurity and pig production and on continued ASFV surveillance and characterization. Most of the experimental ASF vaccines described do not protect against a wider spectrum of viruses and may be less useful in the event of incursions of different strains or where multiple genotypes co-exist. Pathogens

European Study Into ASF Virus Survival in Feed, Materials

African swine fever viruses that may have been introduced into processed byproducts, grain, oilseed meals and compound feed are largely inactivated as a result of the processing steps involved in feed manufacture. This is a key finding of a study of published literature by Germany’s Friedrich Loeffler Institute and Federal Institute for Risk Assessment, as well as the National Veterinary Institute of Sweden (SVA). However, both of the studies highlight a level of uncertainty in their conclusions arising from a lack of scientific data in some areas. A new German-Swedish collaboration aims to fill in those gaps by investigating the stability of ASF viruses in a range of animal feeds and bedding materials under conditions of processing and storage. Feed Strategy

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Feasibility of measles and rubella vaccination programmes for disease elimination: a modelling study. The Lancet Global Health

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