News highlights on health security threats and countermeasures curated by Global Biodefense
This week’s selections include early lessons from Uganda’s Ebola vaccine trial; emergency supply chain preparedness critical needs; variant accommodation in exhaled breath vapor diagnostics; and antibody evasion properties of rising SARS-CoV-2 subvariants.
POLICY + GOVERNMENT
It’s Far From Certain We’ll See a Pandemic Response Overhaul
Partisan bickering has stalled more covid aid for roughly nine months. A pair of key senators are lobbying hard for their bipartisan plan to tackle future pandemics to pass before the end of the year — a package that’s viewed as a down payment on what’s needed. Prospects for sweeping bipartisan legislation next year are dim amid a split Congress and a pandemic that polarized the country. This comes after years of warnings from oversight agencies and experts that the country was ill-equipped to tackle a major public health threat. Washington Post
EU Breaks With US to Plan Budget Support to Uganda for Ebola Response
The European Commission is preparing to send €7 million ($7.4 million) to the Ugandan finance ministry to help fight Ebola, contradicting the approach of other donor nations. The U.S. ambassador to Uganda Natalie E. Brown was quoted saying that donor funds not reaching their intended recipients due to corruption is “a very real and serious challenge. And that is also one of the reasons why we work with so many partners instead of providing budgetary support.” A spokesperson for the USAID said that since the Ebola outbreak was declared on Sept. 20 the U.S. government has channeled more than $33 million, “largely through implementing partners and UN agencies, to support the Government of Uganda-led Ebola response.” DevEx
Global Coalition Outlines How to Beat the Next Disease X Pandemic in 100 Days
CEPI, the Coalition for Epidemic Preparedness Innovations, has issued a report detailing how the world could deliver future pandemic-beating vaccines in 100 Days. The report outlines the paradigm shift needed to speed up vaccine development even more, highlighting the crucial scientific and technological innovations that will enable us to develop new vaccines against future pandemic threats in a little more than three months. CEPI
Coalition Urges Lawmakers to Include Provisions of PREVENT Pandemics Act in Year-End Legislative Package
The American Dental Association and more than 100 organizations are urging lawmakers to include key provisions of the Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act in any final legislative package this year. In a letter to leaders of the House and Senate, the coalition urged legislators to support the BIO Preparedness Workforce Pilot Program; the Tracking Pathogens Act; improvements to public health preparedness and response capabilities, and accelerating research and medical product development; strengthening medical product supply chains; and addressing health inequities exacerbated by public health emergencies. ADA
Wrangling Over the International Pandemic Pact Has Begun
Spearheaded by the WHO, a pandemic treaty is slated for completion in May 2024. Health officials met this week in Geneva to discuss a rough draft of a pandemic treaty, an international plan to avoid another disaster on the scale of COVID-19. Much of the first draft reads as an idealistic list proclaiming the importance of solidarity and equity in various matters of health. As Alexandra Phelan, a professor of global and public health law at Georgetown University, says, the rubber hits the road in the operative parts of the treaty, where countries must agree on how to cooperate in a health emergency. “This is where the real negotiations will happen.” Think Global Health
The New US National Biodefense Strategy—Necessary but Not Sufficient
The National Biodefense Strategy prioritizes data integration for early warning that brings together disease reports, clinical information, and laboratory results in real time to detect “bioincidents.” But foundational to seeing what is new and dangerous is being able to monitor what is happening every day, and most US public health agencies have little insight into day-to-day changes in many urgent health threats from opioid overdoses to asthma. Even with the current “triple-demic” of COVID-19, influenza, and respiratory syncytial virus, many health departments are struggling with limited surveillance data. Major investments are needed to modernize public health systems, digitizing core public health functions to allow public health and clinical data systems to communicate more readily. To succeed in an emergency, health departments also need epidemiologists, inspectors, outreach workers, communications experts, and coordination with the private sector. JAMA Forum
Assessing the SecBio Platform Proposal for the Biological Weapons Convention
In 2022, France, Senegal and Togo submitted a revised proposal to the BWC for the “establishment of an international platform dedicated to biosecurity and biosafety: SecBio”. The proposal includes three pillars: a searchable repository for biosafety- and biosecurity-related materials; a learning module; and a forum for expert networking to exchange information, data and best practices. To this end, this report draws lessons from past initiatives to develop repositories, learning modules and expert forums in order to inform the development of the SecBio platform (and any such similar initiatives). UNIDIR
New York’s Pandemic Preparedness Equipment is Up for Auction
9,000-gallon oxygen tanks, generators, lighting, air filters and even ambulances. New York state is hoping to turn it back all into cash. Joe Brill of the state’s Office of General Services says the State Department of Health reviewed its inventory to pull out any items the state could need in the future. What’s left is up for bid. NPR
Senators File Bills to Support Fort Detrick Biodefense Center
Sens. Ben Cardin and Chris Van Hollen and U.S. Rep. David Trone have introduced a bill that would authorize the continued operations of the National Biodefense Analysis and Countermeasures Center at Frederick’s Fort Detrick. The bill would designate the center as the “lead federal facility dedicated to defending the United States against biological threats.” Frederick News-Post
UK Ambulance Staff to Strike on 21 December
“Ambulance staff and their health colleagues don’t want to inconvenience anyone. But ministers are refusing to do the one thing that could prevent disruption – that’s start genuine talks about pay. Wages are too low to stop health workers quitting the NHS. As more and more hand in their notice, there are fewer staff left to care for patients. The public knows that’s the reason behind lengthy waits.” All the unions have asked for above-inflation pay rises. Under trade union rules, life-preserving care has to be provided so the two highest category calls – covering everything from heart attacks and strokes to major trauma – will still be responded to during the strike. BBC
Week Two of the Biological Weapons Convention Ninth Review Conference
There seems to be significantly greater convergence of perspectives around a number of previously difficult issue areas such as verification and the enhancement of Article X than there has been at other recent Review Conferences. It would be a tragedy if such convergence could not be used as the foundation for substantive progress for the BWC. Even with a greater convergence of perspectives, there are still many details to be fleshed out. The majority of states parties seem to be agreeing on a core set of substantive issues and on where some of the trade-offs may be. Perhaps the most unpredictable element at this stage within the Review Conference is that the geo-political tensions are significant and generate uncertainties that raise concerns that consensus will be difficult to reach at the end of the Conference. CBW Events
Stakeholder Perspectives on the Biological Weapons Convention
Efforts to enhance biological disarmament and build biosecurity can no longer be achieved by States alone. Input from – and collaboration with – a wide range of stakeholders is required to achieve progress in the implementation of the Biological Weapons Convention (BWC) and wider efforts to strengthen biological security. Yet the perspectives of these different stakeholders are not necessarily always well understood or reflected in biological disarmament diplomacy. UN Institute for Disarmament Research
MEDICAL COUNTERMEASURES
Biodefense and EUA: Different Originations, Purposes, and Evolutionary Paths of Institutions in the United States and South Korea
Emergency-use-authorization (EUA) is the representative biodefense policy that allows the use of unlicensed medical countermeasures or off-label use of approved medical countermeasures in response to public health emergencies. This article aims to determine why the EUA policies of the United States and South Korea produced drastically different outcomes during the COVID-19 pandemic, and how these outcomes were determined by the originations and evolutionary paths of the two policies. BMC Globalization and Health
One Step Closer to a Universal Flu Vaccine?
Scientists have seen high levels of cross-reactive antibodies and subtype-specific antibodies when testing a multivalent nucleoside-modified mRNA vaccine against all known influenza virus subtypes. It is in early stages — tested only in mice and ferrets — but the vaccine provides important proof that a single shot could be used against an entire family of viruses. Development of such a universal vaccine is challenging for many reasons, including assessing durability and proving efficacy in clinical trials for non-circulating strains. New York Times, Science
Biopharmaceutical Benchmarks 2022
Monoclonal antibodies (mAbs) remain dominant in overall approvals, representing 53.5% of all approvals in the past four years. They also remain the most prominent category of genuinely new biopharmaceuticals coming on the market. The percentage of the total market value contributed by mAbs grew steadily during this survey, although COVID-19 vaccine sales affected this trend. However, with these vaccine revenues excluded, mAbs still represented 80% of total protein-based global biopharmaceutical sales last year. Also notable is an increase in approval rates for biosimilars, as well as for nucleic acid-based products and gene-engineered cells. Nature Biotechnology
Lung Resident Memory T Cells Activated by Oral Vaccination Afford Comprehensive Protection against Pneumonic Yersinia pestis
Findings in mouse model reveal that lung T cells can be activated via oral Yptb1(pYA5199) vaccination, and that IL-17A and IFN-γ production play an essential role in adaptive immunity against pulmonary Y. pestis infection. This study highlights an important new target for developing an effective pneumonic plague vaccine. Journal of Immunology
An Early Lesson From the Uganda Ebola Vaccine Trial: Shots Must Be Ready to Go Before the Next Outbreak Strikes
“If we’re being truly strategic, what we should be doing is have ready-to-go trial platforms in a set of countries with products ready to go. But that requires … a huge effort on everyone’s part.” The world needs to think about this type of investment as a form of defense spending, having to look no further than the damage the Covid-19 pandemic did to humankind and to the global economy to explain why health security investments make sense. STAT
A Single-Shot Marburg Vaccine Confers Rapid and Durable Protection in NHP
The recent cases of MARV in West Africa underscore the substantial outbreak potential of this virus. To support regulatory approval of the chimpanzee adenovirus 3 (ChAd3)–MARV vaccine that has completed phase 1 trials, here researchers showed that the nonreplicating ChAd3 vector, which has a demonstrated safety profile in humans, protected against a uniformly lethal challenge with MARV/Ang. Protective immunity was achieved within 7 days of vaccination and was maintained through 1 year after vaccination. Science Translational Medicine
Vaccinations with Modified Vaccinia Ankara-Bavarian Nordic Induce Durable B Cell Memory Responses
Though Modified Vaccinia Ankara – Bavarian Nordic (MVA-BN) vaccination is approved for smallpox and monkeypox prevention, immunological persistence and booster effects remain undescribed. The initial and follow-up clinical studies described herein demonstrate the duration and nature of immunological memory in both younger individuals never immunized against smallpox and older individuals vaccinated in the distant past using live-replicating vaccinia vaccines. These findings are of relevance when defining optimal vaccination strategies for outbreaks in a supply-constrained environment and for prophylaxis for those at risk of occupational orthopox exposure, such as healthcare providers, laboratory staff, and military personnel. The Journal of Infectious Diseases
Chemokine CXCL10 Exhibit Broad-Spectrum Antimicrobial Activity Against Biodefense and Antibiotic-Resistant Bacterial Pathogens
The chemokine CXCL10 functions in host defense against infection by guiding immune cell traffic and killing microorganisms. The antimicrobial determinants of CXCL10, and how they relate to those important for cellular effects, have not been previously defined. Here, researchers report the discovery of disparate bactericidal domains in the N- and C-terminal regions of human CXCL10. ACS Infectious Diseases
World’s First Intranasal Vaccine To Receive Both Primary Series and Heterologous Booster Approval
iNCOVACC recently received approval under India’s Restricted Use in Emergency Situation for ages 18 and above for heterologous booster doses (where a person received a different primary series vaccine). iNCOVACC is a recombinant replication deficient adenovirus vectored vaccine with a pre-fusion stabilized SARS-CoV-2 spike protein. The nasal delivery system has been designed and developed to be cost-effective in low- and middle-income countries. Bharat Biotech
Outbreak Response Strategies with Type 2-Containing Oral Poliovirus Vaccines
In order to successfully stop all cVDPV2 transmission globally, countries and GPEI need to address the deficiencies in emergency outbreak response policy and implementation. This will require rapidly achieving and then maintaining much better program performance in areas experiencing outbreaks, and ensuring the maintenance of high polio immunization coverage in polio-free areas. Vaccine
J&J and Merck Ebola Vaccines Produce Lasting Antibodies in Children and Adults
Ebola vaccines developed by Johnson & Johnson and Merck & Co produced virus-fighting antibodies and appear to be safe in children and adults, according to data from two studies published on Wednesday. The vaccines are designed to target the Zaire strain of the virus, not the Sudan strain of Ebola that recently caused an outbreak and at least 56 deaths in Uganda. Only Merck’s shot can potentially be given as a single dose while J&J’s vaccine may need to continue as a two-dose regimen. Reuters, NEJM
BIOSECURITY + BIOPREPAREDNESS
Preparing for Twenty-First-Century Bioweapons
As the Biological Weapons Convention enters its 50th year, involving more nongovernmental organizations can help prepare for a future of weapons and wars that looks different from those the treaty was designed to prevent. NGOs could play significant roles in nonproliferation and disarmament by functioning as a bridge between official government actors and civil society. They could also support these processes by conducting independent research to enhance transparency and confidence. Issues in Science and Technology
Russia’s Allegations of U.S. Biological Warfare In Ukraine
Is the Biological Weapons Convention a “parody of the rule of law”? Far from replicating domestic forms of law enforcement, compliance, enforcement, and accountability, the international legal system takes on unique forms, particularly with respect to powerful States. International law may motivate compliance through those forms, perhaps modestly at times, but in nonetheless desirable ways. While criticism of its shortcomings is always acceptable, we must guard against losing sight of the limitations of powerful States’ willingness to accept international legal restraint. Lieber Institute
Emergency Supply Chain Preparedness and Response
This report outlines best practices in emergency supply chain preparedness and response efforts. It is based on a review of existing literature in the fields of supply chain management and emergency response, as well as interviews with global and local experts from non-governmental organizations, host-country governments and the private sector. GHSC
The East African Community’s Mobile Laboratory Network Rapid Response
Within the first 14 days after outbreak confirmation, the East African Community Mobile laboratory network was actively involved in providing Sudan virus disease and differential diagnostics in the epicentre at Mubende Regional Referral Hospital (and neighbouring districts), as well as in coordination of mobile laboratory preparedness activities in five other East African countries. BMJ Global Health
A Multilingual Tool for Standardized Laboratory Biosafety and Biosecurity Assessment and Monitoring
The Biosafety and Biosecurity Laboratory Assessment Tool (BSS LAT) was developed to gather and summarize the important aspects of biosafety and biosecurity in a laboratory setting, which have been unevenly treated depending on the source of the guidance or standard, as no official global standard currently exists. The development of this tool was supported by the CDC, as part of the Global Health Security Agenda in Burkina Faso, and through the African Society for Laboratory Medicine. Health Security
How to Teach Life Sciences Students About Dual-Use Research—A View From the Field
Practical guidance on how to initiate and integrate a dual-use education program within the curriculum and provide a selection of existing teaching materials. Different course formats like lectures, seminars, or stand-alone events are discussed regarding their advantages, disadvantages, and suitability for conveying the learning objectives to different educational stages and audiences. As a minimum, the authors recommend the incorporation of dual-use issues into at least one mandatory course. Ideally, students should additionally participate in in-depth seminars, which can be voluntary and offered in cooperation with external organisations. Canadian Journal of Microbiology
SELECT AGENTS + PRIORITY PATHOGENS
Uganda: Three Questions for an MSF Epidemiologist About the New Ebolavirus Variant
“In terms of trends, we saw two important peaks in the outbreak. The first one was in September in the Mubende district, which was the first epicenter of this outbreak, and then another in the neighboring district of Kassanda. While cases in these two districts alone represent 80 percent of all cases detected so far in this outbreak, a total of nine districts in the country were affected. Historically, this is the largest geographic spread of Ebola that Uganda has ever faced.” Doctors Without Borders
Global High Consequence Infectious Disease Events: 12 Dec 2022 Update
The report provides detailed updates on known, high consequence infectious disease events (including Ebola virus, Lassa fever, Crimean-Congo haemorrhagic fever, Marburg, mpox and H5N1) around the world as monitored by UK Health Security Agency’s (UKHSA) epidemic intelligence activities. GOV.UK
Close Relatives of MERS-CoV in Bats Use ACE2 as Their Functional Receptors
To shed light on the evolutionary relationship among merbecoviruses, especially NeoCoV and PDF-2180, researchers conducted a phylogenetic analysis of the sequences of several human and animal coronaviruses and report that NeoCoV and PDF-2180 use bat ACE2 as an entry receptor. Although NeoCoV and PDF-2180 use human ACE2 (hACE2) suboptimally, adaptive mutations of this group of viruses might result in future spillover events. Nature
Enveloped Viruses Show Greater Cross-Species Transmission
Using large amounts of data released by recent viral discovery initiatives, here we show that enveloped viruses tend to infect more host species and are more likely to cause zoonotic infections than nonenveloped viruses, while other basic viral features examined play less obvious roles. These findings challenge previous views in the field and will help guide viral outbreak surveillance. PNAS Microbiology
Modelling Control Strategy Impact on Transmission Dynamics of Ebola Virus in Human-Bat Population
This study presents a novel and feasible human-bat (host-vector) model which foretells the spread and severity of the Ebola virus from bats to humans to investigate the combined effects of three control strategies. Heliyon
Sustainable Strategies For Ebola Virus Disease Outbreak Preparedness in Africa: a Case Study
During the 10th EVD outbreak (2018–2020), the largest experienced in the DRC and the second largest and most prolonged EVD outbreak recorded globally, a WHO risk assessment identified nine countries bordering the DRC as moderate to high risk from cross border importation. These countries implemented varying levels of Ebola virus disease preparedness interventions. This case study highlights the gains and shortfalls with the Ebola virus disease preparedness interventions within the various contexts of these countries. Infectious Diseases of Poverty
CHEMICAL + RADIOLOGICAL THREATS
Russia’s ‘Dirty Bomb’ Disinformation, Annotated
In late October, after eight months of war, the Russian government claimed that Ukraine was preparing to use a “dirty bomb” and blame it on Russia. There was never any evidence for this claim. But Russia’s ambassador to the UN, Vassily Nbenzia, nevertheless sent a letter demanding that the Security Council hold a meeting to discuss the “dirty bomb” issue. Russia’s claims have been widely dismissed. Nevertheless, Russian spokesmen are continuing to press the narrative. Bulletin of the Atomic Scientists
African Experts Enhance Hospital Preparedness for Chemical Incidents
A HOSPREP workshop in Morocco, attended by participants from 12 regional Member States, centered on enhancing the capabilities of medical facilities to respond to incidents involving toxic chemicals or chemical warfare agents. Participants also received lectures on key assistance and protection concepts such as: the provisions and obligations of the Chemical Weapons Convention (CWC) with a focus on Article X, types of chemical agents, personal protection, contamination, detection, monitoring and incident command, and medical evacuation. OPCW
Health and Safety Threats to Ukraine From Nonconventional Weapons
“It is essential that our global medical and public health community assist CBRNE readiness throughout Europe to avert a worsening crisis. The World Health Organization, the UN, or OPCW could serve as a lead facilitator for governmental and nongovernmental organizations to enable sharing of best practices and prioritize resources. In every case of a CBRNE threat, the ability to rapidly recognize, evacuate, decontaminate, treat, and rapidly transport victims to higher levels of care is essential to mitigate morbidity and mortality.” JAMA
Benzylation of Phosphonic Acid Nerve Agent Markers During OPCW Proficiency Test Scenarios
Recently, the deliberate use of organophosphorus-based nerve agents in successful and failed assassination attempts in the world has resulted in a resurgence of research efforts towards the development of medical countermeasures against these lethal chemicals, methods for their decontamination and more effective, alternative ways for their analysis and detection by various analytical methods. Comparative studies demonstrated that while the benzylation of the phosphonic acids proceeded smoothly under three conditions (neutral, acid and basic), the p-methoxybenzylation of these was found to work efficiently only in the presence of a base (e.g., Na2CO3). Scientific Reports
Method for Spot Urine Normalization in a Radiation Emergency
To assess the internal radiation dose in radiation emergencies to determine medical interventions, the variability of spot urine normalization methods is studied using 40K measurement results. Applied Radiation and Isotopes
Examining Radiation Emergency Preparedness Among the Citizens of Busan, South Korea
This study used a survey of citizens in Busan, South Korea, where seven nuclear power plants (NPPs) are in close proximity, to examine their radiation emergency preparedness levels. Specifically, the study investigated the public’s risk perceptions, frequent and trusted communication sources, and awareness of the radiation emergency preparedness plan designed by their local government. Results showed that all these variables are significantly associated with individuals’ radiation emergency preparedness levels. International Journal of Disaster Risk Reduction
Influence of Chlorinating Agents on the Formation of Stable Biomarkers in Hair for the Retrospective Verification of Exposure
Chlorine, as a dual-use chemical, is an essential industrial chemical which has been used as a chemical weapon in the past due to its toxicity and availability. The retrospective verification of chlorine intoxication is often especially challenging, and unambiguous markers are still missing. In this study, the effects of different chlorinating and oxidizing agents on human hair were investigated. Analytical Chemistry
Route Attribution of Chemical Warfare Agents: Retrospective Classification of Unknown Threat Samples
This thesis describes conducted research that aims at retrospectively tracing the synthesis methods applied in the production of CWAs. The relative distribution of the impurities gave a unique profile – in effect a “chemical fingerprint” – that was used for retrospective determination of the production method of a specific CWA. Digitala Vetenskapliga Arkivet
SURVEILLANCE + DETECTION
Dielectric Microsphere-Assisted SERS for Anthrax Biomarker Detection
DMs that could focus and collect light were embedded within the polydimethylsiloxane (PDMS) film to avoid direct contact with the analytical solution and improve detection reliability. Frontiers
Predominant SARS-Cov-2 Variant Impacts Accuracy When Screening For Infection Using Exhaled Breath Vapor
Here researchers report that the volatile signature of COVID-19 in breath differs between the Delta-predominant and Omicron-predominant variant waves, and accuracies improve when samples from these waves are modeled separately rather than as one universal approach. Findings have important implications for groups developing breath-based assays for COVID-19 and other respiratory pathogens, as the host response to infection may significantly differ depending on variants or subtypes. Communications Medicine
Disease X Testing: The Results of an International External Quality Assessment Exercise
The “what-if” scenario was to identify the etiological agent responsible for an outbreak that has tested negative for many known pathogens, including viruses and bacteria. Three microbes were added to the samples, Dabie bandavirus, Mammarenavirus, and Gemella spp., of which the last two have not been taxonomically named or published. The animal samples were from Rattus norvegicus, Marmot himalayana, New Zealand white rabbit, and the tick Haemaphysalis longicornis. Of the 11 international laboratories that participated in this activity, six accurately identified pathogen X as a new Mammarenavirus, and five correctly identified the animal origin as R. norvegicus. The technical details are discussed in this report. Journal of Biosafety and Biosecurity
The WHO’s Public Health Intelligence Activities During the COVID-19 Pandemic Response
The high volume of information necessitated an increase in the amount of person-time dedicated to COVID-19 PHI activities, while continuing to ensure sufficient resources for monitoring and detecting other public health events. Finding this balance with resource constraints proved challenging during several different phases of the pandemic. Key future improvements should include greater automation tools that enable analysts to handle large quantities of information, additional training for personnel undertaking PHI and increased PHI capacity building within Member States and WHO. Eurosurveillance
Handheld Diagnostic Lab Offers Point-of-Care Solution for Future Pandemics
Using a circuit board that controls a set of movable, 1mm magnetic disc “ferrobots” to transport samples through the diagnostic workflow of a nucleic acid amplification test (NAAT), the researchers’ ultra-sensitive lab kit was able to detect the presence of genetic material from a virus. By designing the kit for pooled testing, the system requires much lower amounts of reagent chemicals than those needed for testing the samples individually. Up to 16 samples were combined and tested at once in the team’s study. UCLA Samueli School of Engineering
Assessment of Urinary Biomarkers for Infectious Diseases Using Lateral Flow Assays: A Comprehensive Overview
Unaffected by the homeostasis mechanism in the human body, urine accommodates systemic changes and reflects the pathophysiological condition of an individual. Easy availability in large volumes and non-invasive sample collection have rendered urine an ideal source of biomarkers for various diseases. ACS Infectious Diseases
Effectiveness of Early Warning Systems in the Detection of Infectious Diseases Outbreaks: A Systematic Review
Global pandemics have occurred with increasing frequency over the past decade reflecting the sub-optimum operationalization of surveillance systems handling human health data. Despite the wide array of current surveillance methods, their effectiveness varies with multiple factors. Here, we perform a systematic review of the effectiveness of alternative infectious diseases Early Warning Systems (EWSs) with a focus on the surveillance data collection methods, and taking into consideration feasibility in different settings. BMC Public Health
CDC Launches Initiative to Test Wastewater for Polioviruses in Some Communities
The CDC said the work will start in two communities: Oakland County, Mich., and an as-yet-unnamed county in the Philadelphia area. The surveillance may later extend to other parts of the country where polio vaccination rates are low or to locations that have ties to the communities in New York state where polioviruses have been found in wastewater. But the Global Polio Eradication Initiative, the partnership that runs the effort to rid the world of polio, only recommends wastewater surveillance for countries like the United States — countries with good sanitation systems and high vaccination rates — when there is an outbreak of polio. STAT
HEALTH BEHAVIOR + RISK
Ebola in Uganda: The People Spreading Misinformation Online
Uganda has been battling Ebola for two months now. So far, there have been 141 cases with 55 deaths – confirmed by Medecins Sans Frontieres (MSF) – out of its 44.7 million population. The key misleading messages which are spreading have been: the government is using it to justify locking down and controlling citizens; the outbreak is a cover to harvest body organs to sell illegally; the government is falsifying case numbers to attract funding or just to scare people. “Some politicians… are confusing the public by saying there is no Ebola and this epidemic is the government’s propaganda of mobilising resources…They even confidently say the Ministry of Health should leave the disease to spread and people develop immunity, forgetting what happened in West Africa.” BBC
Parental Intentions to Vaccinate Children Against COVID-19: Findings From a U.S. National Survey
Across all age groups of children unvaccinated against COVID-19, parental vaccine intentions increased with increased household income and education levels. COVID-19 vaccine side effects and safety concerns were primary reasons for not vaccinating children. Parental COVID-19 vaccine hesitancy was most evident for children < 2 years old. Vaccinated versus unvaccinated parents were almost seven times more likely to have vaccinated their 12–17-year-old children against COVID-19. Strategies including school vaccination requirements and recommendations from pediatricians were shown to increase parental COVID-19 vaccination intentions for some. Vaccine
Influence of Online Opinions and Interactions on the Covid-19 Vaccination in Chile
Although each country has faced the pandemic differently, the Chilean experience can provide a unique case study of online conversations in a society with widespread internet access that has had high infection rates and a large percentage of its population vaccinated within a short time span, all during a period of considerable sociopolitical conflict. In less than 2 years, Chile went from facing one of the highest transmission rates in the world, in June 20204,5,6, to reaching the first place in Bloomberg’s Covid Resilience Ranking, in December 202113, after a successful vaccination campaign. Scientific Reports
COVID-19 PANDEMIC
Covid Becomes Plague of Elderly, Reviving Debate Over ‘Acceptable Loss’
More than 300 people are still dying each day in the United States from Covid-19, most of them 65 or older. While that’s much lower than the 2,000 daily toll at the peak of the delta wave, it is still roughly two to three times the rate at which people die of the flu — renewing debate about what is an “acceptable loss.” The proportion of deaths among those 65 or older has fluctuated from 8 out of 10 in the first few months of the pandemic, to a low of 6 out of 10 when the delta wave struck in the summer of 2021, to a high of 9 out of 10 today. Washington Post
FDA Authorizes Updated (Bivalent) COVID-19 Vaccines for Children Down to 6 Months of Age
Children 6 months through 5 years of age who received the original (monovalent) Moderna COVID-19 Vaccine are now eligible to receive a single booster of the updated (bivalent) Moderna COVID-19 Vaccine two months after completing a primary series with the monovalent Moderna COVID-19 Vaccine. FDA
Alarming Antibody Evasion Properties of Rising SARS-CoV-2 BQ and XBB Subvariants
The SARS-CoV-2 Omicron variant continues to evolve, with new BQ and XBB subvariants now rapidly expanding in Europe/US and Asia, respectively. As these new subvariants have additional spike mutations, they may possess altered antibody evasion properties. Here, we report that neutralization of BQ.1, BQ.1.1, XBB, and XBB.1 by sera from vaccinees and infected persons was markedly impaired, including sera from individuals who were boosted with a WA1/BA.5 bivalent mRNA vaccine. Compared to the ancestral strain D614G, serum neutralizing titers against BQ and XBB subvariants were lower by 13-81-fold and 66-155-fold, respectively, far beyond what had been observed to date. A panel of monoclonal antibodies capable of neutralizing the original Omicron variant, including those with Emergency Use Authorization, were largely inactive against these new subvariants. BioRxiv pre-print
Omicron Sublineage Recombinant XBB Evades Neutralizing Antibodies in Recipients of BNT162b2 or Coronavac Vaccines
The SARS-CoV-2 omicron variant XBB sublineage, a BA.2.10.1–BA.2.75 recombinant classified as variant under monitoring by WHO, has been found in 35 countries, and has become the dominant strain in Singapore. There is early evidence suggesting that XBB might be associated with a higher risk of reinfection.2 A previous study using a pseudovirus neutralisation test and sera from individuals who received CoronaVac (Sinovac) found that XBB is the most immunoevasive sublineage. The Lancet Microbe
Shelf-Life Extension of Evusheld Under Emergency Use Authorization
ASPR and FDA last week announced an additional extension to the shelf-life from 18 months to 30 months for specific lots of the refrigerated AstraZeneca monoclonal antibody therapy, Evusheld. HHS ASPR
Supporting COVID-19 Policy-Making With a Predictive Epidemiological Multi-Model Warning System
In response to the SARS-CoV-2 pandemic, the Austrian governmental crisis unit commissioned a forecast consortium with regularly projections of case numbers and demand for hospital beds. The goal was to assess how likely Austrian ICUs would become overburdened with COVID-19 patients in the upcoming weeks. Short-term epidemiological models can be valuable ingredients of a comprehensive monitoring and reporting system to detect epidemiological change points, identify their potential causes, and thereby inform decisions to ease or strengthen governmental responses. Communications Medicine
SCARLET FEVER + STREP A
UKHSA Update on Scarlet Fever and Invasive Group A Strep
The latest data from the UK Health Security Agency (UKHSA) shows that scarlet fever (caused by group A Streptococcus bacteria) cases continue to remain higher than typically seen at this time of year. There were 851 cases reported in week 46, compared to an average of 186 for the preceding years. Scarlet fever is usually a mild illness, but it is highly infectious. UKHSA advises to look out for symptoms in your child, which include a sore throat, headache, and fever, along with a fine, pinkish or red body rash with a sandpapery feel. On darker skin, the rash can be more difficult to detect visually but will have a sandpapery feel. In very rare occasions, the bacteria can get into the bloodstream and cause an illness called invasive Group A strep (iGAS). While still uncommon, there has been an increase in invasive Group A strep cases this year, particularly in children under 10. GOV.UK, CDC
Why is Strep A Surging — and How Worried are Scientists?
The tragic deaths of 13 children in England and an unusual rise in autumn cases have put researchers on alert. In England, scarlet fever is carefully tracked, and physicians are required to report cases to health authorities. Between mid-September and mid-November, there were 4,622 notifications of scarlet fever in England, compared with an average of 1,294 in the same period over the past five years. Those numbers don’t show the true extent of strep A infections in the country, says Sriskandan. “Scarlet fever is the tip of the strep-throat iceberg. It’s a very visible marker of what’s going on in the community.” A similar pattern of off-season strep A infections is being observed in other countries as well. Nature
Children’s Hospitals Are Struggling to Cope with a Surge of Respiratory Illness
Children’s hospitals across the nation are stretched beyond capacity by waves of patients with RSV and, increasingly, the flu. A major factor in the bed shortage is a years-long trend among hospitals of eliminating pediatric units, which tend to be less profitable than adult units, said Mark Wietecha, CEO of the Children’s Hospital Association. Hospitals optimize revenue by striving to keep their beds 100 percent full — and filled with patients whose conditions command generous insurance reimbursements. The number of pediatric inpatient units in hospitals fell 19 percent from 2008 to 2018. Just this year, hospitals have closed pediatric units in Boston and Springfield, Massachusetts; Richmond, Virginia; and Tulsa, Oklahoma. NPR, PBS
HISTORICAL REFLECTIONS
How Smallpox Inoculation United America
In The Contagion of Liberty, historian Andrew Wehrman traces the path of the smallpox-inoculation movement, and its generally overlooked impact on politics around the American War of Independence. He argues that smallpox influenced the journey towards independence from British rule, and how Americans conceived of their new, hard-won liberties. It is a tale of startling contemporary relevance. Nature
Dangerous Pathogens Were Lurking Around Every Corner in an Early Medieval Settlement
For this study of the early medieval settlement Lauchheim “Mittelhofen” (modern day Baden-Württemberg), researchers isolated DNA from 70 human skeletons excavated within its borders. The graves could be associated with distinguishable farmsteads and dated to the late Merovingian period (7th–8th century CE). “The DNA data showed that the Lauchheim inhabitants suffered from infections with various pathogens, such as Mycobacterium leprae, the hepatitis B virus HBV, the parvovirus B19 and the variola virus VARV.” The authors noted a substantial number of co-infections with two or even three different infectious agents. Phys.org
No Evidence for Persistent Natural Plague Reservoirs in Historical and Modern Europe
Caused by Yersinia pestis, plague ravaged the world through three known pandemics: the First or the Justinianic (6th–8th century); the Second (beginning with the Black Death during c.1338–1353 and lasting until the 19th century); and the Third (which became global in 1894). It is debatable whether Y. pestis persisted in European wildlife reservoirs or was repeatedly introduced from outside Europe. Here researchers use new methods to conclude there is no support for persistent natural plague reservoirs in either historical or modern Europe. Factors which Europe unfavorable for long-term plague reservoirs include rodent diversity, as well as soil texture and biochemistry. PNAS
SPECIAL INTEREST
Professor Christine Kreuder Johnson to Serve as U.S. Science Envoy
The UC Davis School of Veterinary Medicine professor joins six other distinguished scientists and engineers who will serve as U.S. Science Envoys in 2023, the U.S. Department of State announced Dec. 6. Johnson is a professor of epidemiology and ecosystem health and director of the EpiCenter for Disease Dynamics within the UC Davis One Health Institute. Her work is committed to transdisciplinary research to characterize the impacts of environmental change on animal and human health and guide public policy to mitigate pandemic threats. UC Davis
UTMB Galveston Infectious Science Podcast
The podcast will share stories of new and emerging diseases, research personalities, and the One Health approach to understanding diseases and preventing their spread. Infectious Science
Request for Public Comment: National Strategy for Prevention and Control of Vector-Borne Diseases in Humans
The Strategy represents the Federal Government’s priorities for addressing vector-borne disease (VBD) threats. Goals include better understanding of vector transmission, effects of changing climate, improving detection tools, and the full spectrum of control strategies. Public comments are due by 21 Dec 2022. Federal Register
St. Paul Health Care Workers Create PPE For Muslim Women
When health care workers Yasmin Samatar and Faraoli Adam were on the frontlines of the pandemic, they struggled to find personal protective equipment for Muslim women like them. So they launched Mawadda, a line of hygienic hijabs to help keep Muslim health care workers and patients safe in the hospital. Twin Cities Pioneer Press
Call For Expressions of Interest: Global Leaders Group on AMR
The Global Leaders Group was jointly established in 2020 by FAO, UN Environment Programme, WHO, and World Organisation for Animal Health to accelerate political action on AMR, based on a One Health approach. The GLG is soliciting a call for expressions of interest from serving or former ministers or senior government officials serving in their individual capacities and representatives from foundations, civil society organizations and the private sector to fill vacant positions. Applications are due 31 Dec 2022. Global Leaders Group on Antimicrobial Resistance
Dr. Fauci Reflects on NIAID Tenure, COVID-19 and How to Boost Interest in ID Field
In this IDSA podcast interview, Dr. Fauci discusses his tenure at NIAID; the intersection of his various roles as a physician, a scientist and in public health; how to combat misinformation; the current state of the COVID-19 pandemic; and how to attract more people into the ID field. Excerpts at the link. Infectious Diseases Society of America
First Leader of High-Risk Medical Research Agency Discusses Startup
Nine months after it was created by Congress, President Joe Biden’s new agency for high-risk biomedical research has begun to take shape under its first chief, Renee Wegrzyn. The 45-year-old applied biologist is a veteran of the Defense Advanced Research Projects Agency (DARPA), the model for the new agency that, for now, is part of the National Institutes of Health (NIH). Science
Roger Glass Stepping Down as Director of Fogarty International Center
As the longest-serving director of FIC, Glass has broadened NIH’s global health footprint, partnering with all NIH Institutes and Centers to advance global health research in support of the NIH mission to enhance health, lengthen life, and reduce illness and disability, both in the United States and globally. He will step down in Jan 2023, but will serve as Senior Scientist Emeritus at FIC focusing on bolstering diversity and equity in Fogarty programs, working with NIH leadership to expand engagement in global health, and reinforcing existing partnerships abroad. Nation Institutes of Health
Podcast: Coxiella burnettii with Stacey Gilk
Coxiella burnettii causes Q Fever, a zoonotic disease that is rarely acquired by humans. But Q Fever has a history of being developed as a bioweapon because of its ability to be spread by aerosols and cause debilitating but not lethal disease. Dr. Stacey Gilk is an Associate Professor at the University of Nebraska Medical Center who studies Coxiella. Dr. Gilk talks about what makes Q Fever a potential biothreat agent, how figuring out how to grow Coxiella outside of cells revolutionized the study of this bacterium that was thought to only grow intracellularly, how a large outbreak in the Netherlands led to the deaths of thousands of dairy goats. Mircrotalk
ALSO READING
Infectious disease surveillance update: Cholera in Lebanon. The Lancet Infectious Diseases
Severe mpox (formerly monkeypox) disease in five patients after recent vaccination with MVA-BN vaccine, Belgium. Eurosurveillance
A framework for measuring timeliness in the outbreak response path: lessons learned from the Middle East respiratory syndrome (MERS) epidemic. Eurosurveillance
Evolution of monkeypox virus from 2017 to 2022: In the light of point mutations. Frontiers in Microbiology
Strengthen oversight of risky research on pathogens. Science
Book of Proceedings: XII International Scientific Agriculture Symposium. Research Gate
Non-human Primate to Human Immunobridging Demonstrates a Protective Effect of Vaccines Against Ebola. NPJ Vaccines
Reshaping de Novo Protein Switches into Bioresponsive Materials for Biomarker, Toxin, and Viral Detection. Advanced Materials
Distinct VSV-based Nipah virus vaccines expressing either glycoprotein G or fusion protein F provide homologous and heterologous protection in a nonhuman primate model. eBioMedicine
Two Novel Yersinia pestis Bacteriophages with a Broad Host Range: Potential as Biocontrol Agents in Plague Natural Foci. Viruses