News highlights on health security threats and countermeasures curated by Global Biodefense
This week’s selections include pathogen spillover interventions; considerations for a bird flu vaccine; the exodus of public health workers; and resources to prepare for chemical emergencies.
POLICY + GOVERNMENT
Biden Administration Requests $20 Billion Cash Infusion to Bolster Public Health
In its budget request to Congress on this week, the White House asked for $20 billion over five years to support pandemic preparedness efforts, of which, $6.1 billion would go to the CDC to modernize and build laboratory capacity, strengthen public health data systems, and enhance disease surveillance. The CDC budget request overall increased from $11 billion last year to $13.1 billion this year. The CDC would set aside funds to help build public health capacity at the federal, state, and local levels. The administration proposes giving the CDC federal public health data reporting authority. In addition to the pandemic-related public health funding, the budget also specifically mentions allocating $9 billion to prepare for threats posed by antimicrobial resistance. STAT
Biodefense: Actions Needed to Address Long-Standing Challenges
Key federal agencies have developed response plans and conducted interagency exercises to prepare for and respond to biological threats. In 2021, GAO’s analysis of these exercises—and the federal response to the COVID-19 pandemic and other incidents—revealed long-standing biodefense challenges. These included challenges in coordinating response capabilities, managing information, and in planning and conducting exercise efforts. GAO further found that there was no interagency process to assess and communicate exercise priorities, or monitor results from exercises and incidents. GAO
Proposed Biosecurity Oversight Framework for the Future of Science
This report contains the findings and recommendations of two National Science Advisory Board for Biosecurity (NSABB) working groups charged with evaluating USG policies on Potential Pandemic Pathogen Care and Oversight (P3CO) and Dual Use Research of Concern (DURC). Key recommendations include: an integrated oversight framework for proposed and ongoing research; clarify which types of research are reasonably anticipated to enhance the transmissibility and/or virulence of any pathogen; remove current exclusions for research activities associated with surveillance and vaccine development or production articulated in current P3CO policy, which could be broadly interpreted as blanket exclusions (but create a pathway for urgent, expedited federal review); and expand the scope of research requiring review for potential DURC to include that which directly involves any human, animal, or plant pathogen, toxin, or agent and that is reasonably anticipated to result in one or more of the seven experimental effects:
- Enhance the harmful consequences of the agent or toxin;
- Disrupt immunity or the effectiveness of an immunization against the agent or toxin without clinical or agricultural justification;
- Confer to the agent or toxin resistance to clinically or agriculturally useful prophylactic or therapeutic interventions against that agent or toxin or facilitates their ability to evade detection methodologies;
- Increase the stability, transmissibility, or the ability to disseminate the agent or toxin;
- Alter the host range or tropism of the agent or toxin;
- Enhance the susceptibility of a host population to the agent or toxin; or
- Generate or reconstitute an eradicated or extinct agent or toxin listed in the policy
DURC Policy Scope – Agents and toxins
Research involving one or more of the agents or toxins that produces, aims to produce, or can be reasonably anticipated to produce one or more of the seven categories of experimental effects. The possession, use, and transfer of any of these 15 agents and toxins are also regulated under federal law as Biological Select Agents and Toxins (BSAT)14 by the Federal Select Agent Program (FSAP). DURC oversight requirements do not apply to research involving attenuated or inactive forms of the agents and toxins that are excluded from oversight as select agents by the FSAP. The scope also does not include use of the genes from any of the listed agents, in silico experiments (e.g., modeling and bioinformatics approaches), or research related to the public, animal, or agricultural health impact of any of the listed agents such as modeling the effects of a toxin.
- Avian influenza virus (highly pathogenic)
- Bacillus anthracis
- Botulinum neurotoxin
- Burkholderia mallei
- Burkholderia pseudomallei
- Ebola virus
- Foot-and-mouth disease virus
- Francisella tularensis
- Marburg virus
- Reconstructed 1918 Influenza virus
- Rinderpest virus
- Toxin-producing strains of Clostridium botulinum
- Variola major virus
- Variola minor virus
- Yersinia pestis
WHO Treaty Hopes to Overcome “Catastrophic Failures” of Pandemic Response
The World Health Organization published the first draft of its pandemic treaty earlier this month, giving a glimpse of what could end up in the historic international agreement. All will be little more than symbolism if WHO fails to find ways to make the treaty more enforceable than the IHR, critics have said. The IHR is already legally binding, but much of it was ignored during the pandemic. The treaty obliges countries to share genomic information as soon as possible, and in return they should not be punished with exceptional restrictions on travel or trade, for example—neither of which was adhered to when politics trumped science during Covid-19. The BMJ
Biden Signs Counter-WMD Terrorism National Security Memorandum
President Biden on 2 March signed a National Security Memorandum (NSM) to integrate U.S. policies to counter the use of chemical, biological, radiological, and nuclear weapons by non-state actors. It establishes the first comprehensive policy for securing radioactive materials, which present continuing domestic and global risk, along with new domestic guidelines for the management and security of nuclear material by prioritizing efforts to protect and permanently dispose of weapons-usable materials of greatest concern and transition from high-activity radioactive sources to alternative technologies when technically and economically feasible. The White House
Update from State Department and HHS on Negotiations Towards Pandemic Accord
The Fourth Meeting at the WHO of the Intergovernmental Negotiating Body working on a pandemic accord concluded last week. “The United States used this meeting to underscore its commitment to the process, with a goal of developing an accord that builds on lessons learned during the COVID-19 pandemic and strengthens U.S. national security by establishing clear, agreed roles and responsibilities for the WHO and its member states and partners.” The next meeting of the Negotiating Body will take place next month, with a target date for conclusion of May 2024. U.S. Department of State
Blind Spots in Biodefense
In October, the Biden administration released its National Biodefense Strategy (NBS-22), the first update since the COVID-19 pandemic began. Although the document notes that one of the lessons of the pandemic is that threats originating anywhere are threats everywhere, it frames threats as largely external to the U.S. NBS-22 focuses primarily on bioterrorism and laboratory accidents, neglecting threats posed by routine practices of animal use and production inside the United States. Since 2011, the US has recorded more swine-origin influenza infections than any other country. Most occurred at state and county fairs, where an estimated 18% of swine have tested positive. These fairs attract 150 million visitors each year. In 2012, H3N2v influenza jumped from pigs to humans at livestock exhibitions and infected 306 people across 10 states, with suspected human-to-human transmission. Still, animal fairs remain largely unregulated and exempt from federal oversight. The US is also the largest importer of wildlife in the world. More than 200 million live wild animals enter the US each year, most undergoing no health and safety checks when they arrive.
Each year, the US consumes an estimated 1 billion pounds of “game” (elsewhere called “bushmeat”). Yet, most hunter-harvested meat is not inspected, and no sanitary measures are required. Avian influenza has spread from wild birds to hunters and also appeared in captive game farms, where 40 million birds are raised annually. Three million mink live on US fur farms. Though mink are slaughtered on-site, no federal laws govern them, and few states even require licenses. In Michigan, mink generated a new strain of the SARS-CoV-2 virus, transmitting it to workers; in Utah, health department officials were denied access to an infected farm, unable to carry out containment efforts or even testing. These examples illustrate a regulatory system in urgent need of reconstruction. Science
Report: A Summit on Ending Biological Threats
Pandemic prevention is increasingly seen as a national security issue, which is a promising trend. Building sufficient political will is going to be essential to enable continuous funding. This report summarizes open questions and key findings centered around: pathogen early warning, public-private collaboration, interagency efforts and collaboration, and strategic communications. Council on Strategic Risks
NBACC’s Scientific Research and Operational Posture During the 2020–2021 COVID-19 Pandemic
The National Biodefense Analysis and Countermeasures Center (NBACC) is a national resource established to understand the scientific basis of the risk posed by biological threats, and to analyze evidentiary material from bioterror or biocrime events on 24/7 standby. Like many other U.S. research institutions, the emergence of the SARS-CoV-2 virus, and rapid development of the COVID-19 pandemic allowed only a few short weeks of preparations before infectious disease controls could be implemented at NBACC. To accomplish the mission during a national emergency, laboratory staffing levels needed to be maintained at near prepandemic levels, while most other organizations moved to maximize offsite operations. As a result, BNBI leadership took significant actions to prevent COVID-19 exposure, infection, and transmission within the workforce. Applied Biosafety
Improving U.S. Biosafety and Biosecurity
A variety of incidents occurred in 2014 that shined a spotlight on biosafety shortcomings. Within the span of a few months, three separate incidents demonstrated that pathogens were not being handled with appropriate levels of safety and security. The first two incidents involved highly pathogenic influenza virus and anthrax at the CDC. In the third incident, vials containing live smallpox virus (variola major) were found, having been abandoned for decades in a National Institutes of Health (NIH) cold room. In response, the White House directed two high-level expert committees to analyze biosafety and biosecurity in U.S. laboratories and make recommendations for work with select agents and toxins. Overall, they recommended 33 actions to address areas related to national biosafety, including promoting a culture of responsibility, oversight, outreach and education, applied biosafety research, incident reporting, material accountability, inspection processes, regulations and guidelines, and determining the necessary number of high-containment laboratories in the United States. Applied Biosafety
There’s a New US National Security Obsession — Biotech
Biotechnology has quietly become America’s newest national security concern. When the US last week added several units of BGI Group, a Chinese genetic sequencing firm, to its entity list restricting technology transfer, the primary justification was that the company had been “contributing to monitoring and surveillance”, including of ethnic minorities. Yet the human rights implications of China’s domestic surveillance state aren’t Washington’s only concern. The new regulations also state that BGI’s programmes of “collection and analysis of genetic data [present] a significant risk of diversion to China’s military”.
In last year’s defense budget legislation, the US Congress set up a National Security Commission on Emerging Biotechnology. Meanwhile, the Biden administration last year released its own plan for creating a “sustainable, safe, and secure” bioeconomy, while commissioning new studies of security risks and the biomanufacturing supply chain. Financial Times
A Decisive Moment for the World Bank
Today, most countries’ health financing comes from domestic resources rather than external aid or loans, but the development gains of the past are under threat. The COVID-19 pandemic triggered the largest setback in poverty since the Bank’s founding. 719 million people were living in extreme poverty in 2020, 11% more than in 2019. A recent Oxfam report that investigated 71 health projects under The World Bank’s COVID-19 Strategic Preparedness and Response Program concluded that the Bank had missed vital opportunities to ensure health for all. It failed in several aspects of health systems strengthening, which is critical for protecting health gains and building resilient and equitable health systems. The Lancet
MEDICAL COUNTERMEASURES
Ricin: An Ancient Toxicant, But Still an Evergreen
Treatment with supportive care is still the only means to limit morbidity and mortality. Over the past 20 years, research has been performed to treat or prevent ricin poisoning with neutralizing antibodies. In principle, neutralizing antibodies may effectively counteract ricin toxicity. But most anti-ricin antibodies have shown no neutralizing activity or showed neutralizing activity only in vitro. Antibodies directed against epitopes close to the binding interface of the A and B chain of ricin have a better neutralization performance. According to recent evidence antibody cocktails consisting of chain A and chain B antibodies show better neutralizing activity at lower antibody doses compared to antibodies directed against only one chain. Such promising experimental data now call for in-depth clinical studies. Archives of Toxicology
US Public Investment in Development of mRNA Covid-19 Vaccines: Retrospective Cohort Study
34 NIH funded research grants that were directly related to mRNA Covid-19 vaccines were identified. These grants combined with other identified US government grants and contracts totaled $31.9 billion, of which $337 million was invested pre-pandemic. Pre-pandemic, the NIH invested $116 million (35%) in basic and translational science related to mRNA vaccine technology, and the Biomedical Advanced Research and Development Authority (BARDA) ($148 million; 44%) and the Department of Defense ($72 million; 21%) invested in vaccine development. After the pandemic started, $29.2 billion (92%) of US public funds purchased vaccines, $2.2 billion (7%) supported clinical trials, and $108 million (<1%) supported manufacturing plus basic and translational science. The BMJ
Marburg Virus Outbreak: Researchers Race to Test Vaccines
The practicalities of testing Marburg virus vaccines in Equatorial Guinea are stacked against a successful trial. All the leading contenders are viral-vector vaccines (developers include The Sabin Vaccine Institute, Janssen, Public Health Vaccines (PHV), the International Aids Vaccine Initiative (IAVI), and Auro Vaccines). Only the Janssen and Sabin vaccines have been tested in humans, in early-stage trials in the United States. “I cannot emphasize enough the need for speed,” said John Edmunds, an epidemiologist at the London School of Hygiene & Tropical Medicine, at the WHO meeting. Nature, STAT
Rapid-Response Manufacturing of Adenovirus-Vectored Vaccines
Here researchers show that ‘rapid response’ manufacturing of adenovirus-vectored vaccines can enable compressed development timelines that are competitive with those of other platforms, and discuss the implications of improved vaccine manufacturing for future outbreak response and equity of access to vaccines. Nature Biotechnology
Orthopoxvirus Zoonoses—Do We Still Remember and Are Ready to Fight?
A review of the major aspects regarding orthopoxviruses’ zoonotic infections, factors responsible for viral transmissions, as well as the emerging problem of the increased number of monkeypox cases recently reported. The development of prophylactic measures against poxvirus infections, especially the current threat caused by the monkeypox virus, requires a profound understanding of poxvirus immunobiology. The utilization of animal and cell line models has provided good insight into host antiviral defenses as well as orthopoxvirus evasion mechanisms. To survive within a host, orthopoxviruses encode a large number of proteins that subvert inflammatory and immune pathways. The circumvention of viral evasion strategies and the enhancement of major host defenses are key in designing novel, safer vaccines, and should become the targets of antiviral therapies in treating poxvirus infections. Pathogens
Establishment of an Inactivation Method for Ebola Virus and SARS-CoV-2 Suitable for Downstream Sequencing of Low Cell Numbers
Technologies that facilitate the bulk sequencing of small numbers of cells as well as single-cell RNA sequencing (scRNA-seq) have aided greatly in the study of viruses as these analyses can be used to differentiate responses from infected versus bystander cells in complex systems, including in organoid or animal studies. While protocols for these analyses are typically developed with biosafety level 2 (BSL-2) considerations in mind, such analyses are equally useful for the study of viruses that require higher biosafety containment levels. Many of these workstreams, however, are not directly compatible with the more stringent biosafety regulations of BSL-3 and BSL-4 laboratories ensuring virus inactivation and must therefore be modified. Here we show that TCL buffer inactivates both Ebola virus (EBOV) and SARS-CoV-2, BSL-4 and BSL-3 viruses, respectively. We show that additional heat treatment, necessary for the more stringent biosafety concerns for BSL-4-derived samples, was additionally sufficient to inactivate EBOV-containing samples. Critically, this heat treatment had minimal effects on extracted RNA quality and downstream sequencing results. Pathogens
Antivirals: Research Pinpoints Mechanism and Possible New Therapies Against Multiple SARS-Cov-2 Variants, Other Coronaviruses
Investigators have identified a critical mechanism in human and other animal cells that regulates the expression of the ACE2 receptor, the entry point used by SARS-CoV-2 and other coronaviruses to enter cells and cause infections in humans and other animals. Harvard Medical School
Penetrating the Blood-Brain Barrier for Targeted Treatment of Neurotoxicant Poisoning
Experiments on the treatment of poisoning by gavage with the nerve agent sarin in mice combined with atropine revealed that sustained release of 2-PAM from the composite drug was achieved for more than 72h. Sustained and stable reactivation of poisoned acetylcholinesterase (AChE) was observed with an enzyme reactivation rate of 42.7% in the ocular blood samples at 72h. By using both zebrafish brain and mouse brain as models, here researchers found that the composite drug could effectively cross the blood–brain barrier and restore the AChE activity in the brain of poisoned mice. The composite drug is expected to be a stable therapeutic drug with brain targeting and prolonged drug release properties for nerve agent intoxication in the middle and late stages of treatment. ACS Applied Materials & Interfaces
After Wild Pandemic Ride, is Novavax Destined to Be The Little Engine That Couldn’t?
Novavax was a rags-to-riches story early in the pandemic when it scored a $1.6 billion grant from the government to develop a protein-based ‘traditional’ COVID-19 vaccine. But the company’s efforts were hindered by manufacturing, development and regulatory glitches – and now may not survive past 2023. Timing was never on Novavax’s side. By the time the company gained an FDA approval for its long-awaited shot in July, demand for COVID-19 vaccines was plummeting. By the time the FDA signed off on Novavax’s booster in October, updated vaccines from Pfizer and Moderna had been authorized for several weeks. This year, Novavax hopes to have a variant-adapted booster ready in time to be competitive. Fierce Pharma
BIOSECURITY + PREPAREDNESS
It’s Time for a Flu Vaccine – for Birds
The wave of avian influenza H5N1—which so far has hit 76 countries, triggered national emergencies, and created the worst animal-disease outbreak in US history—keeps roaring through wild birds and commercial poultry. More than 140 million poultry worldwide have died from the virus or were slaughtered to keep it from spreading. And though they are harder to count, the die-offs among wild birds have been catastrophic. Something has to put the brakes on. In the US, where losses are close to 60 million, industry experts are talking quietly about taking a step they have long resisted: vaccinating commercial chickens, laying hens, turkeys, and ducks against the flu. Wired
Almost Half of All Public Health Workers Left Their Jobs Over the Past 5 Years
Nearly half (46%) of all public health workers in state and local agencies left their positions over the last half-decade, a new study found. As for the characteristics of those who left, the researchers observed a “first-in, first-out-the-door” scenario, with roughly three-quarters of workers 35 and younger and of those with 5 years or less tenure no longer at a public health agency by 2021. Of the public health workers with 5 years of experience or less in 2017, about half said they planned to leave, but in actuality 77% left their organization by 2021. Similarly, among those 35 and younger, only 43% considered leaving in 2017 but 74% ultimately left. Like clinicians, public health workers put their lives at risk running COVID-19 clinics, on top of “getting harassed and harangued” for decisions they made around closing schools and other public spaces. For those 35 and younger who reported an intention to leave, the strongest contributing factors were pay (63%), lack of opportunity to advance (51%), work overload and burnout (44%), job satisfaction (41%), and stress (39%). MedPage Today
One Health—Key to Adequate Intervention Measures against Zoonotic Risks
Due to the particular positioning of zoonoses at the human-animal-environment interface, zoonotic disease control is an integral part of One Health. While cooperation between human and veterinary medicine has made significant progress, networking with environmental sciences leaves room for improvement.
The (re-) emergence of antigenic variants from animal reservoirs, which has also been discussed as the origin of the 1918 Influenza A virus (IAV) pandemic, is a major concern. IAVs naturally circulate in aquatic bird species. From there, the virus can be transmitted to other wildlife or livestock such as poultry or swine, where they adapt by mutation. With the intensification of global livestock production, the interfaces for interspecies transmissions, as well as the reservoir population for IAVs, have increased. This development might facilitate the rise of new pandemic virus strains. Pathogens
Interventions to Reduce Risk for Pathogen Spillover and Early Disease Spread to Prevent Outbreaks, Epidemics, and Pandemics
USAID continues to invest in spillover prevention in priority countries through projects to develop a One Health workforce via university networks in Asia and Africa and develop interventions to stop spillover at key high-risk human-animal interfaces. Despite the focus on spillover prevention, these programs are subject to changes in governmental priorities and are not funded at a scale that can sufficiently address the global threat. Addressing the drivers of spillover will have benefits beyond pandemic prevention, including mitigating climate change, preventing biodiversity loss, enhancing basic human health, respecting human rights, and promoting sustainable development. Emerging Infectious Diseases
Enabling Transformational Leadership to Foster Disaster-Resilient Hospitals
Hospital leaders have an unprecedented responsibility to manage their organizational planning, adaptation, and recovery from a diversity and severity of disasters. This study sought to identify key competencies of transformational leaders by exploring their actions in dealing with disasters, considering the disaster cycle of prevention, preparedness, response, and recovery. Environmental Research and Public Health
Epidemic Fears After Health Teams Die in Syria Quake
Syria fears a resurgence of diseases such as polio and cholera, after scores of health centres were destroyed and medical staff killed in last week’s earthquake, the country’s health minister said. “More than 59 health facilities have been completely or partially destroyed. More than 50 health care providers have been killed in the northern Syrian region,” noted the Minster of Health in the Syrian Interim Government. SciDevNet
Hybrid Warfare and Counter-Terrorism Medicine
War and conflict today, particularly in the urban setting, blur the lines between traditional, guerrilla and hybrid warfare and terrorism. Because untrained civilians and insurgency groups taking up arms may not understand or respect the rules of engagement, civilian medical providers may find themselves in unfamiliar and dangerous environments where attacks on healthcare personnel and facilities may be a part of the tactical strategy. Expected and traditional protections under International Humanitarian Law and the Geneva Convention are no longer guaranteed. Counter-Terrorism Medicine emphasizes and highlights the risks of intentional attacks on population health, the risk to responders and medical systems, and incorporates high threat training such as Tactical Emergency Casualty Care as part of the program. European Journal of Trauma and Emergency Surgery
SELECT AGENTS + PRIORITY PATHOGENS
How to Stop the Bird Flu Outbreak Becoming a Pandemic
Poultry farms are a key battleground in the fight against H5N1, the strain of avian influenza that is currently circulating. Outbreaks on farms threaten food security and provide opportunities for the virus to spread to farm workers. Ideas put forward include increased surveillance of people who work in the poultry sector to make sure anyone who becomes infected is quickly detected and isolated; stronger efforts to understand epidemiology in wild bird populations to target conservation measures; surveillance of transmission to mammals; and poultry vaccine development. One problem with existing vaccines is that they cause birds to test positive for the virus, meaning farmers can’t guarantee their birds are free of H5N1 – causing international trade and export implications. Nature
Evolution of Highly Pathogenic H5N1 Influenza A Virus in the Central Nervous System of Ferrets
The central nervous system is one of the most common extra-respiratory tract sites of infection for influenza A viruses. In ferrets—an animal model used to study the pathogenesis of influenza—highly pathogenic avian influenza H5N1 virus can enter the CNS via the olfactory nerve, resulting in the development of a severe meningo-encephalitis. Here researchers show that once inside the CNS, H5N1 viruses can acquire mutations that increase the polymerase activity in vitro. These findings support the idea that H5N1 viruses can invade the CNS efficiently via the olfactory nerve, and have the potential to adapt to the CNS. PLOS Pathogens
Extended Viral Shedding of MERS-CoV Clade B Virus in Llamas Compared with African Clade C Strain
Middle East respiratory syndrome coronavirus (MERS-CoV) clade B viruses are found in camelids and humans in the Middle East, but clade C viruses are not. This paper provides experimental evidence for extended shedding of MERS-CoV clade B viruses in llamas, which might explain why they outcompete clade C strains in the Arabian Peninsula. Emerging Infectious Diseases
Influenza A Virus Reassortment is Strain Dependent
Here researchers show that patterns of genetic exchange show strong strain-dependence, and do not necessarily track similarity between coinfecting strains or their subtype (H1N1 or H3N2). The data support that specific strains can consistently bias genetic exchange, increasing or decreasing exchange independent of the other coinfecting strain. The study suggests the propensity for reassortment is not evenly shared among strains and that identifying high-reassortment strains could improve pandemic preparedness or reveal new treatments. PLOS Pathogens
Human Anthrax: Update of the Diagnosis and Treatment
The relative resistance of Bacillus anthracis spores to environmental conditions such as drought, heat, rain, cold, radiation and disinfectants is one of the reasons why this organism has been explored as a potential biowarfare agent. Although microbiological techniques are the best way to identify the bacteria, they occasional generate ambiguous results, particularly when attempting to differentiate the pathogen from closely related strains of Bacillus cereus. Many phenotypic features of B. anthracis may also be displayed by some B. cereus strains. There have also been reports of strains of B. anthracis that are hemolytic and are resistant to both penicillin and the gamma phage. To determine the sensitivity of the organism to antibiotics and determine the most appropriate treatment regimen it is necessary to cultivate the agent. Diagnostics
Hendra Virus Rarely Spills From Animals to Us. Climate Change Makes it a Bigger Threat
Hendra doesn’t spread easily among humans. There have been only seven documented cases, but four of them were lethal. With such a severe human fatality rate, the possibility of an outbreak could be devastating. Bats have historically been able to manage brief absences of food. But because of climate change and habitat loss, there just aren’t as many of the flowering trees and plants that they once relied on. This means they have to look farther afield for food. “They fission into small populations and reside in urban and agricultural areas, where they feed on species like fig trees that we plant in horse paddocks for shade or the weeds that grow across the landscape.” And since the bats are loaded up with virus, often excreting it near horses, the stage is set for a Hendra spillover. NPR
New Hope for Managing African Swine Fever in Resource-Limited Settings
Smallholder and backyard pig farming in resource-limited settings have been notably affected during the ongoing African swine fever (ASF) epidemic in Eastern Europe, Asia, the Pacific, and Caribbean regions. The aim of the review is to increase acceptance and implementation of science-based approaches that increase the feasibility of managing, and the possibility to prevent, ASF in resource-limited settings. This could contribute to protecting hundreds of thousands of livelihoods that depend upon pigs and enable small-scale pig production to reach its full potential for poverty alleviation and food security. Pathogens
Epidemiology of Ebolaviruses from an Etiological Perspective
Despite several research efforts, ebolaviruses’ natural hosts and secondary reservoirs still elude the scientific world. The primary source responsible for infecting the index case is also unknown for most outbreaks. This review summarizes the history of ebolavirus outbreaks with a focus on etiology, natural hosts, zoonotic reservoirs, and transmission mechanisms. We also discuss the reasons why the African continent is the most affected region and identify steps to contain this virus. Pathogens
Experimental Infection of North American Deer Mice with Clade I and II Mpox Virus Isolates
The global spread of MPXV outside of regions in which this virus was known to be endemic raises concerns over reverse zoonotic events resulting in the establishment of novel wildlife reservoirs. Small mammals, including rodents, have previously been implicated as enzootic reservoirs of MPXV. In North America, studies have shown that prairie dogs are susceptible to MPXV infection and may serve as a potential reservoir, but data on other wild rodents are limited. Here researchers demonstrate that although deer mice are permissive to experimental infection with clade I and II monkeypox viruses, the infection is short-lived and has limited capability for active transmission. Emerging Infectious Diseases
Seropositivity for Coxiella burnetii in Wild Boar and Red Deer in Portugal
Q fever is caused by the pathogen C. burnetii and is a zoonosis that naturally infects goats, sheep, and cats, but can also infect humans, birds, reptiles, or arthropods. The present study represents the largest serosurvey for C. burnetii and is the first one conducted on the prevalence of C. burnetii infection using commercial ELISA in Portugal, to date. The results highlight the importance of a One Health, multidisciplinary approach and the integration of wild animals in the livestock the disease control of Q fever in animals and humans. Pathogens
CHEMICAL + RADIOLOGICAL THREATS
Iranian Officials to Investigate ‘Revenge’ Poisoning of Schoolgirls
The attacks on female students – called an act of ‘biological terrorism’ – are thought to be retaliation for protests against hijabs in the country. Iran’s deputy education minister, Younes Panahi, told reporters: “After the poisoning of several students in Qom … it was found that some people wanted all schools, especially girls’ schools, to be closed.” The attacks have led to girls staying away from school. A teacher from Qom – which is about 85 miles south of the capital Tehran – told Radio Farda that out of 250 students, only 50 attended classes. The Guardian
Resources to Prepare for a Chemical Emergency
FEMA’s 2022 National Household Survey on Disaster Preparedness showed that 70% of people were unprepared for a chemical emergency. The recent derailment of a train containing hazardous chemicals helps to illustrate why local communities should take steps today to be prepared for such events. NACCHO
Drugs as Chemical Weapons: Past and Perspectives
This article looks at some historical examples of the use of drugs as chemical weapons and, conversely, the use of chemical weapons as medicines. Toxics
A Scoping Review of Pediatric Mass-Casualty Incident Triage Algorithms
For the pediatric population, there is no consensus on which triage system to use for mass-casualty incidents. Although some triage systems stress keeping triage for both adults and pediatrics similar, to avoid confusion during infrequent and high-stake events, both primary and secondary triage systems in MCIs should differentiate between adult and pediatric patients because of different anatomy and physiology. As well, the different patterns of injury and causes of death in children and youth suggest the necessity of a pediatric-specific triage system. Disaster Medicine and Public Health Preparedness
New U.S. Policy Focuses on Securing Radioactive Materials Used in Industries
Details of the new memorandum are classified, but the effort focuses on specific radioisotopes that terrorists could potentially use in dirty bombs — improvised weapons that use explosives to blast radiological materials into the surrounding area, potentially sickening or killing people and causing environmental harm. Radiological sources that are powerful enough to be deadly can also be exceedingly small and easily lost if mishandled. Medical devices for treating blood with X-rays — a process that makes transfusions safer — have traditionally used cesium-137 as the radioactive source to produce those rays, but that alternatives that use less dangerous materials now exist. New York Times
Employees Reporting Illness After Working on Cleanup for East Palestine Derailment
Workers that aided in the cleanup of the train derailment in Ohio have experienced lingering migraines and nausea, according to a union representative for workers that build and maintain railways for Norfolk Southern. Norfolk Southern Railway in a statement challenged the claim that proper personal protective equipment was not used at the scene. The Hill
SURVEILLANCE + DETECTION
Planning for the Next Pandemic: Lab Systems Need Policy Shift to Speed Emerging Infectious Disease Warning and Tracking
The COVID-19 pandemic exposed major weaknesses in the nation’s laboratory system, some of which were seen again during the global mpox outbreak in 2022. This article reviews how the US laboratory system has been designed to detect and monitor emerging infections, describe what gaps were revealed during COVID-19, and propose specific steps that policy makers can take both to strengthen the current system and to prepare the US for the next pandemic. Health Affairs
Termination of In Vitro Diagnostic EUA for Detection of Enterovirus D68
Effective 20 February, the Secretary of HHS determined that there is no longer a significant potential for a public health emergency that involves EV-D68 and ended the authorization of emergency use of new in vitro diagnostics for detection of EV-D68. Federal Register
Paper-Based Sensors for Bacteria Detection
The simplicity and low cost of paper-based analytical platforms have led to a plethora of studies on bacteria detection, but several key challenges remain to be addressed. In particular, the LOD needs to be improved, taking into account specific bacteria and applications. Selectivity can be addressed by including interference experiments against target compounds often present in the sample; for example, for clinical diagnostics, the background microbiome and serum proteins should be used as control. In food samples, amino acids, proteins and fatty acids interfere with measurements, whereas in agriculture, soil and plant proteins can affect the assay. Moreover, most studies typically evaluate the selectivity of their platforms against other pathogenic bacteria. It is also important to assess selectivity at the level of the genus or strain to reduce false-positive results. Nature Reviews Bioengineering
Design and Optimization of a Monkeypox virus Specific Serological Assay
Among many assays used to identify exposure to OPXV, a peptide-based ELISA specific for MPXV antibodies is an optimal choice because it eliminates the need for virus in culture, is more conducive for use in serosurveys in endemic areas and can provide high throughput data. The work presented here validates the utility of a novel peptide-based IgG ELISA in detecting exposure to MPXV, specifically in the context of a serosurvey. Pathogens
Assembling the Perfect Bacterial Genome Using Oxford Nanopore and Illumina Sequencing
A perfect bacterial genome assembly is one where the assembled sequence is an exact match for the organism’s genome—each replicon sequence is complete and contains no errors. While this has been difficult to achieve in the past, improvements in long-read sequencing, assemblers, and polishers have brought perfect assemblies within reach. PLOS Computational Biology
HEALTH BEHAVIOR + RISK
COVID-19, Framing and Naming a Pandemic
While the disease name and acronym COVID-19, where ‘CO’ refers to ‘corona’, ‘VI’ to virus, ‘D’ to disease, and ‘19′ the detection year, represents a rational, historically informed, and even culturally sensitive name choice by the World Health Organization, from the perspective of an ethnography of disease framing and naming, this study finds that it does not, however, readily communicate a public health message. This observation, based on linguistic and medical anthropological research and analyses, raises a critically important question: Can or should official disease names, beyond labeling medical conditions, also be designed to function as public health messages? As the ethnography of the term COVID-19 and its ‘framing’ demonstrates, using acronyms for disease names in public health can not only reduce their intelligibility but may also lower emerging public perceptions of risk, inadvertently, increasing the public’s vulnerability. This study argues that the ongoing messaging and communication challenges surrounding the framing of COVID-19 and its variants represent an important opportunity for public health to engage social science research on language and risk communication to critically rethink disease naming and framing. Pathogens
Barriers and Facilitators of Vaccine Hesitancy for COVID-19, Influenza, and Pertussis During Pregnancy and in Mothers of Infants
The aim of this umbrella review is to synthesize the established literature to assess the most influential barriers and facilitators to vaccination during pregnancy. Vaccine hesitancy is higher in women (21%) than in men (14.7%). Vaccination coverage is particularly low among pregnant women, with average uptake rarely exceeding 50% for Pertussis, Influenza and COVID-19. Uptake is especially low in women of lower socioeconomic status. This is a public health concern as pregnant women are a vulnerable population and, if unvaccinated, are at higher risk of hospitalization or even death during pregnancy, with an increased chance of pre-eclampsia, the need for emergency caesarean section, and stillbirth from contracting COVID-19. Pertussis and Influenza pose a threat to the unborn child, as mortality is highest in infants under six months. PLOS One
COVID-19 Vaccination Hesitancy in People Affected By Diabetes and Strategies to Increase Vaccine Compliance
People with diabetes have a 3- to 5-fold higher risk of becoming infected with SARS-CoV-2 and dying from COVID-19 than healthy people. The reason for this epidemiological scenario is related to the angiotensin-converting enzyme 2 (ACE2), which is a receptor for SARS-CoV-2 in the human body. This meta-analysis estimated vaccine hesitancy among persons with diabetes worldwide to be 28 %. Family members and friends of patients play a primary role in vaccination compliance; the opinions and behaviors of people in their environment influenced patients’ willingness to be vaccinated, including the vaccination status of relatives. Vaccine
Wear a Respirator, Not a Cloth or Surgical Mask, to Protect Against Respiratory Viruses
Two recent publications falsely conclude there are no differences between surgical masks and respirators for preventing person-to-person transmission of infectious respiratory viruses like SARS-CoV-2 and influenza. These studies are deeply flawed and are built on the premise that infectious respiratory viruses like SARS-CoV, SARS-CoV-2, MERS-CoV, and influenza are only transmitted person to person by large droplets. A surgical mask might prevent large droplets from contacting the nose and mouth but offers no protection from someone else’s smaller inhalable particles. And it will not prevent such particles from being emitted around the edge of the mask. CIDRAP
COVID-19 PANDEMIC
The High Baseline of Covid Hospitalizations and Deaths
We sit at a very high baseline of daily Covid hospitalizations (over 25,000) and deaths (400) in the United States. This is far beyond (double) where we were in June 2021, pre-Delta, when we got down to close to 10,000 hospitalizations and ~200 deaths per day. There’s still no shortage of circulating virus (currently XBB.1.5) getting people infected and some of the folks of advanced age and immunocompromised are the ones chiefly winding up with severe Covid. The virus is finding the vulnerable people more easily since their guard is let down, abandoning high-quality masks and other mitigations, and the low rate of keeping up with boosters in the last 6 months (the age 65+ rate is 40%). There are about 15% of Americans (more than what many people think or have been led to believe), based on all the serologic data available, who never had Covid and are relying on their vaccines/boosters to avoid their first infection. Reinfections among the 85% with prior Covid are not uncommon and not necessarily benign. That high baseline also shows up in the wastewater data, nowhere close to where we were in the Spring of 2021. Ground Truths
Preparing for End of National COVID-19 Emergency Declaration
The U.S. national COVID-19 Emergency Declaration enacted in March of 2020, will be expiring on May 11, 2023. According to the CDC, as of February 2023, there are still over 200,000 new reported cases of COVID-19, nearly 2,500 COVID-19 related deaths a week, over 3,500 new hospital admissions daily because of COVID-19, and only 16 percent of the US population has received the updated booster dose. COVID-19 vaccines and boosters will still be available for free while supplies last. Having access to free at home testing will depend greatly on what health care insurance you have. Those who are under traditional Medicare will no longer receive free at home tests. Those on Medicaid will be able to access free at home testing until November of 2024. Those under private insurance will no longer be guaranteed free at home test kits. The cost of PCR tests is going to go up regardless of health insurance coverage status. NACCHO
Available Evidence Still Points to Covid Originating from Spillover
One thing everyone involved in studying the origins of SARS-CoV-2 seems to agree on — FBI and Energy Department included: No laboratory modification of a virus was involved. Indeed, there has never been an infection reported as a result of a pathogen generated through gain-of-function research. Zoonotic spillover is not rare. Particularly among people working with animals, SARS-like coronaviruses frequently spill over. If a virus has to evolve to replicate efficiently after it jumps species, it might not have the time or opportunity to take hold. But SARS-CoV-2 is a generalist. It can spread efficiently in deer, cats, dogs, minks, monkeys, rodents and a variety of zoo animals, as well as humans. In a rural setting, SARS-CoV-2 spillover might not have spread in humans. This pandemic could have just as easily begun in Beijing, Shanghai or Guangzhou — where SARS-CoV-1 emerged in 2002, also as a direct result of the sale of live animals at “wet markets. The key point is not that all these places also have laboratories that study coronaviruses. The key point is that in any city where people and animals dwell cheek by jowl, they exchange viruses. And will do so again. Unfortunately, none of the witnesses called so far by the House Select Subcommittee on the Coronavirus Pandemic for its first hearing this week has technical expertise on SARS-CoV-2 origins science. Washington Post
Correcting Inaccuracies in Testimony Before the House Select Committee on the Coronavirus Pandemic
“Mr. (Nicholas) Wade incorrectly asserts that researchers may have done much of the experimentation before applying for the DARPA DEFUSE grant. This is simply not true. The DEFUSE proposal outlined a multi-year project with experiments that required a substantial budget, coordination among multiple labs, and significant development as the work would progress. It was therefore not done prior to the proposal being submitted.” The proposal was not funded and the work was never done, therefore it cannot have played a role in the origin of COVID-19. EcoHealth Alliance
T Cell Response to SARS-CoV-2 Coinfection and Comorbidities
Here researchers have summarized T cell performance during SARS-CoV-2 coinfection with other viruses, bacteria, and parasites. They distinguished if those altered T cell statuses under coinfection would affect their clinical outcomes, such as symptom severity and hospitalization demand. T cell alteration in diabetes, asthma, and hypertension patients with SARS-CoV-2 infection was also investigated in the study. Pathogens
Effectiveness of Successive Booster Vaccine Doses Against SARS-Cov-2 in Residents of Long-Term Care Facilities
This pre-print evaluates the effectiveness of 1-3 booster vaccinations against SARS-CoV-2 related mortality among a cohort of 13,407 older residents of long-term care facilities (LTCFs) participating in the VIVALDI study. Each booster provided additional short-term protection relative to primary vaccination, with consistent pattern of waning to 45-75% reduction in risk beyond 112 days. MedRxiv
UVC-Based Air Disinfection Systems for Rapid Inactivation of SARS-CoV-2 Present in the Air
Unlike bacterial, parasitic, or fungal pathogens, viruses have little genetic material with a simpler physical structure and thus are more susceptible to UV-induced destruction. This study explored ultraviolet C (UVC) radiation for its ability to inactivate SARS-CoV-2 particles present in aerosols and designed an HVAC air disinfection system to eliminate infectious viruses. A risk assessment model showed that the use of UVC radiation could result in the reduction of the risk of infection in occupied spaces by up to 90%. Pathogens
Interactions of SARS-Cov-2 with Cocirculating Pathogens: Epidemiological Implications
As population immunity against COVID-19 accrues in many regions worldwide, it is critical to understand the factors that will affect the future transmission dynamics of SARS-CoV-2. Despite the relevance of interaction this review identified only a few experimental studies in animal models, with markedly different designs and the majority focusing on SARS-CoV-2 interaction with influenza A virus. The estimated effect of coinfection on influenza and SARS-CoV-2 viral loads differed markedly across studies, presumably because of the heterogeneous designs and methods to quantify viral load. Besides influenza, few studies investigated the impact of other pathogens, in particular, other major respiratory viruses like RSV and rhinoviruses, or colonizing bacteria like the pneumococcus. This review suggests the urgent need for further experimental and epidemiological studies to unequivocally infer SARS-CoV-2 interactions. PLOS One
Forecasting the Trajectory of the COVID-19 Pandemic Into 2023
This pre-print paper samples across a range of potential variant-level characteristics to provide global forecasts of infections, hospitalizations, and deaths in the face of ongoing Omicron-related transmission and waning levels of past immunity and evaluates a range of interventions that may diminish the impact of future waves. MedRxiv
No One Really Knows How Much COVID is Silently Spreading … Again
More immunity and relaxed behavior add up to a new COVID mystery: How common is symptomless spread now? On an individual basis, at least, silent spread could be happening less often than it did before. One possible reason is that symptoms are now igniting sooner in people’s bodies, just three or so days, on average, after infection—a shift that roughly coincided with the rise of the first Omicron variant and could be a quirk of the virus itself. But Aubree Gordon, an infectious-disease epidemiologist at the University of Michigan, told me that faster-arriving sicknesses are probably being driven in part by speedier immune responses, primed by past exposures. That means that illness might now coincide with or even precede the peak of contagiousness, shortening the average period in which people spread the virus before they feel sick. That said, a lot of people are still undoubtedly catching the coronavirus from people who aren’t feeling sick. The Atlantic
SPECIAL INTEREST
Inside the Massive Biodefense Lab in Houston Area
When any of the 8,000 or so strains of about 800 viruses kept in the facility are not being used, they are stored in freezers within the BSL4 labs, which are surrounded by eight feet of concrete. Half of the Galveston facility is not labs or office space but massive, sophisticated support systems for the BSL4 labs, including ventilation, filtration, and solid and liquid waste management. ABC 13 Houston
Dr. Nicholas Bergman Selected NBACC Lab Director
After a nationwide search, Dr. Bergman was named Lab Director for the National Biodefense Analysis and Countermeasures Center (NBACC). Dr. Bergman has been serving as the acting BNBI President and NBACC Laboratory Director since August. Prior to taking on the acting position he was the Associate Lab Director for NBACC’s National Bioforensic Analysis Center. Dr. Bergman began his tenure at NBACC in 2009 by founding its genomics department. He holds a Ph.D. from the Massachusetts Institute of Technology. Battelle
RFI: Input for Developing the 2024-2028 National Institute of Environmental Health Sciences Strategic Plan
The vision of NIEHS is to provide global leadership for innovative research that improves public health by preventing disease and disability, including through the management of the National Toxicology Program. NIEHS solicits input from stakeholders in academia and industry, health care professionals, patient advocates and advocacy organizations, scientific or professional organizations, federal agencies, and other interested members of the public by reviewing the goals in the 2018-2023 Strategic Plan and proposing new goals for the 2024-2028 Strategic Plan. Responses must be received by 20 April 2023. NIEHS
Harvard Medical School Media Immersion
The Harvard Medical School and the Massachusetts Consortium on Pathogen Readiness will host a two-day educational immersion for reporters June 8-9. The event will bring together a small group of medical and science journalists and preeminent researchers and physician-scientists for a two-day seminar on the Harvard Medical School campus in Boston. Topics include: lessons from contagions past; lingering questions of long COVID; amplifying effects of co-infections such as HIV; what has COVID taught us about the immune system; and therapies for emerging and mutating viruses. Apply by 31 March 2023. Harvard Medical School
Zoonotic Disease Initiative Funding Opportunity
the Initiative will provide up to $9 million in available funding to states, Tribes and territories to strengthen early detection, rapid response and science-based management research to address wildlife disease outbreaks before they cross the barrier from animals to humans and become pandemics. The highest priority for the funding is to increase organizational readiness and ensure a network of state, Tribal and territorial wildlife managers across the nation are prepared for zoonotic disease outbreaks. Proposals are due 20 April 2023. U.S. Fish & Wildlife Service
ALSO READING
Design of a Military Protective Suit Against Biological Agents. Functional and Technical Textiles
Biotech startup focused on bat biology raises $100 million. Axios
Aerosolize this: Generation, collection, and analysis of aerosolized virus in laboratory settings. PLOS Pathogens
Spike Gene Target Amplification in a Diagnostic Assay as a Marker for Public Health Monitoring of Emerging SARS-CoV-2 Variants. MMWR
Standardization of Data Analysis for Detection of RT-QuIC-Based Detection of Chronic Wasting Disease. Pathogens
How do pandemics begin? There’s a new theory — and a new strategy to thwart them. NPR
Simultaneous membrane and RNA binding by Tick-Borne Encephalitis Virus capsid protein. PLOS Pathogens
Fatal Case of Heartland Virus Disease Acquired in the Mid-Atlantic Region, United States. Emerging Infectious Diseases
Bacterial and Viral Pathogens with One Health Relevance in Invasive Raccoons in Southwest Germany. Pathogens
Laser-assisted intradermal delivery of a microparticle vaccine for RSV induces a robust immune response. Vaccine
A deep-learning algorithm to classify skin lesions from mpox virus infection. Nature Medicine
Current Research on Serological Analyses of Infectious Diseases. Frontiers in Medicine