News highlights on health security threats and countermeasures curated by Global Biodefense
This week’s selections include strengthening the ability to investigate and attribute biological weapons use; Lassa fever virus vaccine candidate; cases of human infections with influenza A(H5N1) in Cambodia; advancing diagnostics for Nipah virus; and an Alaskapox fatality in the U.S.
POLICY + GOVERNMENT
National Public Health Strategy to Prevent and Control Vector-Borne Diseases in People
Reported cases of vector-borne diseases have doubled over the last two decades. Due to shifting land use patterns, global travel and trade, and a changing climate, the threat of existing and emerging vector-borne diseases continues to grow. The U.S. Department of Health and Human Services released the National Public Health Strategy to Prevent and Control Vector-Borne Diseases in People (VBD National Strategy). As directed by the 2019 Kay Hagan Tick Act—named after the U.S. Senator who died due to complications from a tickborne illness—HHS led a four-year process with civilian agencies and defense departments to deliver this strategy. HHS
Key House GOP Health Leader Not Running for Re-Election as PAHPA Remains in Limbo
Energy and Commerce (E&C) Chair Cathy McMorris Rodgers (R-WA) recently announced that she will leave Congress at the end of the year. McMorris Rodgers’s sudden departure creates a major vacancy on the powerful E&C committee, which has jurisdiction over healthcare, including the reauthorization of the Pandemic and All-Hazards Preparedness Act (PAHPA), CDC and NIH and other key issues impacting global health. As for PAHPA, the unexpected leadership shakeup adds new uncertainty to the reauthorization of the must-pass pandemic preparedness bill. In the House, top E&C Democrats continue to insist that drug shortage policy language must be included in the final bill, while E&C Republicans are pressing for a five-year reauthorization without drug shortage language but with CDC oversight language. Meanwhile, the Senate companion bill, which does include expanded FDA authorities that address drug shortages, has not been called up for a floor vote, despite passing the Health, Education, Labor, and Pensions (HELP) Committee on a bipartisan basis months ago. Given the approaching March 1 and March 8 deadlines under the current two-tranche funding agreement, which extended certain PAHPA provisions, the Labor, Health and Human Services, Education, and Related Agencies FY24 appropriations bill may be the most viable legislative vehicle for passing the bill without further delay. However, ongoing uncertainty around a final FY24 spending package and controversial policy differences could dim the prospects of PAHPA being included in any spending agreement. American Society of Tropical Medicine & Hygiene (ASTMH)
HHS Fills Key Vaccine Advisory Panel Slots
It’s still not clear why half the positions were left unfilled on the important Advisory Committee on Immunization Practices (ACIP) for months and months, including the chairmanship, but the Department of Health and Human Services announced last week that it is filling the vacancies. The committee, which advises the Centers for Disease Control and Prevention on how vaccines should be used in this country, saw its membership dwindle because HHS had not appointed replacements for members whose terms expired in 2023, and had not replaced one member, Nirav Shah, who resigned from the committee after he was named principal deputy director of the CDC. STAT
States Adopt Dangerous Legal Reforms Undercutting Public Health Emergency Powers
“Emergency powers laws were designed to give officials broad discretion to choose the means to combat threats because of the impossibility of knowing what may be needed,” they wrote. “Dissatisfaction with how this discretion was wielded during the covid emergency should inspire conversation about procedural checks—not elimination of crucial public health legal tools.” In three states, for example, federal orders won’t be enforced if state officials believe them unconstitutional, regardless of court rulings. Other states have adopted “pre-emption” rules barring local governments from adopting stricter disease-control measures than their state. Stanford Law
CDC’s Labs Are Making a Comeback. Now They Need Support
Several published reports have documented in significant detail the events and decision points at CDC that led to testing failures early in the pandemic. Ultimately, it originated in the fact that testing laboratories at CDC have historically not had adequate levels of staff and resources consistent with the agency’s responsibility as the nation’s premier public health laboratory. Its laboratories have also not had appropriate organizational standing or fiscal authority to drive policy and process for test development and deployment in biological emergencies. Few CDC scientists have the federal qualifications required of a diagnostic laboratory director, and most of CDC’s laboratory leaders report to senior health professionals who lack the specific education and training needed to oversee essential laboratory quality and performance standards. We think that CDC should rely more on special federal pay authorities for health care professionals and scientists to address the urgent need for clinically qualified staff for these laboratory oversight roles, similar to how the NIH and the Veterans Administration handle positions needing specialized expertise. Scientific American
BWC National Implementation Measures Database
The Biological Weapons Convention (BWC) National Implementation Measures Database is a comprehensive and publicly accessible and searchable repository showcasing the commitment of States Parties to the BWC, a crucial disarmament treaty prohibiting the development, production, acquisition, transfer, stockpiling and use of biological and toxin weapons. UN International Computing Centre
Testimony Before the House Committee on Foreign Affairs “AUKUS Implementation and Challenges to International Security and Arms Control in the 21st Century”
Under Secretary for Arms Control and International Security (oversight includes U.S. participation in IAEA, CWC, BWC) testimony on the trilateral partnership between Australia, United Kingdom, and the United States – also known as AUKUS. “We are particularly paying close attention to critical and emerging technologies, including artificial intelligence, biotechnology, quantum, and advanced computing to ensure our security and prevent their misuse by countries like the PRC. While we are using existing regulations, export controls, legislation, and treaties to address these challenges, we fully recognize that we must adapt to the speed, scope, and scale of how fast these technology sectors are moving. Therefore, we must be innovative and think outside the box to apply our toolkits if we want to continue to secure and safeguard our supply chains, our intellectual property, and our security partnerships around the world.” State Department
Will the Pandemic Treaty Make It Over the Line?
The world seems to be seeking to fix political problems with technical solutions. The problems which determined the failures of global action during Covid were wholly political—that governments didn’t act soon enough; that they didn’t share data; that they didn’t share vaccines; that they put travel restrictions on countries despite WHO advising against. These issues will not be solved by public health professionals negotiating the nuances of what digital format vaccine certificates should come in. Not least, because implementing and withstanding international law is a political choice anyway. These need political solutions—and it is this political level which has been missing from the negotiations thus far. The politicians were all too ready to start this process, but since then they have washed their hands of it. The BMJ
Dr. Stephanie Psaki Appointed US Global Health Security Coordinator
President Biden has tapped Stephanie Psaki to be his global health security coordinator. Psaki, a longtime global heath expert who serves on the National Security Council, will help organize the government’s response when an emerging health threat is detected overseas and elevated as a White House priority. The role was mandated by Congress, with lawmakers saying the government’s stumbles in responding to Covid in early 2020 revealed the need for a designated coordinator. Psaki, who joined the federal health department’s global affairs office in March 2021 and moved to the White House in 2022, will remain in her current role as NSC’s deputy senior director for global health security and biodefense. Washington Post
MEDICAL COUNTERMEASURES
Rapid Access to Products in Development (RAPID) Virtual Industry Day
The Joint Program Executive Office for Chemical, Biological, Radiological, and Nuclear Defense (JPEO-CBRND) will host an Industry Day next week on the RAPID program, a planned integrated system composed of both physical medical countermeasure storage and fielding capabilities, and a readily accessible information warehouse and sharing system. Interested companies must register by 19 Feb. Global Biodefense
BARDA Announces Opportunity to Accelerate Retail Clinic and Pharmacy Vaccine Decentralized Clinical Trial Solutions
During the COVID-19 pandemic response, pharmacies and retail clinics were essential to the distribution and administration of vaccines, diagnostic tests, and therapeutics. Developing and testing innovative clinical trial capabilities at these locations is the next step to bringing clinical studies and research to the patient-centric settings that are accessible to most Americans. This will position the U.S. to be better prepared for conducting clinical studies during public health emergencies and to conduct clinical research in everyday settings where medical countermeasure products are used. BARDA is seeking retail clinics, pharmacies, Contract Research Organizations (CROs), or others with access to retail pharmacies to conduct this study. Submissions due 15 March 2024. MedicalCountermeasures.gov
Ebola Vaccine Cuts Fatality Even in People Who Were Infected Before the Jab
The study is the first to show that in addition to preventing infections, the vaccine can save some people who are already sick with the often fatal disease. The research, based on data from the massive 2018-2020 Ebola Zaire outbreak in the Democratic Republic of the Congo, showed that the risk of dying of Ebola was halved among people who had been vaccinated with a single dose of Merck’s Ervebo before developing symptoms — including those who had only received the vaccine a day or two before becoming ill. While that is not enough time for the immune system to develop a robust response to a vaccine, there was clearly a benefit. STAT
Walking the Line – Regulations and the Tenets of Outbreak Clinical Research
For most emerging infectious diseases, outbreaks are the only opportunity for robust evidence generation for new interventions to take place. Between outbreaks, few cases of these diseases are reported, making it challenging to collect sufficient data to evaluate interventions in a meaningful way. Researchers therefore need the research ecosystem to work, and there was a legitimate expectation that the lessons learnt about what works and what doesn’t with Ebola and COVID-19 would make that happen. Sadly, such has not been the case. PLOS Speaking of Medicine and Health
New Class of Small Molecule Inhibitors for Ricin
Structure-based design identifies a new class of compounds, which block ribosome binding of ricin by a novel mechanism. A lead compound showed ∼60-fold improved affinity and submicromolar potency and inhibited ricin and Shiga toxin 2 in cells. Bioorganic and Medicinal Chemistry
The Role of Anti-Viral Drug Development in a New Pandemic Era
In this article, epidemiologist Dr Jay Varma explores the urgent need for researching and developing drugs to combat a range of epidemic-prone pathogens, and reflects on the increased risk of spillovers and the challenges of vaccine limitations. Drug Target Review
Ricin: Long-Term Pulmonary Damage in Surviving Antitoxin-Treated Mice
In this study, long-term consequences of ricin intoxication were evaluated 30 days post-exposure in mice that survived antitoxin treatment. Significant pulmonary sequelae were demonstrated in surviving antitoxin-treated mice, as reflected by prominent histopathological changes, moderate fibrosis, increased lung hyperpermeability, and decreased lung compliance. The concomitant treatment of immune modulating- or anti-fibrotic drugs (such as pirfenidone and nintedanib), should be considered as a medical countermeasure for long-term damage prevention. Toxins
Monoclonal Antibody Therapy Protects NHP Against Mucosal Exposure to Lassa Virus
Lassa virus (LASV) continues to present a significant threat to human health in West Africa, with an estimated 300,000–500,000 cases occurring per year. Here a lethal NHP model LASV infection mimicking natural exposure is described. MAb cocktails targeting LASV GPC demonstrated 100% protection against lethal disease. Cell Reports Medicine
Ciprofloxacin for Pathogens of Concern: Quantification of the Reca Gene for Antimicrobial Susceptibility Testing
Changes in the cellular transcriptome can be rapid in the presence of stressors such as antibiotic pressure, providing the opportunity to develop AST towards transcriptomic signatures. Here, we show that relative quantification of the recA gene is an indicator of pathogen susceptibly when select species are challenged with relevant concentrations of ciprofloxacin. Ciprofloxacin susceptible strains of Y. pestis and B. anthracis have significant increases in relative recA gene expression after 15 min of exposure while resistant strains show no significant differences. Scientific Reports
Inactivated Rabies-based Lassa Fever Virus Vaccine Candidate Protects NHP from Lethal Disease
RABV shares endemic regions with many pathogens, including LASV, which greatly increases the impact this bivalent vaccine could have in the affected areas. An inactivated RABV vectored vaccine can be lyophilized and remains stable when stored at various temperatures, including at 50˚C for up to two weeks. NPJ Vaccines (pre-print)
BIOSECURITY + BIOPREPAREDNESS
Attributing Biological Weapons Use
This report on strengthening the DoD’s capabilities to investigate deliberate biological incidents highlights the complexities in detection and confirming a deliberative versus natural event; the stages at which evidence could be collected prior to, during, and after a biological incident to inform investigations and the collection and handling mechanisms for that evidence to facilitate attribution; and the importance of a robust attribution capability as a deterrent against the misuse of biological agents. RAND
US Covid-19 Lessons for Future Health Protection and Preparedness
The BMJ’s new series on US Covid-19 lessons highlights the societal actions that are needed to prevent the loss of another million citizens in the next pandemic and improve the nation’s health. The authors call for a set of crucial systemic reforms to address fragmented public health responsibilities across federal and state jurisdictions, chronic underinvestment in public health, absence of social safety nets and workplace protections, insufficient legal infrastructure, and long standing social and income inequalities, underpinned by structural racism. The BMJ
The 2023 Model Core Content of Disaster Medicine
While prior academic efforts have succeeded in developing a list of core disaster competencies for emergency medicine residency programs, international fellowships, and affiliated health care providers, no official standardized curriculum or consensus has yet been published to date for Disaster Medicine fellowship programs based in the United States. Members from the Council of Disaster Medicine Fellowship Directors have developed the 2023 Model Core Content for Disaster Medicine in the United States. This living document defines the foundational curriculum for DM fellowships, providing the basis of a standardized experience, contributing to the development of a board-certified subspecialty. Prehospital and Disaster Medicine
SELECT AGENTS + PRIORITY PATHOGENS
ASPR Prepares for Changing Landscape of Mpox Response at Home and Abroad
Since the beginning of the mpox outbreak in 2022, ASPR has shipped over one million vials of the JYNNEOS vaccine and over 40,000 treatment courses of TPOXX, TEMBEXA, and VIG-IV from the Strategic National Stockpile. The virus that causes mpox has two Clades, or genetically distinct groups. While Clade IIb has been the cause of the ongoing global outbreak of mpox, “we are also monitoring an increase of Clade I in the Democratic Republic of the Congo (DRC) – working closely with our federal partners to enhance domestic preparedness. If a Clade I case were to be identified in the U.S., our vaccines and therapeutics will continue to be effective , and ASPR will continue to ensure timely availability of these tools when and where they’re needed.” ASPR
JPEO-CBRND Smallpox Countermeasures Brief to the National Academies
Short slide deck describing Orthopoxvirus biological defense existing capabilities for pre- and post-exposure prophylaxis and status of MCMs in development. Summary of existing diagnostic capabilities and testing networks, BioFire FilmArray as the backbone fielded system to DoD labs. National Academies
USDA Continues Monitoring for African Swine Fever as it Persists Globally
African swine fever (ASF) has not entered the U.S. thanks to continuing efforts to prevent this deadly swine disease from reaching the country’s borders. However, ASF continues to affect swine herds globally, entering five new European countries in 2023. The World Organisation for Animal Health (WOAH, formerly OIE) reports that in the past three years, ASF has been identified in five different regions in 52 countries. It’s currently widespread and endemic in sub-Saharan and parts of western Africa, and has spread through Europe, the Caribbean, the Pacific, and some Asian countries, notably China. The highly contagious and deadly viral disease shows no signs of stopping. Total cases across the EU were well above the previous year’s level. AVMA
So You Think You Know All About the Plague?
The bubonic plague has cropped up in Oregon for the first time in nearly a decade. This time a person likely caught it from their cat, health officials in the central part of the state said last week. Doctors identified the disease quickly and treated the person with antibiotics. They also tracked down all the person’s contacts (and the cat’s contacts) and gave them medication as well. Each year, the world records 200 to 700 cases of plague, although many cases likely go undetected. The U.S. typically records fewer than a dozen cases each year, with most of them occurring in the West. But really, Y. pestis can crop up almost anywhere, even in places where scientists think they’ve eradicated the disease or haven’t seen it in decades. NPR Goats and Soda
Researchers Identify Episodic MERS Cases in Kenyan Camels, Evidence of Infection in People
Year-long sampling of dromedary camels in northern Kenya reveals biphasic (two-phase) peaks of Middle East respiratory syndrome coronavirus (MERS-CoV) and identifies more than three case clusters over 3 weeks in camels from different areas, as well as a 15% infection rate in slaughterhouse workers. There is no vaccine against MERS, and treatment consists of supportive care. It was first discovered in humans in Saudi Arabia in 2012 and has since spread to many other countries. CIDRAP
AVIAN INFLUENZA
Recent Changes in Patterns of Mammal Infection with Highly Pathogenic Avian Influenza A(H5N1) Virus Worldwide
In the current panzootic, 26 countries have reported >48 mammal species infected by H5N1 virus; in some cases, the virus has affected thousands of individual animals. The geographic area and the number of species affected by the current event are considerably larger than in previous waves of infection. The most plausible source of mammal infection in both periods appears to be close contact with infected birds, including their ingestion. Some studies, especially in the current panzootic, suggest that mammal-to-mammal transmission might be responsible for some infections; some mutations found could help this avian pathogen replicate in mammals. H5N1 virus may be changing and adapting to infect mammals. Continuous surveillance is essential to mitigate the risk for a global pandemic. Emerging Infectious Diseases
First Human Influenza A(H5N1) Virus Infections in Cambodia Reported for 2024
Cambodia reported on 12 Feb four recent human infections with highly pathogenic avian influenza (HPAI) A(H5N1) (bird flu) virus. These are the first human infections with HPAI A(H5N1) virus identified in Cambodia in 2024. The four infections occurred in three children, one of whom died, and an adult, all of which were identified in late January and early February. All patients reportedly had a history of recent exposure to sick or dead poultry prior to their illness. Currently, there is no indication of person-to-person spread associated with these four cases of H5N1 virus infection in Cambodia. CDC
CHEMICAL + RADIOLOGICAL THREATS
Potential Exhaled Breath Biomarkers Identified in Chlorine-Exposed Mice
This study details development of a non-invasive method of exhaled breath sampling in awake animals, as well as to analyze breath for volatile biomarkers specific for chlorine exposure or diagnostic biomarkers for chlorine-induced acute lung injury (ALI). Journal of Analytical Toxicology
Machine Learning-Based Decision Support Framework for CBRN Protection
there is no detailed overview to describe which ML methods fit the different CBRN tasks or a guideline on how to select an adequate ML method for automating CBRN steps. This work aims to systematize the functional components of CBRN protection by reviewing the relevant literature, identifying their potential for efficiency improvement, and collecting the best machine intelligence practices that support it. Heliyon
MOF Detection of Chemicals for Anti-Terrorism
Real-time detection of explosives and chemical warfare agents is an important way to prevent terrorist activities but remains a significant technical challenge. In recent years, metal-organic frameworks (MOFs) have been widely studied as promising candidates. This review summarizes the most recent research progress on MOF-based sensors for the precise and rapid detection of hazardous chemicals. TrAC Trends in Analytical Chemistry
SURVEILLANCE + DETECTION
Scientists Seek Out Best Diagnostics for Deadly Nipah and Lassa
In a four-year project funded by CEPI and led by FIND, the team will examine and evaluate all available point-of-care testing options for the two diseases. They will work to advance the best performing ones for further testing, approval and widespread use down the line. CEPI has agreed to grant up to $14.9 million to the project, which will run from February 2024 through January 2028. CEPI
Manual qPCR Assay Validated on Tongue Swabs That Rivals Sputum-Based Molecular TB Diagnostics
Reliance on sputum-based testing is a key barrier to increasing access to molecular diagnostics for tuberculosis. Many people with TB are unable to produce sputum, and sputum processing increases the complexity and cost of molecular assays. Tongue swabs are a promising alternative to sputum for molecular diagnosis of TB, with sensitivity approaching sputum-based molecular tests. Clinical Infectious Diseases
Surveillance Model for Enterovirus D68 Respiratory Disease and Acute Flaccid Myelitis
Details implementation of a multimodal surveillance system in Colorado for EV-D68 and AFM, which promptly and accurately detected the large EV-D68 outbreak in the fall of 2022, enabling actionable, real-time surge planning and effective public health messaging. Clinical laboratory surveillance adds key insights into correlating syndromic signals with specific pathogens; however, it is reliant on test availability and performance. Although the enterovirus/rhinovirus signal from clinical testing is a useful early indicator, if this signal is used alone, EV-D68 epidemics can be misattributed to annual fall back-to-school rhinovirus resurgences. Until an EV-D68-specific target is included on commercial clinical testing platforms, the additional step of performing EV-D68–specific PCR on enterovirus/rhinovirus–positive specimens is necessary. A key limitation of pathogen-specific PCR testing for newly emerging and constantly evolving RNA viruses is that primers must be matched to currently circulating strains to ensure adequate sensitivity. Emerging Infectious Diseases
Role of Research Laboratories in Pandemic and Epidemic Response
Paper shares the experience of research laboratories in the Eastern Mediterranean Region (EMR) that contributed to preparedness and response to highly pathogenic avian influenza (HPAI), Middle-East respiratory syndrome coronavirus (MERS-CoV), and COVID-19. Research groups in the region were pivotal in identifying, characterizing the pathogens and describing their evolution, distribution, transmission routes, and the immunological profile of exposed populations. The EMR experience is a model of how national systems can work with researchers to improve regional preparedness and response to future epidemics. Influenza and Other Respiratory Viruses
The Uncharted World of Emerging Pathogens
It all started when Christopher Mason’s 3-year-old daughter licked a subway pole. Like any parent, he was horrified, but also keenly curious: What types of microbes might be clinging to a metal pipe gripped by countless commuters every day? Mason, a geneticist at Weill Cornell Medicine, soon became obsessed with that question. His toddler’s gross interlude inspired him to embark on a journey to unveil the world of bacteria, fungi, and viruses co-mingling with more than 8 million people in New York City. Undark
Detecting Mpox Cases Through Wastewater Surveillance
Monkeypox virus wastewater detections were compared with reported mpox cases. Wastewater surveillance has a sensitivity of 32% for detecting a single mpox case in wastewater samples that represent thousands to millions of persons. Sensitivity increases as the number of cases in the community increases. Positive and negative predictive values are high. MMWR
ONE HEALTH
Potential Zoonotic Spillover at the Human–Animal Interface
The aim of this study was to review several types of human–animal interfaces with a high risk of zoonotic spillover, infectious agents, and animal hosts or reservoirs. Identifying those factors will support the development of interventions and effective disease control in human–animal interface settings. Veterinary World
Rabies: Rare Case of Infected Opossum in Urban Area Raises Alarm
The opossum was tested for rabies and other diseases as part of an epidemiological surveillance program in São Paulo. Previously thought immune to RABV, interspecies interactions with bats in urban centers is hypothesized as a route of infection. Many opossum deaths in this urban setting are by dogs, creating a bridge to human transmission. Global Biodefense
The Need for One Health Systems-Thinking Approaches to Understand Multiscale Dissemination of Antimicrobial Resistance
AMR evolution, transmission, and dispersal happen largely in environmental settings, for example within farms, waterways, livestock, and wildlife. Systems-thinking, One Health approaches are crucial for tackling AMR, by understanding and predicting how anthropogenic activities interact within environmental subsystems, to drive AMR emergence and transmission. Innovative computational methods integrating big data streams (e.g., from clinical, agricultural, and environmental monitoring) will accelerate our understanding of AMR, supporting decision making. The Lancet Planetary Health
INFECTIOUS DISEASES
Cholera Vaccine Stocks ‘Empty’ as Cases Surge
The emergency global stockpile of cholera vaccines is empty with all available doses for this month already allocated to countries battling major outbreaks. In January alone, 40,900 cases and 775 deaths were reported from 17 countries, the WHO said. The rest of this year will see a predicted shortfall of at least 50 million doses between demand and supply, a UNICEF official added, as cases continue to surge worldwide. The acute shortage of cholera vaccines has been an issue since at least October 2022, when the WHO recommended using only one dose, rather than two, to stretch out the stockpile it jointly manages with other health agencies. But the recent surge in cases, particularly in countries including Zambia and Zimbabwe, has put even more pressure on the scarce supply. Reuters
Measles on the Rise in the EU – Considerations for Public Health Response
In 2023, significant increases in the number of measles cases and outbreaks were observed globally, including in 40 of the 53 countries of the European region, and in at least ten EU/EEA countries. Measles cases are expected to continue increasing in the EU/EEA in the coming months due to sub-optimal vaccination coverage for measles containing vaccines (MCV) in a number of EU/EEA countries, the high probability of importation from areas experiencing high circulation and the fact that the coming months represent the seasonal peak of the virus. ECDC
Minnesota Department of Health Confirms Two Measles Cases
Two siblings in the Twin Cities metro area have confirmed cases. The first case was in a one-year-old who had recently traveled out of the country and developed symptoms after returning. The child’s sibling later tested positive, too. Both children are unvaccinated. MPR News
The Last of Us and the Question of a Fungal Pandemic in Real Life
The television series The Last of Us imagines a postapocalyptic world ravaged by a fungal pandemic caused by a Cordyceps species. Here researchers evaluate whether a fungal pandemic is possible (and reasons behind its current improbability). They further discuss the series’ effect on public perception of fungi, fungal infections, and pandemic response. Emerging Infectious Diseases
What to Know About Rare Virus Alaskapox After 1st Fatal Case
The Alaskapox virus was first identified in Fairbanks, Alaska, in 2015, according to the Alaska Department of Health. Since then, there have been only seven cases reported in the state. The virus typically occurs in small animals, commonly identified in voles and shrews, and there have been no reports of human-to-human transmission. “Given the rarity of Alaskapox and its generally mild course in healthy individuals, the risk to the general public remains low.” ABC News
Oregon’s First Case of Human Plague in 8 Years Likely Came from a Pet Cat
Health officials announced this week that a resident of Deschutes County — a rural part of Oregon — was diagnosed with plague, marking the state’s first human case in more than eight years. The person was likely infected by their pet cat, who had developed symptoms, according to Deschutes County Health Services. NBC News
ANTIMICROBIAL RESISTANCE CRISIS
WHO Issues First-Ever List of Antimicrobials with Category ‘For Use in Humans Only’
The WHO has released a first-ever list of 21 antimicrobials earmarked as “authorized for use in humans only” – a first for the organization in its efforts to protect overuse and abuse of critical first-line drugs that need to be protected by overuse in animal and plant health sectors – and consequent antimicrobial resistance. The category mainly contains newer antimicrobials that are very important in treating serious multidrug-resistant infections in humans. World Health Organization
Rise in Hypervirulent, Carbapenem-Resistant Klebsiella Noted in Europe
European health officials warned today that a strain of hypervirulent, carbapenem-resistant Klebsiella pneumoniae appears to be spreading across the continent. The combination of hypervirulence with resistance to last-resort antibiotics has resulted in challenging, life-threatening, and potentially untreatable infections. CIDRAP
Report Warns of ‘Brain Drain’ from Antibiotic Research and Development
The march against AMR could be severely hampered by a significant “brain drain” from the antibiotic R&D workforce, AMRIA warned in a new report. The “Leaving the Lab” report estimates there are approximately 3,000 AMR researchers currently active in the world, compared with as many as 46,000 for cancer and 5,000 for HIV/AIDS. Analysis of AMR-related research papers highlights the decline in AMR researchers over the last two-plus decades, with the total number of authors on those papers falling from 3,599 in 1995 to 1,827 in 2020. As a result, AMR and antibiotic research output has shrunk. “Our research shows a field that has been in steady decline over the last two decades, across publications, patents, and, most importantly, the number of researchers working and publishing in the field.” CIDRAP
COVID-19 PANDEMIC
C.D.C. Considers Ending 5-Day Isolation Period for Covid
“When you make a public health recommendation, it’s not supposed to be based on what people are already doing,” commented Dr. Boghuma Titanji, an infectious diseases physician at Emory University in Atlanta. Instead, she added, the advice must be grounded in evidence. By focusing on the isolation policy for Covid, the agency is squandering an opportunity to foster better public health policies. The proposed recommendations also seem not to take into account older Americans, or those who are immunocompromised or otherwise at risk of severe outcomes from Covid or long Covid. New York Times
People Who Get a 2023-2024 Updated COVID-19 Vaccine Can Now Register in V-Safe
V-safe is one of several systems CDC uses to closely monitor the safety of vaccines in the United States. V-safe registration is now open to anyone who gets a 2023-2024 updated COVID-19 vaccine or an RSV vaccine. Participants who enroll in V-safe within 6 weeks of vaccination will receive confidential health check-ins via text message or email to share how they feel after vaccination. You can sign up for V-safe using your smartphone, tablet, or computer. CDC V-Safe
Hospitals Deny Immunocompromised Patients’ ADA Requests for Masks
Immunocompromised patients expressed anger at policies like Mass General Brigham’s which state that patients can ask, but providers determine when and if masking in a particular situation is necessary. “I highly doubt that hand washing is left up to the personal preferences of patient-facing staff.” Forbes
CDC Tracking BA.2.87.1 SARS-CoV-2 Variant
The Centers for Disease Control and Prevention (CDC) recently announced that it is monitoring a newly identified SARS-CoV-2 variant called BA.2.87.1 from South Africa that has mutations that may pose a risk of immune escape, but so far there’s no sign that it is spreading widely. CIDRAP
Wastewater Surveillance for Identifying SARS-CoV-2 Infections in Long-Term Care Facilities – Kentucky
Persons living in long-term care facilities (LTCFs) have experienced disproportionate illnesses and deaths from the COVID-19 pandemic. Early detection of SARS-CoV-2 infection in LTCF staff or residents is an important strategy to mitigate SARS-CoV-2 transmission, and this study assessed wastewater surveillance in this regard. Researchers collected and tested 24-hour composite wastewater samples 2–4 times weekly at 6 LTCFs in Kentucky, USA, during March 2021–February 2022. The LTCFs routinely tested staff and symptomatic and exposed residents for SARS-CoV-2 using rapid antigen tests. Wastewater surveillance was 48% sensitive and 80% specific in identifying SARS-CoV-2 infections found on clinical testing, which was limited by frequency, coverage, and rapid antigen test performance. Emerging Infectious Diseases
Commercialization of COVID-19 Vaccines, Treatments, and Tests: Implications for Access and Coverage
This document provides a side-by-side comparison of how vaccines, treatments, and tests were provided during the Public Health Emergency and with a federally purchased supply compared to the current situation, organized by payer. KFF
IN MEMORIAM
Anthony Epstein, Pathologist Behind Epstein-Barr Virus Find, Dies at 102
Dr. Epstein’s work in the 1960s to isolate the virus set the foundation for sweeping studies into viral and biological triggers for cancers such as Hodgkin’s lymphoma and potential links to other diseases including multiple sclerosis, lupus and, most recently, so-called long covid. The research later expanded to detect other cancer-causing viruses such the human papillomavirus, or HPV. Unlike HPV, however, no vaccine has been developed for Epstein-Barr, named for Dr. Epstein and colleague Yvonne Barr, which is believed present in more than 90 percent of the world’s population. Washington Post
Ralph Peter Eckerlin, PhD
The American Society of Tropical Medicine and Hygiene mourns the loss of longtime member Ralph Peter Eckerlin, PhD, on February 9, 2024. He joined ASTMH in 1969 and become an Emeritus Member in 2005. In addition to being a gifted teacher, Dr. Eckerlin was a prolific researcher and writer, collecting and describing at least six new species, including tapeworms and fleas, in the U.S., Costa Rica, Honduras, and Guatemala. He authored over 70 peer-reviewed publications in various scientific journals, a biology laboratory manual, and multiple book chapters. He was a world-renown flea specialist. He is the co-author of an exhaustive compendium, The Siphonaptera (fleas) of North America, soon to be published in the Annals of the Carnegie Museum of Natural History. Dr. Eckerlin was active in at least 13 other professional societies, holding offices in most. After retirement, he was a Research Assistant at the Smithsonian Institute of Natural History. ASTMH
ALSO READING
Forensic Epidemiology: Joint Training for Law Enforcement, Hazardous Materials and Public Health Officials on Investigate Responses to Bioterrorism. CDC
Draft of WHO Pandemic Agreement plays down primary prevention. The Lancet
PPE guide for non-aerosol generating procedures. UK Department of Health and Social Care
White House Office of Science and Technology Policy Releases Updated Critical and Emerging Technologies List. White House.gov
Efficacy evaluation of a bivalent subunit vaccine against classical swine fever virus and porcine circovirus type 2. Scientific Reports
A decision-making tree for policy responses to a pathogen with pandemic potential. Nature Medicine
Unmasking Liability: Analyzing the Effect of Public Health Emergencies on Medical Malpractice Law in the Wake of COVID-19. Louisiana Law Review
MAIVeSS: streamlined selection of antigenically matched, high-yield viruses for seasonal influenza vaccine production. Nature Communications
World Pandemic Control in International Law: Through a Transboundary Harm Perspective. Netherlands International Law Review
The Role of AI in Developing Resilient Supply Chains. Georgetown Journal of International Affairs
Infectious Diseases Training in the 21st Century: A Glass Half Full or Half Empty? The Journal of Infectious Diseases
Legal infrastructure for pandemic response: lessons not learnt in the US. The BMJ