News highlights on health security threats and countermeasures curated by Global Biodefense
This week’s selections include the emerging threat of fungi; how federal budget wrangling harms research and preparedness; a review of animal models for Hendra and Nipah virus research; and a GAO report on the state of antivirals as pandemic countermeasures.
POLICY + GOVERNMENT
Prevention of Zoonotic Spillover: From Relying on Response to Reducing the Risk at Source
The World Bank Pandemic Fund and forthcoming global Pandemic instrument negotiated by the World Health Organization appear primarily focused on the early detection, and reaction to the appearance of human illnesses, often with explicit focus only on action to be taken once pathogen spillover and spread have occurred. Strategies to reduce the probability of spillover events are under-prioritized and underutilized, as highlighted by recent infectious disease crises such as Ebola and Mpox epidemics, and have been lost in overall preparedness discussions and recovery financing. This “more of the same” focus suggests that it is politically more expedient to allocate financial resources to deal with a problem once it has arisen, rather than taking the steps necessary to reduce the risk of it occurring in the first place. PLOS Pathogens
Continuing Resolutions are Harmful to NIH Research
Although Congress could not agree on funding for many areas in the federal government by the start of the federal fiscal year (October 1), it averted a government shutdown and passed a Continuing Resolution (CR) to support funding for the Department of Health and Human Services, including the National Institutes of Health (NIH). Unlike regular appropriation bills, CRs forgo increases and instead fund the NIH and other government programs at their current level with some additional restrictions. Steady funding is essential to maintain momentum from previous investments and support the new opportunities for life-saving medical research. CRs disrupt progress and impede new research because NIH must hold back funds, further restricting funding for R01s and new RFAs. Endocrine Society
Congress Extends Some Pandemic Preparedness Programs, But Not All
Congress temporarily extended a few pandemic-preparedness programs when it forestalled a government shutdown at the last minute Saturday evening. But a program that encourages the development of countermeasures for big public health problems like pandemics expired without reauthorization. STAT
Plan to Cut CDC Programs for Primary Care Package Dismays Public Health Groups
The deal between Senate HELP Committee Chair Bernie Sanders (I-Vt.) and Sen. Roger Marshall (R-Kan.) is partially funded through $980 million from the Prevention and Public Health Fund — mandatory funds established by the Affordable Care Act to bolster the U.S. public health system. Critics argue the decision to tap that pot of money to pay for other health priorities will harm core public health programs, demonstrates a lack of learning from the Covid-19 pandemic and could hamper the funding of public health efforts in the future. Politico
2023 Strategy for Countering Weapons of Mass Destruction
The ability of both the PRC and Russia to procure, develop, and deliver WMD has progressed since the release of the previous DoD CWMD Strategy in 2014, which focused on counterterrorism and counterinsurgency operations and managing risks emanating from hostile, fragile, or failed states and safe havens. In order to address the challenges of the current and future security environment, the Department must now recapitalize, and in some cases reconstitute, its ability to conduct large-scale joint operations within a WMD-contested battlespace. Department of Defense
H.R. 1776, End Tuberculosis Now Act of 2023
H.R. 1776 would require the U.S. Agency for International Development (USAID) to coordinate with the Department of State, the Centers for Disease Control and Prevention, and other federal agencies to update and implement programs for the global prevention, treatment, and eradication of tuberculosis. The bill also would authorize USAID to contribute to the World Health Organization and other international organizations for such initiatives. Congressional Budget Office
Wisconsin GOP Lawmakers, Biosafety Advocates Join Forces On Pathogen Bill
The Wisconsin bill has two primary provisions. The first is a wholesale ban on gain-of-function research on potential pandemic pathogens at institutions of higher education, which include the University of Wisconsin System, the Wisconsin Technical College System, a tribal college, or a private, nonprofit institution. The bill would require researchers to inform the Department of Health Services of their intent to study any potential pandemic pathogens 90 days before experimentation. It doesn’t, however, provide the health department additional staff or funding to perform these functions, which would “unnecessarily delay vital research and create a chilling effect for research in our state.” Wisconsin Watch
MEDICAL COUNTERMEASURES
In the Next Pandemic Antiviral Drugs Could Be Key, But Are They Ready?
Scientists say another pandemic is likely and have even identified several viruses that could be a threat. But there are currently few approved drugs or treatments for these potential threats, nor is there much in the pipeline. Why weren’t antivirals used during the COVID-19 pandemic? They were, but initially only in small quantities, and those were difficult to administer to patients. There is only one antiviral in pill form for use against the virus. It had to be developed from scratch and did not become available until almost 2 years into the pandemic. GAO
WHO Recommends Dropping Component of Many Flu Vaccines
A family of viruses known as influenza B/Yamagata has not been seen since March 2020, when flu circulation worldwide declined to very low levels. Flu transmission eventually resumed, but of the tens of thousands of influenza B viruses detected and subtyped in the years since, B/Yamagata viruses have not been seen. “It’s no longer needed in the vaccine at this point in time and no longer warranted.” Whether that’s easy or difficult to do will depend on whether manufacturers that make flu vaccine still have licenses for former trivalent formulations — vaccines that target three types of flu — or have only licenses for quadrivalent shots, which protect against two types of influenza A, H1N1 and H3N2, plus two lineages of influenza B. STAT, CIDRAP
Combination COVID-19/Flu Vaccines Are Being Tested, with Moderna Starting Phase 3 Trials
A combination COVID-19 and influenza vaccine (mRNA-1083) developed by Moderna is a step closer to approval after early clinical trials proved successful, the pharmaceutical company reported this week. ABC News AUS
Animal Models for Henipavirus Research
A comprehensive review of the currently available animal models (mice, hamsters, guinea pigs, ferrets, cats, dogs, nonhuman primates, horses, and swine) to support HNV research. Includes a discussion of the strengths and limitations of each model for conducting pathogenesis and transmission studies on Hendra virus and Nipah virus and for the evaluation of medical countermeasures. Viruses
Tetanus Toxin and Botulinum Neurotoxin–Derived Fusion Molecules are Effective Bivalent Vaccines
Tetanus toxin (TeNT) and botulinum neurotoxins (BoNTs) are neuroprotein toxins, with the latter being the most toxic known protein. They are structurally similar and contain three functional domains. In this study, fusion functional domain molecules were designed explored in animal models. Two of the recombinant molecules showed promise as strong and effective bivalent biotoxin vaccines, protecting against two biotoxins simultaneously. Applied Microbiology and Biotechnology
BIOSECURITY + BIOPREPAREDNESS
What Have We Learned by Resurrecting the 1918 Influenza Virus?
The 1918 Spanish influenza pandemic was one of the deadliest infectious disease events in recorded history, resulting in approximately 50–100 million deaths worldwide. The origins of the 1918 virus and the molecular basis for its exceptional virulence remained a mystery for much of the 20th century because the pandemic predated virologic techniques to isolate, passage, and store influenza viruses. In the late 1990s, overlapping fragments of influenza viral RNA preserved in the tissues of several 1918 victims were amplified and sequenced. The use of influenza reverse genetics then permitted scientists to reconstruct the 1918 virus entirely from cloned complementary DNA, leading to new insights into the origin of the virus and its pathogenicity. This paper discusses some of the advances made by resurrection of the 1918 virus, including the rise of innovative molecular research, which is a topic in the dual use debate. Annual Review of Virology
Microbial Forensics: What We’ve Learned From Amerithrax and Beyond
The unique level of detail obtained with genetic analysis allows forensic microbiologists to link strain isolates found in victims to perpetrators. It is a fundamental tool that has developed substantially over the past few decades, but previous limitations meant that genetic analysis was too cost-prohibitive for most forensic investigations. Instead, techniques relied on identifying a collection of short sections of genetic material and the similarity between these collections was used to link suspects with victims. Advances empower the rapid, accurate tracking of perpetrators and fortify the ability to preempt, respond, and safeguard against catastrophic bioterrorism threats. In the case of epigenetics, technology has now outpaced its application to microbial forensics and so the field is likely to develop further still. BioTechniques
Beyond Gain of Function: Strengthening Oversight of Research with Potential Pandemic Pathogens
This article assesses the strengths and weaknesses of the P3CO Framework and provides recommendations for strengthening oversight of research with potential pandemic pathogens. The P3CO Framework should be replaced by a national policy that would apply to all relevant research, regardless of the source of funding and be implemented by a new national agency for biorisk management. Pathogens and Global Health
Humans Can No Longer Ignore the Threat of Fungi
Back at the turn of the 21st century, valley fever was an obscure fungal disease in the United States, with fewer than 3,000 reported cases a year, mostly in California and Arizona. Two decades later, cases of valley fever have exploded, increasing roughly sevenfold by 2019. And valley fever isn’t alone. Fungal diseases in general are appearing in places they have never been seen before, and previously harmless or mildly harmful fungi are becoming more dangerous for people. The Atlantic
Exploring Actions for Epidemic and Pandemic Preparedness
Findings from a National Academies of Sciences, Engineering, and Medicine virtual symposium series in May and June 2023 to explore possible strategies for evidence-based prioritization of global health capabilities to prepare for future epidemics and pandemics. NASEM
Reimagining Preparedness in the Era of COVID-19
Public health professionals participated in this NACCHO Preparedness Summit survey. Highlights include the need to clearly define the roles and responsibilities of local health officials and staff during public health emergencies. Competency-based training for preparedness planners was identified specifically as a need. Training needs to be local— many excellent trainings are available for staff, but travel costs can be barriers to education. Better engagement and coordination with healthcare coalitions, hospitals, and federally qualified health centers would aid in the sharing of resources and information. Dedicated funding is needed at the local level for information technology systems and to strengthen staff capacity in geographic information systems, programming, and information technology. Overwhelmingly, participants stressed the challenges of staffing, recruitment, and retention. Health Security
SELECT AGENTS + PRIORITY PATHOGENS
WHO Says No New Cases of Nipah Virus Detected Since Sept 15
No new cases of the deadly Nipah virus have been detected since Sept. 15 in India’s southern state of Kerala. From 12 to 15 September 2023, the Ministry of Health and Family Welfare, Government of India, reported six laboratory-confirmed Nipah virus cases, including two deaths, in Kozhikode district. Aside from the first case, whose source of infection is unknown, the other cases were family and hospital contacts of the first case. As of 27 September, there are 1288 contacts of the confirmed cases traced, including high-risk contacts and healthcare workers, who are under quarantine and monitoring for 21 days. WHO
Monitoring Fruit Bat Colonies Could Provide Early Warning for Nipah Outbreaks
Nipah virus infections always occur in clusters and have a high rate of fatality. With each new outbreak, narrowing down on a single pathway of first exposure becomes remote. While fruit bats are known reservoirs of the Nipah virus, many risk factors need to overlap in time and space at a local and regional scale, for the virus to spill over into humans. Seed collectors routinely handle bat-eaten fruits and nuts making them potential pathways for spillover of the virus Nipah virus can remain alive on fruit surfaces for two hours to over 30 hours, depending on temperature and weather conditions. Nature
Decision Support Framework for Informing Plant Select Agent Designation
Every 2 years the USDA Division of Agricultural Select Agents and Toxins (DASAT) reviews their select agent list, utilizing assessments to rank agroterrorism risk. Here researchers developed and evaluated two risk-based analytical approaches for classifying plant pathogens to support deliberations and recommendations regarding which pathogens to include on the USDA Select Agent list, offering a scientific and logical approach for supporting the biennial assessment of the country’s select agent programs. Frontiers in Bioengineering and Biotechnology
Revisiting the Minimum Incubation Period of Zaire Ebolavirus
The minimum incubation period of EBOV, or the time from infection with the virus to the development of first symptoms, is thought to be 2 days and was initially established during the first EVD investigation in 1976. The presumed source of the infection was a probable case of EVD and was not laboratory-confirmed; it is therefore uncertain whether the source truly had EVD. Second, since the report describes the contact between the source and the case occurring before the source developed symptoms, this implies asymptomatic transmission, which has been established to not occur with EBOV. The Lancet Infectious Diseases
Zoonotic Diseases Transmitted from the Camels
After MERS-CoV was discovered, interest in camels was raised as potential intermediate hosts for zoonotic viruses. A search of the literature revealed that eight (36.4%) of the 22 investigations that offered convincing evidence of camel-to-human transmission involved MERS, five (22.7%) Brucellosis, four (18.2%) plague caused by Yersinia pestis, three (13.6%) camelpox, one (4.5%) hepatitis E, and one (4.5%) anthrax. Camels have been associated with several other zoonotic diseases, including toxoplasmosis, Rift Valley fever, TB, Crimean-Congo hemorrhagic fever, and Q fever, despite having no evidence of a transmission event. Frontiers in Veterinary Sciences
Exploring the Genetic Background of the Botulism Neurotoxin BoNT/B2 in Spain
This study characterizes the acquisition in Spain of two forms of botulism (food-borne and infant botulism), which are largely caused by the main neurotoxin BoNT/B2. Polymorphism analysis of the bont/b2 gene, typing of the flagellin variable region sequence (flaVR), and multilocus sequence typing, were used to explore the genetic background of Clostridium botulinum group I. BoNT/B has the greatest degree of inter-subtype and intra-subtype variability of all BoNTs, perhaps as the consequence of more frequent recombination events allowing the subtype’s proliferation. Microbiology Spectrum
The Global Landscape of Smallpox Vaccination History and Implications for Current and Future Orthopoxvirus Susceptibility
The legacy of smallpox eradication can be observed in the current landscape of smallpox vaccine protection. The strength and longevity of smallpox vaccination campaigns globally, combined with current demographic heterogeneity, have shaped the epidemiological landscape today, revealing substantial geographical variation in orthopoxvirus susceptibility. This study alerts public health decision makers to non-endemic regions that might be at greatest risk in the case of widespread and sustained transmission of a monkeypox outbreak and highlights the importance of demography and fine-scale spatial dynamics in predicting future public health risks from orthopoxviruses. The Lancet Infectious Diseases
Anthrax Revisited: How Assessing the Unpredictable Can Improve Biosecurity
This study is motivated by the narrative that emerging and developing technologies today contribute to the amplification of danger through greater easiness, accessibility and affordability of steps in the making of an anthrax weapon. This paper analyzes and assesses the possible bioterrorism threat arising from advances in synthetic biology, genome editing, information availability, and other emerging, and converging sciences and enabling technologies. Frontiers in Bioengineering and Biotechnology
Predictive Modeling and Control Strategies for the Transmission of Middle East Respiratory Syndrome Coronavirus
This study details a precise mathematical model to capture the transmission dynamics of MERS-CoV. Simulations demonstrate the impact of time-dependent control variables, such as supportive care and treatment, in reducing the number of infected individuals and controlling the epidemic. Mathematical and Computational Applications
Cross-Reactive Antibody Response to Monkeypox Virus Surface Proteins in a Small Proportion of Individuals With and Without Chinese Smallpox Vaccination History
A small proportion of individuals with historic VACV Tiantan strain vaccination more than 40 years ago exhibited serum antibody cross-reactivity against MPXV surface proteins. Combined with the recent literature that VACV vaccination in mice elicited cross-reactive antibodies against MPXV antigens, this study implied the efficacy and effectiveness of smallpox vaccine using VACV Tiantan strain. Surprisingly, some unvaccinated young adults exhibited potent serum anti-MPXV activity but no serum neutralizing activity against VACV; and this is probably due to their past infection by some self-limiting VACV, CPXV or CPXV-like variants. Therefore, it is necessary to restart the smallpox vaccination program in high risk populations; and to further study the antibody response in donors with distinct immunization history would greatly facilitate the understanding and the development of therapeutic antibody drugs. BMC Biology
Plague Gives Surprises in the Second Decade of the Twenty-First Century
From 2010 through 2019, the six leading countries by numbers of human plague cases reported to the WHO were, in order from highest to lowest, Madagascar, Congo, Uganda, Peru, Tanzania, and the United States. From these countries, there was a total of 4,547 cases, of whom 786 (17%) died. Top plague events were four outbreaks of primary pneumonic plague in Madagascar that affected 1,936 persons, including index cases, of whom 137 died. Efficacy of antibiotics in a model of pneumonic plague in African green monkeys for use in bioterrorism revealed the most effective drugs to be gentamicin, ciprofloxacin, and levofloxacin. A recombinant vaccine containing Fraction 1 antigen and V antigen of Y. pestis designed for first responders during a bioterrorism attack and military personnel was tested for safety and immunogenicity but was not licensed for use by the end of the decade. American Journal of Tropical Medicine and Hygiene
AVIAN INFLUENZA
China Reports Fatal H5N6 Avian Flu Case
A 68-year-old man from Chongqing, the fourth largest Chinese city by urban population (31 million), died in August after exposure to live domestic poultry. China has now reported six H5N6 cases this year. CIDRAP
Cambodian Man Dies From Bird Flu
A 50-year-old man has died from bird flu (H5N1) in Cambodia, from eastern Svay Rieng province bordering Vietnam, the health ministry said on Sunday. This is the second death from the virus recorded in the country this year. The ministry said around 50 poultry, some belonging to the man and some owned by his neighbors, had died recently. Medical Xpress
New Restrictions on Poultry and Poultry Products from France and the EU
On Sept 29, USDA APHIS announced that it would be placing restrictions on the importation of poultry from France, as well as live ducks, duck eggs, and unmitigated/untreated duck products from the European Poultry Trade Region (EPTR)), as well as Switzerland, Liechtenstein, and Norway. The restrictions are due to an increased risk of introducing Highly Pathogenic Avian Influenza (HPAI) into the U.S. and became effective October 1, 2023. The U.S. does not currently allow the import of poultry from countries affected with HPAI or from flocks that have received HPAI vaccinations. Vaccinated birds may not show signs of HPAI infection, which could lead to the export of infected live animals or virus-contaminated products to the U.S. These restrictions follow France’s recent decision to vaccinate commercial meat ducks against HPAI. USDA, Daily Intake
CHEMICAL + RADIOLOGICAL THREATS
DARPA Wants to Modernize How First Responders Do Triage During Disasters
The DARPA Triage Challenge (DTC) will use a series of challenge events to spur development of novel physiological features for medical triage. The DTC aims to drive breakthrough innovations in identification of “signatures” of injury that will help medical responders perform scalable, timely, and accurate triage. Of particular interest are mass casualty incidents (MCIs), in both civilian and military settings, when medical resources are limited relative to the need. Popular Science
IAEA Director General Statement on Situation in Ukraine
Ukraine’s Zaporizhzhya Nuclear Power Plant (ZNPP) is preparing to once again use reactor unit 4 to generate steam for various safety functions at the facility, following repairs that put it out of action for several weeks. Regulatory orders are in place to limit the operation of all six reactor units to a cold shutdown state. In addition, the IAEA has been strongly encouraging the ZNPP to find an alternative source of steam generation to cover the plant’s needs, including for processing liquid radioactive waste, and allow for all its six reactors to be maintained in a cold shutdown state. ZNPP had completed drilling another groundwater well to supply the site’s sprinkler ponds used for reactor cooling and other nuclear safety and security functions, bringing the total to 11 new wells as part of efforts to find alternative sources of water following the destruction of the Kakhovka dam almost four months ago. IAEA
MOF-808 on Polyacrylonitrile Nanofibers for Degradation of Chemical Warfare Agents
Highly efficient and reusable protective materials for chemical warfare agents (CWAs) are in high demand. Here researchers used a surface modification technique to develop a material that provides chemical protection. The composite membrane has significant potential for application as protective clothing for CWAs. ACS Applied Nano Materials
Skin Decontamination of Carfentanil
Skin decontamination of Chemical Biological Radioactive and Nuclear (CBRN) materials involves the timely and effective removal of the contaminants from the skin surface. The current work evaluated Fuller’s Earth Decontamination Kit & The Reactive Skin Decontaminant Lotion Kit (RSDL) to investigate whether they were as efficacious against free base Carfentanil skin contamination as they are against chemical warfare agents. Toxicology Letters
SURVEILLANCE + DETECTION
Non-Structural Proteins: A Marker for Detection of Human Coronavirus Families
This research focused on determining the evolutionary relationships of non-structural proteins in human pathogenic coronaviruses. A marked evolutionary conservation of non-structural proteins was observed. The designed cluster provides insight into the trajectory of SARS-CoV-2, demonstrating that it continues to evolve rapidly. Pathogens
Development of a Point-of-care Multiplexed Room Temperature Stable Environmental Toxin Test
The HemBox is a battery-operated, cell phone size with Bluetooth and WIFI module that can be integrated into the Health Management System. The biosensing chips can be programed with bio-receptors to detect pathogens in less than 5 min. This study presents performance characteristics of HBS as a rapid POC to detect toxins from environmental samples. The system was functionalized to recognize Ricin and SEB targets. Clinical Chemistry
Review of Ricin Detection Techniques Focusing on Combined Immunoassay Detection with Abrin and Saxitoxin in Human Plasma
This study aimed to established analytical methods (ELISA and cytotoxicity analysis) for biological toxins ricin, abrin and saxitoxin using OPCW biotoxin exercise samples. Journal of Advances in Military Studies
Host Traits Shape Virome Composition and Virus Transmission in Wild Small Mammals
Most human pathogens have animal origins and emerge through cross-species transmission events. The early identification of zoonotic viruses and their hosts is therefore of great importance in efforts to mitigate and prevent future infectious disease outbreaks. Through the meta-transcriptomic sequencing of internal organ and fecal samples from 2,443 wild bats, rodents, and shrews sampled from four Chinese habitats, researchers identified 669 viruses, including 534 novel viruses, thereby greatly expanding the mammalian virome. Cell
Comparison of Nine Extraction Methods for Bacterial Identification Using ONT Minion Sequencer
The Anthrax mailings bioterrorism attack in 2001 revealed the need for universal and rapid microbial forensic analyses on unknown biological evidence. However, the gold standard for bacterial identification includes culturing isolates, which is laborious. The purpose of this study was to identify a “universal” extraction method that can be coupled with ONT MinION sequencing for use in forensic situations for rapid identification. International Journal of Legal Medicine
On the Mark: Modeling and Forecasting for Public Health Impact
The COVID-19 pandemic highlighted several obstacles limiting the use of forecasts to support public health activities. To address these challenges, modeling and forecasting must be operationalized in a way that facilitates trust and agility during public health emergencies. Dynamic, interactive visualizations can support a deeper understanding of forecast uncertainty and modeling outputs, as well as assumptions and limitations. Standardizing Verification and Validation techniques will increase the interpretability of individual model forecasts and increase trust of the epidemiological modeling domain as a whole. Simplified and standardized visual tools will lower the learning curve for nonexperts and decrease orientation time for decisionmakers using new tools. Health Security
INFECTIOUS DISEASES
Congenital Syphilis: Public Health Failures are Blamed for “Alarming” Increase in Cases in Mississippi
The southern US state of Mississippi reported a 1000% increase in cases of congenital syphilis from 10 in 2016 to 110 in 2022. Medicaid covers two thirds of deliveries in the state, but the state does not mandate syphilis screening for pregnant women. “The health department budget has been devastated.” The team of skilled investigators who carry out contact tracing has been cut from 60 to 20. Partners of infected pregnant women are not contacted, and several pregnant women have been treated but then re-infected. The BMJ
Re-Emergence of HMPV in South Korea After the COVID-19 Pandemic
In South Korea, Human metapneumovirus (HMPV) typically occurs from winter to the following spring; however, it was not detected for two years during the COVID-19 pandemic and re-emerged in the fall of 2022, which is a non-epidemic season. Compared to the period before the COVID-19 pandemic, the incidence rate of HMPV in 2022 increased by 2.5-fold. In children aged 6–10 years, the incidence rate increased by more than 4.5-fold. Non-pharmaceutical interventions during the pandemic disrupted acquired immunity, influencing age distribution of HMPV occurrence. Pathogens
Zimbabwe Announces 100 Suspected Cholera Deaths and Imposes Restrictions on Gatherings
Zimbabwe has recorded 100 suspected deaths from cholera and more than 5,000 possible cases since late last month, prompting the government to impose restrictions to stop the spread of the disease, including limiting numbers at funerals and stopping some social gatherings in affected areas. 30 of the deaths had been confirmed as from cholera through laboratory tests. AP
Lockdown at German Refugee Center Following Measles Outbreak
A strict three-week quarantine has been imposed at a refugee center in Berlin following an outbreak of measles. 600 asylum seekers are subject to the precautionary measures and an urgent vaccination campaign. An estimated 128,000 people died from measles in 2021 – mostly children under the age of five years. The Telegraph
Norovirus in the Wilderness? How an Outbreak Spread on the Pacific Crest Trail
After a stream of sick Pacific Crest Trail hikers came through the Washington Alpine Club Lodge near Snoqualmie Pass last summer, a volunteer named Robert Henry closed the dorm-style lodge and emailed health authorities. Disease detectives with the CDC’s Epidemic Intelligence Service traced the illnesses to a contaminated backwoods pit latrine, cabin and nearby water source. With norovirus, hand sanitizer and common water filters don’t work. Washing after bowel movements and before eating with biodegradable soaps while in the backcountry woods is recommended. NPR
Three Cases of Tickborne Francisella tularensis Infection, Austria, 2022
Report on 3 tularemia cases that developed in Austria, which are on the rise. Bloodstream infections with F. tularensis after tick bites are rarely reported in Europe. One reason might be that the subspecies found in Europe is known to cause milder disease than that found in the United States. Thus, it is notable that bacteremia developed here in 2 patients in Austria. Emerging Infectious Diseases
An Invasive Mosquito Threatens Catastrophe in Africa
Anopheles stephensi, a malaria-carrying species that thrives in urban areas and resists all insecticides, is causing outbreaks in places that have rarely faced the disease. Africa has expertise and strategies to fight malaria as a rural disease but now faces the threat of urban outbreaks, putting vastly more people at risk. Most urban dwellers don’t have immunity from repeated prior exposure and may fall much sicker. New York Times
Cambodia Confirms First Case of Zika Infection in Seven Years
The patient, a seven-year-old girl from central Kampong Thom province, was admitted to Baray Santuk Referral Hospital on Monday suspected of having dengue fever. The test result confirmed on Thursday that she was positive for Zika virus. Despite the low fatality rate, the Zika virus can have severe implications if transmitted to pregnant women. MenaFN
Jamestown Canyon Virus, Powassan Virus Reported in New Hampshire
New Hampshire health officials are reporting this year’s first case of mosquito-borne Jamestown Canyon Virus, and two recent cases of Powassan Virus. Both diseases are transmitted by ticks, which can remain active as long as temperatures are above freezing and there’s no snow cover. There are no vaccines or anti-virus medications to treat either virus infection. NHPR, NH DHHS
RSV Treatments Are Here: Now the Work Begins
RSV is the most common cause of bronchiolitis in children under the age of two. Roughly one-quarter of people admitted to hospital with RSV will require intensive care — and 6.6% of those who are hospitalized will die. Research also suggests that the effects of RSV might linger long after the initial infection has been cleared; studies are beginning to uncover links between RSV infections and respiratory problems in later life, such as wheezing and asthma. Other research is beginning to unpick how other pathogens in a host might collaborate or compete with RSV. Nature
ANTIMICROBIAL RESISTANCE CRISIS
EPA Developing AMR Risk Framework for Antibacterial and Antifungal Pesticides
Recent evidence indicates that the use of some antifungal pesticides can select for resistant organisms that pose a potential risk to human and animal health. The EPA is soliciting public comment on the concept for developing a framework to improve assessments of potential risks to human and animal health where the use of certain pesticides could potentially result in antimicrobial resistance (AMR) that compromises the effectiveness of medically important antibacterial and antifungal drugs. EPA is also seeking feedback on research gaps and other information to help inform the risk assessment and mitigation processes. Global Biodefense
Antibiotic Shows Promise in Fighting Deadly Staph Infections
An antibiotic (ceftobiprole) that has shown effectiveness for bacterial pneumonia also appears successful in fighting methicillin-resistant staph infections, researchers report. Futurity
Bringing Value to the Care Pathway: The Rising Role of Rapid Diagnostics
In this report, CIDRAP-ASP explores the role of outcomes research in making the value case for rapid diagnostics that help to identify infectious diseases and prevent antimicrobial resistance. The report also features two case studies on the role of outcomes research in clarifying the cost-effectiveness of rapid diagnostics for sepsis in different health contexts; and evaluating the cost-effectiveness of rapid diagnostics for invasive fungal infections in people living with HIV in Guatemala. CIDRAP-ASP
COVID-19 PANDEMIC
Novavax’s Updated Protein-Based COVID Vaccine Finally Authorized by FDA
Novavax’s updated protein-based COVID-19 vaccine has finally won authorization from the FDA, a late-coming achievement that provides Americans with their only alternative to mRNA-based shots for the fall booster campaign now underway. Like the mRNA vaccines, Novavax’s updated vaccine for the 2023–2024 season is a monovalent shot designed to target the spike protein of the recent omicron subvariant, XBB.1.5. ARS Technica, STAT
Effectiveness of Maternal mRNA COVID-19 Vaccination During Pregnancy Against COVID-19–Associated Hospitalizations in Infants
Since the winter of 2022, COVID-19–associated hospitalization rates in infants aged <6 months have been higher than hospitalization rates in any age group except adults aged ≥65 years. Infants aged <6 months are not eligible for COVID-19 vaccination and are at risk for COVID-19–associated complications. Maternal receipt of one or more COVID-19 vaccine dose during pregnancy was associated with reduced odds of COVID-19–related hospitalization among infants aged <6 months, particularly among those aged less than 3 months. MMWR
Once a Ticket to Travel and to Socialize, Paper Covid-19 Cards Are Going Away
The days of the paper cards are over. Now that Covid-19 vaccines are not being distributed by the federal government, the Centers for Disease Control and Prevention has stopped printing new cards. People receiving vaccinations will still receive a fact sheet with information about the vaccine. The federal government shipped more than 980 million cards between late 2020, when the first vaccines came out, through May 10. The C.D.C. recommends keeping vaccination records when possible to give to health providers. New York Times, STAT
Viral Kinetics of Sequential SARS-CoV-2 Infections
Immunity from a first SARS-CoV-2 infection affects the viral kinetics of a second SARS-CoV-2 infection principally by speeding up viral clearance and thus shortening the overall time of acute infection. The kinetics of a second BA.1/BA.2 infection are unaffected by the lineage of the first infection. Individuals who quickly cleared their first infection also generally tended to quickly clear their second infection, despite a high degree of variation in individual clearance times, pointing towards persistence of underlying immune response across multiple infections. These findings help guide the interpretation of quantitative SARS-CoV-2 tests both clinically and for surveillance and point towards persistent individual-level immune mechanisms against SARS-CoV-2 that so far remain unexplained. Nature Communications
Did the Government Get a Bad Deal on the Covid-19 Boosters?
The CDC is buying the vaccines for its $1 billion program to provide vaccines for uninsured people. The doses will be sent to state and local health departments and community health centers. The CDC is paying $81.61 for the Moderna booster this year, and $85.10 for the Pfizer shot — which is around triple the amount the federal government paid for each shot last year. Moderna charged the government $26.36 per booster dose last year, and Pfizer charged $30.48. The CDC’s prices this year are significantly discounted from the price the companies are charging private insurers, however, which are $115 for the Pfizer vaccine and $128 for Moderna. European Union officials are in talks to potentially buy Moderna doses for around 25 euros apiece, the equivalent of around $26.30. STAT
How the Littlest Children Stop SARS-Cov-2 in Its Tracks
Compared with adults, babies have a weaker antibody response but better protection in their noses. Nature
Prior Vaccination Promotes Early Activation of Memory T Cells and Enhances Immune Responses During SARS-Cov-2 Breakthrough Infection
These studies revealed heightened spike-specific responses during infection of vaccinated compared to unvaccinated individuals. Spike-specific cluster of differentiation (CD)4 T cells and plasmablasts expanded and CD8 T cells were robustly activated during the first week. In contrast, memory B cell activation, neutralizing antibody production and primary responses to nonspike antigens occurred during the second week. Collectively, these data demonstrate the functionality of vaccine-primed immune memory and highlight memory T cells as rapid responders during SARS-CoV-2 infection. Nature Immunology
COVID Heart Injuries Traced Back to Infected Arterial Plaque, Inflammation
Scientists found that the SARS-CoV-2 virus can directly infiltrate atherosclerotic plaques in coronary arteries and trigger an inflammatory response, providing one mechanism for how COVID-19 infection can lead to cardiovascular complications in some people. SARS-CoV-2 was found to target plaque macrophages, especially cholesterol-loaded primary macrophages, which in turn orchestrated the over-reactive inflammatory response. The virus also showed a stronger tropism for arterial lesions than adjacent perivascular fat. MedPage Today
SPECIAL INTEREST
BSL-3 Transboundary Animal Diseases Summer Program
Applications are now being accepted for the Center of Excellence for Emerging and Zoonotic Animal Diseases (CEEZAD) BSL-3 Training Program for Research Support Personnel. The program consists of hands-on & classroom training at the Biosecurity Research Institute at Pat Roberts Hall on the Kansas State University Manhattan campus. CEEZAD
Nobel Prize Goes To Scientists Behind mRNA Covid Vaccines
Katalin Karikó and Drew Weissman, who together identified a chemical tweak to messenger RNA, were awarded the Nobel Prize in Physiology or Medicine on Monday. The scientists met in the early 1990s when they were working at the University of Pennsylvania, in the United States, when their interest in mRNA was seen as a scientific backwater. “I would go to meetings and present what I was working on, and people would look at me and say: ‘Well, that’s very nice, but why don’t you do something worthwhile with your time mRNA will never work.’ BBC
Exodus of Life Scientists From Academia Reaches Historic Levels, New Data Show
For decades, the number of postdocs and graduate students has ballooned and outpaced the number of faculty positions. That meant faculty had an ample supply of ambitious scientists willing to work hard for relatively low salaries. But it created a broken labor market, labor economists have pointed out, one based on the flawed promise that research trainees could one day run their own labs. The underlying trend had been clear for decades. About 60% of life scientists who earned a Ph.D. in 1963-64 secured tenure within 10 years. By the mid ‘80s, only 38% were tenured within a decade. Biomedical Ph.D. graduates bound for an industry job reported an expected starting salary of $110,000 in 2022, more than twice the $54,000 salary for postdoc-bound grads, according to the latest NSF survey. STAT
Our Side Hustle – Monoclonal Antibodies for COVID-19
The key to doing this successfully was simple: “Make doing the right thing easy.” If we thought monoclonal antibody treatment for high-risk outpatients was the right thing, we had to make it easy for prescribers. Therefore, we had all prescribers order a “consult for monoclonal antibody treatment” rather than order a specific drug. At the time of prescribing, prescribers verbally reviewed with patients that they may receive any of the available monoclonal antibody treatments with an EUA, based on local supply. With the ever-changing nature of federally donated product and shifting demand, we had no way of knowing which drug would be in stock on a given day. Patients verbally consented, per the EUA, to receive any of the antibody therapies. This solved prescriber burden (truly, who on earth can remember those generic names?), patient burden, and system burden, and it facilitated rapid access to treatment. Clinical Infectious Diseases
ALSO READING
Cross-protection and cross-neutralization capacity of ancestral and VOC-matched SARS-CoV-2 adenoviral vector-based vaccines. NPJ Vaccines
Monkeypox Virus Infection in 2 Female Travelers Returning to Vietnam from Dubai, United Arab Emirates. Emerging Infectious Diseases
Here’s How the Novavax COVID Shot Held Up Against Omicron. MedPage Today
Recombinant Sudan virus and evaluation of humoral cross-reactivity between Ebola and Sudan virus glycoproteins after infection or rVSV-ΔG-ZEBOV-GP vaccination. Emerging Microbes & Infections
Molnupiravir for intra-household prevention of COVID-19: The MOVe-AHEAD randomized, placebo-controlled trial. Journal of Infection
Just Breathe: My First 12 Hours as a Clinician Patient With COVID-19. Clinical Infectious Diseases
Disease Severity of Respiratory Syncytial Virus Compared with COVID-19 and Influenza Among Hospitalized Adults Aged ≥60 Years. MMWR
Second malaria vaccine to win global approval is cheaper and easier to make. Nature
Henipavirus naming and regional discrimination. The Lancet Microbe
Special Issue “Novel Antiviral Agents: Synthesis, Molecular Modelling Studies and Biological Investigation”. Viruses
Chronic joint pain 3 years after chikungunya virus infection largely characterized by relapsing-remitting symptoms. The Journal of Rheumatology
Treating cancer with a dose of the pox. Drug Discovery News
A gender-responsive Pandemic Accord is needed for a healthier, equitable future. The Lancet
Optimal control and cost-effectiveness analysis of anthrax epidemic model. Informatics in Medicine Unlocked